Analysis on the Childhood Cancers Based on Cancer Registry Program in Korea in the Recent 5 Years / 대한소아혈액종양학회지

PURPOSE: The purpose of this research is to elucidate the trend of incidence of childhood cancers for the recent 5 years and to use this study as a database of childhood cancers research by comparing to the existing data. METHODS: Childhood cancer patients registered in the cancer registry program of the Ministry of Health and Welfare in Korea during January 1, 1995 to December 31, 1999 were included as study samples. Our current data was obtained to be compared with the previous results 1st report during 1982~1987 and 2nd report during 1988~1992). Analysis of our study was obtained from the data of the patients of childhood cancers under 15 years old registered in the 128 hospitals, except for the patients who are registered repeatedly. RESULTS: Accumulated number of cases of the childhood cancers was 5, 433 (1.5% of the total cases of all ages). A male to female incidence ratio was 1.3 to 1. The most common malignant tumor was leukemia (33.1%). Out of 1, 800 cases of leukemia, 1, 142 cases (63.4%) were lymphoid leukemia, 468 cases (26.0%) were acute non-lymphocytic leukemia and 97 cases (5.4%) were chronic myeloid leukemia. The second most common malignancy was central nervous system tumor (16.0%), followed by lymphoma (8.0%), gonadal and germ cell tumors (7.9%), sympathetic nervous system tumor (6.7%), bone tumor (5.1%), soft tissue sarcoma (4.8%), renal tumor (4.0%), retinoblastoma (3.3%) and hepatic tumor (2.6%). The most common malignant tumor in the 0~4 year-old age was leukemia (32.6%), followed by central nervous system tumor (12.7%) and sympathetic nervous system tumor (11.5%). In the 5~9 year-old age group, the most common malignant tumor was leukemia (38.0%), as well, followed by central nervous system tumor (21.7%) and lymphoma (11.6%). In the 10~14 year-old age group, the most common cancers were leukemia (29.8%), central nervous system tumor (16.5%) and bone tumor (11.7%). CONCLUSION: We were unable to note any differences in the incidence of childhood cancers when comparing the current data and the previous ones.

Childhood Acute Immune Thrombocytopenic Purpura in Korea: Multicenter Study of Korean Society of Pediatric Hematology/Oncology / 대한소아혈액종양학회지

PURPOSE: Childhood acute immune thrombocytopenic purpura (ITP) is a benign hematologic disease. Therapy does not affect the natural history of the illness. We evaluated the clinical and laboratory findings, treatment and prognosis of childhood acute ITP in Korea through a retrospective multicenter study. METHODS: We analyzed retrospectively the data of 1, 829 children with acute ITP through survey of 33 hospitals among 43 hospitals in Korea from Sep. 1992 to Aug. 2001. RESULTS: Male to female ratio was 1.3: 1 and the median age at the diagnosis of ITP was 2.9 (0.1 17) years. Median duration of follow up was 6 months. One hundred and forty nine cases of the total 1, 829 patients (8.1%) received no treatment. The initial median platelet count of the non-treated group was 42, 500/mm3. Among the 861 cases who were followed up over 6 months, 315 cases (36.6%) progressed into chronic ITP. Associated with this high rate of chronicity of childhood acute ITP patients in Korea, we must consider the fact that acute ITP patients with fast improvement in the first episode tend not to follow up. Considering that fact, the rate of chronicity becomes 17.2% of the 1, 829 acute ITP patients. The treated group used many kinds of treatment methods. Intravenous immunoglobulins (IVIG) with or without prednisolone (PD) (67.5%) were the most commonly used regimens. In the group treated with IVIG alone, the platelet count began to rise above 50, 000/mm3 at 2.6 days, 100, 000/mm3 at 3.7 days and 150, 000/mm3 at 4.9 days. Four hundred and twenty two cases of the 1, 686 (25.0%) cases followed up after first episode of ITP relapsed. The relapse rate was significantly higher in older patients and in girls than in younger patients and in boys (P< 0.05). The chronicity of ITP statistically increased with age (P< 0.05) and that was the only valuable factor. CONCLUSION: Despite the fact that childhood acute ITP is a pretty common disaese, there is no agreement on the best treatment method for this disease. The establishment of Korean treatment guideline of childhood acute ITP, based on an analysis of multicenters, seems to be needed.

Epidemiology and Clinical Characteristics of Childhood Acute Lymphoblastic Leukemia in Korea / 대한소아혈액종양학회지

PURPOSE: Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of all cases of childhood leukemia. We investigated epidemiology, clinical and laboratory features and treatment outcome of the children with ALL in Korea during recent 5 years. METHODS: One thousand forty nine patients were enrolled between January 1994 and December 1998 from 37 major hospitals in Korea. The data regarding the clinical and laboratory features including age, WBC counts at diagnosis, immunophenotype, morphology, cytogenetics and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed. The differences between groups analyzed by log-rank test. RESULTS: There were 597 males and 452 females. The distribution between the age 2 and 5 years is most common in 46.1%. The annual incidence rate per 100,000 population varied from 1.6 to 2.2. The 5 year event free survival (EFS) rates according to good prognostic factors were as follows: 67% bet ween 1-9 year of age at diagnosis, 69% in under 10,000/mm3of initial WBC count, 74% in early pre-B cell CALLA ( ) immunophenotype, 65% in L3 morphology, 68% in no CNS invasion. Most of patients were treated by CCG treatment protocol. The 5 year EFS was 63%. Main complications were sepsis (21.8%) and hemorrhage (12.5%). The relapse rate was 15.6%. The common causes of death were sepsis, DIC, pneumonia, relapse. CONCLUSION: Our results could provide the most recent and important information about acute lymphoblastic leukemia of children in Korea.

Survival of Korean Cancer Patients Diagnosed in 1995 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To produce the nationwide 5-year survival rates of Korean cancer patients by primary cancer site. MATERIALS AND METHODS: The study subjects were cancer patients diagnosed in 1995, as documented by the Korea Central Cancer Registry (KCCR) Program. This data was collected in 120 (93%) of 129 nationwide intern- and resident-training hospitals and 75 (94%) of the 80 Korean university hospitals. Follow-up was performed by obtaining information upon vital status (i.e., whether living or dead) from the government administered whole population files. Cumulative observed survival rate (OSR) was calculated by using the life table method and the relative survival rate (RSR) was computed using the life-time table for the years 1995, 1997, and 1999. RESULTS: Of the 55,042 study subjects, the OSR for all Korean cancer patients was 61.4% at 1 year and 38.1% at 5 years. The RSR for all cancers was 62.5% at 1 year and 41.4% at 5 years, and the 5-year RSRs for all cancers in men and women were 32.6% and 53.2%, respectively. CONCLUSION: This is the first nationwide report upon 5-year cancer survival by primary site in Korea. Men showed a lower survival rate than women in most malignancies. Pancreatic and thyroid cancer had the lowest and highest 5-year survival rates, respectively.

Cancer Incidence in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We estimated the incidence of cancer in Korea. MATERIALS AND METHODS: The indicence of cancer was estimated using national mortality data, and the incidence data from four frontier regional cancer registries, including Kangwha, Seoul, Busan and Deagu. These four registries served a population about seventeen million, which is almost 38% of entire population in Korea. RESULTS: The overall age-standardized incidence rates (ASR) were 287.0 and 163.1 per 100,000 for males and females, respectively. Among males, stomach cancer was the most frequent (ASR 69.6), followed by lung cancers, including bronchus cancer (ASR 54.5), liver cancer (ASR 47.0) and colo-rectal cancer (ASR 25.2). The most frequent sites of cancer in females, by rank order, were stomach (ASR 26.8), breast (ASR 20.1), uterine cervix (ASR 18.0), colo-rectum (ASR 15.9), lung (ASR 13.0) and liver (ASR 12.0). CONCLUSION: It is hoped that these results will provide valuable leads for cancer research and cancer control in Korea.

A Study of the Survival Rate of Childhood Cancer in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: It is known that the prognosis of childhood cancer is relatively good, however actual representative nationwide data on childhood cancer, particularly of survival rate, are rare. In this study we attempted to establish the overall survival rate of major childhood cancer. MATERIALS AND METHODS: The primary source of data of childhood cancer under 15 years of age were the registry files of the Central Cancer Registry Report (Ministry of Health & Welfare) from 1993 to 1997. The above data was compared to death case data files of the same period obtained from the Korea National Statistical Office using the personal identification code. We calculated the 1, 3, and 5 year survival rates using the life table of SPSS and Kaplan-Meier method and compared the survival rate of disease according to prognostic factors. RESULTS: A total of 6,720 cases of pediatric cancer from the Central Cancer Registry files were computerized and sorted by personal identification (ID) code to extract duplicated cases as well as cases with incomplete data. The final number of cases entered in this study was 4,983. 1) The number of confirmed death cases was 1,448 (29.1%). 2) The disease distribution showed that the most common pediatric cancer was leukemia (1,468/4,983, 29%), followed by brain tumors (503/4,983, 10%), lymphoma (315/4,983, 6%), Wilms tumor (165/4,983, 3%), etc. in order by number of patients. 3) The 5 year survival rate of disease was as follows: overall 62%, acute lymphocytic leukemia 61%, acute non-lymphocytic leukemia 32%, malignant lymphoma 72%, neuroblastoma 47%, medulloblastoma 51%, Astrocytoma 66%, Wilms tumor 83%, etc. CONCLUSION: We analyzed and report the 5 year survival rate of overall childhood cancer and of each of the twelve major childhood cancers from in Korea 1993 to 1997 to provide basic data on childhood cancer statistics.

Annual Report of the Central Cancer Registry in Korea-1999: Based on Registered Data from 128 Hospitals / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The Central Cancer Registry Center in Korea (KCCR) conducted a nationwide hospital-based cancer registry to provide basic statistical data on cancer. MATERIALS AND METHODS: In 1999, 128 hospitals participated in the cancer registry program. All cancer registry data, which was submitted from the participating hospitals by diskettes during the year, were reviewed and analyzed by the committee members who were all Board-qualified clinical oncologists and pathologists. To avoid duplication, every resident registration number was compared by a computer. Cases that had been diagnosed by a histological examination were preferentially chosen for inclusion in this data. RESULTS: Of 94,003 cases that were registered, there was a total of 8,452 (9.0%) duplication cases which were excluded. Of the remaining 85,551 cases, there were 3,231 cases (3.8%) of carcinoma in situ (morphology code/2) which were excluded. A final total of 82,320 cases were analyzed. Of the analyzed cases, 46,908 (57.0%) were males and 35,412 (43.0%) were females. The leading age groups in the order of their relative frequency were those who were 60~64 years of age (15.3%), followed by the 55~59 age group (13.8%). The six leading primary cancer sites in the order of their relative frequency were stomach (20.7%), followed by the bronchus and lung (12.1%), the liver and intrahepatic bile duct (12.0%), the colorectum (9.9%), the breast (6.4%), and then the uterine cervix (5.0%). In males, the five leading primary cancer sites were the stomach (24.2%), the liver and intrahepatic bile duct (16.3%), the bronchus and lung (16.1%), the colorectum (9.7%), and the urinary bladder (3.3%). In females, the stomach (16.2%) was the most common cancer site, followed by the breast (14.7%), the uterine cervix (11.6%), the colorectum (10.2%), and the thyroid (6.8%). Among the 1,077 cases of childhood malignancies, leukemia (35.4%), CNS tumors (16.7%), malignant lymphomas (7.0%), and sympathetic nervous system tumors (6.9%) were the most common cancer types. CONCLUSION: We analyzed and report the KCCR data from 128 nationwide hospitals during 1999.

A Clinical Observation of Newborns of Unmarried Mothers

PURPOSE: The purpose of this study was to assess the importance of prenatal care of the unmarried mothers. METHODS: Clinical characteristics of 131 newborn babies of unmarried mothers who were hospitalized at National Medical Center from April, 1998 to August, 1999 were compared to 131 newborn babies of married mothers who were also hospitalized at National Medical Center from June, 1999 to August, 1999 by reviewing their medical records retrospectively. RESULTS: Average age of mothers were 20.1+/-4.0 years in unmarried group and 28.8+/-4.4 years in married group, which was statistically significant. In unmarried group, the highest rate of maternal age (55.8%) was below 20 years of age, which showed increased tendency compared to previous report. In cesarean section rate, there was significant difference; 11.4% in unmarried group and 48.1% in married group. In the birth order, the first baby was most frequent in both groups. The sex ratio showed 1.78 : 1 with male preponderance in unmarried group and 1 : 1.02 with slight female preponderance in married group. In average gestational age, birth weight, height, head circumference, chest circumference, 5 minutes Apgar score, and admission rate, there was no significant difference. The unmarried group had more babies in postmaturity and meconium-stained condition. CONCLUSION: There was no significant difference in growth and morbidity rate between newborn babies from unmarried mothers who had prenatal care and those from married mothers.

Three Cases of Subacute Necrotizing Lymphadenitis in Childhood

Subacute necrotizing lymphadenitis was first reported by Kikuchi and Fujimoto in 1972. Young females no more than 30 years of age are mainly affected. It usually manifests as fever and cervical lymphadenopathy. We experienced three cases of subacute necrotizing lymphadenitis in an 11-year-old boy, a 12- year-old boy and an 11-year-old girl. Symptoms presented were URI signs, diarrhea, headache and weight loss along with fever and cervical lymphadenopathy. Fever persisted from 9 to 30 days and did not respond to antibiotics. We performed aspiration biopsy of cervical lymph node which was consistent with subacute necrotizing lymphadenitis in all cases. We used oral steroid in one case. Fever and lymphadenopathy subsided spontaneously within one month. There were no other complications.

Three Cases of Subacute Necrotizing Lymphadenitis in Childhood

Subacute necrotizing lymphadenitis was first reported by Kikuchi and Fujimoto in 1972. Young females no more than 30 years of age are mainly affected. It usually manifests as fever and cervical lymphadenopathy. We experienced three cases of subacute necrotizing lymphadenitis in an 11-year-old boy, a 12- year-old boy and an 11-year-old girl. Symptoms presented were URI signs, diarrhea, headache and weight loss along with fever and cervical lymphadenopathy. Fever persisted from 9 to 30 days and did not respond to antibiotics. We performed aspiration biopsy of cervical lymph node which was consistent with subacute necrotizing lymphadenitis in all cases. We used oral steroid in one case. Fever and lymphadenopathy subsided spontaneously within one month. There were no other complications.

Molecular Epidemiologic Study of Streptococcus pyogenes Analyzed by T protein Serotyping and Pulsed Field Gel Elecrophoresis(PFGE) in Normal Children

PURPOSE: In this study we tried to look at the spreading, duration of colonization, and acquisition of new streptococci which were obtained in one geographical area, as well as the bacteriologic and molecular epidemiology of normal school children carrying group A streptococci and their clonal relationship through the combined application of the serotype of T antigen and Pulsed Field Gel Electrophoresis(PFGE). METHODS: A total of 88 strains of group A streptococci were isolated from 396 normal school children. All isolates were classified in groups by Streptex and serotyped by T. agglutination. Restriction enzyme digestion of DNA was taken using Sma I. DNA fragments were separated by PFGE. RESULTS: A total of 33 strains were allocated their epidemiologic characteristics. Four out of 33 strains were not restricted by enzyme(Sma I). Twenty nine strains out of 33 strains showed 12 subtypes with 8-12 fragments between 40kbp and 500kbp of DNA fragments on PFGE. Eight strains of NT and T6 war same fragment patterns on PFGE, respectively. Three strains out of 4 strains of T8/25 were not restricted and the other one showed different, unique patterns. One strain out of 8 stains of T12 was not restricted, and the others were classified as 5 different subtypes. Two strains of Tl were different patterns from each other, and 2 strains of T4 showed the samefragment pattern CONCLUSION: T serotypes with PFGE will be useful as a screening and molecular epidemiologic method in a country where anti-M antisera is not available, after recognizing the advantages and disadvantages of M and T serotyping.

Annual Report of the Central Cancer Registry in Korea-1998 (Based on Registered Data from 124 Hospitals) / 대한암학회지

PURPOSE: Central Cancer Registry Center in Korea conducted a nation-wide hospital-based cancer registry to provide the basic data on cancer statistics. MATERIALS AND METHODS: In 1998, 124 hospitals participated in the cancer registry program. All cancer registry data, submitted from the participating hospitals by diskettes during the year, were reviewed and sorted out by the committee members who were all board-qualified clinical oncologists and pathologists. To avoid duplication, every resident registration numbers were compared by the computer. Cases diagnosed by histologic examination were preferentially chosen. RESULTS: Of 89,226 cases registered, 9,163 (10.3%) duplication cases were excluded. Of the remaining 80,063 cases, 3,195 cases (4.0%) of carcinoma in situ (morphology code /2) were excluded. Finally 76,868 cases were analyzed. Of the analyzed cases, 44,037 (57.3%) were male and 32,831 (42.7%) were female. The leading age groups in the order of relative frequency were 60~64 years of age (15.3%), followed by 55~59 (14.4%). The leading primary cancer sites in the order of relative frequency were stomach (20.9%), followed by liver and intrahepatic bile ducts (12.2%), bronchus and lung (11.9%), colorectum (9.6%), breast (6.1%). In male, the leading primary cancer sites were stomach (24.4%), followed by liver and intrahepatic bile ducts (16.4%), bronchus and lung(16.0%), colorectum(9.2%) and urinary bladder (3.5%). In female, stomach (16.3%) was the most common site, followed by breast (14.1%), uterine cervix (13.0%), colorectum (10.1%) and liver and intrahepatic bile ducts (6.5%). Among the 1,190 cases of childhood malignancies, leukemia (33.4%), CNS tumor (15.7%) and sympathetic nervous system tumor (8.4%) were common. CONCLUSION: We analyzed and reported the registered cancer data from 124 hospitals during 1998.

Accuraey of Cancer Death Certificates in KOREA: A comparison between diagnoses in the central cancer registry and certified underlying causes of death / 대한암학회지

PURPOSE: We evaluated the accuracy of death certificates for persons who registered in the Central Cancer Registry in 1993 and died from 1993 to 1995. MATERIALS AND METHODS: The study consisted of 27,058 cases which were classified into five groups. according to the possibility of accuracy of the underlying causes of death. We compared the distribution of five groups according to several demographic factors. Also we calculated the detection rate and the confirmation rate for a selected 23,858 persons reported to die of a cancer. RESULTS: Among the 27,058 deaths, only 64.4% was included in the group which had reported the same cancer site with registry as underlying cause of death. The accuracy decreased with increasing age and was worse for women and rural residence. And physicians certification was an important factor to improve the accuracy. Cancers of stomach, lung, esophagus and breast were included into the high accuracy group, cancers of the colon, rectum and gallbladder and extrahepatic biliary tract into the low accuracy group. Cancers of the colon, pancreas, liver and lung were overreported, varied from 1.2 to 1.4 times, and cervical cancer was severely underreported, about 0.5 times. CONCLUSION: These results suggest that the caution in the use and interpretation of cancer certificate data would be required.

A Case of Hemolytic Disease of the Newborm due to Anti - Dib Antibody

The Diego blood group system consists of two pairs of antigens, Dia and Dib The incidence of Dia is low among pure Caucasian, Blacks, Polynesian and Eskimo, however, the rnongolians and American indians have both Dia and Dib. We report a case of two days old male who was admitted on first day of life for jaundice and subsquently exchange transfusion was performed on second day of life for bilirubin of 20 mg/dl. The blood groups of patient and his mother were both Rh D positive 0 type. Direct and indirect Coombstest were strong positive in the patient and indirect Coombstest was positive in his mother. We found anti-Dib antibody in his rnother's serum. The phenotype of Diego blood group system of the patient and his mother were Di (a+b+) and Di (a+b- ), respectively and hemolytic anemia in this case was due to anti-Dib antibody.

The Percentiles of Body Mass Index and Trend of Obesity in Schoolage Children in Seoul

PURPOSE: Many authors have reported that obesity is a serious health problem in schoolage children and adolescents and recently obese children are increasing. Accurate diagnosis is needed to estimate the prevalence rate and trend of obesity. We studied body mass index(BMI) percentile for age and sex as a reliable and valid screening for adiposity. METHODS: We measured weight and height of 33,329 schoolage children to estimate obesity according to body mass index(weight in kilograms/height in meters2) and different standard weight. We also calculated BMI percentiles according to age and sex. We defined obesity for screening purposes as body mass index(BMI) equal to or in excess of the 95th percentile for age and sex. We also compared the prevalence of obesity according to a different standard weight. RESULTS: The mean value of body mass index(BMI) increases with age and tends to be slightly higher for male than female subjects. The 95th percentiles of body mass index(BMI) ranges from 18.9kg/m2 to 28.2kg/m2 for both males and females. No significant differences were apparent in the mean value of body mass index for each year. CONCLUSION: The percentile curves of body mass index(BMI) will help pediatricians to determine the relative ranking of patients compared with large sample of healthy schoolage children. Further studies are needed to define a useful criteria for defining obesity using body mass index(BMI) in childhood and adolescence. A longitudinal study and nationwide sampling will be required to overcome the limitation of this cross-sectional study.

A Study of Reliability of Tympanic Temperature Measurement Using Infrared Thermometer ( Home Model ) in Neonates

PURPOSE: Taking an accurate and rapid body temperature can give a valuable information when taking care of neonates. The purpose of this study is to compare the reliability of taking rapid and less complicated means of measuring body temperature at tympanic membrane by infrared tympanic thermometer(Thermoscan IRT 1020, type 60005711, home model) with the standard method of taking body temperature at axilla and rectum by mercury thermometer. METHODS: Simultaneous rneasurements of tympanic membrane and axillary temperatures were taken followed by rectal temperatures within 5 minutes by 2 different investigators from 107 term infants One investigator measured tympanic membrane temperature by infrared tyrnpanic thermometer for 3 times and took the highest temperature as a final measurement and the other investigator took the axillary temperature for at least 5 minutes and rectal temperature for at least 2 minutes on each patient. RESULTS: Total of 107 term infants including 57 males and 50 females were subjects, The average body temperatures were 36.7+/-0.3degree, 37.0+/-0.4degree, 36.6+/-0.3degree for axillary, reactal and tympanic membrane, respectively. The correlation coefficients between axillary, rectal and tympanic temperature measurements were high at r=0.746- 0.804 and were statistically significant at P<0.001. CONCLUSION: We have shown from this study that taking tympanic membrane temperature can be used as an altemative and reliable means of taking body temperature in place of taking axillary and rectal temperature in neonates.

Changing Social Background Pattern of Children in Adoption Institutions(the 4th Report)

PURPOSE: A study was undertaken to assess the social background of abandoning children at adoption institutions. The results were compared to those of three previous reports from the institution. METHODS: A total of 536 children who had been admitted to the institution during the period of 1993 to 1996 were subjected to the study. The medical records were reviewed retrospectively. RESULTS: The sex ratio of male to female was 1 : 0.9, which was opposite compared to previous studies. Mean birth weight was 2.76+/-0.58kg. The proportion of prematurity was 27.2% and their mean gestational age was 34.0+/-2.25 weeks. The academic background of the mother was mainly high school, comprising 58.4%. The highest rate of maternal age(75.9%) was between 16 to 25 years of age. Maternal age below 15 years was 2.8%, which showed increased in tendency compared to previous studies. Classifying the mother's occupation, they were unemployed(19.4%), office workers(16.8%), store clerks(15.9%), students(13.6%), factory workers(12.3%) and waitresses (5.6%) in this order of frequency. The order of birth showed that the first baby was 89.4%. The reasons for putting their baby up for adoption were they were unmarried(83.2%), poor(8.6%), extramarital birth(3.2%), divorce(2.9%) and death of parents(0.4%) in this order of frequency, showing a significant increased in the rate of unmarried mothers. Only 38.4% of mothers had taken antenatal care. Most of the children (90.8%) were adopted by parents in foreign countries. CONCLUSION: The main reason for adoption was the mothers were unmarried and the maternal age tended to be younger. The rate of foreign adoption was still high.

Changing Social Background Pattern of Children in Adoption Institutions(the 4th Report)

PURPOSE: A study was undertaken to assess the social background of abandoning children at adoption institutions. The results were compared to those of three previous reports from the institution. METHODS: A total of 536 children who had been admitted to the institution during the period of 1993 to 1996 were subjected to the study. The medical records were reviewed retrospectively. RESULTS: The sex ratio of male to female was 1 : 0.9, which was opposite compared to previous studies. Mean birth weight was 2.76+/-0.58kg. The proportion of prematurity was 27.2% and their mean gestational age was 34.0+/-2.25 weeks. The academic background of the mother was mainly high school, comprising 58.4%. The highest rate of maternal age(75.9%) was between 16 to 25 years of age. Maternal age below 15 years was 2.8%, which showed increased in tendency compared to previous studies. Classifying the mother's occupation, they were unemployed(19.4%), office workers(16.8%), store clerks(15.9%), students(13.6%), factory workers(12.3%) and waitresses (5.6%) in this order of frequency. The order of birth showed that the first baby was 89.4%. The reasons for putting their baby up for adoption were they were unmarried(83.2%), poor(8.6%), extramarital birth(3.2%), divorce(2.9%) and death of parents(0.4%) in this order of frequency, showing a significant increased in the rate of unmarried mothers. Only 38.4% of mothers had taken antenatal care. Most of the children (90.8%) were adopted by parents in foreign countries. CONCLUSION: The main reason for adoption was the mothers were unmarried and the maternal age tended to be younger. The rate of foreign adoption was still high.

A Survey for the Hospital Utilization of Cancer patients in Inchon / 대한암학회지

PURPOSE: The purpose of this study was to evaluate the hospital utilization of cancer patients in Inchon and to assess the feasibility of Inchon Cancer Registry (ICR). MATERIALS AND METHODS: We used two data sources from Korean Central Cancer Registry (KCCR) and Korean Medical Insurance (KMI) for analysis. RESULTS: KCCR data analysis showed that 50.8% of cancer patients visited hospitals in Seoul, 46% visited hospitals in Inchon, and 2.6% in other areas at first visit. The analysis of KMI data showed that 43% of cancer patients visited hospital in Seoul, 38.5% visited hospitals in Inchon, and 18.5% in other areas at first visit. From these results, we found many cancer patients visited hospitals located in Seoul. We estimated that 52.1% would be missed when we performed cancer registry project in Inchon area alone from the KCCR data analysis. On the other hand, 60% would be missed from the KMI data. However, if we used registration data at the nation-wide level and actively registered cancer patient data in Inchan, expected unregistration rates would be 5%. CONCLUSION: Even though registration rate to KCCR was relatively low (74%) in Inhon and many patients were treated in other area, we are convinced that almast all cancer patients would be registered because most cancer patients visited at least one of the cancer registry hospitals at the nation-wide level. Therefore, if ICR used KCCR and encouraged the hospitals in Inchon to actively participate in cancer registration, the population-based cancer registration in Inchon would be possible.

The Significance of Plasma Potassium Level in Pseudohyperkalemia with Thrombocytosis / 대한소아혈액종양학회지

PURPOSE: As blood coagulates, potassium is released from cells, causing the concentration of potassium in serum to be slightly higher than that of plasma. We measured serum and plasma potassium levels simultaneously to evaluate the significance of plasma potassium especially in the patients with thrombocytosis. METHODS: The study was designed into two steps. To determine the relationship between platelet count and serum potassium level, the subjects of the first study were 140 children admitted to the National Medical Center (NMC) from January 1996 to June 1997. To determine the significance of plasma potassium level in pseudohyperkalemia with thrombocytosis, the subjects of the second study were 80 children admitted to the NMC from June 1997 to June to 1998. All of them are 1 month to 14 years old. RESULTS: 1) There was no relationship between the platelet count and serum potassium levels in the control group with platelet count from 150x109/L to 400x10(9)/L (r=0.07), but there was significant relationship in the group with platelet count above 400x10(9)/L (r=0.41, P<0.01). 2) As platelet counts increased, the differences between the serum and plasma potassium concentration increased (r=0.518, P<0.01). CONCLUSION: The clinician should pay attention to the possibility of the pseudohyperk alemia when there is thrombocytosis with hyperkalemia without specific hyperkalemic symptoms or EKG changes. Plasma potassium level will be helpful for the accurate assesment of potassium concentration.