Clinical study on a comparison between the compensatory and decompensatory stage of patients with liver cirrhosis / 日本農村医学会雑誌

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.<BR>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.<BR>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.

Study on Clinical Findings of Patients with Minute Hepatocellular Carcinoma / 日本農村医学会雑誌

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.<BR>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.<BR>It is suggested that the survival time of patients with minute hepatocellular carcinoma is fairly influenced by the condition of accompanied liver cirrhosis