Background: The preferred management of localized prostate cancer is yet to be known, due in large part to a paucity of randomized controlled trials comparing benefits and risks across primary treatment options, such as watchful waiting, radical prostatectomy, radiation therapy and androgen deprivation.  Aim: We reviewed treatment outcomes of retropubic radical prostatectomy for clinically localized prostate cancer patients.  Methods and Subjects: We examined 63 patients with localized prostate cancers who underwent retropubic radical prostatectomy from January 2001 to December 2006. Mean age was 67.5 (range: 52-79 ages). Preoperative clinical stages were T1c (21 cases), T2a (29 cases), and T2b (13 cases).  Results: Mean operation time was 261 minutes (range 194-340 minutes). Mean bloodloss was 1,123ml (range 135-3,500ml). As for Gleason scores of prostatectomy specimens, 32 cases had 6 or less, 25 cases had 7 and 6 cases had 8 or more. Pathological diagnoses were pT2a (31 cases), pT2b (4 cases), pT3 (28 cases), pN1 (2cases). As a result, 35 cases (55.6%) were defined as “organ confined diseases (OCD)”.  Early complications occurred 16 cases, including rectal injuries (2 cases), wounds infections (10 cases), anastomotic stricture (2 cases) and epididymitis (2 cases). Slight and mild urinary incontinence (need of two or more pads per day) were recognized in 15cases (24%) as a late complication 3 months after operation, in 2 cases (3.2%) after 1year. Nerve sparing radical prostatectomy was performed on 28 cases. Six of them could keep erectile function with support of Phosphodiesterase type 5 (PDE-5) inhibitors.  Biochemical recurrences were found in 12 cases, so that hormonal therapy was initiated as secondary cancer treatment. We investigated the predictors of PSA recurrence, and the OCD was a significant indicator for biochemical recurrence.

Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.
Method: We conducted a survey with pharmacies throughout Japan that provided home-visit service, asking them questions regarding their work with up to five patients (the survey period was from January 15 through the end of February, 2013).  Main survey questions were: (1) whether they managed unused drugs since the start of their home-visit, and (2) how they managed the unused drugs.  For (2), we conducted case studies by asking the pharmacists to choose the case that impressed them most and describe the unused drugs involved, actions taken, and the results.
Results: Data on 5,447 patients were collected from 1,890 pharmacies throughout Japan (collection rate: 56.9%).  Pharmacists managed unused drugs from 2,484 patients (45.6%). 1,746 patients (3,590 cases) were qualified for analysis.  In 2,332 cases (65.0%), pharmacist intervention eliminated the incidences of unused drugs.  In 782 cases (21.8%), unused drugs were discarded, while the number of drug administration days was adjusted in 2,623 cases (73.1%).  In 21 cases (0.6%), drugs were both discarded and had the number of days adjusted.  There were others for 164 cases (4.5%).  The total price of the eliminated unused drugs was approximately 6,920,000 yen (4,000 yen/person).  Illnesses that benefited most from the elimination of unused drugs were chronic respiratory failure (16,306 yen/person), and Parkinson’s disease (4,803 yen/person).
Conclusion: We confirmed the economic effect of eliminating unused drugs by pharmacists’ home visits.

The purpose of this study is to evaluate the efficacy of hochuekkito for late-onset hypogonadism (LOH) patients. We administered hochuekkito 7.5 g/day for 8 weeks to 47 patients with LOH whose AMS scale was more than 27. We assessed the patients' symptom change with the AMS, SHIM, SDS, BDI, and SF-36. We measured their endocrine profiles and levels of their cytokines. At the end of study, 31 of 47 patients were evaluable. No significant difference in subjective symptoms was seen with any questionnaire after 8 weeks hochuekkito administration. However, hochuekkito significantly increased free testosterone and decreased ACTH/cortisol levels. Thus we believe hochuekkito is beneficial for the treatment of LOH.