1.Four Cases of Male Patients Successfully Treated with Tokishakuyakusanryo
Emi ISHII ; Tetsuro OIKAWA ; Yukari GONO ; Hiroshi ODAGUCHI ; Tomoyuki HAYASAKI ; Toshihik HANAWA
Kampo Medicine 2010;61(3):319-324
Tokishakuyakusan has been used widely to treat various diseases including gynecological disorders. Currently, tokishakuyakusan is frequently used to treat female patients, while indications for use in male patients are unclear. Furthermore, there are few reports of male patients having been effectively treated with tokishakuyakusan or tokishakuyakusanryo. Here, we report four male patients successfully treated with tokishakuyakusanryo. Case 1 was an 84-year-old man who had uncontrolled nasal allergy, and treatment with tokishakuyakusanryo was effective in relieving the patient's allergy symptoms that were accompanied by chills and oketsu (blood stasis) findings. Case 2 was a 63-year-old man whose chief complaints were bronchial asthma, benign prostate hypertrophy, and nasal allergy. All his symptoms improved considerably with tokishakuyakusanryo and hangekobokuto, especially the symptoms of nasal allergy. Case 3 was a 70-year-old man whose chief complaint was persistent proteinuria. Tokishakuyakusanryo was prescribed, in consideration of his clinically observed condition, which included sensitivity to cold, blood stasis and fluid retention. His proteinuria disappeared four months later, along with his other complaints of chills, oketsu, and fluid retention. Case 4 was a 56-year-old man whose chief complaint was ulcerative colitis. He had responded well to treatment with ifuto, but he developed hypertension. His prescription was changed to tokishakuyakusanryo, a similar prescription that does not contain the Glycyrrhiza radix which can cause hypertension. Afterwards, his blood pressure decreased to normal levels and his abdominal symptoms remained stable. Nangai Yoshimasu published the opinion that tokishakuyakusan could be applied not only in female patients but also male patients. Additional reports on male cases would provide helpful information to clarify tokishakuyakusan indications in male patients.
2.Continuous Intravenous Infusion of Oxycodone for Dyspnea from End Stage-heart Failure due to Dilated Cardiomyopathy
Koji Ishii ; Kumi Matsuo ; Maki Ohno ; Shigenori Muto ; Satoru Morishita ; Emi Nagaishi ; Chie Munakata ; Tsunako Ikeda ; Yukiko Nakashima ; Hirohisa Kinoshita ; Emi Ryu ; Minoru Hojo ; Tetsuya Hara
Palliative Care Research 2016;11(2):529-533
Introduction: Patients of end-stage heart failure often develop dyspnea. Although morphine is used for dyspnea, these patients are often inappropriate group for using morphine due to renal failure. Case: A seventy-year-old male with end-stage heart failure due to dilated cardiomyopathy developed dyspnea. We used continuous oxycodone infusion for dyspnea with small dose as an alternative to morphine due to renal failure. His dyspnea was relieved in dose-dependent without heart failure recovery. Conclusion: Oxycodone may be an alternative therapy for dyspnea with end-stage heart failure with renal failure.
3.Changes in Physical Function, Fatigue, and Psychiatric Symptoms in Patients with Hematological Malignancy Undergoing Chemotherapy and Low-intensity Exercise Training
Jiro Nakano ; Shun Ishii ; Takuya Fukushima ; Ayumi Natsuzako ; Koji Tanaka ; Kaori Hashizume ; Kazumi Ueno ; Emi Matsuura ; Yoko Kusuba
Palliative Care Research 2017;12(3):277-284
This study aimed to investigate the changes in physical function, fatigue, and psychiatric symptoms in patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sixty-two hospitalized patients with hematological malignancy undergoing chemotherapy and low-intensity exercise were recruited. At the time of exercise initiation and hospital discharge, grip strength, knee extension muscle strength, maximum walking speed, Eastern Cooperative Oncology Group (ECOG) performance status, a measure of functional independence, cancer fatigue pain, and hospital anxiety and depression were evaluated. When longitudinal data were analyzed in each group, changes in grip strength and knee extension muscle strength were unevenly distributed: some patients showed a decrease in knee extension strength. On the other hand, maximum walking speed, the measure of functional independence, and ECOG performance status were maintained or improved in more than 90% of the patients. Results of fatigue, anxiety, and depression tended to show an improvement in female patients, but not in male patients. In conclusion, physical function was maintained in nearly all patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sex differences were found in changes of fatigue, anxiety, and depression.
4.Combined extracranial and intracranial approach for resection of dermoid cyst of the sphenoid bone with a cutaneous sinus tract across the frontal branch of the facial nerve
Naohiro ISHII ; Emi FUKAZAWA ; Tomoko AOKI ; Kazuo KISHI
Archives of Craniofacial Surgery 2019;20(2):116-120
Frontotemporal dermoid cysts with a cutaneous sinus tract in the sphenoid bone are rarely found, and furthermore, the spreading of these cysts across the frontal branch of the facial nerve has not been reported. Herein, we present a 5-year-old case of a dermoid cyst successfully resected with preservation of this nerve using a combined extracranial and intracranial approach. This approach is recommended for a safe and radical resection of the lesion and for securing an aesthetic outcome.
Child, Preschool
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Dermoid Cyst
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Facial Nerve
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Humans
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Skull
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Sphenoid Bone
5.Awareness Survey on Handling and Exposure of Anti-Cancer Drugs among the Hospital Pharmacists
Emi KABASAWA ; Hiroyuki SHIMIZU ; Takako NAKAMURA ; Takaaki SUZUKI ; Itsuko ISHII
Japanese Journal of Drug Informatics 2019;20(4):213-219
Objective: Anticancer drugs have carcinogenic potential and are associated with occupational exposure risks among healthcareprofessionals who handle them. To minimize occupational exposure, healthcare workers must be adequately aware of the risks ofanticancer drugs and the appropriate techniques for their preparation. However, there is little information on the awareness ofpharmacists who prepare anticancer drugs in medical settings. The aim of this study was to investigate awareness of hazardous drugs(HD) and appropriate preparation techniques among pharmacists, and identify problems that pharmacists experience in managing theirexposure to anticancer drugs.Design: Questionnaire.Method: The questionnaire was sent by e-mail or mail to pharmacists employed at 270 institutions who belonged to the Chiba Societyof Hospital Pharmacists. From September 2015 to March 2016, respondents completed the questionnaires voluntarily and returnedthem by mail. Returning the questionnaire was regarded as informed consent to participate in this survey. Based on the completedquestionnaires, we examined the awareness of pharmacists in their daily work.Results: In total, 218 questionnaires were returned (collection rate: 10%). Awareness of the risks of anticancer drugs was high, and ahigh percentage of respondents use personal protective equipment during drug preparation, but the use of closed system drug transferdevices was low. Overall, however, it was found that many pharmacists had insufficient understanding of safe handling techniques.Discussion: Despite some recognition of the risks associated with exposure to HD, the measures taken to prevent exposure toHDs―including anticancer drugs―were inadequate and this issue must be urgently addressed by medical institutions and pharmacists.Countermeasures such as training sessions in the handling of HDs and the development of manuals are needed for each facility.
6.Predictors for Diarrhea After Administration of Naldemedine: Analysis Focusing on the Administration Period of Opioid Analgesics Before the Start of Naldemedine
Junya HASHIZUME ; Emi RYU ; Seiichi NOSE ; Kei MIYANAGA ; Reiko KISHIKAWA ; Tadahiro NAKAMURA ; Takahiro MURO ; Yukinobu KODAMA ; Haruna YAMASHITA ; Koji ISHII ; Hitoshi SASAKI
Palliative Care Research 2020;15(2):101-109
Purpose: Naldemedine is a peripheral µ-opioid receptor antagonist, including the treatment of opioid-induced constipation (OIC) . However, diarrhea is known as its side effect. We conducted a study focusing on the administration period of opioid analgesics before the start of naldemedine to clear predictors of diarrhea due to Naldemedine. Method: All data were retrospectively collected from the electronic medical record system. We investigated patients who initially administrated naldemedine at Nagasaki University Hospital from June 1 2017 to March 31 2019. Result: One hundred thirty-two patients were subject of investigation. The incidence of diarrhea was 25.0%. The result of the multivariate analysis showed that significant predictors of diarrhea were associated with the opioid analgesics usage period longer than 7 days before naldemedine initiation (odds ratio: 3.76, 95% confidence interval: 1.53-9.20, p=0.004). Discussion: When naldemedine was used for OIC, diarrhea may be avoided by using within 7 days after opioid analgesics.