Background
: Serum alpha-fetoprotein(aFP) is a useful diagnostic test on hepatocellular carcinoma(HCC) However, it is still questionable appropriate screening test or not

Methods : A total of 24,050 patients who visited the General Health Screening Center of Asan Medical Center from June, 1993 to June, 1994, were reviewed by chart and telephone survey. Among them 70 cases where serum aFP were elevated > 20ng/ml and 16 cases where HCC was suspected by abdominal ultrasonogram were selected and investigated for the existence of HCC. Four groups were divided into HBsAg(+), Anti-HCV(+), increased AST/ALT(abnormal LFT) and normal group. Each group was evaluated for sensitivity, specificity, positive, predictive value and negative predictive value of serum aFP for HCC.

Results : The prevalence of elevated aFP was 0.29%(70/24,050). There was a statistically significant difference between sexes. And the total number of HCC as 10 cases (42/100,000). With aging, the prevalence of HCC was increased. The prevalence rate pf elevated serum aFP and HCC had significant difference in anti-HCV(+), HBsAg(+) and abnormal LFT group compared to normal group(sGOT < 40U/1, HBsAg(-) and Anti-HCV(-)) (P<0.01).
In our study, sensitivity and positive predictive value of serum aFP for HCC were 100% and 14% in anti-HCV(+) group, 83.3% and 8.6% in abnormal LFT group, 80% in HBsAg(+) group, and 0% in normal group, respectively.

Conclusion : Serum aFP as a screening test for HCC in asymptomatic healthy people does not seem to be not valid. But it seems to be appropriate when it is applied for cases of abnormal LFT(sGOT >40U/1 or sGPT > 40U/1), HBsAg(+) and Anti-HCV(+) people.

Background
: Not only the drug therapy. But also diet & exercise therapy have to be done in the control for NIDDM patients. But the control of DM is dependent on how much the patients practice it. Therefore authors surveyed knowledge & practice about DM diet & exercise of NIDDM patients.

Methods : We serveyed 104 NIDDM patients who visited family medicine outpatient offices of two tertiary hopital & internal medicine outpatient office of one secondary hospital located in Seoul from June, 1994 through september, 1994. The questionnaire consisted of the patient's general charac-teristics, family environment, attitude toward DM management, exercise, diet education knowledge and degree of practice.
Result : The patients consisted of 58(55.7%) men and 46(44.2%) women. The mean age of men patients was 53 years, and that of women patientswas 56 years. The average duration of the disease was 4.4 year. The number of patients who had participated in DM education was 56(53%). The number of patients who thought the diet therapy was important was 86(85%) The patients who thought it was not important was 4(3.9%). Those who didn't think about it was 11(10%). The number of patients who thought the exercise was important was 92(90%). The patients who thought it was 7(6.8%) The number of patients who practiced diet therapy well was 13(12%). The patients who didn't practice it well was 89(88%). The most common reason why they didn't practice was that it was too hard to practice actually. The number of patients who exercised well was 36(34%), and who didn't exercise well was 67(64%). the most common reason why they didn't practice it was that it was too bothersome to exercise. In the cases of family members concerned to the patients management, the patients practiced diet well. But it was not related with DM education, knowledge about DM and academic background of patients. In the cases of family members' concern with the patients management and in the cases of men, the patients patients practiced exercise.

Conclusion : Nearly half of NIDDM patients never participated in DM education. The patients knew well about how immportant DM diet & exercise was, but they didn't practice it. therfore reinfor-cement in education programs for behavior modification is needed. support from family menbers is needed because their role in managment of DM patient is important.