Background : Because dyslipidemia is a major risk factor of coronary heart disease, it must be screened by sensitive method. Since National Choesterol Education Programm guideline, total cholesterol level has been used for such methods. But now total cholesterol's valididy to dyslipidemia is questionaed bacause of it's limited sensitivity.
Methods : The data were collected from 1,113 subjects who visited yeoung midical center's health center from January 1993 to June 1993. From them fasting lipid profile was tested, and using NCEP guideline we simulated a population based screening programm.
Results : Hypercholesterolemia was the most frequent dyslipidemia, and followed by Low HDL, high LDL, high Triglyceride in order of frequency. Following NCEP process, 48% of those with high LDL concentration and 72.8% of those with low HDL concentration would not be routinely detected. Overall, 66% of those at high risk of CHD would not be promptly evaluated. The sensitivity of the guidelines for promptly idendifying with lipoprotein abnormalities was 34%.
Conclusion : The relatively low sensitivity of total choleterol as a screening tool should be the impetus for rethinking the screening guidelines.
Background : The rate of breast-feeding decreases as the society becomes industrilalized, whereas that of artificial feeding increases. We have performend this study in order to investigate the current feeding trends and to encourage the breast-feeding
Methods : Questionnaires about feding methods were distributed to arbitrarily chosen 300 housewives in Seoul area from Feb. 1 to July 31 in 1992. Among these housewives, 202 who responded voluntarily wre subjected to the analysis.
Results : From the analysis of their 318 children, the rate of breast-feeding, artificial feeding, and mixed feeding turned out to be 37.87%, 37.1%, 25.2%, respectively. The rate of breast-feeding by mother's age was 76.6% in the age of 40 years or more and 30.7 for those between 30 and 39 years old. By the educational background, it was 23.9% in college graduates, 43.2% in senior high school graduates and 93.8% in junior high school graduates. None of premature birth was breast fed, but the rate was 38.7% for full term births. The rate was 43.4% for normally delivered ones whereas only 19.7% for those delivered by Caesarean-section. The rate was 51.1% when delivered in the clinics or public health center whereas 18.5% for those delivered in the general hispital. The rate was 33.3% in mothers whith an occupation and 39.6% in those without the occupation. Most subjects(94%) considered the breast-feeding as the best feeding modes and the way how they obtained the common sense about feeding modes was through the mass media(44.6%), from school education(34.2%), and from medical doctors(2.0%).
Conclusion : To improve the rate of breast-feeding, the thorough monitoring of pregenancy, the intensive care for the breast for feeding before and after delivery, the preparation of optimal environments for breast feeding and the doctors's active education and enlightenment for pregnants are required.
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.
Background : In Korea, prevalence rate of pulmonary tuberculosis has been decreasing, but pulmonary tuberculosis is still one of significant public health problem. This study was done for evaluate for therapeutic efficiency of 6-months short course chemotherapy in Family Practice.
Methods : We prescribed 2HERZ/4HER for 68 pulmonary tuberculosis patients from September 1, 1990 to August 31, 1992 at Department of Family Medicine, Yeungnam University Medical Center. We studied the therapeutic efficiency of 6-months short course chemotherapy-negative conversion, adverse reaction, treatment failure, drop out cause and recurrence rate.
Results : Among 68 patients, bacteriologically positive rate was 14.7% and negative conversion rate was 100%. There was no cases of recurrence, treatment failure and treatment interruption due to drug adverse reaction.
Conclusion : This 6-months regimen (2HERZ/4HER) is effective and can be recommended as a promising regimen for the treatment of pulmonary tuberculosis in Family Practice.
Background : Recently many otolaryngologists use OMU CT(Ostiomeatal unit CT) scan to diagnose chronic sinusitis because PNS plain radiograph has many limitations to perform detailed anatomic examination about ostiomeatal unit. But many primary physicians have depended on plain radiograph to diagnose chronic sinusitis due to high medical cost and accessibility problem. In this study, I compared plain radiograph with OMU CT to know how accurately plain radiograph diagnose and localize the residual sinus diseases.
Methods : I performed a prospective study of 71 patients who were clinically suspected to have a chronic sinusitis. all patients in this study had conventional sinus radioraph and OMU CT. Two examinations were performed on the same day. Before undertaken two examinations, all patients completed a qestionnaire which was accociated with symptoms of chronic sinusitis. The plain radiograph was interpreted by two radiologists and OMU CT were interpreted independently of the plain radiograph.
Results : Of the 71 patients studied, 40 were men and 31 women. Their ages ranged from 15 to 67 years. There is no significant symptom difference between normal and abnormal OMU CT group. With respect to the location of sinusitis, maxillary sinus was most common site and then ethmoid, sphenoid, frontal sinus in sequence. Validity of plain radiograph is as follows : sensitivity 75.5%, specificity 61.1%, positive predictive value 85.1% and negative predictive value 45.8%. Validity of plain radiograph by each sinus shows some difference acording to the sinus (Table 6). Sensitivity is relatively high in maxillary sinus(About 79% and 68% in right and left) but others low(Below 50%). Specificity is almost over 90% except maxillary sinus.
Conclusion : Chronic sinusitis often underdiagnosed or overdiagnosed on the finings of plain radiograph. But considering health care cost and acessibility PNS plain radiograph is still useful diagnositc modality in primary care.
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