Background
: Lymphedema is a common condition occurring in over 50% of breast and cervix cancer patients. The pneumatic pump as used in the past is still utilized for the treatment. A complex lymphatic therapy was developed by Dr. Michael Foeldi of Germany in the 1980s, and was widely practiced with good effects. This study was to observe the practical effectiveness in patients receiving such treatment.

Methods : Twenty two patients diagnosed with lymphedema and treated in department of Family Medicine of National Health Insurance Corporation Ilsan Hospital from August 1,2000 to September 30, 2001. They were observed with respect to the frequency of demographic characteristics, and were compared to assess the improvement of clinical symptoms before and after complex lymphatic therapy by independent samples T-test and the degree of edema reduction before and after complex lymphatic therapy by paired samples T-test (P-value<0.05).

Results : Among the 22 subjects I was a male and 21 were females and their mean age was 49.9±9.3. Cervix and breast cancer patients comprised 86.4% among the total. Twenty one cancer patients developed lymphedema after the operation or radiotherapy. Most were in stage 2 or 3 of edema with 81.8%. Relative to the edema onset time, there were 7(33.3%) of less than 1 year, 5(23.8%) from 1 to 3 years and 9 (42.9%) over 3 years. They came to see a lymphedema specialist in 2.9±3.9 years after edema progressed. The degree of lymphedema with 968.4±545.3 ml before the treatment was improved to 337.3±326.8 ml after the of lymphedema with 968.4±545.3 ml before the treatment was improved to 337.3±326.8 ml after the treatment which showed a statistically remarkable 65.0±33.2% effectiveness.

Conclusion : complex lymphatic therapy for the patients of lymphedema presented with a 65% edema reduction in our study. Thus, the therapy for such patients is considered the most effective method up to present.

Background
: Cervical cancer is the second most commonly diagnosed cancers in women and is responsible for about 14 percent of all female cancer found in Korean women. Early detection is very important because the likelihood of a complete cure is greater, and among the early screening tools to detect cervical cancers, a Pap smear is most widely used. It has the clinical significance to follow-up patients whose results are classified a class II in their Pap smear. Therefore we tried to find the factors associated with follow-up in class II patients.

Methods : On Pap smear practiced from Jan. 1, 2000 to Dec. 31 in a university Hospital, 159 patients Pap smear results were categorized as class II, and among the 159 patients, we were able to collect data from 107 patients who voluntarily answered a phone survey. The categories in the survey were the followings: follow-up for the Pap smear, age, age of marriage, presence of menopause, age of menopause, occupation, family history of chronic diseases or cancers, educational level, presence of concomittant diseases, income, average hospital visit frequency in a year, belief of general health, and reason for doing follow-up and reason for not doing it.

Results : Among 107 patients, only 62 patients(57.9 percent) did follow-up for their Pap smear results. The reason were doctors follow-up recommendation for Pap smear results and regular health check-up, and the two main reasons not doing follow-up were nonexistence of further symptom and financial distress. In a single variable analysis, the higher educational level, individual income, and hospital visit frequency, the more people had follow-up. But in multiple logistic analysis, only individual income was statistically significant.

Conclusion : The follow-up rate was as low as 57.9 percent, and the reasons why they did not follow up were mainly the lack of understanding about the clinical significance II result on the Pap smear. Therefore, an advertisement and public education programs to general public about cervical cancer will make more patients follow up their result on the Pap smear, especially to the low income and low education class people.