Purpose: Ketamine is effective on neuropathic pain that is difficult to respond to opioids among cancer pains, due to its N-methyl-D-aspartate (NMDA) receptor antagonism action. The purpose of this study was to evaluate the effect of oral ketamine on neuropathic pain. Methods: We retrospectively investigated the dosage and the administration period of oral ketamine in 31 patients for one year from December 2004. Results: Pain-relief was achieved in 22 of 31 patients, the average of initial dose was 107.3mg/day and the average administration period was 63 days. Seven patients discontinued oral ketamine within 7 days because of nausea/ vomiting (4 patients) or drowsiness (3 patients). Two patients had no sufficient pain-relief. Conclusion: This experience suggests that oral ketamine is effective on the management of neuropathic pain. Palliat Care Res 2008; 3(1): 216-220

Mistake in Japanese Sentence had been corrected

In order to clarify the effect of exercise on the walking performance and the muscle volume in lower limbs, elderly athletes long continuing to be trained and untrained elderly were compared with regard to their muscle cross-sectional area (CSA) of m. psoas major, thigh muscle and crus muscle and their walking ability. The subjects used consisted of thirty-six 80's-aged male and 70's-aged female elderly athletes and twenty-four elders having no regular exercise (control male group : CM, control female group : CF) . The elderly athletes were further divided into two groups in accordance with their results of Japan Fitness Test (high performance male group : HPM, low performance male group : LPM, high performance female group : HPF, low performance female group : LPF) . The walking performance was evaluated by analyzing their walking speed, stride-length and step rate during walking along a 15 m-strip of passage at normal and fast paces using videotaping. The muscle CSA was determined at m. psoas major, thigh muscle (extensors and flexors) and crus muscle (m. tibialis anterior and m. triceps surae) using MRI. As for the walking speed and stride-length at the normal pace, only HPM and HPF showed significantly higher values than CM and CF (male : p<0.05, female : p<0.01) . Meanwhile at the faster pace, HPF and LPF showed significantly higher values than CF in female (HPF : p<0.01, LPF : p<0.05) and in the case of males, only HPM have a higher value only of the walking speed than CM (p<0.05) . The CSA of m. psoas major in HPM and HPF significantly higher than that in CM and CF (all p<0.05), while in CSAs of knee extensor muscles and m. triceps surae, the statistical differences were not consistent among male and female groups. The results suggested that greater muscle mass of m. psoas major could influence higher walking speed in elderly people, and might be affected by regular exercise training.

BACKGROUND/AIMS: In Japan, it is customary to take a daily bath during which the body is immersed in water to the neck. During full-body immersion, hydrostatic pressure is thought to compress the chest and abdomen, which might influence esophageal motor function and intra-gastric pressure. However, whether water immersion has a significant influence on esophageal motor function or intragastric pressure has not been shown. The aim of this study was to clarify the influence of full-body water immersion on esophageal motor function and intragastric pressure. METHODS: Nine healthy male volunteers (mean age 40.1 +/- 2.8 years) were enrolled in this study. Esophageal motor function and intragastric pressure were investigated using a high-resolution 36-channel manometry device. RESULTS: All subjects completed the study protocol. Intragastric pressure increased significantly from 4.2 +/- 1.1 to 20.6 +/- 1.4 mmHg with full-body water immersion, while the lower esophageal high pressure zone (LEHPZ) value also increased from 20.5 +/- 2.2 to 40.4 +/- 3.6 mmHg, with the latter being observed regardless of dietary condition. In addition, peak esophageal peristaltic pressure was higher when immersed as compared to standing out of water. CONCLUSIONS: Esophageal motor function and intragastric pressure were altered by full-body water immersion. Furthermore, the pressure gradient between LEHPZ and intragastric pressures was maintained at a high level, and esophageal peristaltic pressure was elevated with immersion.
Abdomen ; Baths ; Esophageal Sphincter, Lower ; Gastroesophageal Reflux ; Humans ; Hydrostatic Pressure ; Immersion ; Japan ; Male ; Manometry ; Neck ; Peristalsis ; Thorax ; Water

Objective: Confirmation by pharmacists of brought-in drugs is not only limited to identification of drugs, but also requires prescription design and proposals based on the background of patients and evaluation of associated information. In this study, we analyzed the content of brought-in drugs related PreAVOID reports in our hospital according to the years of pharmacist experience in order to help educate pharmacist for better brought-in drugs confirmation.Method: Various interventions regarding brought-in drugs were compared between two groups: pharmacists with >6 years of experience (group H) and those with < 5 years of experience (group L). PreAVOID reports, which related to drugs brought in by patients admitted to the Ogaki Municipal Hospital between April 1, 2018 and March 31, 2019 were assessed.Result:The PreAVOID reporting rate for the number of brought-in drugs confirmed was higher in group H (1.56%) than in group L (1.12%) (odds ratio 1.399, p = 0.023). The PreAVOID reporting rate when reporting was based solely on prescription information did not differ between these two groups, but when patient background, including disease-related information, was included with prescription information, the rate was higher in group H (0.80%) than in group L (0.30%) (odds ratio 2.725, p < 0.001). Group H provided more reports related to unnecessary drugs.Conclusion: The involvement of pharmacists in the evaluation of brought-in drugs is important when reviewing subsequent medical treatments. Our findings suggest that to improve the quality of treatment, it is necessary to provide appropriate newcomer education, such as conducting case studies using PreAVOID cases.