Background
: The screening tests for alcoholics have been made and use, however, there were few tools to assess the psychopathologic condition of alcoholics objectively for treatment. In this situation, as we can say that treatment of alcoholics begins from the recognition of disease by the patient, we tried to evaluate insight of alcoholics objectively and to investigate the associated factors.

Methods : Among the patients admitted to Alcohol Clinic due to problem of drinking between April and September in 1994, 41 patients who were admitted longer than one month diagnosed as alcoholism by DSM-Ⅲ-R, from whom we get information can be related to insight through data sheet inquiring demographic characteristics. A new insight scale, preliminary Insight Scale for Alcoholics(ISA) was made by this study as tools to measure insight of alcoholics based on insight scale which is used to other psychiatric diseases.

Results : Cronbach's alpha coefficient analysed internal consistency of the preliminary Insight Scale for Alcoholics(ISA) was 0.8371 by SPSS and the correlation between each item score and global score was used for another evaluation of reliability, and then correlation coefficient were from 0.3488 to 0.6851 in both scale done twice(P<0.05). This scale was analysed by factor analysis, and then yielded 8 factors, the factors accounted for more than 65% of items in the scale. These results show that this scale approximates to some of the aspects of insight in the definition of this stydy. The insight scale for alcoholics were enforced twice after earlier detoxification treatment and the education for abstinence from alcohol for 4 weeks, there were significatn changes statistically in scores of the insight scale for alcoholics(P<0.001). Although correlation analysis between MAST scores and scores of these insight scales was proportional(r=0.49), if the history of education for abstinence from alcohol was mediated, it was not significant statistically. The history of admission due to drinking was no significantly for those who has the history of education for abstinence from alcohol than those who has not(P<0.01) and for those who had the withdrawal symptoms(P<0.05). There were no significant between duration of drinking, APGAR score, psycho-social stress and scores of the insight scales.

Conclusion : Although it is necessary to refine the insight scale for alcoholics of this article, is was clinically possible to assess the insight and to evaluate the change of the insight. There was no close relation between MAST scores and the scores of the insight scale for alcoholics, and regardless of the times of admission the education for abstinence from alcohol is important factor associated with insight.

Background
: Because blood pressure is changeable time to time, clinic blood pressure does not represent person's blood pressure and in determing of prognosis of hypertensive patient, 24 hours blood pressure is more important than clinic blood presure. Diurnal variation of blood pressure already was known in many study.
The object of this study was to investigate yhe diurnal variation of blood pressure in nomotension and hypertension.
Mothods : The subjects of nomotension was clinic systolic BP(measured more than one) less than 140 mmHg and diastolic BP less than 99mmHg and healthy. The subjects of hypertension was clinic systolic BP(mean measured more than three) less than 140mmHg and diastolic BP less than 90mmHg and no previous history of anti-hypertensive drugs.
24 hours blood pressures of two subjects was messured using noninvasive 24hours ambulatory blood pressure monitoring. And time interval was 1 hour.
All measurements was classified day-time and night-time, and day time was 7:00am~10:00pm, night time was 11:00pm~6:00am.

Results : The No. of subjects was 21 in normotension and 19 in hypertension. Mean age was 41±11 in hypertension. The mean blood pressure in normotension was 121±12mmHg/78±8mmHg in clinic, 111±10mmHg/72±12mmHg in 24hrs ambulatory, 118±14mmHg/76±11mmHg, and 98±14mmHg/64±11mmHg in night time The mean blood pressure in gypertension was 146±7mmHg/97±8mmHg in clinic, 136±17mmHg/86±12mmHg in 24hrs ambulatory, 141±15mmHg/89±9mmHg in day time, 124±17mmHg/76±11mmHg in night time. Dirunal variation of BP in hypertensive was likely to one in normotensives in graph. And the differences in diurnal variation of BP between two groups was signinificant in systolic BP(p<0.05) ; normotensive more than hypertesives) but not significant in diastolic BP(p>0.05). And the differences between clinic and 24hrs ambulatory BP in hypertensives was significant in systoli and diasyolic.(p<0.05 ; clinic more than 24hrs ambulatory)

Conclusion : Diurnal variation of BP in hypertensive was likely to one in normotensives in graph. From the result of the differences between clinic and 24hrs ambulatory BP in gypertensives was significant in systoli and diasyolic.(p<0.05 ; clinic more than 24hrs ambulatory), I think that in follow up BP of hypertension patients, 24hrs BP was more helpful than clinic BP. And from diurnal variation of BP in hypertensives, I think that further study is necessary in minitoring of anti-hypertensive drugs.

Background
: This study was undertaken to evaluate the validity of fever detection using commonly used infrared tympanic membrane thermometer of the children. It is simple to use, cleanliness, sterility, minimum inconvenience or discomfort to patients, and give a reading in 1-2 seconds.

Methods : One hundred and one children, aged 3 months through 10 years, by comparing it with rectal temperature obtained with a standard mercury-in-glass thermometer.

Results : Correlation of the infrared device and mercury-in-glass thermometer was high(0.87 in less than 3 years old, 0.90 in more than 3 years old). Sensitivity, specificity, positive and negative predictive values are 85.7%, 86.8%, 82.8%, 89.2% in less than 3 years old and 100%, 74.1%, 53.3%, 100% in more than 3 years old respectively.

Conclusion : Our findings indicate that infrared tympanic membrane thermometer providing a reliable temperature reading in children, so infrared tympanic membrane thermometer has high validity in detecting fever of the children.

Background
: Malignant mesothelioma is assocated with the exposure to asbestos. In Korea, asbestos was widely used at various industrial parts since beginning of 1970s. However there was no systematic report of mesothelioma till now. This study may be used as the base of mesohelioma study in Korea.

Methods : This study reviewed histologically proved cases of mesothelioma seen at Seoul National University Hospital during 1979-1993. Forty one cases were included as potential cases, of which only 25 cases had available medical records. This study centered on 22 malignant mesothelioma except 3 benign cases.

Results : Twenty two cases were malignant and 3 cases were benign, Two cases were diagnosed during 1979-1984, 7 cases during 1985-1989, 13 cases during 1990-1993 each, Seventeen cases were admitted to the department of internal medicine, 4 cases to thoracic surgery and 1 case to general surgery. There were 12 female cases(54.5%). The median age was 47.0 years(range 21-73 years). Fourteen cases(63.6%) originated from pleura, 6 cases from peritoneum and 2 cases from pericardium.
Dyspnea and chest pain were most common presenting symptoms o pleural malignant mesothelioma, abdominal distension and mass for peritoneal case. The median interval between initial symptom and diagnosis was 3.5 months(range 1-36 mnths). First impression were pleurisy, tuberculosis, and lung cancer for pleural mesothelioma, Eight of 14 pleural mesothelioma patients underwent open thoracotomy for definitive diagnosis. Five of 6 peritoneal mesothelioma underwent exploratory lapalotomy for diagnosis. Computerized tomogram and magnetic resonance imaging were use as a modality to assess the extent of the disease. The epithelial type was the most common(22.7%) histologic type and 14 cases(63.6%) were not specified. Most cases had multiple poor prognostic factors.
Some patients received surgery or chemotherapy, which however was not effective. The median survival Was 6.5 months in 4 pleural mesothelioma cases. Asbestos exposure was identified in only 7 cases(31.8%) and occupational history was missed in in 4 cases(18.2%). Four cases had probable asbestos exposure history, 3 cases had possible one.

Conclusion : Twenty two malignant mesothelioma cases seen at Seoul Nationa University Hospital were reviwed, They were slightly different from previous studies in site, sex and age but similar in other clinical data. Information on asbestos exposure was insufficient.

Background
: The growing prevalence of alcohol related disorders in Korea has posed significant position in medical practice. In order to detect the alcohol problems before patients have become dependent on alcohol or sustained organ damage, a sensitive and accurate markers has been required. In this study, comparison of laboratory tests and questionnaire(MAST) was undertaken as scree ning instruments that may be used to identify drinking abult males in risk.

Methods : Data was obtained from 423 men in Health Care Center in Ewha Mokdong Hospital on epidemiologic status, alcohol consumption amount, mean corpuscular volume(MCV), MAST scores in the period from July 1994 to August 1994.

Results : MCV was increasing with age(P<0.01), γGT, MCV and age were correlated positively with alcohol consumption(P<0.01). Obesity ratio and γGT also were correlated with alcohol consumption(P<0.01). The relationship between alcohol consumption and these variables was not changed after controlling for age and obesity ratio. Between low alcohol group and high alcohol group, there was a significant difference in γGT, MCV, and alcohol conaumption(P<0.01). When criterion with γGT 50U/L or over and MCV 94 fl or over were taken, sensitivity of γGT was 42.7%, But when MCV and γGT was combined, sensitivity had increased to 63.4%.

Conclusion : γGT and MCV were correlated positively with alcohol consumption. Neverthless, their correlation was insufficient to make the test useful for screening. But When We use them together, their screening power will be increased.

Background
: Department of Family Medicine in Seoul national university hospital has started lifelong health maintenance program(LHMP) since Feb 1991, and developed Health Risk Appraisal to evaulate personal health risk factors. This study aimed to evaluate the effect of LHMP by changes in health rik factors.

Methods : From May to September 1994, those who have been participated in LHMP more than 1 year were enrolled. We made subject answer to Health Risk Appraisal questionnaire when they had registered the LHMP and now, then cmpared with each other. We analysed categorical data for significance using the chi-squre test and analysed quantitative data for significance using t-test.

Results : 169 subjects were included. The overall population had mean age of 50.7±11.6 years and female were 59.2%. Significant change were detected in DM, BP, hepatitis B vaccination, sleep duration and pap smear.
30.6%(26/86) of the unvaccinated were vaccinated, 66.7%(10/15) of the pap-unchecked were ckecked. 75.0%(3/4) of poorly-controlled diabetes were changed to well-controlled. 27.5%(8/29) of smoker quitted smoking, 23.8%(24/102) of non exercisers started regular exercise. 94.1%(16/17) of heavy drinker decreased their drinking amount, 50.0%(5/10) of unmedicated hy[ertensive patients started medication, 54.5%(18/33) of seat belt non-user used seat belt. Recognition rate increased in DM by 78.8%(41/52), in blood pressure by 88.5%(23/26), in hepatitis B antibody by 40.0%(37/84).

Conclusion : Lifelong health maintenance program decreased health risk factor significantly in doctor-leading parts(ex : DM, HT, hepatitis Vaccination, pap smera) but didn't decreased risk factors in patient-leading parts(ex : smoking, exercise, seatbelt).

Background
: Alcoholism is a common disease in the family practice. It causes multiple problems in many aspects such as biologic, psychological, social and family functioning of individual. Therefore, it is necessary for family physicians to study on alcoholic patients in a comprehensive way to understand those problems. We studied in a retrospective method to make basic asessment and approach to alcoholism.

Methods : We reviewed the medical records of 78 of alcoholics who were admitted to a mental hospital from June, 1993 to September, 1994. We inquired into the family function, withdrawal symptoms of alcoholilic patients, each axis(by DSM Ⅳ ) and laboratory test results.
Rusults : The alcoholic inpatients consisted of 76 males(97.4%h and 2 females(2.6%). 76.5% of them were married, and in terms of family stage, school-age family(49.0%) were the greatest. Their drinking duration is over 20 years in 44.9% of the subjects. Most of them were adimitted to a hospital involutarily(71.8%) and their family types(by FACESⅢ) showed extreme type in 30.8%, midrange type in 47.4% and balanced type in 21.8%. As regard to withdrawal symptoms, tyey expressed autonomic gypersesitivity very often(69.2%). In 37.2% of patients, they had personality disorders concommitantly and antisocial personality disorder was also very frequent(17.9%). They have more organic didseases than non-alcohilic patients, such as digestive(66.7%h, endocrine(20.5%), circulatory) 10.3%), respiratory system diseases(9.0%) and so on. They had many psychosocial and environmental problems in primary support group(43.6%) and in occupation(16.6%). They revealed significantly lowered social functioning than before the symptoms due to alcoholism developed(P<0.01).

Conclusion : Alcoholic patients have multiple problems in biologic, psychologic, social, and family functioning. A family physician should participate in the management of alcoholism in a comprehensive and continuous was.

Background
: Recently the elderly population have increased speedly, medical people are highly ineerested in health of the elderly. So, this study was executed to investigate dermographic characteristics of depression in the elderly.
Mothods : From March 1 to July 30 in 1994, the questionaires were distributed to 200 elderly people who were 65 years old or more and lived in urban and rural areas. Jerome A.Yesavage's Geriatric Depression Scale was used to know about the depression scale, and one can get every 1 point about 15 items. the group was divided into two groups. One was normal group which got from 0 point to 5 point, the other was depression group which got 6 points or more. Sex, religion, education level, occupation, living place, economic status, physical illness were studied. We performed sratistical analysis among the results by means of chisquare test and Chisquare trend test.

Results : There were 131 elderly who had depression among 200 elderly. In case of the older, separated, no occupation, the more retired years, the lower education level, the worse economic status, the smaller spending money per month, the lower of satisfaction degree about the spending money per month and the suporter was their offspring, the difference between Depression scale are 6 over and 5 below was statistically significant(p<0.001) and elderly female was also statiscally significant(p<0.05). There was no statiscally significant difference between depression scale are 6 over and 5 below in case of religion, living place, physical illness.

Conclusion : Depression of the aged are common illness, but it is a rare case that they see the doctors because of symptom.. Therefore, the primary care physician who take the primary care has to have concept about the factors influencing depression of the aged. I think it will be very helpful to the practice of the aged that use GDS as a screening test about the depression of the aged.

Background
: Low birth weight is the most important determinant of the newborns morbidity and mortality and the healthy growth and development. Pregnancy can be seen as a time when the family's bounderies are shifting to accommodate a new member. Accordingly each family member can be affected from altered family function. Therefore we carried out this study to determine the effects of family functions on infant birth weight.

Methods : Randomly selected mothers in AnDong General Hospital and SungSo Hospital obstetric clinics who visit for delivery were invited to participate this study from May through June 1994. The mothers perception of family function was assesed with FACESⅢ and collects sociodemographic, biomedical data. 289 mother-infant pair out of 303 complete questionnares(exception congenital anomaly, multiple pregnancy, placenta or uterine anomaly, preterm) were studies. Infant body weight and other variables affecting body weight were compared by family function type.

Results : Infant body weight is positively related with gestational age, maternal BW, weight gain during pregnancy and negatively related with prematurity delivery history, alcohol. 84.8% of family were considered functional and family function averages flexibly separated. There were no statisfically significant difference in this analysis between sociodemographic determinants(education level, occupation, religion, income, marrige, smoking et al) and biomedical characteristics(gestational age, prepregnancy weight and weight gain during pregnancy, hypertension) of functional and dysfunctional families. Infant body weight from with dysfunctional family significantly smaller than from whose mother with functional families(P<0.05).

Conclusion : Infant birth weight can be influenced by family function or its associated factors and dysfunctional family increases low birth weight also. Family dysfunction should be possible to intervene early in pregnancy to modify risk factors associated with family systems. So that it will be helps decrease low birth weight.