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KMID : 0360919630060030285
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Journal of the Korean Medical Association
1963 Volume.6 No. 3 p.285 ~ p.203
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Clinical Observation of Leukemia
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李文鎬/Lee, Moon Ho
李寅永/金淑姬/金相仁/Lee, In Young/Kim, Suk Hi/Kim, Sang In
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Abstract
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One hundred and twenty three cases of leukemia admitted to the Seoul National University Hospital during the period of from January 1959 to September 1962 were analyzed on the basis of age and sex incidency, types, initial signs, chief complaints, physical signs, hematological data, liver function tests, urinalysis and bone marrow findings. Following were the results.
1. Age and sex incidence by types of leukemia:Leukemias occured more frequently in male than in female in the ratio of 1.9:1. The acute forms were most frequently seen in younger persons with its peak incidence at the age group of 0~10, and decreased in order of second, third and fourth decades. The chronic leukemias showed the highest incidence in the fifth decade and decreased in order of third, second, fourth, first and sisth decades. Of the total cases, 72.4% was the acute, and 27.6% was the chroonic leukemias. In acute leukemias the myelogenous type was more common than the lymphogenous type in the ratio of 42.3:17.7. The lymphogenous form in this series of patients was strikingly rare when compared to the data on the white races.
2. Initial signs and chief complaints; Chief complaints in acute leukemias were; fever(56.6%),general weakness(24.1%), diaainess(21.7%), abbominal discomfort (15.7%), anorexia(13.3) and headache(10.8%), while those in the chronic forms were; abdominal discomfort(52.95), fever(38.2%), general malaise(56.3%), anorexia(17.6%), dizziness and headache (each 12.5%). Hemorrhagic tendencies were present in 21.7% of acute, and in 23.4% of chronic leukemias. Splenomegaly and hepatomegaly were found in 26.5% and 31.3% of acute, and in 58.8% and 47.1% of chronic leukemias respectively. Subcutaneous bleeding and lymph node swelling were observed in 26.5% and 21.7% of acute, and in 14.7% and 41.1% of chronic leukemias respectively.
3. Hematological data
a) Red blood cell count
An anemia of severe degree was present in the majority of patients especially in those with acute forms. Red blood cell count of 2 to 4 million per cubic millimeter was observed in 58.7% of acute. and in 81.4% of chronic leukemias. Red blood cell count of less than 2 million per cubic millimeter was found in 38.1% of acute and in 14.8 of chronic types.
b) White blood cell count
The white blood cell count of 10,000 to 50,000 per cubic millimeter was found in 41.3% of acute, and in 25.0% of chronic forms. The white blood cell count of more than 100,000 was encountered in 23.8% of acute, and in 50.0% of chronic leukemias. The acute forms, whatever the type was, showed a rather variable white blood cell count with a range of from subnomal to 100,000.
c) Hemoglobin
The amount of hemohlobin was generally in proportion to the red blood cell count. In 86.7% of acute, and in 96.0% of the chronic leukemias the hemoglobin level was less than 10.0g./dl., and in 13.3% of acute, and in 3.4% of chronic leukemias the hemoglobin level was more than 10.0g./dl,.
d) Platelet count
The platelet count tended to decrease in the majority of patients. In 76.% of acute, and in 85.&% of chronic forms the platelet count was between 50,000 to 150,000 per cubic millimeter was found in 23.8% of acute, and in 14.3% of chronic forms.
e) Bone marrow findings
In 96 cases in whom the bone marrow puncture was carried out, a marked increase in myeloblast (8.2~81%) was observed in acute myelogenous leukemia while a marked increase in the immature lymphocytes(38~85%) was found in acute lymphogenous leukemia. In myelogenous form, an increase of myeloblast though less marked than in acute form was also observed.
4. Liver fonction tests and urinalysis
The liver function of these patients seemed to be impaired to a minor degree, however, the urinalysis showed no specific changes.
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