Although it is ideal that a hospital has full-time radiologists for image diagnosis, it is quite difficult to retain a full-time radiologist in a small hospital because of a shortage of radiologists. In our hospital, CT films were formerly sent to the hospital that had full-time radiologists by mail and diagnostic information was obtained a few days later. Since May 2003 we have introduced teleradiology using SECOM HOSPI-NET system. We transmit a diagnostic request form and CT images using ISDN line. We receive a diagnostic message on the following day. We are able to gain diagnostic information timely. Therefore, we report the usage, reliability, and user-friendliness of this system in comparison with the mailing system from the aspect of responsiveness, economical efficiency, and operating efficiency.
Hospitals ; NET questionnaire ; System ; Teleradiology ; X-Ray Computed Tomography

Alpha-fetoprotein-Producing gastric cancer is associated with poor prognosis because of frequent liver and lymph node metastasis. We present a case with synchronous liver metastasis who survived for 5 years. A 69-year-old man with upper abdominal pain was referred to our hospital. Gastrointestinal endoscopy revealed a Borrmann II-like tumor in the lower part of the stomach. Computed tomography revealed a tumor in the left lobe of the liver. Serum alpha-fetoprotein levels were markedly increased. We performed distal gastrectomy after administering oral tegafur/gimeracil/oteracil potassium and administered hepatic intra-arterial cisplatin injection. Liver metastasis showed partial response on computed tomography. Despite left hepatic lobectomy, further metastases to the liver and mediastinal lymph nodes became difficult to control. After sorafenib tosylate administration, stabilization of the disease was observed for 4 months. We conclude that hepatic intra-arterial chemotherapy and oral administration of sorafenib tosylate may potentially improve the prognosis in such cases.
Abdominal Pain ; Administration, Oral ; alpha-Fetoproteins ; Cisplatin ; Endoscopy, Gastrointestinal ; Gastrectomy ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Niacinamide ; Phenylurea Compounds ; Potassium ; Prognosis ; Stomach ; Stomach Neoplasms