Japanese Journal of National Medical Services

Between January 2001 and December 2005, neurosurgical navigation system (Stealth Station TREON, Medtronic Sofamor Danek, Minneapolis, MN) was used for twenty-four skull base tumors including 11 meningiomas, 4 schwannomas, 4 pituitary adenomas, 2 plasmacytomas, 2 cholesterol granulomas and one epidermoid cyst. The locations of the tumors were as follows; 8 suprasellar/parasellar, 6 uberculum sellae/clinoid, 5 petroclival, 2 foramen magnum, 3 with extracranial extension. The accuracy of the navigation was satisfactory in all cases. This system provided us useful information during surgical procedures such as vascular detachment of large skull base meningioma in an early operative stage, securing encased cerebral arteries, delineating extracranial extensive tumors, and resection of recurrent tumors. In conclusion, the neuronavigation system is an indispensable tool for skull base surgery to facilitate us safely and aggressively resecting the tumor.

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For the outpatients in Kanazawa Medical Center who had been filled prescriptions at pharmacies, we investigated the consciousness of drug costs and generic medicines. We surveyed with questionnaire and obtained the answers from 343 pagents. From the investigation, 50% patients replied that it was “high” or “slightly high” about the drug costs that the patients paid at pharmacies. 30% patients answered that they knew about generic medicines, and it was clarified that generic medicine consciousness was law among the outpatients in this House. For the question whether you demanded detailed explanation about generic medicines, 76% patients replied that they would “demanded”. And 33% patients replied that they were “anxious” about generic medicines. The reasons of anxiety were 45% for “side effects”, and 31% for “efficacy” Therefore it was implied that most patients feeling anxiety for generic medicines thought that the cheaper the drug costs become the more low quality. To reduce patients' individual payment, it is thought that the role of the generic medicines is bigger than bland name. It is needed to have patients recognize of generic medicines widely when we promote them in the future. In addition, it is important to choose the generic medicines of which we can identify the efficacy and safety, not to give the patients anxiety or distrust.

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