Background
: The reference is an important part of medical article. To be useful, it must be accurate. The purpose of this study was to evaluate the accuracy of references in the Journal of the Korean Academy of Family Medicine.
Method: 100 references were randomly selected from the articles of the Journal of the Korean Academy of Family Medicine issued from No.1993 to Oct. 1994. Each reference was verified for citation errors and quotation errors. Citation errors were classified as se-vere, intermediate and trivial. Quotation errors were classified as complete, partial and oth-ers.
Result: Among 91 references which were verified for citation errors, 37.4% had severe errors, 19.8% had intermediate errors, and 14.3% had trivial errors. There was difference between domestic and foreign literatures in the distribution of citation errors(X²-test, P=0.03). Among 82 references which were verified for quotation errors, 15.9% had complete errors, 12.2% had partial errors, and 13.4% had other errors. There was no difference be-tween domestic and foreign literatures in the distribution of quotation errors.(X²-test, P=0.44). Among 154 statements which were verified for quotation errors, 11.0% had complete errors, 7.2% had partial errors, and 9.1% had other errors. There was no difference be-tween domestic and foreign literature in the distribution of quotation errors according to statements(X²-test, P=0.10).

Conclusion : This study showed that the rate of citation error and the rate of quotation error were unacceptably high. It is necessary that contributors and editors should make more efforts to enhance the accuracy of the references.

Background
: A therapeutic model than can be applied practically to family-oriented primary care in the family medicine clinic is not yet developed. The Solution-Frocused Brief Therapy ap-proach not only fully meets the 7 requirements of the primary family counselling but also proved itself of highly successful results and brief therapy sessions through many studies. This approa-ch is applied to the cases with various somatic or psychosocial problems at the family medicine clinic, which tests the effectiveness of the model and suggests the fundamental information to develop effective approach model.

Methods : From September 1994 to October 1996, 49 cases with 66 patients and family mem-bers who received the regular family therapy for more than 45 minutes for each session was studied at the family medicine clinic, a university hospital, Seoul. Recordings of the therapy were done by videotaping, audiotaping, and written records. The Solution-Focused Brief Thera-py approach was used as a therapeutic model. The charateristics of the cases were observed and the success rates of the therapy was calculated. The cases were divided into 2 groups ; a group of those ho came for resolution of somatic complaints at the initial visit, and the other by psy-chosocial problems. And the comparison of the therapeutic effectiveness between the two groups were done. The therapeutic effectiveness was represented as a score given by the patients on the scale from 0 to 10 for achievement of the therapeutic goals.

Results : The frequency by the type of problems was partner relational problem, 33.3%, par-ent-children problem, 18.4%, dysthymic disorder, 18.4%, family violence, 10.8%. Among the pati-ents who came for somatic complaints, cardiovascular symptom group was 38.1%, gastric symp-tom, 33.3%. The frequency of the psychosocial problems of this group that are revealed during family therapy was as follows; partner relational problems, 33.3%, dysthymic disorders, 28.6%, in-law relational problems, 14.3%. The success rate of therapy was 87.7%, the number of ses-sions were from 1 to 6, average 2.6, and 69.4% of the cases gained the therapeutic goals after 2 or 3 sessions. The effectiveness of the therapy was represented by the difference in the score between the first session and the ending session, which was statistically significant(p<0.001). The effectiveness of the therapy in the somatic complaints group and the psychosocial problem group was statistically significant individually(p<0.001). There was no difference of effective-ness between the somatic complains group and the psychosocial problem group(p>0.1).

Conclusion : The Soluton-Focused Brief Therapy is applicable and effective approach model that can be actively used in helping the patients and families with various somatic and psycho-social problems at the family medicine clinic.

Background
: Chronic obstructive pulmonary disease(COPD) is one of the important caus-es of death in Korea, Having mortality rate of 11.4 per 100,000 in 1992. The mortality rate of acutely exacerbated COPD ranges from 6% to 40%. These discrepancies are probably due to differences in baseline patient's characteristics. This study aimed to verify the risk factors of mortality through examination of baseline clinical and laboratory parameters in acutely exacerbated COPD patients.
Method: The 245 COPD with acute exacerbation patients were hospitalized in Yongdong Severance Hospital of Yonsei Medical College from January, 1985 to December, 1994. The patients' clinical and laboratory variables were analyzed retrospectively, including age, sex, body weight and height and were compared between two groups, death group(n=64) and survival group(n=181).
Result: The mortality rate was 26.1%, 64 out of 245. The mean age of death group was 71.0±10.9, which was older than survival group, having no significance. The pulse rate(p<0.001), alveolar-arterial oxygen gradient(p<0.001) in death group were greater than survi-val group. The body mass index(p<0.001), serum albumin(p<0.001), serum sodium ion(p<0.001), serum chloride ion(p<0.001) were significant lesser than survival group. The vavia-bles with Odds Ratio(OR) were serum albumin ≤3.4g/dL(OR 5.65), pulse rate ≥92/min(OR 4.92), chloride ion ≤100mEq/L(OR 3.57), alveoar-arterial oxygen gradient ≥40.1mmHg(OR 3.38), and existence of inflammatory lung disease(OR 1.70).

Conclusion : Serum albumin ≤3.4g/dL(OR 5.65), pulse rate ≥92/min(OR 4.92), chloride ion ≤100mEq/L(OR 3.57), alveolar-arterial oxygen gradient ≥40.1mmHg(OR 3.38), existe-nce of inflammatory lung disease(OR 1.70) were predictive factors of death in acutely ex-acerbated COPD patients.

Background
: It is especially common in the elderly hypertensive patients that pseudohyperte-nsion is, because of the excessive stiffness of the large arteries, measured higher than the actu-al blood pressure. If misdiagnosed as having pseudohypertension, it may cause the loss of expe-nses and the risk of adverse effects to the patients with unnecessary treatments. Especially, the unnecessary antihypertensive treatment of pseudohypertension in the elderly patients has shown to lead to side effects such as bone fracture by a misstep or a transient ischemic dis-ease. In spite of the clinical importance of pseudohypertension, the studies on this subject and the reports about the frequency(of pseudohypertension) are rare.
Method: From June 20 through June 30 of 1995, blood pressure was measured to the hype-rtensive patients over age 60, who have been treated in a hypertensive center of the department of the Family medicine in a metropolitan hospital. Each patient was measured a standardized in-direct blood pressure by a hand-operated mercury blood pressure gauge and was examined the presence of pseudohypertension with the use of Osler's maneuver. Osler's positive patients were remeasured. The socio-demographic characteristics of the patients and the test center's opinion were computerized and examined with comparison.

Results : Among the 345 subjects of the study, percentages of those over age 60 were 58.2%(201/345), and those under age 60 were 41.7%(144/345). The average age of the subjects was 60.7 for the subjects, there was no Osler positive case under age 60 and 2%(4/201) was found over age 60. The socio-demographic characteristic and the test center's opinion showed signifi-cant correlations with blood pressure, but didn't show any correlations with age, weight, height, a disease, a family history, alcoholic drinking, smoking, habit of eating, and the amounts of cho-lesterol.

Conclusion : The Osler's positive(pseudohypertension) of the subjects found only in those over age 60. According to this fact, at the time of initial blood pressure diagnosis of the elderly hype-rtensive, the unnessary treatment of antihypertension should be prohibited considering the pos-sibility of the presence of pseudohypertension. It is considered that, with the clinical importance of pseudohypertension and prevent from the adverse effects by the antihypertension, a pre-cise measurement of frequency of pseudohypertension by the use of direct blood pressure mea-suring method is necessary. Further study will be required to verify these discoveries in the eld-erly hypertensive patients and to develop noninvasive means of confirming the presence of pse-udohypertension.

Background
: Smoking is one of the most significant etiologic factors of carious cardio-pulmonary diseases. For the proper management and good outcome, smoking cessation is thought to be even more important than pharmacologic treatment in these diseases. We studied the proportion of physicians who recommended quitting smoking, the ways of rec-ommendations they did, and the effectiveness of recommendations.

Methods : We performed questionnaire survey by mail twice for the 349 patients who admitted in AMC for COPD, angina or MI from July, 1994 to July, 1995. Among the total 109 respondents(response rate:37.%), we analysed the 49 patients who had been smoking by the time of admission.

Results : The average age of the subjects was 57.0, and the number of men was 41. In hospital the number of patients who were told about smoking cessation by the physicians were 45(97.8%). Among them, those patients who were told to reduce to smoking amount were 6(13.0%), and those who were told just to "quit smoking"were 27(63.0%), and those who were taught how to stop smoking were 11(23.9%). After the recommendations to quit smoking amount were 14(32.6%). The frequency of admission, the number of physicians who recommended and the number of recommendations did no affect the patients' smok-ing. The rate of smoking cessation was significantly higher for concrete recommendations than simple recommendations.

Conclusion : To the patients with smoking-related diseases, most physicians recommended to quit smoking. And for the smoking cessation, concrete and practical educations brought better outcomes than simple recommendations.

Background
: Increasing the need of appropriate prediction formulas of pulmonary function parameters in Korean adults, interest about which affect the pulmonary function para-meters are increasing. Therefore we examined the relationship between pulmonary function pa-rameters derived from the forced expiratory spirogram and age, height, weight, and smoking amount in Korean middle aged men.

Methods : We analyzed the result of parameters derived from the forced expiratory spiro-gram in 1,954 men who enrolled in health examination of on corporation, from March 1995 to April 1996, who are aged from 45 to 59, and who have neither history of cardiopulmonary dis-ease nor lesions on chest X-ray. Pulmonary function was estimated by SPIROVIT SP-200(Switzerland). We evaluated the relationship between pulmonary function parameters and age, height, weight and smoking amount by multiple linear regression method.

Results : Mean age, height and weight were similar among current-smoker, ex-smoker and non-smoker group. Results of the effect on height-adjusted pulmonary function parameters ac-cording to smoking status were that FVC, FEV₁ and FEV₁/FVC showed no difference among three groups, but FEF 25-75% showed significant decrease in smokers group. To adjust the effects of age, height and weight about pulmonary function, we analyzed the parameters by multiple linear regression method. Results showed that all pulmonary function parameters showed nega-tive correlations with smoking amounts. We evaluated the effect of age, height and weight on pulmonary function parameters by multiple linear regression method. FVC and FEV₁showed negative correlations with age, positive correlations with height and no significant correlations with weight. FEV₁/FVC showed negative correlation only with age, and FEF 25-75% showed signi-ficant negative correlation with age and positive correlation with weight, but no significant cor-relation with height. We compared the predicted value estimated for Korean with that for American. Predicted value from prediction formulas for Korean were higher than that for American.

Conclusion : Smokers had significant decrease of FEF 25-75% compared with ex-smokers and non-smokers in Korean middle aged men. This indicates that smoking develops early changes on peripheral small airways. We have got predicton formulas for pulmonary function parameters in which FVC and FEV₁consisted of age and height and FEF 25-75% consisted of age and weight. Because prediction values estimated by Korean were higher than that by American, we must apply appropriate prediction formulas in Korean to Korean pulmonary function test.

Background
: Death and disability associated with breast and cervical cancer can be re-duced by early detection and treatment. Screening tests are readily available, and disability and death associated with those conditions can be lessened through early detection and treatment.

Methods : The study populations were patients who were between the ages of 20 and 65 and visited the department of Family Practice of Uijongbu St. Mary's Hospital from Janu-ary 1, 1994 to April 30, 1994. We examined characteristics of the women that might affect their likelihood of receiving the various screening tests. The characteristics included demo-graphic and reproductive health variables associated in the literature with bresat cancer-and cervical caner.

Results : The overall rates of screening reported by the omen interviewed were 67.8 percent for a Pap test and 13.8 percent for a mammography. The strong predictors for receiving a Pap test or a pelvic examination were age older than 40, living with a partner and taking a regular health screening test.

Conclusion : The prevalence of women ever having undergone a Pap test was high in middle age, those living with a partner, and those taking a regular health screening test and was low in more educated women. The prevalence of omen ever having undergone a mammography was low in regular drinkers.

Background
: Osteoporosis is one of the characteristic adult diseases and important health problem. It brings to high prevalence, easy fracture, many complications, and lowers geriat-ric quality of life. With concern about osteoporosis as a primary care physician, we would like to know the relations between risk factors and BMD.

Methods : Among the patients who have taken the Bone-mineralodensitometry(BMD) ex-amination, from January. 4, 1994, to July. 31, 1995, at Sung Nam Central Hospital, we sele-cted 112. Data was gathered from the BMD examination and questionnaire. These data were analysed using SPSS/PC correlation and stepwise multiple regression statistic program.

Results : The study subjects were composed of 112 patients (female:51, male:61). By osteoporosis definition, the 2.5 S.D. below the peak bone mass is 51(45.5%), the normal group is 61(54.5%). In the stepwise multiple regression analysis, the most important risk factors are age and weight in female, exercise and weight in male.

Conclusion : In the prevention and early diagnosis and treatment of osteoporosis, the physician should consider the risk factors. Due to noticeable frequency of male osteoporosis, more studies are needed.