Background
: Sulfonylurea is recommended to be taken before meal. But since premeal administration is against Korean's usual medication habit, it can be the cause of poor compliance. Such recommendation is based on the results of a few clinical trials about appropriate medication time. But most of the clinical studies had a limitation : observe only acute effects of medication, subjects were only healthy volunteer. So the chronic effect of sulfonylurea of each kind must be validated.

Methods : From 1996 May to 1996 July, data were collected from diabetic patients who visited an university hospitals for managing diabetes and used a intermediate-acting sulfonylurea. The subjects were randomized to two groups of premeal group and postmeal group, by chart number and were asked to take the previous medicine according to assignment. After 1 month medication, mixed meal tolerance test was done with 300Kcal carbohydrate, 400±50Kcal diet. The subjects were switched to the other group and 2nd mixed meal tolerance test was done 1 month later. The Area under curves was calculated in pre-and post-prandial glucose curve and was compared by paired t-test.

Results : During the study period, total 16 diabetic patients were enrolled. There was no significant statistical difference between pre-prandial group and post prandial group in AUC.

Conclusion : Intermediate-acting sulfonylurea can be administered at any time in relation to meal.

Background
: The infection rate of intestinal parasites has been abruptly decreased during a couple of decades, but the report that Clonorchis sinensis has been decreased in infection rate was not shown. Because Clonorchis sinensis could induce the serious complication such as cholecystitis, cholelithiasis, cholangiocarcinoma, authors thought that clonotchiasis requird early diagnosis, treatment and prevention. Therefore the authors surveyed the infection pattern of Clonorchis sinensis for inhabitants who lived in Miryang city, well-known as endemic area for a long time, located at lower basin of Nakdong river.

Methods : The 661 subjects that received worker's health examination in Miryang Youngnam General Hospital from September to November, 1996, were surveyed by using questionnaire, skin test and stool egg examination. This questionnaire contained history, duration, frequency of raw freshwater fish ingestion, history and treatment of clonorchiasis, history of other hepatic disease. The authors performed laboratory examination to 54 stool egg positive subjects.

Results : Among 661 subjects, the stool egg positive subjects were 54 and showed 8.2% in infection rate. In male(8.9%), stool egg positive rate also increased. Compared to the age group less than 30, stool egg positive rate was higher among age group 30 or over, particularly, in age group 50 or over, stool egg positive rate showed highest infection rate, 31.6%. And stool egg positive rate was increased according to increase of period, frequency of raw freshwater fish ingestion. Subjects with history of clonorchiasis and administrating Praziquantel had higher infection rate than the other subjects without the history.

Conclusion : In this survey, the authors thought that high risk factors of clonorchiasis were male, age of 30 or over(particularly age of 50 or over), more than 10 years in raw freshwater fish ingestion period, more than twice per month in raw freshwater fish ingestion frequency. Then people having these risk factors must be performed various examinations for clonorchiasis, although they had not clinical symptoms, signs and abnormal laboratory findings.

Background
: HBsAg carriers are 6-12% of population in Korea. The patients' knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram.

Methods : From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctor's recommendation.

Results : Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positive, 10% answered HBsAg negative, and 26% answered 'I don't know'. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% form carrier mother at birth, 29% by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctor's recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%).

Conclusion : The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctor's recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.

Background
: Adolescent girls are interested in weight reduction, but effective and adequate education for weight reduction is not done in Korean. And so much information is accepted via mass media. We investigated body image perception, weight control activities and their side effects among adolescent girls.

Methods : We used questionnaire about body image and weight control activities of middle and high school girls in Seoul in Sep. 1995.

Results : 88.6% of girls were not satisfied with their own height and 85.1% of girls with their own weight. 66.3% underweight students(BMI<20kg/m²) thought they were too fat and 98% acceptable weight students(20kg/m²≤BMI<25kg/m²) thought they were too fat. So most girls had body image disturbance. 42.4% of girls were trying to lose weight and 85.1% were trying to lose weight reason for attractiveness and 16.6% were trying to lose for health. Self reported weight reduction methods were exercise(31.6%), fasting(21.9%), diet(21.5%), monodiet(10.8%), laxatives(2.3%), very low calorie diet(1.8%) etc. Students who tried to lose weight for attractiveness selected more undesirable methods than who tried to lose weight for health(P<0.01). Most common route is via magazine, TV and newspaper, 43.4% of girls who tried to lose weight experienced side effects after weight reduction, those were dizziness(71.3%), general weakness(51%), apathy(26.5%) etc.

Conclusion : Most girls had body image distortions. Useless weight reduction activities were done or planned and most of information was accepted via mass media. It is important to educate the girls to get adequate body image and effective weight reduction program is needed for health in adolescent girls.

Background
: The obese patients increased recently in Korea due to excessive energy intake and decreased physical activity. We are well known that obesity is associted with an increased risk of cardiovascular disease, angina pectoris, hypertension, but not known to influence of weight gain to change in cardio-vascular risk factors. Once, the study of obesity are many but the study of influence of weight gain are small in Korea. This study investigated to influence of weight gain in cardio-vascular risk factors.

Methods : We gatherd case and control group among persons who has taken twice medical examination except disease person from October 1990 to October 1995 at SungAe General hospital. In our study, total 167 case, compare weight gain group(>3kg) with control group to change in cardiovascular risk factor.

Results : Sex, age, smoking history, obesity index were not statistically significant difference between two group in the first medical examination. systolic blood pressure, diastolic blood pressure, fasting blood sugar, HDL, total cholesterol/HDL were not statistically significant difference between two group for weight gain. Total cholesterol and triglyceride, LDL were stastistically significant increased.

Conclusion : Weight gain was increased of total cholestrol and triglyceride, LDL, so weight control was important.

Background
: Continuity is very important in primary care, and in most studies continuous care has been reported to have a good effect on the result of care. So we studied the factors influencing the continuity of patient care by physician in charge, especially in case of out-patient department in a university hospital.

Methods : We posed questionnaires to 55 persons who had visited continually to Paik Hospital in Pusan for at least 6 months. We classified them into three groups according to the degree of continuity using 'Modified Continuity Index', and compared the lower group(18 patients) with the higher group(18 patients).

Results : The income of the higher continuity group was significantly less than that of the lower continuity group(P=0.042). But there were no significant differences between the two groups according to sex, age, the type of family, marital status, job and the level of education. The higher continuity group agreed more significantly than the lower continuity group with the question whether it is important to be treated continually from physician in charge(P=0.005). About the reasons for visiting to other doctors instead of the physician in charge, most of them in both group replied that they could not keep appointment. And there were no significant differences in the care pattern of disease between the groups.

Conclusion : To improve the continuity of patient care by physician in charge, it is necessary to instruct the importance of continuous care to the patients and to motivate them through various methods.

Background
: Recently preventive clinical care has been proved important to the health. A number of recommendations or programs for preventive health services have been developed. The government made laws for health promotion of the people and for medical check-up for the insured in the district medical insurance association, who had been alienated from reimbursement for periodic health examination. As a result, above 95% of Korean people could took the periodic health check-up by this legislation. According to the national data, however, about 20% of the insured participated in the health screening program which was carried for the first time by the district medical insurance association in 1995. The reason that the compliance of health screening program was much lower than expected has not been clear yet. The purpose of this study is to define the facors affecting on the compliance of the health screening program.

Methods : Two hundreds of compliers and as many non-compliers of the health screening program was selected by the stratified sampling in one district medical insurance association which consisted of one town and eight township within the National Capital region. The telephone survey was performed from June 1 to 15 in 1996. The questionnaire was framed by health belief model with other demographic data. The data was analyzed by chisquare test, wilcoxon rank sums test, and logistic regression for the comparison of the characteristics between compliers and non-compliers.

Results : There was no difference of demographic data and medical history of chronic disease between compliers and non-compliers. 73.3% of the subjects knew they had been the expectant examinee of the health examination, and among them, 68% took the health examination. However, 53% of non-compliers did not know that they had been the expectant examinee. The most common reason that non-compliers didn't took the health examination was "they didn't know"(43.5%). Among 73 families of compliers which had more than 2 expectant examinees of the health screening program, 44 families(60.3%) had more complier other than study subjects. In contrast, among 74 families of non-compliers, only 7 famiies(9.5%) had more complier other than study subjects. Compliers showed lower reliability of the health screening program than non-compliers. Non-compliers had more perception about the severity of the target disease for the examination and had more confidence about self health status than compliers. There was no difference of the answer about the benefit of the health examination, perceived susceptibility about target disease, sue to action, and perceived barriers. The odds ratio of compliance of other family member was 21.2, perceived severity, 0.70, and cue to action, 1.36.

Conclusion : The main reason of low compliance of health screening program for the insured in the district medical insurance association was lack of public information. By the fact that non-compliers had more perception about the severity of the target disease and there was no difference of perceived benefit of the health examination between two groups, public information should be focused on the benefit and efficacy of periodic health of the health examination between two groups, public information should be focused on the benefit and efficacy of periodic health check-up than severity and susceptibility of target disease. Because the health screening program on study subjects was carried for the firt time, only compliers had experience of the examination. The fact that compliers relied on the examination less than non-compliers meant that the examinees was satisfied much less than expected. Therefore, further study of the expectation of the examinees about the health examination is expected.

Background
: There is much harmful influence for health promotion when general publics and medical group misunderstand common health knowledge. Therefore we investigated the proportion of misunderstanding about health knowledge of general publics and medical group.

Methods : The data were collected via questionnaire which consisted of 30 questions (11 health behavior, 5 symptom, 14 treatment knowledge) quoted or revised on the basis of the book('Misunderstood common health knowledge 100' published by humanism practice medical doctor association, 1994, hanwol company, South korea). The subjects were nonmedical group (third grade elementary school teachers and parents of students in Kyong ju city) and medical group (doctors-specialist, resident, intern, oriental doctor, medical student, nurse, assistant nurse in Kyong-Ju, Pohang city). The score was given 0 for false answer or no answer and 1 for true answer.

Results : The dominant subclasses of study subjects were as follows : Sex; female(352:64.5%)/age ;30-40 years old(318 persons : 58.5%) education ; high school graduate group(232:42.8%)/job ; nonmedical group(housewives, 168:36.2%), medical group(nurse, 67:36.2%). Medical group acquired higher total average score than non-medical group. There were no differences in the total scores about treatment, symptom, and health behavior in nonmedical group by job. In the medical group, doctors earned significantly higher score than other jobs. The average score per question was 0.53 in nonmedical group and 0.69 in medical group. Non-medical group received average score below 0.5 in 14 questions among 30 questions, while medical group received only in 5 items.

Conclusion : Medical group acquired higher total average score than nonmedical group. Average score per question was 0.53 in non-medical group and 0.69 in medical group.