Background
: Because dementia tends to be underdiagnosed. Solomon PR developed a brief neurocognitive screening battery to identify Alzheimer's dementia. The 7-Minute Screen consists of four individual tests (orientation, memory, clock drawing, verbal fluency). It can be rapidly administered and it may be appropriately used in the primary care setting. We attempted to develop a screening tool of dementia based on the 7-Minute Screen at primary care setting in Korea.

Methods : We adapted the 7 Minute Screen to the Korean version of 7 Minute Screen(7 MSK). 7 MS-K and MMSE-K were administered to 61 elderly people who visited the Sungbuk Public Health Center. Inter-rater reliability and test-retest reliability were evaluated.

Results : The 7 MS-K has a sensitivity of 92% and a specificity of 92% for cutoff point of MMSE-K 23/24, Inter-rater reliability and test-retest reliability for the entire battery was very high(both r=1). Mean time of administration was 10 minutes.

Conclusion : 7 MS-K has a reasonable validity, reliability and can be administered in a brief period, and requires no clinical judgement and minimal training. It may be a useful tool for screening dementias in primary care setting.

Background
: Although institution of the no-smoking areas have been required in hospitals since 1995, It has not been evaluated. This study was conducted to assess the effectiveness of the current no-smoking areas, and to collect employee's opinions about no-smoking policy in th hospital.

Methods : The self-administered anonymous survey was distributed to all employees of a university hospital in January 1999. Respondents were asked about their smoking status, awareness and compliance of the no-smoking areas, perception of tobacco smoke during work, preference for the type of no-smoking policy. Differences in outcome vairables' distribution by sex, smoking status, and occupation were analyzed using x² analysis.

Results : The overall response rate for the survey was 65.3%(670/1026). Among the total, 77.9% were females, and mean age of the respondents was 31.6 years(±80). While the overall smoking prevalence was 10.6%, men's prevalence was 46.6%. Although the awareness of the no-smoking areas was high in most areas, the rate of which all of the 10 no-smoking areas had been well kept was only 15.2%, 47.% of non-smokers reported that they could still smell some tobacco smoke while on duty. While 65.5% agreed on the opinion that penal regulations should be strengthened in order not to violate no-smoking areas, only 32.1% agreed on the current policy without penalty. 80% of smokers replied that they would follow the strict no-smoking policy.

Conclusion : The current no-smoking areas was not well observed. However, most employees wanted the no-smoking policy with penal regulation. Therefore, this survey could provide a solid foundation to implement a strict no-smoking policy.

Background
: Compared to Europe and America neurotic chest pain patients seems to be much more prevalent in Korea. This study was designed to depict various neurotic symptoms of patients with inorganic chest pain.

Methods : In the course of one year(from March, 1997 to March, 1998), 70 subjects were selected among the people who visited the outpatient clinic of department of family medicine with symptom of chest pain. The control group was selected from a healthy population which matched nearly the same number as the chest pain group. Patients were tested by EKG, treadmill, chest X-ray, 2D-UCG and requested to answer SCL-MPD questionnaire. Statistical analysis by means of SPCC/PC + and for significance using non-parametric Mann-Whitney U teat was done.
Result : The chest pain group scored significantly higher than the control group in obsessive and compulsive, anger-hostility, depression, anxiety and somatization scale. Male chest pain group scored higher in somatization, anxiety, obsessive- compulsive, hypochondriasis, and depression scale. The female chest pain group scored higher in depression scale.

Conclusion : Many inorganic chest pain patients complain through various neurotic symptoms. When approaching chest pain patients we should consider the possibility of a psychosocial cause.

Background
: Although elevated serum cholesterol level has been considered as a significant health problem because it is associated with coronary artery disease, the relation with various health problem (esp. depression) from low serum cholesterol is not well known in Korean people. The authors tried to observe the degree of depression in low serum cholesterol group for its better management.

Methods : The study population was selected among adults who visited the National University Hospital Health Screening Center between May and July 1998. They had no history of cancer and liver disease and no significant medical illnesses which may affect blood cholesterol level. Using the Korean standard BDI, we evaluated the degree of depression scale.

Results : The number of subjects with low serum cholesterol was 77 (males 42, females 35) and that of the control group was 82 (males 47, females 34). The low serum cholesterol group had a statistically significantly higher BDI score(12.2±8.2) than the control group(7.6±6.3) (P<0.05). In males the mean BDI score of 11.9±7.4 in the low serum cholesterol group was significantly higher than the mean score of 5.0±3.8 in the control group(P<0.5), In females, there was no significant difference in depression scale between both groups.

Conclusion : Since the male low serum cholestrerol group had a high depression scale, the multi disciplinary approaches which include psychological supports may be required to manage and treat them. And persistent, significant association between low serum total cholesterol level and psychological problems suggests that further long-term study on the association of low choleserol with depression is necessary.

Background
: The positive effects of hormone replacement therapy (HRT) on the skeleton in postmenopausal women are well defined. However, the effects of vitamin D supplementation on BMD in postmenopausal women are controversial. But many women, who are contraindicated to HRT or afraid of side effects of HRT or are already on HRT regimen, take calcium plus vitamin D supplement for prevention of osteoporosis. Therefore, this study was designed to examine the effect of vitamin D supplementation on BMD in postmenopausal women and to determine whether vitamin D supplementation can give additional benefit to HRP.

Methods : Subjects were 109 postmenopausal women out of total 213, who visited the Sacred Heart Hostpital, Chuncheon and had followed up BMD study one year after during January, 1996 to May, 1999. The study group was as follows : No treatment (n=31) ; Vit D (n=11) ; HRT (n=50) ; HRT+Vit D (n=17). We compared and analyzed the changes of BMD in the region of lumbar spine (L2-4) and femur (femoral neck, trochanter, Ward's triangle). SPSSWIN 7.5 was used for statistical procedure.

Results : Subject had a mean age of 54.4±5.7 years, mean menopausal age of 48.4±2.4 years, mean postmenopausal duration of 6.1±4.1 years, and mean body mass index of 24.1±2.8 kg/m2. No correlation was observed between general characteristics (age, menopausal age, postmenopausal duration, and body mass index) and changing rate of BMD. Lumbar BMD had increased by 1.83% in the Vit D group, by 1.95% in the HRT group and by 3.15% in the HRT+Vit D group, whereas it had decreased by 1.99% in the no treatment group. The increase of femoral neck BMD in the Vit D group was 1.5%, in the HRT group 0.66%, and in the HRT+Vit D group 2.09%, but the loss in the no treatment group was 1.65%. The changes of trochanteric BMD were as follows: No treatment group(-2.49%), Vit D group (0.04%), HRT group (1.48%), and HRT+Vit D group (-4.09%), Vit D group (1.17%), HRT group (-0.01%), HRT+Vit D group (0.16%). In the Vit D group, except for the trochanteric area (P<0.05), there was a significant increase in BMD of L2-4, femoral neck, and Ward's triangle (P<0.05) whereas in the HRT group and HRT+Vit D group significant increases were observed in all areas (P<0.05). But there was no significance among Vit D group, HTR group and HRT+Vit D group.

Conclusion : This study confirmed the beneficail effect of HRT on lumbar and femoral BMD. It also showed that low dose Vitamin D supplementation had effect in the prevention of osteoporosis in postmenopausal women, In the HRT+Vit D group. BMD had increaed more than HRT alone, but does not give benefit additional to that of HRT alone.

Background
: With increase in the prevalence of obesity in recent years, much interest has focused on obesity nowdays. Inerease in abdominal fatness and there is some possibility that smoking has effect on obesity. We evaluated the influence of smoking on abdominal fatness.

Methods : This study was carried out on 475 individuals who visited the Health Promotion Center in Youngnam University Hospital in May, 1999. The subjects were checked on age, sex, life style (smoking, drinking, physical activity, exercise, etc.), past medical history, blood pressure, height, weight, waist circumference, hip circumference, body fat percent and other obesity indexes.

Results : In men, waist circumference(P<0.01), body fat percent (P<0.05), waist hip ratio (P<0.01) were significantly increased according to the amount of smoking after adjustment for BMI, age, alcohol intake, exercise and physical activity. But, the waist circumference, waist to hip ratio and percent body fat of mild smoker were rather shorter than that of the non-smoker or on who abstained from smoking.

Conclusion : In men, it seems that obesity index of abdominal fatness may be significantly high in moderate to heavy smokers and low in mild smokers.

Background
: The first step for the recovery of alcoholics is the formation of true insight which enables them to admit that they are alcoholic. This study was designed to analyze the changes in insight status by treatment programs.

Methods : The subjects were 214 alcohol dependents who participated in the insight-oriented treatment programs for at least 1 week. Their insight status were measured through HAIS before and after treatment.

Results : Of 214 sjbjects, 83(38.3%) were in poor-, 103 (48.1%) in fair-, and 28 (13.1%) in good-insight before treatment, and 56 (26.2%) in poor-, 97(45.3%) in fair-, and 61(28.5%) in good-insight after treatment. Mean HAIS scores of the subjects were 5.35 (SD=8.04) after treatment. The magnitude of insight-improvement was negatively correlated with the HAIS scores before treatment in poor-insight group and positively correlated with the duration of participation in treatment in fair-insight group.

Conclusion : We confirmed the fact that the insight status of patients could be improved by treatment. It was also suggested that the therapeutic strategy needed an individual approach according to the insight state of a patient.

Background
: For Chronic HBsAg-positive patients are a well-known high risk group of primary liver cancer necessitation periodic follow-up examination. This study was performed to evaluate the effectiveness of a reminding letter on the compliance with scheduled follow-up examination in chronic HBsAg-positive patients.

Methods : A randomized controlled clinical trial was conducted at a Family Practice Clinic in Samsung Medical Center located in Seoul from February 1998 to January 1999. A total of 178 HBsAg-positive patients who had no other clinical illnesses and were scheduled to take follow-up examination were randomly assigned to a control (88 subjects) and a letter reminder group (88 subjects).
The outcome measure and attendance at the scheduled follow-up examination were determined through the medical chart review and telephone. Demographic and clinical characteristics were checked through the medical chart review.

Results : The attendance rate was 62.2% among the 82 patients who were actually receiving the letter reminders. Compared to the attendance rate of 37.5% among the control group, it was significantly higher. Even after controlling the demographic and clinical characteristics through the multiple logistic regression analysis, the letter reminder was significantly related to the increased compliance for a scheduled follow-up examination. Frequency of previous visit was also positively related to increased compliance.

Conclusion : These results suggest that the letter reminder can significantly improve compliance with a scheduled follow-up examination in HBsAg-positive patients.