Purpose: Gastric neoplasia is a common manifestation of familial adenomatous polyposis (FAP). This study aimed to elucidate the clinical characteristics, endoscopic features including fundic gland polyposis (FGPsis), and treatment outcomes of gastric neoplasms (GNs) in patients with FAP. Materials and Methods: A total of 35 patients diagnosed with FAP, including nine patients from four pedigrees who underwent esophagogastroduodenoscopy (EGD), were investigated regarding patient characteristics, GN morphology, and treatment outcomes. Results: Twenty-one patients (60.0%) had 38 GNs; 33 (86.8%) and 5 (13.2%) were histologically diagnosed with adenocarcinoma and adenoma, respectively. There were no specific patient characteristics related to GNs.Nodule-type GNs were more prevalent in patients with FGP than without (52.2% vs. 0.0%, P=0.002) in the upper body of the stomach. Conversely, depressed-type GNs were fewer in patients with FGPsis than in those without (13.0% vs. 73.3%, P<0.001). Slightly elevated-type GNs were observed in both groups (34.8% vs. 20.0%, P=0.538). Even within pedigrees, the background gastric mucosa and types of GNs varied. In total, 24 GNs were treated with endoscopic submucosal dissection (ESD) and eight with endoscopic mucosal resection (EMR). EMR was selected for GNs with FGPsis because of the technical difficulty of ESD, resulting in a lower en bloc resection rate (62.5% vs. 100%, P=0.014). Conclusions Our study indicates the necessity of routine EGD surveillance in patients diagnosed with FAP. Notably, the morphology and location of GNs differed between patients with and without FGPsis. Endoscopic treatment and outcomes require more attention in cases of FGPsis.

We report a case of a 64-year-old woman with a history of radiation therapy for breast cancer 27 years ago who developed malignant pericardial mesothelioma. Since 3 years ago, the recurrent bloody pericardial effusion was getting worse, which caused general edema and nocturnal dyspnea. She had a thickened pericardium and the right ventricular pressure curve showed a dip-and-plateau pattern. We diagnosed constrictive pericarditis and performed a pericardiectomy and waffle procedure on the thickened epicardium without cardiopulmonary bypass. The post-operative histology confirmed malignant pericardial mesothelioma and she died on the 17th postoperative day. Pericardial malignant mesothelioma is a rare disorder but very aggressive. This fatal disease may be considered in a patient with recurrent bloody pericardial effusion who has a history of thoracic radiation therapy.

We report the case of a 55-year-old man who received a hard blow to his chest from a liquid nitrogen hose that caused traumatic aortic dissection (Stanford type A, DeBakey type II). He did not have any other hemorrhagic injury ; therefore, we decided to perform an emergency surgery. The postoperative course was uneventful, and he was discharged on postoperative day 19. Pathological findings were compatible with traumatic aortic dissection. Blunt thoracic aortic injury is a potentially life-threatening injury ; therefore, it is worth remembering that relatively low-energy blunt trauma can cause aortic injury in patients with severe atherosclerosis. The optimal timing of intervention should be individualized in traumatic aortic injury with consideration of associated injuries.

The conventional crushing method for administration of drugs to patients with feeding tubes has been commonly used at the Hyogo College of Medicine College Hospital. Compared with this conventional method, the simple suspension method can reduce drug degradation due to light and moisture absorption as well as avoid drug loss and contamination. We conducted a workshop to introduce this method to pharmacists. We asked the participants to fill a questionnaire-based survey both before and after the workshop to determine the effects of the workshop on the change in the degree of awareness among participants about these methods. The awareness of participants about the simple suspension method was approximately 80% before the workshop. Approximately 60% of participants answered that they had questions about simple suspension method from individuals from other occupations, suggesting a high awareness of this method. After the workshop, approximately 98% of participants answered that they were “satisfied” or “slightly satisfied,” suggesting that they were in favor of introducing the suspension method. The results of text mining indicated a requirement for participants to consider incompatibilities and to educate the nursing department. Participants who actively considered the proposal of simple suspension method had an altered perception toward the introduction and utilization of this method. Therefore, this survey suggested that workshops could alter the perception and behavior of pharmacists about the methods of drug administration via feeding tube.

Since attention is sometimes required with regard to the use and handling of external medications or injection drugs in drug therapy, patients may have a feeling of “inconvenience”. We, therefore, focused on a feeling of “inconvenience when using” external medications and injection drugs, and conducted a questionnaire survey to investigate the level of awareness and current status of using assist devices that can effectively reduce such inconvenience. The survey took place at a pharmacy, and involved interviews using a questionnaire. Of the 197 respondents, valid responses were obtained from 147 individuals (74.6%). As the results, 25.9% of individuals using external medications or injection drugs responded ‘yes’ concerning the feeling of “inconvenience when using” them. In addition, 39.4% of individuals using eye drops and 10.5% of those using insulin similarly responded. However, only 10.9% knew of the availability of assist devices that are expected to reduce the inconvenience. The results revealed that a certain number of people feel the “inconvenience” of external dosage forms investigated in this study, suggesting the need for pharmacists to consider that patients may have problems using their medications, and to recommend and support the use of assist devices that can be operated by patients.

Since attention is sometimes required with regard to the use and handling of external medications or injection drugs in drug therapy, patients may have a feeling of “inconvenience”. We, therefore, focused on a feeling of “inconvenience when using” external medications and injection drugs, and conducted a questionnaire survey to investigate the level of awareness and current status of using assist devices that can effectively reduce such inconvenience. The survey took place at a pharmacy, and involved interviews using a questionnaire. Of the 197 respondents, valid responses were obtained from 147 individuals (74.6%). As the results, 25.9% of individuals using external medications or injection drugs responded ‘yes’ concerning the feeling of “inconvenience when using” them. In addition, 39.4% of individuals using eye drops and 10.5% of those using insulin similarly responded. However, only 10.9% knew of the availability of assist devices that are expected to reduce the inconvenience. The results revealed that a certain number of people feel the “inconvenience” of external dosage forms investigated in this study, suggesting the need for pharmacists to consider that patients may have problems using their medications, and to recommend and support the use of assist devices that can be operated by patients.

Small group training, that is “A rehabilitation class to prepare patients for their return to society,” was created for 5 patients with higher brain dysfunction who had not yet returned to normal daily life after undergoing individual cognitive training, in order to provide them with a better insight into their disease, and to improve their communication abilities and interpersonal skills. The class consisted of 10 sessions (each session lasting 2 hours and 30 minutes) over a 4-month period, which consisted of an opening address, a short lecture, social skills training, tea time, and recreation. Before and after the class, the patients and their families were asked to complete the Dysexecutive Questionnaire, and any decrease in the difference in the scores between the patients and families suggested that the class had enhanced the patients' self awareness. The Baum test showed the patients having an increased interest in the outside world and a tendency to also have more internal energy. The Clinical Global Impression, as evaluated by the patients' families, indicated an improvement in all patients. We therefore consider this rehabilitation class to help prepare patients for their return to society to be useful as one step to encourage an increased social participation in patients suffering from a higher brain dysfunction.