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Nineteen patients with liver abscess were treated in our department over a period of 14 years. The cause of the liver abscess was biliary disease in 13 of the 19 or 68%, and 8 of these 13 patients had undergone surgical procedures. The 13 patients with liver abscess received both percutaneous transhepatic abscess drainage (PTAD) under ultrasonography (US) guidance and antibiotics. The remaining 6 were treated with antibiotics alone. Among the 13 cases treated with PTAD, 11(84%) were cured in an average of 22 hospital days. One case (8%) with liver abscess caused by tuberculosis was unchanged and 1 (8%) died of hepatic failure due to liver cirrhosis. There were no complications related to PTAD, but the mortality rate among patients receiving antibiotics only was 33%. PTAD is the most advisable treatment for liver abscess and should be followed by appropriate supplemental management of the original conditions. Moreover, amputation of the distal bile duct is an indispensable part of bile diversion procedures because it prevents reflex cholangitis which may cause future liver abscesses., Acta Medica Nagasakiensia. 1992, 37(1-4), p.71-74

A 26-year-old pregnant woman was admitted to Nagasaki University Hospital complaining rapid enlargement of masses in the bilateral breasts and the right axilla. Biopsy of the right breast revealed malignant lymphoma. Simple mastectomy plus axillary node dissection on the right side (Br+Ax) and excision of the tumor in the left breast were performed. Histologically, the tumor was a diffuse lymphoma of the medium-size cell type according to the LSG classification, originated from B cells. After operation, Vincristine, Adriamycin, and Cyclophosphamide were administrered, but chemotherapy was terminated because of marked leukopenia. The patient has remained asymptomatic for 7 years without any treatment, and there is no evidence of recurrence. We have collected 79 cases of malignant lymphoma of the breast reported in the Japanese literature, including the present case, and examined factors that might affect the prognosis of patients. However, age, size of tumor, axillary lymph node involvement, histological findings, and type of therapy did not exert a significant influence. The most critical factor in a poor prognosis was the extramammary involvement of malignant lymphoma., Acta medica Nagasakiensia. 1990, 35(1-4), p.137-141

The early postoperative results of pancreatoduodenectomy performed in our institute during the last 20 years were reviewed, dividing the cases into two groups, from 1970 to 1979 and from 1980 to 1989. Among a total of 136 pancreatoduodenctomies, 52 were performed in the earlier decade and 84 in the latter decade. Patients were significantly older in the latter than in the earlier decade. In the earlier decade, postoperative complications developed in 28.8% of the patients with a 19.2% overall mortality rate. In the latter decade, the complications occurred in 27.4% with a 6.0% mortality rate. There was a significant decrease in overall mortality rate between the two decades. The most common complication was the dehiscence of pancreatojejunostmy, but life-threatening major leakage was decreased. It was considered that recent improvements in surgical techniques and intraoperative and perioperative management contributed to the improvement of the results of this procedure. However, continuing efforts are needed to reduce the morbidity rate, which remains high., Acta medica Nagasakiensia. 1990, 35(1-4), p.175-180