OBJECTIVES: To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.
Adolescent* ; Body Mass Index ; Body Weight ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Menarche* ; Menstruation ; Prospective Studies

OBJECTIVES: To estimate the prevalence of hypertension, rates of awareness, treatment modalities, and control of hypertension, and also to identify factors in rural Korea that are related to these aspects of hypertension. METHODS: A cross-sectional survey, including blood pressure(BP) measurements and interviews, investigating the variables in the health belief model was performed from August to November, 1999 on 1,426 (79.4%) study subjects out of 1,797 registered residents over 30 years old in Ibansong-Myun, Chinju City. A second survey was performed from January to March, 2000 on 376 (80.0%) subjects out of 470 hypertensive (or suspected hypertensive) subjects found in the first survey. Two BP readings were taken in each survey using a standard mercury sphygmomanometer. Hypertension was defined as either a BP reading < 140/90 mmHg in both surveys, or as subjects on oral hypertensive medication. RESULTS: Estimated hypertension prevalence was 24.9% for men, and 30.4% for women. Rates of hypertension awareness, treatment (the regular use of oral hypertensives), and control (reduction of BP to <140/90 mmHg) were 52.5%, 34.4%, and 12.9%, respectively. The factors related to lower hypertension awareness in the logistic regression analysis were male gender, farming occupation, and higher perceived barrier to medical treatment (those for whom visiting health professionals is a burden). CONCLUSIONS: To improve the low awareness, treatment, and control of hypertension, a more active and out-reaching hypertension control program, including routine BP measurements for every visitor to primary care facilities, is needed in rural Korea.
Adult ; Cross-Sectional Studies ; Female ; Gyeongsangnam-do ; Health Occupations ; Humans ; Hypertension* ; Korea* ; Logistic Models ; Male ; Occupations ; Prevalence* ; Primary Health Care ; Reading ; Sphygmomanometers

OBJECTIVE: To estimate the significance of the Pap smear as a screening tool for cervical cancer. METHODS: A total of 79,840 Pap smear results performed at Pusan Paik Hospital over the 20 year period from 1979 to 1998 were collected and analyzed. RESULTS: The number of Pap smear cases increased markedly during this period, and the results as a whole were classified as consisting of 96.4% normal and benign cytology, 2.2% pre-cancerous cytology, and 1.4% cervical cancer. The relative frequency of cervical cancer decreased from 1.6% in 1979 to 0.7% in 1998. About 64% of the Pap smears were distributed within the age range of 30 to 49 years, and the rate of cervical cancer increased with age, age of marriage and experience of childbirth (p<0.01). The overall agreement of Pap smear results with histologic diagnosis by one histologic degree was 92.7%(1,128/1,217) with 73 overestimated cases and 16 underestimated cases of Pap smear compared to histologic diagnosis. CONCLUSION: This result implies that the Pap smear is an excellent screening tool for cervical cancer with respect to both its scale and validity. Periodic and active Pap smear testing would be helpful for the secondary prevention of cervical cancer.
Busan ; Diagnosis ; Marriage ; Mass Screening ; Parturition ; Secondary Prevention ; Uterine Cervical Neoplasms

OBJECTIVES: To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. METHODS: A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer? ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. RESULTS: The 5 dimensions were as follows ; 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness. A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. CONCLUSIONS: The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.
Consumer Satisfaction ; Cross-Sectional Studies ; Delivery of Health Care ; Factor Analysis, Statistical ; Gyeonggi-do ; Hospitals, General ; Humans ; Outpatients* ; Quality Improvement ; Quality of Health Care ; Surveys and Questionnaires ; Reproducibility of Results

OBJECTIVE: To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription Syste m' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). METHODS: The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. Indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was performed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. RESULTS: The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. CONCLUSION: The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.
Ambulatory Care ; Cost-Benefit Analysis* ; Elasticity ; Fees and Charges ; Humans ; Korea* ; Outpatients ; Pharmacists ; Prescription Fees ; Prescriptions* ; Transportation

OBJECTIVES: To obtain reference values for the pulmonary asbestos and non-asbestos fiber contents of residents in Korea and to compare them with similar results from Japan. METHODS: The autopsied lung specimens from 22 deceased people (20 males and 2 females) in Pohang, without any known occupational history of asbestos exposure, were analyzed for incidence of asbestos and non-asbestos fibers by transmission electron microscopy with energy dispersive X-ray analysis after using low temperature ashing procedures. RESULTS: Chrysotile fiber (46.2%) was the major fiber type found in the lungs of the subjects. The asbestos fiber concentrations found in males and females were 0.09x106 fibers/(g of dry lungs) and 0.30x106 fibers/(g of dry lungs), respectively, showing a geometric mean concentration 0.09x106 fibers/(g of dry lung tissue), due to the predominance of males in the sample. The non-asbestos fiber contents in males and females were 4.61x106 fibers/(g of dry lungs) and 17.79x106 fibers/(g of dry lungs), respectively, with a geometric mean concentration 5.21x106 fibers/(g of dry lung tissue). CONCLUSIONS: Residents in Pohang had significantly lower levels of both asbestos and non-asbestos fibers than urban residents in Korea. Furthermore, Koreans had significantly lower levels of both asbestos and non-asbestos fibers than Japanese.
Asbestos* ; Asbestos, Serpentine ; Asian Continental Ancestry Group ; Female ; Gyeongsangbuk-do* ; Humans ; Incidence ; Japan ; Korea ; Lung* ; Male ; Microscopy, Electron, Transmission ; Reference Values

OBJECTIVES: To analyze differences in health behaviors among the social strata in Korea by using the 1995 National Health and Health Behavior Survey Data. METHODS: Study participants numbered 2,352 men and 1,016 women aged between 15-64 years old, with housewives, students and non-waged family workers excluded. Health behaviors in this study were defined according to the recommendations of the Alameda 7 study. The measure of health behaviors was based on the Health Practices Index(HPI; 0-5 range, with the exclusion of snacking between meals and regularly eating breakfast) developed by the Alameda County research. The significance of the relationship between social strata and HPI was assessed by considering the adjusted means from the multi-variate model. RESULTS: For men, incidence rates of never having smoked, no/moderate use of alcohol, regular exercise, and regular 7-8 hours sleep per night were higher in the upper social strata. Meanwhile, for women, incidence rates of never having smoked, no/moderate use of alcohol, appropriate weight, regular exercise, and regular 7-8 hours sleep per night were higher in the upper strata. HPI varied significantly among social strata in both sexes (p<0.001), a result which held true when adjusted for age, education, income, social insurance type, marital status and region. CONCLUSIONS: Health behaviors assessed by Health Practices Index(HPI) varied significantly among social strata for both sexes. Therefore, the existing gap in health behaviors among social strata can be corrected more effectively by target oriented health promotional activities.
Eating ; Education ; Female ; Health Behavior* ; Health Promotion ; Humans ; Incidence ; Korea* ; Male ; Marital Status ; Meals ; Smoke ; Snacks ; Social Security

OBJECTIVES: To investigate the association between BMI and Mortality. METHODS: This study was based on the analysis and assembly of the 'Kangwha Cohort Study', previously conducted by the Department of Preventive Medicine, Yonsei University. A total of 2,696 males and 3,595 females were followed for almost ten years and ten months from March 1985 to January 1996, a total of whom 2,420 died during this period. The Cox's proportional hazards regression model was used to analyze this data. RESULTS: We found a U-shaped relationship between BMI and mortality among the aged men in the Kangwha cohort. The hazard ratio of dying was adjusted for age, marital status, occupation, self cognitive health level, chronic disease, smoking, and alcohol frequency, then sorted by body mass index into the following groups; less than 18.5, 18.5 to less than 21.0, 21.0 to less than 23.5, 23.5 to less than 26.0 and greater than or equal to 26. The corresponding ratios for men were 1.81(1.50-2.19, 95%CI), 1.31(1.14-1.51, 95%CI), 1.0(referent), 1.05(0.87-1.26, 95%CI) and 1.39(1.09-1.76, 95%CI), respectively. And for women, 1.46(1.19-1.78), 1.12(0.95-1.31, 95%CI), 1.0(referent), 1.00(0.84-1.20, 95%CI) and 1.09(0.89-1.34, 95%CI), respectively. CONCLUSIONS: The risk of death among aged men in Kangwha increased in the under and overweight groups. The relationship between BMI and mortality has been well studied in Western populations, but little is known about the association between BMI and mortality in our country. So, on the basis of this study, it is apparent that more studies of the relationship between BMI and mortality will be needed for future work.
Body Mass Index ; Chronic Disease ; Cohort Studies* ; Female ; Health Status ; Humans ; Male ; Marital Status ; Mortality* ; Occupations ; Overweight ; Preventive Medicine ; Smoke ; Smoking

OBJECTIVES: To determine the prevalence of prostatitis symptoms in the general population by questionnaire survey and to measure the effect of prostatitis symptoms on quality of life(QOL). MATERIALS AND METHODS: A cross sectional community-based epidemiologic study was performed on 2,034 men, living in the Seoul metropolitan area using stepwise random sampling. Out of 2,034 interviewees, 1,356 men who were older than 40 and provided sufficient information were selected for this study. The questionnaires were completed by well trained interviewers. Contents of the questionnaires included demographic data, the Prostatitis Symptom Index(PSI), the International Prostate Symptom Score(IPSS), a general health questionnaire section and a sexual health questionnaire section. The PSI was composed of a sum of the scores from three questions about dysuria, penile pain and perineal pain and it ranged 0 to 12. Incidence of prostatitis symptoms was defined by a score of 4 or more and the reference group was defined as consisting of those with a score of 3 or less. The rate of incidence of prostatitis symptoms was assessed according to age and the difference of QOL between the prostatitis symptoms group and the reference group. RESULTS: The overall positive rate of prostatitis symptoms measured by the PSI, in men older than 40, living in the Seoul metropolitan area, was 4.5%(61/1,356), adjusted to 4.8% by the relative proportion of this age group in the general population of the Seoul metropolitan area as compared to Korea and the World. The proportion of the group with prostatitis symptoms assessed by the PSI did not increase with age although the proportion of participants with moderate to severe lower urinary tract symptoms (LUTS) did increase with age. The group with prostatitis symptoms suffered from a much greater incidence of LUTS compared to the reference group (p<0.05). The QOL scores of the IPSS, and the general health and sexual health status of the group with prostatitis symptoms, were worse than those of the reference group.(p<0.05). CONCLUSIONS: The positive rate of prostatitis symptoms in men older than 40, living in the Seoul metropolitan area, was 4.8% and it didn't increase with age. The general QOL of the group with prostatitis symptoms was much worse than that of the reference group.
Dysuria ; Epidemiologic Studies ; Humans ; Incidence ; Korea ; Lower Urinary Tract Symptoms ; Male ; Prevalence ; Prostate ; Prostatitis* ; Quality of Life* ; Surveys and Questionnaires ; Reproductive Health ; Seoul

OBJECTIVES: To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. METHODS: A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was performed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience , OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. RESULTS: There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. CONCLUSIONS: There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.
Classification ; Education ; Hand ; Humans ; Pharmacists