Background
: The residency is chronic stressful condition. This study was attempted to know related factors to stress and coping responess of residency.

Methods : We selected 526 subjects who were under residency in university hospital in Pusan. We sent stress-related guestionaires by the mail. Among 161 responses, we excluded 4 responses which were inadequate report. The stress was measured by Lee's scale and Brief Encounter Psychoso-cial Instrum, ent(BEPSI). The coping rresponse was examined by 19 ciping options for stressful experie-nce by billings and Moos. Also we examined freguency of stress-related symptoms.

Results : The esx distribution was 123(79%) in male, 33(21%) in female. Lee's scale and BEPSI were not related siggnificantly with age. sex, marital status and resident grade. The feguency of stress-reated symptoms was 5.9(P=0.14) in female, in contrast to 4.1 in male, But other factors were not related with frequency of stress-related svmptoms. Among coping responses, number of avoidance-coping in male was 2.7, and it was signficantly highter than 2.0 in female. Among in male, the number of avoidance-coping was ssignificantly increased (P=0.005). and the numbers of avoidance-coping responses of drinking group and smoking group were significantly higher than those of non-drinking group and non-smoking group (P<0.001, P=0.001, respectively). In variables associated stress and coping response, age shown significant positive correlation with avoidance-coping and emotion-focused coping. BEPSI and Lee's scale were shown significant positive correlation with frequency of stress-related wymptons was correlated with avoida-nce-coping and emotion-focused coping.

Conclusion : Positive correlation was present bwtween stress and aboidance-coping in residency. So, we need social support and change in education program of residency for active copin.

Background
: Though atismoking campaigns are spreading out for prevention of chronic diseases which are related with smoking, smoking rate of korean people in still higher than that of advanced countries. To make a good and appropriate counterplan for smoking, we surveyed smoking pattern and antismoking efforts of Korean soldiers.

Methods : The questionnaire was made by authors regarding smoking status and related factors and the soldiers responded by themselves. We surveyed the questionnaire for soldiers from March to April, 1994. The subjects were 5,427 soldiers who were working in kangwon province, from those 636 questionnaires were excluded due to inadquate responses, then 4791 questionnaires were analyzed using SPSS/PC program. Nicotine dependence was measured by using the fagerstrom Tolerance Questionnaire(FTQ) and the smokers with more than 7 points were regarded as having high nicotine dependence.

Results : among the total respondents of 4,791, the average age was 21.7 and 70.2% was in the age group 20-22. the respondents included smokers(78.1%), ex-smokers(2.4%) and non-smokers(19.4%). The respondents' smoking status were significantly related with their school carrier, religion, parents' smoking status, the number of smoking friends and monthly personal expenses (P<0.01). Before age 18, 74.8% started smoking and common reasons for initiation of smoking were curiosity(36.9%) and stress resolution(31.5%). The conditions when they felt like smoking were stressful events(28.4%), getting along with their friends(27.1%) and drinking(21.2%). Ninotine dependency test using Fagerstrom's Tolerance Questionnaire showed that the average score for smokers was 4.6 and the subjects who got the score 7 or more were689(18.0%)The subjects who had tried to quit smoking were 2,534(67.7%) and the reasons to quit smoking were illness(52.7%) and prevention of future disease(3.15%). The most common reason for failure to stop amoking was stress(48.2%). The subjects who had a plan for stop smoking were 2,129(56.9%) and among the smokers, those who were confidential to stop smoking were 2,208(59.90%).

Conclusion : smoking rate for soldiers was 78.1% and most of them initiatedsmoking before age 18. Among the smokers, those who had tried to quit smoking were 2,534(67.75) and who had antismoking plan were 2,129(56.9%). Therefore we think that positive antismoking education and public relations are needed for those young soldiers who have not only high smoking rate but also high antismoking will.

Background
: Not only the drug therapy. But also diet & exercise therapy have to be done in the control for NIDDM patients. But the control of DM is dependent on how much the patients practice it. Therefore authors surveyed knowledge & practice about DM diet & exercise of NIDDM patients.

Methods : We serveyed 104 NIDDM patients who visited family medicine outpatient offices of two tertiary hopital & internal medicine outpatient office of one secondary hospital located in Seoul from June, 1994 through september, 1994. The questionnaire consisted of the patient's general charac-teristics, family environment, attitude toward DM management, exercise, diet education knowledge and degree of practice.
Result : The patients consisted of 58(55.7%) men and 46(44.2%) women. The mean age of men patients was 53 years, and that of women patientswas 56 years. The average duration of the disease was 4.4 year. The number of patients who had participated in DM education was 56(53%). The number of patients who thought the diet therapy was important was 86(85%) The patients who thought it was not important was 4(3.9%). Those who didn't think about it was 11(10%). The number of patients who thought the exercise was important was 92(90%). The patients who thought it was 7(6.8%) The number of patients who practiced diet therapy well was 13(12%). The patients who didn't practice it well was 89(88%). The most common reason why they didn't practice was that it was too hard to practice actually. The number of patients who exercised well was 36(34%), and who didn't exercise well was 67(64%). the most common reason why they didn't practice it was that it was too bothersome to exercise. In the cases of family members concerned to the patients management, the patients practiced diet well. But it was not related with DM education, knowledge about DM and academic background of patients. In the cases of family members' concern with the patients management and in the cases of men, the patients patients practiced exercise.

Conclusion : Nearly half of NIDDM patients never participated in DM education. The patients knew well about how immportant DM diet & exercise was, but they didn't practice it. therfore reinfor-cement in education programs for behavior modification is needed. support from family menbers is needed because their role in managment of DM patient is important.

Background
: Currently in 1995, Fall, there were PC communication programs about health infor-mation service, health counselling or self-investigation, and so forth to try medical contacts for the benefit of public. furthermore by the environmental and methodological limists of PC communication, we didn't acquire systematic classification of what users want and what they want to know. And we didn't have basic information for their sex, age, occupation, neighborhood, educational background and so on. Therefore in spite of a lot of efforts and inerests, health counselling and medical counselling systems by PC communication did not achieve corresponding effects. To establish more effective medical counselling system, we attempted to summarize and analyze the basic investigation on the users and their major concerns.

Methods : This survey analyzed the contents of health counselling cases form 24, march, 1994 to 7, June, 1995. NO 21 'Welcome to Medical Information', the name of medical counselling program of kangnam CMC medical system, was programmed under Chun-ri-an PC communication.
Result : For 408 days, the total number of user's questions wre 1712 cases : The average was 4.2 cases, is a day. among 1712 cases, 328 cases was not available because they are empty forms. Thus, we analyzed other 1384 cases.In regional analysis, seoul marked 34.3% by 475 cases. In age analysis, the twenties(20~29) marked 52.5% 9average was 28). Men/Women rate was 2.1:1. Men outnumbered women, In educa-tional background analysis, students cerord first (24.7%), hosewives,second(10.0%), and salaried men, thired(8.9%). We analyzed the user's inquriries by ICD-10. Among the inquiries, a719(nonspecificcounselling) was the most frequent cases(19.8%). And R53(malaise and fatigue) and R51 (unspecified chest pain) record as 3.4% each.In main classification of ICD-10, 'XVIII. Symptoms, sign and abnormal clinical and laboratory findings (R00-R99)' recorded 369, cases(27.1%), 'XXI. Fasctors influencing health status and contact with health services (Z00-Z99)' recorded 340 cases(25%) The average rate of answering questions was 81.9%. The users recorded high rate of more than 99% in answering the questions about age, sex and educational background.

Conclusion : In conclusion, this analysis showed that university graduate men of 20s in Seoul was main use in this PC health counselling program. They mainly asked on unspecified symptoms, sign, clinic, and investigations of abonormal findings They showed high interest and enthusiasm on PC counselling according to their responsrate and contents. However, the PC program did not meet completely the users's satisfaction because of the immaturity and non-preciseness of the question. Therefore, throngy objectification of the method of questionnaire, statistical process, and systematization d should develop the medical counselling service.

Background
: Upper gastrointestinal (UGI) symptoms, which are shown by various aspects, are very frequently met on family practice fied, and the diagnostic method has been dependent mostly on endoscopic with or without biopsy. As the patients who needed eddoscopic diagnosis with biopsy owing to complaining various UGI symptoms, we urveyed mutual correlations in order to refer the data in practical field focusing on following items ; sex, age, symptom, duration, lesion site distribution, and sensitivity/specificity/pre-dictive value of endoscopic diagnosis according to confirmation with endoscopic biopsy

Methods : A clinical analysis was carried out on 673 patients taken the endoscopic biopsy who ahve UGI symptoms from April 1991 to July 1994 in department of family medicine, Keimyung University College of Medicine. The sex, age, symptom, duration, lesion site, endoscopic/pathologic diagnosis distribution and correlation of each variable were surveyed.

Results : 1. Of the toal 673 cases, the ratio of male to ffemale was 1.7:1 and the age distribution was in the order of the fifties, forties, thirties and sixties. The symptom distribution was in the order of hunger pain, epigastric soreness, dyspepsia, postprandial pain and fullness. The symptom duration of gastric cancer was 99.5 weeks which was significantly longer than those of gastritis 74.5 weeks and gastric ulcer 73.4 weeks. The most prevalent sex of gastritis, gastric ulcer, gastic cancer was all male, and male to female ratio was 1.7:1, 1.7:1, 2.1:1, respectively. 2. For gastric lesion according to pathologic diagnosis, the gastritis was found in 369 cases(54.8%), followed by gastric ulcer 239 cases(35.5%), and gastric cancer 65 cases (9.7%) For the site distribution of pathologic diagnosis, gastric ulcer, and gastric cancer were in the order of antrum, pylorus, angle, body, respectively all. 3. For the sensitivity and specificity of the gastritis, ulcer, and gastric cancer by endoscopic diagnosis according to pathologic diagnosis, it was repectively 77% and 88%, 86% and 78%, and 58% and 97%, and the positive predictive value was respectively 89%, 69%, and 69%, and the false positive value was respectively 12%, 22%, 3%.

Conclusion : The authors in family practice field conducted endoscopic diagnosis with biopsy on 673 patients and studied the sensitivity, and predictive value of endoscopic diagnosis according to the pathologic diagnosis by lesion site biopsy. For the patients complaining the UGI symptoms, since the endoscopic diagnosis with biopsy conduc-ting family practice field solve their problems and improve the compliance, it is necessary to make and extensive study and obtain profound experience on endoscopic diagnosis.

Background
: Gastric cancer is the most frequent life threatening cancer in Korean and early detection is important because five-year survival after resection of early gastric cancer is quite more frequent than that of advanced gastric cancer. Unfortunately there are rarely symptoms associated with early stage gastric cancer. Practical mass screening and periodic health examination are important to facilitate early diagnosis.
In the this study, we compared medical care utilization and preventive health examination between early gastric cancer patients and advanced gastric cancer patients.

Methods : We reviewed 94 early gastric cancer patients and 97 advanced gastric cancer patients from my 1993 to June 1995 by self-administered questionnaires. we compared chief complaints associated with gastric cancer, perceived severity of chief complaints, duration of symptoms before hospital visit, early management behaviors for the chief complaints and health examination frequency between two groups.

Resultsy The most common chief complaint was epigastria pain in both group. and there was no significant difference between two groups. but advanced gastric cancer group perceived chief complaints more seriously than early gastric cancer group.(P<0.05) Early gastric cancer group visited hospital earlier than advanced gastric cancer group for the management of chief complaints.(P<0.01) The most frequent early management behavior was hospital visits in early gastric cancer group. In advanced gastric cancer group, drug store visit was the most common early management behavior. In 3 or more health examination frequncy, early gastric cancer group had more frequent health examination than advanced gastric cancer group.

Conclusion : Early gastric cancer group had appropriate medical care utilization in relation to the symptom duration and to the early management behaviors. Periodicity and regularity of health examination is important for the early detection of gastric cancer.

Background
: Measurement of VO2max(aerobic capacity) in one of the essential components in exercise prescriptionn for health promotion and maintencance, but direct measurement of VO2max is often not feasible in primary care settings. Therefore, many procedures for estimtion of VO2max have been developed. This study was conducted to determine the reliability and validity of submaximal cycle ergometer test in estimating aerobic capacity in young adults.

Methods : 20 make medical sutdents, mean age 23.5 years(range,22~25 years) were recruited as volunteers for this study. 5 students who had smoking history or mild anemia anemia were excluded in the analysis. submaximal cycle ergometer test was conducted 2 times over two-week period to examine the text0retest reliabilty of it. Validity was assessed by studying the relationships of VO2max estimated by submaximal cycle ergometer exercise test to VO2max measured by maximal cycle ergometer exercise test. All data were analysed by using the statistical Analysis System package.

Results : 1) differences between timel and time 2 were assessed by using paired t-test and there was no significant difference between them, and the pearson correlation between the measurements of aerobic cpacity by submaximal exercise test assessed at each visit was 0.72 and 0.82 when expressed in l/min and ml/kg/min. respectively.(P<0.01) 2) The pearson correlation between VO2max estimated by submaximal cycle ergometer test and VO2max measured by maximal ergometer test was 0.69 and 0.73 when expressed in ml/kg min and l/min, respectively.(P<0.01) 3) There was positive relationship between VO2max and muscle power, flexibilty and vertical jump and negative relationship between VO2max and sum of skin fold and lipid profile. Statistical significance was obsereved only relationships between VO2max and each of flexibility, muscle power(rt) and serum total cholesterol.

Conclusion : It is suggested that submaximal cycle ergometer test can provide a good estimate of VO2max determined by maximal ergometer test in young, well-motivated subjects. Further studies for other age groups and female subjects are also necessary.