Background
: Annually there are about 400-600 reported cases of Hemorrhagic fever with renal syndrome with 5-7% fatality in Korea since 1978. In order to evaluate the immunogenicity of Hemorrhagic fever with renal syndrome vaccine(Hantavax) among children and teenagers, a clinical trial was conducted.

Methods : 76 healthy orphans were included from August to November 1992. 45 Children(group I) were given 0.25ml of Hantavax intramuscularly in the deltoid muscle and 31 teenagers(group II) were given 0.5ml of Hantavax by same method. 2 immunizations were given in monthly intervals and lgG antibody against Hantaan virus was tested before and on month after each vaccination by immunoflurorescent antibody technique.

Results : 88.2% of vaccinees completed the study protocol. The seroconversion rate of group I(97.65) was similar to that of group II(96.2%). Geometric mean titers were 1:209(95% CI 1:167-1:261) in group I and 1:240(95% CI 1:171-1:352) in group II. Adverse effects were pain in injection site(3.0%), erythema(1.5%) and swelling(1.5%).

Conclusion : Immunogenicity of Hemorrhagic fever with renal syndrome vaccine among children and teenagers is excellent and the recommended dose for children is half of the adult dose.

Background
: As the extension of the average life and the developing of the medical technology, there are great interests in the problems of elderly, especially for the early detection of the diseases in the elders. Many elders experience biochemical and physical changes through many causes. Elderly women who have the menopause and who have many physical changes through natural aging process need more medical attention. This study looked more closely to the diseases that contain elderly women. It also showed close attention through the result from data of health examination.

Methods : This study was held in the Specialized Women's Clinic which is located in Seoul. This study was conducted from July, 1991 through June, 1992. There were 1,013 females subjects participated in this study. The result was compared and discussed between the age above 65 and the age under 65.

Results : 1. The age difference of subjects was between 24 and 75. Among them, there were 276 subjects who are above 65. This number was more than the average of our women population. 2.The levels of systolic, diastolic blood pressure and glycosuria were significantly higher than that of controls(P<0.05 & P<0.01) The incidence of anemia and abnormal liver enzyme levels rates were significantly lower than that of controls(P<0.05). 3. The prevalence of UGI abnormalities, abnormal pelvic exams. were significantly higher than that of controls(P<0.05). The obesity rate was significantly lower than that of control group(P<0.001).

Conclusion : There were significant differences between the elderly women who were above 65(experimental group) and control group. The result showed that elderly women needed their detailed medical history, complete physical examination, biochemical laboratory tests, ultrasonogram and bone densitometry. With these examinations, we can promote health of elderly women by early detection diseases.

Background
: In 1979, when Family Practice Residency Training Program began, family practice was presented as a solution to a serious national health care problem of maldistribution among physicians, under-emphasis of primary care, and preference of specialists. In 1992, after fourteen years, the current number of graduates of family practice residency training programs is up to 402. At this point, an assessment of whether family practice has indeed had such an effect on the health care system is appropriate. This study was done to assess the satisfaction level of family practice residency program graduates about their present practice, to survey their geographic distribution, and to identify possible factors associated with their current status.

Methods : From July to September of 1992, a questionnaire was sent to 352 graduates of family practice residency programs whose addresses were known among total of 402 graduates. Response rate was 39.8%. The questionnaire contained items concerning type and location of present practice. Possible factors associated with this status was also asked: place of birth, education history, residency training hospital, religion, medical occupation prior to residency training reasons for selecting current practice, and reasons for choosing family practice.
Result: Greater proportion of the respondents are practicing in smaller communities compared to the geographical distribution of physicians in Korea. Rate of "satisfied" or "very satisfied" responses to the profession of medical doctor was 82.4%, to family life 71.6%, and to being a family practice specialist 68.4%. However, only 46.0% of the respondents responded "satisfied" or "very satisfied" with their social life, 45.6% with type of practice, and 35.6% with income. 71.4% of the respondents who trained in non-university hospital setting, 65.5% of respondents with history of medical occupation prior to residency training, and 73.9% of respondents who were married before residency training are in private clinic practice. 60.3% of respondents practice near their residency training program; 59.5% practice near their medical school. The majority of respondents are in practice settings which they desired at the beginning of their residency training. Reasons for selecting their current practice setting were varied. "Comprehensive care", "well suited to primary care", preference for humanistic principles of family medicine, and being useful for missionary or service work were frequently mentioned as reasons for selecting family practice. Other mentioned reasons included the short duration of training and the newness of family practice as a medical specialty. The great majority of graduates(95.0%) practice as family physicians. 48.6% of the respondents work in private clinic setting, 32.9% in hospitals, and 2.1% in other medical specialty fields. 39.3% of the respondents are located in Seoul, 13.6% in large cities, 23.6% in small cities, and 14.3% in rural areas.

Conclusion : Respondents are generally satisfied with their professional and family life, and larger percentage of them are practicing in smaller cities compared with the distribution of physicians in Korea. Location of residency training program and medical school, history of medical occupation prior to residency training, type of practice desired at the beginning of residency training, and time of marriage are related to the type or location of current practice.

Background
: Obesity constitues a greater risk for developing hypertension, diabetes, hyperlipidemia. The body fat pattern may be an important predictor of risk for this disorder.

Methods : The relationship between body fatness, body fat pattern & weight to height indices was examined in a sample of 384 individuals. Study parameters included 6 anthropometric indices.
Result: Our results had correlations between body fat pattern or weight to height indices & blood pressure: In wemen, systolic blood pressure correlates with age(r=0.324), weight(r=0.17), body mass index(r=0.214), waist hip ratio and percent ideal body weight(r=0.211). Diastolic blood pressure correlates with weight(r=0.252), body mass index(r=0.212), waist hip ratio(r=0.18) and percent ideal body weight(r=0.17). In men, systolic blood pressure correlate with age(r=0.18), waist hip ratio(r=0.13). Diastolic blood pressure correlates with weight(r=0.17), body mass index(r=0.14), waist hip ratio(r=0.16) and Triceps skinfold thickness(r=0.19).

Conclusion : Blood pressure levels are significantly correlated with body fat pattern than body fatness.

Background
: Nation-wide medical insurance has been offered since July 1, 1989 and 129 Emergency Patients Information Center, and emergency medical system has been in operation since July 1, 1991. Emergency patients and those acutely died, however, have been ever increasing. By analyzing emergency patients died, authors made this study to reevaluate the role of doctors of family medicine in emergency medical care who are in responsible for primary medical care.

Methods : Out of 23,802 patients who visited the emergency room of Seoul Christian General Hospital from January 1, 1990 to December 31, 1991, authors examined emergency care charts of 326 patients who died during emergency care at the emergency room and those died before getting to the emergency room.

Results : The total number of patients died was 326 with the ratio of 2 to 1 between male and females. By age, the largest number of patients(19.60%) was in their fifties. In particular, more than half(61.00%) of patients died were in the age of 20 to 59, the period of energetic social and economical activity. Classified by the cause of death, the number of existing diseases(38.04%). The largest number of patients(30.00%) visited the emergency room within 30 minutes after accidents or attacks of diseases. Most of the cases(60.80%) were occurred at Choongrang-ku and 38.70% of the total cases were carried by family members.

Conclusion : The medical care for emergency patients should be done on the spot with the occurrence of the emergency cases. The education to the emergency medical care specialists who actually do emergency care on the spot as well as generals who generally get to the spot first is very important. In this point of view, doctors of family medicine who in charge of primary treatment should alway keep in mind the fact the they the emergency care is one of special fields of primary treatment. They should provide the most efficient, economical and effective emergency medical care with professional knowledge and technique of emergency care.

Background
: After introduction of health care delivery system, the study were analyzed of contents of outpatient in family medicine department in order to special requirments for emdical students and residency training in primary care.

Methods : In order to analyze the patients on departement of family medicine Tae Jeon Sung Sim Hospital from July 1st, 1991 to June 30th, 1992. Except the patient of medical examination and vaccines 1104 patients were reviewed charts.

Results : The ratio of male and female was 1.52:1. 25-34 year old group was largest by 21.8% and then the frequency of the pediatric group under 15 year old was 26.8% respectively. The department distribution of patients was internal medicine(29.2%), ENT(24.5%), pediatrics(20.1%), dermatology(17.6%). The most common chief complaints were cough(10.8), sore throat(7.9%), fever(6.6%), in order. The most frequent diagnositc tests was Urianalysis(17.5%), and then chest X-ray(14.2%), complete blood count(13.4%), in order. The most common diagnosis were acute pharyngitis(11.4%), URI(10.1%), acute tonsillitis(8.2%), gastritis(8.1%). in order. In classifying diseases by system, respiratory, skin, digestive and ear were ranked. 39 cases were referred to and ENT, pediatrics, internal medicine, urology, general surgery 12, 6, 5, 4, 3, cases respectively.

Conclusion : Residency training was concerned about internal medicine, pediatrics, ENT, dermatology in the family medicine department at a general hospital.

Background
: It is important to analyze the stress amount and content of life event according to family life cycle through the recent experience of life event in family practice, because it need to predict disease and understand the relationship among the family members. This study was attempted to establish data base for health promotion and disease management and assist perform the comprehensive and continuous care of the family practice.

Methods : The data were collected from married adult 486 of the above 20 age, from July to September, in 1992. Family life cycle by Duvall and S.R.R.S. by T.H. Holmes and R.H. Rahe was selected and analyzed the stress amount in terms of their recent experience of 43 kinds of life events and induced the 6 life event in the order of frequency, according to family life cycle.

Results : The result were summarized as follows
1. According to increase the family life cycle, mean stress amount was tending to decrease.
2. First 5 life events by frequency about 486 subjects were vacation(35.2%), christmas(28.2%), major change in argument with spouse(22.8%), minor violation of the law(18.7%), change in residence(17.5%).
3. Mean stress amount by abnormal life event associated with family life cycle was higher in diseased group rather than non-diseased group

Conclusion : There were some significant difference in mean stress amount and content of life event according to family life cycle. these finding have implication for the comprehensive and continuous care of the family practice.
It is important to calculate the stress amount in transitional zone. But this study was not noted the finding in transitional zone. Therefore further study in tansitional zone will be needed.

Background
: Recently epidemiologic study of chronic diseases on island inhabitants is very lack. So we searched for the prevalance rate of chronic diseases, classification of chronic diseases and relationship between chronic diseases and health risk factors on island inhabitans.

Methods : This survey was executed from October 10th. 1992 to October 15th. 1992 on 477 Docho Do inhabitans and the results were as follows.

Results : The prevalance rate of chronic diseases on island inhabitants was 48.8%. The difference general characteristics between chronic disease group and non-chronic disease group was statistically insignificant.
There was significant difference between hepatitis vasccination and chronic disease in relationship of health risk factor and chronic disease group. (P<0.05)
The chronic diseases on island inhabitants were arthritis, hypertension, heart disease, gastric disease, liver disease, etc.

Conclusion : We knew result from this study that prevalance rate of chronic disease and the relationship of health risk factor and classification of chronic disease on island inhabitants.
Further studies which can overcome for the limitation of this survey should be performed.
So we need more attention to the health examination on island inhabitants.