Background
: Department of Family Medicine in Seoul national university hospital has started lifelong health maintenance program(LHMP) since Feb 1991, and developed Health Risk Appraisal to evaulate personal health risk factors. This study aimed to evaluate the effect of LHMP by changes in health rik factors.

Methods : From May to September 1994, those who have been participated in LHMP more than 1 year were enrolled. We made subject answer to Health Risk Appraisal questionnaire when they had registered the LHMP and now, then cmpared with each other. We analysed categorical data for significance using the chi-squre test and analysed quantitative data for significance using t-test.

Results : 169 subjects were included. The overall population had mean age of 50.7±11.6 years and female were 59.2%. Significant change were detected in DM, BP, hepatitis B vaccination, sleep duration and pap smear.
30.6%(26/86) of the unvaccinated were vaccinated, 66.7%(10/15) of the pap-unchecked were ckecked. 75.0%(3/4) of poorly-controlled diabetes were changed to well-controlled. 27.5%(8/29) of smoker quitted smoking, 23.8%(24/102) of non exercisers started regular exercise. 94.1%(16/17) of heavy drinker decreased their drinking amount, 50.0%(5/10) of unmedicated hy[ertensive patients started medication, 54.5%(18/33) of seat belt non-user used seat belt. Recognition rate increased in DM by 78.8%(41/52), in blood pressure by 88.5%(23/26), in hepatitis B antibody by 40.0%(37/84).

Conclusion : Lifelong health maintenance program decreased health risk factor significantly in doctor-leading parts(ex : DM, HT, hepatitis Vaccination, pap smera) but didn't decreased risk factors in patient-leading parts(ex : smoking, exercise, seatbelt).

Background
: Computer use in medicine is also incresing now in primary health care. Untill now, there has been no report on the clinical use of computer in family pracice in Korea.

Methods : Among 525 members of Korean Academy of Family Physicians woh are in primary practice in Seoul, 297 physicaian's office telephone numbers are on phone-directory. In August 1993, four-page questionnaires were sent to 297 physicians. To get higher response rate was 52%. To compensate low response rate, phone interview of 38 physician was done by random sampling of nonresponders.

Results : 79% of responders currently use computer in clinic, while 32% use computer personally. There were no differences between responders and nonresponders in sex, rate of computer use, but mean age of responders is lower than that of nonresponders(50.8±13.5 vs. 57.1±10.9). Among clinical usages of computer, billing is by far common(100%). Medical record retrieval systems anre used by 26.4%, Drug management by 14.6% of physicians with computers in their offices. Only one physician used complete electronic medical record.

Conclusion : Majority of family physicians in primary health care use computer in clinic. But the use is confined to a few areas. Among the variabels, age and personal computer use seem to be related to the number of arease used. Major obstacles to the medical computing are 'not acquainted with computer use', 'lack of standardization of programs'. So there are urgent needs for education of computing and standardization of programs.

Background
: The Urinalysis is useful laboratory test in the diagnosis of various diseases. But in many cases, the urine specimen is delayed in room temperature. There are some studies how the result changes with delayed specimen, but there are few study how much change occurs. So this study was carried out to determine the extent of change of delayed urinalysis.

Methods : During July and September 1991, the each urine specimen from medical outpatient department of Incheon Hospital was divided in equal amount and one was examined within 1 hour in fresh state and the other was examined about 4 to 6 hours after collection. The delayed urinalysis results were compared with fresh urinalysis results. Considering fresh urinalysis results as gold standard, the sensitivity and specificity of delayed urinalysis were calculated.

Results : Comparison of dipstick results showed no difference in specific gravity, protein, glucose and occult blood between the delayed specimens and the fresh specimens, but pH was increased significantly(p=0.001). The number of RBC(p=0.03), WBC(p=0.01), and epithelial cell(p=0.001) decreased significantly. The specificity of dipstick and microscopic examination results were above 90%, but sensitivity of all item below 90%. With the specimens resulted positive, there was no significant difference in glucose, protein, occult blood and WBC. But the number of RBC(p=0.012), and the number of epithelial cell(p=0.006) decreased significantly.

Conclusion : In some items, there was no significant difference statistically. But because the pH and the microscopic examination results changed significantly and sensitivity was below 90%, delayed urinalysis can lead to incorrect clinical decision-making. So we reaffirm that the urinalysis must be done with fresh urine specimen.
physicians should take more active role in extending cervical screening corverage.