Neurology

Contains reports on seven research projects.U. S. Public Health Service (B-3055-3,U. S. Public Health Service (B-3090-3)U. S. Public Health Service (38101-22)Office of Naval Research (Nonr-1841 (70))Air Force (AF33(616)-7588)Air Force (AFAOSR 155-63)Army Chemical Corps (DA-18-108-405-Cml-942)National Institutes of Health (Grant MH-04734-03

Neurology

Contains reports on eleven research projects.U.S. Air Force (AF49(638)-1130)Army Chemical Corps (DA-18-108-405-Cml-942)U.S. Public Health Service (B-3055)National Science Foundation (Grant G-16526)U.S. Public Health Service (B-3090)U.S. Air Force (AF33(616)-7588)Office of Naval Research (Nonr-1841(70)

Neurology

Contains research objectives and reports on six research projects.U.S. Public Health Service (B-3055)U.S. Public Health Service (B-3090)Office of Naval Research (Nonr-1841 (70))Air Force (AF33(616)-7588)Air Force (AFAFOSR-155-63)Air Force (AFAFOSR-155-63)Army Chemical Corps (DA-18-108-405-Cml-942)National Science Foundation (Grant G-16526

Neurology

Contains reports on nineteen research projects.United States Public Health Service (B-3055-3, B-3090-3, 38101-22)United States Navy, Office of Naval Research (Contract Nonr-1841(70))Unites States Air Force (AF33(616)-7588, AFAOSR 155-63)United States Army Chemical Corps (DA-18-108-405-Cml-942)National Institutes of Health (Grant MH-04734-03)National Aeronautics and Space Administration (Grant NsG-496

JPN Guidelines for the management of acute pancreatitis:surgical management

Acute pancreatitis represents a spectrum of disease ranging from a mild, self-limited course to a rapidly progressive, severe illness. The mortality rate of severe acute pancreatitis exceeds 20%, and some patients diagnosed as mild to moderate acute pancreatitis at the onset of the disease may progress to a severe, life-threatening illness within 2–3 days. The Japanese (JPN) guidelines were designed to provide recommendations regarding the management of acute pancreatitis in patients having a diversity of clinical characteristics. This article sets forth the JPN guidelines for the surgical management of acute pancreatitis, excluding gallstone pancreatitis, by incorporating the latest evidence for the surgical management of severe pancreatitis in the Japanese-language version of the evidence-based Guidelines for the Management of Acute Pancreatitis published in 2003. Ten guidelines are proposed: (1) computed tomography-guided or ultrasound-guided fine-needle aspiration for bacteriology should be performed in patients suspected of having infected pancreatic necrosis; (2) infected pancreatic necrosis accompanied by signs of sepsis is an indication for surgical intervention; (3) patients with sterile pancreatic necrosis should be managed conservatively, and surgical intervention should be performed only in selected cases, such as those with persistent organ complications or severe clinical deterioration despite maximum intensive care; (4) early surgical intervention is not recommended for necrotizing pancreatitis; (5) necrosectomy is recommended as the surgical procedure for infected pancreatic necrosis; (6) simple drainage should be avoided after necrosectomy, and either continuous closed lavage or open drainage should be performed; (7) surgical or percutaneous drainage should be performed for pancreatic abscess; (8) pancreatic abscesses for which clinical findings are not improved by percutaneous drainage should be subjected to surgical drainage immediately; (9) pancreatic pseudocysts that produce symptoms and complications or the diameter of which increases should be drained percutaneously or endoscopically; and (10) pancreatic pseudocysts that do not tend to improve in response to percutaneous drainage or endoscopic drainage should be managed surgically