Background
: The prevalence of smoking has declined continuously in the developed countries since 1960 due to various antismoking policies, but that remains high in Korea. The surveys of smoking habits of physicians are rare as compared with those of general populations in Korea. In this situation, we surveyed to obtain the basic data for the antismoking activities by the survey of family physicians' smoking patterns who are primarily contact with patients.

Methods : To investigate the smoking habits of family physicians, a qustionnaire was mailed two times in July 1993 to 2,528 family physicians who are legistrated in the Korean Academy of family Medicine. After we excepted 37 incomplete questionnaires among 1,122 respondents, we analysed 1,085 complete questionnaires by the classification of cigarette smoking status and speciality status.

Results : Among the total respondents of 1,085, family residents were 13.9% and family specialists were 86.1%. The sex ratio of residents was 1.7:1 and specialists 4.6:1. The proportion of nonsmoker, ex-smoker and smoker were 38.3%, 35.1% and 26.6% respectivly. And the proportion of male smokers among the residents and specialists were 53.6% and 30.5% respectively. The smokers had 84.0% of smokers in their family. The most common reason for the initiation of smoking was curiosity(45.0%) and the differences of reason between ex-smokers and smokers were statistically significant. 46.9% of all smokers daily consumed less than 15 cigarettes and the amount of daily smoking by ex-smokers was significantly much more than that by smokers. 42.3% of smokers took first morning smoking within 30 minutes after getting up and it was sigificantly higher than that of ex-smokers. Of the why test for smoking patterns, stress solution(30.3%) was the most common reason for smoking among all smokers, and by the smoking behavior, nicotine dependence was the highest in smokers but stress solution was the highest in ex-smokers and by the duty, stress solution was the highest in residents but nicotine dependence was the highest in specialists. Smokers who had ever tried to quit smoking were 78.5% of smokers and health problem was the most common reason to quit smoking. Most of nicotine withdrawal symptom peaked in 2 to 4 days after quitting and this prevalence was 49.8% of all smokers. The drinking habit of smokers was poor compared to the others and the habit of health promotion of ex-smokers was good compared to the others.

Conclusion : The smoking habits of family physicians was better than those of the general population but those of male physicians, especially male residents were worse than females. Recognizing the core of primary care, the family physician shoud make efforts to quit smoking for themselves so that their exemplary role contributes to patient's smoking behaviour and assists patients to quit smoking.

Background
: An obese child had a high risk for becoming an obese adult and many obese children have disorder similar to obese adults. In addition, obese adolescence is refractory to trerapy due to not hypetrophy of adipocyte but hyperplasia of that. So in obesity, prevention at childhood is the best choice of treatment. Factors that affect the childhood obesity are classified into genetic and environmental factors. Familial tendency or aggregation that includes the both sides of these factors is well known. The purpose of this study is to observe the relationship between child obesity and parents' obesity.

Methods : In 332 boys, 316 girls at 10-11 years old of elementary school in seoul, height and weight was measured in April, 1994. Their parents' height, weight and demographic datas were collected by using the self-recorded home questionnaire. Obesity is evaluated by body mass index(BMI=kg/m²). In children, BMI≥85 percentile was defined as obese group and 25-75 percentile was defined as normal weight group. In parents, BMI≥85 percentile was obese group and ≤85 percentile was non-obese group.

Results : Mothers' BMI was significantly(P<0.05) higher in child obese group than child normal-weight group. In child obese group, children's BMI correlated closely with their mothers' BMI(r=0.23, P<0.05). Children with obese mothers were about twice as likely to be obese than children of non-obese mothers state of each parent was significantly(P<0.01) different.

Conclusion : In child obese group, children's BMI was related more closely with mothers' BMI than the fathers'. Maternal obesity can be one of the risk factors for child obesity.

Background
: Industrialization has taken its roll in creating a noisy environment that has resulted in various man-made diseases. Their most distinctive one is Noise-induced hearing loss(NIHL). Although developed NIHL has never treated, developing of NIHL could be prevented if with attention, sufficiently. Thus, its prevention can not be emphasized very much. One method of its prevention is screening test for high risk group of NIHL during priodic health examination. Our study was designed to find prevalence and characteristics of NIHL in men in their twenties with military duty-off and its related factors.

Methods : The selected subjects were 103 males in their twenties with military duty-off taken periodic health examination of new officer candidates in a public enterprise at 8 july 1994 at hanil general Hospital. Data were gathered by questionnaire which is consist of past medical history related to hearing loss, noise exposure and its kinds. Screening Audiometer test was performed. Otoscopic examination and physical examination related to hearing disturbances were performed. Thereafter, audiogram(air-and bone- conduction) were performed if any abnormal finding was detected by screening audiometer test.

Results : Among 103 male subjects, 11 subjects(10.7%) were considered to NIHL cases and were shown to have C-5 dip pattern. Their mean hearing loss at 4,000Hz and by 3-divided method were 45.9(dB), 10.0(dB) in Lt. ear and 36.8(db), 10.3(dB) in Rt. ear, respectively. Among 14 cases of other noise exposure group, only 1 case was considered NIHL case.

Conclusion : Among 103 subjects, 11 subjects were shown to have C-5 dip pattern known as incipient appearance of NIHL or its advanced pattern. Thus, prevalence of NIHL was 10.7%. According to this results, we thought that some hearing conservation programs should be applied to this group. and we considered that, if their job should be performed in a noisy environment, screening test for hearing disturbance should be applied.

Background
: Family is a important social factor which has influenc on health. Therefore, it is thought that the thing which evaluates family function for estimating depressive trend is one method of the systemic approach. Thus, we studied correlation between family function and depression of inpatients in general hospital.

Methods : The studied subjects were 167 inpatients wxcept the patients with poor mentality, the patients who were answered incorrectly among the total 296 inpatients who were admitted to Sung Nam Hospital on some day, March, 1994, and the authors analyzed and evaluated correlation between family function and depression of inpatients through the questionnare which included the demographic and physical characteristics, and through the objective psychological examination, FACES Ⅲ and BDI questionnare which were approved reliability and validity.

Results : Among the respondents, cohesion and adaptability scale of FACES Ⅲ were as high as with age, and cohesion scale is as high as with income. On the other hand, women were significantly higher in depressed inpatients than men, and there was a significant tendency for depression to increase with age, and in lower deucation group, and in lower income group, and in longer hospital duration. Frequency of depression among the total inpatients was 39.5%. In family type according to cohesion scale, separated or disengaged type was predominant in depressed group, but connected or enmeshed type, predominant in nondepressed group, and this results were statistically significant(P<0.05). In family type according to adaptability scale, flexble or rigid type was predominant in depressed and nondepressed group, and there was no significant statistically.

Conclusion : In study of correlation between family funtcion and depression, cohesion scale was lower level in depressed group than in nondepressed group, this result was statistically significant(P<0.05), but, there was no significant correlation statistically between adaptability scale and depression.

Background
: Noncompliance is a important problem in the management of hypertension, which causes major morbidity and mortality among Korean people. The purpose of this study is the assessment of drop-out rate of hypertensive patients in university-based family practice setting.

Methods : The medical records of hypertensive patients for 2 years(July 1, 1991 August 30, 1993) were reviewed. 207 patients visited during this period. Six cases of referral and 45 cases of non-pharmacologic treatment group were excluded. A total of 156 patients were under reivew about the date of the first visit, the date of the last visit, and frequency of visit during study period. We analysed several factors by adherent group, irregular visiting group, and drop-out group according to arbitrary criteria.

Results : Among 156 patients, 33 patients(21%) were compliant, 46 patients (29.5%) were visited irregularly and 77 patients(49.3%) were dropped-out. Patient's compliance in keeping appointment was not related with age, sex, presence of target organ damage and previous awareness of morbid state, except presence of comorbid disease. Patients with several degenerative diseases were keeping appointment better than patients without these comorbid diseased.(P<0.05) 39.5% of hypertensive patients were lost to follow-up after 1 year, and 45.3% remained in antihypertensive therapy after 3 years.

Conclusion : There is a increase in drop-out rate with duration of antihypertensive therapy. 45.3% of hypertensive patients remained in antihypertensive therapy after 3 years of treatment and 12% of patients were dropped out immediately after the first visit. Presence of comorbid diseases was associated with patient's compliance. Strategies improving compliance and decreasing early drop-out rate are needed.

Background
: Diverticular disease of the colon is common in western population, but rare in oriental population. Recently there is increasing tendency in the incidence of the diverticular disease in Korea because of change the diet pattern and development in the diagnostic method. The purpose of this study is to analyze clinical characteristics in diverticular disease of the colon.

Methods : We experienced 28 cases of diverticular disease of the colon from March 1991 to July 1994 at the Department of Surgery, Seoul Christian General Hospital. We study to the age and sex distribution, symptoms and signs, preoperative and postoperative diagnosis, location and number of diverticulum, operation method and postoperative complications.

Results : The peak incidence of age group was 3rd to 4th decade. The ratio between male and female was 6:1. The most frequent symptoms and signs were RLQ pain and tenderness. The preoperative diagnosis were acute appendicitis in 75.0% and peritonitis in 14.3%. The methods of surgical treatment were right hemicolectomy in 11 cases, diverticulectomy and appendectomy in 9 cases, appendectomy in 4 cases and others. The most common location of diverticulum was cecum in 19 cases. The ratio between right side diveticulum and left side diverticulum was 12.5:1(p<0.05). The number of diverticulum was 14 cases in solitary type and 14 cases in multiple type. The postoperative complications were wound infection in 1 case, pneumonia in 1 case, postoperative partial intestinal obstruction in 1 case and others. There was no postoperative mortality.

Conclusion : When suspected acute appendicitis, we must rule out the colonic diverticulitis. After the confirmation of the number and location of diverticulum through the preoperative barium enema as possible, the excision of diverticulum should be done. During the operation for the acute appendicitis, compared the clinical symptoms and signs to the operative findings. If disconcorded, we whave to explore the diverticulum and then excision of the diverticulum shoud be done. The residual diverticulum can confirm through postoperative barium enema.

Background
: Anxiety is one of the major aspects of human emotion, and also one of the important symptoms seen in general medical in primary care practice to recognize, assess, and intervene in psychological aspects of chronic illnesses in view of understanding causes of diseases, predicting clinical progression, and making balanced therapeutic approach. In this regards, the present study compares hypertensives with normal controls on measures of anxiety.

Methods : Typertensive subjects consisted of patients who were receiving treatment for essential hypertension in outpatient clinic of internal medicine or famuly medicine from July 1994 to August 1994. Control subjects consisted of normotensives who were relatives of general patients admitted in Cheju Hankook Hospital during same period. Questionnaires for general inforamtionand translated Zung's Self-Rating Anxiety Scale(SAS) were recorded by all subjects.

Results : 50 male and 50 female subjects were studied in each group by matching. Mean ages were 54, 58 years for hypertensive amle and female groups, and 41,44 years for control male and female groups. Mean SAS scores for hypertensives and controls were 40.2 and 36.7 respectively and revealed statistically significant difference between two groups(P<0.01). In the comparison of hypertensives and controls on individual items of SAS, hypertensives reported significantly greater(P<0.05) tendency for mental disintegration, dizainess, dyspnea, urinary frequency, and sweating than controls did. In the comparison of SAS scores by sex, there was no significant difference between hypertensives and controls in male(37.2, 34,8, respectively), but hypertensives showed significantly higher scores(43.8) than controls(38.2) in female subjects(P<0.001). And the mean SAS scores for female subjects were significantly higher(P<0.05) than male subjects in both hypertensive and control group. The degree of anxiety was increased with age in control group., but such an increase was not reported in hypertensives.

Conclusion : It is needed for physicians treating and managing hypertensive patients to understand. assess on first visit, and intervene in this important psychological aspect, anxiety, especially in female patients.

Background
: The family members with family dysfunction frequently complains of multiple psycosomatic symptoms. Of theses, the psychosomatic factors-sensitive Upper Gastrointestinal(UGI) symptoms account for a large part of them on our out-patient department. This study was carried out to related the family function with UGI symptoms.

Methods : The subjects were 243 cases who attended the department of Family Medicine or Inernal Medicine, Pyung-Tak Bak-Ae Hospital, during a period of approximately 6 months from Feb. 1994 to Jul. 1994, categorized into two groups according to UGI symptoms. One had 106 cases who were regarded as healthy control group without UGI symptoms, another regarded as patient group of 137 cases with them, and who have been given the flexible Gastrofiberscopy with the resulting endoscopic findings.
We compared family function with UGI symptoms using FACESⅢ questionare, acronym for FAmily Adaptibility and Cohesion Evaluatin Scales, which was developed by Dr. Olson, David H. to tap adaptibility and cohesion.

Results : The results processed by SPSS/PC program were as followed :
1) Male was 150(61.7%), and female was 93(38.3%)
2) Epigastric pain(63.2%) or bloating sensation(63.1%) were the most common symptoms and followed by indigestion(37.7%), nausea(32.1%), weight-change(27.4%), vomiting(24.5%), and foreign body sensation(24.5%).
3) Gastroscopic findings were as followed ; niormal finding in 54 cases(50.9%), gastritis in 32.1% , gastric ulcer in 5.7%, duodenal ulcer in 4.7%, cancer in 3.8% and others in 0.9%.
4) The patients group with the indigestion showed significant enmeshed or disengaged cohesion than the contol group.
5) The patients group with the foreign body sensation showed more disengaged cohesion and rigid adaptibility than the paients without it, and the patients group with the epigastric pain showed omre chaotic adaptibility than the patients without it. But these two groups were not nefferent from the healthy control group.
6) No difference was noted in family type related to UGI symptoms or Endoscpic ffindings.

Conclusion : This study showed the family dysfunction from patients with some UGI symptomes. Thus we suggest that the family dysfunction related to UGI symptoms. But as our subjects were not enough, we need further follow up study. N