Background
: Despite the declining tendency of the prevalence of tuberculosis in Korea, pulmonary tuberculosis is still considered to be such an important disease in Korea that tuberculosis of patients have been screened by mass miniature radiography(MMR). Although the prevalence of tuberculosis increases with age, screening of it has been done on students and young workers. There hasn't been any study about the prevalence of tuberculosis in adolescents recently.

Methods : MMR were performed on high school freshmen in Seoul from March to September, 1995. Patients with abnormal MMR were further evaluated on history taking and standard chest X-ray, Their results were classified as normal, active tuberculosis, activity-undetermined tuberculosis, healed tuberculosis, and other diseases. The prevalence of active tuberculosis by this screening method was estimated.

Results : Among 194,102 high school freshmen, 388 were suspected to have pulmonary tuberculosis by MMR. The prevalence of tuberculosis in high school freshmen in Seoul was 0.20%, male 0.18%, female 0.23% by MMR respectively, There was significant difference between the prevalences of both sexes. History taking and standard X-ray was taken for 94 students and among them 68 students were found to have active tuberculosis(72.3%), 14 normal(14.9%), 3 other diseases(3.2%), 9 healed or activity-undetermined tuberculosis(9.6%). Newly-diagnosed patients in active tuberculosis were 59(82.9%). There were family history in 31 out of 94 students(33.0%) and 29 out of 68 students(37.1%) with active pulmonary tuberculosis had family history of tuberculosis.

Conclusion : The prevalence of pulmonary tuberculosis in high school freshmen in Seoul was 0.20% by MMR. Positive predictive value of MMR was 72.3% in follow-up students by standard chest X-ray. Therefore estimated prevalence of active pulmonary tuberculosis by standard chest X-ray after MMR was 0.14%.

Background
: Owing to increase in elderly population, the importance of geriatric health is accentuated strongly. We surveyed cancer patients aged 60 years or more to investigate the common cancers, time trend to compare with whole cancer patients.

Methods : We analyzed the data of cancer patients aged 60 years or more who were admitted cancer patients, diagnosed by pathologic biopsy, received radiotherapy, registered as cancer patients on death certification and diagnosed by the other methods in a university hospital from January, 1987 to December, 1995.

Results : We analyzed at intervals of three year, from 1987 to 1989. The order of common cancer sites were stomach(30.1%), lung(19.9%), liver and intrahepatic(11.4%), bladder(6.2%), colon(5.5%), gallbladder and extrahepatic(4.9%), rectosigmoid(4.2%), pancreas(3.2%), cervix(2.9%), esophagus(2.8%) and the number of patients was 1025. From 1990 to 1992, the order of common cancer sites were stomach(23.5%), lung(19.3%), liver and intrahepatic(10.3%), gallbladder and extrahepatic(4.4%), rectosigmoid(4.2%), pancreas(3.9%) cervix(3.7%), colon(3.5%), esophagus(2.7%) and the number of patients was 1470. From 1993 to 1995, the order of common cancer sites were stomach(19.5%), lung(17.2%), liver and intrahepatic(11%), rectosigmoid(5.1%), colon(4.5%), gallbladder and extrahepatic(4.5%), bladder(4.1%), cervix(3.8%), pancreas(3.7%), esophagus(2.0%) and the number of patients was 1519.

Conclusion : Stomach, lung, and hepatic cancers were decreasing and rectosigmoid and pancreatic cancers were increasing in triannual frequency of cancer patients aged 60 years or more. The proportion of elderly patients in all age cancer patients was increasing except gallbladder and extrahepatic cancer. According to the prolongation of life span, frequency increased in old age.

Background
: The normal sinus heart rate standard of 60 to 100 beats per minute was set by the NYHA(New York Heart Association) in 1928. It has long been accepted to physicians, but clinical studies and experience suggest that both these limits are too high. Thus we reexamined to define operationally normal sinus heart rate that are scientifically and clinically acceptable.

Methods : Total 1,930 subjects(aged 20 to 92 years) were analyzed and evaluated for age, sex, body mass index(BMI), sysiolic blood pressure, diastolic blood pressure, and resting heart rates by electrocardiogram. We used Pearson's correlation test and t-test to analyze these data.

Results : Among 1930 subjects, 982 cases were male(51%) and 948 cases were female(49%), whose mean age was 48 years in male and 51 years in female. For the entire sample, mean heart rate and standard deviation was 68±11 beats/min. There was statistically significant difference between male(67±11 beats/min) and female(68±10 beats/min)(P<0.05). The prevalence of sinus tachycardia and bradycardia, calculated by current normal standard of 60 to 100 beats/min, was 22.0%(424 cases) and 0.9%(18 cases). Mean ± two standard deviation yields rounded extremes of 46 to 89 beats/min for normal sinus heart rate. A positive correlations between resting heart rate and age(r=0.11), systolic blood pressure(r=0.17), diastolic blood pressure(r=0.12) were found(P<0.01).

Conclusion : Two extremes of the normal sinus heart rate standard of 60 to 100 beats/min are set too high. They result in lower sensitivity for tachycardia and lower specificity for bradycardia. We propose that normal range for sinus heart rate should be 50 to 90 beats/min which is statistically justified, more realistic for clinical investigation.

Background
: Hypertension is a chronic disorder that causes various complications. It needs proper pharmacologic and non-pharmacologic treatment. But, other studies show there are many traditional and folk remedies about hypertension in Korean. This study was designed to show behavioral patterns of outcomes and side effects of folk remedies in practice-based network.

Methods : The study subjects were hypertensive patients visited practice-based network from September to December in 1996. Data were collected through questionnaire about sociodemographic features of patients and types, effect, frequency, and side effects of folk remedies.

Results : The responders totalled 160 patients, and those who have tried traditional medicine or folk remedies were 65 patients(27 men and 38 women cases). Information source about remedies were 'family members or friends' in 53.8%, 'TV, magazines, and newspapers' in 13.8%, and 'books that deal with health information' in 3.1%. There were 22 experienced remedies ; the most common remedy was herb medicine. In subjective judgement about anti-hypertensive effect, 6 cases described as 'very effective', 21 as ' somewhat effective', 14 as 'not effective', 17 as 'not sure'. Ten(15.3%) of 65 cases experienced side effects.

Conclusion : 40.6% of total responders used traditional or folk remedies, and 15.3% of them experienced side effects, 9.2% of them told that their remedies were 'very effective'. Physicians need to inform patients of side effects of folk remedies and adequate management of hypertension.

Background
: STDs are major communicable disease group in Korea. This study was carried out to evaluate the current status of sexually transmitted diseases in Seoul.

Methods : We collected the laboratory data of those who visited 11 Public Health Centers in Seoul for venereal disease examination and analyzed abnormal results from Jan 1, 1993 to Dec 31, 1995. The diagnoses of STDs were made by VDRL quantification, RPHA test, Gram's stain, and culture of urine or urethral discharge.

Results : There were total of 10,302 patients. There were 7,836 male cases(76.1%) and 2,466 female cases(23.9%). Mean age was 30.6±9.7, and the most common age group was 25-34 years of age(42.1%). Diagnoses were as follows ; syphilis 2,036 cases(19.8%), gonorrhea 2,249 cases(21.8%), nongonococcal urethritis 4,973 cases(48.3%), vaginitis 954 cases(9.3%), mixed infection of syphilis and gonorrhea 13 cases(0.1%), mixed infection of syphilis and NGU 50 cases(0.5%), mixed infection of syphilis and vaginitis 27 cases(0.3%). The proportion of PPNG among gonorrhea was as follows ; 43.4% in 1993, 55.1% in 1994, 43.8% in 1995. There were more WBCs on Gram's staining in gonorrhea cases than in NGU cases.

Conclusion : The STD patients seen in 11 Public Health Centers in Seoul were mainly young men. Common diagnoses were as follows ; NGU, gonorrhea, syphilis, vaginitis. The proportion of PPNG increased at first and then decreased.

Background
: To assess the efficacy and safety of low-calorie-diet(LCD) using formular diet and to compare clinical usefulness of LCD combined with exercise with LCD alone, sixty obese females were prescribed LCD with exercise or LCD alone, randomly.

Methods : Thirty obese females were treated with LCD of 1,000 kcal/d for 8 weeks(group A). Another thirty obese females were treated with LCD of 1,000 kcal/d combined with supervised aerobic exercise for 8 weeks(group B).

Results : 22 out of 30 obese females in group A[37.3±5.0yr ; body fat 40.3±3.9%] and 26 out of 30 obese female in group B[37.9±7.6yr ; body fat 41.5±3.7%] completed the study. At the eighth week, mean weight loss was 5.8±2.1kg(8.1%) for group A, and 6.8±1.6kg(9.7%) for group B. Differences in weight loss between two groups were statistically significant(p<0.05). In group A, blood pressure, serum glucose, uric acid, total cholesterol, HDL-cholesterol, sodium, chloride, body fat were significantly reduced, and serum zinc, calcium, phosphorus were significantly increased(p<0.05). In group B, blood pressure, serum glucose, uric acid, total cholesterol, HDL-cholesterol, triglyceride, insulin, iron, sodium, body fat were significantly reduced, and serum zinc, calcium, phosphorus, magnesium were significantly increased(p<0.05). However, the differences of the changes in the above laboratory data between two groups were not statistically significant. Side effects were few and occurred mainly during the frist week of the trial.

Conclusion : Low calorie diet for 8 weeks decreased body fat, BP, glucose, uric acid, total cholesterol, HDL-cholesterol levels significantly, and when combined with exercise weight loss was much more than LCD only.

Background
: The immune system is controlled by a complex network of regulatory mechanisms which include neurologic and psychological factors. Previous studies of psychopathological population and population challenged by significant life events have shown that high levels of anxiety and depression are associated with impaired cellular immunity. However, less is known about the psychoimmunological relevance of family function with the immune function in healthy population. The aim of the present study was to investigate the presence and direction of relationship between family function and cellular immunity.

Methods : Design : Cross sectional, observational study. Participants : 41 healthy adult males from a family medicine ambulatory care unit in a tertiary hospital completed a series of psychometric instruments that include the Family APGAR(Adaptation, Partnership, Growth, Affection, and Resolve), FACES III. In parallel, lymphocyte subset assay, lymphocyte proliferative responses to the mitogen concanavalin(ConA), interleukin 1-beta, interleukin-2 was analysed to assess cell-mediated immune function.

Results : Family adaptability was inversely correlated with total T cell, B cell counts, helper T cell(T₄) and lymphocyte proliferative response to low dose mitogen Con A(p<0.05). Family cohesion was inversely correlated with suppressor T cell(T8)(p<0.05). In the lymphocyte proliferative response to low dose Con A stimulation, the extreme family showed the highest response compared to midrange and healthy family(p<0.05). Relative to moderately dysfucntional family, severe dysfucntional family and healthy family had significantly higher lymphocyte proliferative responses to the high dose Con A(p<0.05).

Conclusion : We suggest that family function could be related with immune function and it may impact on health and susceptibility to illness in healthy adult males. Further studies are required to elucidate the direction of relationship of family function and cellular immunity and the psychosocial mechanisms involved in the immune system.

Background
: The most important thing to prevent diseases and to promote health is to change or remove health risk factors. One of the trials to improve health status by changing the health risk factors is to appraise health risk factors and to counsel about these factors during the health examination. This study is aimed to evaluate the effects of the 'health examination' on changes of health risk factors.

Methods : The medical records of the clients who have taken health examinations more than twice from June 1991 to March 1996 at a health examination center were reviewed. Those health risk factors were compared between pre- and post- health examination.

Results : The selected medical records accounted to 1,045. The study subjects consist of 758(72.5%) male. Mean age is 47.9±7.6 years(range 18~80). The health risk factors before health examination consisted of smoking(39%), non-exercise(34%), negativity of HBsAb(29.1%), obesity(18.3%), irregular diet habit(17.6%), high salt ingestion(14.1%), alcohol(1%). Also high cholesterolemia(46.2%), high blood pressure(10.7%), high uric acidemia(7.1%), high glycemia(1.6%) were found. The health risk factors such as smoking. drinking. cholesterolemia, uric acidemia, blood pressure seemed to be controlled well. But, the factors like exercise, diet habit, salt ingestion, HBsAb, obesity, glucose appeared not to be controlled adequately.

Conclusion : Behavioral changes to avoid health risk factors after periodic health examination were shown only in some kinds of health risk factors such as smoking and alcohol drinking and in males or those who showed high health risk factor score(total score > 6) in the first health examination.

Background
: Chronic stress is associated with physical illness such as coronary artery disease and hypertension. Daily life habits being able to affect physical health and are associated with mental stress. We studied the relationship between physical illness and stress amount so far. However, the investigation about the stress and the health habits to affect disease directly was not studied enough. Eventually we tested this investigation to know the relationship between stress amount and health habits.

Methods : We measured stress amount and health habits for a month(from May 1 to May 31, 1997) through the people who had already received health screening and were working as researchers. We used 147 results out of 212. Health habits were investigated about 6 articles out of "Breslow's 7 health habits" and stress amount was measured by evaluation scale made by Lee, Pyoung-sook.

Results : There were no differences in amounts of stress of subjects according to age, years in work, hours of sleeping, having breakfast or not, the frequency of exercise and body mass index(BMI). But there were significant differences in amounts of stress of subjects according to drinking amount, smoking or not, and health habit index(P<0.01).

Conclusion : Drinking and smoking appeared to be health habits related to the amounts of stress. Prospective studies are needed to find a causal relationship between health habits and stress amount.

Background
: Recently, the concept of health is extended to physical, mental and social aspects, which leads people to pursue health behavior positively. But the evaluation of health condition shows a tendency to be biased to functional side. It this case, even if he is in physically good health, he is not rated as healthy. We analyzed the relationship between one's health state and the factors related with health perception including health behavior, mind and social environment.

Methods : For a month of May 1996, we surveyed those who visited for periodic medical check-up at one general hospital in Seoul. The questionnaire consisted of the total of 25 items ; diet behavior, weight control, coffee, coke, tea, drug use of, smoking, drinking, exercise, leisure, safety belts use, jay walking, sleep, stress, personality, anxiety, depression, occupational satisfaction, relationships with family and friends. Five point scale is used as the answer of each question item with high point as good living behavior. Among 406 who had sincerely answered the questionnaire, we divided them into healthy and unhealthy group and compared with the point of each question item and with the laboratory data(obesity, blood pressure, hemoglobin, fasting blood sugar, cholesterol and ALT).

Results : Among 406, the number of those who perceived themselves to be healthy was 175(43.1%, healthy group) and the one of those who did not was 231(56.9%, unhealthy group). The difference between both groups was not significant in distribution of sex, age, academic career, income and religion. In laboratory data and living behavior they showed same results, also. But the points of unhealthy group were significantly lower than those of healthy group in coffee, coke, tee, drugs usage, exercise, leisure, stress, personality, anxiety, depression, occupational satisfaction and relationship with family and friends. So was the total point of all items of unhealthy group in comparison with that of health group. In the case of male, the points of unhealthy group were significantly lower in smoking, safety belt use, jay walking, sleeping as well as the above items. On the contrary, in the case of female, both groups were not significantly different all items except exercise and leisure.

Conclusion : Health perception is influenced by psychosocial factors and living behavior more than by physical health. Therefore family physician must be concerned about patient's living behavior, mental and social problems and must make an effort to change their perception of health as well as physical improvement.