Background
: The obesity has increased recently with economic growth and its associated diseases have impacted on public heath. We studied on the prevalence of obesity and the relationship between obesity and its associated diseases.

Methods : We gathered 781 cases who have taken medical examination from January 1993 to June 1993 at Dongsan Medical Hospital and measured weight, blood pressure, fasting blood sugar, fasting serum total cholesterol and triglyceride, EKG finding and USG finding.

Results : The prevalence of overweight in 781 cases revealed 28.6% in males, 19.4% in females. In obesity group, the prevalence showed 11.8% in males, 26.8% in females. The prevalence of obesity increased as the age group increased in both sexes. Sex, age, serum total cholesterol, triglyceride, diastolic blood pressure, EKG finding, USG finding were significantly related to relative body weight. Systolic blood pressure, blood sugar level were not related to the relative body weight.

Conclusion : The prevalence of obesity was 17.5% in 781 cases, was higher in females, and increased as age increased. Hyperlipidemia, hypertension, abnormalities of electrocardiographic and ultrasonographic finding are significantly related to relative body weight.

Background
: This study was attempted to evaluate the influence of the family function on individual health by analyzing an association between Smilkstein's APGAR Score and depression scales, anxiety scales, degree of fatigue.

Methods : Data were gathered by questionnaires which is consisted of Smilkstein's APGAR Score, Beck's depression inventory(BDI), Zung's self-rating anxiety scale(SAS), and subjective complaints of fatigue from 239 passers of Jeonju Teachers college in 1992.

Results : The mean of Family APGAR Score was 13.74±3.33 and among them the dysfunctional group(point 0 to 13) was 113(47.3%), and functional group(point 14 to 20) was 126(52.7%). There was significant difference between dysfunctional and functional group in depression and anxiety score(P<0.05), but no significant difference in degree of fatigue(P>0.05). The depression scores of each APGAR item showed a significant difference between satisfactional and dissatisfactional groups in all items(P<0.05). Also, there were meaningful difference in all anxiety scores except affection item as well as in all fatigue scores except adaptation item between two groups.

Conclusion : These results suggested the family APGAR Score has an association with depression, anxiety, fatigue of individual family members. Thus, it is recommanded to approach for evaluation of family function in treatment of depressive, anxious, or fatigued patients.

Background
: Alcoholism is a common disease in the family medicine. Therapeutic interest in the alcoholics is increasing between patient ad family. It was known that the alcoholics accompanied personality disorder and psychologic symptoms. It is necessary to study on psychologic symptoms in alcoholics.

Methods : We investigated the psychologic symptoms of 50 patients with alcoholic dependence, who had been admitted to the Han Il general hospital, Neuropsychiatric department in Dae Jeon and member of alcoholic anonymous in Seoul. The control group are the business depart. of M Co. in Seoul, teachers and parents in K girls high school in Ku Ri city. This study was done by some questionaires for 6 months from March, 1993 to August, 1993. Two family physicians visited the meeting. SCL-90-R was developed by Kwang Il Kim, M.D. in Korean version. The subject group was diagnosed with alcohol dependence, and the number of subjects are 50. The control group was 50 social drinkers, who had less than 4 score on MAST. All subjects were evaluated with age, martial state, education level, family life cycle, SCL-90-R, family APGAR score.

Results : The mean APGAR score of the alcoholics is 4.70±1.92, that of non alcoholics is 6.48±1.28 The APGAR score of the alcoholics is significantly lower than that of the non alcoholic. The score of the alcoholics shows significantly higher score on DEP subscale(p<0.01), ANX and PSY subscale(p<0.05)

Conclusion : Alcoholics has higher psychologic symptom such as depression, anxiety and psychotics Alcoholism inversely reacts in family function.

Background
: It is important in heaith examination to select the kinds of target diseases and screening tests in the respect of cost-benefit effect. Therefore we carried out this study to aid selection of target diseases and screening tests.

Methods : We reviewed questionnaires for medical history, medical charts and screening test results of 832 adults who visited outpatient department of family medicine for the purpose of health examination from April, 1991 to March, 1993. We selected 576 adults who had not suffered from chronic diseases.

Results : The selected subjects were composed of 300 males (52.1%) and 276 females(47.9%). The screening tests which showed high positive rates were upper gastrointestinal series/Gastrofiberscopy(27.1%), blood pressure measurement(20.3%), abdominal ultrasonography(16.9%), urine microscopic examination(13.0%), chest X-ray(12.5%). The detection rates of target diseases were 25%(144 subjects) in all, 22.7% in males, and 27.5% in females. The 4 most common target diseases were hypercholesterolemia(8.0%), anemia(7.5%) liver disease(5.0%), and hypertension(4.2%). Among males, higher detection rate of liver disease were seen in the 3rd and 4th decades : liver disease and hypercholesterolemia in the 5th decade. Males older than 50 years of age had higher rate of hypercholesterolemia, hypertension, and anemia. Among females, higher detection rate of anemia were seen in the 3rd and 4th decades ; anemia, hypercholesterolemia and HBsAg(+) in the 5th decade. Females older than 50 years of age had higher rate of hypercholesterolemia, hypertension, and anemia.

Conclusion : Target diseases in health examination were observed in 25% of selected subjects. The detection rate of target diseases were significantly different according to age and sex.

Background
: Hysterectomy and hysterectomy with oophorectomy are the one of the most common surgical operations, and the cases of this surgical operations have been increasing now. Moreover, the concern about hormone replacement therapy to postmenopausal women is growing now, therefore the importance of accurate information about oophorectomy state is more emphasized than before. We can get information about oophorectomy state through patient medical record and self-report, but in Korea the only available source of information in reality is patient self-report on primary care setting, regrettably. Many physicians in Korea are skeptical to self-report of patient. Therefore this study is designed to know accuracy of patient's recall about bilateral oophorectomy in whom received hystrectomy and bilateral oophorectomy through medical record review and telephone interview. And we analyze factors with the accuracy of patient's recall.

Methods : The subject of this study is the patients who is accessible through telephone interview and medical record review of those who was received hysterecomy with bilateral oophorectomy in a third grade hospital. Their surgical operations were done from Jan. 1990 to Aug. 1993. The patient proven to have malignancy was excluded. The inforamation about accuracy of their self-report and associated factor was achieved through medical record review and telephone interview.

Results : The number of accessible subject is 117. Of 117 woemn, 112(95.7%) know their hysterectomy state accurately. But the number of persons who know their own bilateral oophorectomy state accurately is 74(63.3%), and the persons who don't know their bilateral oophorectomy state accurately is 43(36.8%). Of whom who don't know accurately their bilateral oophorectomy state, 28(23.9%) women answer that they didn't know whether bilateral oophorectomy had been done or not, 15(12.8%) women denied their bilateral oophorectomy state. Women who know accurately their bilateral oophrectomy state in comparison with who don't know their bilateral oophorectomy state are younger in average age, higher in education level, and have more opportunities of listening doctor's explanation of their post organ extraction state, and have received hormone replacement therapy more. And this differences of two groups are statistically significant. The differences between two groups on monthly salary, having occupation or not, living in city or not, marital state, period after operation, pre-operative diagnosis, and whether she knows post operative diagnosis or not, are not significant statistically. The major determinants in the accurate knowledge of their own bilateral oophorectomy state are whether patients listened Doctor's personal explanation of their state or not, and whether she received hormone replacement therapy ever or not.

Conclusion : The proportion of whom know accurately their own bilateral oophorectomy state is 63.3%. That proportion is considerably low which leads to conclude that it is not advisable to make a clinical decision based on patient self-report state only in this sugical operation cases. And because the most important determinants of the accuracy knowledge of their own bilateral oophorectomy state is whether patients listened medical doctor's personal explanation of their state, therefore the importance of this aspect of doctor's education must be emphasized to medical doctors.

Background
: Hypertension and diabetes are similar to each other in their courses of disease progress and management, and especially are so when patient compliance is considered in view of long-term prognosis of the diseases and of the concerns in health politics. Though it is not so easy to evaluate compliance objectively and apply to management of diseases, efforts need to be continued for objectification of evaluation of patient compliance. Therefore, this study was performed for identifying trend of treatment survival rate and factors related to compliance of patients with hypertension and/or diabetes.

Methods : One part was by means of review of medical records for detecting treatment survival rated of 641 patients who had visited Koksung-gun Health Center from May 20, 1989 to May 31, 1993. The other was by means of questionnaire and review of records for testing significance of the factors assumed to be related to compliance behaviors in 100 patients who had visited the center from June 1, 1993 to August 31, 1993.

Results : The treatment survival rate of the 641 patients showed rapid decrease in early stage, which was 51.2% and 26.4% two months and one year later from start to treat, respectively. According to diagnosis, the rate showed more rapid decrease with significance in hypertension group. In the questionnaire study of compliance behaviors of 100 patients, the important factors related to patient compliance were cost for each visit, number of days of prescription, medical security, and diagnosis. According to treatment duration, important factors were cost for each visit in the group of less than 1 year, and number of days of prescription and diagnosis in the group of more than 1 year.

Conclusion : Because most of patients cease to be treated in early stage during management of chronic illnesses such as hypertension and diabetes, strategies for the patients to be treated steadily in that stage need to be developed. Especially, it is required to take poor compliance into account in groups of hypertension, heavy cost for each visit, low number of days of prescription, and medical insurance.

Background
: Hearing loss is one of the most common of all physical impairments, but physicians seldom screen adults for it, and patients often overlook hearing problems. The development of screening instruments to detect hearing impairment in populations is an area of active research. A new hearing impairment screening questionnaire, the Smith Hearing Screening(SHS), was developed by Mary F. Smith, PhD which was made up of total 14-items ascertaining hearing impairment-related information. This study was conducted to estimate validity and reliability of SHS questionnaire using portable audioscope(Welch Allyn Inc.).

Methods : Self-administered screening questionnaire(Smith Hearing Screening) and a hearing screening evaluation using the Welch Allyn Audioscope instrument were given to 176 consecutive family practice patients over the age of 18 years during the period from June 1993 to August 1993. By estimating sensitivity, specificity, positive predictive value, negative predictive value of Smith Hearing Screening(SHS) questionnaire, validity of SHS was assessed. And reliability of SHS was assessed by 1 month test-retest method.

Results : The prevalence of hearing impairment in this sample was 15.34%(27patients). Starting with Smith recommended cut-off score of 6 or greater, the sensitivity of SHS was 70.37% and specificity was 86.58%. Starting with cut-off score of 5 or greater, the sensitivity of SHS was 77.78% and specificity was 77.85%. SHS's reliability measured by test-retest correlation coefficient in 30 patients by random telephone follow-up interviews, who had reported that there was no change of SHS score between test(Time 1) and retest(Time 2) period, was 0.923(P<0.001).

Conclusion : The SHS questionnaire is valid, reliable, easy and inexpensive tool for detecting hearing impairment in adults. Since hearing impairment is a very common problem throughout the world, authors recommend that all adult patients be evaluated for hearing impairment.