What kind of service satisfies customers in dispensing pharmacies in the process of dispensing prescriptions and providing pharmaceutical information about their medicines ? In order to clarify the major factors involved in customer satisfaction, this study analyzed the factors influencing overall satisfaction based on a random questionnaire-style survey of 130 dispensing pharmacies and 24107 customers (valid responses=15034, 62.4%) in one week in November, 2005. The results in descending order were staff responses (standard coefficient=0.456), explanation about the medicines (0.162), waiting time (0.108), kindliness (0.091), neat appearance of staff(0.084), greetings from the stuff(0.058), age (0.038), and language used by the stuff(0.021). From these results, we suggest that to raise customer satisfaction in dispensing pharmacies, it is necessary to improve the explanation about the prescribed medicines and the waiting time, as well as the overall response from the staff.

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Hypophosphatasia is a hereditary autosomal recessive disease characterized by a defect in tissuenonspecific alkaline phosphatase (TNSALP) activities. A one-month-old boy showed poor weight gain. His body weight and height were 3,202g (-2.7SD) and 53cm (-1.4SD), respectively, 7 weeks after birth. Serum calcium level was very high with a value of 17.6mg/dl. Serum alkaline phosphatase level was 30 IU/l, while bone-type ALP was undetectable. Urine phosphoethanolamine, one of the substrates of ALP, was 3,056.8nmol/mgCr. Urine Ca/Cr ratio was 1.4. Radiological findings showed osteopenia of cranial bones and irregular ossification of metaphyses of long bones. He was diagnosed with infantile type hypophosphatasia. He was treated with diuretics, a low Ca diet and calcitonin to decrease his serum calcium level. Appropriate body weight gain was not achieved even after the serum Ca level improved. He repeatedly suffered respiratory tract infection and died from pneumonia at 6-months. Analysis of TNSALP gene of the patient revealed compound heterozygous mutations of K207E and T1559del.

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本注入療法は，抗コリン薬に反応しない難治性尿失禁に対する新しい治療法として最近注目されている。信州大学病院においても，先進医療としての申請を目指して，昨年医倫理委員会の承認を得て，今年度から臨床治験を開始する。

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