Fatty change of the liver is a histological finding caused by various diseases such as chronic alcoholism, obesity, diabetes mellitus, malnutrition and certain hepatotoxic drugs.
For the purpose of comparison of characteristics between fatty and normal liver diagnosed by abdominal ultrasonography. we analyzed 126 cases of fatty liver and 133 cases of normal liver among the 1,736 patients, who visited at the Youngdong Severance Hospital for heath care mainterance.
The results were as follows;
1. The fatty liver groups were statistically significant in case more alcohol drinking, obesity, diastolic hypertension, hypercholesterolemia, abnormal SGOT and γ-GT than normal liver groups.
2. There were no significant difference between fatty and normal liver group in smoking, diabetes, systolic blood pressure, HDL-cholesterol, SGOT and alkaline phosphatase.

To know whether computerized EKG system improves the accuracy of family practitioner's EKG interpretation and, if so, whether this improvement brings considerable acquirement of clinically significant informations, we collected all EKGs(total 207 cases) processed by computerized EKG machine from April 1,1989 until March 31,1990 in the outpatient department of Family Medicine, Seoul National University Hospital.
Firstly, these 207 EKGs were evenly and randomly distributed to the 10 family medicine residents and we requested them to interpret each EKG unaided by computerized EKG system. Secondly, these 207 EKGs were evenly and randomly reassigned to the previous 10 family medicine residents and we requested them to interpret each EKG with the aid of computerized EKG system.
Cardiologist's interpretation aided with computerized EKG system was used as a standard interpretation and evaluation of accuracy of residents' interpretation was done according to it.
1. Degree of agreement with cardiologist's interpretation increased from 72.9%(precomputer interpretation) to 76.3%(postcomputer interpretation).
2. Sensitivity of the residents' interpretation on the normal EKGs increased from 0.80(precomputer interpretation) to 0.85(postcomputer interpretation).
3. Specificity of the residents' interpretation on the normal EKGs increased from 0.80(precomputer interpretation) to 0.82(precomputer interpretation).
4. When compared with postcomputer interpretation, precomputer interpretation was changed in the 60 cases out of 207 cases.
In the normal EKGs(total 123 cases), 22 cases(17.9%) were changed.
In the abnormal EKGs(total 64 cases), 38 cases(43.0%) were changed.
5. Analysis of postcomputer interpretation was as followed;
more agreements with cardiologist's interpretation were in 38 cases(60.3%), less agreements were in 20 cases(33.3%) and unchanged cases were 2(6.4%)
6. More agreement brought clinically significant informations in 17 cases(44.7%) out of more agreed EKGs (38 cases).
We concluded that postcomputer interpretation made the family medicine residents' interpretation more agreed with cardiologist interpretation and this increased agreement brought clinically significant informations. Thus this result suggested that computerized EKG system serve as a useful teaching tool for educating EKG interpretation and increase the quality of practice by acting as a backup opinion for more accurate interpretation.

Clinical observation was performed on 56 cases of active tuberculosis combined with D.M., from January, 1986 to December, 1989 at Inchon tuberculosis hospital.
The following results were obtained.
1. The active tuberculosis combined with D.M. was 5.7% of the active tuberculosis.
2. The male-female sex ratio was 4.6:1 and peak incidence of age was 50~69 years
3. In chest P-A view, the far advanced tuberculosis was most common and the tuberculosis with cavity was 71.4%.
4. In patten of the infiltration on chest P-A view, patch or confluent pattern was most common.
5. In chest P-A view, the improved cases within 6 months regardless of D.M. control were 39(69.5%)cases and 18(69.2%)cases among well controlled state, 7(70%)cases among fairly good controlled state, 9(75%)cases among not controlled state, and 5(62.5%)cases among worse cases had improved.
As a results, D.M control was not significant influence in the tuberculosis treatment.
6. The cases who were resistant to 2 or more drugs were aggravated in the 50% cases.

The diabetic patients were evaluated by Diabetes Quality of Life(DQOL) measure in this study. The diabetes quality of life(DQOL) was initially designed for use in the Diabetes Control and Complication Trials.
The purpose of this study is to evaluate DQOL toward fasting blood sugar, sex, treatment modality, duration of the D.M., and site of life. This study has been made of 105 patients that have been visited to Severance, Kanghwa, Chungmu hospital during 6 months (1990.4-1990.9)
1. The difference between males and females was not found on the total DQOL, but males were significantly less distressed than females in diabetes related worry individual scale. (P<0.05)
2. The difference in fasting blood sugar levels was not found on the DQOL. There were no significant differences in fasting glucose levels.
3. The difference in treatment modality group such as diet & exercise group, oral hypoglycemic agent group, and insulin therapy group were found on the the total DQOL, with diet & exercise group being significantly less distressed than oral hypoglycemic agent group and insulin therapy group were found on the the total DQOL, with diet & exercise group, being significantly less distressed than oral hypoglycemic agent group and oral hypoglycemic agent group being significantly less distressed than insulin therapy group.(P<0.01), especially in satisfaction and impact individual scale.
4. The difference between urbans and rurals, was found a total DQOL, with urbans being significantly less distressed than rurals.(P<0.01), especially in worry individual scale.

Acne is one of the most common skin disease especially in the teens, however, it is not clear whether general public has right information about acne.
A survey was done to study the informations and opinions of high school students about acne. The 1005 cases of respondents among 1500 high-school students were evaluated about grade of perception for acne at june 1990.
1. A questionnair composed of 8 items of preliminary identification and 17 items of the grade of perception about acne. The questionnaire was completed by 1005 students of three high schools in Seoul Korea, ranged in age from 15 to 19.(489 boys and 516 girls)
2. More than two thirds(686,70.3%) of the respondents had acne on the day of survey, or had experienced acne at least once before. Among them, only 45 (6.2%)student have received diagnosis by doctors.
3. The mean age of onset of Acne was 14.92 years old for boys and 14.98 years old for girls.
4. More than half of the respondents had incorrect information in items among 17 questions about the perceptions of acne. As to the information about acne, no difference was found between those who were diagnosed by the doctors and those who were not.
5. From these results, we consider that many people have incorrect informations about acne, and more active education is needed to their patients and general public by the medical doctors.

The purpose of this study is to find out the better Body Mass Index for Korean children.
We surveyed 737 students in a primary school in Seoul. Among them, 373 were boys. Using the records of the physical examination done for the children every last 5 years, the data of the children's weights and heights for last 5 years were obtained. From these data, we calculated 6 Body Mass Indices(Quetelet Index, Modified Quetelet Index, Rohrer Index, Ponderal Index, Weight for lenght Index, and Body Surface Area Index). We analysed the trends of indices by age and by sex. The results were as follows ;
1. In boys, Quetelet, Modified Quetelet, and Body Surface Area Indices increased as the age.
The Ponderal Index increased till the second year and then remained unchanged. The change of the Weight for Lenght Index were unnoticeable for the the firs year, but the Index increased for next two years, and then there was no change. The Rohrer Index changed insignificantly all the years.
2. The trends of girls' indices were very similar to those of boys except the Weight for Length Index, which decreased slightly for the second year and increased till the fourth year for girls while never decreased for boys.
3. The Quetelet Index were significantly larger for boys than for girls in the first and second year(p<0.05). The Weight for Lenght Index was significantly larger for girls in the first and the second year, while it was opposite in the third and fourth year(p<0.05). The Body Surface Area Index was significantly larger for girls all the years but the fifth year(p<0.05).

One hundred and fifteen cases of cases of cerebrovascular accidents admitted at Sung Nam hospital were studied clinically for 1 year from July, 1989 to June, 1990

Following results were obtained.
1. Of 115 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 39.1%, cerebral thrombosis in 30.4%, T.I.A. in 23.5%, subarachnoid hemorrhage 7.0%.
2. The cerebrovascular accidents were most common in sixth decade.
3. The ratio between male and female is 1:1.74 in whole group.
4. 38 cases(33.0%)had the attacks in summer, 35 cases(30.4%)in winter, 22 cases(19.1%) in spring, 20 cases(17.4%)in fall.
5. Among the preceding diseases at the onset of carebrovascular accidents, hypertension was present in 55.7% in all cerebrovascular accidents in 57.8% of cerebral hemorrhage, in 45.7% of cerebral infarcion, in 50.0% of subarachnoid hemorrhage, in 66.7% of transient ischemic attack.
6. Most important precipitating factors in cerebral hemorrhage, cerebral infarction and subarachnoid hemorrhage, were thought to be emotional stress, whereas in transient ischemic attack was rest.
7. Prodromal symptom and sign at the onset of cerebrovascular accidents, headache was present in 100.0% of subarachnoid hemorrhage, in 46.7% of cerebral hemorrhage, in 40.0 of cerebral infarction, in 14.8% of transient ischemic attack. there were nausea and vomiting in 62.5% of subarachnoid hemorrhage, in 88.9% of transient ischemic attack, in 40.0% of cerebral hemorrhage, in 31.4% of cerebral infarction, hemiplegia in 74.3% of cerebral infarction, in 62.2% of cerebral hemorrhage, in 11.1% of transient ischemic attack, in zero percent of subarachnoid hemorrhage.
8. 29.6% of all cerebrovascular accidents patients were normal finding in E.K.G. on admission, most common abnormal finding were left ventricular hemorrhage(40.0%).
9. 41.7% of all cerebrovascular accidents in W.B.C. count were over 10,000/mm3, especially W.B.C. count in cerebral infarction(68.6%) and transient ischemic attack(81.5%) were less 10,000/mm3.
10. Mental state on admission in cerebrovascular accidents, was alert in 88.9% of transient ischemic attack, in 57.1% of cerebral infarction, in 50.0% of subarachnoid hemorrhage in 26.7% of cerebral hemorrhage, whereas semicoma or coma were in 42.2% of cerebral hemorrhage, in 17.2% of cerebral infarction, in 12.5% of subarachnoid hemorrhhage, in zero percent of transient ischemic attack.
11. Intracerebral hemorrhage occurred most frequently in basal ganglia(60.0%), followed by thalamus(17.8%), pons(11.1%), suboptical(6.7%), cerebellum(4.4%).
12. The progress of cerebrovascular accidents were closely correlated with the mental state on admission.

Five family medicine residents reviewed charts which were practiced by a family physician from September 1989 to August 1990.
After classifying the collected data in reference to ICPC coding system, following results were obtained.
1. The total number of patients were 3,485 and 1,596 were male, 1,889 were female.
2. The age distribution of patients was 0 through 96 years old. The largest was the 0 to 9 year old goup by 34.8%, the smallest was above 90 year old group by 0.1%, the pediatric group consisted of 44.2% and geriatric group consisted of 3.3%.
3. The total number of Reason For Encounter(RFE) was 4668, the average RFE per patients was 1.4 per patients and the kind of RFEs was 265. Among them cough, fever, generalized abdominal pain, symptoms/complains of throat and U.R.I ranked most common.
4. The total number of diagnoses was 4141, the average number of diagnoses was 1.2 per patient. Among them U.R.I., acute bronchitis/bronchiolitis, disod. stomach function, other resumed infection and irritable bowel symdrome ranked most common.
5. According to division of diagnosis by chapter, respiratory(44.4%), digestive(26.9%), general(5.8%) and musculoskeletal(3.8%) were ranked.
6. The number of diagnostic tests per patient was 0.38. Among the top 10 include 91.5% and chest X-ray, Urinalysis, LFT, HBsAg/anti-HBs, CBC were 18.0%, 15.1%, 13.5%, 11.6%, 9.9% respectively.
7. 39 cases were referred to Internal medicine, General Surgery, Urology, Pediatrics 8, 7, 5, 4 respectively.

Routine chest X-ray examination has been taken to detect chest abnormality, especially for pulmonary tuberculosis in university freshmen since 1969. These days the prevalence rate of pulmonary tuberculosis is decreased considerably owing to these effect and the value of routine chest X-ray examination is decreased.
So we analyzed the chest X-ray films of 5,775 freshmen of 6 universities in 1991 and performed questionnaire in 82 students radiologically associated with pulmonary tuberculosis in order to determine of new chest abnormality in university freshmen.

The results were as follows;
1. Finally significant chest X-ray abnormality by standard chest X-ray technique were 87 cases(1.4%); active pulmonary tuberculosis 40, inactive pulmonary tuberculosis 18, undetermined activity 22, pleural effusion 2, pneumothorax 2, others 3.
2. Among 82 students with chest X-ray abnormality associated with pulmonary tuberculosis, newly diagnosed patients were estimated 22(28.9%) and there was one case of pneumothorax who needed treatment.
So, newly diagnosed case which needed treatment by routine chest X-ray examination were estimated as 25(0.4%).
3. Among newly diagnosed pulmonary tuberculosis patients, 15 patients(68.2%) had subjective symptoms when they were diagnosed.
4. There were 5 students(15.2%) who were not under required therapy or follow-up among 76 respondents.
In conclusion, present study showed low efficiency of routine chest X-ray examination to detect new chest abnormality in university freshmen in 1991. We recommend the change of routine chest X-ray examination to select examination through questionnaire and physical examination, and serological test for HBV is more effective in aspect of cost-effectiveness.