1 0 0 0 OA 乳房Paget病術後18年目に発症した肺腫瘍塞栓症の1例
- 著者
- 福岡 恵 木村 桂子 木村 充志 米山 文彦 芥川 篤史 河野 弘 佐竹 立成
- 出版者
- 日本臨床外科学会
- 雑誌
- 日本臨床外科学会雑誌 (ISSN:13452843)
- 巻号頁・発行日
- vol.78, no.6, pp.1236-1242, 2017 (Released:2017-12-30)
- 参考文献数
- 13
- 被引用文献数
- 3 2
今回著者らは,稀な肺腫瘍塞栓症の1例を経験した.症例は62歳,女性.平成6年9月に左乳癌に対して乳房切除術を施行し,病理組織診断はPaget病,pT1micN0M0 Stage IAであった.平成21年7月に検診で胸部異常影を指摘されて受診.CTで腋窩・鎖骨上窩・縦隔リンパ節腫大を認め,生検結果よりリンパ節転移再発,ER・PgR陰性,HER2陽性と診断し,PaclitaxelおよびTrastuzumab療法を開始した.4サイクルでPRを得られたが,患者が化学療法の継続を拒否し,通院を自己中断した.平成25年1月に労作時の息切れを自覚して入院し,心臓カテーテル検査で肺高血圧症を認めた.原因不明の肺動脈微小血栓症の疑いで抗凝固療法を開始したが無効で,入院第4病日に呼吸状態が悪化し死亡した.病理解剖の結果,肺の細動脈・肝臓・甲状腺・骨髄の細血管内に癌細胞の浸潤を認め,肺腫瘍塞栓症と診断した.
1 0 0 0 OA 適正管理を目指した医薬品管理システムの構築とその評価
- 著者
- 福岡 恵理子 鎌田 志乃ぶ 中島 克佳 折井 孝男 中村 均 佐藤 均 伊賀 立二
- 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.27, no.5, pp.523-530, 2001-10-10 (Released:2011-03-04)
- 参考文献数
- 2
- 被引用文献数
- 1 1
In the University of Tokyo Hospital, the reentry of data, the re-output of documents, the transfer of data by hand writing, etc. has to be routinely carried out in each department, because there is no compatibility in the related work between the systems and generated information.In this study, we developed a medication management system to share drug-requesting information generated inside the hospital with medical wholesalers who introduced the Value Added Network (VAN) -ordering system, and evaluated the usefulness of this system by sending questionnaires to those who are working in the wholesale, clinical wards, and office work sections.The developed medication management system unified a series of information on the request-to-order processing of medicine between the hospital and wholesalers, the warehousing processing in the pharmacy department, the supply processing for the clinical wards, and the expenditure processing of purchased medical supplies. In addition, the system was designed to work with the LAN of our hospital information system under the environment of Windows NT®.In the investigation on the introduction situation of the computer for the drug wholesalers, 14 out of 16 companies (88%) introduced a computerized system to receive orders. Moreover, 12 out of 14 companies (86%) replied with “it is useful” regarding the usefulness of the system. On the other hand, in clinical wards, 41 out of 55 (75%) replied with “the requesting process has become more convenient by using this system”. In office sections, the time needed to process orders was drastically shortened from approximately 20 to 5 minutes on average.By utilizing this newly developed medication management system, it became possible to share the drug-requesting information originally generated in the clinical wards with the pharmacy department and office work section in the hospital and the medical wholesalers ; therefore, we find this system to be a useful supporting system for the proper management not only for hospitals but for medical wholesalers as well.
