RESUMEN
With the aim of increasing efficiency of paper work attendant on traveling health screen-ings, notifying examination results expeditiously and dispensing with individuals' health sheets, an on-the-spot input system using portable personal computers has been introduced through cooperation from 10 town and village offices. Every examinee is given an interview chart (ticket?) with a bar cord containing his or her ID number printed on it. At each examination unit, the bar cord is read by PC and the identity of the examinee and items for examination (required) are confirmed. Measurements of height and weight, and results of urinary and visual acuity tests are inputted by a bar-cord handy terminal. For blood testing and stool examination for occult blood, the numbers of samples are automatically registered into the PC at the reception desk by way of an optical transmission unit. For ECG and ophthalmoscopy (fundus-copy), reference numbers are given at the interview server. Information gained in the interview is entered into the PC at the interview room and then the information-packed floppy disc is sent the reception desk for storage in the PC. Film numbers of stomach and breast X-rays are also registered into the PC at the reception desk. Thus, all the information is stored by the PC at the reception desk. After checking and confirmation are done, a daily report is made. Upon return to the hospital, all the data are transmitted to the hospital's central computer through the in-house network (local area network). Before the introduction of the new system, the registration of the data garnered by a one-day mass health examination in the out-of-hospital setting took about 10 days, but it is now done within the day. It has also become possible to report the results of examination in two weeks.
RESUMEN
Introduction. The principal therapy for gallstones was open cholecystectomy. Recently, however, with remarkable advances in laparoscopic surgery on the biliary tract in particular, laparoscopic cholecystectomy has become preferred treatment for symptomatic cholelithiasis. To assess our experience in surgical treatment for gallstones and determine the best method to reduce postoperative discomfort, cases of cholecystectomy performed in our institution were reviewed.<BR>Patients.-During the past 14 years, 524 patients were treated for cholelithiasis (cholecystolithiasisin 412, choledocho-cholecystolithiasis in 75, choledocholithiasis in 36, intrahepatic stones in 1). The ratio of men to women was 1: 1.7 and the average age was 61 years. Results.-Only cholecystectomy was performed on 86% of the patients with cholecystolithiasis and 91% had accompaning open surgery with laparoscopic cholecystectomy in latest years. Open cholecystectomy by inserting a T tube was done on 61% of choledochocholecystolithiasis cases. In some cases papilloplasty and/or choledochoduodeno or choledochojejunostomy followed. Almost all patients with choledocholithiasis had open cholecystectomy with T-tube insertion and additional procedures to remove stones in thebiliary tract in earlier years. In these years, no more addidional procedures except for choledochotomy with T-tube insertion had been performed in any cholelithiasis cases.<BR>Conclusions.-Laparoscopic cholencystetomy is a safe and effective procedure and should be preferred for symptomatic cholelithiasis except for cases with acute cholecystitis, common bile duct stones, gallbladder cancer and other severe complications.