著者
武長 徹也 堀内 行雄 伊藤 恵康 古島 弘三 草野 寛 船越 忠直 古賀 龍二 山本 譲 宮本 梓 井上 彰 村山 俊樹
出版者
日本肩関節学会
雑誌
肩関節 (ISSN:09104461)
巻号頁・発行日
vol.43, no.2, pp.584-588, 2019

18歳以下の若年で胸郭出口症候群(TOS)に対し手術を要したオーバーヘッドスポーツ選手の特徴を明らかにするため調査を行った.TOSに対して手術を施行したオーバーヘッドスポーツ選手110例119肢を対象とし,手術時年齢で18歳以下群と19歳以上群に分け,術前臨床症状,画像所見,術中所見などを比較した.18歳以下群は82例89肢(平均15.8歳,男性78例,女性4例,野球75例),19歳以上群は28例30肢(平均20.6歳,男性26例,女性2例,野球26例)であった.臨床症状の各項目に有意差は認めず,18歳以下群の特徴として①前中斜角筋間距離が狭い,②肩関節90度外転外旋位で腋窩動脈2nd partの血流が遮断される選手の割合が高い,③挙上位血管造影3DCTによる鎖骨下動脈の圧迫所見陽性率が高いことが明らかとなった.静的,動的に肋鎖間隙が狭い選手ほど,オーバーヘッドスポーツキャリアの早期でTOSを発症し競技継続困難となり手術を要すると考えられた.
著者
山本 譲 粟屋 敏雄 小城 香緒里 森田 真樹子 川守田 早紀 神崎 郁代 小川 聡 板垣 祐一 大滝 康一 山本 久仁子 田﨑 嘉一 松原 和夫
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.38, no.1, pp.34-42, 2012-01-10 (Released:2013-01-10)
参考文献数
10
被引用文献数
3 2

Shortage of physicians is a serious social issue in Japan. It has become an urgent challenge to support busy physicians. While the number of anesthetists is remarkably insufficient, the number of operations has increased in many hospitals after Diagnosis Procedure Combination (DPC) is implemented. Drugs used in operation rooms include many narcotic analgesic and poisonous drugs, which medical staff are required to strictly control. From the viewpoint of medical safety management, pharmacists should be involved in the management of these drugs. We have started preparation of injections in the operation rooms aiming mainly at supporting anesthetists. Pharmacists make up the anesthetic sets according to anesthetists' order by the evening of the previous day. The pharmacists carry the sets from the pharmacy to the operation room on a wagon. On the early morning of the operation day, two pharmacists mix the injection drugs, fill the syringes, attach the labels, assemble the routes, and check the completed sets in each operating room according to the list. All pharmacists in our pharmacy department engage in this service. We have conducted opinion surveys of pharmacists and anesthetists on this service. Although the workload of pharmacists increased, most pharmacists thought it was worthwhile. Most anesthetists evaluated that this service has improved medical safety. However, there were many requests that the pharmacists should be further involved throughout the entire operation. It is important to support physicians with services such as this by the pharmacist based on pharmaceutical knowledge. This service has a beneficial impact on healthcare professionals.
著者
山本 譲 樋口 昭平 藤橋 俊明 清水 栄 西出 和憲 上坂 征夫
出版者
公益社団法人日本薬学会
雑誌
藥學雜誌 (ISSN:00316903)
巻号頁・発行日
vol.97, no.3, pp.244-250, 1977-03-25
被引用文献数
1

The metabolic fate of ο-chloro-α-(tert-butylaminomethyl)-benzyl alcohol hydrochloride (C-78) in the rat was studied by oral administration of 14C-C-78, and the bronchodilating activities of the metabolites were also examined. The major metabolites in the urine, bile, and feces were unchanged C-78 (I) and 4-hydroxy- (II), 3-hydroxy- (III), and 4-hydroxy-5-methoxy-C-78 (IV), and their corresponding conjugates. As the minor metabolites, ο-chlorobenzoic acid, ο-chloromandelic acid, and 1-(ο-Chlorophenyl)-1, 2-ethanediol were detected by gas chromatography. These results suggested that the major metabolic pathway of C-78 in the rat is hydroxylation of the benzene ring. Although IV had no activity, II had a stronger bronchodilating activity than C-78, and III was as effective as C-78, suggesting the participation of the metabolites in the bronchodilating action and durability of C-78.