1.Clinical consideration of patients with chronic liver diseases.
Tetsuo MORIMOTO ; Kinya MURATA ; Mitsuru SAITO ; Mitsuaki TAJIRI ; Minoru MIZUTA
Journal of the Japanese Association of Rural Medicine 1987;36(2):69-70
Patients with chronic liver diseases who were hospitalized into our clinic were studied. Chronic liver diseases consisted of three groups, namely chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Patients with peptic ulcer were studied as a control group. The mean age was the difference of 8.4 years between a group of chronic hepatitis and that of liver cirrhosis, but only 3.0 years between a group of liver cirrhosis and that of hepatocellular carcinoma. HBs antigen positive ratio was almostly same between a group of chronic hepatitis and that of liver cirrhosis, but about twice in a group of hepatocellular carcinoma. Ratio of hard drinker was lowest in a group of hepatocellular carcinoma, and therefore we considered that the effects of alcohol upon carcinogenesis were little. HBs antibody positive ratio was no difference among groups of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma.
2.A study on the influence of both drinking and smoking habits to a nutritional state of a whole body.
Tetsuo MORIMOTO ; Kinya MURATA ; Mitsuaki TAJIRI ; Yukinori OKAZAKI ; Minoru MIZUTA
Journal of the Japanese Association of Rural Medicine 1990;38(5):1030-1033
We gathered information of both drinking and smoking habits by questionnaires. Objects of our study were 246 male cases around Yanai City. These cases were divided into six groups. The 1st: less than 20 grams of ethyl alcohol daily and less than 10 cigarettes daily (56 cases). The 2nd: 20 grams and less than 10 cigarettes (39 cases). The 3rd: more than 40 grams daily and less than 10 cigarettes (36 cases). The 4th: less than 20 grams and more than 10 cigarettes (36 cases). The 5th: 20 grams and more than 10 cigarettes (23 cases). The 6th: more than 40 grams daily and more than 10 cigarettes (56 cases).
The 1st group was a control group, and was compared among the 4th, 5th and 6th group. Consequently obesity index and serum total protein level were decreased signifiacantly in the 5th and the 6th group. There were no significantly different items in the 4th group. It was thought that both drinking and smoking habits suppressed a nutritional state of a whole body.
3.Clinical findings of patients with liver cirrhosis and minute hepatocellular carcinoma in rural district.
Tetsuo MORIMOTO ; Kinya MURATA ; Hiroko SAKIYAMA ; Mitsuaki TAJIRI ; Minoru MIZUTA ; Kiyoshi SHINTANI ; Toshihiro KANEYUKI
Journal of the Japanese Association of Rural Medicine 1986;35(4):779-786
During the past five years, 141 cases of liver cirrohosis were hospitalized intoour clinic. The mean age of these patients was 57.8 years old, and the ratio of male to female was 2.8 to 1. HBs antigen was positive in 16 cases, and among the patients without HBs antigen 49 cases of heavy alcoholic drinker were found. Seventy patients with liver cirrhosis were dividedinto a compensatory group and a decompensatory group according to three clinical findings, ascites, hepatic encephalopathy and bleeding from gastrointestinal tract. It was suggested that five items of biochemical data for liver function were very important on discriminating these two groups. The five items were cholinesterase, indocyanine green test, albumin, prothrombin time and erythrocyte count.
Next, we studied clinical findings of eight patients with minute hepatocellular carcinoma hospitalized into our clinic during the past five years. About a definition of minute hepatocellular carcinoma, we have defined that the tumor size should be less than 3 cm in diameter. Six of these patients were male, and average age was 56.7 years old. Of these patients, five were complicated by liver cirrhosis, and only one revealed positive HBs antigen in serum. The serum alpha-fetoprotein level showed more than 400 ng/ml in three patients. And we have thought that ultrasonographic examination is most effective to diagnose minute hepatocellular carcinoma in various diagnostic imaging methods. Most of patients exhibited a decreased functional reserve in the liver, but six patients underwent hepatic resection. After operation, one patient died of acutehepatic insufficiency on the 8th day, and one died of the recurrence of tumor on the 11th month. Otherfour patients have been alive now.
4.Study on Clinical Findings of Patients with Minute Hepatocellular Carcinoma
Tetsuo Morimoto ; Yutaka Hatano ; Yuji Nagatomi ; Hiroko Sakiyama ; Mitsuaki Tajiri ; Kinya Murata ; Minoru Mizuta
Journal of the Japanese Association of Rural Medicine 1984;32(5):978-981
Thirteen patients with primary hepatocellular carcinoma less than 5 cm in size were seen in our clinic during the past four years. Clinical data of these patients were evaluated to clarify the clinical significance of minute hepatocellular carcinoma. Eleven of these patients were male, and average age was 58 years old. Of these patients, ten (77%) were complicated by liver cirrhosis, and only one revealed positive HBs antigen in serum. The serum alpha-fetoprotein level showed more than 400 ng/ml in five patients (38%). And we thinked that ultrasonographic examinations were most effective to diagnose minute hepatocellular carcinoma in various diagnostic imaging methods.
Most of patients exhibited a decreased functional reserve in the liver, but seven patients underwent hepatic resection. After operation, one patient died of acute hepatic insufficiency on the 8th day, and one died of the recurrence of tumor on the llth month. Other five patients have been alive now.
It is suggested that the survival time of patients with minute hepatocellular carcinoma is fairly influenced by the condition of accompanied liver cirrhosis
5.Clinical study on a comparison between the compensatory and decompensatory stage of patients with liver cirrhosis.
Tetsuo Morimoto ; Ryosuke Omura ; Fujio Murakami ; Yuji Nagatomi ; Hiroko Sakiyama ; Mitsuaki Tajiri ; Kinya Murata ; Minoru Mizuta ; Kenichi Nakamura
Journal of the Japanese Association of Rural Medicine 1984;33(4):786-790
Seventy patients with liver cirrhosis hospitalized into our clinic were divided into a compensatory group and a decompensatory group according to three clinical findings, ascites, hepatic encephalopathy and bleeding from gastrointestinal tract. It was suggested that five items of biochemical data for liver function were very important on discriminating these two grops. The five items were cholinesterase, indocyanine green test, albumin, prothrombin time and hematocrit.
We have tried to devise a new staging system for liver cirrhosis by scoring method using the five items. According to the total score calculated from scoring method, clinical stages were divided into four such as stage I, stage II, stage III, and stage IV. It was suggested that cases of stage III had to be treated very carefully.
Liver and spleen volume of patients with liver cirrhosis were calculated by computed tomography. It was suggested that liver volume/spleen volume ratio was very important on discriminating these two groups.