Background
: Falling, urinary incontinence, and sleep desturbance are common physical problems in elderly. These conditions are generally assumed to negatively influence overall health and functio-ning and tend to be interrelated with depression. The purpose of this study is to investigate the prevalence of falling, urinary incontinence, sleep disturbance, and depression in nursing home residing older persons aged 65 or above and to determine the interelations between these conditions.
Method: Subjects were 90 older adults residing in 2 nursing home including 35 Sakhalin immigra-nts who had different sociocultiral background from others. Seven investigators interviewed the subjects by questionnaires about recent history of falling, urinary incontinence, and sleep disturbance, geriatric depression scale(GDS), and 'Barthel Activities of Daily Living(BADL)'. Dependent variable was depression defined by GDS, and independent airiables were 3 physical conditions and other convariants.
Result: Failling occured in 32.2% during last 1 year, urinary incontinence affected 21.1%, and 81.1% of the subjects experienced sleep disturbance. Prevalence of depression defined by GDS score above 11 was 50.0%. Sakhalin immigrants were more vulnerable to depression that Korean old people(p<0.0005). In multiple and logistics regression procedure, sociocultural factor and urinary incon-tinence were significant predictors of depression in elderly. And the relative risk for depression was 5.5 in Sakhalin immigrants, and 5.1 in elderly affected by urinary incontinenece. Though most older adults reported urinary incontinence to family or friends, none of them discussed this condition to health providers including doctors or nurses.

Conclusion : Urinary incontinence was an important risk factor for depression in elderly, and health providers should have more concerns to this condition.

Background
: Recently, cancer have become the major cause of death in Korea. But the diagnosis of the terminal cancer have been made, patients have been left alone without any discharge plan or have been admitted to a university hospital. In order to offer useful medical care to terminal cancer patients and to increase the efficiency of the sickbeds, it is needed to study the reasons for terminal cancer patients’ admission to a university hospital and problems associated with the admission.

Methods : Two groups of each 60 and 25 terminal cancer patients were randomly selected as subjects of. The patients were admitted to one university hospital located in Seoul and one university hospital located in a country city from Sep. 1, 1995 to Nov. 30, 1995. Their medical problems and treatment were reviewed. And through interviewing with patients’ chief doctor and families, we surveyed 69 patients’ reasons for admission, problems of home care, and the type of medical service needed by patients and familes.
Result: The most common medical problem precipitating the terminal care patient’s admission was pain(25.9%). 61.2% of chief doctors and 44.9% of family stated that the reason for admission to the hospital was symptom control including pain. Of 69 families who stated the place for patient’s death, 28(40.6%) chose the hospital. Concerning the worrying aspects of home care, 13(18.8%) families stated difficulty of admission, 10(14.5%) said inability to leave patient attended, 10 did inability to call medical personnel, 9 did no medical team for consultation. About 90% of the families wanted 24hr telephone service, readmission and continuous care of their hospital. Also, many families(about 70%) wanted admission to other hospital and care by other medical team. There was no significant difference between two university hospitals.

Conclusion : The main problems of care for terminal cancer patients were insufficiency of medical institutions and home care services for terminal cancer patients, and inappropriate symptom control. The refore, through introduction of home care service, establishment of palliative care centers and construction of strong connection with acute care institutions, we should be able to offer efficient and good medical service.

Background
: Recently it is under discussion to apply the LHMP(Lifelong Health Maintenance Program) to whole primary health care centers. We wanted to get baseline data for the application and the recognition status of health promotion and LHMP in Seoul.

Methods : We sampled 1200 telephone num-bers randomly among houses in Seoul by random digit dialing method, and telephone interviews were executed by 2 well-trained interviewers.

Results : The 305 subjects consisted of 118 men and 1987 women, and their mean age was 38.6±13.1 in men and 39.0±11.6 in women.
The most frequently practiced health promotion behavior was periodic health examination(male:55.1%, female:46.0%) followed by regular exercise(male:46.6%, female:27.8%), health food intake(male:31.4%, female:18.2%) in the order of frequencies. The frequencies of periodic health exami-nations was as follows ; every 2-3 years in 45.3% of men and 36.1% of women, every year in 31.3% of men and 30.2% of women, less than every 5years in 15.6% of men and 25.6% of women, every 425 years in 7.8% of men and 8.1% of women.
The health promotion behavior which they thought important was regular exercise(male;84.7%, female;81.8%), followed by periodic health examination(male:10.2%, female:10.7%), health foold intake(male:2.5%, female:4.3%), taking family doctor's advice(male;2.5%, female:1.6%) in the order of importance. Only 26.3% of men and 26.7% of women have ever heard ad ices explanations order disease provention of health promotion from thier doctors.
The specialties of the the doctors who gave them advices or explanations were internal medicine(58.1%), general surgery(6.5%), general practitioner(6.5%), family medicine(3.2%) in men, and internal medicine(41.1%), obstetrics and gynecology(19.6%), general surgery(13.7%), family medicine(9.8%) in women in the order of frequencies. The proportion of men who thought they have thier family doctors was 10.2% and that of women was 12.8%. The proportion of men who recognized the necessity of family doctors was 61.0% and that of women was 74.9% The specialties which they thought fit for family doctors were internal medicine(55.5%), family medicine(19.4%), general surgery(12.5%) in men and internal medicine(45.7%), family medicine(32.9%), general surgery(7.9%), pediatrics(14%) in women in the order of frequencies.
64.6% of the subjects have never heard of LHMP, but 57.5% of the subjects were willing to become members of lifelong health maintenance program.

Conclusion : Most people in Seoul know the necessity of family doctors, and thought that internal medicine, family medicine, general surgery were the specialties fit for doctors, and were willing to become members of LHMP.

Background
: It is current trend that health promotion and disease prevention are important target to the health seeking people. The health promotion is very closely related wit lifestyles which can be modified. Physician's role nowadays would be advocating health lifestyle for their patients, but many physicians in busy practice are reluctant to do so. If brief counselling requiring minimum time can be effective in changing poor lifestyle factor, it is of great help in preventive ptactice among primary care physicians.

Methods : During three months of period from 3 April 1995 to 30 June 1995, patients attending the health examination center in two hospitals was randomly assigned to control group and interven-tion group. Intervention group were advised to modify their poor lifestyles trough three to five minute brief counselling, given health related leaflets. Data for follow up questionnaire were obtained from 100 patients by the end of 1st month and 77 patients by the end of 3rd month.

Results : Intervention group had shown significantly increased mean score in exercise, seatbelt use, nutrition and weight control, smoking, drinking, behavior, overall health score one month later. Control group had shown significantly increased mean score in exercise only one month later. Interve-ntion group showed better behavior change than control group in the aspect of overall health score, nutrition and weight control significantly by the end of one month. Intervention group had shown significantly increased mean score in exercise, seatbelt use, nutrition and weight control, smoking, drinking behavior, overall health score three month later. Control group had shown significantly increased mean score in overall health score and exercise three month later. Intervention group showed better behavior change than control group in smoking nutrition and weight control, overall health score significantly by the end of three month.

Conclusion : The results show that doctor's brief counselling modifying poor lifestyles for their patients was effective and thus primary care physicians should play a key role in counselling and encouraging their patients having desirable habits.

Background
: As modern epidemiologic studies began to identify obesity as a risk factor for cardio-vascular disease diabetes, hypertension, and cancer, measuring the degree of excess body fat s important on primary health care. The evaluation of obesity level in outpatient clinic setting has been mostly done by measuring patient's height and weight. But, the anthropomentry could not be done to all visitors of clinics as well as to responders of epidemiologic survey. This study was attempted to develop a new instrument for evaluating the level individual obesity in outpatient clini setting in Korea.
Method: For assessing validity of the instrument, questionnaire study and measurement of sta-tus/weight was done to new visitors of clinic. Two weeks later, questionnaire retest was done by using same instrument for assessing reliability.

Results : The data were collected from 140 subjects of 20 years of age and older. When the validity was measured through correlation with Body Mass index(kg/M²), Spearman's correlation coefficient(r) was 0.79(P<0.001), that reliability of instrument using test-retest method was demonstra-ted(r=0.905).

Conclusion : Quick instrument using somatotype drawing are applicable to screen degree of body fat in outpatient clinic setting in Korea.

Background
: It is suggested that the protection of the cardiovascular disease, including Myocardial infarction, in danger group is also important as well as the treatment of the disease after its attack. The rick factor of myocardial infarction, the most critical disease among cardiovascular disease, is well known and a lot of research papers are reported in Korea. But there are a few case studies on the behavior type and cardiovascular disease. Thus this study is intended to promoted the early detection and treatment of Myocardial infarction in primary care stage by surveying the influential behavior pastern to cardiovascular, especially the relation of Type A personality pattern.
Method: We set the 117 patients who came to six university hospitals in the vicinity of Seoul and Kyung-ki Province from April to August in 1995, as the patient group, and set 113 patients without cardiovascular disease who came to the same hospitals as the control group. The information on the disease and sociocultural elements of the 230 patients is obtained by questionnaire and medical records. As a method of behavior patten survey, the Danakawa. Type A behavior questionnaire of Tokai University in Japan is adopted This questionnaire is based on the Jenkins Activity Survey. We use the T-test and Chi-square test, CATMOD test in statistical correlation, and use th linear model in multivarient analysis.

Results : In the sociocultural aspects of the research object, there is no noticeable difference. Howe-ver, the patient group shows significantly high frequency in high blood pressure, DM, cholesterol, smoking and myocardial infarction family history. There play the role to cause Myocardial infarction. Type A behavior patten shows 81 patients(69.2%) in patient group,46 patients(40.7%) in control group. Accordingly the patients with Type A behavior pattern shows noticeably higher level than the control(x²=18.912, DF=1, P=0.000). Cholesterol(P=0.0001) and smoking(P=0.01), the major risk factors of Myocardial infarction, seem to be significantly related to the Type A behavior pattern, And factor of Myocardial infarction, seem to be significantly related to the Type A behavior pattern. And even though we exclude each factro of critical factors of Myocardial infarction and other variables, the Type A behavior pattern shows high influence on Myocardial infarction.

Conclusion : It is surveyed that Myocardial infarction, the most critical cardiovascular disease, and the Type A behavior pattern is deeply related as a cause and effect. In the exammination on the relations of serum cholesterol, smoking, the main risk factors of cardiovascular disease, the result shows thers is meaningful relations between them. Therefore we can conclude that the Type A behavior pattern plays the causative role to Myocardial infarction. Thus we can conclude that it is recommended to educaste the patients on the basis of the behavior-scientific approaching method of Type A behavior pattern for the better treatment, prevention and prohibition of recurrence of the Myocardial infarction as well as the interception of the direct factor. And more studies are required

Background
: Owing to a recent socioeconomical development, a variety of health-seeking behaviors to improve one's own health are in vogue. In this study we intended to search for the correlation between each health-seeking behavior and upper respiratory tract infection which primary care physi-cians are most commonly in contact with.

Methods : From March. 17, 1994 to April 16, 1994, we questiond 736 students of 3 universities in Seoul about their health-seeking behaviors and the duration of upper respiratory tract infection which they contracted from November 1993 to February 1994 via questionnaire and then analyzed 718 responses, excluding cases with insufficient answers.
Result: Singificantly more collegewomen(80%) than collegemen(68%) experienced URI symptoms for 4 months in winter. The collegewomen group who asserted alcohol abstinence and smoking cessation for health experienced URI symptoms less frequently than other groups. The collegewomen showed significant positive relations of URI with sportstime. However, the duration of URI symptoms in collegemne wast not related with sportstime. In view of the relation between smoking and URI sysmptoms, we found more incidence in smokers than non=smokers among collegemne. The survey of the reliance on the tonis or herb medicine revealed that 266(48.2%) collegemen and 75(45.2%) collegewomen were relying on tonics or herb medicine for health. But no significant correlation were found between tonics or herb medicine and the duration of URI symptoms, in collegemen or in collegewomen. Otherwise, there was no correlation between the duration of URI symptoms and heat-keeping diet, or drinking habits.

Conclusion : In this study we have a conclusion that primary care physicians should encourage people to abstain from smoking and to avoid excessive exercise in order to prevent URI infection Furthermore, it may be necessary that we should perform prospective study based on the widespread, epidemiological data about health-seeking behaviors in order to uncover the correlation between the illness and one's desirable health-seeking behaviors.

Background
: The purpose of this study is to investigate hospital doctors' knowledge and acceptance for hepatitis B prevention. We examined uptake of HBV vaccine among doctors and the reasons non-uptake of the vaccine. In addition as needlestick injuries represent the most frequent route of HBV infection among doctors, respondents were asked the history of needlstick injuries. We also examined the positive rate of HBsAg, HBV infection rate and positive conversion rate of HBsAg to investigate the risk of hepatitis B infection among doctors. Finally we examined the preventive methods from hepatitis B infection among doctors who are high risk group of hepatitis B infection.

Methods : We assessed 283 doctors and 1987 general staffs who employed St. Mary's hospital and other three branches of Catholic University Medical College, and completed quetionnaires given from May to August, 1995 and health screening examination from 1992 to 1994. This questionnaire consists of 11 questions. It contains hospital work period, HBsAg/Anti-HBs status, positive conversion rate of HBsAg during hospital work, HBV vaccination status, reasons for incomplete vaccination or non-uptake of vaccine, experience of needle stick injury and description of preventive method against hepatitis B infection.

Results : The positive rate of HBsAg in doctors(3.9%) was higher than of general staffs(2.5%) (P<0.01) and positive conversion rate of HBsAg was higher in doctors(1.60%/yr vs 0.22%/yr). Repor-ted needlestick injuries in doctor were significantly than that of general staffs(P<0.001). Those who reported unknown for their HBsAg/Anti-HBs status are significantly more common in general staffs(P<0.01). The opinion about B prevention, most doctors answered that we have to carry out systematic HBV vaccination programs.

Conclusion : Hospital doctors should examine HBsAg/Anti-HBs in health sceening examination, and the if the results are HBsAg(-)/Anti-HBs(-), the doctors must have taken HBV vaccination according to systematic vaccination program. In addition, if needlestick injury occured during hospital work, doctors have to take proper action to protect HBV infection.

Background
: Clinicians are based on routine urinalysis when they treated urinary tract infection as primary laboratory finding. In this study we analyzed the relationship between routine urinalysis and the results of urine cultures in order to identify predictors of cultures result in the diagnosis of UTI.

Methods : Bacteriuria, pyuria and nitrite test as predictors of UTI's in patients, who were not tooked medication, were eveluated in 158 visits in one hospital, using a positive urine culture as a gold standard.

Results : The overall culture positivity rate was 34.8%(55 out of 158 cases). A difference was not found between ages(P>0.05). The sensitivity and specificity of microscopic bacteriuria were 78.2% and 79.6%, repectively. The results of nitrite of nitrite test were 50.9% and 87.3%. The validity of pyuria was increased by increasing number of WBC, but specificity was higher than sensitivity. Urine tests consisting of a positive nitrite test, microscopic bacteriuria, microscopic WBC>15/HPF, the sensitivity and specificity were 34.8% and 89.5%, respectively.

Conclusion : Sensitivity and specificity of bacteriuria and specificity of nitrite test were contributed the highest validity in the prediction of urine culture result.