Background
s: The education by the family physician. is important for more practical primary care medicine education. In this study, we try to know the present state of education and the future and the number of education resource and how to multiply this resource.

Methods : we have got the list of family physicians who have their clinic in Seoul by the help of the Korean Academy of Family Medicine. And we performed telephone questionary. We also asked the demographic factors.

Results : 134 persons were asked questionary by the telephone. 17 persons were joining in education. Trainee by the 3rd grade hospitals was the major, the next was by 2nd grade hospital, and doctors who did not have the training. 14 persons have begun education by asking of the training hospital, 3 persons wanted it, but none thought it beneficial to them. 44 persons wanted to join education in the future, and there was no difference between the 3rd and the 2nd grade hospital trainee.

Conclusion : There was no difference between the 3rd and 2nd grade hospital trainee but 2nd grade hospital trainee was less joining than the 3rd. This shows that the 2nd grade hospital trainee can be the good pool of the future education if there are adequate supply. So many adequate supply is necessary.

Background
: The new Bethesda System terminology has opened a series of problems about the atypical squamous cells of undetermined significance and low grade squamous intraepithelial lesion categories, particularly on their follow up.

Methods : We observe 12300 Pap smear examination, from Jan 1995 to Dec 1999, in the Health Promotion Center in a university hospital. Subjects were defined at the Health Promotion Center in a university hospital by electrical record and chart review.

Results : We find 48 cases of ASCUS and 33 cases of LSIL. When it is followed up by Pap smear, 34 cases of ASCUS are confirmed normal 19 cases (55.9%), benign cellular change 6 cases (17.6%), ASCUS 5 cases (14.7%), HSIL 4 cases (11.8%) and 27 cases of LSIL are confirmed normal 11 cases (40.7%), benign cellular change 3 cases (11.1%), ASCUS 3 cases (11.1%), LSIL 8 cases (29.6%), HSIL 2 cases (7.4%). 14 cases of ASCUS and 23 cases of LSIL are diagnosed by biopsy. Histologic results of 14 cases of ASCUS are confirmed cervicitis 10 cases (71.4%), moderate dysplasia 2 cases (14.3%), carcinoma in situ 2 cases (14.3%) and histologic results of 23 cases of LSIL are confirmed cervicitis 15 cases (65.2%), mild dysplasia 3 cases (13%), moderate dysplasia 3 cases (13%), severe dysplasia 1 case (4.3%), carcinoma in situ 1 case (4.3%), Pap smear only was used for follow-up at family medicine clinic and 14 cases (29.2%), 4 cases (12.1%) are follow-up loss.

Conclusion : After it is diagnosed ASCUS or LSIL lesion of Pap smear in healthy care visitors, Follow-up loss is high in only follow-up Pap smear examination and follow-up results are presented more severe lesions. To reduce follow-up loss, aggressive diagnosis and managements may be needed more than Pap smear follow-up examination.

Background
: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone.

Methods : We screened adults over 20 years who were visited the Health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression.

Results : Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P<0.05). Multiple logistic regression showed that prevalence of asymptomatic gallstones was increased by age (>40 years old) and were associated with BMI (>25㎏/㎡), fasting blood glucose.

Conclusion : Associated factors of prevalence of asymptomatic gallstone were increased by age (>40 years old) and were associated with BMI (>25㎏/㎡), fasting blood glucose, and were not different from those in West countries. Further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to symtomatic gallstone.

Background
: In spite of harmfulness of smoking, the smoking rate of adult male is high in Korea and that of adolescent and women has risen recently. Most smokers try to stop smoking for themselves without doctor's help or medication, but the success rate is extremely low. Although the number of smoking-cessation clinic has risen year by year, there are few researches about smoking cessation. In this study, we tried to find the factors associated with successful smoking cessation and the effective smoking cessation modalities.

Methods : 114 smokers, who has visited the smoking-cessation clinic of Seoul Paik Hospital from Oct. 1998 to June 2000, were included. After doing a survey with basic questionnaire and smoking cessation counselling, we followed up them. We also checked their smoking behavior 6 months later.

Results : The success rate was 32.5%. the demographic characteristics of success group and failure group showed no significant difference. But the factors such as age, BMI, expiratory CO level at initial visit to hospital, nicotine dependence scale, the duration using nicotine patch and the number of visit to smoking-cessation clinic showed significant difference between the two groups.

Conclusion : The results of logistic regression showed that BMI and nicotine dependence scale were significantly different.

Background
: As patients can go to specialists and family doctors do not have gate-keeping role, doctor-shopping is very popular in Korea. The introduction of family doctor registration program is proposed several years ago, and the debate is still being done about that issue. This study is to show the possession rate of regular doctor and to investigate the factors associated with it.

Methods : We interviewed 657 adults of Seoul, Bundang, Ilsan and Pyungchon with preformed questionnaire which included the questions about regular doctor and attitudes to the family doctor registration program. Respondents were sampled according to the age structure and population distribution of the cities.

Results : About half of the respondents had regular doctor. Internists were regular doctors of nearly half of the respondents and pediatricians 30.6%, oriental doctors 5.6%, general surgeon 4.4%, and family doctors 3.8%. About half of the regular doctors worked in primary clinic and 48.2% in hospitals. The most important reason choosing regular doctor was distance to the medical facilities. The most frequently provided service by regular doctor was vaccination (57.1%), the least was home visit (2.9%). Factors associated with the possession of regular doctors were residence area, sex of respondents, level of income and education.

Conclusion : Nearly half of the respondents had regular doctors and half of the regular doctors were internists and worked in primary clinics. The area of residence, sex, income level, level of education, and interest for health were related with the possession of regular doctor.

Background
: Many patients with Type I Diabetes Mellitus treated by insulin therapy were observed their blood sugar dropped even after meal. The ecology and treatment for this phenomenon was unknown. A clinical research making an approach to treat this phenomenon is inevitable.

Methods : 9 patients whose blood sugar dropped right after meal (from 15 minutes to 1 hour) were selected among 58 IDDM(Insulin Dependant Diabetes Mellitus) patients admitted in Daejon Sungsim hospital from March 1999 to Feb. 2000. The subjects were consist of 6 female and 3 male, average age was 57.2. Blood samples were taken from their capillaries and measured by Super Glucocard Ⅱ glucometer. Insulin was injected 30 minutes before breakfast and 50% glucose 30 ml was taken orally 15 minutes after the insulin injection. Breakfast was taken 15 minutes after the glucose taken. Blood sugar was measured 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 120 minutes and 2 hours after a breakfast.

Results : Though average blood sugar dropped after breakfast was 44.5 ㎎/㎗, average blood sugar after taken 50% glucose 30 ml was 114.1 ㎎/㎗. 2 patients had good effect among 3 male patients and every 6 female patients had good effect.

Conclusion : Taking 50% glucose 30 ml in oral 15 minutes after insulin injection improved the IDDM patient's blood sugar drop right after meal.

Background
: A prospective study about the association between serum ferritin concentration and diabetes mellitus showed that higher risk of diabetes was found in men in higher concentration of serum ferritin. The aims of this study is to examine the association between serum ferritin concentration and the risk of diabetes mellitus in healthy Korean in hospital-based samples.

Methods : In a volunteered healthy population(n=14.782), who underwent health examination in Samsung Medical Center, from January to December 1997, serum ferritin and glucose were determined.

Results : After adjusting for age, BMI, serum triglyceride concentration, and multiple logistic regression analysis showed that those in the highest quartile had increased risk of diabetes mellitus (OR: men 2.26(95% CI 2.41-2.95, p=0.0001), women 3.03(95% CI 2.51-3.67, p=0.0001), compared with those in the lowest quartile.

Conclusion : In studied population, elevated serum ferritin concentration was associated with an increased risk of diabetes.

Background
: Thesedays, the physical strength of adolescents had been weakened compared to the past, The reasons are that adolescents like to enjoy watching TV or video and PC in their rooms and going to school by car even though it is near distance. Therefore, the authors were to investigate the relationship between their physical activity and the amount of maximal oxygen uptake.

Methods : The subjects of this study were 103 freshmen of the college of physical education and 115 freshmen of general college of a university. The instruments used in this study are the step-test and the questionnaire which is composed of sex, age, physical activity, inactivity, rate of perceived exertion, and sports activity.

Results : The quantity of the physical activity of the freshmen of the college of physical education such as daily walking distance, floors of step-up and active sports was significantly higher than that of the freshmen of general college. The hours spent on sitting in chair is less than that of freshmen of general college. The quantity of physical inactivity such as watching TV or video and using PC of freshmen of the college of physical education was lower than that of freshmen of general college. The amount of maximal oxygen uptake(VO2max) estimated by the step-test was significantly higher in freshmen of the college of physical education than those of general college.

Conclusion : The amount of maximal oxygen uptake of the freshmen of the college of physical education was higher than that of freshmen of general college. And VO2max was related with physical activity, sports activity and RPE.

Background
: It was known that the prevalence of reflux esophagitis in Korea was below 5% and there were few epidemiological data on reflux esophagitis in Korea. It was reported that the associated factors of reflux esophagitis were sex, smoking, alcohol consumption, obesity, drugs, exercise, diet habits, but the number of systematic studies on these factors was small. Thus, we studied to estimate the prevalence and associated factors of reflux esophagitis in Korea.

Methods : We examined 5,487 subjects (male 3,450, female 2,037, age;18-82 year) visiting health promotion center for routine check-up including esophagogastroduodenoscopy. All of them were given a questionnaire about past medical history, use of drugs, smoking, alcohol consumption, social history, diet habits. We recruited 275 cases with reflux esophagitis and 550 controls without reflux esophagitis on esophagogastroduodenoscopy. We estimated the prevalence of reflux esophagitis and performed retrospectively a cross-sectional study to evaluate the associated factors of reflux esophagitis.

Results : The prevalence of reflux esophagitis was 5.01%, 7.10% in male, 1.47% in female. The prevalence in male was significantly higher than that in female(p<0.05). The associated factors of reflux esophagitis were smoking, alcohol consumption, serum total cholesterol, triglyceride (p<0.005). It was investigated that the cases with reflux esophagitis in relation to diet habits ate more frequently fried foods in oil, Chinese dishes than controls (p<0.05)

Conclusion : The prevalence of reflux esophagitis in routine check-up subjects was 5.01%. The associated factors of reflux esophagitis were smoking, alcohol consumption, serum total cholesterol, triglyceride.

Background
: The relation between lifestyle and chronic diseases in now well established. For example, smoking, high dietary fat intake, lack of exercise have been identified as independent risk factors for the development of cardiovascular disease. So changing risk factors related to lifestyle is very important to minimize the burden of many kinds of chronic diseases including cardiovascular disease and cancer. Patients who are at increased risk of developing chronic diseases should be identified and if this increased risk is modifiable unhealthy behavior, appropriate advice should be given to encourage behavioral change. That is one of the most important role of primary care physician. However, we do not know how often patients with varying risk factors receive lifestyle advice from their physician in Korea. This study is to know how often patients having cardiovasculr risk factors receive lifestyle advice from their physician and what is the predicting factor of that.

Methods : Cross-sectional study was done by direct interview. Subjects were 3151 people aged 19-61 years who had consulted a physician at leat once during 12 months before interview and who were employee of the national company which had branches nationwide. Possible cardiovascular risk factors were identified from the result of health check. Subjects were asked whether they had received lifestyle advice for each of identified risk factors from physician. The data about sociodemographic characteristics also were collected during interview. We used x2 test for trend to establish whether increasing risk levels were associated with a change in the likelihood of receiving advice about modifying risky behaviors.

Results : The proportion of smokers who received advice about smoking was just 29.3%, but smoking was unhealthy behavior most likely to receive advice from physician. The proportion of subjects receiving advice about exercise was only 8.6% and was significantly higher among those who were diabetic (27.6%), hypertensive (22.7%), or who had a history of cardiovascular disease (36.4%). The proportion of subjects receiving advice about low dietary fat intake was only 6.8%. The proportion was higher among obese subjects (13.7%) and rose with increasing serum cholesterol level (x2 trend=9.46, df=1; p<0.01). The proportion of subjects receiving advice about alcohol consumption was 18.1%. Women were significantly less likely than men to receive advice about smoking, exercise, alcohol consumption except about dietary intake and weight control. Age was significantly associated with the likelihood of receiving lifestyle advice.

Conclusion : Patients reported a low rate of receiving lifestyle advice from physician. This results suggest that more preventive advice about healthy lifestyle should be given in primary care.