Background
: The pathophysiology of non-ulcer dyspepsia remains unknown. But Several related factors have been investigated and psychologic factor is one of the possible mechanism. Alexithymia was introduced to explain the psychopathology of psychosomatic disorder. Until now alexithymia has been variously shown to be associated with many psychosomatic disorder, psychiatric disorder, even medical patients. This study is designed to investigate whether non-ulcer dyspepsia has more relationship with alexthymia than other illness.

Methods : To compare alexthymia tendency between non-ulcer dyspepsia and general medical patients, we collected sample from January to September 1999. Each group of 72 patients were tested using Toronto alexthymia Scale.

Results : A rate of 37.5%of alexthymia was found in the non-ulcer dyspepsia group compared with significant lower rate of 19.4% in the general medical patients group.

Conclusion : Non-ulcer dyspepsia patients had more alexthymia compare to general medical patients. This finding shows the alexthymia could be part of the pathophysiology of non-ulcer dyspepsia.

Background
: Coronary artery disease are increasing in recent years among Korean due to change of dietary pattern. We conducted a cross-sectional study to analyze various factors for low HDL-cholesterol knowns as a independent fisk factor for coronary artery disease.

Methods : At the health care center of Asan Medical Center in 1999, 7259 people without cardiovascular disease, cerebrovascular disease, hyperlipidemia were selected. They were exmined wight, health blood pressure. Other data was drawn from questionnaire, blood chemistry. SPSS(version 7.5) was used for analysis of this data.

Results : 1) The means of HDL, cholesterol level was higher in women than men. 2) The means of HDL cholesterol of men was lower in subgroup of age below 45 years-old, obesity, lower total cholesterol(< 240 mg/dL), higher triglyceride (≥ 200 mg/dL) than others. By multiple logistic analysis, obesity, triglyceride, current smoking, moderate alcohol drinking were significant factors associated with low HDL, cholesterol ( < 42 mg/dL, 25 percentile of study paricipants).

Conclusion : These resluts suggest that obesity, high triglyceride. current smoking are indepen-dent risk factors and moderate alcoholic drinking is negative risk factor of low HDL-cholesterol in this study participants.

Background
: Anxiety is a common disorder, but its diagnosis is often overlooked. Although there are several evaluating instruments, they are difficult to use in busy outpatient clinics because of its length. Furthermore, scales developed for screening are insufficient in the standardization. The purpose of this study is to measure reliability and validity of scale that can efficiently detect the anxiety patients in busy primary care setting.

Methods : With translation and assistance from psychiatrist, the questionnaire was developed. From March to July 2000, anxiety and control group at the department of family medicine in Seoul Joongang Hospital were tested with the questionnaire. After one week later, test was retaken. Reliability was verified by calculating Kappa value. Also validity was validity was verified by comparing the scores between the anxiety group and the control group. Then sensitivity and specificity were evaluated, and the cutoff point was determined.

Results : Kappa values were ranging from 0.65 to 0.88. For each cutoff point 3,4,5 and 6 in validity. As the purpose was screening, we determined score 5 as the best cutoff points.

Background
: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1-year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3-4 months. Some data showed that changes of bone markers after 3-months could predict the changes of the BMD after 1-year.

Methods : 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups. HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made.

Results : Our results showed those findings. 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8%, 4.7%).

Conclusion : These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1-year treatment. But, HRT with antiresorptive agent may be effective in treating postmenopausal osteoporotic Korean women.

Background
: It is well known that heavy alcohol consumption may result in various lesions on multiple organs and tissue, especially liver. The aim of this study was to measure prevalence of raised liver-derived enzymes in healthy men and possible association with alcohol consumption, smoking and body mass index.

Methods : All subjects were 450 men who received Adult Health Examination at Seoul Hospital of Konkuk medical center from May, 1998 to October, 1998. We carried out telephone survey and analyzed 360 men, excluding men with HBs Ag(+), hepatic problems within 6 months, medication drug that could change serum activity of hepatic enzyme or joints, muscles, cardiac problem and non-responder to telephone survey. We examined prevalence of raise liver enzymes and its possible association with alcohol consumption, smoking, and body mass index, applying logistic regression analysis.

Results : In 20.3% of study subjects, we found raised levels of liver-derived enzymes. If the alcohol consumption was higher than 270 g/week, the odds ratio(OR) for raised liver enzymes, adjusted for body mass index and smoking, increased ; serum gamma glutamyltransferase(r GTP) (OR: 9.48), serum aspartate aminotransferase(AST) (OR: 13.09), and serum alanine aminotransferase(ALT) (OR: 7.40). Smoking was not associated with the risk of raised liver enzymes and obesity(body mass index 25 kg/㎡) showed a positive association with two enzymes ; rGTP(OR: 1.92) and ALT(OR: 2.08).

Conclusion : If alcohol consumption was higher than 270 g/week, the risk of raised liver enzymes increased dramatically and rGTP, AST were shown more sensitive than ALT in alcoholic liver disease.

Background
: Eosinophilia is associated with distinctive disease processes that include helminthic parasitic infections, allergic diseases and a diversity of disease of ill defined etiology. But the rate of persistent eosinophilia is not known in incidental eosinophilia without definite disease such as parasite of allergic disease.

Methods : This study included 242 middle aged men who found eosinophilia incidentally in health check up at a general hospital and followed-up after 2 years. The man who didn't know eosinophilia and never treated nor worked up for eosinophilia included. We study the persistent rate of eosinophilia after a follow-up of 2 years.

Results : In 78% of incidental eosinophilia, the number of eosinophilia was less than 1000/㎕. The rate of persistent eosinophilia which incidentally founded after a follow-up 2 years is 29.8%. Higher numbers of eosinophilia, hither rate of persistent eosinophilia. Eosinophil number less than 1000/㎕ showed 23.8% persistent eosinophilia, 1000-1499/㎕ 46.3%, 1500-1999/㎕ 57.1%, more than 2000/㎕ 80% persistent eosinophilia respectively(P<0.05).

Conclusion : Incidental eosinophilia less than 1000/㎕ usually mormalized without intervention, so simple observation is recommended.

Background
: Recently, the apartment complex is rapidly increasing as a new type of housing in a large city. So the purpose of the this survey is to research the experience rate of young children's allergic disease in an area of the apartment complex of a large city and to help the family medical doctor to diagnose and treat the young patients.

Methods : The experience rate of atopic dermatitis, bronchial asthma, allergic rhinitis, allergic conjunctivitis, food allergy was surveyed on June 1999 at an elementary school in a large apartment complex in Kwang-ju. The survey group were 832 students attending elementary school from the second to sixth grade. Also this survey was used to elicit information about the relationship between allergic disease and factors such as age, sex, birth history, family history, and home environment. For analysis of our finding, we have been used chi-square test.

Results : The survey shows that the experience rate of allergic disease is 40.4%. The experience rate of allergic disease was not related with sex, but the more ages the less experience rate. Allergic disease was not related with birth weight, gestational age, feeding method, use of carpet, breeding of pet, smoker in home, and the previous housing type. But experience rate of allergic disease was increased with positive family history.

Conclusion : General facts of allergic disease in elementary school children had no differentiation between large city and the other region. The experience rate of allergic disease is 40.4%.

Background
: Korea Academy of Family Medicine recommands HBsAb and HBsAb test in youth health promotion program. Adequate management are necessary for prevention of vertical transmission at perinatal period. especially girls' high school students as a future's conceivable woman. Health examination program for the first grade students of high school which was established by the Educational Ministry has been acted since 1998. So, throught the students health examination we'd like to find an adequate method of prevention and management in hepatitis B.

Methods : Our study examines HBs Ag/Ab about girl's high school students at two high schools in an city. According to the results of hepatitis B, active intervention in carrier group, passive intervention in candidate were done. And then a year later, hepatitis B management was investigated through the questionnaire.

Results : In active intervention group, regular check up of hepatitis B is 21.4%, hepatitis B blood test in family is 39.3% and in passive intervention group, hepatitis B vaccination rate after health examiantion is 9.1%.

Conclusion : More active intervention such as mass vaccination are required in health examination for the purpose of hepatitis B management at youth.

Background
: The purpose of this study is to define the clinical characteristics of Tsutsugamushi disease.

Methods : We analyzed 12 cases of tsutsugamushi disease admitted to BAG-AE general hospital from 1999. Oct. 1st to Dec. 10. Tsutsugamushi disease was diagnosed by indirect immunofluorescent antibody test.

Results : 1) Among them, 8 cases were female and 4 cases were male. The prevalence was predominantly high in female. 2) The age distribution ranged from 40 to 80 years old. The high incidence of age was 70's and 80's. 3) The peak incidene was showed between October and November(91.6%). 4) The most frequent symptoms were fever and chills(91.6%). 5) Rash and eschar were observed in 83.3%(10 or12) both. 6) Hepatosplenomegaly and lymphadenopathy were also observed in 25%(3 or 12), 16.6%(2 or 12) respectively. 7) The Laboratory finding showed the elevation of AST 66.6% (8 of 12), ALT 58.3% (7 of 12), alkaline phosphatse 25% (3 of 12), and LDH 25% (3 of 12). Albuminuria and hypoalbuminuria were also observed in 25% (3 of 12), 58.3% (7 of 12) respectively. 8) The therapeutic efficacy of doxycycline was excellent.

Conclusion : Tsutsugamushi disease which appeared in Pyoungtack area showed typical clinical pattern and was effective to doxycycline treatment.