Background
: Primary hepatocellular carcinoma(HCC) is the second cause of cancer death in our country. Hepatitis B virus(HBV) and hepatitis C virus(HCV) are important risk factors for hepatocellular carcinoma. The mechanism of HCC development and the epidemiology in HCV- infected individuals are still unclear. In this study, we investigated the epidemiolgical and chilnical features of HCC in relation to viral infection.

Methods : We reviewde the medical records of 160 HCC patients retrspectively who had been admitted to one University Hospital located in Seoul between January 1991 and December 1995. Among theses patients, 113 patients were positive for HBsAg(B group, 24 for anti-HCV(C group). We compared epidemiological and clinical data between B group and C group.

Results : Anti-HCV positivity was significantly higher in HBsAg negative patients than in HBsAg positive patients(53.3:17%, p<0.01). The mean age of patients in B group was significantly lower than that in C group(52:62yr, p<0.01). In C group, the proportion of Child-Pugh class B and C was significantly larger than that of B group(35.4:75.0%, p<0.01). In C group, the proportion of transfusion history was significantly larger than that in B group(4.4:16.7%, p<0.05), and the proportion of drug abuse hestory was significantly larger than that in B group(31.0:62.5%, p<0.01). In C group, the albumin, cholesterol, Gamma-glutamyl transferase leves were significantly lower than those in B group. In B group, the proportion of metastasis was significantly larger than that in C group(31.9:4.2%, p<0.01). Alpha fetoprotein levels greater than 400ng/ml are much more prevalent in group B significantly(67:39.1%, p<0.05). No significant differences in cumulative survival rate(1yr, 2yr) and median survival time were observed between the two groups.

Conclusion : We ascertain that the HBV and HCV are inportant factors in HCC. In epidemiology and clinical features of HCC, there were some difference between the HBsAg and anti HCV positive group. Therefore, on primary health care settings, it is necessary to test for hepatitis C as well as hepatitis B in order to prevent and manage HCC and chronic liver desease.

Background
: After the first public exposure to child abuse case in 1975, the seriousness of the case was raised by the first child abuse investigation which took place in elementary schools in seoul in 1986. Thereafter, 'Korean Association for the Prevention of Child Abuse and Neglect' was formed and conducted studies on child abuse. We, as family physicians, recognized the seriousness of the child abuse as a case of family violence, and conducted the following study with interest in the prevention and treatment for child abuse.

Methods : The survey was carried out in June, 1995 and the total number of investigated groups was 944 of elementary school students of 5th and 6th grade and they were 302 students in Taegu, 367 students in Gumi, 275 students in Samcheonpo. We analyzed 944 replies from our questionnaire that included battering degree, family structure and characteristics, parents job and eduation level, battering aspects, family violence, sexual abuse and APGAR SCORE.

Results : In our study, it was analyzed with no battering(15.4%), mild battering(76.9%), severe battering(7.7%). In comparison with community, 5.9% in largest urban city, 8.2% in industrial city, 9.1% in rural area showed the case of severe battering. Therefore, the children living in urban were less exposed in severe battering case than male(P=0.000). In comparison with APGAR SCORE, among 92 children whose score 0~3, 13% were exposed, and among 533 children whose score 7~10, 42% were exposed in severe battering case. Therefore, in the lower APGAR score group, battering child is more common(P=0.000).

Conclusion : In the occasion of considering child who is severely battered as child abuse group, its prevalence is very high. As a family physician who is charged with primary care, we care patients with interest in family violence and child abuse. In case APGAR score of child is low, we consider any possibility of child abuse and must show our continuous effort and study for prevention and treatment of child abuse.

Background
: Recently the elderly population have increased speedly, medical people are highly ineerested in health of the elderly. So, this study was executed to investigate dermographic characteristics of depression in the elderly.
Mothods : From March 1 to July 30 in 1994, the questionaires were distributed to 200 elderly people who were 65 years old or more and lived in urban and rural areas. Jerome A.Yesavage's Geriatric Depression Scale was used to know about the depression scale, and one can get every 1 point about 15 items. the group was divided into two groups. One was normal group which got from 0 point to 5 point, the other was depression group which got 6 points or more. Sex, religion, education level, occupation, living place, economic status, physical illness were studied. We performed sratistical analysis among the results by means of chisquare test and Chisquare trend test.

Results : There were 131 elderly who had depression among 200 elderly. In case of the older, separated, no occupation, the more retired years, the lower education level, the worse economic status, the smaller spending money per month, the lower of satisfaction degree about the spending money per month and the suporter was their offspring, the difference between Depression scale are 6 over and 5 below was statistically significant(p<0.001) and elderly female was also statiscally significant(p<0.05). There was no statiscally significant difference between depression scale are 6 over and 5 below in case of religion, living place, physical illness.

Conclusion : Depression of the aged are common illness, but it is a rare case that they see the doctors because of symptom.. Therefore, the primary care physician who take the primary care has to have concept about the factors influencing depression of the aged. I think it will be very helpful to the practice of the aged that use GDS as a screening test about the depression of the aged.