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1.The Type of Medical Service Desired by Those Communities Which at Present have None.

Korean Journal of Preventive Medicine 1978;11(1):49-58

To try to determine the type of medical service wanted by the rural population, in Chungnam Province, a survey amongst the populations of 6 counties was conducted; Within the 6 counties, 2 local communities, which had no access to local medical services, were surveyed. The 12 communities were actively involved in Sae-Maul activities, and total number of households surveyed, was 822. The survey was conducted over a 1 month period, from July 16th, 1976, thru August 20th, and the followings are the results, summarized. 1. The largest number of respondents desired a combination of Public Health Center and Country Hospital, followed in order by Private Clinic and Modern Medical Facility. 2. The respondents, aged under 40 years, desired the Private Clinic type medical service, whilst those over 40 years of age, wanted the County Hospital, and as the numbers in this age bracket, were larger, so the ratio was much higher. 3. Sex, educational background, and occupation did not play any particular emphasis in the decisions. 4. Monthly income affected the responses to the survey. These in the lower-income bracket, wanted the County Hospital, and the ratio was high. These in the high income bracket desired the Modern Medical Service, accordingly. Those with an income of 50,000 won or less, amongst the low-income bracket, favored the Public Health sub-center type of service. The ratio for this service was very high.
Chungcheongnam-do ; Surveys and Questionnaires ; Family Characteristics ; Hospitals, County ; Occupations ; Public Health ; Rural Population

BACKGROUND: Left ventricular hypertrophy(LVH) is the independent poor prognostic factor in hypertensives. But, it is uncertain that the reduction of LVH by antihypertensives therapy will improve the prognosis of hypertensive patioents. THe effect of reduction of LVH on LV function(espacially diastolic function) and the mechanism of reduction of LVH are not clarified also. The aim of this study was to ascertain whether reduction in LV mass with enalapril has a beneficial effect ofn LV diastolic filling in hypertensive patients with diastolic dysfunction. METHODS: Mild to moderate hypertensive patients were treated with enalapril(10-20mg once daily) for 4 months. Their blood pressure and pulse rate were regularly measured devery 2 weeks. Using M mode echocardiograms, LV dimensions at end-diastole and end-systole, thicknesses of ventricular septum and LV free wall were measured. LV ejection fraction(EF), LV mass index(LVMI) and total peripheral resistance(TPR) were calculated. Pulsed ddoppler examination of transmitranl flow for assessment of LV diastolic function was performend from apical four chamber viw. The peak flow velocities of the early and late waves and their ratio(PFVE, PFVA, PFVE/PFVA) were measured from consecutive 3 cardiac cycles. In addition, the time velocity integral of the early and late waves and their ratio(EA, AA, EA/AA) were measured. Echocardiographic evaluations were performed at baseline and at the end of treatment. RESULTS: Average systolic and diastolic blood pressure decreased after treatment with enalapril. But there was no significant difference of pulse rate between basal and after treatment. The LV dimensions at end-diastole and end-systole and the thickness of LV free wall didn't change significantly. The thickness of interventricular septum, LVMI and TPR reduced significantly after treatment. The ejection fraction of LV didn't change significantly after treatment. There was no significant change in PFVE, EA, AA and EA/AA. But PFVA was significantly decreased after treatment with enalapril for 4 months. PFVE/PFVA was significantly increased also. CONCLUSION: In conclusion, antihypertensive treatment with enalapril led to a significant reduction of LVH partially associated with improvement in LV diastolic performance and no deterioration of LV systolic function.
Antihypertensive Agents ; Blood Pressure ; Echocardiography ; Enalapril ; Heart Rate ; Humans ; Hypertension* ; Prognosis ; Ventricular Septum