Background
: Upper gastrointestinal diseases are relatively important in Korea. There are various studies on upper gastrointestinal diseases, especially relationships with Helicobacter pylori, but studies on young adults are relatively fewer. Therefore, we conducted this study in order to know the prevalence of various upper gastrointestinal diseases and the association with Helicobacter pylori among young policemen.

Methods : Diagnosis and classification of upper gastrointestinal diseases were made in 260 policemen, who visited the outpatient department of family medicine at one general hospital in Seoul from March 2, 2001 to December 31, 2002.

Results : The frequencies of upper gastrointestinal diseases were gastritis (62.2%), duodenal ulcer (14.4%), gastric ulcer (7.5%), duodenitis (6.9%), and no active lesion (9.0%). The frequency of multiple upper gastrointestinal disease was chronic superficial gastritis and duodenal ulcer (37%), chronic superficial gastritis and duodenitis (21.9%), and acute gastritis and duodenal ulcer (16.4%), and these groups comprised the most with 75.3%. The location of the lesion was found at antrum (62.2%) and duodenum (21.6%). Ulcer stages in gastric and duodenal ulcer were mostly in active stage. Helicobacter pylori infection in gastric and duodenal ulcer were 36% and 85.4%, respectively.

Conclusion : Most symptomatic patients had lesions which were found at antrum and duodenum as in other studies. Ulcer diseases in duodenum were much more frequent than those in stomach, which probably be associated with Helicobacter pylori. Therefore, suitable examination and treatment are necessary.

Background
: It is well-known that a decline in the prevalence of smoking among physicians has preceded a decline in the general population. For the purpose of finding out the reason for lower smoking rate in Korean medical doctors than that of general population whether it is due to knowledge of toxicity related to smoking perceived as health professionals or as the only leader group in society this study was investigated. We selected lawyers as a representative of other professional groups. We investigated smoking rate, habits and attitudes towards smoking in Korean lawyers and compared the smoking rate and attitudes towards smoking in lawyers with those of medical doctors.

Methods : This study investigates smoking rate, habits and attitudes towards smoking in Korean lawyers. An anonymous self-administered postal survey was used. One-third of registered lawyers were sampled according to stratified random sampling. Among 1,401 target population, 463 (38.3%) responded.

Results : Among male lawyers, 38.0% were current smokers, 38.9% were ex-smokers and 23.1% were non-smokers, while 7.7% were ex-smokers and 92.3% were non-smokers among female lawyers. The direct age-adjusted smoking rate among Korean male lawyers was 42.1%.

Conclusion : In comparison of the direct age-adjusted smoking rate among male lawyers, medical doctors and general population in Korea, the rate in lawyers was 42.1%, medical doctors 34.9%, and general population 67.6%. The smoking rate of lawyers was found to be higher than that of medical doctors, but considerably lower than that of general population. In comparison of the attitudes towards smoking between lawyers and medical doctors, the lawyers were found to have a lower level of support in questions of the knowledge about the harmful effects of smoking and smoking bans on health than medical doctors.

Background
: Many endoscopists generally use topical pharyngeal anesthesia as a premedication for upper gastrointestinal endoscopy. However, the use of topical pharyngeal anesthesia for upper GI endoscopy has been debated since its inception. The purpose of this study was to compare the effect of no premedication to the effect of a lidocaine premedication.

Methods : One hundred consecutive examinees scheduled for diagnostic upper endoscopy, divided into two group 50, were randomly assigned to receive topical lidocaine spray or without. The test group involved subjects not using topical pharyngeal anesthesia and the control group involved subjects using it without sedation. The collected data included intubation time (seconds), procedure time (minutes), pulse rate, blood pressure, the difficulty of the endoscopy (VAS), anxiety (STAI), and discomfort. Examinees were also asked whether they would agree to another endoscopy if their doctor thought it was medically necessary.

Results : In the response to the amount of cough, belching, bloating or the degree of difficulty in endoscopic procedure, there was no statistically significant difference between the test group and the control group. The intubation time was significantly different comparing the no-premedication group versus lidocaine premedication group. However, the procedure time was not significantly different. In the normotensive group, the changes of systolic blood pressure during endoscopy were significantly higher in the test group than in the control group.

Conclusion : Evaluating all variables, there was no statistically significant difference between the test group and the control group.

Breaking bad news to patients with an advanced cancer is a difficult task for physicians. Some strategies can be used when breaking bad news to patients with advanced cancer. However, many doctors were not trained sufficiently. 43-year old male complaining of general weakness and melena was diagnosed as an advanced gastric cancer with hepatic metastasis. We could deliver this bad news to the patient and his family step by step. Honest discussion allowed patient to be reassured about many points of concern and helped them to be calmer and to plan and readjust hopes and aims. Bad news cannot be broken gently, but it can be given in a sensitive manner and at the individual's pace. Sometimes doctor's own anxiety can be barrier to tell the truth. When we give the information, we always keep in mind about the respect for truth, the patient's rights, the duty to inform, maintaining hope, and the sanctity of the individual contract between patient and doctor.