Fitz-Hugh-Curtis syndrome (FHCS)-inflammation of the liver capsule (Perihepatitis) associated with genital tract infection-occurs in 4∼14% of patients with pelvic inflammatory disease (PID). Generally presenting as sharp, pleuritic right upper quadrant pain, usually but not always accompanied by signs of salpingitis. It needs differential diagnosis such as cholecystitis, pyelonephritis. The pathogenesis of FHCS is incompletely understood. But Neisseria gonorrhoeae and Chlamydia trachomatis are thought to be the primary causative germs of FHCS. We make a report about FHCS in 19-year-old woman who had been sexual history recently. (J Korean Acad Fam Med 2008;29:134-139)

Background
: A 15-item GDS form is now widely used to screen for depressive symptoms in elderly patients, but even the 15-item version seems fairly long for routine use in busy outpatient settings. This study was conducted to determine which of the three short-form GDS tools with four or five questions extracted from the 15-item GDS tool could be a valid alternative to the 15-item GDS.

Methods : This study was performed using a questionnaire survey of 102 elderly patients over sixty-five, who had either visited or had been admitted in either one of the two universities hospitals in Seoul or ChungCheong district from October 1999 to June 2004. Questionnaire contained demographic and statistical characteristics, items related to health behavior, 15-item GDS, Mini-Mental State Examination Korean (MMSE-K) and activities of daily living. Three scales, namely, D'Ath GDS-4, Van Marwijk GDS-4, and Hoyl GDS-5 were compared to the 15-item GDS. Sensitivity, specificity, positive predictive value and the area under the ROC curves were calculated for each short-form GDS scales.

Results : The mean 15-item GDS score was 7.4±3.3 and 69.6% of the subjects were to have suggested depression. Hoyl GDS-5 instrument had the highest sensitivity of 87.3%, specificity of 80.6%, and positive predictive value of 91.1% among the three short-form alternatives. The 5-item Hoyl GDS version had the highest area under the curve (0.84), compared to 0.76 for the 4-item Van Marwijk and 0.66 for the 4-item D'Ath GDS version.

Conclusion : The 5-item Hoyl GDS had superior validity over the D'Ath GDS-4 and Van Marwijk GDS-4. The GDS5/15 may be an effective alternative screening tool.

Background
: With the rapid increase in elderly population arousing from development of medical technology and in standards of living, mental disorders as well as organic disorders according to aging constitute a serious social problem. This study aimed to find a factor related closely to cognitive impairment by analyzing the risk factors influencing cognitive impairment, which is one of the typical geriatric neuropsychiatric conditions.

Methods : This study was conducted using a questionnaire survey and history taking and physical examination was done in 200 elderly patients over sixty-five, who had visited either of the four universities hospitals in the Kyongin district from July 1997 to June 2002. A variety of factors being widely known to be related to cognitive impairment by was investigated using the existing comprehensive geriatric assessment. By using MMSE-K (Korea version of Mini- Mental State Examination), the relation between cognitive impairment and each variable was analyzed by using chi-square test and logistic regression analysis with SPSS 10.0k/PC statistical program.

Results : The number of males and females was 73 (36.5%) and 127 (63.5%), respectively, among the total number of 200 examinees. Males and females having symptoms of cognitive impairment was 25 (34.2%) and 49 (38.6%) among the total number of 74 (37%), respectively. Total mean point of MMSE-K was 24±5.4, 24±5.3 in males and 23.9±5.5 in females. According to the results of multi-variable quantities analysis, it was shown that the cognitive impairment had positive relation to age (P= 0.004), but negative relation to regular exercising (P= 0.016), instrumental activities of daily living (P=0.039) and social support (P=0.003).

Conclusion : The factors having a close relation to cognitive impairment of elderly people were social support, age, regular exercising and instrumental activities of daily living.

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
: It is generally accepted in Korea that most of the third year high school(H3) students who are under the academic competitive pressure for college enterance examination seem to be forced to restrict their daily amount of sleep in order to have more time for studying. It is well known that sleep and anxiety interact in a complex manner. The aim of this study is to determine if the trait anxiety could affect sleep patterns in H3 students This article is part of a broad survey study concerning sleep patterns in Korean middle and high school students.

Methods : In the survey study, the Korean version of Spielberger's trait anxiet scale(1970) and sleep questionnare were administered to 240 H3 students(160 male, 80 female) who go to the same school and live in a large city, Kwangju. Two groups of students with high and low trait anxiety levels(58 in each group) were selected based on the trait anxiety scale ratings and then the differences between the two groups were examined in terms of night sleep and daytime sleepiness on weekdays, as well as experiences of abnormal sleep episodes.

Results : Regarding the night sleep, the high anxiety group estimated their sleep was significantly less refreshing than the low anxiety group despite the fact that there were no significant differences between the groups in terms of bed time, rise time, time in bed, sleep latency, frequency of awakening and awakened methods. On components of night sleep regularity, bed time and sleep length were significantly more irregular in the hight anxiety group than in the low anxiety group whereas rise time did not differ between the two groups. Daytime naps were more frequently taken in the high anxiety group than in the low anxiety group, while the experience of daytime dozing and the situations of dozing were not significantly different between the two groups. Abnormal sleep episodes at night such as difficulty in falling saleep, sleep talking, nightmare, and waking up due to headache, seizure, or leg discomfort were significantly more frequent in the high anxiety group than in the low aniety group.

Conclusion : Although all vriables of sleep are not clearly different between the high and low anxiety groups, the findings demonstrated that trait anxiety may contribute to sleep characteristics in H3 students, and suggested the need for further studies on a variety of behavioral aspects along with daytime learning efficacy associated with sleep restriction in H3 students with high trait anxiety.

Background
: Thirteen years ago, The Journal of the Korean Academy of Family Medicine was first published, through analysis of this journal, we can observe the staus of grouwth, development of further family medicine as a scientific and academic discipline.

Methods : An analysis was carried out by major content, type of paper, used statistical procedure and level of quality from 1981 to 1992 of The Journal of Family Practice(below JFP) and The Journal of the Korean Academy of Family Medicine(below JKAFM).

Results : Total 2357 papers of various type have been published. Among the 2375 papers, in JFP 1484, in JKAFM 891 papers published. Compared with both research type, 48.9% JFP used review article, 41.6% used cross-sectional design, 60.7% JKAFM used review article, 41.6% used cross-sectional design, 60.7% JKAFM used review article, 29.4% used cross-sectional design. Compared with the both journal content, biomedical article comprised the largest category in both journal(49.7% JFP, 79% JKAFM). level of quality was 5.31 in JFP, 5.72 in JKAFM(P<0.05). Most frequently used statistical procedure were Chi-square test and T-test in both journal.

Conclusion : Family practice specialty began with no research tradition, and work in this new area has required development of research skill method, and organized approach. This result reflect willingness of family practice for comprehensive, continuous care as scientific and academic discipline.

Background
: This study is how shiftworks among the socioeconomic factors is influenced on family function.

Methods : We have selected 237 shiftworkers group and 248 non-shiftworkers group in the industry and evaluated their family function by Olson's FACESⅢ.

Results : We compared the family function of shiftworkers with that of non-shiftworkers and then the results were below. In FACESⅢ cohesion of shiftworkers there were 59(24.8%) family in disengaged group and 80(33.7%) in separated and 62(26.1%) in connected and 36(15.1%) in enmeshed. In that of non-shiftworkers 52(20.9%) in disengaged and 70(28.2%) in separated and 73(29.4%) in connected and 53(21.4%) in enmeshed. In FACESⅢ adaptability of shiftworkers, there were 71(29.9%) family in rigid and 82(34.5%) in structured and 60(25.3%) in flexible and 24(10.1%) in chaotic. In that of non-shiftworkers 64(25.8%) in rigid and 84 (33.8%) instructured 65(26.2%) in flexible and 35(14.1%) in FACES III family types of shiftworkers there were 88(37.1%) family in balanced and 108(45.5%) in midrange and 41(17.2%) in extreme. In that of non-shiftworkers 88(35.4%) family in balanced and 116(46.7%) in midrange and 44(17.7%) in extreme.

Conclusion : In this resuls we found it out significant statistically that in shiftworkers there were more prevalent in disengaged and rigid family than that of non-shifftworkers and in non-shiftworkers there were more prevalent in enmeshed and chaotic family. In family types there were no significant differences in two groupes