Background
: In Korea, tertiary medical care almost totally provided by the university hospitals, which makes the university hospital acting as community-health care centers only. Moreover, the tertiary care hospitals became difficult to performer but also differentiation of specialty in the care are restricted by overloaded patient care in the tertiary care hospital. The purpose of this study is to analyse the functions of tertiary care hospital within the health care delivery system in order to check it university hospital plays its role properly as it should be.

Methods : The authors have selected the patients visited, the doctors trained as residents, the medical students, and the jouranls reported in Guro hospital from Sep. 1983 to Feb. 1992, which were analyzed into the aspects of the care, medical research, medical education and community support. We identified the numbers of the patients and their adresses, disease entities of the patients as the ICD-9 three-digit categories and found out the physician's offices who trained in Guro hospital.

Results : The total number of the patient are 1,548,188 persons(inpatient care) and 2,687,330 persons(outpatient care). The internal medicine is the most. (In patients ; 16.15%, out patient ; 23.16%) The frequency of the disease for 10 years is as follows in descending sequence ; unspecified anemia, essential hypertension, organism unspecified pneumonia, enterocolitis, anemia by complicating pregnancy and childbirth, adult-onset type diabetes mellitus, hypertrophy of tonsils and adenoids, unspecified fetal distress, Caesarean delivery, liver cirrhosis. The number of the papers reported in the each department are 1,407 cases(clinical review 96.0%, experimental reports 4.0%). The number of educated medical students is 1.139 and trained residents are 144 persons. In 144 trained doctors, approximately 28.5% worked in tertiary care hospitals and the remainders are belonged to the primary and secondary health care facilities.

Conclusion : Although the Korea University Guro hospital has been doing well as a tertiary care hospital in the care of the patients, there are many problems in the aspects of the research, medical education and patient care yet.

Background
: Primary care physicians frequently meet the patients who complain of edema. We carried out this study to know the characteristics of the patients who complained of edema and to evaluate the exact causes of edema.

Methods : There were 77 patients whose chief complains were various types of edema among 12,932 patients who had visited the Family Medicine Clinic of Seoul Paik Hospital from November 1992 to August 1993. We took their medical histroy, perfomed physical examination, and requested chest X-ray and laboratory tests such as CBC, serum BUN/Cr, Na/K, GOT/GPT, Albumin, HBsAg, TSH, Urinalysis with microscopic examination. And then we check the weight of 64 patients twice a day to evaluate their diurnal weight change.

Results : Among 77 patients, women were 67 persons(87.0%). There were 20 persons(31.3%), the healthy ones whose diurnal weight change was below 0.5kg were 9 persons(14.0%), and healthy people whose weight change was not checked were 35 persons(54.7%). In the respects of age, sex, Quetellet index, onset-time of edema, family history of edema, type of occupation, there were no statistically significant differences between the group who complained of edema and the range of diurnal weight change was over 0.5kg, and the other group who complained of edema but the range of diurnal weight change was below 0.5kg. But the patients who had suffered from idiopathic edema had longer duration of recently developed edema.

Conclusion : Among 77 persons there were 13 patients(16.9%) who had complained of edema and had organic problems that had made them have edema.

Background
: Family physicians may be interested in the health promotion and disease prevention, and they are capable of advising their patients to stop smoking. There may exist some difference between smokers and nonsmokers in the attitude toward their patient's smoking. We surveyed to know the family physician's attitude to the patient's smoking and the difference between smoking and nonsmoking groups.

Methods : A questionnaire was mailed in July and September 1993 to 2,528 family physician in Korea who is legistrated in the Korea Academy of Family Medicine. After then we analyzed 1,122 questionnaires(44.4%) which were responded through three groups ; nonsmoking, ex-smoking and smoking group.

Results : The respondent included no-smokers(38.0%), ex-smokers(34.4%) and smokers(27.6%). The physicians with opinion that the patient's smoking is addiction of nicotine were 47.9% in average and there was significant difference among the three groups(P<0.01). The physicians who assess the patient's smoking only in case of the patient's smoking related disease were 56.9% and there was significant difference among the three groups(P<0.01). The physicians who answered that the advice to quit smoking to their patients is effective were 94.0%. The physicians who answered that the reasons for no advice to quit smoking were that the patients were not interested to smoking cessation and lacked motivation were 47.8%. In the methods which the physicians use for the smoking cessation, the explanation about the relation between smoking and disease and advice to quit smoking was 85.1%.

Conclusion : There is significant difference in some knowledges and attitudes to patients' smoking according to the physicians' smoking status. The methods which physicians use for the smoking cessation were not various or insufficient. Family physicians must endeavour to quit smoking first and it must be continuous for them to assess the patients' smoking status and to develop and supply the materials and programs on smoking cessation.

Background
: Nowadays more women have jobs and the number of female physicians is increasing. Many studies have shown that sexual discrimination is present. In order to predict medical manpower of women in the future, we studied the status of female physicians and attitudes of physicians about sexual discrimination.

Methods : We sent 1,000 questionnaires to male and female physicians from May 1st to June 15th, 1992. The questionnaire was composed of questions about attitudes toward sexual discrimination. Two hundred and eighty four physicians responded.

Results : The number of female physicians is increasing.(15% of all physicians, 1991) Female physicians are younger than male physicians and reside more in urban areas. The proportion of specialties of female physicians is less than that of male ones ; Female physicians tend to be employees rather than practice privately. They are employed more in the clinics of other private practitioners than hospitals, They specialize more in finite areas such as Pediatrics, Obstetrics and Gynecology, Family medicine, Anethesiology, Radiology and Opthalmology but less in sugeries.
Most male and female physicians think that there was sexual discrimination in medical fields especially in entering residency programs. They felt it is also present in employments and promotions. They said that the reasons for sexual discrimination were mainly the sexual prejudice of society(43.7%), pregnancy and childcare(33.8%). Male respondents added incapacity of female physicians(21.1%) and lack of professionalism(10.2%). Most male(58%) and female(73%) physicians oppose to sexual discrimination induced by pregnancy related problems.

Conclusion : Female physicians are increasing and their manpower will be more important than ever. They choose specialties of narrow range and are employed rather than practice themselves. Male and female respondents agree that there is sexual discrimination but don't agree about the reasons and propriety of it.

Background
: An elevated blood pressure is important public health problem, being common, asymptomatic, readily detectable, usually easily treatable, and often leading to lethal complication if left untreated. To attempt to improve the health status of population through periodic health examination, we should try not only to find cases but also to detect hypertension management behaviors. The purpose of this research is to aid to manage hypertension efficiently.

Methods : We obtained detailed data from periodic health examination and questionnaire at an interval of two years.

Results : 1. Our study population comprised 86 patients : male 85, female 1. 2. Number of case seeking hypertension management behaviors was 71(82.6%). 3. Reasons of no hypertension management behaviors was usually normal blood pressure at follow-up and no symptoms. 4. Distributions of hypertension management behaviors was self-care 56(65.1%), physician encounter 26(30.2%), utilzation of drug store or herb medicine 25(29.1%), folk medicine 5(5.8%). 5. The numbers of hypertension management behaviors ; only one 41(57.7%), two 23(32.4%). three or more 7(9.9%). 6. No. of hypertension under control was 11(12.8%) ; In no hypertension management behavior group ; 4(26.7%), in one management behavior group ; 3(7.3%), in two management behaviors group ; 3(13.0%), in three or more management behaviors group ; 1(14.3%).

Conclusion : According to this study, hypertensive patients usually showed various hypertension management behaviors but these behaviors were not effective for hypertension control. We feel necessity of aggressive, concrete and continuous education for efficient hypertension management.

Background
: Doing genogram is easy way to assess patients' families. Drawing family diagram is the first step to give medical students interests for understanding family systems and family centered health care. The purpose of this study is to draw several Korean famous families' genograms and assess their family functions. The results of this study could be used as examples to understand family function.

Methods : I read the biographies of seven Korean historic persons and drew their family diagrams. They were the persons belonging to Lee's dynasty or recent Korean history. I used these diagrams for the lecture to the medical students.

Results : I presented King Se-Jong's family and Hwang Lee's family for the examples of the families having typical family structure. Sa-Yim-Dang Shin's family was presented as an example of pattern repetition across generations. I presented three families for the examples of life events and changes in family functions. I presented King Ko-Jong's family and Yi Lee's family for the examples of typical relational patterns(triangle).

Conclusion : Genograms of Korean famous families seem to be good for the educational examples, representing well characterestic patterns of Korean families.