Background
: The purpose of this study was to investigate the characteristics of and to analyze the factors related to the cost of the resolution of a medial dispute.

Methods : We have reviewed 2,346 cases reported to the Korean Medical Association(KMA) mutual-aid association from Nov.1. 1981 to Oct. 31, 1994.

Results : The percentage of reported cases of related field were as follows : obstetric-gynecology(OBGYN) 31.9%, general practitice 28.1%, general surgery 13.3%, orthopedics 6.9% and internal medicine 6.4%. 1,829 cases(80.0%) were settled out of court and without public intervention. 310 cases(13.2%) were settled by the police, the public procurator's office or the court. The mean settlement amount per cases was 9,340,000 won with annual growth rate 10.8%, and median settlement amount was 5,890,000 won. The mean settlement amount for OBGYN was 930,000 won, surgical group 8,900,000 won, medical group 7,710,000 won, and general practitice 7,490,000 won. The cases of medical dispute according to the types of medical care were : operation 21.1%, injection 18.0%, treatment and care 13.0%, artificial abortion 10.3%, Cesarian section 7.2% and anesthesia 2.5%. The mean settlement amount according to the types of medical care were : delivery and Cesarian section 15,190,000won, operation and anesthesia 9,500,000 won, others 6,610,000 won, and injection and medication 6,230,000 won. The mean settlement amount that was settled out of court without public intervention was 7,940,000 won. The mean settlement with public intervention in the court was 17,290,000 won. The cases of medical dispute according to the patient's status were : death 37.5%, complications 20.8%, disability 12.2% and others 28.9%. The mean settlement amount for death was 16,150,000 won, disability 9,430,000 won, others 4,850,000 won and complication 3,550,000 won. The mean settlement amount where doctors have asserted that the outcome was inevitable or have not agreed that it was their fault was higher than the cost of cases where they had admitted responsibility. The settlement amount where there was a misiagnosis present had not shown to be higher than when the misdiagnosis was absent. The mean settlement amount for cases where multiple doctors were involved was higher than for cases of single doctor. The mean settlement amount for disturbing the medical practice and suspension of are high. The mean settlement amount for complications was lower than others, and the mean settlement amount for disability and death presented were high. Concerning the types of care, the mean settlement amount for operation/anesthesia, delivery/Cesarian sections were higher than the injection/medication. Concerning the type of settlement, the mean settlement amount in the police and public procurator's office was higher than in out of court without public intervention.

Conclusion : The mean settlement amount depended on the patient's status, the type of settlement, and the disturbance of medical practice regardless of the doctor's misdiagnosis, fault, and standard care. Therefore, a reasonable method of resolution for medical dispute is needed.

Background
: This study was performed to assess the effect of hormone replacement therapy(HRT) on the menopausal symptoms of Korean women by comparing the postmenopausal symptoms before and after HRT in women who continued therapy and those who stopped.

Methods : The subjects were 40 menopausal women(24 women on continuous medication, 16 women who discontinued medication) who received HRT and were aiding follow-up of at least 2 months later in the Department of Family Practice. The menopausal symptoms were evaluated by two doctors according to the modified Kupperman Index.

Results : The basic values of Kupperman Index were not significantly different between women who had received the HRT continuously and those who discontinued HRT. In women with continued HRT improved symptoms after HRT were hot flushes, sweating, fatigue, headache, tachycardia and total score of Kupperman Index. However, only vertigo and headache were improved in women who discontinued HRT. Treatment period was the single most predictor of total score of Kupperman Index after therapy. And it could explain the 44.1% of variance of total score in the direction of improvement proportional to the treatment period.

Conclusion : The HRT is helpful to relieve the menopausal symptoms. And the treatment period is more important than the severity of basic symptoms to improve menopausal symptoms after therapy.

Background
: The effect of Video Display Terminals(VDT) Syndrome is well documented. The purpose of this study is to examine the difference in systemic subjective symptoms between long term users of computers with that of the general population and to help plan to avoid the risk of developing Video Display Terminal Syndrome.

Methods : Data was collected for this study between August 1996 and February 1997. Two groups consisting of seventy(70) long term computer users(Exposed Subjects) and fifty-nine(59) non users(Non Exposed Subjects), were selected for the survey. Data were gathered from the exposed subjects through their response to the survey questionnaire posted on the internet requiring detailed responses concerning ten systemic subjective symptoms that were experienced as a result of the long term exposure to VDT. Data were gathered from the non-exposed subjects through written responses to the questionnaire.

Results : Among the more significant difference was the experience of ocular symptoms among the exposed group. The exposed group experienced in descending order eleven items of ocular symptoms: congestion, strain, decreased visual acuity, ocular pain, and dryness. Among seven items of lifestyle, the exposed group characteristically exercised less(P<0.05) and did more home activity(P<0.05), characteristically lead healthier life than the non-exposed group. Particiption in exercise differed most among the groups. The exposed group participating in moderate exercise scored 517±551.6 compared to the non-exposed group which exercised very vigorously(p<0.05). In comparison of subjective symptom and life styles per daily exposure time(over 8, 10, 16 hours daily) there was significant difference between 8 and 10 hour exposers only in the stress item(P<0.05). In the exposure group there were less cardiovascular symptoms(P<0.05) due to more art activity(P<0.05), more cardiovascular symptoms and less sleep activity(P<0.001) and more ocular symptoms(P<0.05) due to higher levels of stress.

Conclusion : By exercising, exposers can decrease the respiratory symptoms, and by seeking methods that enable efficient management of work time, the subjects can benefit from the reduced work time, and by seeking methods so that one receive less stress and can resolve them they can reduce their ocular symptoms, sleep problems, cardiovascular symptoms. And in their spare time, the subjects can be recommended to involve in art activity for each person, through PC indirectly. Designing the development of cyber gallery, museum, literature room, concert can reduce the occurrence rate of cardiovascular symptoms.

Background
: Previous studies have suggested that regular exercise may increase bone mineral density. However the effects on bone mineral density are different depending on the types of exercises and recent studies on the effects of different exercises on bone mineral density are insufficient. This study was conducted to assess the effects of 2 different exercises(Judo, Taekwondo) and physical fitness(back muscle strength, grip strength, broad jump, vertical jump, flexibility, sit ups) on regional BMD.

Methods : Subjects were healthy adults female volunteers aged 19 to 22 years and consisted of eight Judo athletes, twelve Taekwondo athletes, and eight nonathletic controls. We measured their bone mineral density of lumbar spine, femur neck, femoral greater trochanter, Ward's triangle, femoral shaft and distal radius using dual exergy X-ray absorptiometry and assessed their physical fitness. We investigated the mean differences of regional bone mineral density between the groups and the relationships between physical fitness and regional bone mineral density.

Results : ANCOVA revealed that there were significant differences in the regional bone mineral density between the groups. The Judo athletes group had significantly higher bone density of greater trochanter, femoral shaft, distal radius, femoral neck and lumbar spine that the control group and had significantly higher bone density of greater trochanter, femoral shaft and distal radius than the Taekwondo athletes group. There were no significant differences of bone density in all the regions between the Taekwondo athletes and the control groups. Partial correlation coefficients between the back muscle strength and the bone density of Ward's triangle, greater trochanter, distal radius, femoral neck, femoral shaft, and lumbar were 0.581, 0.570, 0.526, 0.502, 0.424 and 0.418, respectively(P<0.05). Correlation coefficients between the broad jump and the bone density of femoral neck, greater trochanter, and femoral shaft were 0.577, 0.539 and 0.457, respectively(P<0.05). Correlations of the grip strength, flexibility, sit ups and vertical jump with bone density of all regions were not high(r≤0.5).

Conclusion : Different types of exercises showed different effects of bone density. The back muscle strength among the physical fitness factors was considered to be the most important predictor of bone density. In the future, further studies are necessary for the effects of other exercises on bone density.

Background
: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of health individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination.

Methods : From Feb. 1996 to Aug. 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBs negative and a normal LFT). All subjects were vaccinated with Hepavax-B® 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonresponders(anti-HBsTiter < 2mIU/ml) and the hyporesponders(2~10 mIU/ml). All 13 nonresponders were revaccinated with 2 ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later.

Results : The difference in age(p<0.01) and smoking amount(p<0.05) between the responders andhe hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 58.08 mIU/ml(1~132.4 mIU/ml).

Conclusion : Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.

Background
: There were a lot of problems in the health care system of Korea, which was divided into Western and Korean Traditional Medicine since 1951. In 1976 WHO published program of "The promotion and development of traditional medicine'. In 1977, Korean Medical Association(KMA) asked 'unification of health care system' to government. But there was no progress because there were the lacks of mutual respect and understanding between doctors of Western and Korean Traditional Medicine. As one health care group competed with the other, so KMA proposed the unification of health system again in 1997. The objectives of this research are to analyze attitude and opinions of western medical doctors on Korean Traditional Medicine and to analyze the opinions on the unification of medical care system in Korea.

Methods : A list of western medical doctors in Seoul and Incheon was obtained form Korean Medical Association. We sampled 937 doctors by stratified random sampling method. We sent them postal questionnaires with prepaid return envelopes two times during March and April 1997. Of the 937 questionnaires, 266 replies were received. We analyzed the preference score related to referral, Korean Traditional Medicine education and unification of medical care system. We analyzed the data by Chi-square test, t-test, ANCOVA.

Results : This study shows that the western doctors have negative attitude on Korean Traditional Medicine(M=18.8, SD=5.2). They thought Korean Traditional Medicine was not reliable because it was not scientific(79.4%). Doctors, who didn't take oriental medical education, preferred unification of health care system, but it was not statistically significant. Those who experienced oriental medical education used oriental medical treatment more frequently(F=1.17, p=0.04). The more positive attitude they have about Korean Traditional Medicine, the most frequently they refered the patients to oriental medical doctors(t=3.57, p=0.0004).

Conclusion : Western medical doctors have a negative attitude on Korean Traditional Medicine. Doctors, who did not have oriental medical education, preferred unification of health care system, but it was not statistically significant. In summary, the lack of mutual respect and understanding between doctors of the Western and Korean Traditional Medicine prevent unification of medical care system.