Background
: NSAIDs is one of the most commonly used drugs in primary care. Although they are generally well tolerated, they have been implicated in some side effects. The purpose of this study is to investigate the incidence and features of adverse reactions associated with nonsteroidal antiinflammatory drugs.

Methods : We tried post marketting surveillance for NSAIDs in the department of Family Medicine among five medical centers from Feb. 1994 to Oct. 1994. 268 patients who have NSAIDs at least one week to manage degenerative joint disease, headache and other diseases were included. We monitored adverse reactions regularly at interval 1,2,3 and 4th week after use of NSAIDs. We analized the incidence patterns using Chi-square test.

Results : The adverse reactions of NSAIDs were edema(13.6%), abdominal pain(12.8%), dyspepsia(10.1%), flatulence(2.7%), constipation(2.2%) and diarrhea(1.6%) in order. The incidence rate of edema is significantly higher in female as 16.6% than in male as 3.6%(p<0.05), and higher in old ages(≥ 50 years) as 19.4% than in younger ages(<50 years) as 8.2% (p<0.05). The incidence rate of abdominal pain is significantly higher in group who had gastritis as 23.4% than group who had not gastritis as 11.9%(p<0.05).

Conclusion : The adverse reactions of NSAIDs were edema, abdominal pain, dyspepsia, flatulence, constipation and diarrhea in order. The incidence rate of adverse reactions varied according to sex, age, drugs, and histories of gastritis.

Background
: Hypercholesterolemia is the one of the major risk factors of coronary heart disease, and is increasing due to the change of diet habits in Korea. In the United States of America, National Cholesterol Education Program (NCEP) recommends total serum cholesterol, if possible with HDL-cholesterol, as screening test, and dietary therapy and physical activity as treatment before starting lipid lowering drug therapy. In our study we assessed the effects of brief diet education by doctors on blood total cholesterol.

Methods : We conducted a case-control study for the patients who's serum total cholesterol level were 200-300mg/dL, during routine health examination at an university hospital between April to July 1994. They were divided into two groups by inclusion orders. We educated case groups for dietary therapy, and simply noticed high blood cholesterol levels for control groups. After 1 month We re-checked total serum cholesterol levels. Three residents of family medicine were dedicated to the patient education using the patient education materials which were produced by the department of family medicine of an university hospital.

Results : 85 patients, 42 case group and 43 control group, were followed for 1 month There was no difference between two groups for age, sex, BMI, education, smoking and alcohol habits. Baseline cholesterol levels of control and case groups were 231.1±18.5mg/dL and 239.9±24.3mg/dL for case group. The dicreases were 7.4±23.0mg/dL (P<0.05), 29.6±20.1mg/dL (P<0.0001) Seperately which were stastitically significant. but, there was significant difference between two groups by ANCOVA test. (P=0.0001)

Conclusion : In our study brief diet education by doctors was more effective in blood cholesterol reduction than simple notice of high blood cholesterol level.

Background
: DM is a chronic disease which self-management has been required for a long timee. Besides blood sugar control, the Quality-of-Life which the patients themselves have been satisfied with is important in diabetic management. But the studies for the diabetic QOL have been rare until now. The purpose of this study is to help that family physician take care of diabetic patient with evaluation and understanding of diabetic quality of life.

Methods : This study has been made of 108 NIDDM patients that have been visited to Incheon Segiwang and Seoul Seoboo hospitals during 7 months(1994.3-1994.9). The diabetic patients were evaluated by Duke-UNC general health profile as the Diabetic Quality-of-Life(DQOL) scale in this evaluated by Duke-UNC general health profile as the Diabetic Quality-of-Life(DQOL) scale in this study. The prupose of this study is to evaluate DQOL was scaled and compared with age, weight, economics, education, job, fasting blood sugar, treatment modality, and duration of the D.M..

Results : 1. The difference between males and females was not found on the total DQOL, but females were significantly more distressed than males in emotional function(P<0.05) and physical function(P<0.01).
2. The differences in non-diabetic factors(weights, economics, educations, jobs) were not found on the DQOL.
3. There was no significant difference in fasting glucose levels. The difference in durations of D.M. was not found on the DQOL.
4. The difference in treatment modality group such as diet&exercise group, oral hypoglycemic agent group and insulin therapy group was found on the total DQOL(P<0.01), especially with insulin therapy group being significantly more distressed than diet&exercise therapy group in emotional function(P<0.01), symptom status and social function(P<0.05).

Conclusion : The difference in treatment modality group such as diet&exercise group, oral hypoglycemic agent group and insulin therapy group was found on the total DQOL. The DQOL in treatment modality was depressed in order of insulin therapy group, oral hypoglycemic agent group and diet&exercise group. Finally, besides biochemical controls such as blood glucose level and prevention of the diabetic complications, the various factors in diabetic management which depress diabetic QOL should be detected and repaired, and the diabetic treatments and educations which improve diabetic QOL should be investigated further.

Background
: The hypercholesterolemic patients have increased recently in Korea due to the westernized pattern of diet. The saturated fatty acid and cholesterol in the food are important factors that elevate cholesterol in serum. But the assessment of amount of intake is insufficent. We investigated the amount and source of cholesterol intake.

Methods : We gathered case groups among persons who had taken medical examination from June 1992 to September 1992 at the Asan medical Center. In our study, we used the Food Frequency Questionare to get quantitative estimates of dietary cholesterol intake. The amount of cholesterol intakes were calculated by the nutrient analysis program used to the standard nutrient composition for each food.

Results : The estimated mean intakes of cholesterol is 295±241mg/day in all sujects, 332±255mg/day in male, and 242±212mg/day in female, This survey show that the main sources of cholesterol intake in male are Chicken's egg(16.8%), Common squid(14.4%), Meat for Gug(13.3%), Bulgogi, Loin, Ribs, Stakes(10.4%), Korigome-Tang, Seolnong-Tang(8.0%), and Seonji-Gug(13.3%), Bosin-Tang(7.4%) in order, and those in female are Chicken's egg(21%), Common squid(17.3%), Meat for Gug(15.5%), Bulgogi, Loin, Ribs, Stakes(7.5%), Korigome-Tang, Seolnong-Tang(5.8%), ordinary liquid milk(6.7%), and Hair tail, Mackerel, pacific cod, Alaska pollack, Spanish mackerel(3.9%) in order

Conclusion : Recently, the isease associated with atherosclerosis in Korea in increased with the change of diet pattern. We hope that this survey will be used for the effective diet intervention program in gyperlipidemic patients.

Background
: Specimens obtained by means of a endoscopic bite biopsy are too small and superficial to arrive at a correct histological diagnosis of gastric submucosal tumors. However, Strip biopsy which was devised and developed to obtain larger and deeper specimens of gastric mucosa has made it possible to diagnose and resect submucosal tumors.

Methods : Strip biopsy was done in 26 patients with submucosal tumor lesions who visited Seoul Medical hospital from January in 1992 to August in 1994, and clinical characters including histopathology were evaluated.

Results : Mean age of patients was 47.5 years old. The sex ratio of the male to female was 1:1.17, The removed gastric lesions were mostly from 1.0cm to 1.9cm in size(38.5%), and the biggest lesions was 4cm in size. According to Yamada type, type I was most common(46.2%). The most common location of lesions was gastric antrum 12(46.2%). The common clinical symptoms were epigastric pain(46.2%), epigastric discomfort(26.9%), nausea and anorexia(26.9%), and indigestion(23.1%), These were non-specific symptoms, compared with other gastric lesions. Histopathologic examinations revealed that the leiomyoma was most common(26.9%), and the remainders was heterotopic pancreas(7.7%), gastritis cystica profunda(3.8%), telangiectatic blood vessels in submucosa(3.8%), benign stromal nodule(3.8%), severe edematous & fat cell at submucosa(3.8%), hypertropy of muscularis mucosa(3.8%), microretention cyst(3.8%), and as only mucosal lesion, fundic gland hyperplasia(19.2%), chronic gastritis(15.4%), tubular adenoma(3.8%) and adenocarcinoma(3.8%). Bleeding from the artificial ulcer was developed in Two cases and these patients could be treated endoscopically. But, there was one case with gastric perforation which tumor was 4cm in size.

Conclusion : Strip biopsy, by which large and deep specimens can be obtained, is a useful procedure for the purpose of diagnosing gastric submucosal tumors. But, it is considered that 4cm sized tumor demands partial resection for complication, gastric perforation.

Background
: Papanicolaou smear adequacy is directly related to endocervical edll discovery, and therefore can improve the value of the Papanicolaou smear as a cancer screening test. One of the pruposes of this study is to assess capture rate of endocervical element of the current Pap smear method in Korea which is performed by using only dry cotton swab. The other purpose is to compare effectiveness of cytobrush cell collector when performing Pap smear.

Methods : This study was performed for 333 patients visiting Family medicine outpatient department at Konkuk University Medical College Hospital to take Pap smear test from March 3, 1994 to July 12, 1994. The both dry cotton swab and cytobrush cell collector were used to collect specimen for each of total 333 patients.

Results : The endocervical cell capture rate was 37.2% for dry cotton swab, 73.0% for cytobrush. The difference of endocervical cell capture rates among two methods was significant statistically. A significant higher number of atypical epithelial changes was found in smears with endocervical cells than in smears without endocervical epithelial changes was found in smears with endocervical cells than in smears without endocervical columnar cells. Thus, the chance of missing an abnormal epithelial change is increased in smears without endocervical columnar cells irrespective of instruments. The use of the cytobrush incresased the number of smears that contained endocervical cells for reproductive age and postmenopausal women.

Conclusion : The use of cytobrush is considered as a more effective method for collection of endocervical cells compared with dry cotton swab, and the chance of detecting an abnormal epithelial change is increased in smears with endocervical cells.

Background
: Head injury has been increasing because of high social mechanization and industrialization. The outcomes of mild head injured patients who had GCS score more than 13 were good. But sometimes there were fatal or disabled cases. Therefore we had investigated clinical features of head injuries that related to outcomes.

Methods : The retrospective analysis of 830 mild head injury patients who were visited to Dongguk University, Po Hang Hospital from march 1990 to february 1991 was performed which correlate outcomes to clinical features and abnormal CR findings to clinical features. We investigated age, sex, causes of injury, arrival period after injury, arrival period after injury, loss of consciousness, nausea or vomiting, anisocoria, simple skull radiography, brain CT and outcome of mild head injury patients. We investigated clinical features that are able to predict outcomes and abnormal CT findings.

Results : The people at the age of younger than 10, the third decade and the fourth decade were frequently affected. The males were more frequently affected(71.7%) than females. The most common cause was traffic accident(41.9%). The patients who visited within 3 hours after mild head injury were 89.1%. The people with loss of conciousness were 29.6%. The nausea and vomiting were shown in 17.6%. The people with anisocoria were 0.8%. The people with akull fracture were 11.4% of whom were examined by simple skull radiography. The people with abnormal CT Findings were 19.6% of patients who were examined by brain CR. The patients who were admitted in the department of neurosurgery were 212 patients(25.5%), and 17 patients(2.0%) were taken cranial operation. 823 patients(99.2%) had good recovered 6 patients(0.7%) moderately disabled, 1 patient(0.1%) was dead. There was correlation between outcomes and loss of consciousness, nausea or vomiting, skull fracture or facial bone fracture, and abnormal CR finding. There was correlation between abnormal CT findings and skull fractures or facial bone fractures.

Conclusion : The outcomes of people who had mild head injury were almost good. But physicians must be coerfal in dealing mild head injury patients because there were sometimes the cases of death or disability.

Background
: Computer use in medicine is increasing now. We studied patients' attitudes on computer use in consultation room.

Methods : 250 patients were given questionnaire who visited on family practice in Incheon during one month since March 1994.
The patients' views of their relationship with their doctor after the computer was introduced were compared with their view of their relationship before the installation of the computer.

Results : More than 80% of the patients(n%209) stated that the contact with their doctor was easy as before. More than 70% of the patients stated that the contact with their doctor was as personal as before. More than 60% of the patients stated that their privacy was more secure than before.

Conclusion : We found that patients have little difficulty in accepting the presence of a computer in the consultation room and personal computers do not make doctors seem less personal.