Down syndrome is known as one of the most common causes of mental retardation. Screening for Down's syndrome in the second trimester of pregnancy, based on the concentrations of various markers in serum and maternal age, has become widely used in the past decade. Down's syndrome is associated with low maternal serum alpha-fetoprotein and unconjugated estriol concentrations and high maternal serum human chorionic gonadotropin and inhibin A concentrations. Measurements of the first three markers, in addition to age, constitute the widely used triple test; measurements of all four markers with age make up the quadruple test. The triple test shows 62% of detection rate and the quadruple test was substantially better than the triple test (70%). Also several sonographic markers, especially nuchal translucency and nasal bone apprears to be a highly effective method to screen for Down syndrome.

ackground: Burn is one of the most common illness in primary care. Most burns are partial skin thickness burns. The purpose of this study was to evaluate the use ofSilvadene (silver sulfadiazine) ointment (antibacterial agent) and DuoDERM® (artificial syntheticmaterial).

Methods : The subjects of this study were 46 patients with partial skin thickness burns who had visited a general hospital burn clinic from May 1, 2002 to June 30, 2002. They were randomly assigned to the silvadine ointment or DuoDERM® group. The patients were evaluated for pain, the number of dressing change, the ease of dressing application and removal, limitation of activity, comfortableness, satisfaction with the appearance, sleep disturbance, treatment cost, and the number of days for complete epithelialization.

Results : DuoDERM® treated burns had a fewer dressing change (3.19 times vs 5.36 times), less time for dressing change (4.13 min vs 6.26 min) and less cost (P＜0.01). But there was no statistical difference in the number of days for complete epithelialization (P=0.197) and it depended on the size of the wounds (P=0.005). The cost of treatment was related with the number of dressing change (P=0.000).

Conclusion : Treatment methods had no effect on duration of treatment but artificial synthetic material was shown to reduce the time for dressing and the cost.

Background
: Recently, the number of internet users is rapidly increasing and internet medical counseling for medical information is also becoming frequent. The aim of this study was to assess the responses and accuracy of internet medical counseling, and compare the responses according to years and operating groups.

Methods : The subject websites were 79 websites in August, 2000, and 88 in May, 2002, which operated board-type medical counseling. We questioned a simulated case of an acute dermatologic disease. Then we analysed the response rate, the time taken to reply and the accuracy of reponses.

Results : The number of websites that answered the question was 38 (48.1%) in 2000, and 73 (83.0%) in 2002. The response rate was significantly higher in 2002 than 2000. Time to reply was significantly shorter in 2002 than 2000. The response rate in hospital or clinic groups was higher than in other groups. The rate to make a correct diagnosis was significantly higher in 2002 than 2000. The rate to mention prognosis and necessity of intensive treatment was significantly higher in 2002 than 2000.

Conclusion : The response rate was higher 2002 than 2000. Time to reply and the accuracy of answer improved in 2002. The response rate was higher in hospital or clinic group than in other groups.

Background
: For cancer patients, pain is the most common symptom and the most important factor that seriously affects their treatment and quality of life. The purpose of the research was to determine the controllable factors for pain management in order to increase patients' satisfaction for pain management.

Method: This study was based on the survey answers and medical records of 464 cancer patients, in 8 hospitals in Korea from March until September 2000.

Results : As shown by Chi-square test, according to the degree of satisfaction for cancer pain management, those patients who were "satisfied" with pain treatment showed better activity rate (P=0.007) than the "unsatisfied" group. Additionally, the frequency of using painkillers according to WHO step-ladder, Pain Management Index (PMI), or patients own knowledge and attitude toward cancer pain control was not found to be relevant to patients satisfaction (P=0.106, P=0.382, P＞0.05). But, in the "satisfaction" group, more patients were informed of the importance of pain management (P=0.004) and reported less pain (P＜0.05). A close relationship between higher satisfaction and lower pain interference rate was discovered, but no correlation was found for activity, mood, or gate. The average of interference rate was lower in the "satisfaction" group (P＜0.05).

Conclusion : For higher satisfaction rate for pain management among cancer patients, high activity rate, patient education of importance of pain management, less severity of pain, and low interference rate in life are found to be the determinants.

Background
: Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD.

Methods : This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA.

Results : The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise.

Conclusion : The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.

Background
: Obesity and decreased pulmonary function increase mortality and morbidity of diseases. Obesity is a major factor of decreased pulmonary function. There are variable results of how much body mass index (BMI) and body fat percent influence pulmonary function. There arefew data between obesity and pulmonary function in Korea. This study observed the association of BMI, body fat percent and pulmonary function, and quantified the impact of obesity to pulmonary function.

Methods : 603, non-smoking women in their forbles visited the Health Promotion Center of Inha University Hospital from January 3, 2000 to December 31 2000. Questions concerning smoking, exercise, and past medical history were made. Body fat percent and pulmonary function were measured. Correlation, simple linear regression and multiple linear regression between obesity indices and pulmonary function were used executed.

Results : BMI has no correlation with FVC, FEV1 and FEV1/FVC ratio. Body fat percent was negatively correlated with FVC and FEV1 (r=-0.162; P＜0.01, r= -0.195; P＜0.01), and was not correlated with FEV1/FVC ratio. In a multiple linar regression, body fat percent was inversely related to FVC and FEV1 (β=-10.380; P＜0.01, β=-11.379; P＜0.01).

Conclusion : Increased body fat percent has association with decreased pulmonary function and has more impact on FEV1 than FVC. FVC was decreased by 10.380 mL and FEV1 was decreased by 11.379 mL when body fat percent increased by 1%.

Background
: Recently, various effective and rapid acting treatment modality for depression have been massively developed. Thus, early detection and treatment of depression is vitally important to improve community mental health. Using BDI, primary practitioner can easily find depressive symptoms that can complicate other physical diseases. Finding and treating depression early can improve general prognosis of physical diseases. The purpose of this study was to find out the prevalence of depression and depressive symptoms and their correlates among residents in Jeju and to provide baseline data.

Methods : The study subjects were 1,086 residents consisting of 531 males and 555 females of 10-Li in rural Jeju island and the data was gathered from trained interviewer using BDI and questionnaire about sociodemographic factors and health behavior. Depression was defined as BDI total score over 23 in males and over 24 in females. Depressive symptom was defined as BDI STEN score over 7.

Results : The prevalence of depression in rural Jeju island was 5.8% in total, 4.9% among males, 6.5% among females. The prevalence of depressive symptoms was 16.7% in total, 14.9% among males, 18.4% among females. The risk factors of depressive symptoms were self-assessed living standard, education years, perceived health status, self-assessed level of stress, perceived social support, body image, breakfast intake, and sleep. Sex, marital status and drinking habit were not statistically significant risk factors.

Conclusion : The prevalence of depression and depressive symptoms in rural Jeju island was very low, especially among females. With intensive mental health service for those who are in low socioeconomic class and low education level and those who have poor health behavior, early detection of depressive symptoms from community will be important to improve general health status.