Background : With improvement of Medicine, prevalence of acute, infectious disease declined and Incidence of Coronary artery disease increased, in Korea. The causes of this finding are bad lifestyles, for example eating habit, insufficient physical activity and fitness, smoking and these are the major risk factors of chronic disease. Recent data suggest the important effect of physical activity and fitness on prevention of chronic disease. This study will show the frequency of leisure time physical activity and characteristics of people in Seoul according to physical activity. Method: A modified version of Minnesota Leisure Time Physical Activity Assessment was adminis-tered to the people selected by Randm Digit Dialing, Mitofsky-Waksberg method from May to August, 1995. This report focused on time spent in specific activities during previous month and questions asked included frequency per month of engaging in activities. Participiants were asked about cigarette smoking, alcohol, blood pressure, age, sex, periodic health examination, education. Responses were differentiated to create four categories of physical activity status ; inactive, regular active, irregular active.
Results : The final response rate was 136 persons(30.8%), for a total 441 persons. Among them, Man was 51 persons(37.5%) and aged 20 years and older. Proportion of people who reported being inactive, irregular active, regular active are 21, 83 and 32 persons. Women were more likely to report being inactive than men. The proportion of people in Seoul who reported an inactive status increased with increasing age, and shorter, less smoker, less drinker. The three most commonly repor-ted physical activities for both men and women are Calisthenics, Walking with pleasure, Climbing stairs.
Conclusion : We studied people in Seoul, selected by Random Digit sampling. The most commonly reported physical activities for both men and women was Calisthenics. The Proportion of people in Seoul reported an active status increased with decresing age and increasing height.
Background : Acute appendicitis is one of the common surgical diseases which urgent diagnosis is needed in emergency or primary practice. But its diagnosis can be complicated because acute appendicitis has diverse clinical manifestations. Moreover facilities for accurate diagnosis are limited in most primary practice, so we investigated the usefulness of acupoints in the diagnosis of acute appendicitis as the more accurate, easy and simple method.
Methods : The number of appendicitis patients group were 26, whose diagnosis was confirmed by pathology after operation (appendicitis patients group). For the control groups, we selected 20 patients of acute abdominal pain whose clinical diagnosis were other than acute appendicitis (nonappendicitis patients group). Another 20 persons were selected for healthy control group. The subjects of each group were measured the pressure pain threshold by pressure algometer at four acupoints of right lower leg. The four acupoints were Joksamni, Nanmi, Sangeoher, Jogu. We analysed the mean pressure of pain threshold and the order of pain intensity at each acupoint and group.
Results : There was no statistical difference of age and sex in each group. The mean pressure of pain threshold at the Nanmi acupoint ; in appendicitis patients 2.98±0.93㎏/㎠, in nonappendicitis patients 3.79±1.04㎏/㎠, in healthy control 5.08±1.05㎏/㎠, The appendicitis patients' pressure of pain threshold was lower than other groups(p<0.001). The mean pressure of pain threshold in appendicitis patients at each acupoint were as following : nanmi acupoint 2.98±0.93㎏/㎠, Joksamni 4.08±1.61㎏/㎠, Sangeoher 4.75±1.43㎏/㎠, Jogu 5.58±1.47㎏/㎠. The Nanmi acupoint was lower than other acupoints(p<0.001). The diagnostic values of the Nanmi acupoint by the pressure of pain threshold were as following: if the pressure was lower than 3.0㎏/㎠, the sensitivity of diagnosis was 76.9%, specificity was 82.5%, if the pressure was lower than 3.5㎏/㎠, the sensitivity and specificity was 88.5%, 75.0% respectively. The diagnostic value by the order of pain inthnsity; in the most painful acupoint was the Nanmi, the sensitivity was 92.2% and the specificity was 70.0%. The diagnostic alue by the combination of pressure and order of pain intensity : if the most painful acupoint was the Nanmi and the pressure threshold was lower the 3.5㎏/㎠ at the Nanmai, the sensitivity and specificity were 80.1%, 80.0% respectively.
Conclusion : If the pressure threshold was lower than 3.5㎏/㎠ at the Nanmi acupoint and the most painful acupoint was the Nanmi acupoint, acute appendicitis could be diagnosed in sensitivity 80.1% and specificity 80.0%.
Background : As if is known to us that a family is a primary social factor affected in its health and is more influenced on patients and its function in chronic diseases, this research has been done to help medical treatment comparing the degree of chronic renal failure patient's depression and the family function with healthy peoples.
Methods : This research has been done by means of questionnaire reports to translate Beck Depression inventory(BDI) on the part of depression and the Family Adaptability and Cohesion Evaluation Scales III(FACESIII) in the part of family funcion, in which 138 chronic renal failure patient treated in hemodialysis and 142 people of health screen transferred into family physician have taken part at renal center in the Dong-San Medical Center from April to August in 1994.
Results : 1. The study group had average BDI's score of 25.05±12.76, which was higher than control group with BDI's score of 11.63±8.83. Thus, in patient group, depression degree were higher than control group. 2. In FACESIII cohesion of the patient group, there were 90 people(65.2%) in "Disengaged" and 26 people(18.8%) in "Separated" and 17 people(12.4%) in "Connected" and 5 people(3.6%) in "Enmeshed". In that of the contrast group. 53 people(37.3%) in "Disengaged" and 45 people(31.7%) in "Seperated" and 41 people(28.9%) in "Connected"and 3 people(2.8%) in "Enmeshed". 3. In FACESIII adaptability of the patient group. there were 36 people(26.1%) in "Rigid" and 43 people(31.2%) in "Structured" and27 people(19.6%) in "Flexible" and 32 people(23.2%) in "Chaotic". In that of the control group. 15 people(10.6%) in "Rigid" and 56 people(39.4%) in "Structured" and 49 people(34.5%) in "Flexible" and 22 people(15.5%) in "Chaotic". 4. In FACESIII family types of the patient groups, there were 47 people(34.1%) of "Extreme" and 69 people(50.0%) of "Mid-Range" and 22 people(15.9%) of "Balanced" type. In those of the contrast group, there were 73 people(51.4) of "Balanced" and 114 people(40.7%) of "Mid-Range" and 24 people(16.9%) of "Extreme" type.
Conclusion : This study suggested that depression and family dysfunction should be considered in the management of the chronic renal failure patients.
Background : Physician satisfaction has been shown to influence quality of patient care and correlates with patient satisfaction, improved continuity of care, lower patient no-show rates, and more reasonable charges for routine follow-up visits. Therefore we evaluated the recent physicians' satisfaction and factors correlated with physician satisfaction.
Methods : October 1995, we mailed a survey to 181 primary care doctors in Cheong-Ju city, Choong-Buk.
Results : 31.2% of respondents were satisfied with their jobs. Difference of overall job satisfaction was absent in sex, age, years of practice, numbers of patients, specialty, practice. Most, respondents agreed to 'Medical Insurance system is essential'(82%), 'Doctor is more important in the society'(60%), No respondent agreed to medical charge(0%) and medical investigation(0%). Most respondents were dissatisfied with change of care(87%), clinical freedom(87%), difficulty in rational settlement of sue(86%), defensive treatment(83%), The questionnaire items, worth on the work(r=0.66), choose to be a physician again(r=64%), pursue a career in medicine to their children(r=0.51) were highly correlated with overal job satisfaction. Defensive treament is negatively correlated with overall job satisfaction, but correlation coefficient was low(r=0.21).
Conclusion : Overall job satisfaction was low. About medical insurance system and medical dispute, most respondents were dissatisfied, but correlation coefficient is low. Having worth on their work demonstrated the strongest correlation with overall job satisfaction. It is suggested that efforts directed at helping physicians to derive worth from their work may be of paramount importance in oder to improve overall job satisfaction.
Background : For control of diseases, the relative importance of prevention and treatment of the disease has become greater day by day and, accordingly. the importance of health education is being emphasized. In conducting health education, we are aware that using mass media exerts a great effect upon the readers in general. However, We seldom find any study on what kind of health in formation the mass media is providing and furthermore. if the if the information provided is fit for reader in general. In this study, we strove to ascertain, through a content analysis, if the daily newspapers reported adequate articles of health information on cancer, on of the most important health problems in this country.
Methods : A prepared analysis table containing 11 different items(evaluation standards) was distributed to a family medicine specialist and internal medicine specialist, and a graduate student in the doctoral course of public health science. they were asked to analyze 143 articles, pertaining to cancer, reported in nine different daily newspaper during the period from January 1992 December 1993. Three different analysis tables, prepared by the three analyzers, were consolidated by each of the 11 items and the consolidated table was analyzed.
Results : As for the items entitled "The contents of article were too professional for the readers(in general) to understand." and "Article contained too difficult terminologies for the readers to understand", 39.2% and 34.3% of the readers gave affirmative answer to the respective question. This meant that more than on third of the readers thought the articles were too difficult to understand. The result of analysis reflects that the headlines accurately reflected the contents of the articles(88.8%) and there were very few academic errors(2.1%). Articles pertaining to high technology were 35.0% of the total and articles including an adequate explanation of the prevention and early diagnosis of cancer were only 34.5% of th total It also indicates that 14%, 2.1%, 20.3%, and 35.7% affirmative answers were given to each of the following four (4) items, respectively: "foreign case was reported as if it were a case in this country". "rare case was reported as if it were a common case", "case in a limited area was inadequately generalized and reported as a common case", and "article was written by using only on viewpoint on a topic which was being criticized." If we consider any on of the above four items as an exaggerated article, 42.7% of the total articles fall into this category. As for the last item, "in total view, the article contributed to the health promotion of the readers", only 53.1% of the articles had a affirmativex answer.
Conclusion : The articles concerning cancer. reported n the daily newspapers in this country, did not provide inaccurate on health. However, many of the articles were determined to be too difficult to understand, or provided exaggerated information, and only about on half of the articles are considered to have contributed to the health promotion of the readers.
Background : Most health professionals agree that exercise has positive effect on physical well-being. In addition, they believe that exercise has benefit for improvement of psychologic stress, mood sate, social relationship and sleep disturbance. The purpose of this study is to evaluate the effect of regular exercise on complaining of somatic symptoms in healthy adults.
Methods : 309 healthy adults were selected among the visitors at hanil health screening center from February 23 to June 23, 1995. The evaluation was done about the frequency of exercise and somatic symptoms via questionnaire which consisted of 21 symptoms chosen from a list of 35 symptoms of somatization disorder met by DSM-III-R criteria. The 3 categories for exercise were classified as regular, Intermittent and none exercise groups.
Results : Women did lesser regular exercise and had more somatic symptoms than men. In general population, regular exercise group had significantly lesser somatic symptoms than none and intermittent exercise group, and general, cardiovascular, digestive and musculo-skeletal symptoms showed positive association with regular exercise. In men, regular exercise group was associated with lesser somatic symptoms and only cardiovascular symptoms showed positive association with regular exercise. But in women, the numbers of somatic symptoms were not significantly different among exercise groups.
Conclusion : In the study of the effect of exercise regularity on somatic symptoms, the numbers of somatic symptom were fewer for the regular exercise group than none an intermittent exercise group in men. Therefore regular exercise helps reduce complaining of somatic symptoms.
Background : Recent improvement of economic life-style and increase in mean lifespan make the incidence of prostatic cancer increase in Korea. Tests that can diagnose prostatic cancer accurately and rapidly are need. Prostatic acid phosphatase which has been used over decades is not specific for prostatic tissue, but ross-reacts with other tissues. So it was helpful for diagnosing metastatic prostatic cancer, but found to be not a useful indicator in diagnosing and follow-up of prostatic cancer because of its low sensitivity and high false negative rate. Recently reported tumor-maker for prostatic cancer, serum gammaseminoprotein is reported to be highly sensitive and the authors evaluated the diagnostic usefulness of test in prostatic cancer.
Methods : The patients who visited a university hospital from Aptil 1993 to October 1994 consists of 15 cases of untreated prostatic cancer, 44cases of benign prostatic hypertrophy(BPH) and 27 cases of benign urologic diseases. The author analyzed the values of √-Seminoprotein(√-Sm) and prostatic specific antigen(PSA).
Results : The level of √-Sm and PSA showed significant increase in patiens with prostatic cancer as compared with those of BPH and benign urologic diseases. The best estimate of cutoff value in √-Sm and PSA test were 3.0ng/ml and 7.0㎍/L respectively. Detecion sensiivity, detecion specificity, positive predictive value, negative predictive value and diagnostic efficiency of √-Sm test were 86.7%, 88.7%, 61.9%, 96.9% and 88.4%, respectively. The result of coefficient of correlation between √-Sm and PSA was 0.641 and meaningful. A significant correlation was found between √-Sm and PSA. The result of consistent coefficient between √-Sm and PSA was 0.83. Either of the two tests was positive in all cases of prostatic cancer group.
Conclusion : On the basis of these results, it can be suggested that serum √-Sm and PSA test were useful parameters for the screening of early prostatic cancer and that addition of physical examination such as digital recal examination or transrectal ultrasonography to the assessment of tumor marker is more superior for screening of latent prostatic cancer.