• Title/Summary/Keyword: Trauma center

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결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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A Study of Industrial Patients from Selected General Hospitals in the Kyung Pook and Taegu City Areas (일부지역 산업재해환자 실태 연구 -대구, 경북지역 일부 종합병원 중심으로-)

  • 허춘복;남철현
    • Journal of Environmental Health Sciences
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    • v.17 no.2
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    • pp.78-94
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    • 1991
  • The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure pain. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu Kyung Pook University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as follows: 1. Among the 179 cases, 51.6 % were male and 48.4 % were female. The two largest age groups were 30~39, 31.8 % and 20~29, 27.4 %. Among the 179 cases, 51.6% were married, the largest family number was 2 to 3, 41.1% and 4 to 5, 25.6%. Educationally, graduation from high school was the largest group, 46.4% among the patients, followed by middle school and primary school. The largest group income level was from 40~69만원, 45.2%. The largest group of patients who worked over 50 hrs. a week was 52.0%. The largest group of patients who worked less than 1 year was 44.7%, of the patients in work places of less than 100 people, 60.3% were injured and in work places of 100~299 people, 20.1% were injured. In manufacturing, the lagest group injured was 55.3%, the next group was transport, stroage, communication. The largest group of production workers injured was 40.2%. 2. The cause of injury in the largest group was facility problems, 33.5%. The next group was unsafe habits, 30.2% a lack of safety knowledge, 17.9% and insufficient supervision, 12.3%. The 30~39 year age group was head the highest number of injuries, 40.4% work places with more than 10 yeras of work, 44.4% work palces with more than 1000 people, 56.3% and mining accidents, 80.0%. Among these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries 28.5% as the largest group, followed by falls & falling objects 17.3%, fire & electric 15.1%, struke by an object 14.5%, followed by overaction and vehicular accidents. The accident pattern showed 46.4 % among workers over the 50 year age group, workers in the 5~10 year group, 50.0 % places employing more than 1000 workers, 35.3 % : construction 73.7%, and construction workers 57.1%, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures 54.8%, trauma 14.5%, amputation 11.7%, open wound, and burns. The largest number of fractures occurred in people in the 30~39 year age group, 63.2 % over 10 years of work, 55.6% in work places of 300~400 people, 63.6% construction 63.2% and general workers 57.2 %. 5. The largest group of injuries was upper extremity 45.3%, lower extremity 24.0%, trunk 18.5 % and head or neck 12.2%. Of these groups, upper extremity injuries were the highest in those less 20 years old 75.0%, less than 1 years of work 59.5%, in work places of 500~999 people 60.0%, manufacturing 56.6 % and production workers 55.6%. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 August, 22 people July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work(r=.2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation(r =.4372) p<0.001.

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Investigation of Domestic and Foreign Unexpected Antibodies for Emergency Blood Transfusion (응급수혈을 위한 비예기 항체의 국내·외 실태조사)

  • Weonjoo, Hwang;Sang-Hee, Lee;Chang-Eun, Park
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.279-284
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    • 2022
  • Certain pre-transfusion tests are not commonly performed during emergency blood transfusion. In this study, we reviewed and analyzed the data of post-blood transfusion antibody screening tests to establish the effects of unexpected antibodies causing hemolytic transfusion reactions. We reviewed information published domestically and internationally, and selected the data of 68,602 antibody screening tests and 528 antibody identification tests conducted at P hospital. We found that unexpected antibody positive (1198,1.74%), Rh type (161, 30.49%), Lewis type (67, 12.69%), others (Di (a), 28, 5.30%). The anti-E type positive was 93 (17.61%), and that of the cases with anti-C (13, 2.46%). Only data of domestic cases were included for analysis that were published before 2007, which established the presence of antibodies of the following types and numbers of cases: anti-E (196, 22.45%), anti-Le a (82, 9.39%), and anti-E+C (60, 6.87%). In 2018, anti-E (107, 17.12%), anti-E+Canti-E+C (56, 8.96%), and anti-Di a (28, 4.48%) were detected. In other domestic cases, S hospital was detect to anti-E, anti-Le a, anti-E+C. The Anti-E, anti-D, anti-E+C, and anti-C+E were detected in D hospital. In Saudi Arabia, Anti-D, anti-E, and anti-Jka was detected. The Anti-M, Anti-N, Anti-Le (a), and Anti-D were detected in India. Requests for emergency blood transfusion increased 1.8 times after the opening of the trauma center. This study has the disadvantage of being a cross-sectional study. additional studies are needed to provide basic information on alternative treatments that can increase the safety and reduce the side effects of hemolytic transfusion in emergency transfusion situations.

Transaortic Mitral Commissuroplasty with a Bentall Procedure or Artic Valve Replacement (대동맥 판막 치환술과 벤탈 수술 환자에서 대동맥 근부를 통한 승모판막 교련 성형술)

  • Kim, Si-Wook;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.727-732
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    • 2007
  • Background: The reciptents of aortic valve replacement or a Bentall operation usually display various degrees of mitral regurgitation. When deciding whether or not to correct the mitral regurgitation, one must consider its severity, underlying causes and operative risk. Recently, the operation method for correcting the concomitant mitral regurgitation has been done through aortic root to reduce the operation time and the cardiac trauma. We report our experiences that transaortic mitral valve commissuroplasty done with aortic valve replacement or a Bentall operation has been a simple, less invasive, effective method in the operative management of mitral valve regurgitation without significant organic changes. Material and Method: Between June 2002 and June 2005, twenty patients under-went mitral valve commissuroplasty via the aortic root with aortic valve replacement (n=14) or a Bentall operation (n=7). The mitral valve regurgitation of the patients didn't exceed a moderate (grade 2) degree and there was no significant organic disease. The preoperative diagnosis of MR was established by TTE and intraoperative TEE, and the patients were followed postoperatively by TTE. The operative technique was a simple anterolateral commissuroplasty of the mitral valve with a single mattress suture via the transaortic annular approach after excision of the aortic valve leaflets. Result: The mean patient age was 56.2 years and 65% (n=13) were male. The preoperative MR was mild (grade 1) in 9 (45%), mild to moderate in 8 (40%), and moderate (grade 2) in 3 (15%) patients. There were no operative mortalities. The MR improved in all patients (p=0.002) and the left ventricular ejection fraction (LV EF) improved in 14 (70%) patients (p=0.005). The mean cross-clamp time for the patients who under- went aortic valve replacement with transaortic mitral repair was $62.1{\pm}13.9 min$ and this was $137.5{\pm}7.2 min$ for the patients who underwent a Bentall operation with transaortic mitral repair. Conclusion: For selected patients without significant mitral organic disease, transaortic mitral valve commissuroplasty combined with aortic valve replacement or a Bentall operation may be a feasible, effective method without adding significant aortic cross clamping time and more cardiotomy.

A Study on Relationship between Physical Elements and Tennis/Golf Elbow

  • Choi, Jungmin;Park, Jungwoo;Kim, Hyunseung
    • Journal of the Ergonomics Society of Korea
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    • v.36 no.3
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    • pp.183-196
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    • 2017
  • Objective: The purpose of this research was to assess the agreement between job physical risk factor analysis by ergonomists using ergonomic methods and physical examinations made by occupational physicians on the presence of musculoskeletal disorders of the upper extremities. Background: Ergonomics is the systematic application of principles concerned with the design of devices and working conditions for enhancing human capabilities and optimizing working and living conditions. Proper ergonomic design is necessary to prevent injuries and physical and emotional stress. The major types of ergonomic injuries and incidents are cumulative trauma disorders (CTDs), acute strains, sprains, and system failures. Minimization of use of excessive force and awkward postures can help to prevent such injuries Method: Initial data were collected as part of a larger study by the University of Utah Ergonomics and Safety program field data collection teams and medical data collection teams from the Rocky Mountain Center for Occupational and Environmental Health (RMCOEH). Subjects included 173 male and female workers, 83 at Beehive Clothing (a clothing plant), 74 at Autoliv (a plant making air bags for vehicles), and 16 at Deseret Meat (a meat-processing plant). Posture and effort levels were analyzed using a software program developed at the University of Utah (Utah Ergonomic Analysis Tool). The Ergonomic Epicondylitis Model (EEM) was developed to assess the risk of epicondylitis from observable job physical factors. The model considers five job risk factors: (1) intensity of exertion, (2) forearm rotation, (3) wrist posture, (4) elbow compression, and (5) speed of work. Qualitative ratings of these physical factors were determined during video analysis. Personal variables were also investigated to study their relationship with epicondylitis. Logistic regression models were used to determine the association between risk factors and symptoms of epicondyle pain. Results: Results of this study indicate that gender, smoking status, and BMI do have an effect on the risk of epicondylitis but there is not a statistically significant relationship between EEM and epicondylitis. Conclusion: This research studied the relationship between an Ergonomic Epicondylitis Model (EEM) and the occurrence of epicondylitis. The model was not predictive for epicondylitis. However, it is clear that epicondylitis was associated with some individual risk factors such as smoking status, gender, and BMI. Based on the results, future research may discover risk factors that seem to increase the risk of epicondylitis. Application: Although this research used a combination of questionnaire, ergonomic job analysis, and medical job analysis to specifically verify risk factors related to epicondylitis, there are limitations. This research did not have a very large sample size because only 173 subjects were available for this study. Also, it was conducted in only 3 facilities, a plant making air bags for vehicles, a meat-processing plant, and a clothing plant in Utah. If working conditions in other kinds of facilities are considered, results may improve. Therefore, future research should perform analysis with additional subjects in different kinds of facilities. Repetition and duration of a task were not considered as risk factors in this research. These two factors could be associated with epicondylitis so it could be important to include these factors in future research. Psychosocial data and workplace conditions (e.g., low temperature) were also noted during data collection, and could be used to further study the prevalence of epicondylitis. Univariate analysis methods could be used for each variable of EEM. This research was performed using multivariate analysis. Therefore, it was difficult to recognize the different effect of each variable. Basically, the difference between univariate and multivariate analysis is that univariate analysis deals with one predictor variable at a time, whereas multivariate analysis deals with multiple predictor variables combined in a predetermined manner. The univariate analysis could show how each variable is associated with epicondyle pain. This may allow more appropriate weighting factors to be determined and therefore improve the performance of the EEM.

DEVELOPMENT OF ALLOTRANSPLANTED TOOTH GERMS AT VARIOUS DEVELOPMENTAL STAGE INTO THE WHITE RAT'S EXTRACTION SOCKET (흰쥐의 발치와에 이식한 단계별 치아싹의 발육 과정)

  • Jung, Hwi-Hoon;Jung, Han-Sung;Kim, Seoung-Oh;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.205-215
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    • 2008
  • The purpose of this study is to evaluate at which stage of tooth germ would develop into normal calcification and hence to increase the success rate of transplantation. Therefore, tooth germs on the 15th, 17th embryonic day and the 3rd day of birth were separated for allotransplantation into maxilla of adult rat of 11 weeks. Calcification processes were analyzed radiographically and histopathologically at 4 weeks and 8 weeks after allotransplantation. The results are as follows: 1. Allotransplanted tooth germ at 4 weeks and 8 weeks showed delayed calcification compared to that of normal odontogenesis. 2. At 4 weeks, abnormal calcified tissue, such as odontoma and ankylosis of osteodentin with surrounding alveolar bone were observed. 3. At 8 weeks, allotransplanted tooth germs of the 15th and 17th embryonic day showed calcification and osteodentin surrounded by periodontal ligament. 4. At 8 weeks, allotransplanted tooth germs of the 3rd day of birth showed calcification composed of cementum and osteodentin. In this study, we observed small sized and amorphous calcified tissue from allotropic allotransplantation of tooth germs. Since these calcified tissue were underdeveloped and shaped irregularly, for calcification into normal tooth form, further study needs consideration about the reduction of surgical trauma, developmental stage of transplanted tooth germ, blood supply from recipient site, fixation method in transplanted site and period of transplantation.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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