Background
: The role and future of family physician are not yet clearly determined even when 20 years lapsed since its introduction to korea. This study was conducted to establish identity of family physician, to develop pragmatic. curriculum of training, and to sort out frame of certification exam by analysing the job of family physicians who were practicing in community.

Methods : We analysed the job of practicing family physician by using DACUM(Development of Curriculum) method from March 11, 2000 through March 12. Job analysis team was composed of five practitioners, four professors, one facilitator, and one scriber. Six sessions of 2 hours were mainly devoted to brain storming of the idea related to family physician.

Results : Job analysis results are as follows. Family physician was defined as "primary care physician who provides primary medical service continuously and comprehensively by offering individual patient and/or family health promotion, disease prevention, and treatment of common illness". Family physician had seven duties and 129 tasks. The duty of physical exam had 18 tasks, duty of test, 21 tasks, duty of treatment, 40 tasks, duty of health promotion and disease prevention, 15 tasks, duty of patient/client, management, 12 tasks, duty of clinic management, 15 tasks, and self-development, 8 tasks respectively. Number of tasks whose impotance was classified as 'A'(very important) were 43 as total, 3 in physical exam, 7 in test, 9 in treatment, 11 in health promotion and disease prevention, 2 in patient/client management, 9 in clinic management, and 2 in self-development respectively. Number of tasks whose difficulty was classified as 'A'(very dif-ficult) were 19 as total. 2 in physical exam, 7 in test, 7 in treatment, 1 in clinic management, and 2 in self-development respectively. Number of tasks whose frequency was classified as 'A'(very frequent) were 22 as total, 6 in physical exam, 1 in test 8 in treatment, 3 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively. Number of tasks which were required for entry level were 74 as total, 18 in physical exam, 14 in test, 29 in treatment, 9 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively.

Conclusion : Family physicians in Korea perform 7 duties and 129 tasks. Seventy four tasks are required to enter into the job.

Background
: There are very few cohort studies on the hypertension in family practice. In order to investigate epidemiological characteristics of hypertensive patients and assess the safety and tolerabiliy of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out.

Methods : A total of 1,181 patients were observed from July 1997 to August 1999. At 2,4,8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment is continued and development of any adverse reactions.

Results : Calcium channel blockers(CCBs) were the most commonly prescribed initial drug class(44.2%) in family practice, followed by angiotensin converting enzyme inhibitors(ACEI) (21.0%), angiotensin II receptor antagonists(ARA) (11.8%), B-blockers(9.6%), a-blockers(3.9%), and diuretics(3.6%), During the first 12 weeks, the percentage of subjects continuing their initial ACEIs(40.7%) was substantially lower than the percentages that of subjects continuing ARAs(66.2%), a- blockers*(63.0%), CCBs(61.3%), B-blockers(55.8%), and diuretics(53.5%), respectively(P<0.001), The following adverse reactions were detected: cough(7.5%), headache(6.1%), dizziness(3.9%), flushing(3.7%), and impotence(2.4%). The incidence of cough associated with ACEI(27.9%), was higher than those of other classes(P<0.01)

Conclusion : CCBs were the most commonly prescribed initial drug class in family practice, followed by ACEIs, ARAs, B-blockers, a-blockers, and diuretics. The tolerability of antihypertensive medication was the highest in Korean patients treated with ARAs, followed by CCBs, B-blockers, diuretic, a-blocker, and ACEIs.

Background
: Cerebral infarction is one of the common cause of death in Korea. There are many studies about risk factors of cerebral infarction in the world and Korea. and there are some studies about risk factors of mortality and recurrence after first cerebral infarction in the world. but there are no reliable epidemiologic studies about risk factors of mortality and recurrence after first cerebral infarction in Korea. So this study was designed to investigate the risk factors of mortality and recurrence after first cerebral infarction in Korea.

Methods : A cohort of 257 patients with diagnosing first cerebral infarction at our hospital were selected and followed for at least 5 years. 30 days, 1 year, 5 year cumulative mortality and recurrence was calculated. Risk Factors classified at the time of first cerebral infarction. and then entered into a Cox proportional harzards model for mortality and for recurrence.

Results : The cumulative risk of mortality after first cerebral infarction was 13%, at 30days, 21%, at 1year, 49% at 5years. The cumulative risk of recurrence after first cerebral infarction was 4% at 30days, 11% at 1year, 24% 5years. The significant risk factors of mortality after first cerebral infarction were age(≥65), heavy alcohol drinking history, heart, failure, untreated diabetes mellitus history, untreated hypertension history, high admission Hct(≥50%), high admission glucose(≥200), atrial fibrillation at admission, under drowsy mental state at admission, embolic infarction type, high admission systolic bolld pressure(≥160), high admission diastolic blood pressure(≥100). The significant risk factors of recurrence were age(<65), men, heavy alcohol drink-ing history, ischemic heart disease, untreated DM history, high admission glucose(≥200).

Conclusion : Diabetes mellitus, hypertension, heavy alcohol drinking, cardiovascular disease were important factor of cerebral infarction prognosis on our study. So primary care physicians focus on these factors when treating cerebral infarction patient.

Background
: Smoking is the single most important factor of the prevention of diseases and the promotion of health. The objectives of this study are to compare the health-related quality of life and other factors between the adult male smokers and nonsmokers.

Methods : Study subjects were selected from the parents of students of three schools; one elementary school, one middle school, and one high school in Suwon city , Kyungki- Do. Among 2.308 respondents to the questionnaire, 1.127 were analyzed.
The questionnaire consisted of questions of general socioeconomic status, health-related quality of life questionnaire, Fagerstrom nicotine tolerance questionnaire, and the Why test.

Results : There were no significant socioeconomic differences between the smokers and nonsmokers except religion(p=0.000). The smoking rage of the subjects was 66.2%, the average amount smokers ranked lower scores in all scales of the health-related quality of life than nonsmoker. The health-related quality of life of the group of high nicotine dependence was low in comparison with the group of low nicotine dependence. The most common reason of smoking was to relieve tension.

Conclusion : Smokers ranked lower scores in all scales of the health-related quality of life than nonsmoker.

Background
: Hearing impairment is one of the most common physical handicaps of the aged. This diseases has recently attracted such amount of social attention and understanding as never attracted several years age, and high degree of achievement was made with regard to screening test method, diagnosis, treatment and rehabilitation. However, unfortunately, even now, not enough attention is being paid upon early discovery hearing handicap for patients frequently encountered in clinics.
Therefore, as a screening test method of senile hypacusis, we were to apply "Hearing Handicap Inventory for the Elderly - Screening Version" (HHIE-S) inquiries in Korea and studied the usabulity, sensitivity, specificity, positive predictive value and negative predictive value and cutoff point of this method.

Methods : This study was performed for 120 persons over the age of 60, who visited general health screening centers of one university hospital located in Seou, during the period of October 1996 through to March 1999. HHIE-S questionnaires were used and pure tone audiometry was performed to generate gold standard.

Results : Only 119 out of 120 initial subjects were included in the study because of incomplete questionnaire answers by excluded 10 subject. We defined gold standard of hearing handicap to be ⑴ lower than 30 dB of hearing capability of both ears to frequency between 1000 Hz and 2000 Hz or ⑵ lower than 40 dB of hearing capability of an ear to frequency between 1000 Hz and 2000 Hz, as determined by pure tone audiometry. Assuming cutoff point of HHIE-S as 4 points, the sensitivity and specificity resulted to bo 80%, and 67% each. Assuming cutoff point of HHIE-S as 6 points, the sensitivity and specificity were 76% and 78% each. At 8 points, the percentages were 64%, and 80%, At 10 points, the percentages were 64% and 85%. As a result of this study, the appropriate cutoff point is 6 points. In order to specify the correlation between questionnaire result and pure tone audiometry, we performed 500 Hz, 100 Hz and 200 Hz audi-ometry which are within conversational range, calculated arithmetic mean from the results, and inspected correlation between the resultant mean of the better performing ear and questionnaire resultant points. The correlation coefficient was 0.612 and Chronbach's alpha, as a measurement of internal consistency of the questionnaire was 0.9044.

Conclusion : HHIE-S proved to be useful in screening hearing handicap in the Korean elderly.

Background
: Upper gastrointestinal symptoms is the one of the most frequent symptom in primary medicine, those manifestations are various and can not find the cause in many cases. In Korea the management patterns for upper gastrointestinal symptoms are using drug store. oriental medicine, folk methods, diet therapy in addition to medical service. We have investigated the behavioral patterns for the control of upper gastrointestinal symptoms.

Methods : The authors surveyed the patients who had visited Dong-guk university Kyung-ju hospital with upper gastrointestinal symptoms from April 1 to Jun 30 in 2000.

Results : 269 questionnaires were collected and among them 247 completed ones were analysed. 112 subjects were used medical service only(45.3%(, 135 subjects were used alternative methods also(54.7%). Among the 135 subjects who used alternative methods, 60 visited to drug store(44.4%), 36 took oriental medicine(26.7%), 18 used folk herbal remedy(26.7) 5 used diet therapy(3.7%) 16 used folk manual therapy(11.9%), most commonly. Women more commonly used alternative methods(P<0.01). By occupation, housewives more commonly used alternative methods and specialists less commonly used alternative methods. There were no significant difference between two groups in other general characteristics, most severe symptom, cost, satisfaction.

Conclusion : We find the behavioral patterns for relieving upper gastrointestinal symptoms are using alternative methods(drum store, oriental medicine, folk herbal remedy, folk manual therapy, diet therapy) in addition to using medical service. Women and housewives more commonly used alternative methods, and specialist less commonly used alternative methods.

Background
: This prospective study was performed to evaluate factors influencing weight changes pregnancy period and postpartum period.

Methods : A total of 195 women followed by prenatal care of the department of OBGY at Ajou University hospital. Suwon, Korea, between march, 1998 and march, 2000. Parity, activity, alcohol, smoking, age of menarche, and age of first and last pregnancy were recorded for prenatal information. Anthropometric measurements was checked at regular visits until 6 weeks after delivery and by telephone call at 6 months and 1 year postpartum.
Rerults : Mean age was 30.1 years old and mean body mass index was 21.1 ㎏/㎡, Mean total weight gain during pregnancy was 13.6±4.63 ㎏ and wide range was at third trimester. It shows that weight reduced gradually until 6 months postpartum but increased after that time. 1 year postpartum weight gain had high correlation(R=0.999, p<0.01) with 6 months postpartum weight gain. Total pregnancy weight gain, weight retention on 6 week postpartum were not significantly correlated with 1 year postpartum Weight gain. OR for becoming overweight on 1 year postpartum(≥5.2 ㎏) with excessive rate of gain on 6 months postpartum(≥2.9 ㎏) was 5.41(95% CI 2.20-13.31) adjusted by multiple logistic regression analysis (age, activity level, parity). OR for becoming overweight on 1 year postpartum with excessive rate of Total pregnancy weight gain(≥13.6 ㎏ was 4.4895% CI 1.84-10.89) by multiple logistic regression analysis.

Conclusion : 1 year postpartum weight gain had the correlation with only 6 months postpartum weight gain.

Background
: Hormone replacement therapy is effective for improvement of climacteric symptoms, and prevention of postmenopausal osteoporosis but patient compliance is very low. The aim of the study was to assess the comprarative effects on bone mineral density(BMD). lipid, mammographic finding, biochemical bone markers of tibolone and continuous combined hormone replacement therapy in postemeopusal women.

Methods : Body mass index, BMD in the spine and femur neck. lipid, alkaline phosphatase, serum osteocalcin, urine deoxypyridinolone were measured before and after 1 year therapy in 88 post - menopausal subjects. Of theses, 54 women received CEE 0.625 ㎎ and MPA 2.5 ㎎ (CEE/MPA) per oral, 34 tibolone alone for 1 year.

Results : Body mass index didn't changed in both groups. Significantly increased mammographic density in CEE/MPA groups(p<0.05). Total cholesterol was decreased in both group, but no significant differences between the different treatment groups. Triglyceride decreased in tibolone group and ther are significant difference between the two groups(p<0.01). HDL-cholesterol increased in CEE/MPA group(p<0.01) but decreased in tibolone group(p<0.01). There are significant difference in HDL- cholesterol response between two groups(p<0.01). LDL-cholesterol respone between two groups(p<0.05). Total alkaline phosphatase(TALP) and serum osteocalcin decreased in 새호 groups(p<0.01) but no differences between two groups. Urine deoxypyridinoline was not decreased in both groups and no differences between two groups. Spine bone mineral density(BMD) increased in both groups(p=0.0001) but no differences in treatment response between two groups. Femur neck BMD didn't not increased in both groups and no differenced of treatment responses between two groups. Urine deoxypyridinoline was not decreased in both groups and no differences between two groups.

Conclusion : Tibolone was effective on BMD of lumbar spine as much as CEE/MPA and may be safe in terms of mammographic changes in postmenopausal women.

Background
: According to previous studies, it was suggested that coffee consumption ,may protect liver toxicity caused by alcohol drinking. Our study is design to analyze association between coffee consumption and serum gamma-glutamyltransferase(GGT) in alcohol drinking male adults.

Methods : From 1996 May to 1995 July, data were collected from alcohol drinking male adults who visited a university hospitals for health check-up. Among them, subjects who had disease could affect liver function test were excluded. Sociodemographic data, alcohol drinking amount, smoking status, coffee drinking amount data were collected by questionnaire and subject’s weight and height were measured.

Results : We excluded 12 male adults because they had a disease which may cause liver dysfunction. In analysis of variance, coffee consumption and BMI were significantly associated with serum GGT(p=0.023). Alcohol drinking and cigarettes smoking were not significantly associated with GGT. In multiple regression analysis, coffee consumption was inversely related to serum GGT levels independently (p=0.002). Cigarettes smoking was also independently and positively associated with serum GGT levels(p=0.040).

Conclusion : Coffee consumption may lower serum GGT levels in alcohol drinking male. It may suggest that coffee consumption protect liver toxicity caused by alcohol drinking and It must be validated in large sized prospective study involving non-alcohol drinker.

Background
: This study is to investigate on how much the dysmenorrheal and lower abdominal pain(LAP)/back pain are improved by the aromatherapy which is emerging as an alternative therapy.

Methods : In order to get the data by questionnaire, 245 subject was selected from women student class of a high school at rural area from June 2000 to August 2000. 125 subject, aroma was given to 69 subject and placebo was given to 56 subject. The subject was investigated how the dysmenorrhea was improved by using the aroma and placebo.

Results : After the aromatherapy, severities of dysmenorrheal and LAP/back pain improved in aroma group and placebo group. Therefore, there is not statistical difference between both groupts.

Conclusion : The herbal aroma is not effective more than placebo aroma to relieve dysmenorrhea.

Background
: Stress is found to have influence on physical and mental disorders, and also to healthy life habits related to physical health mental stress. Job holders are groups that have suffered from chronic stressful condition. Consider medical people of job-holders to received exessstress. So, we tested this investigation to know the relationship between health habits and stress amounts about nurse.

Methods : This study was performed on nurses who worked on one hospital in Pusan Metropolitan city for one months(from April, 1, to April, 30, 2000). We used 128 results. Health habits were investigated about 5 articles out of “Breslow’s 7 health habits” and stress amounts were measured by Korean-translated BEPSI(Brief Encounter Psychosocial Instrument) and Bae Jong- Myun’s 30-items SRRQ(Social Readjustment Rating Questionnaire).

Results : There were differences in amounts of stress of subjects according to marital state(P<0.05), job department(P<0.05), BMI(Body Mass Index) (P<0.05), sleeping time(P<0.05).

Conclusion : This investigation has showed that having excess stress in nurses. Body Mass Index, sleeping time appeared to be health habits related to amounts of stress.

Background
: The present it is getting to be on aged society there is increasing that hospital has higher rate for place of death than home. Because we can expect that many patients who are faced with death come to hospital or hospice in the future, we have studied preferred place of death with an old women in seoul to have essential material of plan to understand asking for medical service of death, to divide medical manpowers and equipments and to supplement and to revise of medical educations.

Methods : Through the internet, 71 schools for the elderly . Of 277 an old woman who attending the schools out of 7 schools. We research into preferred place of death by self answering way through the June to July in 2000.

Results : The average age was 72.4 years. Of 277 respondents, 87 respondents(32.46%), reply their homes as a place of death and 166(61.94%) reply hospital, 15(6.5%) reply hospice, missing is 9. Statistical significance has connections with only level of education. The highest reason(47.5%) why respondents choose the hospital or hospice is only to reduce their children’s burdens. Unlike respondents that education attending period is below 6-year, the relative risk of choosing the hospital or hospice between respondents who are 6-9year and above 9-year is each of 3.66, 5.58.

Conclusion : This research shows that an elderly women I seoul prefer hospitals or hospice to homes as their place of death.

No abstract available.