We have tried surgical pathologic diagnosis using a still image transmission system. The equipment we used was a medical information network system (Telepathology) developed jointly by Inohara Shokai and NTT. During the 9-month period from April to December in 1995, we performed pathological diagnosis on a total of 63 cases received via this system. The cases included 21 stomach cancers, 13 colorectal cancers, 5 breast tumors, 4 lung tumors, 5 thyroid tumors and 3 ovary tumors. Materials presented for pathologic examination were 44 lymph nodes, 20 stumped sections of the lesions and 13 tumor tissues. The correct diagnosis ratio was as high as 93.7%. Improvement in the specimen-making procedure reduced the time required to arrive at a firm diagnosis. However, the quality of images of low magnification is unsatisfactory. It should also be pointed out that there is much room for improvement in the technical skill and knowledge of the persons concerned. Nevertheless, great expectations could be placed on this system. With progress in data transmissions technology, it will find its use more widely.

Objective: To clarify the barriers pharmacists face in handling patients with adverse drug events at community pharmacies and to propose solutions.
Design: Cross-sectional study.
Methods: One hundred-twenty-one pharmacists, who worked and experienced to work at community pharmacies (76.0%), hospitals (22.3%), or elsewhere, participated in this study.  All of them were divided into 12 groups and asked to note the barriers, and abstract and structure them through discussion in each group according to the KJ-method.  On the other hand, workers at community pharmacies including people with experience were also asked to fill out a prepared questionnaire on barriers.
Results: Six groups structured the barriers from the perspective of professional flow as pharmacists and the other groups structured them from the perspective of a medical care team.  The barriers emerging from both structures were (a) difficulty in identifying adverse drug reaction and assessing its grade at community pharmacies, (b) lack of standardized protocols for informing physicians from community pharmacies, (c) not being informed about a physician’s assessment of suspicious adverse drug reactions, and (d) difficulty in explaining adverse events to patients and their families.  Those barriers were reported by a high percentage of respondents to the questionnaire.
Conclusion: The barriers are all crucial in order to avoid health damage caused by medication at community pharmacies and should be urgently solved.