The human rotavirus in adult diarrhea cases was evaluated in 109 cases during 12 months, 1996. Rotavirus antigen was identified, using the ELISA technique, in stool samples in 23 cases (21%). We arranged the positive cases as rotavirus-associated gastroenteritis in adults and analyzed them. Fourteen out of them (74%) occurred from June through September. Fourteen cases (74%) needed to be hospitalized. Colonoscopy revealed some inflammatory changes in 9 out of 16 cases (47%). Most of symptom was watery diarrhea, but bloody diarrhea was observed in 6 cases (32%). It was suggested we should introduce a concept of rotavirus-associated gastroenteritis in adults.
The aim of this study was to clarify factors influencing the induction of remission and to compare the short term remission rate of EN with that of TPN. From 1985 to 1992, 87 active patients treated for more than 4 weeks with EN and 71 active patients treated with TPN were analysed. Excluding the case with severe complications (abdominal abscess, external fistula, sub-ileus), 132 patients were divided to two groups (patients with remission and non-remission) based on clinical response to the treatment. Remission was defined as Crohn's disease activity index (CDAI) <150 and ESR < 20mm/hr after 4 weeks of treatment. Clinical characteristics and radiographic findings were compared between the two groups. Furthermore, a multiple logistic regression analysis was performed to clarify the relative importance of various clinical or radiographic factors associated with remission. Remission rate at four weeks with EN was 77% and that with TPN was 62%. By a multiple logistic regression analysis using 15 factors, which were significant by a single variable analysis, four factors (times of previous nutritional treatment, IOIBD, WBC, polyposis score of the colon) in EN cases and three factors (ESR, platelets, extent of Crohn's disease) in TPN cases were selected as independent prognostic factors after adjusting for the effect of other factors. Moreover, mode of therapy was not selected as a valuable factor. From the above mentioned results, it was concluded that EN and TPN were equivalent in the efficacy of short-term therapy and patients having had several previous nutritional therapy, high IOIBD score, high WBC count, severe cobblestoning of the colon were tended to be resistant to EN therapy and high ESR value, high platelet count, broader extent of Crohn's disease were tended to be resistant to TPN therapy. Both clinical and radiographic features are important prognostic factors in predicting response to nutritional therapy.
To assess regional differences in the etiology of liver cirrhosis in Iwate, we analyzed 324 patients with liver cirrhosis treated at various hospitals. The etiology was HCV 44.8%, HBV 11.1%, HBV+HCV 4.6%, alcohol 27.5% (including heavy drinkers 17.9%), PBC 1.5% and non-B non-C 10.5% in Iwate. The incidence of alcoholic cirrhosis was higher than that in other prefectures, while that of HCV was lower. Especially in the northern area of Iwate, the rate of alcoholic cirrhosis was very high (39.1%—including heavy drinkers 21.8%) while viral cirrhosis was relatively low. Although the alcohol consumption volume in Iwate was not very high, marked alcohol consumption, especially shochu, was observed in the northern area of Iwate. The volume and kind of alcohol consumed in each area differed, and the etiology of liver cirrhosis differed regionally in Iwate. Thus, we should consider these districts and levels of alcohol consumption when treating patients with liver cirrhosis.