In recent years, increasing attention has focused on providing preventive services that have been associated with dramatic reductions in morbidity and mortality.
To compare the desires of patients, recommendations of physicians and actual performance of health care centers, we surveyed 977 patients from three university based family outpatient clinics and six private family clinics and 59 family physicians by questionnaires and we investigated health care contents that were performed by 23 health care centers in Seoul, in July, 1989.
The results were as follows :
1) Of the 977 patients, 482 patients(49.3%) desired a periodic health examination, even if feeling well. There were no differencies in age, sex, marital status between who desired a periodic health examination and those who did not, but more educated, higher income patients were more desired it.
2) In counselling of periodic health examination, physicians recommended more than patients desired and a few item was performed at health care centers.
3) In physical examination, physicians recommended more than patients desire, and the most selected item was blood pressure by physicians and patients. At health care centers, height and weight, blood pressure, vision, hearing were performed more than patient's desire and physician's recommendation, but oral cavity, mammography, pelvic examination, digital rectal examination were performed less than.
4) In diagnostic procedure, physicians recommended more than patients desire, and patients selected more than counselling and physical examination. At health care centers, laboratory examination through blood and urine samples were performed more than patient's desire and physician's recommendation, but Pap smear(78.9%). mammography(39.1%), barium enema(0.0%) were performed less than.
5) In frequency of selected health care items, patients desired more frequently than physicians recommended, and there was no recommendation about it at health care centers.

This is a report of a study of 39 cases with upper gastrointestinal bleeding entered to emergency room in St. Vincent Hospital for 1 year from June 1988 to May 1989. The following resulst were obtained.
1. The male-female ratio was 3:1
2. The age incidence revealed a greater prevalance on 5th to 6th decade(64.2%) : 5th decade in 14 cases(36.0%), 6th decade 11 cases(28.2%)
3. The causative desease was gastric ulcer in 19 cases(48.7%), esophageal varix in 16 cases(41.0%), Mallory-Weiss syndrome in 2 cases(5.1%), stomach cancer in 1 case(2.6%) and duodenal ulcer in 1 case(2.6%)
The mortality rate was increased relatively in the esophageal varix.
4. There was ascites in 13 cases(33.3%).
The increased mortality rate was related to a presence of a ascites.
5. The frequencies of previous bleeding were : no previous bleeding history in 22 cases(56.4%), one previous bleeding history in 11 cases(28.2%) and two and more previous bleeding history in 6 cases(15.4%).
Increased mortility rate was related to frequency of upper gastrointestinal bleeding.
6. A combined disease was found in 13 cases(33.3%).
The increased mortality rate was related to the presence of a combined disease.
7. On admission, hematemesis combined with melena was most frequently observed in 25 cases(64.1%) moderate and massive bleeding 9 cases(23.1%) and mild bleeding 30 cases(76.9%). The mortality rate increased associated with the amount of blood loss.

Topical application of glucosteroids in the treatment of allergic rhinitis has gained widespread use during the past 10 years. Intranasal injection of steroid into the turbinate was done in 45 cases of allergic rhinitis. Its clinical effect was analysed and reported. Especially the nasal obstruction was improved markedly. The total nasal symptomatic score was improved in 75%.

Carbon disulfide(CS₂), a clear colorless volatile fluid of sweetish aromatic odor, has been used in the process of viscose rayon synthesis, and known to be a neurotoxin and to cause atherogenesis in the vascular system.
The authers experienced and managed 13 patients, highly suspected of chronic CS₂ poisoning.
These patients were workers in viscose rayon industry for long years.
The results were as follows.
1. The mean age of total patients was 46.7±1.2 years old, 12 males and 1 female, and the mean duration of exposure was 15.4±0.6 years.
2. All patients had the symptoms of peripheral neuropathy, and the 9 cases had the symptoms of cranial nerve dysfunction.
3. The symptoms of the peripheral neuropathy were general weakness, weakness and paralysis of extremities, and the polyneuropathy was found at the 3 cases in EMG.
4. The symptoms of cranial nerve dysfuction were headache, dizziness, dysarthria, aphasia, memory disturbance, and furthermore. mental retardation, dementia in the severe cases, and the cortical atrophy of brain and cerebral infarction are found in the brain computed tomography in 5 cases of 9 patients.
5. There were cardiovascular diseases in 7 cases, hyperlipidemia in all cases and hypertension in 4 cases.
6. There were proteinuria in 5 patients and azotemia in the 4 patients.
7. Four patients had liver disease, and the other one had DM.

This is the clinical studies of 90 cases of acute poisoning in pediatric age, visited the emergency room of Jeong Eup General Hospital, during the past 3 years from Jan., 1986 to Dec., 1988.
The following results were obtained.
The incidence of acute poisoning among the emergency pediatric patients was 1.96%.
The incidence was higher in boys than girls. The highest incidence was noted in the 1 to 3 year age group(28.9%), and followed by the 3 to 6 year age group (25.6%) and 13 to 15 year age group (23.3%).
The peak incidence in a year was shown in April (16.7%), and August (14.4%) with prominence in spring and summer season.
The accidental poisonings were frequent (67.8%) than suicidal or therapeutic purposes, which were 28.9% and 3.3% respectively.
The accidental poisonings occurred most frequently from 4:00 P.M. to 8:00 P.M. during the day.
The causative substances were 19 kinds. The agricultural chemicals were most common(45.6%) and the next common agents were rodenticide (13.3%), acetic acid (7.8%) fly & mosquitocides (4.4%), antifungal agent (4.4%) in order of frequency.
The clinical manifestations at emergency room were nausea & vomiting (46.7%), altered consciousness (22.2%), irritability(17.8%), bronchial secretion(16.7%), miosis(12.2%) in order of frequency. 25 cases(27.8%) of the patients were found incidentally without symptoms.
Outcome at emergency room was admission (55.6%), discharge at E.R. (30%), transfer (6.7%) hopeless, discharge (4.4%), exdeathed (3.3%) in order of frequency. The most common duration of admission was 2-3days (56%).

Patient satisfaction is a concept that has been addressed as important for many years. To investigate the patient satisfaction, we utilized the Smith-Falvo Patient-Doctor Interaction Scale analysed validity and reliability and surveryed to 279 consecutive patient-initiated visits from June to July 1990. Also, making use of the reconsidered items, we surveyed the frequency of each item which has positive effect on patient satisfaction and the frequency of each item according to the characteristics of both patients and physicians.

1. Patient satisfaction is scored 55.8%(73%), as mean, and the dispersion is scored from 32(42%) to 76(100%).
2. Patient's sex, age, education, econmoic state, admission history and interview history does not effect patient satisfaction.
3. Patient satisfaction to family physician is higher than that to internal physician as 57.4(71%) and 54.4(71%)(P<0.05), but no difference between hospital and local clinic.
4. In Doctor's professional attitude and manner to patient, patient satisfaction to family physician is higher than that to internal medicine physician as 24.8(77%) and 23.1(72%)(P<0.05), but no difference between hospital and local clinic.
5. In doctor's explanations given to patient, patient satisfaction to family physician is higher than that to internal medicine physician as 11.7(73%), and 10.9(68%)(P<0.05), but no difference between hospital and local clinic.
6. In comparative survey of patient satisfaction about each 19th scale, family physician is highly scored in 'It seems that doctor is interesting about my condition'. and other 9 scales, but no difference between hospital and local clinic.

In order to analyze the patients who visited long period on Family Practice office, 862 patients who were followed up more than 6 months by residency trained family physician were classified according to the ICPC coding system.
The results were as follows.

1. The ratio of male and female was 1 : 1.3.
2. 0-9 year old group was largest by 33.6%
The frequency of the pediatric group under 15 years old was 41.0% and the geriatric group above 65 years old was 5.2%
3. The total number of reasons for encounter (RFEs) was 1999, the average RFE per patient was 2. 3 and the kind of RFEs was 125.
Among them, cough, fever, symptom/complaint throat, URI ranked most common.
4. The most common RFE system were respiratory system(37.2%), digestive system (20.9%), general system (15.05), respiratory system (6.2%).
5. The 113 kinds of diagnoses were used. All number of diagnoses was 1749, and mean number of diagnoses of each patient was 2. 02.
The most common disease were URI (24.9%), disordered stomach function (8.9%), acute bronchitis/bronchiolitis (8.6%), tonsilitis acute (5.4%).
6. The most common disease system were respiratory system (49.8%), digestive system (24.4%), psychological system (4.0%), dermatologic system (3.8%).