Background
: Family medicine was introduced into Korea in 1979 according to social needs of primary care physician of goods quality due to specialization and dehumanization of modern medicine, and became the 23rd specialty in Korea. More than 2,500 family physicians are contributing in the field of primary care, but it is still in shortage of covering the whole primary care fields in Korea. This study was designed to collect the data as basics for development of undergraduate education of family medicine in Korea.

Methods : We sent the author-made questionnaires to the professors in 32 medical colleges in Korea, excluding 5 medical colleges only with pre-medical course asking of number of faculty members, student lecture on family medicine, clerkship rotation in family medicine, evaluation method of stude-nts, current status and barrier of undergraduate education in family medicine, and also future expecta-tions of undergraduate education of family medicine in Korea.

Results : Of 32 medical colleges, 20(62.5%) had family medicine departments in the university hospitals and family medicine was mostly 1 or 2. Of 19 medical colleges having family medicine undergraduate education, 7(36.8%) provided family medicine lecture as an independent course, and the history of student lecture was rather short, mostly 1 to 3 years. Most of medical schools gave lectures to the students on sophomore of junior grade and the credit of family medicine course was 1 or less. The clerkship rotations in family medicine were provided in 11(57.9%) of 19 medical colleges. The evaluation methods of undergraduate education in family medicine mostly depended on the written examination(84.2%). To he questions asking the current status of undergraduate education in family medicine, 10 out of 19 answered negatively and 9 answered positively. The barriers of undergraduate education in family medicine would be lack of insight of administrators in the university, lack of cooperation by other departments, lack of a model for undergraduate educa-tion, and lack of effort by the family medicine department in rank order. Most of faculties, 14 out of 19, answered positively for the future of undergraduate education in family medicine.

Conclusion : Since family medicine has been introduced and settled in Korea for 17 years, facilities and current status are not enough to cover primary care in Korea. But the faculties evaluated the current status and future expectation positively. With the efforts to overcome the barriers of undergra-duate education of family medicine in Korea, undergraduate education program of family medicine will improve and family medicine will contribute to improve the health status of Korean people.

Background
: Body image distortion is found in eating disorder and obesity and there are some evidence that a few chronic diseases are associated with body image distortion. Diabetes Mellitus patient may have body image distortion because diabetes mellitus is well accompanied with weight loss. Some researches reported that there was some association between insulindependent diabetes mellitus with body image distortion, but there were no research between non-insulin-dependent diabetes mellitus and body image distortion.

Methods : From 1996 March to 1995 April, data were collected from 51 diabetes mellitus patients who visited one university hospital for management(patients group), and 51 sex, age, body mass index matched people who visited two university hospitals for medical examination. Body image was assessed by asking subjects' perceived actual body somatotype.

Results : Body image distortion between diabetic patient and normal person was not significantly different. When body image in diabetic patient was stratified with sex, age, BMI, weight change at beginning of diabetes mellitus, maximum body weight change, BMI and maximum body weight change were significantly associated with body image distortion.

Conclusion : Body image distortion in diabetic patients and normal person was not significantly different and the meaning was not clear.

Background
: It is well known fact that health behaviors affect one's health status. The purpose of this study was to know freshmen's health behaviors and the degree of practice, and to investigate the correlations of their health behaviors with their health state, family APGAR scores, family income, salt in foods, and so on.

Methods : A self-recorded questionnaires were administerd to 6150 freshmen who had taken physical checkup for university or college entrance in K Medical Center, from December 1994 to February 1995. We analyzed what they think important and the degree of practice. And we made statkstkca analysis of the family APGAR score, family income, subjective health status, past medical history, BMI, health foods, sex, salt in meals and health practice index by means of correlation and nonparametric statistics. We used the sum of eight items scores for health behaviors as health practice index.

Results : Number of male freshmen was 2982(48.5%), female was 3162(51.5%). Good practicing group in male was 13.9% compared to 16.4% in female. The family APGAR, salt in meals and subjective health state had significant(p<0.05) correlations with health behavior scale in both male and female. And BMI in male, age, family income, self breast examination in female had, correlations too.
Which they thought was important to maintain and promote health were regular exercise(92.1%), maintenance of balanced diet(90.4%), regular lifestyle(872%), proper sleeping and rest(85.9), maintenance of psychological comfort(84.1%), no smoking and no drinking(20.9%), regularly visiting hospital(7.0%) and eating health foods(3.5%). But only 11.5% of them exercised regularly, and 55.6% ate health foods.

Conclusion : In spite of their great concerns for regular exercise, a few of the subjects exercised and they preferred to take health foods for health. The health practice index was high in group of high family APGAR scores, those who regarded their health as goods and those who ate insipidly. Health state had significant correlations with health behvaiors in the freshmen group, so it is helpful to public health promotion to let them know this fact.

Background
: The mortality of coronary artery disease and cerebral vascular disease is increasing. The risk factors in the development of coronary artery disease is known as tobacco, hypertension, obesity, cholesterol, hyperlipidemia etc. The importance of lipoprotein(a) in the development of coro-nary artery disease is supported by the recent studies. The purpose of this study was to investigate the association of Lp(a) concentration and the other risk factor of coronary artery disease.

Methods : The concentration of Lp(a) was measured in 507 cases, free of disease and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by immunonephelometry.

Results : In men, Lp(a) were not associated with age. In women, Lp(a) concentration increased with age. If postmenopausal women were excluded, the relation between age and Lp(a) disappeared. Lp(a) levels had no relations with smoking, obesity, and hypertension.

Conclusion : These results suggested that Lp(a) level was a significant independent risk factor for coronary artery disease.

Background
: Despite of the medical importance and commercial value of adult immunization which is being embossed, immunization levels remain extremely low. One of the main reason for this may be physicians non-compliance and misinformation. The aim of this study is to provide reference data about primary physicians knowledge and attitude for adult immunization.

Methods : The questionnaire was composed of 29 items concerning physicians' knowledge and attitude for adult immunization and we mailed on November 26, 1995 to 1450 physicians of private clinics registered in Korean Medical Association in 1994, and then we analyzed 314(21.6%) question-naires which were returned to us within 3 weeks.

Results : Among 314 cases, according to their specialty, general physician 32(10.2%), internist group 166(52.9%), surgeon group 73 (23.2%), minority group 43(13.7%) in number. Recognition rate of each immunization was 95.2% for Hepatitis B, 87.4% for Influenza, 24.5% for Pneumococcs, 96% for Measles. Keeping rate was 83.4% for Hepatitis B, 72.6% for Influenza, 11.5% for Pneumococ-cus. In surgeon group, keeping rate of Hepatitis B vaccine was 85.3%, Influenza vaccine 54.7%. 179(57.2%) physicians answered "absolutely need" of "much important" about adult Influenza immu-nization for healthy life and elderly internist Yubgroup tended to emphasize the importance. roung internist subgroup tended to know more indications. 85(27.1%) physicians have recommended the immunization actively to their patients and their major obstacle to recommendation was "patients' negative attitude" and in internist group, "can not convinced efficacy of immunization" in surgeon group, "out of my duty" in minority group. Only 40(12.7%) physicians answered "absolutely need" or "much important" about adult Pneumococcal immunization. Also, young internist subgroup tended to know more indications. Only 27(87.9%) physicians have recommended Pneumococcal immunization actively to their patients and their major obstece to recommendation was "can not be convinced efficacy of immunization" in internist group, "can not identify the indications" in surgeon group, "out of my duty" in minority group. As many as 247(78.7%) phyicians answered "absolutely need" the Hepatitis B immunization for healthy life and 243(77.6%) have recommended actively to their patients and 76.0% of surgeon, 65.0% of minorities also have recommended Hepatitis B immunization, and their major obstacle to active recommendation was "patients negative attitude"

Conclusion : Since the main body of practicing immunization can not be limited to internist, education for adult immunization should be provided to all physician regardless of their specialty. Various adult immunization education programs are essential to eliminate patients negative attitude which, in turn, may improve physicians recommendation rate.

Background
: In general as a mass screening test for pulmonary disease, the indirect chest X-ray has been used. But recently the use of that is being replaced widely by the direct chest X-ray, because of the applicant's distrust for the former and preferring tendency for the later. This study was carried out for the basic data for considering the best screening tools.

Methods : The subjects were 200 who had abnormal finding of the indirect chest X-ray on the periodic health examination at Sungae general hospital, and then who took the direct chest X-ray for further evealuation in 1994.

Results : The thirtieth were 73(36.5%) and men were 172. On the results of indirect chest X-ray, the pulmonary tuberculosis was 42.5%, the non-tuberculosis pulmonary disease 51.0%, the circulatory disease 3.5%, and the undetermined 3.0%, That of the direct chest X-ray revealed that normal finding was 85.0%, the pulmonary tuberculosis 2.0%, the non-tuberculosis pulmonary disease 8.0%, the circulatory diseases 1.0%, and the undetermined 4.0%.
The cost difference of both methods was approximately one million won in this study. The amount of radiologic exposure by analyzing the film badge exposured experimently was 408 rem in indirect and 17 rem in direct.

Conclusion : Considering the very low concordance rate between positive findings of direct and indirect chest X-ray, their cost-benefit aspects, their amount of radiologic exposure, and the difficulty in follow-up of indirect chest X-ray, we suggest that the selection of the direct chest X-ray as a screeing test for pulmonary disease will be considered.

Background
: This study was performed practicing primary care and was intended to find out their common disease types, contents of life change events, amount of stress and family functions among adolescent patients visiting outpatient departments of family medicine. It can develop an app-roach to adolescent patients and provide basic data to evaluate associations between disease and stress.

Methods : Self-administered questionnaire consisting of reasons for visits, 45 life change events and 20 family functions was completed by adolescents aged 13 to 19 who visited 2 outpatient departme-nts of family medicine from Dec. 1993 to Aug. 1994 while they were waiting to see their family docotrs.

Results : Of the total 184 subjects, males were 111 and females were 73. The most common reason for visit was physical complaint and the most common symtom was headache. The most common diagnosis was functional gastrointestinal disease. The most frequent life change event was 'easy distraction due to day dreaming and spurious thoughts.' 'School problems and anxiety about carrier planning' was the most frequent category among 8 categorized life change events. 'Death of sibling' and 'acquiring visible deformity' received the highest scores in life change units. The most common family function type was categorized as rigid in adaptability and disengaged in cohesion. Balanced families were 13.3%, - mid-range 50.0%, and extreme 36.7%, respectively. There were no differences between groups with or without some diagnosis of physician in numbers of life change events, amount of stress and family functions.

Conclusion : Most of the adolescent patients' diseases in this study were problems that could be managed in priamry care, and many of them required biopsycosocial approaches. The assessment of life change events, amount of stress and family functions of adloescent patients in the outpatient department is considered to be helpful to understand adolescent patients.

Background
: Most of the Poisonous snakebites occurs during summer time and in rural area. Mortality from poisonous snakebite is low but some develop serious complications or even die. Because many authors have different opinions how to treat snakebites, especially regarding the use of antivenin, we have conducted this study in order to review the indicators that can predict the severity of snakebites, and to examine to effectiveness of antivenin.

Methods : From January, 1990 through December, 1994, 178 patients were admitted for treatment of poisonous snakebite. Reviewing theses patients' medical records, incidence of occurrence in accorda-nce with sex, age, and season, local and systemic symptoms and signs, and abnormal laboratory findings, were investigated. Seven randomly seleced prognostic indicators-patient age and sex, bitten month, time of day bitten, bitten site, time of arrival at hospital after biting, and use of constricting band-were used to compare patients' severity. In addition, patients' severity and period of hospotaliza-tion with respect to patients who received antivenin and those who did not were also compared.

Results : Of the 178 patients, the number of female patients was larger than that of male patients, in the ratio 1.5 to 1.0. Most patients were in their 50s, and most bites occurred during. July and August. Pain around the bitten area was found in 172 patients(96.6%), and proved the most common local symptom. Of systemic symptoms, dizziness was the most common, found in 64 patients(36.0%). Of obnormal laboratory findings, leukocytosis was most frequently encountered, affecting 55 patients(30.9%). In analyzing correlation between prognostic indicators and severity, patient age(P<0.01) showed significant differences. In addition, the group which received antivenin showed significant differences with regard to severity similarly showed significant differences with regard to period of hospitalization(P<0.05 for minimal and severe cases; P<0.1 for moderate cases).

Conclusion : Older patients, and those bitten in the upper limbs rather than in the lower limbs are predicted to have greater severity. Thus, such patients need more intensive observation and treatment. All snaka-bitten victims must be transferred to a hospital as rapidly as possile; and administration of antivenin should be actively considered for those who show symptoms of envenoma-tion.