• Title/Summary/Keyword: Pregnancy and delivery

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Resistance to Naegleria fowleri infection passively acquired from immunized splenocyte, serum or milk (면역시킨 마우스의 비장세포, 혈청 또는 모유를 통해 얻을 수 있는 Naegleria fowleri 감염에 대한 방어 능력)

  • 안명희;민득영
    • Parasites, Hosts and Diseases
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    • v.27 no.2
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    • pp.79-86
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    • 1989
  • A pathogenic free-living amoeba, Naegleria fowleri, causes primary amoebic meningoencephalitis to human and experimental animals. This infection is rare, but the mortality is very high. Nowadays, drug treatment or active immunization of human or mice are being tried with partial effectiveness. This study shows passive immunization effect by transfer of immunized spleen cells, serum, or milk from immunized mother in mouse experimental model. Young BALB/c mice were immunized intraperitoneally with $2~3{\times}10^{6}$ trophozoites of N. fowleri, and spleen cells and sera were collected for injection to recipient mice. There were seven transfer groups, i.e., immunized mouse serum, spleen cells, serum and spleen cells, normal mouse serum, spleen cells, serum and spleen cells, and control group. Three days later, BALB/c mice were inoculated with $1{\times}10^{4}$ trophozoites of N. fowleri intranasally. After infection, decreased mortality ana prolonged survival time of mice were noted in immunized Bloops compared with non.immuniBed control group. The groups Injected with immunized spleen cells or normal serum shewed lower moltality than that of controls bult showed no changes of Serum IgG level. The groups injected with immunized serum or normal spleen cells showed increased serum IgG level after immunization but hundred percent mortality was observed. Mother mice were ifnfnunised increperitqneeliy with $2~3{\times}10^{6}$ trephozoites of N. fowleri at the end of pregnancy and weaning Period. Soon after the delivery, Jitters born of non-immunszed mother were matched with immunized mother for feeding immune milk. After three weeks, the litters were infected with $1{\times}10^{4}$ trophozeites of N. fowleri or sacrificed for serum collection to measure the IgG levels. The results show that anti-JV. fowleri IgG from mother was transferred to litter through milk but this IgG did not inauence the mortality or survival time of the infected mice.

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Upper Gastrointestinal Bleeding in Full-Term Infants (만삭아에서 발생한 상부위장관 출혈에 대한 임상적 고찰)

  • Choi, Hyon Ju;Kim, Jae Seon;Yoon, Hye Sun;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.164-171
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    • 2005
  • Purpose: The aim of this study was to evaluate the clinical characteristics, endoscopic findings and risk factors related to the upper gastrointestinal bleeding (UGIB) seen in full-term infants. Methods: A clinical analysis for 9 cases with UGIB confirmed by endoscopy was carried out retrospectively. Patients were admitted to the Department of Pediatrics, Eulji Hospital, from January to December 2003. Results: UGIB from gastric or duodenal mucosal lesions has been seen in 0.13% in newborns infants. All patients were full-term AGA neonates without asphyxic findings at birth. Hematemesis, melena or recurrent vomiting developed within $4.4{\pm}3.8days$ after birth. Vital sign and laboratory test was normal on admission. Endoscopic findings showed hemorrhagic gastritis in 6 cases and peptic ulcers in 3 cases. All patients were successfully managed by medical treatment for $18.6{\pm}5.0days$. On treatment, clinical symptoms improved within $0.9{\pm}0.3days$. Follow-up endoscopy was not performed because there was no recurrence of symptoms in all patients. Case mothers had no history of gastritis, ulcer or anti-ulcer medications before and during pregnancy. Conclusion: If the healthy full-term infants express UGIB within a few days after birth, it is necessary to take careful history of family, mother and delivery process and to practice endoscopy for mucosal lesions of the patients. A follow-up endoscopy dose not seem to be necessary if the infant is clinically well.

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Effects of Sour Tastes on Blood Components in Anemic mice - Animal Experiment for Nursing Intervention of Female Anemia - (신맛(酸味)이 용혈성 빈혈흰쥐의 혈액성분에 미치는 효과 - 여성빈혈의 간호중재개발을 위한 동물실험 -)

  • 신혜숙;김상우
    • Journal of Korean Academy of Nursing
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    • v.31 no.2
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    • pp.268-278
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    • 2001
  • Many women in the world have suffered from anemia produced by menstruation, pregnancy and delivery. In the theory of oriental medicine, a sour taste is believed to have a tonic effect on the blood. Thus this paper is to investigate the effect of sour tastes on the improvement in anemia-induced female mice, using citric acid and Fructus schizandrae(五味子). The method used in this experiment was the change of RBC, WBC, Hemoglobin, Hematocrit, Fe, and TIBC in the blood of female mice who were fed citric acid and Fructus schizandrae(五味子). The results obtained were as follows ; 1. Compared with the control group (anemia- induced group without treatment), the mean number of RBC in the blood of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae (五味子) 500mg/kg. 2. Compared with the control group (anemia- induced group without treatment), the mean number of WBC in the blood of mice was not significantly larger in both sample groups fed citric acid and Fructus schizandrae(五味子). 3. Compared with the control group (anemia- induced group without treatment), the mean number of Hemoglobin in the blood of mice was significantly larger only in evaluating the change of the sample group fed Fructus schizandrae(五味子). 4. Compared with the control group (anemia- induced group without treatment), the mean percentage of Hematocrit in blood of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae(五味子) 500mg/kg and sample group fed Fructus schizandrae(五味子) 250mg/kg for 3days. 5. Compared with control group (anemia- induced group without treatment), the mean volume of Fe in serum of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae(五味子) 500mg/kg. 6. Compared with control group (anemia- induced group without treatment), the mean TIBC in serum of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae(五味子) 500mg/kg and sample group fed Fructus schizandrae(五味子) 250mg/kg for 7days. According to these results, a sour taste is presumed to have a general tonic effect on anemia, but more study must be taken on the effects of citric acid in improving female anemia.

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A Microscope Study of Fluoride Effects on the Rat Incisor Enamel Formation (흰쥐 절치의 법랑질 형성에 미치는 불소의 효과에 관한 현미경적 연구)

  • Lim, Do-Seon;Chang, Byung-Soo;Jeong, Je-O;Jeong, Soon-Jeong;Jeong, Moon-Jin
    • Applied Microscopy
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    • v.34 no.2
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    • pp.145-157
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    • 2004
  • The aim of the present study was to examine in detail, both at light and electron microscopical levels, the morphological variations in ameloblast of the fetal rat incisor enamel organ. Rats were started on distilled water at the beginning of pregnancy. The pups were sacrificed 11 days after delivery and animals were perfused intravascularly with glutaraldehyde and the incisors were removed. To examine on the ultrastructure of the ameloblast, the study employed primary light microscopy but electron microscopy was used to clarify some of the light microscopic finding. Longitudinal sections through the incisors of the rat show a continuous layer of ameloblasts on the labial surface of the tooth. This layer contains the entire sequence of developmental stages in enamel production. The ameloblast layer was divided into three main zones: 1) Presecretory zone, region of ameloblasts facing pulp. 2) Secretory zone, region of inner and outer enamel secretion. 3) Maturation zone, region of reduced ameloblasts. In particularly, the present study has shown that two distinctively different types of ameloblasts appear in the enamel organ during enamel maturation in the rat incisor. These two types have been designated ruffle-ended ameloblasts (rAB) and smooth-ended ameloblasts (sAB). The fluoride produces marked alteration in the fine structure of ameloblast from teeth of young rats, such as large confluent distensions of the endoplasmic reticulum and swelling of isolated mitochondria. This experimental data suggested that exposure prolonged of animal to high level of fluoride appears to induce a few dramatic changes in the normal appositional growth and initial mineralization of enamel created during amelogenesis.

Plasma Levels of Cytokines in Patients with Postpartum Depression (산후우울증 환자에서 혈장 Cytokine의 농도변화에 대한 전향적 연구)

  • Lee, Younjung;Kim, Yong-Ku;Kim, Kye-Hyun;Lee, Bun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.177-184
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    • 2020
  • Objectives : Postpartum depression is known to occur in 10-15% of mothers. The concentration of cytokine varies depending on stress, depression, pregnancy and general medical conditions. We hypothesized that the concentration of cytokines may be related to reproduction and childbirth, and that women with postpartum depression would show alterations in cytokines levels. Methods : A total of 104 pregnant women were selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups perinatal non-depression controls (n=61), postpartum depression-recovery (n=18), and postpartum depression (n=25). Results : The plasma concentration of TGF-β1, IGF-1 was higher in the pregnant group than in non-pregnant controls (TGF-β1 ; p<0.01, IGF-1 ; p=0.026). At 24 weeks of pregnancy and 6 weeks of delivery, there were no significant differences in the plasma concentration of TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α between the three groups. There was no statistically significant difference in all three groups during the course of depression in pregnant women. Conclusions : This study found significant difference in plasma cytokines concentrations between non-pregnant controls and perinatal non-depression controls.

Studies on Dairy Farming Status, Reproductive Efficiencies and Disorders in New Zealand (II) A Survey on Reproductive Efficiencies and Disorders in Palmerston North Area (뉴질랜드 (Palmerston North) 의 낙농 현황과 번식 및 번식장해에 관한 연구 (II) Palmerston North 지역의 낙농 번식현 황과 번식장해에 관한 조사)

  • 김중계;맥도날드
    • Korean Journal of Animal Reproduction
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    • v.24 no.1
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    • pp.19-33
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    • 2000
  • Eighty dairy farms (38 farms responded) in Palmerston North area of New Zealand were questioned by mail questionnaire on: 1) general characteristics, 2) milk yield and feed supplementary, 3) reproductive efficiencies (12 questions) and 4) reproductive disorders (12 questions) from February to July, 1998. Among those 4 items, the reproductive efficiencies (3) and disorders (4), various diseases and culling rates were surveyed and analyzed for Korean dairy farmers (especially in Cheju island) and compared with New Zealand. The results are as follows: 1. Fifteen farms in 38 dairy farms relied entirely on artificial insemination, the rest of 23 dairy farms (60.5%) raised 5∼6 bulls to increase conception rate. The dairy farmers in Palmerston North used artificial insemination from Oct 4th to Dec 10th for 42.8 days, and then used bulls from that point to coming Jan 10th for 41.4 days. The submission rate within 3, 6 and 10 weeks following the initiation of AI season was 84.7, 93.9 and 97.9% respectively. 2. The average age of heifers at the first estrus, pregnancy and calving was 11.0, 18.0 and 24.7 months respectively, and an average 1.4 estrus cycles were required for conception. The intervals of estrus recurrence and the following conception after calving were 38 and 68 days respectively. 3. Among inseminated cows, calving, abortion and empty cow was 90.9, 1.6 and 7.4% respectively. Calving rate decreased according to increasing farm size, while the number of empty cows decreased. 4. Stillbirth, retained placenta and delivery abnormalities were 5.3, 3.7 and 5.5% respectively, not different depend on herd size. 5. The incidence of milk fever, grass tetany, and ketosis was 3.6, 3.0 and 1.0%, respectively. The delivery abnormality and mastitis treated with medicine were 3.1 and 6.7%, but decreased according to farm size. Lameness was 8.6% on average, but over 10% in farms which has more than 400 milking cows. 6. Among the culled cows (15.5% of the total), those culled due to an old age, lameness and other diseases were 2.9, 1.8 and 4.3% respectively and those culled due to low milk production, reproductive abnormality reduced with farm size. 7. Compared with the data collected in Korea, the reproductive efficiency was better, and lameness, metabolic problem and culling rate were higher in New Zealand

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Effective Method for Extraction of Cell-Free DNA from Maternal Plasma for Non-Invasive First-Trimester Fetal Gender Determination: A Preliminary Study

  • Lim, Ji-Hyae;Park, So-Yeon;Kim, Shin-Young;Kim, Do-Jin;Kim, Mee-Jin;Yang, Jae-Hyug;Kim, Moon-Young;Kim, Min-Hyoung;Han, Ho-Won;Choi, Kyu-Hong;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.53-58
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    • 2010
  • Purpose: To find the most effective method for extraction of cell-free DNA (cf-DNA) from maternal plasma, we compared a blood DNA extraction system (blood kit) and a viral DNA extraction system (viral kit) for non-invasive first-trimester fetal gender determination. Materials and Methods: A prospective cohort study was conducted with maternal plasma collected from 44 women in the first-trimester of pregnancy. The cf-DNA was extracted from maternal plasma using a blood kit and a viral kit. Quantitative fluorescent-polymerase chain reaction (QF-PCR) was used to detect the SRY gene and AMEL gene. The diagnostic accuracy of the QF-PCR results was determined based on comparison with the final delivery records. Results: A total of 44 women were tested, but the final delivery record was only obtained in 36 cases which included 16 male-bearing and 20 female-bearing pregnancies. For the blood kit and viral kit, the diagnostic accuracies for fetal gender determination were 63.9% (23/36) and 97.2% (35/36), respectively. Conclusion: In non-invasive first-trimester fetal gender determination by QF-PCR, using a viral kit for extraction of cf-DNA may result in a higher diagnostic accuracy.

Maternal and Neonatal Outcome of Twin Pregnancies after in vitro Fertilization and Embryo Transfer (체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석)

  • Kim, Kyung-Ah;Min, Uoo-Gyung;Lim, Jae-Woo;Jun, Nu-Lee;Won, Hye-Sung;Kim, Chung-Hoon;Kim, Ellen Ai-Rhan;Lee, Pil-Ryang;Lee, In-Sik;Kim, Ki-Soo;Kim, Ahm;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.224-229
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    • 2003
  • Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

The Expression of TGF-${\beta}_1$ Protein Level during Periparturient Periods in the Recipients Pregnant by SCNT Embryos (체세포 복제란 이식우의 분만 전.후 TGF-${\beta}_1$ 단백질 농도)

  • Hwang, Seong-Soo;Chang, Yoo-Min;Ko, Yeoung-Gyu;Yang, Byong-Chul;Im, Gi-Sun;Kim, Myong-Jik;Min, Kwan-Sik;Yoon, Jong-Taek;Kim, Chang-Keun;Seong, Hwan-Hoo
    • Reproductive and Developmental Biology
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    • v.32 no.1
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    • pp.27-31
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    • 2008
  • This study was performed to investigate the correlations between steroids and TGF-${\beta}_1$ levels and delayed parturition in SCNT clone calving. The recipients pregnant by AI were used as control (AI-R). All AI-R were labored by natural delivery (n=5, day $284{\pm}0.71$ of pregnancy). The recipients pregnant by SCNT embryo (SCNT-R) showing no signs of delivery about 10 days after expected date were operated by Caesarean section (n=5, day 292). The blood and placentome samples were obtained and weighed at parturition. The concentrations of plasma progesterone (P4) and Estradiol-$17{\beta}$ (E2) were measured by radioimmunoassay (RIA). The levels of plasma and placental TGF-${\beta}_1$ levels were examined by ELISA. The placentomes from SCNT-R were overweight (p<0.05) compared to those of AI-R. The plasma P4 (p<0.01) level in SCNT-R at parturition was significantly higher compared to that of AI-R. In contrast, the plasma E2 level in the SCNT-R was significantly lower compared to that of AI-R (p<0.05). The plasma and placental TGF-${\beta}_1$ protein levels in the SCNT-R were significantly higher than those of AI-R at parturition, respectively (p<0.01). Based on these results, aberrant expressions of steroid hormones and high levels of plasma and placental TGF-${\beta}_1$ protein at parturition may be one of the key indicators on delayed parturition of SCNT clone calving.

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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