Background
: The quality of specimen for Papaniolaou smear depends on the sampling methods of uterine cervix. This study was designed to test specimen adequacy and the de-tection of disease using tow cervical cytological sampling

Methods : pastic spatula plus Cytobrish and Cervex-Brush.

Methods : Research subjects were the examinee for screening for cevical cancer in Family Practice. Center and Health Promotion Center of University Hospital. Research sub-jects were classified to two groups randomly. 5 physicians used each device ar random. A group 80 test smples(plastic spatula plus Cytobrush) were compared with B group test samples(Cervex-Brush) for the presence rate of endocervial cells and specimen adequacy. The laboratory was blind to the sampling methods.

Results : The plastic spatula plus Cytobrush and Cervex-Brush were comparable in cap-turing in endocervical cells. But the capturing rates of both methods were high(over 70%). Both the pastic spatula plus Cytobrush and Cervex-Brush produced adequate samples, and the adequacy scores between two methods were not different significantly.

Conclusion : Use of the plastic spatula puls Cytobrush and Cervex-Brush produced ade-quate smear for interpretation.

Background
: It is necessary for most effective treatment of neoplasms to detect it in early stage. For the purpose we use many screening tests currently, however, the tumor marker have many limitations as a screening test for neoplasm. Nevertheless most of Hea-lth screening centers are using CEA as a screening test for neoplasm. So, we began this study for the assessment of validity of CEA as a screening test for neoplasm.

Methods : The subjects were 4265 persons who visited Health screening center of Kyung-hee Medical Center from July 1995 to June 1996. The number of elevated CEA among the subjects was 156. We evaluated the frequencies of factors known as etiologies of in-creased CEA. We followed up whether neoplasms were developed in normal CEA group. Through the random sampling of normal CEA group, 391 subjects were obtained for statis-tical analysis by SPSS/PC+. Immunoradiometric assay kit of Eiken company was used for gauging CEA level and normal level was less than 2.4ng/ml according to manual of manu-facturer.

Results : There was no significant difference of CEA according to sex, age. The factors that significantly affect CEA were neoplasms, chronic lung disease, liver cirrhosis. In this study, smoking, hypertension, diabetes mellitus, fibrocystic disease, chronic renal failure, al-cohol drinking, hepatitis, peptic ulcer disease known as etiologies of elevated CEA in other studies did not show statistical significance. 9 cases of neoplasms were developed in both elevated CEA and normal CEA group during follow up. In former, 4 cases of 9 neoplasms were early stage. In latter, all cases were stage IV and inoperable. Specificity and sensitiv-ity of CEA were each 96.5%, 50.0%. Positive & negative predictive value of CEA were each 5.8%, 99.8%.

Conclusion : CEA was increased in various benign conditions and even if any neoplasm exists, CEA was not elevated in most of all in early stage. Is showed high false positive rate and low sensitivity. Thus, this study showed that it was not valid to use CEA as a screening test for early detection of neoplasms.

Background
: Fatigue is one of the most common complaints of primary care practices and consists symptoms of physical diseases and neurotic symptoms. This study was con-ducted to find that fatigue related to neurotic symtoms is an important as fatgue related to symptoms of the physical diseases itself. In addition to it, this study is to clarify and to understand the details of the neurotic symptoms.

Methods : In the course of six months(from April to september, 1996). the 73 subjects were selected among the people that visited the outpatient department of family medicine with symptom of fatigue. The control group was selected from the healthy population which matched nearly the same number as the fatigue group. As tolls of measurement, we used SCL-MPD consisted of 67 items. We performed statistical analysis among the data by means of SPSS/PC+. We analysed statistical data for significance using non-para-metric Mann-Whitny U test.

Results : There was no difference between the prevalence of men and women in the fa-tigue group. As the level of education decreased and employement increased, the proportion of patients that complained of fatigue increased. The fatigue group scored significantly higher than the control group in all questionnaire of SCL-MPD. The results of the somati-zation scale and phobic-anxiety were significantly high(p<0.01) and the rest of the scales were even more significantly high(p<0.001). Women scored higher in all aspects of SCL-MPD than men.

Conclusion : The author emphasize the importance of neurotic symptoms related to fati-gue and biopsychosocial approach towards the patient. Considering the increase in medical cost and the decrease in productivity due to fatigue, there needs to be a thorough study of fatigue.

Background
: Administration of hepatitis B vaccine has played a major part in the man-agment of public health in this country. There were many researches to assess the immunogenecity, safety, long-term ffectiveness, does, and route of administration of hepa-titis B vaccine. But there was lack of validation of the recommendation that hepatitis B vaccine should be administered in adults with negative HBsAg and AntiHBs, in an endemic area with high prevalence of HBsAg. Authors tried to establish a proper candidate for hepatitis B vaccination evaluating viral markers of hepatitis B in adults vaccinated.

Methods : 172 hepatitis B vaccinated-subjects(35.0%) were drawn from 491 adults who have visited at health care center, Asan Kangnung Hospital from April 1st to May 31th, 1997. They were asked designed questions about the beginning year, frequency of vaccina-tion, and the presence of family members with HBsAg in a direct line.

Results : Of the subejcts(172), 2.3% were HBsAg(+), 63.4% AntiHBs(+), 68.6% AntiHBc(+). Among the HBsAg(-) adults(149) who had been vacinated more than three times, 70.4%(105) were AntiHBs(+), of whom 66.6%(70) were AntiHBc(+) and 29.6%(44) were AntiHBs(-), of whom 56.8%(25) were AntiHBc(+). In the subjects(20) with family history of HBsAg, 80% were AntiHBc(+), which is higher than 61.2% in the group(129) without family history. Among the HBsAg(-) and AntiHBc(-) adults(54) who had been vaccinated more than three times, AntiHBs(+) group was not significantly different from AntiHBs(-) group in comparison of age and years after initial vaccination.
Conslusions: The two thirds(68.9%) of vaccinated subjects showed AntiHBc(+), which means reflection of previous exposure to Hepatitis B virus. Accordingly, vaccination is not thought to be required for these. Consequently, all individuals are thought to have to be pretested for the presence of AntiHBc as well as HBaAg and AntiHBs in Korea.

Background
: Hepatitis B vaccination schedule commonly used in Korea is divided largely into 0, 1, 2 month schedule vaccination group(0, 1, 2 group) and 0, 1, 6 month scheduled vaccination gorup(0, 1, 6 group). The only difference between two groups is the interval from 2nd dose to 3rd dose. This study had been carried out to find whether the difference of vaccination interval influence the vaccination completion rate or not.

Methods : Study objects are 135 persons over 20 years old who had hepatitis B vaccina-tion more than once in injection room of Dongkuk University Kyong-ju Hospital from Jan. 1st in 1996 to Dec. 31th in 1996. Data about vaccination completion were gathered form record book of injection room and telephone interview.

Results : Hepatitis B vaccination completion rate is 73.8% in 0, 1, 2 group and 72.5% in 0, 1, 6 group. The reasons for incomplete vaccination are forgetting vaccination date(36.4% in 0, 1, 2 group and 50% in 0, 1, 6 group), having no time to spare for vaccination(54.5% in 0, 1, 2 group and 43% in 0, 1, 6 group) and knowing positive HBsAb before completion of scheduled vaccination(9.1% in 0, 1, 2 group and 7% in 0, 1, 6 group).

Conclusion : There is no difference in Hepatitis B vaccination completion rate between 0, 1, 2 group and 0, 1, 6 group.

Background
: This study was performed to compare the effectiveness of cholesterol-low-ering diet therapy instructed by physicians with that instructed by dieticians using techni-ques that remove regression to the mean.

Methods : 118 patients who visited the office Family Medicine department in Pusan Paik Hospital from February to November, 1996 and had serum total cholesterol(TC) con-centrations greater or equal to 200mg/dL from two measurements were enrolled. The pati-ents were divided into two groups randomly according to the cholesterol-lowering dietary education

Methods : the one was educated by physicians(Group I), and the other by dietici-ans(Group II). We evaluated the differences of lipid levels after education in consideration of regression to the mean.

Results : The mean reduction in TC concentrations achieved by dietary therapy was 10.7% and 7.3%(without and with adjustment for regression to the mean) in Group I, and 9.8% and 6.5%(without and with adjustment for regression to the mean) in Group II. The baseline TC concentrations and TC concentrations after dietary therapy were significantly different in individual group regardless of adjustment for regression to the mean. However, the reduction degrees of TC concentrations were not significantly different between two groups.

Conclusion : The results indicate that even after adjustment for regression to the mean, dietary therapy will achieve the expected reduction. And it seems that the diet education by physicians will be effective as mush as that by dieticians.

Background
: A survey is the only direct way of determining the distribution of behav-ioral risk factors among a population. The department of Family Medicine in Seoul national university hospital adopted telephone interviewing for collecting information about behavior-al risk factors of Koreans. Because methodological aspect of telephone survey is different according to the telephone and communication environment of the area in which the sur-vey would be held, we tried to figure out adequate methodological aspects of a telephone survey on the behavioral risk factor in Korea.

Methods : We sampled telephone numbers from the telephone number database which is supported by Infornet Ltd. with stratified cluster random sampling method and selected re-spondent by using algorithm of Kish. 13 part-time job interviewers were trained for 6 hours and then interviews were made in a fixed area for the time assigned.

Results : 13 interviewers tried to do 1,826 interviews for 4 weeks. Sociodemographic characteristics of respondents were compared with the census estimates and another face-to-face interview and there were no significant differences. A response rate of 79.8%, re-fusal rate of 12.9% and interview efficiency of 58.1% were obtained, yielding 1060 comple-ted interview. A total of 28,830 person minutes of interview time were spent on the survey with an average of 27.2 minutes per completed interview.

Conclusion : Sampling method using the telephone number database could be used keeping the representativeness of the samples and telephone survey was considered to be reliable and affordable method for determining the prevalence of behavioral risk factors in Korea.

Background
: Gender and social relationships are believed to have a strong influence on health care attitudes and behavior. This study was designed to determine the effect of the gender of closely associated persons on the health care-seeking behavior of persons of the oppsite sex.

Methods : We developed a 10-item questionnaire that requested information on social and demographic characteristics, health status, and influences on the decision on seek hea-lt care, and administered it to 314 consecutive patients seen ar two family medicine clinics in Seoul. Data were analyzed by means of one way analysis of variance for continuous variables and the chi-square test for categorical variables. Additionally, data were analyzed by means of a multivariate logistic regression model that calculated odds ratios and 95% confidence intervals.

Results : Men were 4.6 times more likely to be influenced than women to seek health care by a member of the opposite sex(95% CI, 2.4 to 8.9).

Conclusion : Women make an important influene on the decisions for men to seek hea-lth care.