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  • 名徳 倫明, 田井 浩子, 竹内 純子, 土師 久幸
    病院薬学
    1995年 21 巻 5 号 454-461
    発行日: 1995/10/10
    公開日: 2011/08/11
    ジャーナル フリー
    To prescribe drugs or check a prescription, it is very important to understand the contraindications. We developed an original drug information system utilizing commercialy available application software. On the base of this system, we made a list of drugs sequenced due to each contraindication and a list of drugs contraindicated due to drug interactions for combination use. Thus, this list enables us to save times in our searching for the information.
  • 注射剤調剤から患者投与まで
    名徳 倫明
    医療薬学
    2005年 31 巻 2 号 89-98
    発行日: 2005/02/10
    公開日: 2011/03/04
    ジャーナル フリー
    Many medical accidents concerning errors in the administration of injections have been reported in recent years but many of them could be prevented through the active involvement of pharmacists in this respect. At the Department of Pharmacy of the Municipal Ikeda Hospital, a ward pharmacy was established in April 2000 and the dispensing of injections, including the mixing of injections, was commenced. In October, 2001, an injection distribution surveillance system was also established. Under the system, injections are distributed to the patients' bedsides, information provided on the drugs in them and monitoring performed.
    We conducted a survey of the dispensing of injections and the surveillance system. The mixed injection preparations targeted by the survey were drip infusions for administration between 10 : 00 and 22 : 00 whose prescriptions were received by the Department of Pharmacy by 17 : 00 on the day before use, and injection preparations were mixed 4 times a day.The dispensing of injections was divided into 5 tasks : receipt of dispensing requests, preparation of labels, measuring of quantities, mixing of preparations, and preparation of infusion sets and each task was investigated for dispensing errors.Warnings were issued under the distribution surveillance system when pharmacists misidentified patients in distributing injections to the patient's bedside and the situation was investigated.
    The rate of pharmacist errors in mixing injection preparations was 2.23 % in a 4-month period and though 0.04% of the preparations in error were sent to wards, they were not administered to patients. Out of the 7, 690 instances in which injections were distributed to the patient's bedside by pharmacists in the 4-month period, in 3 instances (0.04%) pharmacists were warned about misidentifying patients. All of errors were human errors, but did not lead to errors in administration. This study suggests that risk of errors made with injections could be avoided by the close involvement of pharmacists in the work of administering injections. Greater use of codes was suggested for preventing human errors in future, since codes were printed on the injection in only 14.5 % of the injections distributed during our survey. Besides the increased use of such codes, the development of an injection dispensing surveillance system using them is also necessary.
  • 名徳 倫明, 下村 一徳, 川口 進一, 土師 久幸
    医療薬学
    2005年 31 巻 1 号 58-64
    発行日: 2005/01/10
    公開日: 2011/03/04
    ジャーナル フリー
    At Ikeda Municipal Hospital, we created an order entry system for the dispensing and mixing of injections in November 2003. We then compared the numbers of injections that pharmacists mixed and administered to patients, the rates for injections mixed by pharmacists, return rates for injections mixed by pharmacists and dispensing error rates between the four months before and after introducing the system. Compared to before the introduction of the system, the number of injections that pharmacists mixed and administered to patients increased by about 40%, the rate for injections mixed by pharmacists increased by 2% and the return rate for injections decreased by approximately 1%. The dispensing error rate decreased to 0.26%, a marked drop from the 2.23% error rate before introducing the system. Based on these results, we felt that our order entry system for the dispensing and mixing of injections was very useful.
  • 石川 達哉, 中川 翼, 阿部 弘, 宮坂 和男, 阿部 悟, 小岩 光行, 柏葉 武
    脳卒中の外科
    1987年 15 巻 2 号 182-187
    発行日: 1987/07/10
    公開日: 2012/10/29
    ジャーナル フリー
    Using the detachable balloon technique, we treated two patients with inaccessible giant internal carotid aneurysms located at the cavernous and the petrosal portion.
    An angiogram of the first patient, a 27 year-old female with the right trigeminal and abducens paresis revealed a giant right internal carotid aneurysm at the petrosal protion. Three days after right STA-MCA double anastomoses, intravascular surgery was performed. The internal carotid aneurysm was trapped with Debrun's No.16 and No.9 balloons placed distal and proximal to the aneurysmal neck. Following the surgery, her neurological deficit disappeared, with no repeat ischemic episode. Neuroradiological examinations showed a thrombosed right internal carotid artery with no visualization of aneurysm.
    Angiogram of the second patient, a 56 year-old female with left oculomoter palsy, revealed a giani left internal carotid aneurysm at the cavernous portion. Using two Debrun's No.16 balloons, trapping of internal carotid aneurysm was performed three days after left STA-MCA anastomosis. whose anastomosis was not patent at the time of intravascular surgery. Following the trapping, transient sensory aphasia appeared. However, the oculomotor palsy gradually improved, and the aneurysm and the left internal carotid artery were found to be completely thrombosed on neuroradiological examination.
    We emphasize that the trapping of the internal carotid aneurysm by the detachable balloon technique with an EC-IC bypass is the safest and most beneficial method in terms of the lesser possibility of delayed ischemic complications caused by newly developed collateral vessels to the parent artery at a site close to the aneurysm.
  • 鈴木 重晴, 尾田 宣仁, 関谷 徹治
    Neurologia medico-chirurgica
    1978年 18pt2 巻 5 号 409-413
    発行日: 1978年
    公開日: 2006/12/28
    ジャーナル フリー
    We reported herein on the usefulness of ventriculography by means of percutaneous injection of a recently developed watersoluble contrast media of greater safety, through a shunt flushing reservoir; the method is called trans-reservoiral ventriculography, and is presented here with twelve clinical cases in which this examination was applied.
    The trans-reservoiral ventriculography is useful especially in observing the course of brain tumor after either surgical or non-surgical treatment, inclusive of examination for tumor recurrence.
  • 兼松 善範
    日本釀造協會雜誌
    1987年 82 巻 1 号 11-19
    発行日: 1987/01/15
    公開日: 2011/11/04
    ジャーナル フリー
    農林水産省の食品産業膜利用技術研究組合に参画し, 火入醤油の膜済過についての実用性を広範囲にわたって系統的に検討し, 多くの基礎的データを得ることができた。
  • -2 次元コードを用いた注射薬混合調製監査システム-
    森山 雅弘, 河崎 陽一, 松香 直行, 古野 勝志, 五味田 裕
    医療薬学
    2007年 33 巻 8 号 666-673
    発行日: 2007年
    公開日: 2009/09/04
    ジャーナル フリー
    With the objective of preventing medical errors,the authors created an auditing system using a QR-code for the mixing of injections.The number of injections mixed has been increasing year by year ever since the system was introduced.Approximately 12,000 prescriptions have been audited by the system up to now and no medical errors related to the mixing of injections have occurred.We also included a function for storing auditing records in the system which as reduced our workload.
    Our system not only prevents medical errors it also raises efficiency in the injection mixing process.
  • 名徳 倫明, 冨田 由美, 村山 洋子, 五十嵐 恵美子, 中西 晶子, 深尾 知子, 藤原 紀子, 下村 一徳, 川口 進一, 土師 久幸
    医療薬学
    2003年 29 巻 4 号 421-426
    発行日: 2003/08/10
    公開日: 2011/03/04
    ジャーナル フリー
    Our hospital developed a dispensary inspection system for injections in October, 2001 as a preventive measure against the administration of wrong instillations due to a misidentification of patients and started a service for delivering the injections prepared at the pharmacy to the patients' bedside. The injections delivered by pharmacists are those for instillation prepared at the pharmacy to be administered between 10 : 00 and 22 : 00. The injection delivery service was monitored by the dispensary inspection system using two-dimensional codes (QR codes) printed on the labels of instillation bottles at 3 points, i.e. at dispensing, at delivery, and at administration. The number of cases in which pharmacists were warned by the injection dispensary inspection system and the circumstances of warning were investigated during the 4 months from February 1 to May 31, 2002. During the 4 months, 3 (0.04%) of the 7, 690 deliveries of injections by pharmacists to the patients' bedside were misidentified. All misidentifications were caused by human error. The close involvement of pharmacists in the delivery of injections has contributed to the prevention of accidents due to the erroneous delivery of injections.
  • 川口 進一, 名徳 倫明, 下村 一徳, 乾 とし子, 土師 久幸
    日本病院薬学会年会講演要旨集
    2000年 10 巻
    発行日: 2000/09/01
    公開日: 2019/03/15
    会議録・要旨集 フリー
  • 原 明宏, 酒井 正博, 菅 紀子, 黒川 實, 中田 正幸
    日本病院薬学会年会講演要旨集
    2000年 10 巻
    発行日: 2000/09/01
    公開日: 2019/03/15
    会議録・要旨集 フリー
  • 名徳 倫明, 五十嵐 恵美子, 冨田 由美, 村山 洋子, 中西 晶子, 下村 一徳, 深尾 知子, 乾 とし子, 藤原 紀子, 阪本 絵美, 川口 進一, 土師 久幸
    医療薬学
    2004年 30 巻 9 号 594-600
    発行日: 2004/09/10
    公開日: 2011/03/04
    ジャーナル フリー
    We evaluated whether doctors' prescribed injections properly or not by examining information obtained from a pharmacist's checklist of cautions in the dispensing of injections, and used the results to investigate the current situation of checking injection prescriptions based on prescriptions for the 2002 calendar year. Cases in which pharmacists contacted doctors to check on drugs and dosing schedules were investigated and their numbers tallied. For the total of 23, 441 prescriptionsconsidered, the change rate was 0.97%. When we tallied change rates according to modality, that for antineoplastic drugs was 4.51% in 554 prescriptions, that for, IVH was 1.48% in 3, 313 prescriptions, and that for other injections was 0.69% in22, 284prescriptions. In addition, in the first six months of 2002, the prescription change rate was 0.68% and it almost doubled to 1.26% in the remaining 6 months of the year. The present study enabled pharmacists to provide information on the adverse effects of injections to doctors and nurses when dispensing them and aidedrisk management in our hospital.
  • 田上 秀男
    日本醸造協会誌
    1997年 92 巻 8 号 557-562
    発行日: 1997/08/15
    公開日: 2011/09/20
    ジャーナル フリー
    醤油は清澄な液体調味料であることが要求される。製造工程では火入工程 (加熱) の後に, 清澄・濾過が行われる。一般的には珪藻土を助剤に使用して清澄度向上の目的で濾過が行われる。ここでは珪藻土を含む火入沂をセラミック製精密濾過膜を用いた清澄濾過技術を披露していただいた。
  • 津田 恭子, 杉浦 宗敏, 上野 正貴, 遠藤 理夏, 伊藤 瑞紀, 高山 和郎, 清野 敏一, 中村 均, 伊賀 立二
    日本病院薬学会年会講演要旨集
    2000年 10 巻
    発行日: 2000/09/01
    公開日: 2019/03/15
    会議録・要旨集 フリー
  • 名徳 倫明, 冨田 由美, 入潮 佳子, 五十嵐 恵美子, 井原 有紀, 川口 進一, 土師 久幸
    日本病院薬学会年会講演要旨集
    2000年 10 巻
    発行日: 2000/09/01
    公開日: 2019/03/15
    会議録・要旨集 フリー
  • -1 次·2 次チェックシステムの導入による処方の安全性向上-
    池嶋 孝広, 田中 雅幸, 打谷 和記, 村中 達也, 鶴見 由美子, 大植 謙一, 廣田 育彦
    医療薬学
    2008年 34 巻 10 号 931-937
    発行日: 2008年
    公開日: 2010/02/07
    ジャーナル フリー
    We have introduced a computerized prescription checking system for cancer chemotherapy that helps ensure medical safety.In developing it,we incorporated a regimen ordering function into the electronic medical record system (EMRS) and registered chemotherapy regimens for which prescriptions could be ordered,restricting orders for antitumor drugs from physicians to those in the regimens.All registered regimens were reviewed and approved by an in-hospital pharmacotherapy committee.Under the primary check system,doses of antitumor drugs are automatically calculated based on patient body weight or body surface area.The limit on the highest dose of each antitumor drug is 110% of the automatically calculated dose.When ordering chemotherapy regimens,doses of antitumor drugs are ordered without converting to the number of vials of each size.In the pharmacy subsystem,orders are sent to the pharmacy and totals made of all prescriptions.Then,doses of antitumor drugs are automatically converted into the number of each size of vial based on cost performance and the numbers of vials is printed on prescriptions to support dispensing.The system also makes chemotherapy administration records to help ensure that doses of antitumor drugs for each patient are reasonable.
    The introduction of our system has made chemotherapy dosage errors much less likely and the total prescription error rate was reduced to 0.15% (0.10% for outpatient chemotherapy,0.21% for inpatient chemotherapy).It has also greatly reduced pharmacists’workload in prescription checking.We feel that our prescription checking system has decreased the chemotherapy prescription error rate for the errors that were most likely to harm patients.
  • 名徳 倫明, 下村 一徳, 深尾 知子, 乾 とし子, 陶山 忠士, 川口 進一, 土師 久幸
    医療薬学
    2002年 28 巻 4 号 315-320
    発行日: 2002/08/10
    公開日: 2011/03/04
    ジャーナル フリー
    The system of intravenous injections (i.v.) being mixed by pharmacists is necessary to prevent contamination and dispensing errors. Such a system was started at the Municipal Ikeda Hospital on April 2000. The dispensing of injections consists of five steps, including the labeling, dispensing, setting and mixing, and the application of check systems. Dispensing errors that induced serious medical complications were examined over a 4-month period (2000.10. 1-2001. 1.31). In addition, resource management during dispensing errors were researched, and countermeasures against dispensing errors were developed. Dispensing errors involving i.v. mixing, which were identified after the preparation had been taken to the ward by nurses, were also surveyed for a 4-month period (2001. 6. 1-9.30). There were 9, 611 i.v. mixing by pharmacists in a 4-month period (2000.10. 1-2001. 1.31). There were 214 dispensing errors (2.23%) during those 4 months, those discovered in the final check comprised 0.28% (27cases), while those involving i.v. mixing taken to the ward by nurses was 0.04% (4 cases). The percentage of serious dispensing errors was 0.01 % (1 case). Fortunately, these mixed i.v. preparations were not administered to patients. In the second survey, there were 10, 478 i.v. mixings by pharmacists in a 4-month period (2001. 6. 1-9.30). There was only 1 case (0.01 %) of a dispensing error involving i.v. mixing identified after being taken to the ward by nurses. There were no cases involving serious dispensing errors. These erroneous instances of i.v. mixing were not administered to patients. When these two surveys are compared, no significant difference was observed, but the number of errors decreased after the establishment of countermeasures to reduce dispensing errors. As a result, it became clear that dispensing errors could occur at any step, but they were preventable by both making several checks and by developing countermeasures against dispensing errors at each step.
  • 上田 孝, 有川 章治, 中薗 紀幸, 脇坂 信一郎, 和田 徹也
    脳卒中
    1992年 14 巻 6 号 627-632
    発行日: 1992/12/25
    公開日: 2009/09/03
    ジャーナル フリー
    脳梗塞発症後24時間以内に高気圧酸素 (HBO) 療法を施行し得た39症例と, 非治療例の治療成績を比較検討した.HBO施行群では, 治療開始10日で運動麻痺や言語障害の程度が有意に改善し, 30日後も継続して改善していた.X線CT上低吸収域が無いか, 小さい症例ではHBO治療の効果は高かった.初診時意識レベルがJapan Coma ScaleでII-20以上の重症例や, X線CT上広範な脳梗塞が出現している症例, 多源性心室性期外収縮, 心房細動, うっ血性心不全, 腎不全, 閉塞性動脈硬化症などを合併する症例では, 症状が進行性に悪化したが, HBO非施行群とに差はなかった.以上より急性期脳梗塞のHBO治療は安全かつ有用であることが示唆された.
  • 中台 忠信
    日本釀造協會雜誌
    1987年 82 巻 2 号 95-98
    発行日: 1987/02/15
    公開日: 2011/11/04
    ジャーナル フリー
    バイオリアクターによって醤油様の調味料を得る技術が発表されて2年余を経た。このほか, 醤油の製造工程に膜利用技術やコンピューター利用の計測制御システムに関する研究, 新しい形態をした原料の開発等, 枚挙に暇ない昨今である。これら醤油の製造技術ないし品質管理に導入されつつある最新技術の情報について2回に分けて掲載するようまとめていただいた。
  • ポキポキモータの進化
    中原 裕治
    パワーエレクトロニクス研究会論文誌
    2002年 28 巻 2-7
    発行日: 2003/04/28
    公開日: 2010/03/16
    ジャーナル フリー
    This paper presents the motor manufacturing technology using dividing stator cores. The novel manufacturing technology called Poki-Poki motor has been developed from 1993, and applied to various motors used in such products as information devices, industrial equipments, electrical household appliances, motor vehicles and elevators, etc.. Poki-Poki motor can provides not only high productivity but also light and compact devices, saving energy, high efficiency.
  • -治験例の術後1年の脳血管写所見について-
    小岩 光行, 柏葉 武, 川口 進, 下山 三夫, 中川 翼, 竹井 秀敏, 阿部 悟
    脳卒中の外科研究会講演集
    1984年 13 巻 217-221
    発行日: 1984/10/25
    公開日: 2012/10/29
    ジャーナル フリー
    Last year, we reported a 28-year-old female whose right internal carotid giant aneurysm was successfully treated with the detachable balloon technique with subsequent complete recovery both neurologically and socially.
    At this time we investigated follow-up angiograms to evaluate the aneurysm and hemodynamic states.
    On the 40th postoperative day, the angiogram showed a right internal carotid artery occluded at the point 1.5cm distal to the bifurcation, where an external carotid artery branched off an accessory meningeal artery and a twig of the internal maxillary artery, draining into an inferolateral trunk of the cavernous portion. Retrograde filling of an ophthalmic artery was seen from an anterior deep temporal artery.
    The C2-C4 segment of the internal carotid artery was filled via these arteries, but was prominently elevated and compressed by giant aneurysm.
    Approximately one year after the operation, these angiographic findings were almost unchanged except that collaterals and the C2-C4 segment were larger, and the latter took the normal course.
    From these findings, we discussed the danger of rerupture because of retrograde or anterograde cerebral blood flow to an aneurysm of the cavernous and petrosal portion, and of delayed cerebral ischemic episodes.
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