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Usability assessment of thermoplastic Bolus for skin VMAT radiotherapy (피부 병변에 대한 VMAT 치료 시 열가소성 bolus의 유용성 평가: case review)

  • Kim, Min Soo;Kim, Joo Ho;Shin, Hyun Kyung;Cho, Min Seok;Park, Ga Yeon
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.85-92
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    • 2020
  • Purpose: To find out the advantages of thermoplastic bolus compared to conventional bolus, which is mainly used in clinical practice, We evaluated Two cases in terms of dose and location reproducibility to assess Usability of thermoplastic Bolus for skin VMAT radiotherapy. Materials and Methods: Two patient's treated with left breast skin lesion were simulated using thermoplastic Bolus and planned with 2arc VMAT. the prescription dose was irradiated to 95% or more of the target volume. We evaluated The reproducibility of the bolus position by measuring the length of the air gap in the CBCT (Cone Beam CT) image. to evaluate dose reproducibility, we compared The dose distribution in the plan and CBCT and measured in vivo for patient 2. Results: The difference between the air gap in patient 1's simulation CT and the mean air gap (M1) during 10 treatments in the CBCT image was -0.42±1.24mm. In patient 2, the difference between the average air gap between the skin and the bolus (M2) during 14 treatments was -1.08±1.3mm, and the air gap between the bolus (M3) was 0.49±1.16. The difference in the dose distribution between Plan CT and CBCT was -1.38% for PTV1 D95 and 0.39% for SKIN (max) in patient 1. In patient 2, PTV1 D95 showed a difference of 0.63% and SKIN (max) -0.53%. The in vivo measurement showed a difference of -1.47% from the planned dose. Conclusion: thermoplastic Bolus is simpler and takes less time to manufacture compared to those produced by 3D printer. Also compared to conventional bolus, it has high reproducibility in the set-up side and stable results in terms of dose delivery.

Study on dose comparison using X-Jaw split in VMAT treatment planning for left breast cancer including supraclavicular lymph nodes. (쇄골 상부 림프절을 포함하는 왼쪽 유방암의 VMAT 치료계획시 X-Jaw split을 이용한 선량비교에 관한 연구)

  • Kim, Hak Jun;Lee, Yang Hoon;Min, Jae Soon
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.137-144
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    • 2021
  • Purpose : The usability of X-Jaw split VMAT was evaluated by comparative analysis of the dose distribution between the treatment plan divided by X-Jaw and Full field VMAT treatment plan in left breast cancer treatment including supraclavicular lymph nodes. Materials and Methods : 10 patients with left breast cancer, including supraclavicular lymph nodes, were simulated using vacuum cushion, and 2 Full field Arc VMAT and 4 X-Jaw split Arc VMAT were planned The treatment plan was designed to include more than 95% of the Planning Target Volume (PTV) and to be minimally irradiated in the surrounding Organ at risk (OAR). Dose analysis of PTV and OAR was performed through dose volume histogram (DVH). Results : The Full field VMAT treatment plan and the X-Jaw split VMAT treatment plan of 10 patients were expressed as average values and compared. The difference between the two treatment plans was not large, with a Conformity index (CI) of 1.05±0.04, 1.04±0.03, and a Homogeneity index (HI) of 1.07±0.008, 1.07±0.009. For OAR, V5 in the left lung is 56.1±6.50%, 50.4±6.30%, and V20 is 20.0±4.15%, 13.52±3.61%. Compared to Full field VMAT, V5 decreased by 10.0% V20 by 32.6% in X-Jaw split VMAT. The V30 of the heart is 3.68±1.85%, 2.23±1.52%, and the Mean dose is 8.93±1.65 Gy, 7.67±1.52 Gy. In the X-Jaw split VMAT, V30 decreased by 39.3% and the Mean dose decreased by 14.1%. The left lung and heart, which are normal tissues, were found to have a statistical significance of that p-value is less than 0.05. Conclusion : In the case of left breast cancer treatment, which includes Supraclavicular lymph nodes with a large PTV volume and a length of X Jaw of 15 cm or more, the X-Jaw split VMAT shows improved dose distribution, which can reduce radiation dose of OAR such as lungs and heart, while maintaining similar PTV coverage with HI and CI equivalent to Full field VMAT. It is thought to be effective in reducing radiation complications.

Diagnosis and Treatment of Brown Tumor (Brown 종양의 진단 및 치료)

  • Cho, Yong Jin;Cho, Yung Min;Na, Seung Min;Jung, Sung-Taek
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.54-61
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    • 2020
  • Purpose: Brown tumor is a tumor-like disease that can occur as a linked disease of hyperparathyroidism which can causes osteoporosis, osteitis fibrosa cystica, pathologic fractures. Brown tumor has been reported as a case report, but there is no comprehensive report on the exact diagnosis and principle of management for osseous lesion. The purpose of this study is to report the treatment and results of osseous lesions through 5 cases. Materials and Methods: From February 2004 to May 2015, five cases of Brown tumor were diagnosed in Chosun University Hospital and Chonnam National University Hospital orthopedic department. Medical records and radiographs were reviewed retrospectively. Parathyroid tumors were surgically removed, and surgical treatment and observation were performed for orthopedic osseous lesions. Results: The mean length of the long axis of the symptomatic osseous lesion was 6.2 cm (4.5-9.0 cm). An average of 7.6 (range, 3 to 14) of high uptake osseous lesion showed in whole body bone scan. The absolute value, T-score and Z-score of the vertebrae and proximal femur were adequate for diagnosis of osteoporosis using dual energy X-ray absorptiometry bone mineral density at diagnosis and recovered to normal at the last follow-up. In laboratory tests, serum concentrations of total calcium, ionized calcium, inorganic phosphorus, serum alkaline phosphatase, and parathyroid hormone were helpful to diagnosis and normalized upon successful removal of parathyroid adenoma or cancer. Conclusion: For accurate diagnosis of Brown tumor, it should be accompanied by systemic examination as well as clinical symptoms, laboratory tests and radiologic examination for osseous lesions. And a good prognosis can be expected if the hyperparathyroidism is treated together with the comprehensive treatment of osseous lesions.

Effects of Drip Irrigation Volumes on Plant Growth and Yield of Tomato Grown in Perlite (펄라이트 재배에서 급액량이 토마토의 생육과 수량에 미치는 영향)

  • Kim, Doo Han;Shawon, Md Rayhan Ahmed;An, Jin Hee;Lee, Hyoun Jin;Lee, Yun-Jae;Kim, Minkyung;Lee, Yong-Beom;Choi, Ki Young
    • Journal of Bio-Environment Control
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    • v.31 no.4
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    • pp.300-310
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    • 2022
  • The objective of this experiment was to investigate the effect of drip irrigation volume on tomatoes (Solanum lycopersicum L.) grown in a greenhouse using perlite medium. Plants were treated by three different irrigation treatment I0, I25, and I50 (where irrigation volume of I25 and I50 was 25% and 50% higher than I0, having limited or no leaching). Growth characteristics of plants, yield and water use efficiency were measured. The result showed that plant height, leaf length and leaf width were lowest in the I0 treated plants. However, these parameters were not statistically significant differences between the plants that were grown in the I25 and I50 treatment. Soluble solids content, acidity and dry matter of 111th, 132nd, and 143rd days harvested tomato were higher in the plants irrigated with lowest volume (I0) than the higher volume (I25 or I50). In addition, water content was lower in the 111th and 132nd days of harvested tomatoes from the I0 treatment. The number of big-size tomatoes (>180 g) was significantly higher in the I25 irrigated plants. There was no significant difference in the total number of harvested fruits among the treatments. The average fruit weight and total yield of harvested tomatoes were lowest in the I0 treated plants. The water consumption of tomato was not significantly different amongst the treatments but water use efficiency was lowest in the I0 treatment. Principal component analysis revealed that total soluble solid and acidity of tomato showed a positive correlation between each other. These results suggest that I25 was the optimum irrigation treatment for tomato based on its measured growth characteristics, yield and water use efficiency.

Studies on Growth Characteristics and Propagation Method of Introduced Hop (Humulus lupulus L.) Cultivars (홉(Humulus lupulus L.) 도입 품종의 생육특성 및 영양번식 연구)

  • Tae Hyun Ha;Jae Il Lyu;Jun-Hyung Lee;Jaihyunk Ryu;Sang Hoon Park;Si-Yong Kang
    • Korean Journal of Plant Resources
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    • v.36 no.2
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    • pp.181-190
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    • 2023
  • Domestic hop (Humulus lupulus L.) production has been suspended since the early 1990s due to foreign imports, but interest in local production is rising due to the recent craft beer boom in Korea. This study was conducted focusing on the development of growth characteristics and propagation technology for 6 introduced hop cultivars as a basic study for domestic hop production and breeding program. In the hop growth survey conducted in 2021 and 2022, the 5-year-old plants after planting generally showed a tendency to increase the height of strobile setting, strobile size, number and weight of strobile per hill compared to the 4-year-old plants. As a result of the experiment with hop vine cuttings, the average rooting rate of all cultivars was as high as 88% even in only water treatment that were not added with Atonik (Atonik, Arysta, Japan), a rooting agent. There were differences between cultivars in rooting length and rooting rate according to the Atonik treatment method. When checking the survival rate of the rooted cuttings seedlings after transplanting into the soil, it was confirmed that the survival rate of the cuttings in the tissue culture room was significantly lower than that of the cuttings in the greenhouse. However, in transplanting step, cutting plants from culture room condition was strongly inhibited plant growth because of changing environment conditions. As a results of tissue culture, the thidiazuron (TDZ) 1 ㎎/L treatment in the media generated 6 to 9 shoots/explant, while the 6-benzylaminopurine (BAP) 1 ㎎/L treatment generated only 1 to 2 shoots/explant. Therefore, it is more effective to culture by adding TDZ rather than BAP. These results indicated that the development of technology to manage stably after transplanting of cutting or micropropagating plants into potting soil is important for mass propagation of hops.

Effect of Shading and Supplemental Lighting for Greenhouse Cultivation of Cucumber in Summer Season (하절기 오이 온실재배 시 차광 및 보광 효과)

  • Jin Yu;Ji Hye Yun;So Yeong Hwang;Eun Won Park;Jeong Hun Hwang;Hyeong Eun Choi;Jeong Kil Koo;Hee Sung Hwang;Seung Jae Hwang
    • Journal of Bio-Environment Control
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    • v.32 no.3
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    • pp.226-233
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    • 2023
  • High solar radiation in summer season causes excessive respiration of crops and reduces photosynthesis. In addition, the rainy season, which mainly occurs in summer, causes a low light condition inside the greenhouse. A low light condition can reduce crop growth and yield. This study was conducted to evaluate the effect of shade and supplemental lighting on the growth and yield of cucumber during summer season. Cucumber grafted seedlings were transplanted in two plastic greenhouses on August 30, 2022. To reduce the light intensity inside the greenhouse, a 50% shading screen was installed in one greenhouse. Supplemental lighting was conducted from September 7, 2022 to October 20, 2022. HPS (high-pressure sodium lamp), W LED (white LED, red:green:blue = 5:3:2), and RB LED (combined red and blue LED, red:blue = 7:3) were used for supplemental lighting sources, and non-treated (nonsupplemental lighting) was as the control. The supplemental lighting was conducted before sunrise and after sunset for 2 hours with a photosynthetic photon flux density of 150 ± 20 µmol·m-2·s-1. The plant height, leaf length, leaf width, and SPAD value tended to increase in the shading group. RB LED increased stem diameter regardless of shading treatment. Fresh and dry weights of fruits were not significantly different in shading and supplemental lighting. Average fresh weight of fruits was not significantly different among supplemental lighting as the harvest date passed. In conclusion, in this study 50% shade treatment significantly improved the growth of cucumber during the summer season. In addition, the growth and fruit characteristics are better than the control without supplemental lighting. This study can be used as basic research data for applying supplemental lighting technology to cucumber cultivation.

Distribution and Frequency of SSR Motifs in the Chrysanthemum SSR-enriched Library through 454 Pyrosequencing Technology (국화 SSR-enriched library에서 SSR 반복염기의 분포 및 빈도)

  • Moe, Kyaw Thu;Ra, Sang-Bog;Lee, Gi-An;Lee, Myung-Chul;Park, Ha-Seung;Kim, Dong-Chan;Lee, Cheol-Hwi;Choi, Hyun-Gu;Jeon, Nak-Beom;Choi, Byung-Jun;Jung, Ji-Youn;Lee, Kyu-Min;Park, Yong-Jin
    • Journal of the Korean Society of International Agriculture
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    • v.23 no.5
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    • pp.546-551
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    • 2011
  • Chrysanthemums, often called mums or chrysanths, belong to the genus Chrysanthemum, which includes about 30 species of perennial flowering plants in the family Asteraceae. We extracted DNA from Dendranthema grandiflorum ('Smileball') to construct a simple sequence repeat (SSR)-enriched library, using a modified biotin-streptavidin capture method. GS FLX (Genome Sequencer FLX System which provides the flexibility to perform the broad range of applications) sequencing (at the 1/8 run specification) resulted in 18.83 mega base pairs (Mbp) with an average read length of 280.06 bp. Sequence analyses of all SSR-containing clones revealed a predominance of di-nucleotide motifs (16,375, 61.5%) followed by tri-nucleotide motifs (6,616, 24.8%), tetra-nucleotide motifs (1,674, 6.3%), penta-nucleotide motifs (1,283, 4.8%), and hexa-nucleotide motifs (693, 2.6%). Among the di-nucleotide motifs, the AC/CA class was the most frequently identified (93.5% of all di-nucleotide types), followed by the GA/AG class (6.1%), the AT/TA class (0.4%), and the CG/GC class (0.03%). When we analyzed the distribution of different repeat motifs and their respective numbers of repeats, regardless of the motif class, of 100 SSR markers, we found a higher number of di-nucleotide motifs with 70 to 80 repeats; we also found two di-nucleotide motifs with 83 and 89 repeats, respectively, but their product lengths were within optimum size (297 and 300 bp). In future work, we will screen for polymorphisms of possible primer pairs. The results will provide a useful tool for assessing molecular diversity and investigating the population structure among and within Chrysanthemum species.

Comparative Analysis of Forage Characteristics in Six Medium Maturing of Italian Ryegrass (Lolium multiflorum Lam.) Varieties in Korea (국내 육성 이탈리안 라이그라스 중생종 6 품종의 품종특성 평가)

  • Chang-Woo Min;Jae Hoon Woo;Bo Ram Choi;Eun-A Lim;Ki-Won Lee
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.44 no.2
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    • pp.118-126
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    • 2024
  • This study was conducted in Cheonan, the middle region of South Korea, to evaluate the forage characteristics of six medium maturing Italian ryegrass varieties: 'Kowinmaster', 'IR 601', 'IR 602', 'IR 603', 'IR 604' and 'IR 605'. In growth characteristics, 'Kowinmaster' exhibited the earliest heading date on April 30, while 'IR 601' exhibited the latest on May 17. 'IR 601' exhibited the highest lodging resistance, and all varieties demonstrated excellent disease resistance, waterlogging tolerance, and cold tolerance. 'IR 603', 'IR 604', and 'IR 605' demonstrated above-average plant length, with 'IR 604' reaching the longest at 114.8 cm. In productivity, 'IR 602' and 'IR 605' produced the highest total dry matter yield, each exceeding 12,800 kg/ha. Regarding feed values, 'Kowinmaster' recorded the highest RFV and TDN at 119.18 and 66.07%, respectively, with 'IR 605' exhibiting the second highest. 'IR 604' and 'IR 601' demonstrated crude protein concentrations over 9%, with 'IR 604' exhibiting the highest at 9.74%. Analysis of monosaccharide content in Italian ryegrass revealed that 'IR 605' exhibited the highest glucose and fructose content at 23.35 g/kg and 50.70 g/kg, respectively. In summary, 'IR 602' exhibited the highest productivity, 'Kowinmaster' recorded the highest feed value, and 'IR 605' exhibited the highest glucose and fructose content. Therefore, 'IR 605' is considered the most outstanding variety due to its superior productivity, second highest feed value, and significant monosaccharide content.

Fish Community Characteristics and the Influence of Fish Sampling Gears in Lake Singal, South Korea (신갈호의 어류군집 특징 및 어구별 채집 효과 분석)

  • Myeong-Hun Ko;Mee-Sook Han;Kwang-Seek Choi;Ihn-Sil Kwak;Young-Seuk Park
    • Korean Journal of Environment and Ecology
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    • v.38 no.3
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    • pp.263-276
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    • 2024
  • Fish community characteristics and the influence of sampling gear were investigated in Lake Singal, South Korea, from August 2020 to October 2021. The employed sampling gears included a kick net, cast net, gill net, and fyke net, which are commonly utilized within the lake. Across three survey stations, a total of 18 fish species from seven families, comprising 3,501 individuals and contributing to a total biomass of 117,670 grams, were identified. Dominance among species was assessed based on individual count and biomass. Pseudorasbora parva was the most abundant, constituting 29.9% of the total catch, followed by Zacco platypus (25.1%) and Micropterus salmoides (19.3%). In terms of biomass, Carassius auratus was predominant, accounting for 45.1%, followed by Cyprinus carpio (17.4%) and M. salmoides (14.3%). Among the sampled species, three were identified as endemic to Korea: Squalidus japonicus coreanus, Cobitis nalbanti, and Odontobutis interrupta. Additionally, four exotic species were recorded, including M. salmoides and Lepomis macrochirus, both classified as invasive alien species, along with C. cuvieri and a variant of Cyprinus carpio (nudus type). Analysis of the average standard length (SL) and body weight (BW) revealed significant size variations among species. P. parva, the dominant species, measured 60 ± 24.1 mm (SL) and weighed 4.4 ± 3.42 g (BW). The subdominant species, Z. platypus, exhibited an SL of 82 ± 17.6 mm and a BW of 10.4 ± 7.27 g. M. salmoides, another dominant species, registered 96 ± 25.1 mm (SL) and 24.9 ± 96.02 g (BW), while C. auratus measured 125 ± 77.3 mm (SL) and weighed 168 ± 336.5 g (BW). In terms of gear-specific performance, the kick net captured eight species from three families, totaling 302 individuals with a biomass of 1,269 g. The cast net was more effective in coastal zones, collecting 11 species from four families, amounting to 948 individuals and 31,343 g of biomass. The gill net yielded the highest biomass, capturing 13 species from four families with 682 individuals weighing 69,695 g. The fyke net recorded the highest species diversity and number of individuals, capturing 15 species from seven families, totaling 1,569 individuals and 15,362 g of biomass. The fyke net proved most efficient in species and individual counts, whereas the gill net was superior for biomass collection. Conversely, the kick net demonstrated effectiveness in collecting small benthic species in coastal areas.

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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