Background
: Thyroid diseases is common in adult and frequently has significant clinical consequences. But, Prevalence have not been accurately estimated before performance of sensitive TSH and high resolution ultrasound devices on thyroid gland in practice. The objective of the study was to obstain prevalance rate of thyroid dysfunciton and structural abnormality by sensitive TSH, Free T4 and high resolution ultrasound.

Methods : The subjects were 10,543(5,638 male and 4,815 female) individuals who visited a health care center of a general hospital in Kangnung city during the period of Jun. 1st, 1997 through May 31st, 2000. For thyroid dysfunction, serum TSH(Thyroid Stimulation Hormone)and Free T4 concentration of those were measured by RIA or IRMA. During the period of Dec. 1St, 1997 through May 25th, 1998, 1,316 individuals were examined by radiology specialists using high resolution ultrasonography with 7.5 MHz linear array. Consequently 21 patients who showed thyroid nodule were performed ultrasound-guided fine needle aspiration. Accordingly medical records containing results of physical examination made by 3 specialists in family medicine before thyroid ultrasonography were investigated in association with other diagnostic modalities.

Results : The measurements of thyroid function revealed that 10,090(96.5%) were normal, 240(2.3%) low(below 0.39 mU/L) and 123(1.2%) high (above 5.1 mU/l) in TSH. In terms of prevalence rate per 1,000 population, 15.2 cases were with subclinical hyperthyroidism, and 9.0 cases with subclinical hypothyroidism, 7.7 cases with hyperthyroidism and 3.3 cases with hypothyroidism. Among 94 individuals(7.1%) with structural abnormality on thyroid gland by ultrasonography, 60(4.6%) showed solitary solid nodule, 12(0.9%) multiple solid nodules, 18(1.4%) cystic nodules and 3(0.3%) diffuse parenchymal lesions. Physical examination found only 13.3% of 91 nodules found by high-resolution ultrasongraphy, and nodules as large as above 1.0 cm in size were palpable only in 22.2%. 21 Of 91 thyroid nodules was received ultrasound-guided FNA and 4(19%) were found to have malignant nodules.

Conclusion : The study results showed the relatively high rate of thyroid diseases among general population, with the prevalence rate of thyroid dysfunction 3.6%, thyroid nodule 6.9%, malignant incidentaloma among thyroid nodules 4.4%. Physical examination was relative ineffective in detection for thyroid nodules in routine health examinations.

Background
: Sigmoidoscopy reduce colorectal cancer mortality by identifying both cancer and adenomatous polyp for treatment. However, this screening technique, sigmoidoscopy is extremely limited to family physician. We performed sigmoidoscopy and attemped to analyze colon polyps.

Methods : The authors performed rectosigmoidoscopy from January 2000 to January 2001 at ulsan university hospital health promotion center. We reviewed and analyzed all subjects at which time all polyps were biopsied.

Results : In total, 1107 case sigmidoscopy examination were performed without complication. Polyps were found in 11.5%. 44.5% were neoplastic adenoma and 33.6% were hyperplastic polyps. Cancer was detected in 2 subjects. All case of neoplastic and 33.6% were hyperplastic polyps. Cancer was detected in 2 subjects. All case of neoplastic polyps were refered to colonoscopist. The difference of polyp incidence rate was significant in age and sex group(p<0.01).

Conclusion : The prevalence of colon polyps was 11.5%. This data is simillar to colonoscopist's data. These results suggest that screening sigmoidoscopy can be performed usefully by family physicians.

Background
: Comprehensive geriatric assessment is identified as a dynamic process responsive to the changes on health status that occurs over time in the context of extremely increasing trend in the numbers of the elderly people, their office visit, and the medical cost universally. We completed the comprehensive geriatric assessment and applied it to the Korean elderly through the multi-center trials.

Methods : We performed studies variables using questionnaires, with interviewing, physical examination to number of total 312 elderly people who visited the department of family medicine or physical medicine and rehabilitation of the 11 university hospital or general hospital in Korea from July 1, 1999 through October 31, 1999. We, the geriatrician, met and discussed 3 times to complete the comprehensive geriatric assessment through the consensus panel.

Results : We found the sex ratio of 312 subjects was 1 to 2 (104 males and 208 females) and the average age was 73.2 years old. The orders of more frequency of self-reported health status of the respondents were hypertension, arthritis, cataract, gastrointestinal disturbance, diabetes mellitus, urinary/fecal incontinence, depression, cerebrovascular accident, anemia, and heart disease. Nearly 15% of those showed depression 41.6% of those were in the status of socially isolation. We found 43.1% of those showed hypertension, 3.7% isolated systolic hypertension, and 20.2% orthostatic hypotension. Of those, cognitive impairment were measured in 37.1%, gait disturbance 13.0%, and the risk of malnutrition 39.6%. Geriatrician spent 21.1 minutes per person during the process of comprehensive geriatric assessmnet.

Conclusion : We realized we could diagnose and intervene effectively certain hidden conditions/ diseases, particularly urinary incontinence, falls, visual impairment, hearing impairment, pain, depression, social isolation, cognitive impairment, and orthostatic hypotension, with using the comprehensive geriatric assessment. These results reflected the fact that the comprehensive geriatric assessment might be necessary for the care of the elderly.

Background
: Pharmacists could dispense medicines without doctors' prescription in Korea before July 2000. The aim of this study was to compare the prescription behaviors of practicing doctors and pharmacists to common cold by the simulated patients. We selected the common cold as a subject of simulation because it was the most frequent health problem to visit doctors and pharmacists and the abuse of antibiotics might be prevalent in management of it.

Methods : Seventy five private clinics and drug stores were selected in Seoul, Korea. The simulated patients were selected and trained standardized symptoms of common cold. The simulated patients recorded the prescription behaviors of doctors and pharmacists.

Results : Average number of prescribed medicines were 5.0 and 5.6 in clinic and drug store respectively. 54.7% of the clinics and 61.3% of the drug stores prescribed antibiotics respectively with no significant difference between them. The most frequently prescribed antibiotics were penicillines. About 7% of the doctors and 11% of the pharmacist prescribed glucocorticoid to simulated patients respectively. About 20% of the pharmacists performed some kinds of physical examination to the simulated patients. Both doctors and pharmacist gave little ingormation or advice on use of medicines, possible side effects and past side effects of medicines.

Conclusion : There were frequent abuse of antibiotics and occasional use of glucocorticoid in private clinics and drug stores. Both doctors and pharmacists did not give enough information on use of medicines to the simulated patients.

Background
: An association between low serum cholesterol concentrations and depressive symtoms has ever been found in several studies. The objective of this study is to evaluate neurotic symptoms in hypocholesterolemia.

Methods : In the course of two months (from June to August, 1998), 81 subjects were selected among the people who screened in adult disease survey of one university hospital. As the control group, 80 subjects were selected from a healthy population. In the study population, we excluded people who had medical history of hypertension diabetes mellitus, ischemic heart disease, chronic liver disease and history of any medication to lipid metabolism and other psychotic disease history. Neurotic symptoms were measured by Symptom Checklist for Minor Psychiatric Disorders (SCL-MPD) questionnaire.

Results : There was no difference between the distribution of age and sex in the hypocholesterolemia groups. As the level of the education and kind of employement, no significant difference between two groups. Hypocholesterolemia groups scored significantly higher than conrol group in some questionnaire of SCL-MPD. The results of depression scale (p<0.01) and anxiety, hypochondriasis scale (p<0.05) were significant. The men of hypocholesterolemia groups have significant relation to hypochondriasis scale (p<0.001) and the women to anxiety scale (p<0.05)

Conclusion : Though in some scale of neurotic symptoms, the association between hypocholesterolemia and neurotic symptoms was found in our study. There need to be a further study on the correlation of hypocholesterolemia and neurotic symptoms.

Background
: Pusan is geographically far away from the indigenous area of malaria. it is the area were the tourists and foreigners travel through frequently because of the port. We investigated the situation in Pusan concerning malaria through the examination of malaria patients who contracted it recently. We found the ways to decrease erroneous diagnosis presuming malaria on the basis of these studies.

Methods : We retrospectively analyzed the medical records of 28 confirmed cases of malaria with the chief complaint of repeated high fever, who were admitted and treated in the Pusan Adventist Hospital and Pusan Samsun Hospital from June 1997 to August 2000.

Results : 25 cases were indigenous and 3 patients were imported cases contracted overseas. Peripheral blood smears revealed Plasmodium vivax in all indigenous cases, wheresa 2 were P. falciparum and I case was P. vivax in the imported cases. Yeonchon-goon(9 cases) was the most prevalent area in the indigenous cases. Africa and Southeast Asia (3 cases) were the contracted aresa in the imported cases. 27 cases were men and 1 case was a women among the 28 cases, and the incidence was high peak in 8 - 10 month. Most of the patients(72.1%) were in the their 20's, and most of all had worked in the millitary bases near the demilitarized (DMZ). Thrombocytopenia and leukopenia were found more frequently by the laboratory findings. 23 of the cases(82%) were suspected to be malaria, before we confirmed it by peripheral blood smears.

Conclusion : The number of patients with indigenous malaria from the other areas in Korea and patients with malaria from foreign countries will be expected to increase. Before we confirmed the malaria by peripheral blood smears, the cases suspected of malaria were 82.1% This is a high diagnostic rate due to careful history taking and physical examination. The doctors decreased the rate of erroneous diagnosis of malaria and should be careful in the choice of the proper drugs.