A lower abdominal tumor with thrill and bruit was pointed out in a 59-year-old female. Angiography showed a pelvic arteriovenous malformation (AVM) with remarkably dilated vessels resembling an aneurysm. Feeding arteries for this AVM originated from the right internal iliac artery, right lumbar artery and right renal artery, and drainage blood flowed into the inferior vena cava from the dilated vessel via a large vein. At operation the right internal iliac artery and right lumbar artery were ligated and the dilated vessel with AVM, which connected with the right renal artery, was resected. An angiography 16 days after the operation revealed the normal arteries without AVM and the right internaal iliac artery filled through collateral arteries. Recently catheter embolization in frequently the first choice for treatment of AVM. However, in the case of AVM with aneurysmal dilated vessels, surgical resection should be selected.

BACKGROUND/AIMS: The effects of Histamine-2 receptor antagonists and proton pump inhibitors on the gastrointestinal motility have not yet been sufficiently investigated. The aim of this study was to determine the effects of intravenous bolus administration of famotidine and omeprazole on the rate of gastric emptying using the continuous 13C breath test (BreathID system, Exalenz Bioscience Ltd, Israel). METHODS: Twelve healthy male volunteers participated in this randomized, 3-way crossover study. After fasting overnight, the subjects were randomly assigned to receive 20 mg of famotidine, 20 mg of omeprazole or 20 mL of saline alone by intravenous bolus injection before a test meal (200 kcal per 200 mL, containing 100 mg of 13C-acetate). Gastric emptying was monitored for 4 hours after the ingestion of test meal by the 13C-acetic acid breath test performed using the BreathID system. RESULTS: No significant differences in the calculated parameters, namely, the T1/2, Tlag, GEC, beta and kappa, were observed among the 3 test conditions. CONCLUSIONS: The study revealed that intravenous administration of gastric acid suppressant drugs had no significant influence on the rate of gastric emptying in comparison with that of saline alone as a placebo. Our results indicating the absence of any effect of either famotidine or omeprazole on accelerating the rate of gastric emptying suggest that both medications can be administered safely to patients suffering from hemorrhagic peptic ulcers who need to be kept nil by mouth from the viewpoint of possible acceleration of gastrointestinal motility in the clinical setting.
Acceleration ; Administration, Intravenous ; Breath Tests ; Cross-Over Studies ; Eating ; Famotidine ; Fasting ; Gastric Acid ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Male ; Meals ; Mouth ; Omeprazole ; Peptic Ulcer ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Stress, Psychological

BACKGROUND/AIMS: The aim of this study was to examine the convenience of the quality of life and utility evaluation survey technology (QUEST) questionnaire and the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire as self-assessment diagnostic instrument. METHODS: This was a two-way crossover study conducted over 6 weeks from September 2010 to November 2010. The subjects were 60 consecutive patients admitted to the Hiratsuka city hospital with a gastrointestinal condition, regardless of the coexistence of heartburn. They were assigned to fill in both the QUEST and FSSG questionnaires in random order. We analyzed the time taken to complete the questionnaires, whether subjects asked any questions as they filled in the questionnaire, and the questionnaire scores. RESULTS: Comparison of the QUEST and the FSSG revealed significant differences in the completion time (196.5 vs. 97.5 seconds, respectively; P < 0.0001) and in whether subjects asked any questions (37 vs. 15 subjects, respectively; P < 0.0001). Completion time in QUEST scores of > or = 4 was lower than < 4 (170.5 vs. 214.0 seconds, respectively; P = 0.022), and the QUEST score was significantly higher without questions than with question (3 vs. 1 points, respectively; P = 0.025). CONCLUSIONS: This study revealed that the FSSG questionnaire may be easier for Japanese subjects to complete than the QUEST questionnaire.
Asian Continental Ancestry Group ; Cross-Over Studies ; Gastroesophageal Reflux ; Heartburn ; Hospitals, Urban ; Humans ; Quality of Life ; Surveys and Questionnaires ; Self-Assessment

Aim: The usefulness and safety of strontium chloride (89Sr), a radiopharmaceutical agent for painful bone metastasis, varies from patient to patient, but the reasons for why the usefulness and safety vary have not been elucidated. The purpose of this study is to explore the background factors of patients who experienced pain relief or bone-marrow suppression after 89Sr was administrated. Methods: In the cases of pain relief, we divided the results from a numeric rating scale (NRS) before and after 89Sr administration into effective and ineffective groups as outcomes. In the cases of bone-marrow suppression, we analyzed neutrophil cells, blood platelets, and hemoglobin levels, respectively, before and after 89Sr administration as outcomes. Then, we performed statistical analyses on both case groups. Results: The results showed that the background factors associated with pain relief were weight, the 89Sr dosage amount, NRS, eGFR, SCr, and Ca levels before 89Sr administration and the area of bone metastasis (number of sites reached). We found that background factors associated with bone-marrow suppression have a moderate significant correlation with hemoglobin, NRS, and SCr levels before 89Sr administration after investigating factors which influence neutropenia. In the case of thrombocytopenia, there was a moderate significant correlation with platelet counts before 89Sr administration. In the case of hypochromia, there was a moderate significant correlation with hemoglobin levels before 89Sr administration. Discussion: Our study could elucidate patient background factors associated with pain relief and bone-marrow suppression after 89Sr administration.

The aging population in Japan continues to grow, leading to the emergence of complex issues. To understand the current awareness of these issues among member pharmacies of the Fukuoka City Minami Ward Pharmaceutical Association and promote various initiatives, support tools such as the “Consultation Flowchart” and “Consultation Checklist” were distributed to share information about the elderly with the local comprehensive support center. A survey was conducted to assess the awareness of complex issues and support tools. The survey revealed that about half of the pharmacy pharmacists were aware of the complex issues themselves, but the Consultation Flowchart had a recognition rate of 35.34%, and the Consultation Checklist had a recognition rate of 31.03%. It was also found that pharmacies with higher participation in regional collaboration meetings and a greater number of visits for medication management counseling had higher awareness of complex issues and support tools. To enhance efforts in addressing complex issues, the Fukuoka City Minami Ward Pharmaceutical Association needs to approach pharmacies with limited participation in regional collaboration meetings and a lower number of visits for medication management counseling. Building visible relationships with diverse professions in the community is crucial for improvement initiatives related to complex issues.