Background
: Korea is one of the endemic areas of viral hepatitis B, and 6-8% of general population are hepatitis B virus carriers. Although there have been little reduction in morbidity and infectivity of viral hepatitis B owing to newer vaccines and the effects of immunizations, there are some differences among physicians in managing hepatitis B virus infection, and guidelines have not been established. Therefore in this study, we investigated general practitioners' concept and the practical management of viral hepatitis B in comparison with the hepatologists'.

Methods : Information was obtained through questionnaires sent to 67 hepatologists and 400 general practitioners(general internists, general surgeons, family physicians, general physicians, and public health center managers) in Pusan during the 5 months from April to August, 1997. Overall respondents were 142(116 General practitioners, 26 Hepatologists), and the response rate was 32.9%.

Results : In general practitioners, the most commonly used serologic test for viral hepatitis was HBsAg/HBsAb(71.0%). 51.9% of subjects underwent anti-HBs test 3-5 months later after vaccination. The most common revaccination method for healthy non-responders of initial vaccination was 3 series of immunizations with the same vaccine of equal dosage(36.9%). 65.7% of subjects were tested for LFT every 6 months for chronic carriers, and 41.5% of them were advised α-interferon treatment for chronic active hepatitis patients only if the patients requested it. In comparison with general practitioners, hepatologists had a tendency to add anti-HCV test for the serologic evaluation of hepatitis(56.6% vs 26.2%), to limit age for vaccination(82.6% vs 54.1%), and to delay prescribing hepatotonics until the AST and ALT levels increased up to 2 folds normal(53.8% vs 39.1%). 38.5% of hepatologists did not recommend giving booster injection of hepatitis.

Conclusion : Practical guideline is necessary to manage viral hepatitis B patients.

Background
: The prevalence of adolescent obesity is so rapidly increasing in Korea that there are concerns not only for increased risk of adult obesity in the future, but also for psychosocial problems in this period. This study is to find out the psychosocial correlates of adolescent obesity such as demographic characteristics, concerns about body image and weight, self-esteem, depression, and the locus of control for obesity.

Methods : A total of 963(obesity, 433 ; normal weight, 530) among 8,209 students from schools that underwent survey of physical examination in Seoul were assessed with a self-administered questionnaire.

Results : There were statistically significant differences between the obese group(OG) and the normal weight group(NWG) in family structure(p<0.05) and economic status(p<0.01). Adolescents in a extended family were more frequent in the OG(14.3%), than in th NWG(9.4%). Those in the high economic status were less frequent in the OG(15.3%) than in the NWG(23.8%). Although almost all obese adolescents considered that they were fat, normal weight students did not view themselves as they really were(p<0.001). That is, 57.5% of the NWG thought that they were either fat of thin instead. The majority of the OG was not satisfied with(86.4%) and worried(88.0%) about their weight(p<0.001), and these aspects were more remarkable in women(p<0.001). The total self-seteem score in the OG was higher(p<0.001) than the NWG, and the depression score was lower in the OG than the NWG(p<0.001). Higher scores for powerful others and chance in th OG than those in NWG were shown(p<0.001). The psychosocial aspects which were highly associated with obesity were self-esteem in peers(odds ratio=1.547) and school(odds ratio=2.041), and powerful others(odds ratio=2.181) and chance(odds ratio=2.367) locus of control for obesity, and less probable characterisrics were depression(odds ratio=0.723) and high economic status(odds ratio=0.498).

Conclusion : Obese adolescents neither had low self-esteem nor were they depressive to the contrary of belief in the general public. Since they were not satisfied with and worried about their body weight, however, there is a need to change our misconception of obese people who may risk unhealthy weight reduction. Further studies using various insrtuments and reinforcing internality for management of obesity would be needed to deeply understand the psychosocial correlates of obesity.

Background
: Research is essential for the development of family medicine as a professional field in primary care, Since information is available through the articles in the Journals of Family Medicine which contain subjects such as disease mechanism, pathophysiology, drug or new treatment method, and it is necessary to evaluate the contribution of recent researches in this field. The paper is intended to evaluate the current status of the quality of papers published in the Journal of the Korea Academy of Family Medicine (below JKAFM) and provide statistical data & direction of studies in the future.

Methods : 1218 articles in 185 editions of JKAFM were analyzed among 188 editions published from Nov.1980 to Dec. 1996. The papers were classified into Case Report, Original Article, Review Article by the type of papers, and then categorized into descriptive studies, analytic studies, and clinical trials by its methodology. In each category, the papers were stratified by the topic. Also, the analysis was conducted according to the authors, research subjects, sampling methods and the statistical methods, and observed the changes each year through 1980s to 1990s.

Results : The portion of original articles has increased from 18.6% in 1980s to 73.9% in 1990s. In terms of research methodology, the portions of analytical studies and clinical trials occupy 28.8% and 2.1% in 1990's respectively, compared with those of 1.8% and 0.6% in 1980's. When the papers were stratified by study topics, topics on family medicine showed the highest of 34.9% of the total. According to the detailed stratification, the principle of family medicine recorded 24.2%. In terms of sampling method, 89% and above was from the clinical data when current data were used, and 69.1% was by questionnaires when the data were newly collected. The most of the study subjects were outpatients of family medicine departments. The portion of papers in which the statistical analysis was not included was 29.9% in 1980s which decreased to 15.7% in 1990s. In terms of the statistical analysis methodology, the Chi-square test was the most frequently used(26.2%), followed by Descriptive(19.6%), t-test(18.2%) and ANOVA(8.7%) were the next.

Conclusion : The academic performance of family medicine can be most effectively measured by the analysis of the journals on family medicine. According to the analysis, the papers based on clinical activity is increasing in recent years with substantial contribution, which means that the field of family medicine has found its own position in medical science and is developing actively. In terms of study methodology, the portion of analysis study is getting larger, and the various method are being tried. The application of statistical methods is being developed in its quality and quantity. It should be noted that research on family medicine should provide the basis for new knowledge and promote public health by the integrated and intensive efforts.

Background
: Liver disease is an important public health problem in Korean. The aim of this study was to estimate the prevalence of hepatitis C virus antibody(anti-HCV) in the adult population of Ulsan and to identify risk factors for HCV infection by case-control study.

Methods : The anti-HCV test was performed in 10,140 adults older than 20 years of age who underwent a general medical checkup in Ulsan University Hospital, Health Promotion Center from January 1997 to November 1997. 33 cases and 99 controls matched for age and sex with a 1:3 ratio of cases to controls were enrolled. The cases were defined as positive anti-HCV and positive HCV-RNA whereas the controls were negative anti-HCV, negative HBsAg and ALT ≤40. Exposure data were obtained by self-administered questionnaire.

Conclusion : The overall prevalence of anti-HCV was 1.3% and true prevalence of HCV infection was 0.45% in the adult population of Ulsan. Transfusion was the major route of transmission of HCV but the risk will likely reduce.

Background
: Research of clinical contents and proper development of education program is essential in family medicine. Therefore, this study is carried out to obtain data for residency training, and to provide references to family physicians who give primary health care in rural community by analyzing prospectively the clinical contents of new patients in a local family practice clinic.

Methods : The authors visited family practice clinic in a rural area practiced by a family physician board certified in family medicine. There were 3,126 new patients from Jan. 1996 to Dec. 1996 evenly distributed by month and area, 1,000 patients were sampled randomly and the collected data were classified according to the ICPC(International Classification of Primary Care) coding system.

Results : Among the selected 1,000 patients, males were 432(43.2%) and females were 568(56.8%). Age distribution was highest in the fifties(50-59 years old)(20.7%). The total number of Reason For Encounter(RFE) was 1,417, the average RFE was 1.41 per patent, and the kind of RFEs was 93, among which cough was the most frequent RFE by 233 cases(16.4%). The 87 kinds of diagnoses were used and URI(Upper Respiratory Infection) accounted for the major portion by 287 cases(21.9%). The diagnostic examination per patient was 0.42. The most frequently used test was X-ray of an extremity by 68 cases(16.1%). Referrals to other departments were made in 3.3% of visitors of which Internal Medicine was highest(39.4%).

Conclusion : The clinical contents were classified more comprehensively by using ICPC with given code RFE, care process, and diagnosis. More study on ICPC is necessary for classification to help analyze clinical contents in primary care.

Background
: Cigarette smoking is a major risk factor for cardiovascular disease and a correctable risk factor. In middle and old-aged men, cardiovascular disease is in prevalence than at any other age. Most smokes, start smoking in their twenties and continued to do of that in middle and old aged men, especially in young-and middle-aged men. We examined the association between smoking and their level of plasma lipids.

Methods : Subjects were 238 healthy male non-smokers and 238 male smoker of 21-45 years of age, age matched, and were comparatively observed from May 1 to November 30, 1997 in a university hospital, Taegu, Korea. Subjects were interviewed by a research doctor who recorded subject's sociodemographic data, drinking amount, exercise, smoking status and smoking amount. We checked the level of serum total cholesterol, HDL-cholesterol, triglyceride on a fasting state and BMI.

Results : The results showed that smoking had a remarkable influence on HDL cholecterol, triglyceride, atherogenic index(ratio of total cholesterol to HDL cholesterol) between HDL cholesterol of smoking group in 31-35 year age group were obviously lower than nonsmoking that age group. The level of triglyceride in 31-35, 41-45 year age group were obviously higher than same nonsmoking groups. Atherogenic index in 31-35 year age group was obviously higher than nonsmoking that age group. But, no association between cigarette smoking and level of plasma total cholesterol was observed. HDL cholesterol, triglyceride, atherogenic index were significantly different beyond 11 pack-years or 20 cigarettes/day smoking groups than nonsmoking groups.

Conclusion : Based on the these findings, it is recommend that smoking cessation strategies for perceived healthy third decade and fourth decade men build up. I suggest smoking cessation education should start in the early age as soon as possible.

Background
: Stress is found to have influence on physical and mental disorders, and also to daily life styles related to physical health and mental stress. There are many studies that concern the stress and coping response and the relationships among physical, mental disorders and stress. But relationship between stress and life styles have seldom been investigated. Therefore, we investigated the relationship between stress and life styles.

Methods : From June 2, 1997 to June 30, 1997, we selected 463 businessmen we who had undergone regular health screening SUN hospital as subjects of the investigation in the survey on life styles included diet habit, salt ingestion, meat ingestion, alcohol drinking, smoking habit, physical exercise, sleep disturbance, and stress perception was measured by Psychosocial Well-being Index(PWI).

Results : There was significant difference in diet habit according to age, marital status, education level, monthly income(P<0.01), and job tenure(P<0.01), salt ingestion according to monthly income and body mass index(P<0.05), alcohol drinking according to religion or none, smoking according to age, marital status, monthly income, body mass index(P<0.05), and religion(P<0.01), exercise according to age, education level(P<0.01), monthly income(P<0.01), job department, and job tenure(P<0.05), and sleep disturbance according to age, education level, body mass index(P<0.05), and monthly income(P<0.01). There was no difference in the average scores of PWI according to general characteristics. The average scores of PWI concerning about life styles showed significant difference in diet habit, alcohol drinking, smoking habit, exercise, and sleep disturbance.

Conclusion : The correlation of health habit and mortality rate has already proved. This investigation has showed that there is a correlation between life styles and stress. So, we concluded that it is the best way to keep the good health habit by stress control for health promotion and disease prevention.