Cigarette smoking is the most important preventable cause of death in Korea. Smoking should be considered as a chronic disease attributed to nicotine dependence which needs a long term care. Nicotine dependence and withdrawal symptoms are major barriers to smoking cessation and can be successfully managed by pharmacotherapy. There are two types of pharmacotherapy for nicotine dependence, nicotine-replacement therapy(NRT) and nonnicotine-replacement therapy. Nicotine, which can be administered by patch, gum, inhaler, and nasal spray, doubled the smoking cessation rate. NRTs are usually well tolerated. Sustained-release bupropion, an antidepressant, doubled the smoking cessation rate when combined with counselling. Bupropion can induce seizure in less than 0.1% by lowering the seizure threshold. Nortriptyline and clonidine can be used as second line drugs for smoking cessation. They are similar in efficacy compared to NRT or bupropion but they frequently have adverse drug reactions. Combination of bupropion with NRT is more efficacious than NRT alone but not more effective than bupropion alone. There is no convincing evidence to recommend a specific drug for smoking cessation in women. NRT and bupropion can be useful in special situations for adolescent smokers, but evidence is not enough to recommend pharmacotherapy for adolescent smokers. Weight gain is the main barrier to smoking cessation, especially in women. Vigorous exercise reduced weight gain. Nicotine gum, bupropion also temporarily reduced weight gain after smoking cessation, but only while the drug was being administered. As there are sound evidences for the effect of pharmacotherapy in smoking cessation, it is necessary for physicians to integrate it into their daily practices.
Adolescent ; Bupropion ; Cause of Death ; Chronic Disease ; Clonidine ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Female ; Gingiva ; Humans ; Korea ; Long-Term Care ; Nebulizers and Vaporizers ; Nicotine* ; Nortriptyline ; Seizures ; Smoke ; Smoking ; Smoking Cessation ; Substance Withdrawal Syndrome ; Tobacco Use Disorder* ; Weight Gain

No abstract available.
Health Promotion* ; Primary Health Care*

No abstract available.
Hepatitis B* ; Hepatitis* ; Vaccination*

BACKGROUND: This study was performed to determine and compare the practice patterns of management of hypertension of the internists and family physicians in general hospitals and to compare them according to the JNC V guidelines. METHODS: Questionnaires were mailed to total 964 of internists and family physicians in general hospitals during May, 1996. 217 of them were returned with the response rate of 23.5%. Chi-square test and Fishers exact test were performed to examine the statistical difference between two groups. RESULTS: The mean age of the respondents was 39.1 and 77.9% of them were male. 65.4 % of hospitals for respondents were located in metropolitan cities. Concerning the number of measurements of blood pressure, 0.5% of the respondents measured just once before confirmation of the diagnosis. Items for physical examinations for initial evaluation were as follows; cardiac auscultation(94.0%), measurements of body weight and height(58.9%), abdominal examination(52.8%), auscultation for carotid bruit(41.7%), fundoscopic examination (25.6%). Regarding the laboratory tests, the frequency of evaluation of all item were higher than that of the physical examinations. For initial drug therapy, calcium channel blockers and ACE inhibitors were the most frequently chosen mediations. No difference was found between two specialties or tertiary and secondary hospitals in this trend. With educations for the life-style modification, 60-80% of the respondents educated the patients. No difference was found between two specialties except one item. CONCLUSIONS: As a whole the JNC V guidelines were not followed faithfully for the management of hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Auscultation ; Blood Pressure ; Body Weight ; Calcium Channel Blockers ; Surveys and Questionnaires ; Diagnosis ; Drug Therapy ; Hospitals, General* ; Humans ; Hypertension* ; Male ; Physical Examination ; Physicians, Family* ; Postal Service ; Surveys and Questionnaires

No abstract available.
Depression*

No abstract available.
Family Practice* ; Humans ; Smoke* ; Smoking*

BACKGROUND: Superoxide disrnutase(SOD) provides a protective defease mechanism against potential cytotoxicity of superoxide radical in the aerobic organism. Although human skin is constantly at risk for developing acute and chronic changes by ultraviolet radiation and phototoxic reactions with exogenous and endogenously procluced photosensitizing molecules, studies in SOD in the human skin are rare. OBJECTIVE: We measured the level of SOD activities in the scar tissues and the normal human skin specimens. This study was to investigate changes of SOD activity by age, sex, and regional differences of SOD activities in the scar issues and the normal skin. METHODS: Aut,hors assayed the level of SOD activit,ies in 32 scar tissues(male 8, female 24) and 11 normal human skin specimens(male 8, female 3), which were obtaine 3 from face/neck(17 and 3 specimens), forearm(only 4 scar tissues), trunk(10 and 8 specimens), and lower extremity(only 1 scar tissue). RESULTS: First, activities of total SOD, Cu, Zn-SOD, and Mn-SOL ere 18.93+5.49, 16.97+55.31, and 1.96+0.90 units/mg proteiii respectively in the scar tissues. Second activities of total SOD, Cu, Zn-SOD, and Mn-SOD were 17.27+7.09, 13.82+6.44, and 3.45+1.07 units/mg protein respectively in the normal skin. Third, the changes of total SOD, Cu, Zn-SOD, and Mn-SOD activities by age and sex were similar each other and three were no significant, differneces between age groups in total, Cu, Zn- SOD, and Mn-SOD activities. Fourth, in sun exposed area and unexposed area there were no significant differences in the scar tissues in SOD activities. But, SOD activite.(total, Cu, Zn, and Mn-SOD) in face/neck were higher than those in trunk and lower extremity in tae normal skin(P<0.05). CONCLUSION: These findings suggest that there are no differences in the intrinsic SOD activities by age and sex in the mature scar tissues and the normal skin. Differences between exposed and unexposed area in the normal skin are due to the induction of exogenous SOD activity by sun-light generation of superoxide radicals. In wound, increased production of leukocyte derived superoxide radicals is the main factor of increased level of SOD activity.
Cicatrix* ; Female ; Humans ; Leukocytes ; Lower Extremity ; Skin ; Solar System ; Superoxide Dismutase* ; Superoxides* ; Wounds and Injuries

No abstract available.
Breast Neoplasms* ; Breast* ; Mammography*

No abstract available.
Dislocations*

No abstract available.
Delivery of Health Care* ; Humans