Background
: Family physicians in their on primary practice frequently encounters patients with fever, which is one of the common symptoms. Fever is an important symptom and can occur in mild disease, common cold, influenza, acute pharyngotonsillitis or can originate from a particular severe disease, such as bacterial endocarditis, malignant lymphoma and SLE, which need more aggressive management. Therefore, we studied patients who were admitted with short-term fever or long-term fever to find out their causes of febrile diseases and to compare the differences with previous other studies.

Methods : 601 patients with fever above 37.2 degree centigrade or those who were transferred from other hospitals due to long-term fever were enrolled from Jan. 1991 to Jun. 1997. Patients' medical records were reviewed and classified according to disease, sex, age. Srandardization of Petersdorf's rule for F.U.O. was used.

Results : 601 patients were randomly selected among which 301 were males and 300 females. Males were 147 and females 147 young adult patients as compared to 154 males and 153 females were elderly patients. According to disease category, the number of infections, connective tissue diseases, neoplastic diseases and other diseases were 442(73.5%), 14(2.3%), 87(14.5%) and 21(3.5%), respectively. The number of diseases of undetermined case was 37(6.2%). The most frequent disease was pneumonia with 103(31.1%). UTI and tuberculosis were the 2nd and 3rd most common diseases. The total number of F.U.O. patients was 82(13.6%). According to the disease categories there were 29(35.4%) in infections, 2(2.4%) in connective tissue diseases, 12(14.6%) in neoplasms, 2(2.4%) in others and 37(45.2%) in unknown origin. The most common disease in the classification of sex and age of F.U.O. was infections and tubrculosis.

Conclusion : In the clinical study of febrile patients admitted from Jan. 1991 to Jun. 1997 through medical record review, the disease category in the order of frequency was infection, neoplasm, connective tissue disease and the distribution of F.U.O was same result. In comparison with other study, the order of connective tissue disease and neoplasm was different in other hospital study but same result was taken in comparison with Petersdorf's study.

Background
: Smoking increases the risk of respiratory, cardiac diseases and cancer. This study is to ascertain the relationship between passive smoking, the modes of residence, its location and the immunoglobulin values as well as the eosinophil counts in relation to child patients suffering from bronchial or cardiac asthma.

Methods : The research was conducted at a general hospital with cooperation of 242 patients who had been hospitalized 1991 through 1995. We compared the average values of immunoglobulin between the groups of exposed and non-exposed to smoking by T-test. A same work for residential modes was done by T-test, while the data regarding the residing locality were processed by ANOVA.

Results : Each values of TEC, IgE, IgA, and IgM in both groups has been analysed but spelling no significant differences. The group residing in apartments showed lower value of IgM than those of flats.

Conclusion : The reason the IgM value of apartments is lower than that of flats is due to the difference of living quarters. This signifies the modes of residence may as well affect the IgE value.

Background
: The drug abuse has become cone of social problems especially in the adolescents. It has been well known that the drug abuse is concerned with interaction of biopsychosocial factors and family relation factors. So I have studied the general characteristics and rearing attitude and family state of the adolesents who were in a jail because of drug abuse and have in tended to give some help for establishing effective strategies for family education and therapy.

Methods : The study was done for adolescents who were in a jail because of violation the illegal drug control law. The group was total 55 men and the age distribution was from 15 to 20years. The Questionnaire was used in Mar 1996 for study and I analyzed 53 cases excluding 2 cases because they were nearly illiterate. The FACES III(Family Adaptability and Cohesion Evaluation Scales), family APGAR score and PBI(Parental Bonding Instrument) were used for evaluating the characteristics of family function and the parental rearing attitude. Statistical management with SAS was executed for data analysis.

Results : The average age of the group was 6.9±1.4. 48.1% of them lived in the metropolitan area, 40.4% lived in the middle-sized cities and 11.5% lived in the small country towns. The education level of 91.8% was under middle-school graduate. They have use drugs since the age of 14.6±1.8, they began to use glue sniffing at the first time in 78.8% and butane gas inhalation in 17.3%. The state of family showed the death of father in 28.9% and the death of mother in 13.5% and 76.9% of deaths occurred before they have become 13 years. Their parents divorced in 25%. The mean APGAR score was 4.56±2.6, which means moderately dysfunctional state of family. In FACES III adaptability score was 20.3±5.7 and cohesion score was 26.2±6.9. According to the family type by FACES III, there were 5 cases(9.4%) in balanced, 19 cases(35.9%) in midrange, and 29 cases(54.7%) in extreme. In PBI mother overprotection score was 16.24±4.59, mother care score was 22.5±6.8, father overprotection score was 16.71 5.1 father care was 21.94 6.24.

Conclusion : The drug abused adolescents in a jail were in handicapped family because of deaths and divorce of parents. Their family function score was low and more than half of them had the extreme type of family. Therefore it is wise for us to have a concern for the family problem when understanding and managing drug abused adolescents.

Background
: Obesity is a risk factor for developing hyperlipidemia and cardiovascular diseases. Various diagnostic methods and criteria of obesity have been developed. The predictive values of health risk factors(hyperlipidemia, hypertension, diabetes mellitus, and body fatness) were different for cardiovascular diseases. We reviewed the medical records to assess the relation of health risk factors to waist-hip ratio(WHR) and body mass index (BMI).

Methods : We gathered 5100 cases who have taken medical examination from March 1995 to February 1996 at Ajou University Hospital and measured BMI, WHR, body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar etc.. Except 1350 abnormal cases on current illness and laboratory study, 3750 healthy cases were analysed. First we divided the Healthy cases into obese and non-obese group according to BMI 25kg/m2 in men and women. And then, the obese and non-obese group was divided into central and non-central obese type by WHR 0.8 in women and 0.9 in men.

Results : Except only diastolic blood pressure in male, other lab data such as body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar in male and female were significantly different between the two groups divided by WHR in BMI<25kg/m2. But in BMI>25kg/m2, men had higher(P<0.01) triglyceride at WHR?0.9. Women had higher(P<0.05) triglyceride, systolic and diastolic blood pressure at WHR?0.8.

Conclusion : We thought that the increase of WHR was risk factor for hyperlipidemia, hypertension, diabetes mellitus in men and women when BMI was less than 25kg/m2. In obese group(BMI?25kg/m2), increase of WHR was risk factor for hyperlipidemia in men and hyperlipidemia and hypertension in women.

Background
: The climacterium I defined as a group of physical and psychological sympto-mps commonly experienced in the middle ages due to estrogen deficiency, sociocultural and psy-chological gactors This analysis focused on the relationship beteen climacteric sympotoms and life event cagne. The aim of this study was to investigate the relationship between various life event characteristics, possible medisting factors and climacteric symptomtology.

Methods : The data were collected at the Yonsei Medical Center, a outpatient clinic of the de-partment of family medicine, over a three month period from June, 1995 to August, 1995. Each female subject completed a 21 item symptom self-rating scale. This scale yielded three main in-dependent factors which were composed of 11 psychological symptoms and 7 somatic symptoms and 3 vasomotor symptoms. The level of life event stress experienced was measured by the Life Event Stress Rating Scale of House Wives in Seoul, which had been developed by Wan Sang Yoo(1994), and the Life Event Scale were subclassified into 6 life change items by Kang-E Hong and Do-En Jeong(1982). The collected data were analyzed with the SAS program.
Result: A significant difference in climacteric symptoms occurred between the 45~54 age group and the 55~65 age group(P<0.05). When the climacteric symptoms were subclassified into three subscales, there were statistically significant increase of climacteric symtoms is the 45~54 age group when compared with 55~64 age proup. Health stress of the six Life Event Stress Scale was significantly correlated with somatic symptoms(P<0.05).

Conclusion : Health stress of the Life Event Stress Scale was correlated with somaticc symtoms of the climacteric symptoms. Multiple regression analysis revealed that somatic symp-toms were closely related with the Life Event Stress Scale.

Background
: It is known that diabetic retinopathy is the most specific complication of dibet-ic microvascular complication, and a important cause of blindness in adults. We investigated the risk factors of diabetic retinopathy on non-insulin dependent diabetic male patients.
Method: The 107 diabetic male patients with retinopathy and the same number of diabetic patients without retinopathy were chosen randomly, who were hospitalized in a university hospi-tal. They were called up for a inquiry and their medical records were also reviewed. The obtai-ned data were the age, family history of diabetes, duration of diabetes, onset age of diabetes, status of diabetes control, diabetic complication, blood pressure, obesity, lipid profile, drinking behavior, and amount of smoking.
Result: The mean age of the group with diabetic retinopathy is 57.2 years and that of the group without diabetic retinopathy is 58.3 years. Compared to the group without diabetic retino-pathy, there shows statistical difference in family history of diabetes, using insulin, diabetic complication, hypertension in the group with diabetic retinopathy(P<0.01). Also it is observerd that the age of onset of diabetes is younger, the duration of diabetes is longer(P<0.01), and the status of diabetic control is worse in the group with diabetic retinopathy(P<0.05). On the other hand, there shows no difference in the obesity, smoking, drinking between two proups.
Through multiple logistic regression analysis, diabetic retinopathy seemed to be associated with factors such as family history of diabetes, duration of diabetes and level of fasting blood sugar.

Conclusion : The risk of diabetic retinopathy is more increased in patients with family history of diabetes, the longer duration of diabetes, and the worse control of blood sugar.

Background
: As a dramatic shift is occurring the demographics of Korean society, especially in the proportion of individuals over the age 65, there is a great concern to the disease commonly developed in the aged including pneumonia. Pneumonia is a major cause of death for the elderly. Clinical symptoms and signs of pneumonia in the elderly are often muted. Timely, accurate diagnosis and therapy depend on recognition of atypical manifestations of pneumonia in the elderly. The goals of this study were to describe atypical clinical manifestation of pneumonia in the elderly and to analyze the predictors associated with mortality.

Methods : The records were retrospectively reviewed of randomized patients older than 65 years with a diagnosis of pneumonia who were admitted to Yonsei Medical Center from January, 1990 to June, 1992 and were compared to the those of younger-aged groups with pneumonia who were admitted to Yonsei Medical Center at the same period of time.

Results : In the elderly, pneumonia is associated with considerable mortality, 28.3%. More atypical clinical symptoms and signs were presented in the elderly, comparing to those of the younger control group. Cough, sputum and fever were less frequently presented in the elderly. Patients with preexisting chronic lung disease, tachypnea, tachycardia or without temperature elevation were associated with mortality. The most commonly identified pathogen was gram-negative bacilli and there were no difference of chest X-ray pattern and therapeutic regimens between the elderly and control groups.

Conclusion : Pneumonia in the elderly is a serious condition with high mortality. Because of atypical and subtle clinical manifestations of pneumonia in the elderly, a high index of suspicion will induce the physician to diagnose and treat pneumonia timely and properly.