Ebstein's anomaly is a rare congenital heart disease. We treated two patients with this malformation using a new surgical technique proposed by Carpentier. The technique consists of reconstructing the longitudinal plication of the atrialized chamber and repositioning the anterior and posterior leaflets of the tricuspid valve to the true anatomical annulus. The first patient, a 16-year-old boy, underwent surgery on September 5, 1990, and the second patient, a 13-year-old girl, on July 24, 1991. Atrial septal defect was seen only in the second patient, and was closed without a patch. Aortic cross clamping lasted an average of 96 minutes. The surgical technique was relatively easy, and the postoperative course was uneventful in both patients. The cardiothoracic ratio was reduced from 68% to 54% in the first patient and from 64% to 52% in the second. We concluded that Carpentier's operation led to good clinical results for Ebstein's anomaly.

The awareness of many residents on generic drugs has increased recently, which is also reflected in their increased consumption. Enlightenment activities for citizens have become an important tool to further promote the use of generic drugs. We performed a questionnaire survey and assessed residents’ consciousness after a lecture on generic drug usage in a people’s forum. We received responses from 105 of the recruited 127 participants. Most questionnaire respondents were from the age group of 70 years and comprised about half of the sample. The respondents having undefined will to the question about use of generic drugs was the most frequent. Only a few participants answered that they hoped getting generic drugs from a pharmacy or hospital. The concerns and future requests for generic drugs were the cost of medicine, validity, safety, and quality. The middle group by which the participants were classified into a positive group, a middle group and a negative group among question on usage and request of generic drugs, in its percentage each age groups, was most. Many respondents answered that generic drug use “should be spread” after the lecture. However, it was identified that the communication between doctor, pharmacist, and the patient on generic drug use is insufficient in the open question. Enlightenment activities for citizens will become necessary because half of the respondents expressed negative opinions on the use of generic drugs.

Purpose: To report a case of successful treatment using gabapentin against hot flashes due to LH-RH agonist in a patient with advanced prostate cancer. Case summary: A male patient in his seventies with advanced prostate cancer had hot flashes due to LH-RH agonist therapy. The patient began to notice hot flashes within a few months after starting hormone treatment. Oral gabapentin was administered at a starting dose of 400mg/day and was gradually escalated to 1,200mg/day. Within 7 days of administration, the patient achieved a partial improvement of his symptoms. After 17 days of gabapentin therapy, the hot flashes significantly improved. While the patient was taking a maintenance dose of 1,200mg/day, he remained to be asymptomatic. Conclusion: There are only a few reports (none in Japan) that show effectiveness of gabapentin against hot flashes due to hormone treatment in male patients with prostate cancer. Although the mechanism of the hot flash-relieving effect of gabapentin is not fully understood, this case report indicates that gabapentin may help treating patients suffering from intractable hot flashes. Palliat Care Res 2009; 4(2): 334-338