Sixteen patients with a pericholecystic abscess were classified into three groups according to the sonographic findings: Nine patients had an abscess in the gallbladder bed, three in an intramural location in the gallbladder, and four in an intraperitoneal cavity. In the gallbladder bed group, six patients with a localized abscess responded well to conservative therapy, followed by an elective operation. Two patients with a complicated abscess were initially treated with ultrasonically (US) guided percutaneous transhepatic gallbladder drainage and then with percutaneous transhepatic aspiration of the liver abscess, followed by an elective operation. A patient with a communicating abscess underwent an elective operation because the abscess completely disappeared after percutaneous transhepatic abscess drainage under US guidance. One of the three patients with an intramural abscess needed an immediate operation, and the other two were treated conservatively, followed by an elective operation. All four patients with an intraperitoneal abscess needed an emergency operation. Because each type of abscess received differing and successful treatments, the authors' method of classification of US findings seemed to provide a useful way to select the specific therapeutic procedure to achieve optimal results.

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Previously the authors reported that the fat emulsion of 1-(2-tetrahydrofuryl)-5-fluorouracil, tegafur (FT-207), yielded significantly higher concentrations of tegafur in the lymph and plasma compared to tegafur enteric-coated granules (FT-G). However, the emulsification did not improve the metabolic conversion rate of tegafur to 5-fluorouracil (5-FU). A study was performed to assay the plasma and lymphatic concentrations of tegafur, 5-FU, and uracil in seven patients after radical surgery for gastric carcinoma who were given a combined oral preparation of FT-207 and uracil (UFT). Both lymph and plasma 5-FU levels after UFT were 20 times greater than those after FT-G, although FT-207 levels were not different. Patients given UFT showed significantly greater 5-FU and uracil concentrations in the lymph compared with the plasma. The results of this study suggest a potential use of UFT as an adjuvant postoperative chemotherapeutic agent for gastric carcinoma.

PurposeThe use of mesh in the surgical repair of adult indirect inguinal hernias is widely recommended in Western countries, but no randomized controlled trials have so far been reported in Japan. The purpose of the present randomized prospective trial was to compare a mesh method with non-mesh method for surgical repair of primary adult indirect inguinal hernias in which the diameter of the internal inguinal ring was up to 3.0 cm (I-1 or I-2 of Japanese Hernia Society Classification).MethodsPatients with a primary unilateral inguinal hernia and I-1 or I-2 surgical findings were randomized to undergo either Marcy repair or Prolene Hernia System® repair. Primary endpoints were recurrence, infection, and pain, with follow-up continued for 3 years postoperatively.ResultsNinety-one of 479 patients with an inguinal hernia during the study period did not meet the exclusion criteria, and 46 were allocated to Marcy repair and 45 were allocated to Prolene Hernia System® repair. No recurrence was observed in either group, and no significant differences were identified between the groups in any of the primary endpoints.ConclusionThis randomized prospective trial of I-1 and I-2 inguinal hernias suggests that Marcy repair is not inferior to PHS repair. A large-scale randomized controlled trial appears warranted to confirm whether to use mesh for Japanese adult I-1 and I-2 hernias.

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