• Title/Summary/Keyword: Upper arm

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Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases) (전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)))

  • Park, Wook;Ok, See-Young;Song, Hoo-Bin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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A Kinematical Analysis of Belle Motion on Parallel Bars (평행봉 Belle 기술동작의 운동학적 분석)

  • Kong, Tae-Ung
    • Korean Journal of Applied Biomechanics
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    • v.15 no.4
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    • pp.43-53
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    • 2005
  • This study is to define how the difference of athletic change influence on the last regrasp after somersault in Belle movement of parallel bars. For his study, the following conclusion was produced by analysis of athletic change by means of three dimensional visual image in three athlete of nation. 1. As the picture of S1, there are total used time(2.01 sec), S3(2.17 sec) and S2(2.19 sec). In case of a short needed time, it is difficult for them to perform the remaining movement of the vertical elevating flight easily and comfortably, it is judged as performing the small movement with restrict swing. 2 In the change of body center sped by each event, it is calculated as $-89.1^{\circ}$ the narrowest in S1, $-81.96^{\circ}$ the widest and then $86.34^{\circ}$ in S3. In E3 event, average compound speed is 4.07m/s, S2 showed the fastest speed of 4.14m/s whereas S1 the narrowest angle of 3.95m/s. 3. A shoulder joint and coxa are the period of mention in E3. In E4 which was pointed out the longest vertical distance, S2 that is indicated the highest vertical height as the period of detach in parallel bars. showed -3.91m. This is regarded as a preparatory movement for dynamic performance after using effectively elastic movement of shoulder joint and coxa while easily going up with turning back movement. In the 5th phrase, long airborne time and vertical change position is showed as the start while regrasping securely air flight movement from high position. 4. In E5, a long flight time and a long vertical displacement were shown as the regrasp after somersault efficiently in high position with stability from the point of the highest peak of the center of the body. Especially, S2 is marked as a little bit long position, while S1 is reversely indicated as performing somersault and unstable motion in a low position. 5. In E3, at the point of the largest extension of the shoulder joint and hip joint the shoulder joint is largely marked in $182^{\circ}$ and the hip point $182^{\circ}$ in S2. The shoulder joint is marked at the smallest angle in $177^{\circ}$ and the hip point $176^{\circ}$ in S1. And S1 is being judged by its performance of the less self - confident motion with lessening a breath of swing. S2 makes the most use of flexion and extension of the shoulder joint and the hip joint effectively. It was performed greatly with swinging and dropping the rotary movement and the rotary inertia naturally. 6. In E6, as the point of regrasp of the upper arm in parallel bars it is recognized by the that of components of vertical and horizontal velocity stably. During this study, the insufficient thing and the study on the parallel bars at a real game later are more activated than now. If it is really used as the basic materials by means of Belle Picked Study of Super E level after Bell movement, you may perceive the technique movement previously and perform without difficulty. Especially, such technique as crucifix is quite advantageous for oriental people thanks to small body shape condition. In conclusion we will nicely prepare for our suitable environment to gradually lessen trials and errors by analyzing and studying kinematically this movement.

Customer Acceptance Procedure for Clinac (21EX-Platinum)

  • Hong, Dong-Ki;Lee, Woo-Seok;Kwon, Kyung-Tae;Park, Kwang-Ho;Kim, Chung-Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.43-61
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    • 2004
  • Purpose : For qualify improvement in radiotherapy, it is important to set up and evaluate equipment (linac) accurately. In addition, technicians are needed to be fully aware of the equipment's detailed quality and its manual. Therefore, the result of ATP is evaluated and introduced, in order that the technicians are skilled by participating in quality assurance (QA) and understanding the quality of the equipment before clinical use. Method and Material : QA for LINAC 21EX (Varian, US) was done with suppliers its procedure was divided into radiation survey, mechanical test, radiation isocenter test, bean performance, dosimetry, and enhanced dynamic wedge and using X-omat film (Kodak), multidata, densitometer, and electrometer. QA of MLC (Millennium, 120 leaf) attached to LINAC and EPID (Portal vision) were done separately. Result : The leakage dose by survey meter was below the tolerance. In mechanical test, collimater, gantry, and couch rotation were less than 1mm, and the angles were ${\pm}0.1^{\circ}$ for digital and ${\pm}0.5^{\circ}$ for mechanical. The alignment test of the light field and crosshair were evaluated less than 1mm. The (a)symmetrical jaw field was less than ${\pm}0.5mm$. The radiation isocenter test using X-mat film was less than 1mm. The consistency of light field and radiation field was less than ${\pm}0.1mm$. PDD for photon energy was less than ${\pm}1\%$ and for electron energy of $90\%,\;80\%,\;50\%,\;and\;30\%$ were evaluated within the tolerance. Flatness for photon and electron energy was evaluated $2.3\%$ (tolerance $3\%$) and $3\%$ (tolerance $4.5\%$), respectively, and symmetry was $0.45\%$ (tolerance $2\%$) and $0.3\%$ (tolerance $2\%$), respectively. Dosimetry test for short term, MU setting, rep rate, and dose rate accuracy of photon and electron energy was within the tolerance depending on energy, MU, and gantry angle. Conclusion : Accuracy and safety for clinical use of Clinac 21EX was verified through customer acceptance procedure and the quality of the equipment was found out. These can reduce the difficulties in using the equipment. Furthermore, it is useful for clinically treatment of patients by technicians' active participations.

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A Study on the Blood Health Status and Nutrient Intake in Elderly Women Dwelling in Longevity Region in Jeonla Province according to Bone Mineral Density (전라도 장수지역에 거주하는 여자노인의 골밀도에 따른 생화학적 지표 및 영양섭취상태에 관한 연구)

  • Oh, Se In;Kwak, Chung Shil;Lee, Mee Sook
    • The Korean Journal of Food And Nutrition
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    • v.28 no.2
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    • pp.228-240
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    • 2015
  • This study was conducted to investigate the dietary and other factors affecting bone mineral density (BMD) in older Korean women. A total of 340 women aged 65 to 74 were recruited from the Kugoksoondam area (Kurye, Goksung, Soonchang and Damyang counties), known as the longevity-belt region in Jeonla province, Korea. They were categorized into two groups according to bone status by T-score : a nonosteoporotic group and an osteoporotic group. Demographic characteristics were collected, as well as information on physical measurements, blood tests for biochemical indicators, health status health-related life style, dietary behavior, favorite food groups, nutrient intake and mini nutrition assessment (MNA). The results are as follows: The mean age of 185 nonosteoporotic women was 69.6 years and that of 155 osteoporotic women was 70.9 years (p<0.001). The mean T-score of the nonosteoporotic group was $-1.5mg/cm^3$ and that of theosteoporotic group was $-3.2mg/cm^3$ (p<0.001). Height and body weight in the nonosteoporotic group were significantly higher than in the osteoporotic group (p<0.001, respectively). There was no significant difference in BMI, although the BMI in the nonosteoporotic group was slightly higher. Waist and hip circumferences in the nonosteoporotic group were significantly higher than in the osteoporotic group (p<0.01, respectively), and the mid upper arm and calf circumferences were also significantly higher than in the osteoporotic group (p<0.001, p<0.01, respectively). The 5 m walking ability was significantly superior compared to the osteoporotic group. Serum levels did not show any significant differences between the groups and were within normal range. The serum total protein, albumin and Insulin-like growth factor (IGFs) levels of the nonosteoporotic group were significantly higher than those of the osteoporotic group (p<0.05, p<0.05, p<0.001, respectively). IGF was 104.7 ng/mL for the nonosteoporotic group and 88.1 ng/mL for the osteoporotic group. Physical activity and appetite in the nonosteoporotic group were significantly higher (p<0.01, p<0.05, respectively). The favorite food groups of the nonosteoporotic group comprised more meats and fish than those of the osteoporotic group (p<0.05, respectively). Nutrient intake was not significantly different, with the exception of niacin intake (p<0.05), but the nutrient intake of the nonosteoporotic group was slightly higher than that of the osteoporotic group. The niacin intake of the nonosteoporotic group and the osteoporotic group were 11.4 mgNE and 10.0 mgNE, corresponding to 103.6% and 90.9% of the Korean EAR, respectively. The MNA score of the nonosteoporotic group was significantly more favorable than for the osteoporotic group. In conclusion, it is necessary to maintain adequate body weight and muscle mass. Habitual physical activity may have a beneficial effect on BMD for older women. Dietary factors, such as meat and fish, higher intake of niacin rich foods and nutrient status for older women also appear to have favorable effects on bone mineral density.

Effects of Vibration Stimulation Therapy on Neglect of Stroke Patients (진동감각 자극치료가 뇌졸중 환자의 편측무시에 미치는 영향)

  • Jeon, So-Hyun
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.87-95
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    • 2018
  • Objective : Vibration stimulators are easier to obtain in clinical settings than other treatment tools, and it is advantageous that the arm activation training can be performed passively. Despite the following advantages, recent studies on vibration sense have not been activated yet. The purpose of this study was to investigate the effect of vibration sensation on the hands of the affected upper limb on unilateral reduction of stroke patients. Method : Patients with unilateral neglect due to stroke were enrolled in this study for about 3 weeks from October 19, 2018 to November 7, The research design used ABA design among the single-subject experimental research design, and a total of 18 circuits (4 baseline, 6 intervention, 3 baseline regression) were performed once a day on weekdays Respectively. MMES-K was used to select the subjects. Line bisection test (LBT), Albert's test and Star Cancellation Test (SCT) were used as unilateral neglect test. For the analysis, the baseline and intervention period measurements were visually analyzed using graphs and mean values were used. Result : All three evaluations showed that the number of errors missed during the training period was lower than the baseline period, and this decrease remained after training. The error was reduced by an average of $2{\pm}1.2$ omissions and an average omissions of $0.6{\pm}0.5$ omitting an average of $4.5{\pm}1$ omissions in the line break test. As a result of the Albert test, the average error decreased by $22.5{\pm}1.9$ omissions and $8{\pm}7.3$ omissions and $0.3{\pm}0.5$ omissions, respectively. In the star clearance test, the average error decreased from $26{\pm}4.6$ to $21.8{\pm}1.7$ and $20{\pm}0$, respectively. Conclusion : In this study, vibrotactile stimulation therapy showed a continuous effect on improving unilateral neglect. Based on these findings, further research should be conducted in order to improve objectivity in future studies. Further research on various arbitration methods that maximize the effect of intervention will be needed.

Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

A Survey of Nutritional Status on Pre-School Children in Korea (학영기전아동(學齡期前兒童)의 영양실태조사(營養實態調査))

  • Ju, Jin-Soon;Oh, Seoung-Ho
    • Journal of Nutrition and Health
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    • v.9 no.2
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    • pp.68-86
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    • 1976
  • The primary purpose of this study is to evaluate the correct nutritional status on pre-school children in Korea. Furthermore, it made an attempt to find and define nutrional problems, and assist in establishment on their nutritional improvement plan. For this, food intake and health condition (physical, clinical, biochemical and parasitological) survey on 109 Pre-school children in both sexes, randomly selected from Yang-Gu area in Gang-Won province and Rea-ju area in Kyong-gy Province, were conducted by means of three-day records, during the two periods of Spring and Fall season in 1975. The results obtained are summerized as follows: 1. The food intake; Average food intake of the subjects per day were $508{\sim}647g$ ($83{\sim}91%$ in vegetable foods and $5.5{\sim}11.7%$ in animal foods) in Yang-gu area, and $587{\sim}698g$ ($88{\sim}89%$ in vegetable foods and $6.3{\sim}7.6%$ in animal foods) in Rea-ju area. 2. The intake of energy and nutrients; a) Calory intake. Average energy intake of subjects per day in Yang-gu area$(1120{\sim}1415kcal)$ were all lower than the Korean Recommended Dietary Allowances (RDA) in either Spring and Fall survey, whereas the subjects in Rea-ju area were lower intake $(1213{\sim}1418kcal)$ than the RDA in the Spring but higher intake$(1516{\sim}1755kcal)$ than the RDA in the Fall, and the average intake were similar level with that of RDA. b) Protein intake. Average protein intake of the subjects per day in Yang-gu area $(33{\sim}43g)$ girl subjects in Rea-ju area $(35{\sim}39g)$ were lower than the RDA in either Spring and Fall survey, whereas the boy subjects in Rea-ju area$(36{\sim}38g)$ were lower in Spring and higher $(49{\sim}57g)$ in the Fall than that of the RDA, but the average $(43{\sim}47g)$ were similar level with the RDA. The protein intake from animal sources in all subjects were much lower $(5.5{\sim}11.7\;of\;total\;protein)$ than the RDA. c) Fat intake. Average fat intake were very lower in all subjects of both area $(14{\sim}24g\;in\;Yang-gu,\;10{\sim}12g\;in\;Rea-ju)$ than that of RDA which is recommended $12{\sim}14%$ of total energy to be supplied from fat. d) Calcium intake. Average calcium intake were very low in all subjects of both area $(264{\sim}355mg\;in\;Yang-gu\;and\;283{\sim}429mg\;in\;Rea-ju)$, especially, these in Spring were about a half level of the RDA, and it was much increased in the Fall due to increased intake of milk, but it was still not enough than the RDA. e) Vitamin A intake. Average intake of V.A ($703{\sim}1465\;IU$ in Ynag-gu and $750{\sim}1521\;IU$ in Rea-ju) were also lower than the RDA, moreover their V-A sources were mainly vegetable, so that the V-A supply might be critical one for the subjected. f) Riboflavin intake. Average riboflavin intake on all subjects in both area except boys in Rea-ju area in Fall, were very lower than the RDA. 3. The physical status; a) Average weight and height of boys aged 4 and 5 in Yang-gu area and girls of aged 5 in Rea-ju area were lower than those of Korean Standard of 1967 report, but those by age of girls in Yang-gu area and boys in Rea-ju area were a little heigher than the Korean Standard. It is, hower, present Korean standard of physical status might be somehow heigher than the 1967, since the socio-economical situation has been much improved during past a decade. So that, if one considered on this sense, the physical status of the subjects on this survey might be somehow lower than those of present Korean standard. b) Average upper arm circumference in both area were no difference each other, and their mean values of age 4, 5 and 6 in boy and girl were 15.6, 16.5, 16.4 and 15.5, 16.5, 16.4cm respectively. c) Average chest girth of boys were similar to those of Korean standard whereas the girls were smaller than the Korea standard. The average head circumference also showed similar tendency with the chest girth. 4. The clinical findings; The most popular clinical signs were angular stomatitis and dental caries, and boys had more heigher incidence then the girls. 5. The biochemical findings; a) Hemoglobin and anemia Average Hb value of boys and girls were 11.4 and 10.9g per 100 ml of blood respectively. The incidence of anemia (Hb value below 11 g/100 ml, by WHO) was increased by age, and girls had more heigher incidence than the boy (34% : 48%). The incidence of anemia in age of 4,5, and 6 in boys and girls were 28%, 41% 34%, and 33%, 50%, 49% respectively. The degree of the anemia was not severe, and the anemia of there subjects may be caused mainly low intake of better quality protein and low iron intake as well. b) Hematocrit. Average Ht value of whole subject were $39.9{\sim}41.6%$. c) Blood plasma protein. Average blood plasma protein contents of whole subjects were $6.6{\sim}7.4gm$ per 100 ml. The incidence of deficient range (<6.0g%, by ICNND) was only one girl of age 4 in yang Gu area. 6. Parasitological findgs; The most popular parasitism were asicris lumbicoides and trichocephalus trichiura, and about 2/3 of the whole subjects were suffering one or more of these parasitism.

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