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KMID : 0378019740170020159
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New Medical Journal
1974 Volume.17 No. 2 p.159 ~ p.172
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A Clinical Study on Primary Carcinoma of the Liver
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Abstract
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A clinical study was performed on the 92 patients of primary hepatoma who had been admitted to the department of the internal medicine in Woo Sok Hospital, Korea University College of Medicine during the period of three years and four months from January 1970 to April 1973.
The presentation was attempted to observe the incidence, clinical manifestations and laboratory findings on diseases which were confirmed by physical examination, liver biopsy and liver scintigram. All cases were confirmed as hepatocellular carcinoma by histopathological study.
The results obtained were summerized as follows:
1. The incidence of male to female ratio was 41:1 and the highest incidence of the age was seen in the 5th decade. The mean age was 51.5 years in male and 51.6 years in female.
2. The most common chief complaints were epigastric or RUQ pain, abdominal distension or fullness, general weakness and palpable -mass which were seen in 34.8, 25.0, 10.8, and 7.6 per cent, respectively.
3. The duration from onset to admission were found in 43.3 per cent within one month and 32.6 per cents from one to three months.
4. There were major symptoms such as anorexia(71.7%), abdominal pain (68.5%), general weakness (58.7%), abdominal distension or fullness (43.5%), weight loss (39.2%), and physical signs as hepatomegalv(92.4%), jaundice(43. 5%), edema(30. 4%), ascites(27. 0%), and liver tenderness(27. 0%). Hepatomegaly was the most prominant physical finding in which 76.5 per cent were palpable over 3 fingers breadth.
5 Total protein showed 6.0 gm/dl in 21.7% of cases and albumin was below 3.4 gm/dl in 42.4%. A/G ratio reversed in 25%. In electrophoresis of serum protein an alpha 2 component decreased in 64.9% but a gamma component increased in 55.8%. The serum alkaline phosphatase was increased in 85.9% of cases, and the mean was 5.6±0.33 Bessey-Lowry units. Serum iron was decreased in 52.0%.
6. Liver scintigram showed the solitary space occupying lesions with 71.4% and the multiples with 28.6%. Solitary cold area was seen in 59. 2% in the right lobe but 8.8% in the left lobe. Enlargement of the liver in size showed in 83.5% of all cases. Among them 36.3% in the right lobe and 31.8% in the left lobe were noted.
7. Associated diseases were observed with liver cirrhosis(23.9%), ascariasis(17.3%), pulmonary tuberculosis(9.7%), peptic ulcer(5.4%), and clonorchiasis(3.3%).
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