Citations

• Assessing the Communication Skills of Medical Workers Using Various Scales
  N. I. Mustafayeva, Z. S. Vezirova, Z. F. Gumbatova, N. M. Shirinova
  Virtual Technologies in Medicine.2023; (1): 30.     CrossRef

Background
Platelet has been known as an implicating factor in the pathophysiology of atherosclerotic disease. Larger platelets are more reactive and produce more prothrombotic factors. Several studies have shown relationship between mean platelet volume (MPV) and coronary artery disease. The present study has been designed to investigate association of MPV and subclinical CAD (coronary artery disease; abnormal finding in coronary multidetector computed tomo-graphy [MDCT] in asymptomatic individual). Methods: This cross sectional study was carried out in 103 men and 72 women (over 40 years old) who underwent coronary MDCT as screening test for disease prevention in the health examination center of Hanyang University Medical Center in Korea from January 1 to April 30, 2009. Subclinical CAD was defined when either of the following findings are present in asymptomatic patients: 1) plaque or calcification, 2) stenosis of any level. After adjustment for age, gender, hypertension, diabetes, BMI, smoking (pack-years), LDL cholesterol, odds ratios (ORs) for the prevalence of the subclinical CAD were calculated for quintiles of MPV using logistic regression analysis. Results: After adjustment for age, gender, hypertension, diabetes, BMI, smoking (pack-years), LDL cholesterol, the OR for subclinical CAD, comparing the fifth quintile of MPV with the first quintile, was 5.83 (95% confidence interval, 1.51 to 22.42; P = 0.010). Conclusion: Highest level of MPV is independently associated with the prevalence of the subclinical CAD after adjusting for other risk factors.

Citations

• Association of mean platelet volume-to-platelet count ratio for 24-hour mortality in patients with severe trauma
  Seokjin Ryu, Donghun Lee, Jiho Lee, Byungkook Lee
  Medicine.2025; 104(35): e44165.     CrossRef
• A Study of the Mean Platelet Volume and Plasma Fibrinogen in Type Two Diabetes Mellitus Patients Versus Healthy Controls and Their Role as Early Markers of Diabetic Microvascular Complications
  Sindhuri Goud Nimmala, Vijayashree S Gokhale, Ponvijaya Yadav, Sangram Mangudkar, Satbir Malik
  Cureus.2024;[Epub]     CrossRef
• Predictive Effects of Platelet Indices in Cirrhotic Patients with or without Portal Vein Thrombosis
  Filiz Araz, Barış Soydaş
  European Journal of Therapeutics.2023; 29(4): 838.     CrossRef
• Relation Between Oxidative Stress and Hematologic Abnormalities in Children With Type 1 Diabetes
  Adel Abdel-Moneim, Mohamed I. Zanaty, Amr El-Sayed, Rehab G. Khalil, Hanan Abdel Rahman
  Canadian Journal of Diabetes.2020; 44(3): 222.     CrossRef
• Mean Platelet Volume as a Marker of Vasculogenic Erectile Dysfunction and Future Cardiovascular Risk
  Andrea Crafa, Rosita A. Condorelli, Laura M. Mongioì, Rossella Cannarella, Federica Barbagallo, Antonio Aversa, Giulia Izzo, Anna Perri, Aldo E. Calogero, Sandro La Vignera
  Journal of Clinical Medicine.2020; 9(8): 2513.     CrossRef
• Simple hematological parameters before detailed glycemic investigations: An easy approach for pre-assessment of diabetic complications in Indian scenario
  Manoj Saluja, Yogesh Kumar Swami, Saurabh Chittora, Hemant Vimlani
  Current Medicine Research and Practice.2019; 9(3): 89.     CrossRef
• A Study of Platelet Indices in Type 2 Diabetes Mellitus Patients
  Kumari Shilpi, R. M. Potekar
  Indian Journal of Hematology and Blood Transfusion.2018; 34(1): 115.     CrossRef
• Platelet function in diabetic and nondiabetic patients with chronic obstructive pulmonary disease: a case control study
  Hoda Ahmed Makhlouf, Samiaa Hamdy Sadek, Asmaa Abdel Hakim Nafady
  The Clinical Respiratory Journal.2018; 12(1): 48.     CrossRef
• Can mean platelet volume levels of trauma patients predict severity of trauma?
  Sadiye Yolcu, Gokben N. Beceren, Önder Tomruk, Duygu Kumbul Doguç, Ozlem Balbaloglu
  Platelets.2014; 25(4): 279.     CrossRef
• Mean platelet volume and coronary artery disease: a systematic review and meta-analysis
  Nakarin Sansanayudh, Thunyarat Anothaisintawee, Dittaphol Muntham, Mark McEvoy, John Attia, AmmarinThakkinstian
  International Journal of Cardiology.2014; 175(3): 433.     CrossRef
• Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis
  Ozlem Balbaloglu, Murat Korkmaz, Sadiye Yolcu, Fatih Karaaslan, N. Gökben Çetin Beceren
  Platelets.2014; 25(2): 81.     CrossRef
• Lack of association of the mean platelet volume with plasma lipids in a general population of unselected outpatients
  Giuseppe Lippi, Elisa Danese, Camilla Mattiuzzi, Martina Montagnana
  La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine.2014; 10(2): 97.     CrossRef
• Effects of Glucose Control on Hematological Indices in Patients with Diabetes Mellitus
  Ceyhun Varım, Tezcan Kaya, Ahmet Nalbant, Ayşenur Uçar, Ali Tamer
  Open Access Macedonian Journal of Medical Sciences.2014; 2(1): 83.     CrossRef
• Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study
  Hilmi Demirin, Hakan Ozhan, Taner Ucgun, Ahmet Celer, Sule Bulur, Habip Cil, Cemalettin Gunes, Hayriye Ak Yildirim
  Thrombosis Research.2011; 128(4): 358.     CrossRef

Background
Aging population correspond with an increase in the numbers of dementia patients. Dementia decreases the quality of life of patients and care-givers. However, current pharmacological treatment is limited by modest efficacy and adverse effect. Nonpharmacological treatment for dementia has been considered to be a substitute treatment. Recently we developed a special planned program for dementia with depression. The aim of this study was to evaluate therapeutic effect of this program. Methods: We included patients aged 65 and older who diagnosed dementia with depression in a geriatric institution from April to June, 2006. We surveyed their sex, age, education period, and histories of hypertension, smoking, and alcohol intake. Patients in experimental group carried out our program, including cooking, painting, recreation, and activity, 9 times for 60 minutes a session. All included patients were checked Korean Mini-Mental State Examination (K-MMSE) and Korean Form of Geriatric Depression Scale (KGDS) before starting program and after 3 months when programs finished. Results: There was no difference in demographic factors between two groups. K-MMSE was significantly improved in experimental group compared with control group (P = 0.01). And, the KGDS was significantly improved in experimental group compared with control group (P = 0.00). Conclusion: Multidivisional program for social skill improvement was effective on treatment for patients of dementia with depression. Nonpharmacological treatment for dementia with depression would be developed and studied to enhance the qualities of life of patients and care of dementia.

Citations

• Evaluating the Efficacy of Therapeutic Programs on Improving Cognitive Function and Depression among Older Adults Living with Dementia in Korea
  Jaeeon Yoo, Sunhee Lee
  International Journal of Environmental Research and Public Health.2020; 17(9): 3218.     CrossRef

Background
Sexual dysfunction such as erectile dysfunction (ED) may be a hidden agenda, but, it should be dealt with by family physicians in primary care. We investigated the prevalence of ED and utilization of sexual consultation practice among community family physicians. Methods: We analyzed the subjects who were males aged over 30 and married who visited 10 community family clinics around Seoul, Korea and completed questionnaires related to erectile function and utilization of sexual consultation service from May 9 to 28 2009. ED was designated if the 5-item version of international index of erectile dysfunction (IIEF-5) scores were less than 17. Results: The average age of the responders was 45.6 years. The prevalence of ED was 43.3% and increased according to age, chronic disease, low educational history and low family income. Almost all of the mild ED patients answered that they needed sexual consultation. But, half of them had no plan to have a sexual consultation. Odds ratios (ORs) with 95% confi dence intervals (CIs) for having a sexual consultation or not according to variables were calculated with logistic regression. More severe ED (OR = 0.875; 95% CI, 0.827 to 0.926), existence of chronic disease (OR = 1.828; 95% CI, 1.026 to 3.260), inferior education (OR = 0.395; 95% CI, 0.196 to 0.796), and lower income (OR = 0.326; 95% CI, 0.124 to 0.857) were the factors which infl uenced to have a sexual consultation with a family physician.Conclusion: The prevalence of ED in family clinic was over 40%, but the utilization of sexual consultations was under 50%. We need to develop intervention strategies for more sexual counseling practice according to educational history, family incomes and status of ED in community family medicine clinics.

Citations

• A Structural Equation Modeling of Sexual Adjustment in Radical Prostatectomy Patients
  Min Kweon Ahn, Hyun Kyung Kim
  Korean Journal of Adult Nursing.2021; 33(5): 532.     CrossRef
• Effects of Schisandra chinensis fruit extract and gomisin A on the contractility of penile corpus cavernosum smooth muscle: a potential mechanism through the nitric oxide - cyclic guanosine monophosphate pathway
  Bo Ram Choi, Hye Kyung Kim, Jong Kwan Park
  Nutrition Research and Practice.2018; 12(4): 291.     CrossRef
• Association between periodontal flap surgery for periodontitis and vasculogenic erectile dysfunction in Koreans
  Jae-Hong Lee, Jung-Kyu Choi, Sang-Hyun Kim, Kyung-Hyun Cho, Young-Taek Kim, Seong-Ho Choi, Ui-Won Jung
  Journal of Periodontal & Implant Science.2017; 47(2): 96.     CrossRef
• Periodontal disease and vasculogenic erectile dysfunction: a longitudinal health-examinee cohort study in South Korea
  Jae-Hong Lee, Yeon-Tae Kim, Jung-Kyu Choi, Seong-Nyum Jeong, Seong-Ho Choi
  Oral Biology Research.2017; 41(3): 120.     CrossRef
• Association between periodontal flap surgery for periodontitis and vasculogenic erectile dysfunction in Koreans
  Jae-Hong Lee, Jung-Kyu Choi, Sang-Hyun Kim, Kyung-Hyun Cho, Young-Taek Kim, Seong-Ho Choi, Ui-Won Jung
  Journal of Periodontal & Implant Science.2017; 47(2): 96.     CrossRef
• Prevalence of Erectile Dysfunction and Associated Factors in Korean Older Adults With Coronary Artery Disease
  Youn-Jung Son, Miyoun Jang, Eun-Young Jun
  Journal of Gerontological Nursing.2016; 42(10): 32.     CrossRef

Background
Within a recent few years, the number multicultural families had been increasing rapidly in Korea. This study was conducted to investigate the characteristics of the function of multicultural families and its determining factors.Methods: The study subjects were 68 foreign women who had been married to Korean men and immigrated to Korea. All participants were registered in one of the three migration support centers in South Jeolla Province. They completed a self-administered questionnaire which evaluated the demographic information, FACES III, and the family APGAR scores. We compared their family function with that of the typical Korean families reported in previous articles.Results: Multicultural families were prone to be an extreme family according to the FACES III. Their family APGAR scores were lower compared to those of ordinary Korean families. Family dysfunction of multicultural families as signifi cantly associated with women's age, hometown, education level, the number of family members, and her religion.Conclusion: Multicultural families may show different features compared to typical Korean families. Family physicians needs to be concerned with functional patterns of multicultural families. Further studies should be followed to understand modifi able factors for fi xing dysfunction of multicultural families.

Citations

• Emotional and behavioral problems associated with food addiction in children and adolescents with obesity
  Hye-Ji An, Sarah Woo, Hyun Jung Lim, Yoon Myung Kim, Kyung Hee Park
  Obesity Research & Clinical Practice.2025; 19(1): 34.     CrossRef
• Relationship between Health Behaviors and Marital Adjustment and Marital Intimacy in Multicultural Family Female Immigrants
  Jung-Yoon Lee, Jong-Sung Kim, Sung-Soo Kim, Jin-Kyu Jeong, Seok-Jun Yoon, Sun-Jin Kim, Sa-Mi Lee
  Korean Journal of Family Medicine.2019; 40(1): 31.     CrossRef
• Comparison of Clinical Features among Children of Multicultural Families, Ethnic Koreans and Native Koreans
  Tae Hwan Moon, Dong Gyu Choi, Seok Hyun Bae, Mi Young Choi
  Journal of the Korean Ophthalmological Society.2018; 59(9): 854.     CrossRef
• Family adaptability and cohesion in families consisting of Asian immigrant women living in South Korea: A 3‐year longitudinal study
  Yeon‐Pyo Kim, Sun Kim, Ju‐Youn Joh
  Asia-Pacific Psychiatry.2015; 7(2): 206.     CrossRef
• Family Function of the Families Consisting of Asian Immigrant Women Living in South Korea
  Yeon-Pyo Kim, Ju-Youn Joh, Il-Seon Shin
  Asia Pacific Journal of Public Health.2015; 27(2): NP2702.     CrossRef
• Evaluating the Satisfaction of Immigrant Women from a Rural Community Regarding Family Functioning and Health-Related Quality of Life
  Su-Ying Tsai, Wen-Jung Sun
  Women & Health.2013; 53(2): 135.     CrossRef

Background
After referral system had been established, patients wishing to consult with a specialist with 'self- referral' in mind is increasing in university hospital family medicine clinics. This study was conducted to know whether those by self-referral to a specialist in a university hospital could benefit from family physician's consultation or not. Methods: Three hundred and sixty patients were serially assigned to either 'simple referral' group provided with a referral note without consultation or 'referral after consultation' group with consultation from a family physician. Patient satisfaction was rated by using questionnaires with 5-point Likert scale. Results: Patients in the 'simple referral' group were more satisfied with the whole process of family physicians' consultation compared to the 'referral after practice' group in both the appropriateness and patient satisfaction of the consultation (both, P＜0.001). Males, longer encounter time, and shorter waiting time were significantly influenced patient satisfaction compared to each counterpart. Conclusion: Patients who want only a referral note from a family physician in a university hospital may received some benefit from the coordination and comprehensive care by a family physician. Health delivery system should be rectified according to the consideration of the role of the primary care physician such as a family physician. (J Korean Acad Fam Med 2008;29:325-329)

Amiodarone is a potent antiarrhythmic agent that is used to treat ventricular arrhythmias and atrial fibrillation. But it has a wide range of adverse effects, including pulmonary toxicity, thyroid dysfunction, liver toxicity, gastrointestinal events, corneal deposits, peripheral neuropathy and so on. Patients treated with amiodarone should be followed regularly to assess ongoing need for amiodarone, efficacy of the drug, appropriateness of dosage, adverse effects, and potential drug interactions. We experienced a case of severe weight loss due to amiodarone-induced multiple toxicity after a long course of a low dose therapy. So we report this unusual case with literature review.

Background
: There is a widespread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease.

Methods : From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated.

Results : CAM was used by 59.3% (95% CI=52.1∼66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855∼0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105∼19.348) times higher than non-disabled.

Conclusion : CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.

Background
: Recently, adolescent smoking has become one of the most serious problems in our society. In this study, we surveyed smoking status, family function by Korean family function assessment tool, history of abuse, and others to know the factors associated with smoking for high school students.

Methods : In May 2001, a total of 1,033 students from 2 male and 2 female general high schools located in Seoul were assessed with self-completing questionnaire. Among the total, there were 502 male and 533 female students.

Results : The percentage of male smokers was 27.7% and that of female smokers was 14.5%. The percentage of smokers was significantly higher in students with a history of physical abuse, psychological abuse or negligence (only in males) than in students without them. The family function score of the smokers was 127.3±20.3 and that of the non-smokers was 140.3±21.0 in males. The family function score of the smokers was 121.5±17.45 and that of the non-smokers was 140.9±22.1 in females. The family function score of the smokers was significantly lower than that of the non-smokers in males and females. In 6 factors (supportiveness, alienation, closeness, roles, sociality, authority (only in males)) each family function score of the smokers was significantly lower than that of the non-smokers in males and females.

Conclusion : Adolescent smoking was associated with family function and history of abuse (physical, psychological and negligence (only in males)).

Background
: Recently, physicians have been challenged to see more patients per office session while maintaining patient satisfaction. We examined the variables related to patient satisfaction with the time spent with physician during office visit.
Methods
: In the department of family medicine of an university hospital, a trained researcher observed patient visits by VTR and collected additional data using medical record reviews and patient exit questionnaires from July 1 to July 31, 2002 The data was analyzed statistically by SPSS ver11.0/PC+.
Results
: Visits by 103 patients were observed in this study. Age, functional health status, time of Dr.'s talking to patients and the ratio of Dr.'s talking time to visit length were significantly associated with patient satisfaction (P＜0.05). Sex, marital status, education level, new vs. established patient, reason for visit, visit length, number of problems, number of medications, body mass index, and satisfaction for time spent were not significantly associated with patient satisfaction. According to logistic regression analysis, greater patient satisfaction were associated with better perceived health status, with more ratio of Dr.'s talking time to visit length and with age younger than 40 years.
Conclusion
: Physician can enhance patient satisfaction during an office visit by spending sufficient time to talk with patients during each visit and should take an interest in elderly patients and patients with multiple problems.

Background
: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients.

Methods : A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and Kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire.

Results : Eighty two patients (42.5%) were male and mean age was 57.4±9.9 years. Using Kaplan-Meier's method, 8% of non-exercise group (N=115) in diagnosing hypertension started exercise after 1 year and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91mmHg). In the degree of recommendation, sporadic group showed the highest and non-exercise group, the lowest which showed significant difference(p=0.0024).

Conclusion : I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.

Background
: There are very few cohort studies on the hypertension in family practice. In order to investigate epidemiological characteristics of hypertensive patients and assess the safety and tolerabiliy of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out.

Methods : A total of 1,181 patients were observed from July 1997 to August 1999. At 2,4,8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment is continued and development of any adverse reactions.

Results : Calcium channel blockers(CCBs) were the most commonly prescribed initial drug class(44.2%) in family practice, followed by angiotensin converting enzyme inhibitors(ACEI) (21.0%), angiotensin II receptor antagonists(ARA) (11.8%), B-blockers(9.6%), a-blockers(3.9%), and diuretics(3.6%), During the first 12 weeks, the percentage of subjects continuing their initial ACEIs(40.7%) was substantially lower than the percentages that of subjects continuing ARAs(66.2%), a- blockers*(63.0%), CCBs(61.3%), B-blockers(55.8%), and diuretics(53.5%), respectively(P<0.001), The following adverse reactions were detected: cough(7.5%), headache(6.1%), dizziness(3.9%), flushing(3.7%), and impotence(2.4%). The incidence of cough associated with ACEI(27.9%), was higher than those of other classes(P<0.01)

Conclusion : CCBs were the most commonly prescribed initial drug class in family practice, followed by ACEIs, ARAs, B-blockers, a-blockers, and diuretics. The tolerability of antihypertensive medication was the highest in Korean patients treated with ARAs, followed by CCBs, B-blockers, diuretic, a-blocker, and ACEIs.

Background
: The role and future of family physician are not yet clearly determined even when 20 years lapsed since its introduction to korea. This study was conducted to establish identity of family physician, to develop pragmatic. curriculum of training, and to sort out frame of certification exam by analysing the job of family physicians who were practicing in community.

Methods : We analysed the job of practicing family physician by using DACUM(Development of Curriculum) method from March 11, 2000 through March 12. Job analysis team was composed of five practitioners, four professors, one facilitator, and one scriber. Six sessions of 2 hours were mainly devoted to brain storming of the idea related to family physician.

Results : Job analysis results are as follows. Family physician was defined as "primary care physician who provides primary medical service continuously and comprehensively by offering individual patient and/or family health promotion, disease prevention, and treatment of common illness". Family physician had seven duties and 129 tasks. The duty of physical exam had 18 tasks, duty of test, 21 tasks, duty of treatment, 40 tasks, duty of health promotion and disease prevention, 15 tasks, duty of patient/client, management, 12 tasks, duty of clinic management, 15 tasks, and self-development, 8 tasks respectively. Number of tasks whose impotance was classified as 'A'(very important) were 43 as total, 3 in physical exam, 7 in test, 9 in treatment, 11 in health promotion and disease prevention, 2 in patient/client management, 9 in clinic management, and 2 in self-development respectively. Number of tasks whose difficulty was classified as 'A'(very dif-ficult) were 19 as total. 2 in physical exam, 7 in test, 7 in treatment, 1 in clinic management, and 2 in self-development respectively. Number of tasks whose frequency was classified as 'A'(very frequent) were 22 as total, 6 in physical exam, 1 in test 8 in treatment, 3 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively. Number of tasks which were required for entry level were 74 as total, 18 in physical exam, 14 in test, 29 in treatment, 9 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively.

Conclusion : Family physicians in Korea perform 7 duties and 129 tasks. Seventy four tasks are required to enter into the job.

Background
: Use of Complementary and Alternative Medicine(CAM) is common among patients with chronic conditions such as rheumatic disorder. This study was conducted to know rate and behavior of using CAM and to improve doctor-patient relationship in rheumatic patients.

Methods : Among patients visiting a tertiary hospital rheumatology clinic, 867 persons (15.8% of total) were selected conveniently and interviewed by a trained nurse according to structured questionnaire from July 1st through July 31st 1999. Three hundred and sixty two CAM users completed the interview.

Results : Among 867 persons interviewed, 372 persons had used CAM (use rate 44%). Use rate of Chinese medicine was 26%, CAM except Chinese medicine 21%. Herb medicine(49.4%) was the commonest single category of all CAM. Twenty four percents of users had used two or more types of CAM, 6.8% had experienced adverse effects. The average yearly cost for CAM was 704,000 won/person, 64% of the one for hospital use, 1,100,000 won/person. The subjectively rated degree of effectiveness was 6.3 points which was significantly higher when compared with 5.9 points for hospital services. The degree of satisfaction with CAM was 5.6 points which was higher than that of hospital services, 4.8 points. The most frequently reported reason for using CAM was the hope for synergistic treatment effect(32%). The proportion of experiencing adverse effects from CAM was 7% of all users. Only one fourth of the users had discussed on the CAM use with the western doctors. The commonest reason for not discussing CAM was that the respondents had no need to discuss about it (40%). Among doctor's attitudes when discussing CAM with patient, limited aproval was most common(40%).

Conclusion : Among patients with rheumatic conditions, 44% use CAM. Herb medicine was most commonly used CAM. Comparing with hospital services, cost for CAM is 2/3 but its subjective effectiveness and satisfaction are higher. Western doctors must consider appropriately the need from users of alternative medicine.

Background
: A discharge against medical advice(AMA discharge) means a critical failure of doctor-patient relationship and noncompliance. Most AMA discharge studies had been limited to psychiatric patients. This study was conducted to determine the factors associated with AMA discharge, especially focused on appropriateness of admission and hospital days.

Methods : From January 1998 to June 1998, there were 366 AMA discharges of total 11,716 discharges. We selected 132 AMA discharge patients as cases. Controls were selected by individual matching by sex, age(±2 years), and length of stay(5 days). Medical records were reviewed by a doctor. Appropriateness of admission and hospital days were assessed by an experienced quality assurance nurse according to the appropriate evaluation protocol & delay tool.

Results : Sixty one percent of the 132 cases was male. Mean age of case group was 53.9 years, and mean hospital day was 8.3 days, which was not significantly different from those of control group. Less patients had graduated high school in cases when compared with controls (37.9% vs 56.8%). More patients had been admitted via emergency room in cases compared with controls (53.0% vs 33.3%). More patients had been admitted to the department of internal medicine, neurology, or neurosurgery room in cases compared with controls. Neoplasms, disease of circulatory system were more frequent primary diagnosis in cases than those in controls. Appropriateness in both admission and hospital stay higher in cases than those of controls and those effect persisted even after controlling hospital days. Department of admission, patient’s status at discharge, and primary diagnosis at discharge remained as significant factors associated with AMA discharge after adjustment for other potential risk factors. The reasons for 120 AMA discharge were “personal obligations” (20%), “felt better” (14.6%), “financial obligations” (12.3%), and “hopeless” (10.8%), in order.

Conclusion : Department of admission, primary diagnosis, and patient’s status at discharge were associated with AMA discharge. Appropriateness in both admission and hospital stay was higher in cases than that of controls.

Background
: Korean health related Quality of Life Scale(KQOLS) was developed to measure the quality of life reflecting Korean’s own language expression and culture. In order to confide in the results of KQOLS, it is necessary to establish verification of the psychometric properties(reliability, validity, responsiveness).

Methods : KQOLS’s final 46 items and item option responses were established by expert panels. Reliability was tested by 2 weeks test-retest method and internal consistency methods. Validity was tested by factor analysis and clinical validity. Sensitivity and specificity for detecting treatment-related changes were also tested.

Results : A high degree of internal consistency was observed for each of domains(Cronbach’s alpha value of 0.77 or higher). Two weeks test-retest reliability correlation coefficients scores were highly significant except health perception domain. A principal components analysis identified 9 factors with eight values greater than 1.0 which were approximately the same as intended domains. Normal control group had statistically significant higher scores than patients group except in spiritual health and social function domains. Improved group of patients had statistically significant higher scores than non-improve group of patients after treatment except in spiritual health and health status perception domains.

Conclusion : Korean health related Quality of Life Scale(KQOLS) is both a valid and a reliable instrument, but fine refinements such as items revision and item response options modification will be needed.

Background
: The status of development of instruments to asses the health related quality of life' reflecting Korean's own language expression and culture is still far from satisfaction, despite their importance in building basic date for health promotion, evaluation of effectiveness of treatment, health policy and so on.

Methods : Symptom descriptions in both ill and healthy conditions were collected from 292 Koreans based on definition and domains of 'health related quality of life' which was established by 7 family physicians. The collected results were categorized into each domain and edited to be used as questions. Questions of health change and spiritual health domains were added. A selection of most pertinent items were pursued through the internal consistency analysis on 417 patients. Pretest was performed on 20 ordinary people to see if they think selected questions were understandable and related to their quality of life.

Results : A total of 1934 symptom descriptions were collected and categorized into 44 of 7 domains including physical function, mental health, social function, pain, role, vitality, and health perception. Two items of health change and 3 items of spiritual health domain were added. Among those 49 items, 45 items of 9 domains were selected after discarding 4 items lowering internal consistency coefficient. Some items were corrected for more precise meaning, concise meaning, concise sentence, proper expression and word order, and nuance after pretest.

Conclusion : We developed a Korean health related Quality of Life Scale(KoQoLS) reflecting Korean's own language expression and culture.

Background
: Fatigue is one of the most common problems encountered in family practice but its diagnosis and management are neither standardized nor simplified. This baseline study was conducted to find out the clinical characteristics. clinical courses, and outcomes of fatigued patients.

Methods : This study included 163 fatigued patients who visited a department of a university hospital based family practice due to fatigue as their prima교 or secondary complaint. We classified fatigue which persisted for more than 6 months as chronic fatigue, less than 6 months as acute fatigue. Retrospective review of medical record was used to collect all related clinical all related clinical characteristics and telephone interview was done to follow the course and outcomes of fatigue.

Results : Of the total 163 fatigued patients, 105 patients(64.4%) were men. Fifty two patients(31.9%) visited the clinic for complete health check-up due to fatigue. The rate of response to telephone interview was 62.6%. Fifty five patients(33.7%) were acute fatigue, 75 patients(46.0%) chronic fatigue, and 33 patients(20.2%) unknown duration of fatigue. According to the causes of fatigue, 11.7% of patients corresponded to organic cause, 60.7% psychiatric cause, 27.6% unknown cause. Specified organic causes of fatigue, chronic hepatitis was the most common disease followed by alcohol liver disease, most common disease followed by alcohol liver disease, arthritis, anemia, viral syndrome and hyperthyroidism. As psychiatric causes of fatigue, stress was the most common cause followed by overwork, alcohol abuse, depression, and anxiety. Reassurance and observation(71.8%), drug therapy(17.8%) were the most common treatments. These who felt their function decreased below 50% were 7.6% of total 102 patients. On the survival analysis, 58.2% of acute fatigue patients, 62.4% of chronic fatigue patients, 67.0% of unknown patients had fatigue for 2 years since the initial visit.

Conclusion : As the cause of fatigue in a family practice, psychiatric causes were more frequent than organic causes. As psychiatric causes of fatigue, stress was the most common cause followed by overwork and alcohol abuse. Only one third of the third of the fatigued patients had improved two years later.

Background
: Influenza is a respiratory infectious disease with high morbidity and relatively high mortality which occurs every winter. Therefore, influenza vaccination is recommended annually for high risk groups. However, the vaccination rate is not very high. It is well known that influenza vaccination prevents influenza, and some reports show partial preventive effects for the common cold. Therefore, the authors implemented this study to find out the preventive effects of influenza vaccination for influenza and the common cold.

Methods : The study period was six months form October 1997 to March 1998, and the subjects were chosen from those who visited seven Family Practice Clinics and two Family Practice Outpatient Departments of University Hospital. The vaccination group composed of those who received influenza vaccination during the period and the control group was those who did not receive the vaccination with age difference ±3 years and of same gender.
The study was done by a survey questionnaire. The data were analyzed using SPSS version 8.0 and chi-square test, t-test, and logistic regression was implemented.

Results : The number of vaccination group was 223, the number of control group was 214, and the total subjects were 437 persons. Influenza occurred in 4 persons(1.8%) for the vaccination group, and 12 persons(5.6%) for the control group which showed significant difference(p=0.032). The common cold occurred in 69.1% of vaccination group and in 71.0% of control group with no difference. However, the duration of the common cold was 6.0 days for the vaccination group which was slightly shorter than 7.5 days for the control group(p=0.088), and the frequency of the common cold was 1.49 times for the vaccination group and 1.84 times for the control group(p=0.033). Logistic regression analysis showed that the relative risk of influenza for the vaccination group was 0.261(p=0.032), which meant 73.9% protective effect for influenza, but not for the common cold.

Conclusion : Influenza vaccination can protect people from influenza, but did not protect them from common cold. However, it can lessen the frequency and duration of the common cold.

Background
: One of the main objectives of medical school is to provide high-quality primary care physicians. To fulfill this objective it is increasingly important to utilize ambulatory care setting, particularly community private practice clinic for medical students' clerkship. But program evaluation of this type of clerkship is lacking. The authors intended to evaluate th e community primary care clerkship with a view to students' perspective.

Methods : We used students' and preceptors' evaluation forms with semi-structured questionnaires using 5-point Likert scale and students' essays for program evaluation. We analyzed 76 students' and 89 preceptors' evaluation forms by description, and categorized emergent themes from 89 students' essays using qualitative method.

Results : Over seventy percent of students rated overall satisfaction, achievement of knowledge, preceptors' educational effort, and practical application as excellent on the 5-point Likert scale. In the evaluation of the discussion topics with preceptors, they rated medical insurance and health care delivery system as relatively poor compared to other topics such as realities of private practice, management of private practice and equipments necessary in primary care. They understood positively the importance of patient characteristics and good patient-physician relationship in primary care, and the realities of private practice. They were also concerned about the problems of health care system and assumed a sound suspicion whether the education in medical school was practical in primary care. On the other hand, they showed ambivalence towards expressing the negative aspect of primary care in terms of the repetition of simple cases and lack of stimulation to achieve sophisticated medical knowledge.

Conclusion : Community primary care clerkship was generally satisfactory in the students' perspective, which is necessary to standardize preceptor education and establish a role model of primary care in order to provide the soil for high-quality primary care physician.

Background
: It is important for the health care provider, particularly primary care physicians as gatekeepers of health care, to understand the social interests and needs toward health care. This study was done to find ways to deal with public opinion by analyzing the contributions of health care in the newspapers.

Methods : Two hundred twenty four contributions about health care were sorted out in the three national newspapers during one calendar year from January to December, 1996. These contributions were coded by themes and subjects according the content analysis and qualitative text interpretation.

Results : The contributions were classified into three categories; medical insurance, and hospital ser-vices, and health care policies. Forty four contributions of medical insurance category were coded into 5 themes and 18 subjects. Fifty eight contributions of hospital services category were coded into 3 themes and 31 subjects. One hundred twenty two contributions of medical insurance category were coded into 8 themes and 32 subjects. The themes and subjects were listed and major findings were described qualitatively. The characteristics of public opinions about health care were diversity, conflicting interests, plentifulness of complaints and discontent, and finally, infrequency of alternative proposals for problem solving. How to deal with public opinions were discussed.

Conclusion : We can recognize the public attitude of health care and complaints of patients and consumers of health care by analyzing the contributions in the newspapers. These data can be used to develop ways of primary care physicians to deal with patients' needs.

Background
: Hypertension is one of the frequent problems for which family physicians are well encountered to manage. Nonpharmacologic measures-which include stress relaxation, low salt diet, weight reduction, moderation of alcohol intake, physical activity, tobacco avoidance-are used as definitive or adjuvant therapy for hypertension. Family physicians should vigorously encourage their patients to adopt these life-style modifications. This study was conducted to know how many nonpharmacologic treatment modalities are adopted by hypertensives and to find predicting factors.

Methods : A total of 100 of the hypertensive patients who are followed up via the department of family medicine, Hanyang University Hospital, from September 1995 through November 1995 are included in this study. A trained nurse interviewed patients according to the previously designed structured questionnaire. The overall response rate was 90% and the fill-up rate of the questionnaire was 100%.

Results : Sixty three patients were women. The mean age was 57.4 years(range, 20 to 84). Sixty one percent accompanied one or more other diseases, of which diabetes mellitus was the most common disorder. The mean systolic pressure was 143.9 mmHg and the mean diastolic blood pressure was 89.3%mmHg. Ninty-three percent of patient received antihypertensives with compliance of 81 to 100%. Twenty four percent of patients adhered to regular exercise, 36 percent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent no smoking. Of those six non-pharmacological treatment, 3.6 behaviors were adhered. Male patients were more attended with the low salt diet. Eleven patients of 25 alcoholics(44.0%) reduced their amount of alcohol intake and 8 of 17 smokers quitted smoking(47.1%) after they were diagnosed as hypertension. The mean BEPSI score was 1.5. Fifty one percent of patients has stress within the last three months, 32 percent has cumulative fatigue. The occupational stress was the most common one. All exercise which patients reported were isotonic. Seventeen percent of the patients took certain herb medicine or folk medicine.

Conclusion : Of those 100 hypertensives who were treated at the department of family medicine, Hanyang University hospital, 24% adhered to regular exercise, 36 percent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent quit smoking in order. Of those six non-pharmacological treatments, 3.6 behaviors were adhered on the average. Nonpharmacologic treatment should be promoted by family physician as an important strategy for treatment of hypertension.

Background
: Blood pressures measured by a nurse at reception room as a part of routine physical examination are often used as a indicator of medical care. Blood pressure at reception room and consultation room are, however, often different to each other and these differences are caused by various factors including difference of white coat effect by nurse and doctor. Thus, this study was performed in order to know whether blood pressure difference really exit, and its associated factors.

Methods : Two hundred ninety one patients who visited to one university hospital family practice were enrolled in this study. Blood pressure and pulse rate at reception room and consultation room, waiting time, time interval between reception and consultation, smoking status, and intake of coffee and food were collected. Nine patients were excluded, because blood pressure either at reception room or at consulation room was not recorded. This study was performed by one nurse and two doctors. They defined the guideline for method of blood pressure measurement before the study, and used the same kind of indirect cuff sphygmomanometer.

Results : Two hundred eighty two patients were analyzed. The number of men was one hundred twenty five. Systolic blood pressure at consultation room was higher than that at reception room by 1.6±11.9mmHg(P<0.05). Sixty five cases(65%) in systolic blood pressure and 111 cases(40%) in diastolic blood pressure showed blood pressure differences more than 5mmHg. The group with systolic blood pressure difference between reception room and consultation room(Δ SBP) in more than 5mmHg is more likely to be hypertensive than the group with ΔSBP in less than 5mmHg(P<0.01). More female patients(66%) and hypertensive patients(59%) were belong to the group whose systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). Twenty four patients(30%) of the group whose systolic blood pressure at reception room were 5mmHg higher than at consultation room had cigarette smoking within 1 hour, and this ratio was significantly higher than the other groups whose systolic blood pressure difference was less than 5mmHg or systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site(Overall kappa ; 0.747, P<0.01).

Conclusion : Many patients showed blood pressure differences more than 5mmHg between reception room and consultation room. Systolic blood pressure at consultation room was higher than that at reception room, and there was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site, but the adverse effect by misclassification should not be neglected. The importance as well as the limitation of blood pressure measurement at reception room should be considered in screening and treating hypertensive patient. Every time when blood pressure is taken, physicians should keep in mind to consider patient's factors which may influence blood pressure level.

Cronbacch's alpha was 0.6438 and with a score over 0.6, the coping score is found to have reliability. Correlation was found between the total score and individual items' scores.(P<0.0001) The R coefficiency between the coping score and the interview score was determined to be 0.5697 also showing correlation.(P<0.0001) The R coefficiency between the coping score and the interview score was determined to be 0.5697 also showing correlation.(P<0.0001) The R coefficiency between the coping score and APGAR score was 0.6410 again showing correlation (P<0.0001) and demonstrating the validity of the coping score.

Background
: Malignant mesothelioma is assocated with the exposure to asbestos. In Korea, asbestos was widely used at various industrial parts since beginning of 1970s. However there was no systematic report of mesothelioma till now. This study may be used as the base of mesohelioma study in Korea.

Methods : This study reviewed histologically proved cases of mesothelioma seen at Seoul National University Hospital during 1979-1993. Forty one cases were included as potential cases, of which only 25 cases had available medical records. This study centered on 22 malignant mesothelioma except 3 benign cases.

Results : Twenty two cases were malignant and 3 cases were benign, Two cases were diagnosed during 1979-1984, 7 cases during 1985-1989, 13 cases during 1990-1993 each, Seventeen cases were admitted to the department of internal medicine, 4 cases to thoracic surgery and 1 case to general surgery. There were 12 female cases(54.5%). The median age was 47.0 years(range 21-73 years). Fourteen cases(63.6%) originated from pleura, 6 cases from peritoneum and 2 cases from pericardium.
Dyspnea and chest pain were most common presenting symptoms o pleural malignant mesothelioma, abdominal distension and mass for peritoneal case. The median interval between initial symptom and diagnosis was 3.5 months(range 1-36 mnths). First impression were pleurisy, tuberculosis, and lung cancer for pleural mesothelioma, Eight of 14 pleural mesothelioma patients underwent open thoracotomy for definitive diagnosis. Five of 6 peritoneal mesothelioma underwent exploratory lapalotomy for diagnosis. Computerized tomogram and magnetic resonance imaging were use as a modality to assess the extent of the disease. The epithelial type was the most common(22.7%) histologic type and 14 cases(63.6%) were not specified. Most cases had multiple poor prognostic factors.
Some patients received surgery or chemotherapy, which however was not effective. The median survival Was 6.5 months in 4 pleural mesothelioma cases. Asbestos exposure was identified in only 7 cases(31.8%) and occupational history was missed in in 4 cases(18.2%). Four cases had probable asbestos exposure history, 3 cases had possible one.

Conclusion : Twenty two malignant mesothelioma cases seen at Seoul Nationa University Hospital were reviwed, They were slightly different from previous studies in site, sex and age but similar in other clinical data. Information on asbestos exposure was insufficient.

Background
: Hysterectomy and hysterectomy with oophorectomy are the one of the most common surgical operations, and the cases of this surgical operations have been increasing now. Moreover, the concern about hormone replacement therapy to postmenopausal women is growing now, therefore the importance of accurate information about oophorectomy state is more emphasized than before. We can get information about oophorectomy state through patient medical record and self-report, but in Korea the only available source of information in reality is patient self-report on primary care setting, regrettably. Many physicians in Korea are skeptical to self-report of patient. Therefore this study is designed to know accuracy of patient's recall about bilateral oophorectomy in whom received hystrectomy and bilateral oophorectomy through medical record review and telephone interview. And we analyze factors with the accuracy of patient's recall.

Methods : The subject of this study is the patients who is accessible through telephone interview and medical record review of those who was received hysterecomy with bilateral oophorectomy in a third grade hospital. Their surgical operations were done from Jan. 1990 to Aug. 1993. The patient proven to have malignancy was excluded. The inforamation about accuracy of their self-report and associated factor was achieved through medical record review and telephone interview.

Results : The number of accessible subject is 117. Of 117 woemn, 112(95.7%) know their hysterectomy state accurately. But the number of persons who know their own bilateral oophorectomy state accurately is 74(63.3%), and the persons who don't know their bilateral oophorectomy state accurately is 43(36.8%). Of whom who don't know accurately their bilateral oophorectomy state, 28(23.9%) women answer that they didn't know whether bilateral oophorectomy had been done or not, 15(12.8%) women denied their bilateral oophorectomy state. Women who know accurately their bilateral oophrectomy state in comparison with who don't know their bilateral oophorectomy state are younger in average age, higher in education level, and have more opportunities of listening doctor's explanation of their post organ extraction state, and have received hormone replacement therapy more. And this differences of two groups are statistically significant. The differences between two groups on monthly salary, having occupation or not, living in city or not, marital state, period after operation, pre-operative diagnosis, and whether she knows post operative diagnosis or not, are not significant statistically. The major determinants in the accurate knowledge of their own bilateral oophorectomy state are whether patients listened Doctor's personal explanation of their state or not, and whether she received hormone replacement therapy ever or not.

Conclusion : The proportion of whom know accurately their own bilateral oophorectomy state is 63.3%. That proportion is considerably low which leads to conclude that it is not advisable to make a clinical decision based on patient self-report state only in this sugical operation cases. And because the most important determinants of the accuracy knowledge of their own bilateral oophorectomy state is whether patients listened medical doctor's personal explanation of their state, therefore the importance of this aspect of doctor's education must be emphasized to medical doctors.

Background
: Nowadays, since Aquired immunodeficiency syndrome(AIDS) prevailing all of the world has no exact cure yet, the only countermeasure is to guide the masses' steps in the path of awareness through publicity & education. In the first stage, only the high risk group and countries hea the opportunity of infection. But, at the present the way of infection has changed to 'within the general publics' and multiplied among Koreans. Since, it has become important to educate the low risk groups(general publics). We research the general public's knowledge of AIDS.

Methods : A questionnaire was given to two groups; one was composed of the people who visited a hospital for periodic health examinations during one month(April 1993). The other group was composed of people who worked in a government office.

Results : A total of 289 people answered the questionnaire. The rate of response was 90.1%. And the percentage of males was 53.3%, Concerning the question of the latent period, 49.5% had a correct understanding of the fact that AIDS development took more than several years after HIV infection. 52.2% of the subjects of investigation didn't want to visit hospital even though they felt they might have the infection. Among them, 83% said that the reason was the contempt and isolation from society, when they are regarded as AIDS patient. Once guaranted of security, most of them(78.9%) wanted a consultant, especially by phone(36%). Concerning the risk routes of infection, most of them(from 83.1% to 99.0% each items) looked at in the right light. However, concerning the possibility of the infection in daily life, they have some misconception, c.g. mosquitoes(88%), donation of blood(48%0, swimming(36.1%) etc. Only 56% know that condoms can protect from AIDS.

Conclusion : Nearly half of the respondents would not visit a hopital, even though they have recognized their infection with AIDS. Almost all of them duly recognized the importance of sex and blood in AIDS transmission. But, many of them considered AIDS as an acute disease and had misconceptions that it was carried by the donation of blood, mosquitoes. We also find that half of the subjects of investigation didn't acknowledge that condoms could prevent AIDS.

Hyperlipidemia has long been associated with cardiovascular disorders by increased incidence of artherosclerosis. So it remains one of the chief risk factors accociated with coronary artery disease and cerebrovascular accidents.
In Korea, there is a increased tendency of hyperlipidemia because of increased ingestion of animal fat, which may account for increased incidence of cardiovascular disease.
It was revealed that the low prevalence of artherosclerosis and cardiovascular disease among Eskimos in Greenland despite a diet as high in fat and cholesterol as that of the Danes or American resulted from different composition of fat consumed, which contained much higher proportion of omege-3 polyunsaturated fatty acids in the fish diet. The omega-3 fatty acids have lowering effect of serum lipid level. Among the 44 hypercholesterolemic patients who visited Family Practice Center, the randomly selected 26 patients took 650mg omega-3 fatty acid daily and their serum lipid levels were compared with those of the control group. In the case group. omega-3 fatty acids led to decrease in plasma cholesterol (8.2per cent), triglyceride (18.2 per cent), and low density lipoprotein (9.8 per cent). There was no side effect. In the control group. it had much less effect. We conclude that omega-3 fatty acids have lipid lowering effect in hyperlipidemic patients, especially with hypertriglyceridemia.

No abstract available.