BACKGROUND: Since 1998, mass urinary screening tests have been conducted in Korean school children. We analyzed the urinary screening test data gathered from the metropolitan city, Seoul, to identify the prevalence of persistent urine abnormalities. METHODS: The students were tested for hematuria and/or proteinuria using dipstick urinalysis. If the results were positive, the students were asked to visit a medical clinic to recheck urinalysis and in report their results. RESULTS: Among 1,337,210 students, who were screened with initial urinalysis, 10,871 students (proteinuria, 3,626 (0.27%); hematuria, 7,634 (0.57%); both, 389) were recommended to undergo second urinalysis in which 8,819 students (81.1%) did. Among them, 851 had persistent proteinuria and 2,618 had persistent hematuria. The results of the first urinalysis were scored based on the severity of hematuria and proteinuria from +1 to +4. Among all students 24.7% of the students who scored +1 and 40.4% who scored +3 proteinuria on the first test had persistent proteinuria, and 56.4% with both proteinuria and hematuria had persistent proteinuria on the second test. For hematuria, the more positive in the first test showed more prevalence of persistent hematuria. And 61.6% of students with both proteinuria and hematuia had persistent hematuria on the second test. CONCLUSION: The presence of both hematuria and proteinuria seemed to be a powerful predictor for persistent abnormal urine finding. And the more positive response in the first test was related to persistent abnormal finding. Therefore we should follow up closely for those students with positive findings.
Adolescent ; Child* ; Follow-Up Studies ; Hematuria* ; Humans ; Mass Screening ; Prevalence* ; Proteinuria* ; Seoul ; Urinalysis

No abstract available.
Depression* ; Mass Screening* ; Primary Health Care*

BACKGROUND: Such screening tools for alcoholism as MAST, NAST, CAGE focused on the alcohol-related psyhosocial problems. But some men can be exduded in a study using these tools whereas they might be at risk for alcohol related physical problems. From this perspective the new tools focusing under quantity and frequency of intake for detection of early-stage drinkers not yet manifesting evident psychosocial problems but having alcohol- related potential harms, are being developed. With focus on these aspects, 10 itemed AUDIT was developed by WHO and this study was developed to provide standard points for screening alcohol problems in Korea with cultural difference through AUDIT. METHOD: The subjects were 85 drinking men and 11 male alcohol dependents who visited Kangmung hospital af Asan foundation from July until August 1998. The team composed of 2 family physicians and 1 psychiatrist, who delivered structured interviews based on DSM-IV criteria in terms of psychosocial problems, and examined them and reviewed the patient records in terms of alcohol-related physical problems. Accordingly the subjects were classified into 'normal', 'physical problems-related drinkers' without psychosocial problems, and 'alcohol abuser' and 'alcohol dependent' according to DSM-IV criteria. Aside from physicians diagnostic procedures, they were again made to complete a questionnaire induding all the items of AUDIT, MAST, NAST and CAGE. RESULTS: As regards physicians' diagnostic results, 31 were normal, 8 had physical problems without psychosocial problems, 36 abused alcohol, and 21 were alcohol-dependent. The mean AUD1T scores of all the sub were 17.5(+/-9.5) and the mean AUDIT scores of each group were 7.1(+/-4.3), 16.6(+/-3.4), 19.9(+/-5.0), 29.3(+/-5.1), respectively and revealed significant difference among them AUDlT scores were significantly correlated with those marked from physicians' diagnostic results and also significantly correlated with MAST, NAST and CAGE, respectively. After consideration of mean AUDIT scores and standard deviations of each group according to diagnostic results, the preliminary standard AUDIT scores for detection of a broader sense of 'problem drinker' including physical as well as psychosocial problems were most possibly 12, 13, 14 points. Their sensitivity and specificity were 96.9% and 87.1% in 12 points, 92.3% and 90.8% and 90.3% in 14 points, respectively. The preliminary standard AUDIT scores concerning alcohol use disorders hased on DSM IV criteria were most possibly 14, 15, 16 with its sensitivity and specificity of 91.2% and 74.4% in 14 points, 89.5% and 79.5% in 15 points, and 84.2% and 84.6% in 16 points. The preliminary standard AUDIT scores for 'alcohol dependence' were most possibly 25, 26, 27 with its sensitivity and specificity of 85.7% and 90.7% in 25 points, 85.7% and 93.3 in 26 points, and 71.4% and 94.7% in 27 points. CONCLUSIONS: The authors recommend AUDIT cut-off scores of 12 points as the standard value for a broader sense of problem drinking including physical as well as psychasocial problems, 15 for 'alcohol use disorders' based on DSM IV criteria, and 26 for 'alcohol dependence' in Korea.
Alcoholism* ; Chungcheongnam-do ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Humans ; Korea* ; Male ; Mass Screening* ; Physicians, Family ; Psychiatry ; Sensitivity and Specificity ; Surveys and Questionnaires

BACKGROUD: It is known that patients with depression can have physical and social dysfunction. Even though adolescents spend most of their time in school, researches on the relationship between adolescent depression and school adjustment are lacking. Therefore, this research surveys depression of adolescents and deals with the relationship between depression and school adjustment or school achievement. METHOD: Questionnaires were distributed to 572 students in one coed high school located in Incheon. Depression tendency was based upon BDI as cut off point 21. School adjustment was based on school related adjustment scale and the dass standing following the first semester. RESULTS: 25% (143) of 572 responses belonged to the depression tendency group. The school related adjustment scale of the depression tendency group averaged 80.06 14.78, while that of the non-depression tendency group averaged 91.78 14.98. The relationship between depression tendency and school adjustment was statistically significant(P<0.001). The relationship between depression tendency and school lifereated adjustment, school environment related adjustment, school friend related adjustment, school teacher related adjustment or school instruction-related adjustment was statistically significant(P<0. 001). In addition, the relationship between depression tendency and dass standirg was statistically significant (P<0.001). CONCLUSIONS: There was a significant relationship between depression tendency and school adjustment or school achievement. As a result, family physicians as primary care physicians need to consider examination of psychiatric symptoms such as depression tendency as well as physical symptoms, when consulting with adolescents who have trouble adjusting to school or those who bave low school achievements.
Adolescent ; Depression* ; Friends ; Humans ; Incheon ; Physicians, Family ; Physicians, Primary Care ; Surveys and Questionnaires

BACKGROUD: Fatigue is one of the most common problems encountered in family practice but its diagnosis and management are neither standardized nor simphfied. This basehne study was conducted to find out the clinical characteristics, dinical courses, and outcomes of fatigued patients. METHODS: This study included 163 fatigued patients who visited a department of a university hospital based family practice due to fatigue as their primary or secondary complaint. We dassified fatigue which persisted for more than 6 months as acute fatigue, less than 6 months as acute fatigue. Retrospective review of medical record was used to collect all rehted dinical characteristics and telephone interview was done to follow the course and outcomes of fatigue. RESULTS: Of the total 163 fatigued patients, 105 patients(64.4%) were men. Fifty two patients(31.9 %) visited the dinic for complete health check up due to fatigue. The rate of response to telephone interview was 62.6%. Fifty five patients(33.7%) were acute fatigue, 75 patients(46.0%) chronic fatigue, and 33 patients (20.2%) unknown duration of fatigue. Accordirg to the causes of fatigue, 11.7% of patients corresponded to organic cause, 60.7% psychiatric cause, 27.6% unknown cause. Specified organic causes of fatigue, chronic hepatitis was the most common disease followed by alcohol liver disease, arthritis, anemia, viral syndrome and hyperthyroidism As psychiatric causes af fatigue, stress was the most common cause followed by overwork, alcohol abuse, depression, and anxiety. Reassurance and observation(71.8%), drug tberapy(17.8%) were the mast common treatments. Those who felt their function decreased below 50% were 7.6% of total 102 patients. On the survival analysis, 58.2% of acute fatigue patients, 62.4% of chronic fatigue patients, 67.0% of unknown patients had fatigue for 2 years since the initial visit. CONCLUSIONS: As the cause af fatigue in a family practice, psychiatric causes were more frequent than organic causes. As psychiatric causes of fatigue, stress was the most common cause followed by overwork and alcohol abuse. Only one third of the fatigued patients had improved two years later.
Alcoholism ; Anemia ; Anxiety ; Arthritis ; Depression ; Diagnosis ; Family Practice* ; Fatigue ; Hepatitis, Chronic ; Humans ; Hyperthyroidism ; Interviews as Topic ; Korea* ; Liver Diseases ; Male ; Medical Records ; Retrospective Studies

BACKGROUND: Appropriate referral without failure, one af important health care services provided by primary care physicians, is very helpful not only to patients but also to the referring physiciasn. This study was performed to observe the rate of referral failure and to evaluate the factars related to referral failure. METHODS: From June 10 to October 31, 1997, all referrah made in the department of family practice in the Samsung Medical Center were studied. Structured questionnaires inquiring of referral initiator, pbysicians view af dinical severity and referral necessity, and tbe reason for referral were completed by referring physician whenever each referral was made. On the 60th day after referrals were initiated medical records of the referred patients were reviewed to obtain the information on the demographic characteristics of the patients referred, the contents of referral, and the patient's attendance the specialist clinic after referraL Each referral was audited by five family physicians working at the Samsung Medical Center to examine the appropriateness of the time when the referral was initiated. The patients who did not attend at specialist dinic to which they were referred to were telephoned to ask about the reasons for the referral failure. Chi-square test and multiple logistic regression analysis were used to evalute the factors related to referral failure. RESULTS: During the study period, total of 477 referrals were made among 9,384 encounters and the referral rate was 5.08%. Fifty-eight patients failed to compkte the referral process within predetermined periad and the rate of referral failure was 12.16%. The risk of referral failure was significantly low in cases whose referral time was assessed as appropriate(odds ratio=0.53). Female was a significant increasing the risk of referral failure(odds ratio=1.91). Being too busy(24.14%) was the most common reason for referral failure. Other reasons induded improverment or resolution af syrnptoms (12.06%), information on the referral was not given (6.9%) and too great a distance the between hospital and the patients home (6.9%). Four patients forgot to attend the hospital. CONCLUSIONS: Considerable proportion of patients being referred did not complete the referral process. Timely referral and sufficient discussion between pbysician and patient being referred seems to be necessary to prevent referral failure.
Delivery of Health Care ; Family Practice ; Female ; Humans ; Logistic Models ; Medical Records ; Outpatients* ; Patient Dropouts ; Physicians, Family ; Physicians, Primary Care ; Referral and Consultation* ; Specialization ; Surveys and Questionnaires

BACKGROUD: Primary care physicians (PCPs) and ariental medical dactors (OMDs), as primary healthcare providers, could directly affect patients use of complementary and alternative medidne(CAM). This study was carried out to compare the practice experience with, the knowledge about, and the attitudes taward CAM between PCPs and OMDs in Korea. METHODS: A total of 502 PCPs and 500 OMDs in urban area of Karea were selected by the proportionate quota and systematic sampling methood. Face-to-face interviews were done with structured questionnaire. RESULTS: The rate af practice experience with and referral rate af CAM were reported 13.7% and 38.6% in PCPs, 76.8% and 85.4%. in OMDs respectively. OMDs evaluated the efficacy of each CAM higher than PCPs. Both doctors had wide variatians of knowledge in how to practice each CAM. However more than half OMDs knew how to practice chiropracic, taping therapy, aromatherapy, and iridology respectively, about 30% of PCPs high colic/enema and chiropractic. PCPs had mcire negative attitudes toward CAM and the advertisement of the other professional medidne (korean traditional medicine) than OMDs. OMDs more strongly supported the natural healing process, health-disease continuum, and psychological effect on health, and opposed Descares view on human body than PCPs. CONCLUSIONS: This study showed OMDs had more experience with, knowledge about, positive attitudes toward and supportive health concepts to CAM than PCPs. CAM practice would be diffused with chiropractic, taping therapy, aromatherapy, and iridolagy in OMDs; high colic/enema and chiropractic in PCPs.
Aromatherapy ; Chiropractic ; Complementary Therapies* ; Human Body ; Humans ; Korea ; Medicine, East Asian Traditional ; Medicine, Korean Traditional* ; Physicians, Primary Care ; Primary Health Care ; Referral and Consultation ; Surveys and Questionnaires

BACKGROUD: The lack of standardization in measuring bone mineral density (BMD) is generally recognized as an important and unresolver issue. The National Health Insurance System in Korea covers the cost of asteoporosis treatment according to the relative value ( T score < -1.0) of normal BMD. Consideriong this issue, we are concerned about whether Korean women have a normal value of BMD. We analyzed numerous research papers published in Korea which related to BMD, and calculated the normal BMD of Korean women using cross calibration equipment on three different DEXA scanners (Lunar/Norland Hologic). METHODS: We searched for key words such as 'osteopcsis' and 'bone mineral densito' in the Korean Medical Journal CD- ROM from 1987 to 1997. We received 145 full texts, and analyzed 114 original artides all of which used one af the above three scanners, over 100 normal Korean women as sub and focused an the lumbar spine. We found five artides that fit the criteria. Among the scanners used in the five artides are three were Lunar, one Hologic and one Norland. We substituted the results of Norhnd and Hologic with Lunars using a cross calibration equation, and calculated the mean BMD according to age by using a weighted average. Standard deviations of the calibrated data were calculated by using pooled estimates af variance equation. RESULTS: The lumbar spire BMD values of narmal Korean women were 1.181+/-0.683(g/cm2) in their thirties, forties, fifties, sixties were 1.128+/-0.144, 0.989+/-0.161, 0.862+/-0.162, respectively in Lunar scanner, 1.020+/-0.586, 0.974+/-0.124, 0.854+/-0.139, 0.746+/-0.139, respectively in Norland seanner. CONCLUSIONS: We calculated the lumbar spine BMD values for normal Korean women among three major companies using DEXA scanners. Further studies on BMD in randomly selected healthy adult women are needed
Absorption* ; Adult ; Bone Density* ; Calibration ; Female ; Humans ; Korea ; National Health Programs ; Reference Values ; Spine

BACKGROUD: The use of video display terminal(VDT) is growing rapidly. The purpose of this study was to examine detailed symptoms related to VDT use, factors related to symptoms of VDT users. METHODS: 852 bank clerks using VDT who visited to a haspital in Pusan were enrolled in this study. Collected data ineluded age, sex, symptoms associated VDT, weekly VDT usage time, distance from head to hard distance from eyes to VDT, angle to VDT. RESULTS: The prevalence of symptoms related to VDT use was 27.0 percent. Symptoms involved visual (19.9%), musculoskeletal(10.8%), neurological system (0.5%). The prevalence of musculoskeletal symptoms of women was higher than men. The prevalence of visual symptoms of subjects less than 30 years of age was higher than those of 31 years and over. The prevalence of subjects with more than one symptoms was 33.7 percent; subjects with visual and musculoskeletal symptoms were most common. Angle to VDT af group having symptoms related to VDT use was 5.1+/-22.6 degrees while those without was -0.5+/-17.0 degrees(P<0.05). Weekly mean VDT usage time of group having symptoms related to VDT use was 25.0(3.0- 90.0) hours while thase without were 11.0(0.5- 100.0) hours<0.01). In order of fvequency subjects having visual, musculoskeletal, and neurolagical symptoms, angle to VDT and weekly mean VDT usage time were increased CONCLUSIONS: Factors related to symptoms of VDT users were weekly VDT usage time and angle to VDT. The prevalence of symptoms related to VDT use was 27.0 percent.
Busan ; Computer Terminals ; Female ; Head ; Humans ; Male ; Prevalence

BACKGROUND: Helicobacter pylori infection is thought to be an important factor in the pathogenesis af gastric and duodenal ulcer. But in Korea, there are few studies on the prevalence of Helicobacter pylori infection in peptic ulcer patients and their relationship between the location of ulcers and Helicobacter pylori infection. The aim of this study was to investigate the prevalence af Helicobacter pylori infection of gastric and duodenal ulcer patients in Korea and the relationship between the location of ulcers and Helicobacter pylori infection. METHODS: We studied 476 consecutive patients with duodenal ulcers or benign gastric ulcer which were diagnased by gastrofiberscopy in Family Medicine of Hanil Hospital from January 1995 to December 1998. Helicobacter pylori infection was evaluated with rapid urease test ( CLO test) in 72.7% patients. RESULTS: The test rate of CLO test was not significantly different by sex, age and site of gastric ulcer lesions, but test rate in the gastric ulcer was significantly lower than in the duodenal ulcer. The prevalence of Helicobacter pylori infection diagnosed with CLO test was 90.1%. The prevalence cf Helicobacter pylori infection was not significantly different between rnales and females. Also it was also not significantly different according to age. 90.8% of those with gastric ulcer patients and 88.9% of the duodenal ulcer had Helicobacter pylori infection, but the difference was not significant. 94.6% of gastric ulcers located in only one area had Helicobacter pylori infection, compared to 83.6% of gastric ulcers which was located in multiple areas. The prevalence of Helicobacter pylori infection was significantly lower in patients who had lesions located in multiple areas. CONCLUSIONS: We condude that the majurity of peptic ulcer patients in Korea have Helicobacter pylori infection. Gastric uker located in multiple areas had significantly lower prevalence af Helicobacter pylori infection, which may suggest that gastric ulcers in multiple areas have other etiologic factors.
Duodenal Ulcer ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Peptic Ulcer* ; Prevalence* ; Stomach Ulcer ; Ulcer ; Urease