Background
: Most of the Poisonous snakebites occurs during summer time and in rural area. Mortality from poisonous snakebite is low but some develop serious complications or even die. Because many authors have different opinions how to treat snakebites, especially regarding the use of antivenin, we have conducted this study in order to review the indicators that can predict the severity of snakebites, and to examine to effectiveness of antivenin.

Methods : From January, 1990 through December, 1994, 178 patients were admitted for treatment of poisonous snakebite. Reviewing theses patients' medical records, incidence of occurrence in accorda-nce with sex, age, and season, local and systemic symptoms and signs, and abnormal laboratory findings, were investigated. Seven randomly seleced prognostic indicators-patient age and sex, bitten month, time of day bitten, bitten site, time of arrival at hospital after biting, and use of constricting band-were used to compare patients' severity. In addition, patients' severity and period of hospotaliza-tion with respect to patients who received antivenin and those who did not were also compared.

Results : Of the 178 patients, the number of female patients was larger than that of male patients, in the ratio 1.5 to 1.0. Most patients were in their 50s, and most bites occurred during. July and August. Pain around the bitten area was found in 172 patients(96.6%), and proved the most common local symptom. Of systemic symptoms, dizziness was the most common, found in 64 patients(36.0%). Of obnormal laboratory findings, leukocytosis was most frequently encountered, affecting 55 patients(30.9%). In analyzing correlation between prognostic indicators and severity, patient age(P<0.01) showed significant differences. In addition, the group which received antivenin showed significant differences with regard to severity similarly showed significant differences with regard to period of hospitalization(P<0.05 for minimal and severe cases; P<0.1 for moderate cases).

Conclusion : Older patients, and those bitten in the upper limbs rather than in the lower limbs are predicted to have greater severity. Thus, such patients need more intensive observation and treatment. All snaka-bitten victims must be transferred to a hospital as rapidly as possile; and administration of antivenin should be actively considered for those who show symptoms of envenoma-tion.

Background
: Until recently, the study of knowledge and practice rate of adult immunization is insufficient. The aim of this study is to provide reference data about adult immunization for primary physician.

Methods : We assessed 258 out-patients and their caregivers who visited 3 local clinics in Seoul and near-Seoul area, and completed questionnaires given from June to August, 1993. Vaccine-preventable diseases using this study are tetanus, rubella, hepatitis B, influenza and pneumoccoccal pneumonia. The immunization schedule of each diseases insisted briefly to subjects before answering questionnaires.

Results : Among 258 cases, male subjects were 104 in number(40.3%), and female were 154(59.7%). The mean age was 33.9 years. The subjects answered that the most useful method of knowing names of vaccine-preventable diseases was mass-communication(72.9%). About tetanus booster immunization for adult, the cognition rate was mass-communication (72.9%). About tetanus booster immunization for adult, the cognition rate was 16.7% and the performance rate qas 2.3%. The number of female in reproductive ages between 15 and 49 years was 140. Among them, the cognition rate of rubella immunization was 25.7% and the performance rate was 39.3%. About hepatitis B, the cognition rate was 95.0% and the performance rate was 58.9%(P<.0001). The number of those aged 65 years or more was 9, and they all did not know and not perform influenza or pneumococcal pneumonia immunization.

Conclusion : With all disease entities of adult immunization except hepatitis B, the cognition and performance rates were revealed low. 84.7% of all subjects answered that adult immunization is necessary.

Background
: It is important in heaith examination to select the kinds of target diseases and screening tests in the respect of cost-benefit effect. Therefore we carried out this study to aid selection of target diseases and screening tests.

Methods : We reviewed questionnaires for medical history, medical charts and screening test results of 832 adults who visited outpatient department of family medicine for the purpose of health examination from April, 1991 to March, 1993. We selected 576 adults who had not suffered from chronic diseases.

Results : The selected subjects were composed of 300 males (52.1%) and 276 females(47.9%). The screening tests which showed high positive rates were upper gastrointestinal series/Gastrofiberscopy(27.1%), blood pressure measurement(20.3%), abdominal ultrasonography(16.9%), urine microscopic examination(13.0%), chest X-ray(12.5%). The detection rates of target diseases were 25%(144 subjects) in all, 22.7% in males, and 27.5% in females. The 4 most common target diseases were hypercholesterolemia(8.0%), anemia(7.5%) liver disease(5.0%), and hypertension(4.2%). Among males, higher detection rate of liver disease were seen in the 3rd and 4th decades : liver disease and hypercholesterolemia in the 5th decade. Males older than 50 years of age had higher rate of hypercholesterolemia, hypertension, and anemia. Among females, higher detection rate of anemia were seen in the 3rd and 4th decades ; anemia, hypercholesterolemia and HBsAg(+) in the 5th decade. Females older than 50 years of age had higher rate of hypercholesterolemia, hypertension, and anemia.

Conclusion : Target diseases in health examination were observed in 25% of selected subjects. The detection rate of target diseases were significantly different according to age and sex.