Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 104 , Issue 3
Showing 1-11 articles out of 11 articles from the selected issue
Review article
Monthly report; Hepatic Encephalopathy
Original article
  • Takeshi ISHIKAWA, Takashi ANDO, Tsuguhiro MATSUMOTO, Mika OKITA, Eiko ...
    2007 Volume 104 Issue 3 Pages 357-363
    Published: 2007
    Released: March 05, 2007
    Based on the results of a retrospective review of clinical data on inpatients with ischemic colitis treated at our hospital, we created a clinical pathway and evaluated its usefulness. We used the clinical pathway for 21 inpatients, and the patient who fulfilled the criteria consisted of 18 inpatients. The fasting period after the onset and the duration of hospitalization were compared with those of 60 patients before implementation of the clinical pathway. The fasting period after the onset before and after implementation were 6.20± 3.42 days (mean± SD), and 5.28± 1.27 days, respectively. The duration of hospitalization before and after implementation was 10.37± 7.32 days, 8.37± 2.89 days, respectively. The clinical pathway is useful for shortening the duration of hospitalization, enhancing the uniformity of treatment and controlling the treatment risk.
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  • Erika INADA, Yuji KATAHIRA, Mamiko MATSUNAGA, Susumu AMANO, Goro SATO, ...
    2007 Volume 104 Issue 3 Pages 364-372
    Published: 2007
    Released: March 05, 2007
    Tomiura, a rural area of Chiba Prefecture in which community-based HCV screening has been carried out since 1991, is known as a high-incidence area of HCV. This study was conducted to clarify the clinical characteristics of subjects with positive HCV antibody titer found on mass survey, in relation to the development and outcome of hepatocellular carcinoma. We analyzed clinical data of patients with positive HCV antibody test results followed up for 9 to 11 years after the mass survey examinations. Among 171 patients, we identified 23 cases (13.5%) of hepatocellular carcinoma in a 9-year period. Correlations have been identified between the occurrence of hepatocellular carcinoma and those factors including gender, aminotranseferase levels, platelet count and ultrasound findings at the time of the first health screening, as well as patterns of fluctuation in aminotranseferase levels during the follow-up period. Among those patients with hepatocellular carcinoma, 11 patients survived for more than 5 years. The survival period has been found to be related to AST level at the time of first health screening, the findings in ultrasound scanning when the carcinoma was initially identified, and patterns of fluctuation in aminotranseferase levels subsequent to the first diagnosis.
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  • Shunji ARIKAWA, Masafumi UCHIDA, Masaharu SHINAGAWA, Jun UOZUMI, Naofu ...
    2007 Volume 104 Issue 3 Pages 373-380
    Published: 2007
    Released: March 05, 2007
    Thirty patients with intraductal papillary-mucinous tumor (IPMT) of the pancreas underwent multidetector-row CT (MD-CT) in addition to endoscopic retrograde pancreatography (ERP), and, in 27 cases magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS). The usefulness of MD-CT was investigated by comparing various imaging methods of the communication from the main pancreatic duct (MPD) to patulous/bulging papilla in addition to the indices for benign or malignant disease, the degree of dilation of the MPD, localization and size of cystic lesions, and presence or absence of neoplastic lesions, such as thickened walls and septa, intramural nodule, solid mass. With MD-CT, dilation of the MPD and localization and size of cystic lesions were accurately assessed, even in patients with obstruction of the main pancreatic duct in whom ERP was difficult to perform regardless of the presence or absence of massive amount of mucus. MD-CT with reconstructive imaging, such as MPR imaging and CPR imaging, allowed us to assess communication with the MPD and patulous/bulging papilla easier than MRCP. In our study, MD-CT was useful in the evaluation of thickened walls and septa that are predictive factors of malignancy in IPMT.
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Case Report