• Title/Summary/Keyword: 자료분류

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Dietary Behavior Related to Salty Food Intake of Adults Living in a Rural Area according to Saline Sensitivity (농촌 지역의 중년이후 성인의 염분 민감도에 따른 짠 음식 섭취 관련 식행동)

  • Kim, Mi-Kyoung;Han, Jang-Il;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.44 no.6
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    • pp.537-550
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    • 2011
  • This study was conducted to identify behavioral characteristics of salty food intake according to saline sensitivity of adults living in a rural area. Anthropometry and blood pressure were measured and salt intake-related dietary behavior was surveyed by questionnaires through interviews with 402 subjects aged ${\geq}$ 40 years in Chungcheongbuk-Do, Korea. The percentages of overweight and obese among the subjects were 37.8% and 3.8% respectively. Mean blood pressure of the subjects was in the normal range, but the distribution of subjects who were normotensive, high normal, and hypertensive was 48.7%, 17.7%, and 33.6% respectively. Approximately 27% of all subjects habitually consumed salty food, which was the smallest group, followed by 38.1% normal and 35.1% not-salty food. However, 34.6% of the eldest group of ${\geq}$ 65 years consumed salty food. The saline insensitive group showed a higher percentage of irregular meals, overeating, speed-eating, an unbalanced diet, a preference for fried food, and habitual intake of salty foods. These subjects recognized the risk for eating salty food, but they lacked the will to reduce their salty food intake. Compared to spouses and family members, experts such as doctors, nurses, and dieticians were the most influential for reducing the salty food intake of subjects. Saline sensitive group had relatively better control over salty food intake at every meal, eating out, and even when eating salty food that the spouse preferred. The saline sensitive group ate more frequently vegetables and fruits, whereas the saline insensitive group ate more frequently hot spicy foods. In conclusion, the results suggest that it is necessary to establish a social atmosphere toward reducing salt intake at the level of the government and food industry and to set action plans to be available for nutrition education programs to reduce salt intake nationwide.

The Pattern Analysis of Financial Distress for Non-audited Firms using Data Mining (데이터마이닝 기법을 활용한 비외감기업의 부실화 유형 분석)

  • Lee, Su Hyun;Park, Jung Min;Lee, Hyoung Yong
    • Journal of Intelligence and Information Systems
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    • v.21 no.4
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    • pp.111-131
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    • 2015
  • There are only a handful number of research conducted on pattern analysis of corporate distress as compared with research for bankruptcy prediction. The few that exists mainly focus on audited firms because financial data collection is easier for these firms. But in reality, corporate financial distress is a far more common and critical phenomenon for non-audited firms which are mainly comprised of small and medium sized firms. The purpose of this paper is to classify non-audited firms under distress according to their financial ratio using data mining; Self-Organizing Map (SOM). SOM is a type of artificial neural network that is trained using unsupervised learning to produce a lower dimensional discretized representation of the input space of the training samples, called a map. SOM is different from other artificial neural networks as it applies competitive learning as opposed to error-correction learning such as backpropagation with gradient descent, and in the sense that it uses a neighborhood function to preserve the topological properties of the input space. It is one of the popular and successful clustering algorithm. In this study, we classify types of financial distress firms, specially, non-audited firms. In the empirical test, we collect 10 financial ratios of 100 non-audited firms under distress in 2004 for the previous two years (2002 and 2003). Using these financial ratios and the SOM algorithm, five distinct patterns were distinguished. In pattern 1, financial distress was very serious in almost all financial ratios. 12% of the firms are included in these patterns. In pattern 2, financial distress was weak in almost financial ratios. 14% of the firms are included in pattern 2. In pattern 3, growth ratio was the worst among all patterns. It is speculated that the firms of this pattern may be under distress due to severe competition in their industries. Approximately 30% of the firms fell into this group. In pattern 4, the growth ratio was higher than any other pattern but the cash ratio and profitability ratio were not at the level of the growth ratio. It is concluded that the firms of this pattern were under distress in pursuit of expanding their business. About 25% of the firms were in this pattern. Last, pattern 5 encompassed very solvent firms. Perhaps firms of this pattern were distressed due to a bad short-term strategic decision or due to problems with the enterpriser of the firms. Approximately 18% of the firms were under this pattern. This study has the academic and empirical contribution. In the perspectives of the academic contribution, non-audited companies that tend to be easily bankrupt and have the unstructured or easily manipulated financial data are classified by the data mining technology (Self-Organizing Map) rather than big sized audited firms that have the well prepared and reliable financial data. In the perspectives of the empirical one, even though the financial data of the non-audited firms are conducted to analyze, it is useful for find out the first order symptom of financial distress, which makes us to forecast the prediction of bankruptcy of the firms and to manage the early warning and alert signal. These are the academic and empirical contribution of this study. The limitation of this research is to analyze only 100 corporates due to the difficulty of collecting the financial data of the non-audited firms, which make us to be hard to proceed to the analysis by the category or size difference. Also, non-financial qualitative data is crucial for the analysis of bankruptcy. Thus, the non-financial qualitative factor is taken into account for the next study. This study sheds some light on the non-audited small and medium sized firms' distress prediction in the future.

THE EFFECT OF ND:YAG LASER IRRADIATION ON THE FORMATION OF CALCIUM FLUORIDE AND ACID RESISTANCE OF TOOTH ENAMEL (Nd:YAG 레이저 조사가 Calcium Fluoride 형성 및 치아 내산성에 미치는 영향)

  • Lee, Jae-Ho;Sohn, Heung-Kyu;Kim, Seong-Oh;Park, Kwang-Kyun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.377-398
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    • 1999
  • Calcium fluoride, created by topical fluoride application, is the reservoir for fluoride ion regulated by pH in the oral environment. Therefore, the amount and the maintenance of calcium fluoride have an important role in preventing dental caries. The aim of this study is to evaluate the effect of Nd:YAG laser irradiation on the generation of calcium fluoride and the acid resistance of tooth enamel. The bovine anterior permanent teeth were prepared (n=276), and divided into following groups : no treatment (control) fluoride application alone, laser irradiation alone, laser irradiation after fluoride application, and fluoride application after laser irradiation. And each group was subdivided based on the application time of 1.23% acidulated phosphate fluoride (APF) (5 min and 30 min) and the irradiation energy of Nd:YAG laser ($20J/cm^2\;and\;40J/cm^2$). In case of fluoride application, each group was divided according to KOH treatment. Twenty three treatment conditions were made for this experiment and twelve specimens were assigned to each treatment condition. In each treatment condition, ten specimens were used for chemical analysis and two specimens were observed under SEM. In groups without treating KOH, fluoride content and the depth of enamel dissolved were measured using enamel biopsy technique. In groups with treating KOH, the amount of calcium fluoride was measured by the treatment with 1 M KOH for 24 hours and enamel biopsy was performed after KOH treatment. The results were analyzed by the fluoride content and the depth of enamel dissolved by enamel biopsy, amount and thickness of calcium fluoride, and the surface structures of enamel. The results are as follows: 1. In groups without treating KOH, the fluoride content of removed enamel showed a positive relationship with the energy density of laser when the laser irradiated before fluoride application 2. In groups without treating KOH, the depth of enamel dissolved decreased more with the combined laser and fluoride treatment than with laser or fluoride treatment, except for the case of $20J/cm^2$ laser irradiation after 5 minute fluoride application (p<0.05). 3. The amount of calcium fluoride did not increased by laser treatment with no statistical significance(p>0.05). 4. The particle size of calcium fluoride increased in case of fluoride treatment after laser irradiation, compared with fluoride application alone. In case of laser treatment after fluoride application, the particle size of calcium fluoride increased and some of the particles fused as well. 5. There were no significant differences in the fluoride content of dissolved enamel between groups without treating KOH and control group, except for the case of laser irradiation after treatment of APF for 30 minutes (p>0.05). 6. In groups with treating KOH, depth of removed enamel in the groups of combined treatment with laser and fluoride was shallower than that in fluoride application groups (p<0.05). 7. In groups without treating KOH, the relationship between fluoride content and the depth of enamel dissolved showed more negative (Spearman correlation coefficient: -0.6281) than in groups with treating KOH (Spearman correlation coefficient: -0.3792). The greater amount of calcium fluoride could be found in case where there was a significant differences of the depth of enamel dissolved between groups with and without treating KOH. From these results, it can be concluded that laser seems to be a little effects on the amount of calcium fluoride formation, but has some effect on the lowering the solubility of calcium fluoride. As the combined treatment of laser and fluoride application showed more effective acid-resistant property, more extended recall period for fluoride application can be achieved with this combined treatment in the clinic.

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Relationship between Broca Index of Late School-Aged Children and Their Mothers' Eating, Cooking, and Exercise Habit (어머니의 식습관, 요리습관 및 운동습관과 학령기 후기 아동의 Broca 체질량지수와의 상관관계 연구)

  • Lee, Hyerim;Lee, Kyoung-Eun;Ko, Kwang Suk;Hong, Eunah
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.10
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    • pp.1488-1496
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    • 2016
  • The purposes of this study were to analyze mothers' eating, cooking, and exercise habits based on their demographic characteristics and to examine the relationship between those habits and their late school-aged children's Broca index. A total of 393 questionnaires were mailed to the mothers of late school-aged children who registered at four elementary schools in the Seoul area, of which 159 participants (40.0%) completed questionnaires. Statistical data analyses were performed using SPSS/Win 21.0 for descriptive statistics, t-test ANOVA, and Pearson's regression coefficient. There was a statistically significant difference in mothers' cooking habit (F=3.920, P=0.022) and exercise habit (F=3.211, P=0.043) according to their educational level. Interestingly, 82.4% of mothers had a Broca index of less than 90% of normal body mass level. A significant positive correlation of Broca index between mothers and their late school-aged children (r=0.345, P<0.001) indicated that children whose mothers had a low body mass level also tended to have a low body mass level. In this study, late school-aged children's Broca index was not significantly related with mother's eating (r=-0.072, P=0.367) or exercise habits (r=-0.010, P=0.897) but was significantly related with their mother's cooking habits (r=-0.157, P=0.048). Considering there are few studies examining the impacts of mother's cooking habits on their children's appropriate body mass, the results suggest that developing an effective educational program to cultivate mothers' healthy cooking habits to improve school-aged children's health status is very important. The findings of this study provide important data that could be used when developing health education programs tailored to the multi-dimensional impacts of mothers' life habits on their last school-aged children's developmental health status.

Analysis of the Effects of Some Meteorological Factors on the Yield Components of Rice (수도 수량구성요소에 미치는 기상영향의 해석적 연구)

  • Seok-Hong Park
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.18
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    • pp.54-87
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    • 1975
  • The effects of various weather factors on yield components of rice, year variation of yield components within regions, and regional differences of yield components within year were investigated at three Crop Experiment Stations O.R.D., Suweon, Iri, Milyang, and at nine provincial Offices of Rural Development for eight years from 1966 to 1973 for the purpose of providing information required in improving cultural practices and predicting the yield level of rice. The experimental results analyzed by standard partial regression analysis are summarized as follows: 1. When rice was grown in ordinary seasonal culture the number of panicles greatly affected rice yield compared to other yield components. However, when rice was seeded in ordinary season and transplanted late, and transplanted in ordinary season in the northern area the ratio of ripening was closely related to the rice yield. 2. The number of panicles showed the greatest year variation when the Jinheung variety was grown in the northern area. The ripening ratio or 1, 000 grain weight also greatly varied due to years. However, the number of spikelets per unit area showed the greatest effects on yield of the Tongil variety. 2. Regional variation of yield components was classified into five groups; 1) Vegetation dependable type (V), 2) Partial vegetation dependable type (P), 3) Medium type (M), 4) Partial ripening dependable type (P.R), and 5) Ripening dependable type (R). In general, the number of kernel of rice in the southern area showed the greatest partial regression coefficient among yield components. However, in the mid-northern part of country the ripening ratio was one of the component!; affecting rice yield most. 4. A multivariate equation was obtained for both normal planting and late planting by log-transforming from the multiplication of each component of four yield components to additive fashion. It revealed that a more accurate yield could be estimated from the above equation in both cases of ordinary seasonal culture and late transplanting. 5. A highly positive correlation coefficient was obtained between the number of tillers from 20 days after transplanting and the number of panicles at each(tillering) stage 20 days after transplanting in normal planting and late planting methods. 6. A close relationship was found between the number of panicles and weather factors 21 to 30 days, after transplanting. 7. The average temperature 31 to 40 days after transplanting was greatly responsible for the maximum number of tillers while the number of duration of sunshine hours per day 11 to 30 days after transplantation was responsible for that character. The effect of water temperature was negligible. 8. No reasonable prediction for number of panicles was calculated from using either number of tillers or climatic factors. The number of panicles could early be estimated formulating a multiple equation using number of tillers 20 days after transplantation and maximum temperature, temperature range and duration of sunshine for the period of 20 days from 20 to 40 days after transplantation. 9. The effects of maximum temperature and day length 25 to 34 days before heading, on kernel number per panicle, were great in the mid-northern area. However, the minimum temperature and day length greatly affected the kernel number per panicle in the southern area. The maximum temperature had a negative relationship with the kernel number per panicle in the southern area. 10. The maximum temperature was highly responsible for an increased ripening ratio. On the other hand, the minimum temperature at pre-heading and early ripening stages showed an adverse effect on ripening ratio. 11. The 1, 000 grain weight was greatly affected by the maximum temperature during pre- or mid-ripening stage and was negatively associated with the minimum temperature over the entire ripening period.

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A Study on the Characteristics of Dietary Behaviors and Food Intake Patterns of University Student according to the Obesity Index (대학생의 비만도에 따른 식생활 특성 및 식이섭취 양상에 관한 연구)

  • Oh Se-In;Lee Mee-Sook
    • The Korean Journal of Food And Nutrition
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    • v.19 no.1
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    • pp.79-90
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    • 2006
  • This study was performed to investigate the dietary behaviors and food intake patterns of university students according to the obesity index(OI). The subjects were 349 students(107 males and 242 females) who were assigned to one of the following groups based on the percentage of ideal body weight: underweight(OI< 90%), normal ($90%{\leq}Ol<10%$) and overweight($OI{\geq}110%$). The dietary behaviors and food intake patterns were evaluated by questionnaires and 24 hour recall method. The results were summarized as follows. The rates of underweight, normal, and overweight students were 33.8%, 61.0%, and 5.2% respectively. The ratios of underweight was higher than overweight, especially in case of female. The 60.46% of subjects responded that they had an irregular eating habits, especially in overweight group(72.22%). The 52.44% of subjects showed skipping mealtime more than one time per day. The overweight group had a tendency to overeat themselves than other groups. The normal group had less unbalanced dietary pattern than the other groups(p<0.0019). Most subjects had a snack(96.27%). The percentage of those who drank and smoked were 86.74% and 19.54%, respectively. The smoking value was significantly higher in the overweight group(p<0.0009). The food consumption frequency by food groups was not different among the groups except instant and fast food. More than 50% subjects consumed fish, legumes & its products, and vegetables everyday. There was significantly less rate of the instant and fast food consumption frequency in the normal group(p<0.0177). The 3/4 subjects that showed the lower consumed level in RDA(< 75%) were under-nutritional state in the Fe and Ca. In case of Ca, there was a higher NAR value in the overweight group(p<0.0257) significantly, and Fe, protein, vitamin $B_1$, vitamin $B_2$, and niacin showed similar tendencies. The INQ of Fe was significantly higher in the overweight group than other groups(p<0.0335).

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients (고도비만환자에서 베리아트릭 수술 (Bariatric Surgery) 후 영양교육이 체중감량에 미치는 효과)

  • Jeong, Eun-Ha;Lee, Hong-Chan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.30-45
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    • 2015
  • Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

The Evaluation of Radiation Dose to Embryo/Fetus and the Design of Shielding in the Treatment of Brain Tumors (임산부의 전뇌 방사선 치료에 있어서의 태아의 방사선량 측정 및 차폐 구조의 설계)

  • Cho, Woong;Huh, Soon-Nyung;Chie, Eui-Kyu;Ha, Sung-Whan;Park, Yang-Gyun;Park, Jong-Min;Park, Suk-Won
    • Journal of Radiation Protection and Research
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    • v.31 no.4
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    • pp.203-210
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    • 2006
  • Purpose : To estimate the dose to the embryo/fetus of a pregnant patient with brain tumors, and to design an shielding device to keep the embryo/fetus dose under acceptable levels Materials and Methods : A shielding wall with the dimension of 1.55 m height, 0.9 m width, and 30 m thickness is fabricated with 4 trolleys under the wall. It is placed between a Patient and the treatment head of a linear accelerator to attenuate the leakage radiation effectively from the treatment head, and is placed 1 cm below the lower margin of the treatment field in order to minimize the dose to a patient from the treatment head. An anti-patient scattering neck supporters with 2 cm thick Cerrobend metal is designed to minimize the scattered radiation from the treatment fields, and it is divided into 2 section. They are installed around the patient neck by attach from right and left sides. A shielding bridge for anti-room scattered radiation is utilized to place 2 sheets of 3 mm lead plates above the abdomen to setup three detectors under the lead sheets. Humanoid phantom is irradiated with the same treatment parameters, and with and without shielding devices using TLD, and ionization chambers with and without a build-up cap. Results : The dose to the embryo/fetus without shielding was 3.20, 3.21, 1.44, 0.90 cGy at off-field distances of 30, 40, 50, and 60 cm. With shielding, the dose to embryo/fetus was reduced to 0.88, 0.60, 0.35, 0.25 cGy, and the ratio of the shielding effect varied from 70% to 80%. TLD results were 1.8, 1.2, 0.8, 1.2, and 0.8 cGy. The dose measured by the survey meter was 10.9 mR/h at the patient's surface of abdomen. The dose to the embryo/fetus was estimated to be about 1 cGy during the entire treatment. Conclusion : According to the AAPM Report No 50 regarding the dose limit of the embryo/fetus during the pregnancy, the dose to the embryo/fetus with little risk is less than 5 cGy. Our measurements satisfy the recommended values. Our shielding technique was proven to be acceptable.

The Precision Test Based on States of Bone Mineral Density (골밀도 상태에 따른 검사자의 재현성 평가)

  • Yoo, Jae-Sook;Kim, Eun-Hye;Kim, Ho-Seong;Shin, Sang-Ki;Cho, Si-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.67-72
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    • 2009
  • Purpose: ISCD (International Society for Clinical Densitometry) requests that users perform mandatory Precision test to raise their quality even though there is no recommendation about patient selection for the test. Thus, we investigated the effect on precision test by measuring reproducibility of 3 bone density groups (normal, osteopenia, osteoporosis). Materials and Methods: 4 users performed precision test with 420 patients (age: $57.8{\pm}9.02$) for BMD in Asan Medical Center (JAN-2008 ~ JUN-2008). In first group (A), 4 users selected 30 patient respectively regardless of bone density condition and measured 2 part (L-spine, femur) in twice. In second group (B), 4 users measured bone density of 10 patients respectively in the same manner of first group (A) users but dividing patient into 3 stages (normal, osteopenia, osteoporosis). In third group (C), 2 users measured 30 patients respectively in the same manner of first group (A) users considering bone density condition. We used GE Lunar Prodigy Advance (Encore. V11.4) and analyzed the result by comparing %CV to LSC using precision tool from ISCD. Check back was done using SPSS. Results: In group A, the %CV calculated by 4 users (a, b, c, d) were 1.16, 1.01, 1.19, 0.65 g/$cm^2$ in L-spine and 0.69, 0.58, 0.97, 0.47 g/$cm^2$ in femur. In group B, the %CV calculated by 4 users (a, b, c, d) were 1.01, 1.19, 0.83, 1.37 g/$cm^2$ in L-spine and 1.03, 0.54, 0.69, 0.58 g/$cm^2$ in femur. When comparing results (group A, B), we found no considerable differences. In group C, the user_1's %CV of normal, osteopenia and osteoporosis were 1.26, 0.94, 0.94 g/$cm^2$ in L-spine and 0.94, 0.79, 1.01 g/$cm^2$ in femur. And the user_2's %CV were 0.97, 0.83, 0.72 g/$cm^2$ L-spine and 0.65, 0.65, 1.05 g/$cm^2$ in femur. When analyzing the result, we figured out that the difference of reproducibility was almost not found but the differences of two users' several result values have effect on total reproducibility. Conclusions: Precision test is a important factor of bone density follow up. When Machine and user's reproducibility is getting better, it’s useful in clinics because of low range of deviation. Users have to check machine's reproducibility before the test and keep the same mind doing BMD test for patient. In precision test, the difference of measured value is usually found for ROI change caused by patient position. In case of osteoporosis patient, there is difficult to make initial ROI accurately more than normal and osteopenia patient due to lack of bone recognition even though ROI is made automatically by computer software. However, initial ROI is very important and users have to make coherent ROI because we use ROI Copy function in a follow up. In this study, we performed precision test considering bone density condition and found LSC value was stayed within 3%. There was no considerable difference. Thus, patient selection could be done regardless of bone density condition.

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Referral Patterns and Needs for Specialist Care among Patient Referred from Health Center (보건소의 진료의뢰 양상과 의뢰환자들의 전문과목 요구도)

  • Hwang, Tae-Yoon;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.133-143
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    • 1996
  • This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongju-City Health Center, Seongju-Gun Health Center and Koryong-Gun Health Center in Kyongsangbuk-Do, from June 10 to October 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6%), easy to get referral permission in health centers(27.1%), and very difficult to get referral permission in local clinics(16.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% of patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested specialty is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.

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