Background
: To prepare the basic educational data for primary care physicain who work to maintain and enhance the health of people in community. The authors carried on disease frequency analysis in medical Insurance in Korea.

Methods : To clarify the frequency of reasons which made people to use health delivery system in Korea, the authors has made descriptive study with 113,244,548 cases of actual visits to the health delivery system of Korean medical insurance from January 1st to December 31st of the year 1991. The objectives of this study are 100,000 random sampling cases of medical visits among 113,244,548 actual cases of those.

Results : 1. Females(54.5%) have made more frequent medical visits to the health care system than males(45.5%) 2. The frequent diagnoses are acute upper respiratory infection of multiple or unspecified site, acute bronchitis&bronchiolitis, acute nasopharyngitis, acute tonsilitis and acute pharyngitis in order. 3. There is a significant dissimilarity of disease pattern between the in-parient and out-patient group. Among the upper twenty frequent disease, only five disease are concord between the two groups. 4. There are higher prevalence of respiratory infections in the first and second decade, genitourinary infections in the third and forth decade, gastrointestinal diseases in the fifth and sixth decade and then hypertension above the seventh decade.

Conclusion : 53.3% of all visits to health care system were upper twenty frequent diseases. The people who have acute, transient problems made more frequent visits to the primary health care system than to the secondary or tertiary of those. It is needed to encourge primary health care system.

Background
: Hypertension is one of the most prevalent, chronic diseases in Korea. Hypertension is needed to be control for life-long period for prevention of complications. It is thought that there are many management forms of hypertension in Korea, such as self care, folk medicine use, drug store use, herb medicine use, and doctor visit. This study was done for practical understanding of management behavior of hypertensive patients and its effect, in Korea.

Methods : The study subjects were hypertensive patients who were screened for health promotion of residents in Kyeongju County, in 1991, Korea. Data were collected in 1993, through questionnaire via interview by health personnel and community health practitioner of the Kyeongju Medical Center.

Results : The number of collected data was 1,236. Self care use was 14.5%, folk medicine use 6.1%, drug store use 15.3%, herb medicine use 8.4%, doctor visit 55.8%, and no intervention 34.8%. The contents of folk medicine were highly variable. The patterns of hypertension managemet behaviors were as follows ; In one management behavior, doctor visit was the most common(78.7%), followed by drug store use, self care, herb medicine use, and folk medicine use. In two management behaviors, doctor visit-self care was the most common(37.2%), followed by doctor visit-drug store use, doctor visit-self care-drug store use was the most common (29.4%), followed by doctor visit-drug store use-herb medicine use. The percentage of controlled blood pressure was higher in one or two management behavior-group than in no effort or in three or more management behavior-group.

Conclusion : It was revealed that there were many management behaviors for controlling high blood pressure, such as self care, folk medicine use, drug store use, herb medicine use, and physician encounter. Physician encounter was the principal management behavior and other behaviors were selected concomittantly with physician encounter. There was slightly higher control rate in blood pressure in one or two management behavior-group than in no effort or three or more management behavior group.

Background
: In Korea we did not have the report on the rate of possenssion and usage of medical equipment and the rate of performance of laboratory test in private clinics. In this stydy, we investigated items related to possession of medical equipment and performance of laboratory test. We also tried to know about the contents and level of primary care in the community.

Methods : From August 5, 1993 to September 25, 1993, of the registered 338 members of the Korean Association of Family Medicine Physicians in the Pusan, we chose 240 doctors of private clinics to be a part of our study. We analyzed 120 replies from our questionnaire that included absence or presence of 104 items of medical equipment, their frequency of use, and laboratory test of 60 techniques including those done at the clinic, requested at another hospital and not routinely done.

Results : In our study 50% replied, and of those that replied 106 were men(88.3%), 14 were women(11.7%) and the mean age was 56.5 years old. Besides Family Medicine other departments involved as the practice style were Internal Medicine(62.5%), Pediatrics(61.7%), Obstetrics and Gynecology(39.2%), General Surgery(29.2%), Dermatology(20%) and Urology(18.3%). Medical equipment in which both the rate of possession and usage were high included basic items ; thermometer, blood pressure guage, adult stethoscope, weight scales, glove, headlamp, X-ray view box, and reflex hammer, examination and diagnostic items ; urine analysis multisticks, microscope, X-ray machine, centrifuge, blood sugar sticks, pregancy test kits, surgery and treatment items ; dressing car, hot air and autoclave sterilizer. Equipment that were high in the rate of possession but low in usage included basic items such as resuscitation kits, ophthalmoscope, color vision cards, visual acuity chart, nasal speculum, and also surgical and treatment items such as oxygen tank, enema equipment, nelaton and foley catheter. Equipment in which the rate of possession was low but usage was high included electrocardiogrape, computer and ultrasonogrape. Outpatient laboratory tests that were performed greater than 40% in the private clinics included protein, sugar, RBC and WBC analysis of urine, and analysis of Hb and WBC in blood. Test requested to outside the private clinics greater than 40% included blood chemistry of GOT, GPT, total bilirubin, total cholesterol, globulin, albumin and immunological tests for HBsAg and HBsAb.

Conclusion : We can understand the medical equipment possession rate and laboratory test performance rate of private clinics responsible for the primary care of the community. It also forms the basic data for the present condition of medical equipment and laboratory practice in private clinics(primary care).

Background
: Currently, the head trauma is acknowledged as the prime cause to death in the getting increased traffic accidents and industrial injuries. Generally, the post-treatment physical and mental sequelae which head-trauma patients mostly suffered could be developed as the critical disabilities. In this investigation, major causes, occurances and associated injuries of head trauma that were treated in our emergency room by our medical residents was evaluated in order to develop the initial evaluations that could estimate the prognosis of patients accurately.

Methods : The 209 case which admitted in our neurosurgery through emergency room from 1, January 1993 to, 31, January 1994 was evaluated as the analyzed group. All of reviewed case was involved head trauma and experienced the computerized tomography diagnosis of brain.

Results : The major cause of admitted head trauma case was turned to be traffic accidents as 78.3%. Glasgrow Coma Scale score on arrival was 58.8% in 13-15, 29.7% in 9-12, 11.5%, in 3-8. The skull fracture was estimated 28.7%, and abnormal finding in computerized tomography was 37.7% The most common lesion in computerized tomography was found as the hemorrhagic contusion, subdural hematoma, and then epidural hematoma. And, degree of abnormal finding in computerized tomography accrding to Glasgrow Coma Scale was characterized as 100% in 3-5, 99.2% in 6-8, 80.2% in 9-12, 20.6% in 13-15. The 10.5% of 209 case underthrough the operations, and the mortality rate was 2.2%. The severe associated injuries were sequentialy developed as facial fractrue, extremity fracture and chest contusion.

Conclusion : The primary cause of head turama was observed as traffic accidents. Regarding to the degree of Glasgow Coma Scale, the low score generally inclined to the skull fracture, abnormal finding in computerized tomogaphy and sequale. Therefore, the on-arrival Glasgow Coma scale could be the critical estimate in prognosis of forward outcome and sequelae.

Background
: Obesity has been considered as a significant health problem because it is associated with several metabolic diseases, low self esteem and variable psychological problems which include anxiety, Depression and conversion reaction. The authors tried to observe the degree of depression in obese patients for better management of them.

Methods : Obese group was selected among the first visitor at Family Medicine department of Asan Medical Center and Sports Medicine Center. The criteria of obese group was over 120 percent to ideal body weight(n=93). The control group was the body weight under 110 percent to ideal body weight(n=177). The subjects who had psychologic disease and took the medication related to the depression and anxiety were excluded. Using Korean standard BDI, we evaluated to depression scale. The cut-off points of the depression were determined as 10,13, 17, and 21 points.

Results : The number of the subject of obese group was 93(male : 49 ; female : 44) and that of the control group was 177(male : 100 ; female : 77). In the male subjects, there was no significant difference in depression scale between both groups. In female subjects, the mean BDI score, 18.2±7.4 in the obese group was significantly higher than the mean score, 7.5±6.5 in the control group(P<0.05). The frequencies of depression at each cut-off points(10, 13, 17 and 21) were significantly different between the obese group and the control group in cases of all and female subjects(P<0.05). The frequencies of derpession in the each cut-off points showed no difference between both groups in case of male subjects(P>0.05).

Conclusion : Since the female obese group had the high depression scale, the multi-disciplenary approaches which include the psychological supports are required to manage and treat them.

Background
: It is known that underlying depression is expressed to psychosomatic symptoms. There was suggested that many of subjects who wanted comprehensive health check-up had not experienced symptomatic relief after having taken primary care by psychosomatic symptoms. So this study was attempted to support information on primary care by analyzing their depressive tendency and characteristics.

Methods : We adapted 148 subjects who wanted comprehensive health check-up as case group and 129 subjects who taken periodic health check-up as control group who visited Taejon Chongchon Sun Health Screening Center from May to August, 1994. Thereafter we compared and analyzed their depressive tendency and characteristics with self-answering paper CES-D.

Results : Wanted comprehensive health check-up group was higher than periodic health check-up group at CES-D score(P<0.001). On defining when potential cut-off CES-D was over 21, depressive group was 32.4% in case group and 15.4% in control group(P<0.05). Depressive tendency was higher in case group than in control group of female, lower economic state & lower educational state. But the difference by age, religion state did not have statistical significance(P>0.05).

Conclusion : Subjects who wanted comprehensive health check-up reported significantly higher depressive tendency than periodic health check-up group in female, lower economic state & lower educational state. We recommend that primary care physician should pay attention to patient's psychosomatic symptoms.

Background
: There are some reported cases that diet damages the health in adolescent. So we examined the weight and height in adolescent(12=19 years) and investigated the correlation between diet and related factors.

Methods : The relationship between diet and age, sex, height, weight, preferred weight, body mass index, size judgement, percieved overweight was examined in a survey of 570 Incheon schoolchildren from six age groups.

Results : Our results had correlation between diet and body mass index or size judgement. In women, diet correlates with weight, size judgement, perceived overweight(P<0.05). In men, diet correlates with body mass index, size judgement, perceived overweight(P<0.01). Diet do not correlates with age, sex, height, preferred weight.

Conclusion : Diet is significantly correlated with body mass index, size judgement, but not correlated with age, sex in adolescent.