1.Primary Cardiac Lymphoma in the Right Atrium
Manabu Motoki ; Toshihiro Fukui ; Yasuyuki Sasaki ; Toshihiko Shibata ; Hidekazu Hirai ; Yosuke Takahashi ; Shigefumi Suehiro
Japanese Journal of Cardiovascular Surgery 2008;37(6):321-324
We report a rare case of primary cardiac lymphoma in the right atrium. An 85-year-old woman with severe heart failure was referred to our hospital. The echocardiography revealed a huge tumor occupying the right atrial cavity. We conducted an emergency operation to resect the tumor. However, as the tumor strongly adhered to the wall of the right atrium and tricuspid valve, we performed partial resection of the tumor to improve hemodynamics. The pathological examination of the tumor was consistent with malignant lymphoma of B-cell origin. Although the postoperative chemotherapy was effective to reduce a volume of the tumor, the patient died because of the adverse reaction to medication.
2.The large gap between customer expectations and actual explanations of supplements by pharmacists
Toshihiro Noda ; Yuji Arashiki ; Keiko Anzai ; Keiko Kawasaki ; Tomohito Kurihara ; Kazuyuki Takaichi ; Noriko Takano ; Mineo Nakamura ; Kenzo Nishino ; Kazuya Yamada ; Midori Hirai ; Yoshikazu Tasaki ; Kazuo Matsubara ; Yuji Yoshiyama ; Ken Iseki
An Official Journal of the Japan Primary Care Association 2013;36(2):93-98
Abstract
Objective : In this study, we conducted a survey on both the use of supplements by customers and information provided by pharmacists, to clarify customer understanding. We also sought to ascertain the actual current state of information provided by pharmacists to customers, as well as investigating both how, and to what extent, pharmacists should be involved in customers 'use of supplements.
Methodology : During regular pharmacy visits, pharmacists used a questionnaire to interview 1,253 customers, in 14 community pharmacies, in Tokyo and Hokkaido, respectively. A different questionnaire, designed for pharmacists, was also given to 289 pharmacists who were either working in those same pharmacies, or who attended the Conference on Pharmaceutical Sciences in Hokkaido (2011, Sapporo).
Results : The results of the survey showed that approximately 50% of consumers greatly desired the provision of safety and efficacy information about supplements by pharmacists. However, few pharmacists answered customers' questions satisfactorily (only 7.3% of total responses).
The results also indicated that only 30% of pharmacists actively gathered information about supplements, despite the fact that 67.5% of pharmacists were aware that they were expected to do so by customers, in their roles as primary information providers regarding such treatments. Furthermore, even those pharmacists who checked information regarding supplements depended mostly on information acquired from the Internet.
Conclusion : There is a large gap between customers' expectations for explanation of supplements and the reality of such explanations, and the information actually provided by pharmacists. In order to live up to their customers' expectations, pharmacists should foster both wider dissemination and better understanding of evidence-based information about supplements. Pharmacists should also provide integrated management of drugs and supplements for patients.
3.Ameliorating Effects of Electroacupuncture on Dysmotility, Inflammation, and Pain Mediated via the Autonomic Mechanism in a Rat Model of Postoperative Ileus
Haruaki MURAKAMI ; Shiying LI ; Robert FOREMAN ; Jieyun YIN ; Toshihiro HIRAI ; Jiande D Z CHEN
Journal of Neurogastroenterology and Motility 2019;25(2):286-299
BACKGROUND/AIMS: Postoperative ileus increases healthcare costs and reduces the postoperative quality of life (QOL). The aim of this study is to investigate effects and mechanisms of electroacupuncture (EA) at ST36 and PC6 on gastrointestinal motility in rat model of postoperative ileus. METHODS: Laparotomy was performed in 24 rats (control [n = 8], sham-EA [n = 8], and EA [n = 8]) for the implantation of electrodes in the stomach and mid-jejunum for recording of gastric and small intestinal slow waves. Electrodes were placed in the chest skin for electrocardiogram (ECG). Intestinal manipulation (IM) was performed in Sham-EA and EA rats after surgical procedures. Small intestinal transit (SIT), gastric emptying (GE), postoperative pain, and plasma TNF-α were evaluated in all rats. RESULTS: (1) Compared with sham-EA, EA accelerated both SIT (P < 0.05) and GE (P < 0.05) and improved regularity of small intestinal slow waves. (2) Compared with the control rats (no IM), IM suppressed vagal activity and increased sympathovagal ratio assessed by the spectral analysis of heart rate variability from ECG, which were significantly prevented by EA. (3) EA significantly reduced pain score at 120 minutes (P < 0.05, vs 15 minutes) after the surgery, which was not seen with sham-EA. (4) Plasma TNF-α was increased by IM (P = 0.02) but suppressed by EA (P = 0.04) but not sham-EA. CONCLUSION: The postoperative ileus induced by IM, EA at ST36 and PC6 exerts a prokinetic effect on SIT and GE, a regulatory effect on small intestinal slow waves and an analgesic effect on postoperative pain possibly mediated via the autonomic-cytokine mechanisms.
Animals
;
Electroacupuncture
;
Electrocardiography
;
Electrodes
;
Gastric Emptying
;
Gastrointestinal Motility
;
Health Care Costs
;
Heart Rate
;
Ileus
;
Inflammation
;
Laparotomy
;
Models, Animal
;
Pain, Postoperative
;
Plasma
;
Quality of Life
;
Rats
;
Skin
;
Stomach
;
Thorax