Background
: Recently several herbal cigarettes are marketed in Korea as an aid to help smokers stop smoking. However, there is no firm evidence that these products are safe to use. This study was to examine the safety of a herbal cigarette (Simsimcho) by measuring its carbon monoxide(CO) exposure as a result of consuming such cigarettes.

Methods : CO concentrations in expired air were measured in six male smokers with the Bedfont Micro Smokerlyzer. Baseline CO concentrations were initially measured in all individuals. Two design models were used. In the first model, concentrations after the first and second herbal cigarette consumed were measured. In the second model, the course of CO concentrations over 1 hour after the consumption of one herbal cigarette was assessed. Also, CO concentrations were measured after inhaling ordinary cigarettes in the same manner for each model.

Conclusion : In the first model, CO concentrations after the two herbal cigarettes rose from 14 ppm to 39 ppm (Smoker 1) and from 7 ppm to 22 ppm (Smoker 2), respectively. In the same smokers, CO concentrations after the two ordinary cigarettes rose from 17 ppm to 28 ppm (Smoker 1) and from 12 ppm to 24 ppm (Smoker 2), respectively.
In the second model, CO concentrations rose from 28 ppm to 42 ppm (Smoker 3), 16 ppm to 36 ppm (Smoker 4), 16 ppm to 23 ppm (Smoker 5), and 8 ppm and 15 ppm (Smoker 6), respectively. After inhaling an ordinary cigarette, CO concentrations rose from 26 ppm to 32 ppm (Smoker 1) and from 17 ppm, to 33 ppm, (Smoker 2).

Conclusion : Our data showed that smoking these herbal cigarettes led to a similar degree of exposure to CO as smoking ordinary tobacco cigarettes, and may even exceed the latter. Thus, the product was shown to be a potential hazard to health.

Background
: The purpose of this study was to provide useful information for prevention and management of childhood obesity in a school-based setting.

Methods : One thousand and 981 elementary children from 2 different elementary schools in Seoul were studied. The survey concerning the risks of childhood obesity was carried out by having parents answer a questionnaire.

Results : The prevalence of childhood obesity was 18.1% showing significantly higher rate in boys than in girls (P<0.05). It was found that obese children had a higher intake of fish and meat (P<0.05) and a lower intake of vegetables compared to the non-obese group (P<0.05). Obesity was more prevalent among children who frequently skipped breakfast (P<0.05) and also more prevalent among an only child (P<0.05). The obese children significantly spent more time watching TV (P<0.05). There was a higher family history of obesity, hypercholesterolemia and DM in the obese group (P<0.05). The factors which significantly attributed to childhood obesity were birth weight, parenteral BMI, and father's age (P<0.05).

Conclusion : The prevalence of childhood obesity was 18.1%. There was a statistically significant correlation between childhood obesity and gender, eating habit, time spent on watching TV, number of siblings, birth weight, parenteral BMI, father's age and family history such as obesity, hypercholesterolemia and DM.

Background
: The cognitive subscale of the Alzheimer's Disease Assessment Scale(ADAS-Cog) has been extensively validated in assessing cognitive function in patients with Alzheimer's Disease (AD) and used as an efficacy measure in clinical trials of AD. There is a need for additional data on the relationship between cognitive performance and other measures of dementia to fully assess the value of the ADAS-Cog as a measure of treatment efficacy.

Methods : We used data from 53 AD participants in 8 multicenter clinical drug trials to examine the distribution of baseline ADAS-Cog scores in relation to Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDES), Katz Index of Activity of Daily Living(ADL), Lawton Instrumental Activity of Daily Living(IADL), Geriatric Depression Scale(GDS) and Mini-Nutritional Assessment(MNA).

Results : The ADAS-Cog score was statistically significantly correlated with MMSE (T=-0.755, P<0.001), GDES(R=0.403, P<0.003), ADL(R=-0.532, P<0.001), IADL(R=-0.626, P<0.001) and MNA(R=-0.427, P=0.004) scores. But GDS scores were not associated with ADAS-Cog scores.(R= -0.123, P=0.396)

Conclusion : This study characterizes the relationship between ADAS-Cog scores and other commonly used measures of dementia in AD patients. As expected, baseline scores on ADAS-Cog and MMSE demonstrated significantly high correlation. The relatively weaker correlation between ADAS-Cog and GDES scores may be related to the fact that GDES does not evaluate cognitive function only. There are also significant correlations between ADAS-Cog and ADL, IADL, and MNA which indicate the severity and progression of dementia in AD patients. Further studies with larger samples including cognitive function of broader spectrum need to confirm the findings in this study.

Background
: Because of many physical, psychological, and social stresses, adolescence is a vulnerable period to psychiatric disorders. But in Korea, there is actually not enough time for primary care physicians to screen such patients during ordinary medical interviews. Therefore this research was done to develop and validate a brief screening questionnaire for the detection of adolescent patients with psychiatric problems.

Methods : Three family physicians in charge of their own adolescent clinics developed a five-item questionnaire for screening adolescents with psychiatric problems by reviewing related literature with consultation by a psychiatrist. After performing a pretest and gathering second opinions from other psychiatrists and nurse-teachers, final questionnaire was redeveloped. Verification of its reliability by using test-retest method and internal consistency by calculating Cronbach's alpha coefficient was done. Also inspection of its validity by comparing the scores of psychiatric patient group to normal group was done. And finally the discrimination point was obtained.

Results : For reliability Kappa value or new questionnaires ranged from 0.33 to 0.63. One item was dropped because of its negative influence to the internal consistency and the discrimination power. With the four final items, we estimated the validity for distinguishing psychiatric patients from the normal group by calculating the sensitivity and specificity of each cutting point of scores. For the each cutting point 1, 2, and 3, sensitivity was 85%, 75%, 40%, respectively, and specificity was 27%, 62%, 84%, respectively. We considered score 1 as the best cutting point because the purpose of the questionnaire was screening rather than diagnosis.

Conclusion : A brief four-item screening questionnaire(SAPPO. Screening method of Adolescent Psychiatric Problems in Outpatient clinic) was developed and its reliability and validity was estimated.

Background
: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea.

Methods : Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. After pretest on ordinary people. The completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group.

Results : Kuder-Richardson or Cronbach-α that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted.

Conclusion : Korean versions of TDAS, DDS and SSIS were reliable and valid.

Background
: 　Antibiotics are often indiscriminately prescribed for respiratory tract infections. This study was conducted to describe the prescription pattern of family physicians for respiratory tract infections.

Methods : In each clinic of 50 representative family practitioners, about 20 consecutive patients with diagnosis of respiratory tract infection were enrolled into the study. The data were collected by questionnaire to physicians just after patient interview.

Results : The number of study subjects was 1020, of which 55.7% was less than 15 year old. Antibiotics were prescribed to 73.9% of total subjects. According to diagnosis, the antibiotic prescription rate was 51.5% in common cold, 86.0% in pharyngitis, 88.6% in bronchitis, 98.9% in sinusitis, and 100% in otitis media. In common cold, the factors which significantly increased the antibiotic prescription were 1)patient age less than 15 year old (OR=1.70, CI= 1.06-2.73), 2)more than two visits during the same episode(OR=1.95, CI=1.27-2.99), 3)yellow and thick rhinorrhea(OR=2.22, CI=1.16-4.25), 4)yellow and thick sputum(OR=3.31, CI=1.34-8.19), and 5)throat injection(OR=2.50, CI=1.42-4.39). Among patients to whom antibiotics were prescribed, 48.7% of patients were given the antibiotics by intramuscular injection. The most frequently prescribed antibiotics were penicillin and macroride among per-oral medicine and ribostamycin and lincomycin among intramuscular medicine. The reason for antibiotic prescription were 1)possibility of bacterial infection(43.4%), 2)prevention of bacterial complication(23.7%), and 3)definite evidence of bacterial infection(22.5%).

Conclusion : Family practitioners prescribe antibiotics indiscriminately for the respiratory tract infection. The prescription was influenced by patient's age, number of clinic-visit, and clinical symptoms and signs.

Background
: Amezinium methylsulfate(Risumic) is the useful drug in the treatment of essential hypotension. This drug elevate blood pressure by stimulating sympathetic nervous system and improve symptoms related hypotension. This study was designed to evaluate efficacy and safety of Risumic for patients with essential hypotension.

Methods : This study was performed in patients with systolic blood pressure less than 100mmHg from June, 1999 to December, 1999. Risumic blood pressure response, improvement of symptom and side effect were examined in a double-blind, placebo-controlled, crossover trial.

Results : Total of 54 patients participated in this study and only 55.6% of them were finished and the rest of them(44.4%) was stopped. 6 patients of this patients were stopped because of side effects. But there was no difference in side effects in Risumic and placebo periods. In diastolic BP, Risumic group is 5mmHg higher than placebo group. And then there was significant difference in statistics.

Conclusion : In essential hypotensive patients, Risumic is elevater DBP than SBP, side effects frequency was no significant difference in Risumic and placebo group.