Background: s/Aims: Patients with hepatocellular carcinoma (HCC) and histologically confirmed F4 cirrhosis often have limited hepatic reserve, making major hepatectomy difficult. Although laparoscopic liver resection is increasingly performed, its perioperative safety in this setting remains unclear. This study compared laparoscopic and open partial hepatectomy in these patients using propensity score matching (PSM). Methods: Among 298 patients who underwent hepatectomy for HCC between 2006 and 2023, 112 with histologically confirmed F4 cirrhosis who underwent partial hepatectomy were included (laparoscopic, n = 60; open, n = 52). PSM was performed using previous liver resection, difficulty score, tumor size, tumor number, and platelet count, yielding 32 matched pairs. Outcomes included operative time, blood loss, transfusion requirements, complications, hospital stay, posthepatectomy liver failure (PHLF), R0 resection rate, and 30-day mortality. Results: After matching, intraoperative blood loss was significantly lower in the laparoscopic group than in the open group (50 mL vs. 295 mL, p < 0.001). Operative time, transfusion rate, complication rate, R0 resection rate, and 30-day mortality were comparable between groups. Hospital stay was significantly shorter in the laparoscopic group (13 vs. 22 days, p < 0.001). Grade A PHLF occurred in one patient in the open group, with no significant between-group difference. Conclusions In patients with HCC and histologically confirmed F4 cirrhosis, laparoscopic partial hepatectomy was associated with less blood loss and shorter hospital stay than open surgery, without increasing perioperative morbidity. It may be a safe option in carefully selected patients undergoing limited liver resection.

We experienced a case of severe alcoholic hepatitis. Combination treatment of continuous hemodiafiltration and steroid hormone was started immediately after admission. This treatment was very effective for severe alcoholic hepatitis, resulting in the shortening of the length of hospital stay. The reasons why this treatment was effective were; 1. The patient was younger, so the regeneration ability of liver cells was stronger. 2. The infection and bleeding of digestive organs except for acute renal failure were not found, resulting in the enhancement of the effectiveness for steroid hormone treatment. 3. The intensive blood purification treatment was started immediately. From this experience, we realized again that a fine collaboration of doctors, nurses and clinical engineers was very important in the intensive care of the severe diseases.
therapeutic aspects ; Steroid hormone, NOS ; Hepatitis, Alcoholic ; Combined ; Review [Publication Type]

A 16-year-old girl with aortitis syndrome under treatment with a low dose of prednisolone was admitted because of severe headache and intermittent claudication. Angiography revealed diffuse stenosis of the thoracoabdominal aorta and the bilateral renal arteries. Extra-anatomical bypass grafting from the ascending to the abdominal aorta was first made with a 14mm woven Dacron graft through a midline sternolaparotomy. Bilateral renal arteries were difficult to dissect due to periarterial adhesion. Bypass grafting for the left renal artery could be performed with a 5mm external velour wrap-knit Dacron graft (Sauvage, Bionit); however, the right renal artery was so thin that bypass was made with a 4mm EPTFE graft which was demonstrated to be occluded by follow-up angiography 3 years after surgery. The postoperative course has been uneventful and she has been free from symptoms up to now. The good long-term function of the bypass graft from the ascending aorta holds promise for diffuse coarctation of the thoracoabdominal aorta due to aortitis syndrome.

1) The molluscicidal effect of 10 agricultural chemicals which are commonly usedby farmers in Saitama Prefecture was tested experimentally against A. ollula in the laboratory. The snails were made to contact with chemical solution for 48 hrs. at 23-25°C, then transferred to new containers with fresh water. The death rate was observed after 1 more hr.
LC₅₀ value of Saturn emulsion (Benthiocarb 50%), Saturn-S granule (Benthiocarb 7%, Simetryne 1.5%), MO emulsion (CNP 20%), NIP emulsion (NIP 25%), Sumithion emulsion (MEP 50%), Baysid emulsion (MPP 50%), Disiston granule (Ethylthiometon 5%), Bassa emulsion (BPMC 50%), Kitasin-Pemulsion (IBP 4%), and Lime nitrogen granule (CaNCN 21%) were 13.0, 92.5, 24.8, more than 50, 16.5, 13.5, more than 500, more than 50, more than 50 and 360 ppm. respectively, all figures were far larger than the doses in practical use for each chemicals. So it can not be expected that these chemicals would be effective against the snail in the ordinally practice.
2) Themolluscicidal effect of Lime nitrogen granule was also investigated with the snail in the paddy field where this fertilizer had been applied at an ordinally dose that is 2 Kg per are., 5 days prier to the test. The snails were introduced into the paddy and the mortality rate was observed 1, 2 and 3days after the introduction. The mortality rates of the snails at each day were 7.5%, 11.0% and 12.9% respectively. In the untreated field these figures were 7.0%, 14.9% and 4.4%.
It was concluded that Lime nitrogen granule was not effective against the snail at the ordinally dose for the use for fertilizer.

An endemic dermatitis of unknown etiology has occurred among farmers working in paddy fields in the eastern area of Saitama Pref. In view of the results of the epidemiological and clinical observations, it was anticipated that the dermatitis might be caused by a bird schistosome (Ozu et al., 1972).
Thus, the research for snail intermediate hosts was carried out in the paddy fields as well as in the laboratory. Snails from the fields were placed in containers in which they could be checked for the shedding of cercariae. As a result, a species of furcocercous cercaria was obtained from Austropeplea (Lymnaea) ollula. The cercaria was identified as species belonging to the genus Trichobilharzia on the basis of the flame cell pattern, the behaviour, the responses to light and the detailed morphology of living and preserved specimens.
In order to determine the dermatitis-producing properties of the cercaria, an experimental infection with the cercaria into the human skin was performed.The cercaria invaded into the human skin and produced a dermatitis quite similar to that prevailing in the endemic area.
On the basis of the results from this study, the paddy field dermatitis occurring in the eastern area of Saitama Pref.was proved to be caused by the invasion of the cercaria belonging to the genus Trichobilharzia into the human skin.It was also proved that A.ollula served as the snail host of the cercaria.

A dermatitis of unknown etiology has occurred among farmers working in Chichibu City, in north-west of Saitama Prefecture from 1970 to 1972.
The dermatitis exhibited clinical, manifestations quite similar to a already known bird schistosome.dermatitis being characterized by erythemato-papulo-vesicular eruptions accompanied with severe itching on the parts exposed to the water, especially legs and arms.
Survey on the snail intermediate hosts were undertaken in the paddy fields and a species of furcocercous cercaria was found from Polypylis hemisphaerula.The incidence of the snails infected with the cercariae was 3.2%.The cercaria resembled to that of Gigantobilharzia struniae in size and shape.
The cercaria invaded into the human skin within 30 minutes after being put on a part of the surface of skin and caused a pinpoint-sized red maculae and tingling itching.
From these results, the paddy field dermatitis occurring in Chichibu City was proved to be caused by the invasion of the cercaria into the human skin, which differed from that served as causative organism of the dermatitis occurring in the eastern area of Saitama Prefecture.

A dermatitis of unknown etiology has occurred among farmers working in paddy fields in the eastern area of Saitama Prefecture (Ozu et al., 1972). And it was proved to be caused by the invasion of a bird schistosome cercaria shed from Austropeplea ollula (Suzuki et al., 1973).
In an attempt to dertermine the final host of this schistosome, a survey on the wild birds was undertaken in the endemic area. But, no natural infection was found in 8 Corvus corone, 7 Sturnus cineraceous, 5 Egretta garzetta, 4 Nycticorax nycticorax, 8Anas platyrhynchos, 7 A. crecca and 170 A. poecilorhyncha.
Experimental infections with the cercariae were performed using domestic ducklings and canaries, and a bird schistosome egg could be found in feces of the domestic ducklings 20 days after the infection. The egg was crescent-shaped and the miracidium was clearly seen within.
Based on the results of the experimental infections, the most probable final host of this schistosome in Saitama Prefecture was supposed to be the anatid birds.