Background
: The Urinalysis is useful laboratory test in the diagnosis of various diseases. But in many cases, the urine specimen is delayed in room temperature. There are some studies how the result changes with delayed specimen, but there are few study how much change occurs. So this study was carried out to determine the extent of change of delayed urinalysis.

Methods : During July and September 1991, the each urine specimen from medical outpatient department of Incheon Hospital was divided in equal amount and one was examined within 1 hour in fresh state and the other was examined about 4 to 6 hours after collection. The delayed urinalysis results were compared with fresh urinalysis results. Considering fresh urinalysis results as gold standard, the sensitivity and specificity of delayed urinalysis were calculated.

Results : Comparison of dipstick results showed no difference in specific gravity, protein, glucose and occult blood between the delayed specimens and the fresh specimens, but pH was increased significantly(p=0.001). The number of RBC(p=0.03), WBC(p=0.01), and epithelial cell(p=0.001) decreased significantly. The specificity of dipstick and microscopic examination results were above 90%, but sensitivity of all item below 90%. With the specimens resulted positive, there was no significant difference in glucose, protein, occult blood and WBC. But the number of RBC(p=0.012), and the number of epithelial cell(p=0.006) decreased significantly.

Conclusion : In some items, there was no significant difference statistically. But because the pH and the microscopic examination results changed significantly and sensitivity was below 90%, delayed urinalysis can lead to incorrect clinical decision-making. So we reaffirm that the urinalysis must be done with fresh urine specimen.
physicians should take more active role in extending cervical screening corverage.

Background
: Fatigue is an undifferentiated symptom and originated from physical and/or psychological causes, which include day-to-day problems and undue stress. Although fatigue is one of the most common complaints in primary care, few studies about fatigue are available in the family medicine literature. Therefore we carried out this study to determine the effect of stress in life events on fatigue.

Methods : Data were gathered on epidemiologic status, organic disease, alcohol, smoking, drug history, exercise, sleep and stress scale of 102 fatigue group(cases) and 51 no fatigue group(controls) during the period from June 1991 to September 1991. By using these data, the effect of stress on fatigue was analyzed and evaluated.

Results : The average stress amount of fatigue group(275±252) was significantly higher than that of no fatigue group(196±175) (p<0.05).

Conclusion : Fatigue is most commonly originated from psychological factor. Life event stress was highly associated with fatigue. Clinicians must evaluate multiple causes of fatigue and communicate the understanding of those causes to patient to gain support.

Background
: Hypertension is a chronic and usually symptomless disease. Studies have shown that the quality of life in persons with undiagnosed hypertension does not usually differ from that in normal control subjects. Nevertheless, many patients who are aware of their condition do not perceive themselves as being in a state of total wellbeing. Therefore, we carried out this study to compare the quality of life between hypertensive patients and normal control subjects.

Methods : Hypertensive patients without complication and another disease visiting the Department of Family Medicine from July to September, 1991. The number of the total respondents was 52.

Results : The quality of life in normal control subjects was higher than that of hypertensive patients(p<0.01). The quality of life in patients with uncontrolled hypertension was lower than that of patients with controlled hypertension or normal control subjects(p<0.01). The quality of life in patients with uncontrolled hypertension was lower than that of patients with controlled hypertension or normal control subjects(p<0.01). The quality of life between patients with controlled hypertension and normal control subjects had no distinct difference.

Conclusion : This study shows that the quality of life of patients with uncontrolled hypertension is statistically lower than that of patients with controlled hypertension or normal subjects. Therefore, anti-hypertensive therapy is effective in increasing the quality of life of patients as well as in reducing the mortality and morbidity from congestive heart failure, renal disease, stroke, and other complications of hypertension.

Background
: More energetic activities of family physicians have been required as the role and contents of medical care in department of Family Medicine have been enlarged since the establishment of new health care delivery system, which came into effect on July 1, 1989. Accordingly, it is expected that family physicians will care for more patients, at the same time, suggested that it is very important for family physicians to manage their inpatients in the aspect of continuing care. We analyzed the hospitalized patients to help in establishing the training contents of family medicine residency.

Methods : We examined the medical records of the patients who had hospitalized in department of Family Medicine of Asan Medical Center from July, 1, 1989 to June, 30, 1991.

Results : A total of 266 patients were hospitalized during study periods. They were hospitalized during study periods. They were composed of 134 males(50.4%) and 132 females(49.6%). The patients were relatively evenly distributed among all ages. The majority of them were 4th decades in male and 6th decades in female, respectively. The most common symptom, which the patients complained at the time of admission, was abdominal pain(57 cases). The next common symptoms were as follows; headache(12.0%), fatigue(10.9%), medical examination(9.8%), and fever(9.4%). A total of 133 kinds of diseases were diagnosed, and the number of diseases of the patients was 1.6 per capita. The most common diagnosis at discharge was gastritis of 65 cases(24.4%). The next common diagnoses were as follows ; DM(13.2%), hypertension(10.2%), fatty liver(6.4%), and anemia(6.4%). 185 patients were consulted with more than one department; a total of 347 cases in 18 departments. The departments in the order of frequency of consultations were Ophthalmology of 66 cases(35.7%), Internal medicine(29.2%), OB & GY(20.0%), ENT(20.0%), and Rehabilitation medicine(18.4%). 56 patients were transferred to the other departments. Internal medicine held a majority of 35 patients, and General Surgery(8), Psychiatry(3), Orthopedic surgery(2), ENT(2), and Neurology(2) followed it. At transfer, each 5 cases of lung cancer and acute cholecystitis was most common diagnosis, and hepatoma(4), stomach cancer(3), DM(3), pneumonia(3), and acute viral hepatitis(3) followed it. Interview with patients and their families of 10 patients were carried out including one time of consultation with a social worker and one time of home visit.

Conclusion : In the management of hospitalized patients in family medicine, it is essential to train about managing the chronic disease and diagnosing malignant disease differentially, and family-oriented approach must be emphasized.

Background
: Low birth weight is the most important determinant of the chances of the newborn to survive and to experience healthy growth and development. Pregnancy can be seen as a time when the family's boundaries are shifting(or are failing to shift) to accommodate a new member. According to the circumplex model, one would hypothesize that families at either extreme of cohesion or adaptability would not do well at navigating the transition of pregnancy and the birth of a child, Therefore we carried out this study to determine the effects of family functioning on infant birth weight(IBW).

Methods : The mother's perception of family function was assessed with FACES Ⅲ and collects sociodemographic data. Randomly selected mothers in Korea University obstetric clinics, while they are in 28 to 36 weeks of their gestational period were invited to participate this prospective study from June through August 1991. Listwise deletion on any one variable reduced the sample to 120 mother-infant pairs. IEW and other variables affecting IBW were compared by family function type.

Results : IBW is positively related with gestational age(r=0.361) and weight gain during pregnancy(r=0.267) and negatively associated with highest systolic blood pressure(r=-0.240) and age of pregnant women(r=-0.180). 15% of family was considered to be dysfunctional. There were no statistically significant difference in this analysis between sociodemographic determinants(educational level, occupation, religion, income, et al) and biomedical characteristics(gestational age, prepregnancy weight and weight gain during pregnancy, highest systolic blood pressure) of functional and dysfunctional families, IBW from women with dysfunctional family significantly smaller than from whose mother with healthy functional families(p<0.05).

Conclusion : Maternal anxiety and stress or social support have been to be related to the outcome of pregnancy, as understanding of the contribution of the family system to pregnancy outcome increases, it should be possible to intervene early in pregnancy to modify risk factors associated with family systems, the major goal of this research is to generate information that can improve the outcome of pregnancy.

Background
: We tried to obtain data for education of medical students and residents of Family Medicine and for establishment of Family Medicine as a specialized subject by analyzing the contents of ambulatory care in Family Practice Center of university hospital.

Methods : We accumulated data on computer after we described sex, age, reasons for encounter, assessment, disposition, duration of service on Encounter Form daily. We examined the referral rate of doctor’s need by storing the Encounter Form separately for about 5 months from June 1 to October 26, 1991.

Results : The 19,940 patients composed of 39.7% of males and 60.3% of females. The highest number of patients was showed in the age group of 25~34(23.6%). The percentage of the age group of 0~14 was 5.4% and that of the over 65 years group was 7.5%. During about the 2 years period, the enrage number of visits per patient was 2.7. The total number of reasons for encounter was 19,419, and we observed 422 kinds of reasons for encounter. The top 10 reasons occupied 46.4%, 20 reasons 61.1%, and 30 reasons 71.5%. The 5 most common reasons for encounter were other local abdominal pain(9.0%), general weakness(6.3%), headache(5.6%), cough(5.2%), and stomachache(4.8%). The total number of diagnoses was 10,944 and we observed 331 kinds of diagnosis. The top 30 diagnoses occupied 81.3%. The 5 most common diagnoses were disordered stomach function(17.8%), irritable bowel syndrome(8.7%), infectious hepatitis(7.2%), complicated hypertension(6.9%), diabetes mellitus(4.6%). 82.9% of patients were expected to return at the specific time or if needed. The overall referral rate was 15.4%, but referral rate by doctor’s need was 3.3%.

Conclusion : We obtained useful data for education of medical students and residents of Family Medicine through analysis of content of ambulatory care in Family Practice Center of university hospital. And we thought that it is necessary to educate students and residents about common problem found in this research. And we thought that the more study to solve the problem of referral by patient's need after introduction of health care delivery system is essential.