Background
: Previous studies reported an increased risk of pancreatic cancer among diabetes patients, and fasting blood glucose level is widely used to determine the presence of diabetes mellitus. The aim of this study was to analyze the influence of fasting blood glucose level on pancreatic cancer death by a large, prospective cohort study in Korean population.

Methods : A total of 1,306,476 participants in the Korean Cancer Prevention Study (KCPS) were enrolled. A health examination including fasting blood glucose level and life style questionnaire was done as a baseline examination from 1993 to 1995, and they were followed up to 2002. Pancreatic cancer death outcome for 10 years according to the fasting blood glucose level was explored.

Results : At the beginning 63,510 (4.9%) participants had diabetes mellitus. In multivariate Cox proportional hazards models, controlling for age and current smoking, the presence of diabetes increased the risk of mortality for pancreatic cancer excluding those who died of pancreatic cancer within 1 year (Men: HR 1.7; 95% CI, 1.4∼2.1, P＜0.0001, Women: HR 1.8; 95% CI, 1.3∼2.6, P=0.0003). As fasting blood glucose level, elevated the pancreatic cancer risk was increased. Men with fasting blood glucose level≥140 mg/dL had a higher risk of pancreatic cancer than those with FBG＜100 mg/dl. (Men: HR 2.0; 95% CI, 1.6∼2.5, P＜0.0001, Women: HR 2.1; 95% CI, 1.4∼3.1, P=0.0002).

Conclusion : Elevated fasting blood glucose level increased the risk of pancreatic cancer death among Koreans.

Background
: Stomach cancer is the most common cancer in Korea. Lifelong health management program recommends that males over 40 years and women over 50 years should undergo stomach cancer screening by endoscopy or upper gastrointestinal series every two years. The importance of re-screening of stomach cancer in a high risk group is emphasized.

Methods : A telephone questionnaire was done one year after to 123 patients over 40 years old considered as a high risk group with either chronic atropic gastritis, intestinal metaplasia, gastric ulcer, gastric adenoma among 804 subjects who had undergone an endoscopic examination from February 2002 to June 2003 at a university hospital health promotion center.

Results : The number of patients who responded were 109. The average recognition rate of high risk group was 53.2%. The rate of recognition of high risk group was lower in good subjective health estimation group and in less educated group, in old age group, and in chronic atrophic gastritis and intestinal metaplasia group. The rate of not receiving re-screening after 1 year was 48 (44.0%). Re-screening rate in patients with intestinal metaplasia (35.3%) and chronic atropic gastritis (39.1%) compared to gastric ulcer (77.8%) and gastric polyp (90.0%), in those not recognizing themselves as high risk group, in low education group, in old age, was lower.

Conclusion : In patients with chronic atropic gastritis and intestinal metaplasia, in those not recognizing themselves as high risk group, in old age and in good subjective health state. We need to educate the importance for regular screening of stomach cancer more intensively.

Background
: Adolescent smoking is one of the most serious social problems. This study was conducted to investigate the effect of the attitude of parent and school on smoking status and to help to reduce the smoke rate in high school students.

Methods : Data was collected by self-administered questionnaire between September and October 2002. The study subjects were 977 students of 7 high schools in the Nonsan area. The data was analyzed by using the SPSS program which included t-test, X²-test and logistic regression test.

Results : The smoking rates were 18.1% of general school students and 20.8% of vocational school in males, while 2.6% of general school students and 7.9% of vocational school in females. The mean starting age for the first cigarette was 15.3±1.9 in males and 15.6±1.3 in females. The mean age for regular smoking was 16.0±1.3 in males and 16.2±1.3 in females. Multiple logistic regression analyses indicated that the smoking rate increased in males (OR=2.75), early age for the first cigarette (OR= 7.04), small family (OR=8.60), high family income (OR= 1.95), colleague smoking (OR=5.68), strict attitude by school (OR=0.28) and loss of one's parents (OR=2.58). Among smokers, 71.4% of male smokers and 75% of female smokers wanted to quit.

Conclusion : This study suggests that the strict attitude of parents on their children's smoking decreased the smoking rate, while the stern attitude of school on their students increased it. Therefore, in order to decrease smoking rate, the strict attitude of parents on smoking should be continued and the attitude of school will have to consider aspects of students' characteristics and their interests when they propose to practice a school-based education program. It may have an effect on smoking prevention and reduction of the smoking rate.

Background
: Central venous catheterization allows the measurement of hemodynamic variables, the delivery of medications and nutritional support. It also has been used as a means to treat sepsis, cardiogenic and hemodynamic shocks. Arterial puncture, hematoma, and pneumo-hemothorax are the most common mechanical complications during the insertion of central venous catheters. This study was done to find out the factors attributing to the increase of puncture attempts in subclavian venous catheter insertion.

Methods : We have conducted surveys in residents who had previous experience with insertion of subclavian venous catheterization in Ilsan hospital from 01/09/2003 to 30/11/2003. A total of 40 cases were marked as two groups, those with less than three puncture attempts and those with more than or equal to three attempts.

Results : The incidence of three or less insertion attempts were 23, whereas in 17 cases three or more attempts were required. The results of the comparison between these two groups proved that the patient's hemoglobin level, skeletal deformity, the level of experience (more than 20), puncture site marking and insertion in the mid-clavicular line were significant factors (P＜0.05).

Conclusion : It seemed necessary to try three or less puncture attempts in order to decrease the incidence of mechanical complications. The operator factors such as previous experience with the procedure, puncture site marking prior to insertion, and insertion in the mid-clavicular line had affected the number of puncture attempts.

Background
: In general, long-term weight loss maintenance is difficult. Thus we have attempted to examine the factors associated with weight loss maintenance after weight reduction to appropriate level in obese people.

Methods : The study subjects were 170 obese adults who visited the Yeung Nam University Medical Center Obesity Clinic from January 2002 to April 2004. Selected individuals for this study were those who have intentionally lost at least 5% of their body weight and have kept it off for at least 1 year and considered to be ; weight loss maintainers ; and the factors that are associated with weight loss maintenance were obsened and assessed by telephone survey.

Results : Among all study subjects, the successful weight loss maintainers were 61 (35.9%) subjects (males: 23, females: 38) and re-gainers were 109 (64.1%) subjects (males: 42, females: 67). The difference between maintainers and re-gainers according to sex, age and basal body weight was not statistically significant. The difference between maintainers and retainers were statistically significant in those with regular exercise more than 3 times per week (P=0.001), no alcohol intake (P= 0.001), physical activity more than moderate level (P＜0.001), TV viewing (internet using) times less than 2 hours (P＜0.001), dietary control (P＜0.001), and no overeating (P＜0.001). According to multiple regression analysis, obesity treatment medication use during the weight loss maintenance period had the greatest influence (R²=0.336, P=0.000), and the following were TV (internet) viewing time, smoking, exercise, and physical activity in order.

Conclusion : By using, medications, reducing TV viewing (internet using) times, smoking cessation, diet control exercise weight loss were maintained significantly.

Background
: The study was aimed to examine the validity and the reliability of self-report of gastric cancer screening (endoscopy or upper GI), mammography, and Pap smear.

Methods : The study subjects for validity included those who had undergone 276 endoscopies or UGIs, 127 mammograms, and 125 Pap smears performed at a health promotion center of P and I university hospital during January 1, 1999 to June 30, 1999 and January 1, 2002 to June 30, 2002. The study subjects for reliability included those who had undergone 86 endoscopies or UGIs, 31 mammograms, and 33 Pap smears who went through two surveys. The data was collected by mail or telephone interview. We calculated the sensitivity of self-reports by comparing the self-report and the laboratory results as a gold standard, and the agreement between repeated reporting.

Results : The sensitivities based on the test year were 49.3% for gastric cancer screening, 56.7% for mammography, and 53.6% Pap smear, and the sensitivities on the test month were 39.1%, 45.7%, and 46.4%, respectively. The agreement between the two self-reporting on the test year were 59.6% for gastric cancer screening, 67.7% for mammography, and 63.6% Pap smear, and the agreement on the test month were 82.3% for gastric cancer screening, 74.2% for mammography, and 72.7% for Pap smear.

Conclusion : Self-report alone may not provide accurate or reliable data on the cancer screening compliance. It is recommended to utilize other objective data for cancer screening. And it would be helpful to utilize a memo- book as a reminder to screen for cancer in order to enhance the validity and the reliability of self-report.