Long-term effects of music therapy on elderly with moderate/severe dementia

Over a period of 2 years we assessed the long-term effects of group music therapy carried out once weekly on the elderly (mean age: 83 years) suffering from moderate or severe dementia by observing changes in the cortisol level in saliva and in blood pressure and by an intelligence assessment. Systolic blood pressure determined 1 and 2 years after the start of therapy increased significantly in the nonmusic therapy group compared with that in music therapy group (p < .05). Systolic blood pressure increases with aging; the systolic blood pressure was significantly lower in participants who received music therapy. No significant differences in cortisol level in saliva or intelligence assessment score were observed, but the music therapy group maintained their physical and mental states during the 2-year period better than the nonmusic therapy group. This result indicates the lasting effect of once-a-week continuous music therapy. Even the elderly with moderate or severe dementia were able to participate in the group music therapy, and results suggest that enjoying singing and playing musical instruments in a concert was effective in preventing cardiac and cerebral diseases.     

In vivo real-time imaging of chemotherapy response on the liver metastatic tumor microenvironment using multiphoton microscopy

In?vivo real-time visualization of chemotherapy response at the cellular level provides us with direct evidence of what happens on the tumor microenvironment of metastatic organs. We imaged the response of metastatic tumor cells and host stromal cells to chemotherapeutics on liver metastatic xenografts in living mice using intravital two-photon laser scanning microscopy (TPLSM). Red fluorescent protein-expressing human colorectal cancer cells (HT29) was inoculated to the spleen of green fluorescent protein-expressing nude mice. 5-Fluorouracil or irinotecan was intraperitoneally administered after the formation of macroscopic liver metastases. Intravital TPLSM was performed at multiple time-points for time-series imaging of liver metastatic xenografts in the same mice. Under the 1st TPLSM, HT29 cells were visualized in hepatic sinusoids at the single cell level. Liver metastatic nodules consisting of viable cancer cells and surrounding stroma with tumor vessels were visualized under the 2nd TPLSM. After chemotherapy, tumor cell fragmentation, condensation, swelling and intracellular vacuoles were observed under the 3rd TPLSM. There was no obvious morphological difference in tumor response between these chemotherapeutics. Time-series intravital TPLSM imaging on the metastatic tumor xenografts may be useful for screening and evaluating new chemotherapeutics with less interindividual variability.     

Differentiation of first-episode schizophrenia patients from healthy controls using ROI-based multiple structural brain variables

Background

Brain morphometric measures from magnetic resonance imaging (MRI) have not been used to discriminate between first-episode patients with schizophrenia and healthy subjects.

Methods

Magnetic resonance images were acquired from 34 (17 males, 17 females) first-episode schizophrenia patients and 48 (24 males, 24 females) age- and parental socio-economic status-matched healthy subjects. Twenty-nine regions of interest (ROI) were measured on 1-mm-thick coronal slices from the prefrontal and central parts of the brain. Linear discriminant function analysis was conducted using standardized z scores of the volumes of each ROI.

Results

Discriminant function analysis with cross-validation procedures revealed that brain anatomical variables correctly classified 75.6% of male subjects and 82.9% of female subjects, respectively. The results of the volumetric comparisons of each ROI between patients and controls were generally consistent with those of the previous literature.

Conclusions

To our knowledge, this study provides the first evidence of MRI-based successful classification between first-episode patients with schizophrenia and healthy controls. The potential of these methods for early detection of schizophrenia should be further explored.     

Effects of the femoral offset and the head size on the safe range of motion in total hip arthroplasty

The purpose of this study was to quantify the effects of femoral offset and head size on range of motion (ROM) after total hip arthroplasty. Modular prostheses were implanted into 11 cadaveric hips using a posterolateral approach and tested for ROM with 3 different offsets and 5 different femoral head sizes. Increasing the femoral offset to 4 and 8 mm resulted in 21.1 degrees and 26.7 degrees of improved flexion, and 13.7 degrees and 21.2 degrees of improved internal rotation, respectively. The ROM improved in a head size-dependent manner primarily because of increasing the jumping distance of the femoral head rather than delaying any impingement. In contrast, the effectiveness of femoral offset was driven by delayed osseous impingement.     

Recurrence Patterns After Hepatectomy of Hepatocellular Carcinoma: Implication of Milan Criteria Utilization

Background  Bridge hepatectomy followed by salvage liver transplantation has been proposed for patients with hepatocellular carcinoma (HCC) and preserved liver function. Methods  Data were prospectively collected for 501 consecutive patients who underwent curative primary hepatectomy for HCC between 1990 and 2006. Patient survival, disease-free survival (DFS), recurrence patterns, and risk factors were analyzed in patients classified according to the Milan criteria. Results  Patients were divided into two groups on the basis of whether their disease was within the Milan criteria (group 1, n = 321) or not (group 2, n = 180). Group 1 patient survival and DFS rates were 73.6% and 40.6% at 5 years. Recurrence was observed in 160 group 1 patients (49.8%); in 42 (26.3%) of these 160 patients, the recurrence exceeded the Milan criteria. No recurrence was noted in 145 group 1 patients (45.2%). Group 2 patient survival and DFS rates were 52.2% and 23.2%, respectively, at 5 years. Recurrence was noted in 116 patients (64.4%); recurrence in 58 (50.0%) of these patients was within the Milan criteria. In group 2, no recurrence was noted in 55 patients (30.6%). In group 1, indocyanine green retention rate at 15 minutes of >15%, nonanatomical resection, and multiple tumors were statistically significant risk factors for survival; 10-year patient survival was 78.5% for patients with no risk factors and 64.9% for patients with a single risk factor. Conclusions  The Milan criteria should be used to recommend hepatectomy for patients with HCC; however, it is important to consider the high recurrence rate after hepatectomy and the possible requirement of salvage transplantation.