Comparative studies were made mainly on malignant cases of cholelithiasis in 111 patients with gallstones detected in our regular chekup (group A) during the five-year period from 1985 to 1989 and 67 patients who had gallstones surgically removed together with malignancies (group B) during the same period.
The group A patients representing 4.2% of the total 2, 637 examinees were suspected to suffer from biliary obstruction and malignant tumors involving the digestive system. However, further examination found only one case of biliary tract cancer.
The group B patients account for 20.9% of the total 321 surgery cases. In 37 (55.2%) of the 67 patients, 45 legions were malignant-mostly cancer in the digestive organs. Cancer of the lower portion of the digestive tract was found in 11 patients (29.7%) of the 37. The occult blood test at hospitalization revealed that 8 patients (28.6%) in 28 were positive, and 9 were not clear. Follow-up examination showed the rate of false-positive reaction to blood test stood at 14.3%.
From the foregoing results, to detect cancer of the large intestine at an early stage in the regular medical checkup sponsored by the agricultural cooperative, the occult blood test using the stool of examines alone is not enough. It is high time to introduce endoscopic examinationinto the screening program. In view of the fact that most of the gallstone cases detected at the regular checkup were symptomless, careful followup examinations are deemed necessary with the possibleonset of gallbladder cancer and presence of malignancies in mind.

Objective: The wrong dose of high-risk drugs such as oral steroids is a serious issue that needs to be addressed. This study aims to determine the appropriate upper tolerable dose threshold and to develop a multi-variable logistic regression model to detect dose-errors in oral prednisolone tablets.Methods: Data on Prednisolone prescriptions were obtained from a single center. Out of the data collected, positive cases consisted of cases where dose-related modifications were made. A univariate logistic regression model was developed with the current daily dose. In the model, the Youden Index was used to determine the upper tolerable dose threshold. The investigation was done to determine whether the performance of the multivariate model was improved by adding clinical department and previous prescription information as variables.Results: Univariate models (AUC: 0.645) with only current daily doses and estimated optimal thresholds of 6 mg/day or 11 mg/day, respectively were determined to be appropriate. Including variables improved the performance of the predictive model; the best performing model (AUC: 0.840) was derived when the following variables were entered: “current daily dose,” “current prescription days,” “clinical department,” “daily dose of the previous prescription,” and “prescription days of the previous prescription”.Conclusion: A single upper tolerance limit is insufficient to determine dose adequacy for prednisolone tablets owing to their broad clinical dose range. Itmay be possible to develop a high-performance dose audit support model by adding information.