Background
: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnormal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management.

Methods : We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultra-sound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was deriva-ted from Food Composition Table, and we analyzed several biochemical variables.

Results : There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertri-glyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8% in patients, 7.4% in controls(p<0.05). There were no significant stati-stical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient group or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patie-nts, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0.05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and exce-rcise between patients and controls.

Conclusion : The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.

Background
: A child battering can lead to a serious obstacles to the development in mental, physical and social life. Also it can produce an impediment to a domesticity. A child bettering has been studied in Seoul, but there has been little study on the frequency and the related fac-tors according to the region. Therefore, this study was carried out to investigate the frequency and the related factors with a child battering in urban and rural areas.

Methods : A questionnare survey was conducted on 1,652 children in 3rd 4th grade of two el-ementary school(one urban area and the other in suburban area) in Taegu and one school in rural area of Kyungbook province from September 1 to September 10 1995. The children were grouped by straus' CRT scale according to the degree of battering.

Results : Among 1,652 surveyed children 1,196(72.4%) children belonged to the battered group. 227(23.2%) children in the battered group belong to light battered group and 919(76.8%) children belong to the severely battered group. the common reasons for severe battering were making troubles(47.9%), poor school performance(16.5%) and disobedience to the parents(9.2%). The primary battering persons are biologic mother(57.5%) and biologic father(25.7%), a rod is mainly used(72.2%). The frequercy of severely battering was significantly higher in the following cases ; living in suburban(78.8%), middie school graduation in father's education level(89.3%), high school graduation in mother's education level(84.9%), laborer(22.0%) or salary worker than in rural areas(P<0.05), also the cases of significantly high battering level were as followings ; in suburban areas, father only working(55.7%), both parents working(34.5%), la-borer in father's occupation(22.0%), one or two times quarreling an year between father and mother(39.4%). 7 to 11 battering times an year(P<0.05%). However, the level of battering was not signficantly different among grade, sex, house type or religion. Majority of the physical in-juries due to battering were no marks(60.7%) and bruise(31.5%). The most of the symptoms from severely bettered were tingling sensation of extremities(51.6%) and a poor appetite(11.5%). The common psycho-behavioral complaints of the severely battered children were unamus-ing(30.9%), don't like studying or going to school(34.8%), don't like going home(12.8%).
Conciusions: When diagnose and treat in family office, family physician must assess the family function that included a place of residence, the type of hose, parent's education, occu-pation and a religion, must affiliate a wound that don't exposed in physical examination. Also standardized and verified physical violence for child abuse and battering child is necessary to be studied in korea.

Background
: At present, there are many instruments to diagnose anxiety and depression. However, most of the instruments have a number of questions. Therefore, we have many diffi-culties in applying them to the primary care. The purpose of this study was to measure the reli-ability and the validity of a Korean-translated Goldberg's short screening scale for anxiety and depression, which were developed for screening of anxiety and depression in primary care.

Methods : 178 asymtomatic subjects and 58 patients(anxiety 15, depression 43) aged from 18 to 64 years old were selected. The patients were diagnosed by psychiatrist according to DSM-IV criteria. This study was performed for 3 month, from May to August 1996. The reliability of this instrument was measured by internal consistency reliability. The validity of this instrument was measured by three methods. The first method was the comparison of the score between the patients and the control group. The second method was to measure te relationships of this in-strument with the other instruments such as Self-rating Depression Scale and State-Trait Anxiety Inventory. The last method was to measure the relationship of this instrument with Comprehensive Global Assessment. In addition, we calculated the sensituvity and specificity at the cut off values.

Results : The Cronbach's α value was 0.736 for the anxiety and 0.749 for the depression. Goldberg anxiety scale was significantly associated with state in STAI(r=0.279, P<0.001), and trait in STAI(r=0.125, P<0.041). However, Goldberg depression scale was not sigficantly asso-ciated with SDS. Goldberg anxiety scale as well as Goldberg depression scale were significantly associated with CGA(r=0.433, P=0.001 ; r=0.695, P=0.001). The score of Goldberg anxiety scale was significantly higher in the anxious patients than in the control group(P=0.047). The score of Goldberg depression scale was significantly higher in the depressive patients than in the control group(P<0.001). For anxiety scale of Goldberg scale, the sensitivity and specificity was 60% and 68% at score 3. For depression scale of Goldberg scale, the sensitivity and the spe-cificity was 80% and 68% at score 2.

Conclusion : We concluded that the value of Cronbach's α in Goldberg scale was 0.736 for anxiety and 0.749 for depression. For the validity, the scores of Goldberg scale were higher in patient group than in asymptomatic group. However, the relationships of Goldberg scale with other screening instruments were variable. So further study for the validity of Goldberg scale is requested.

Background
: Korea is known to be endemic area of viral hepatitis B, and 5-6% of population are carriers. Immunization can reduce the spread of hepatitis B infection. Ho-wer, not all people respond to hepatitis B immunsation. 5-15% of primary vacciness fail to be immunized. After revaccination, only 37.5%-44% of the primary failures elicit antibody response. Recent studies have reported that it is effective to inject a double dose vaccina-tion in immunocompromsed patients. In some country, they recommend that neonate whode mother is HBV carrier shoud receive double dose vaccination. This study documented the results of double dose vaccintion only once to nonrsponders toward the HBV immunzation.

Methods : Healthy nonresponders to Hepatitis B immunization were recuited from Sep. 1995 to Aug. 1996. Subjects with their AST/ALT level over 40, or over 65 years old were excluded. They were received 2ml of plasma-derived vaccine(Hepavax-B) intramuscularly in the deltoid muscle. Anti-HBs antibody testing were performend at 1 to 3 months after vaccintion.

Results : 17 healthy nonreponders to Hepatitis B immunization(male 10, female 7) were included. Their mean ages were 47(32 to64). AST/ALT level 20/19(16 to 28/11 to 35), smoking 4.3pys(1 to 7). Seroconversion occured in 13 of them(76.5%).
Conlusions: Nonresponders to Hepatitis B vaccintion respond well to double dose vacci-nation once.

Background
: The interest of medicine was moved from disease treatment to disease prevention and health promotion. Especially, there has been marked increased interest in health promotion recently. Perception and health behaviors held or acquired during medical training can influence the acceptance and prevention atrategies. This exploratory study surveyed medical and non-medical student to assess both preventive health behaviors and perception, to find relations of personal behaviors and corresponding perception.

Methods : This survey were conducted 140 medical students and 131 non-medical stu-dents in one big city. Data were obtained by self-reported questionnaire. Weschler' survey was adapted to assess perception toward preventive behavior, and Fantastic lifestyle was adapted to assess health behavior.

Results : Among the questionnaire of perception of preventive behavior, quitting cigare-tte smoking ranked highest frequency as very important in medical student. In non-medi-cal student, use seat-belt is ranked highest frequency. Mean score of FANTASTIC lifestyle is 29.98 in medical student, 28.86 in non-medical. The result show significant relationship between student-reported behavior and corresponding perception in 6 questionnaire that is eat breakfast, moderate or no alcohol use, eliminate smoking, use seat-belt, limit coffee, get seven hours sleep.

Conclusion : In comparing medical and non-medical students, health perception and he-alth behavior were no significant difference. Overall, the result indicated that the prepon-derance of respondents that is engaging in health behaviors are high in health perception.

Background
: Many of the major life events that appear to affect biologic system and health occur within the context of the family and can have a profound psychosocial and biologic impact on family memebers. So, the present study attempted to exmins the relati-ons of family function with stressful life events, depression, and physial and psychological symptoms reported by partients.

Methods : Design : Cross sectional, observational study. Participants : 41 healthy adult males from a family medicine ambulatory care unit in a tertiary hospital located in Guro completed a series of psychometric instruments that include the Family APGAR(Adaptation, Parnership, Grorwth, Affection, and Resolve< FACESIII(Family Adaptability and Cohesion Evaluation Scale), Modified 46-item Stressful Life Events Scale, Lee's 98-items Stressful Life Event Scale, Korean version of BEPSI(Brief Encounter Psychosocial Instrument) and BDI(Beck's Depression Inventory Scale).

Results : Family APGAR was negatively correlated with stress related life event(both in total negative events -0.30, -0.37, respectively ; p<0.05) and BEPSI(0.56, p<0.0001). No significant correlation could be found between family function and positive life events. Family APGAR also revealed significant negative correlation with BDI(-0.61;p<0.0001). Among the three family types, severe dysfunctional family demonstrated highest level of stressful life events, score, perceived stress, and depression(p<0.05).

Conclusion : The higher the assessment of the family functions(Family APGAR), the lower the level of stressful life events, perceived stress and depression. There, knowledge of the family function, stress, and coping could useful to family physicians in the whole person approach of their patients.

Background
: Recently, it is substituted automatic sphygmomanometer for mercury sphygmomanometer. But it seems to be insufficient for data of its accuracy. A sample ac-curate automatic sphygmomanometer could have an important role in the management of hypertension. The aim of this study is to assess the accuracy of the automatic sphygmo-manometer that is used common practice and at home.

Methods : We collected 247 patients who visited the department of Family Practice of Taegu medical center from April to August 1996. BP was measured sequentially same arm by standard device(mercury, sphygmomanometer), test device A(A&D TM-2650), test de-vice B(seine SE-2000). We assessed the automatic sphygmomanometer according to the standards set out by the British Hypertension Society(BHS) protocol and the American As-sociation for the Advancement of Medical Instrumentation(AAMI). These data were ana-lysed using pearson' correlation and paired t-test.

Results : Test device A was highly correlated to mercury sphygmomanometer in systolic and diastolic BP(r=0.90, r=0.88). Also test device B was highly correlated to that(r=0.90, r=0.87). The mean difference between BP value obtained by the standard device and those obtained by the test device A were 0.59±7.66mmHg systole(mean±SD) and 3.83±6.43mmHg diastole, whereas the difference between the former and those obtained by the test device B were 1.70±7.99mmHg systole. and 5.58±6.38mmHg diastole. Comparing to standard device, there were a significant difference except systolic BP of test device A(P<0.05). According to the criteria of the AAMI, the diastolic BP of test device B was not enough and according to the criteria of te BHS, the diastolic BP of both test device were not enough.

Conclusion : Both test device were highly correlated to mercury sphygmomanometer. But according to the criteria of the BHS and AAMI, there were not enough. Because the use of automatic sphygmomanometer was popularized, I think that further study will be required to assess of accuracy.

Background
: From 1980's the methamphetamine(phillopon) was suddenly spread to our country and it becomes a serious social problem. Although the proportion of transfusion-associated hepatitis C declined after introduction of Anti-HCV assay as screening test of blood donors, the overall prevalence of hepatitis C has remained the same, primarily be-cause of increase of the proportion of hepatitis C patients among intravenous drug abuse-rs. So we studied about prevalence of Anti-HCV, and other viral infectious disease trans-mission by intravenous drug abuse.

Methods : Total 202 drug abusers who had been admitted to Taegu Medical Center in 1994-1996 were tested for the presence of Anti-HCV. Epidemiologic data and histories re-lated to drug use were obtained, as were serum test for hepatitis B, aminotransferase, HIV.

Results : The overall seropositivity of anti-HCV was 79.2%. Patients In HCV positive group were significant old age(34.0 yrs) and had long duration of injection(3.0 yrs) and the number of patient who had elevated aminotransferase level were significantly more than HCV negative group(p<0.05). No significant difference in sex, prevalence of HBs Ag and Anti HBc were observated between HCV positive group and negative group. The prevalence of Anti HBc was 52.1% and HBs Ag was 4.2%, but anyone was not detected for AIDS.

Conclusion : The seropositivity of Anti-HCV in intravenous drug users in Taegu, Korea was 79.2%, comparable to that in Europe and U.S.A. This finding suggest that it's time to hurry up for medical and public walfare service personal to concern and education of drug abusers, and inview of preventive medical care the need of general public information and education is pressing.