Background
: It is an important task to give adequate nutritions to infants and to wean properly for rapid growth during infancy. Adequate behavior requires precise knowledge. This study was conducted to assess the level of child-caretakes' knowledge about weaning food which is essential to infants' healthy growth.

Methods : From April to June, 1997, we acquired 156 child-caretakers who visited a family medicine clinic in Kyungju and a pediatric clinic in Taegu(from 2 months old to 6 years old) medical care. They were asked to respond to the pre-made questionnaire. The data were coded and analyzed using Excel and SPSS/PC(version 7.0). Student's t-test was used to test the score difference between two groups by general characteristics.

Results : The proportion of correct answers to the question concerning the definition of weaning, was 66.7% ; on proper feeding method when infants do not accept weaning food. 18.5% ; on the starting time of weaning food, 64.1% ; on the interval to add new ingredients, 23.1% ; on the sequence of feeding weaning food compaed to milk or breast milk, 56.4% ; on how to prepare commercial weaning food, 54.5% ; and to the question on the completing time of weaning food, the proportion of correct answers was 19.2%. The main information sources on weaning food were books and magazines related to child care and rearing(50.6%). The total average score was 4.6/10.

Conclusion : There are many child-caretakers who misunderstand the knowledge of weaning food. Therefore, primary care physician plays an important role in the education of child-caretakers on weaning food.

Background
: Proper management of diabetes is important in family practice. This study aimed to assess the quality of diabetes care in an outpatient department of family medicine in a general hospital.

Methods : We reviewed all the charts of patients who had a new diagnosis code of diabetes in an outptient department of family medicine at Asan medical center from January 1, 1994 to December 31, 1995. The documentation of medical history, physical examination, laboratory tests and treatments were examined. We surveyed the doctors who had managed the above patients.

Results : This study included 95 patients with diabetes. In the chart audit, history of smoking and symptoms of chronic complications of diabetes were documented in 61.1% and 33.6%, respectively. Blood pressure measurement, fundus examination and neurologic examination were done in 100.0%, 47.4% and 18.9%, respectively. Lipid profile and urine microalbumin were checked in 47.4% and 1.00%, respectively. Management of hypertension and exercise education were documented in 65.0% and 47.4%, respectively. In the doctor survey, doctors responded that they had provided services to diabetic patients more frequently than the results of chart audit except on a few items.

Conclusion : The care of diabetic patients was relatively adequate in many items, but insufficient in some items. Efforts to improve the quality of diabetes care in family practice are needed.

Background
: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program is to identify people with diabetes at early stage so they might have adventages of early treatment to prevent complication of the disease. Oral glucose tolence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolence, but the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA₁c and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA₁c for the purpose of diabetes diagnosis with the OGTT as reference method.

Methods : in this study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungsang Hospital. Blood samples for HbA₁c and fructosamine determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recommendations. The subjects were classified according to the American Diabetes Association classification.

Results : In our study, we observed fasting plasma glucose of 145.32±75.00mg/㎗, two-hour plasma glucose of 245.83±155.22mg/㎗, HbA₁c of 7.06±2.77%, and fructosamine of 308.77±128.23㎛ol/ℓ. The correlation coefficient between FPG and HbA₁c was 0.9098(p<0.05), betwen FPG and fructosamine 0.7953(p<.05), between two-hour plasma glucose and HbA₁0.7955-(p<.05), between 2h-PG and fructosamine 0.7770(p<.05), and between HbA₁and fructosamine 0.8142(p<.05). We found good sensitivity, specificity and positive predictive value HbA₁, and fructosamine with OGTT as a reference. After combination of FPG or 2h-PG and HbA₁especially fructosamine, sensitivity was increased. Receiver operating characteristic curves showed the cutoff point of HbA₁ 7.0 %, of fructosamine 290㎛ol/ℓ.

Conclusion : As observed in our study, HbA₁and fructosamine were highly correlated with FPG and 2h-PG. Combination of HbA₁or fructosamine and FPG or 2h-PG improve prediction over FPG or 2h-PG alone, especially fructosamine and FPG or 2h-PG combination. We conclude that mearurement of HbA₁c or fructosamine may be a useful diagnostic test for diabetes.

Background
: The waist/hip ratio is an useful index of abdominal obesity, but it includes two variables which may result in a false interpretation. The purpose of this study is to evaluate the usefulness of waist/height ratio as a predictor for the risk factors of coronary artery disease(CAD).

Methods : 1395 persons(818 men & 577 women) were selected as subjects who visited the Health Examination Center at Ewha Mokdong Hospital from October 1996 to March 1997. Waist circumference was measured at the level of umbilicus with standing position. Hip circumference was measured at the level of the largest circumference of the hip. We set the criteria of the risk factors as hypertension(systolic BP≥140mmHg and/or diastolic BP≥90mmHg), glucose intolerance(fasting blood glucose≥115mg/dl), hypertriglyceridemia(>160mg/dl), hypercholesterolemia(≥200mg/dl), and low HDL-cholesterol level(<35mg/dl). The morbidity index of CAD was calculated by the sum of the risk factor scores(one point per item if present).

Results : There was significant correlation between waist/height ratio, waist/hip ratio and body mass index(BMI)(p=0.0001). BMI had more strong correlation with waist/height ratio(r=0.81) than waist/hip ratio(r=0.48). According to the simple regression analysis, BMI, waist/hip ratio and waist/height ratio had significant correlation with all of the risk factors and the morbidity index. According to the multiple regression analysis, waist/height ratio had significant correlation with age, weight, height, systolic BP, triglyceride, cholesterol and HDL-cholesterol. The risk factor morbidity index of the groups with waist/height ratio over 0.45 was significantly more higher than the group of the lowest risk factor morbidity index(waist/height ratio under 0.4) in men(p=0.01). For women, 0.46 was the level which the risk factor morbidity index increased significantly(p<0.01).

Conclusion : Waist/height ratio can be a useful index of abdominal obesity. And it may be used as a more easier and better predictor of multiple CAD risk factors than waist/hip ratio. We can predict that waist/height ratio over 0.45 in men and over 0.46 in women may have more higher coronary artery disease risk.

Background
: Headache is one of the most common medical complaints. The majority of headaches are not associated with significant organic disease. Many persons are susceptible to headaches at times of emotional or physical distresses. The purpose of this study is to evaluate neurotic symptoms of headache patients.

Methods : The present study was made in the patients whit headache symptoms. who had visited the outpatient clinic of Family Medicine of a University Hospital form April 1st to July 31st, 1996, 110 subjects with headaches and 136 controls which were closely matched according to sex, age and socioeconomic status. Neurotic symptoms were assessed using the Symptom Check List for Minor Psychiatric Disorders(SCL-MPD). The statistical analysis was made between the two groups.

Results : 1) All but 3 items were significantly higher in headache group(p<0.05 : 2 items; p<0.01: 9 items; p<0.001: 53 items). 2)The headache group had a statistically significant higher score of the each neurotic dimension in comparison of the non-headache group(somatization, anxiety, depression, anger-hostility, interpersonal-sensitivity, phobic anxiety, obsessive-compulsive, neurasthenia, hypochondriasis and general)(p<0.001). 3)The age and the presence of occupation were significantly associated with headache symptoms. The somatization and depression scales had the strongest independent association with headaches as compared with other dimensions.

Conclusion : Persons with headache had higher levels of neurotic symptoms and psychological distresses compared to the non-headache group. Physicians need to be aware of the various types of distresses comprehensively with psychosocial assessments and evaluations.

Background
: The objective confirmation of subjective symptom of patient is important in the primary care consisted largely by functional disorders of which mechanism could not explain the symptoms clearly. Definite diagnostic method is not established yet for the functional disorders densptie the fact that various investigations have been done. So, we tried to reveal the relationship between the value of indicator drop(ID) from electroacupunctrure point accordint to Voll and the clinical diagnosis and subjective symptom by using noninvasive electroacupuncture diagnosis according to Voll.

Methods : Among the patients of three university level hospitals health care centers from April to June 1997, consenting 203 persons were enrolled .Various laboratory finding and ID from EAV were measured by double blind test methods. In parallel, subjective symptoms were classified by each organ. Validity was tested by the relationship between the gastrofiberscopy finding and the stomach control measurement point ID.

Results : There were statistically significant ID increases in the CMPs of endocrine, lung, circulation system, gastrointestinal system, kidney and bladder compared to a laboratory findings or subjective symptom by the comparison between the variables of the assessed clinical or laboratory findings and organ specific CMP score. Especially, the ID increase of stomach shows 79.3%-90.9% positive predictive value to positive findings of gastrofiberscopy when gastrofiberscopy is definded to confirmation test of gastritis, gastric ulcer and duodenal ulcer.

Conclusion : Our results show that the noninvasive electrodiagnostic method result by measuring EAV of organ system is related statistically to subjective symptoms and laboratory findings. Also they show that it could be useful tool as a clinical diagnostic method. We suggest that further study is needed to reveal organ specific sensitivity, specificity, positive and negative predictive value by using confirmation method of organ specific disease.