Malignant pleural effusion is characterized by fluid buildup between the lung and the chest wall due to cancer cells in the pleura. Most cases are caused by lung cancer, breast cancer, ovarian cancer, or malignant lymphoma. Urothelial carcinoma is a rare cause of malignant pleural effusions and is difficult to diagnose by cytological examination. We report a case of malignant pleural effusion due to urothelial carcinoma. An 80-year-old man presented with right back pain. After close examination, he was diagnosed with ureteral cancer. During the course of treatment, a unilateral pleural effusion was found, and cytological and histological examinations were performed on suspicion of malignant pleural effusion. Cytological examination revealed numerous round-to-ovoid cells with irregularly enlarged nuclei. Immunohistological studies were performed on cell block specimens, and urothelial carcinoma was diagnosed. Cytological examination of malignant pleural effusions may require estimation of the primary site. It is important to take a multifaceted approach that considers not only the cytological findings but also the clinical findings and medical history.

Clarifying the current state of ophthalmic solutions and the handling of eye drops is important for the proper use of ophthalmic solutions. In this study, a questionnaire survey was conducted from May 2018 to February 2019 on 200 ophthalmic inpatients who provided consent. In total, 36.5% of the patients were dissatisfied with the usability of ophthalmic containers due to their hard material andthe difficulty of releasing the ophthalmic solution. In addition, 43.0% of the patients repliedthat they hadlearnedfrom medical professionals, such as doctors and pharmacists, about the handling of eye drops, whereas 45.0% reported failing to apply ophthalmic solutions onto their eyes correctly. Only 2.0% of the respondents answeredthat they hadconsulteddoctors or pharmacists about the use of ophthalmic solutions. These findings underscore the current problems about patients’ satisfaction with ophthalmic solutions andhandling of eye drops. Therefore, pharmacists may needto be actively involvedin patients’ selection of ophthalmic solutions andinstruct them regarding usage.

Background: Because generic medicines reduce the financial burden on patients and medical insurance providers, they become more popular year after year.  However, there are still few reports that analyze the efficacy and safety of generic medicines, especially in terms of their characteristics and side effects.
Methods: Paclitaxel is an antineoplastic frequently used with good results in the treatment of breast cancer, ovarian cancer, gastric cancer, and angiosarcoma, but fat solubility is high and various kinds of adverse events, such as myelosuppression and arthralgia, peripheral neuropathy, and alcohol hypersensitivity are known to develop.  We investigated the efficacy, characteristics, and the incidence of adverse events for the generic product of paclitaxel.
Results: Differences were found for the generic version in terms of the characteristics and preparation time.
Conclusion: The incidence of adverse events was not significant, suggesting that the generic version could be a reasonable substitute.

BACKGROUND/AIMS: To confirm the feasibility of using newly developed endoscopic ultrasound (EUS) with Zone sonography(TM) technology (ZST; Fujifilm Corp.). METHODS: Seventy-five patients with pancreatic disorders were enrolled: 45 with intraductal papillary mucinous neoplasm; 15 with ductal carcinoma; five with neuroendocrine tumors; three with serous cystic neoplasms; and seven with simple cysts. The endoscopes used were EG-530UR2 and EG-530UT2 (Fujifilm Corp.). Two items were evaluated: visualization depth among four frequencies and image quality after automatic adjustment of sound speed (AASS), assessed using a 5-scale Likert scale by two endosonographers blinded to disease status. Because sound speed could be manually controlled, besides AASS, image quality at sound speeds of 1,440 and 1,600 m/sec were also assessed. RESULTS: In all cases, sufficient images were obtained in the range of 3 cm from the EUS probe. Judgments of image quality before AASS were 3.49+/-0.50, 3.65+/-0.48, respectively. After AASS, A and B scored 4.36+/-0.48 and 4.40+/-0.49 (p<0.0001). There were significant differences in the data before and after AASS and plus 60 m/sec, but no significant difference between the datasets were seen after AASS and at sound speeds manually set for minus 100 m/sec. CONCLUSIONS: EUS with ZST was shown to be feasible in this preliminary experiment. Further evaluation of this novel technology is necessary and awaited.
Endoscopes ; Endosonography ; Humans ; Judgment ; Mucins ; Pancreatic Diseases

We administered Bofutsushosan (Bo) to 127 obese patients who consulted our clinic, and investigated the effect of this herbal formula on reducing body weight in 33 obese patients who received continuous adminis tration for more than six months. The abdominal muscle tension of these 33 patients was assessed mainly as “strong” (four) under the five-grade scale of Kampo diagnostics, which was higher than that of 9 other patients with side effects (including diarrhea and abdominal pain) assessed mainly as “middle” (three). Sixteen patients reported a decrease in appetite following administration of Bo. Weight before medication in the patients with decreased appetite was 67.1±2.5kg, and that in 17 patients with unchanged appetite was 75.9±2.4kg. There was a significant difference between the two. Weight change in the patients with decreased appetite was -4.8±1.0kg and was significantly lower than -1.4±0.7kg in the patients with unchanged appetite. Their blood triglycerides levels decreased significantly following administration of Bo. This decrease in appetite was considered to be due not only to activation of the adrenaline β₃ receptor, through the administration of Ephedrae Herba, Schizonepetae Spica, Rhei Rhizoma, Forsythiae Fructus and Glycyrrhizae Radix but also to the psychotropic actions of Ephedra Herba, Rhei Rhizoma and Gardeniae Fructus. Recently severe side effects of Bo have been reported. This study suggested that patients showing a grade of strong (four) or more in abdominal muscle tension, were indicated for this treatment and that the long-term administration of this herbal formula should be continued in patients whose appetite was identified as being suppressed.