Long-term evaluation of animal-assisted therapy for institutionalized elderly people: a preliminary result

Background: Many researchers theorize that animal‐assisted therapy (AAT) will have an effect on people suffering from the symptoms of dementia by evaluating short‐term‐effects. The purpose of this research was to evaluate the psychological and behavioral effects of AAT on elderly residents of a nursing home on a long‐term basis. Methods: The subjects consisted of 10 residents of a residential nursing home. Researchers first created each participant’s goal in an agreement with the nursing home staff. Visits were made twice a month, and on each occasion three or four dogs were taken. The residents were able to freely feed, hold and play with the dogs, with each dog placed on a separate table. Data collection methods included GBS Scale Japanese Version (GBSS‐J) and Mental Function Impairment Scale (MENFIS). Data was collected four times during the period 2003–05. The scores were analyzed using SPSS11.5J. Results: According to GBSS‐J, the scores for intellectual function, spontaneity, emotional function and other mental functions decreased during the first 6 months of the study and then increased until the twelfth month. The score for Motor function increased over the 12 months. When comparisons were made item by item, there were significant decreases in impaired orientation in space, and emotional liability during the first 6 months. According to MENFIS, the overall score tended to decrease during the first 6‐month period but increased from 6 months to 12 months. There was a tendency for scores to decrease in impaired emotional function, especially impaired suitability of emotional expression and impaired stability of emotional expression over the 12‐month period. Conclusions: After 6 months of participation in AAT, there were improvements in mental functions, though physical functions decreased. It is suggested that after a 6 month period each subject’s needs and goals should be re‐examined.     

Long-term follow up of abdominal aortic aneurysm complicating Kawasaki disease: Comparison of the effectiveness of different imaging methods

A 2 month old boy with Kawasaki disease developed the rare complication of abdominal aortic aneurysm (AAA). He was followed up over 7 years by ultrasonography (2D-ECHO) with and without Doppler flow evaluation, angiography and computed tomography. Calcification was noted 33 months after the onset of the disease but the aneurysm did not decrease in size. 2D-ECHO was adequate for evaluating the size of an aneurysm, but did not show thrombus formation or calcification. Doppler flow studies did not show abnormally high blood flow velocities either at the inflow or outlet of aneurysms, which are indicative of stenosis. On the other hand an abdominal aortogram provided information regarding the luminal shape and abnormalities in flow pattern suggestive of thrombus formation. Fluoroscopy cannot demonstrate calcification in the early stages. Computed tomography (CT) was the imaging method of choice for the evaluation of obstructive or calcific changes; an organizing thrombus was clearly demonstrated and early detection of calcification was possible.     

A case of advanced gastric cancer with peritoneal dissemination responding remarkably to TS-1/CDDP combination chemotherapy

A 57-year-old woman visited a physician with complaints of anorexia and pollakiuria. Because a pelvic tumor and ascites were detected, she was referred to our department. Douglas pouch puncture revealed adenocarcinoma cells. Further examination showed an advanced gastric cancer with peritoneal dissemination. The cancer was judged to be unresectable. Chemotherapy with a combination of TS-1 and CDDP was performed before the operation. After 2 courses of the chemotherapy, her complaints disappeared, although abdominal CT confirmed remaining peritoneal dissemination. After 7 courses of chemotherapy, abdominal CT showed that the peritoneal dissemination had disappeared. Total gastrectomy and lymph node dissection were performed. Histological findings of the stomach revealed complete disappearance of cancer cells in the stomach and the regional lymph nodes. We confirmed that the TS-1/CDDP therapy resulted in a complete response to advanced gastric cancer and peritoneal dissemination. We recommend that chemotherapy be continued until the peritoneal dissemination disappears.     

Profiling of gene expression associated with hepatolithiasis by complementary DNA expression array

By use of cDNA expression array method, we compared the expression profiles of genes in hepatolithiasis tissues with those of paired normal tissues. Expression of 1176 cancer related genes that include 33 tumor suppressor genes, 100 proto-oncogenes and 37 DNA damage repair genes were examined in this study. We found that expression of tumor suppressor genes and proto-oncogenes was systemically activated in hepatholithiasis tissues, suggesting that expression of genes controlling cell growth becomes unstable in liver lobe of hepatolithiasis. In contrast, expression of DNA damage repair genes were not activated but rather remained unchanged in hepatholithiasis tissues, suggesting that repair process is not strongly activated but rather impaired in hepatholithiasis tissues.     

Splenic Vein Thrombosis as a Consequence of Chronic Pancreatitis: A Study of Three Cases

Splenic vein obstruction was found in three patients with chronic pancreatitis. All had suffered epigastric pain, but no specific findings which suggested obstruction of the splenic vein were evident on physical or laboratory examinations. Enlarged pancreatic contour with calculi and pseudocyst formation were observed by CAT scan in all three cases. Gastric varices were found in two patients who had episodes of gastric bleeding. The splenic vein was shown to be occluded in two patients in the venous phase of celiac angiography and was entirely nonvisualized by percutaneous portography in the third case. The first patient underwent elective surgery, while the second patient had emergency surgery due to intraabdominal abscess formation with gastric bleeding. The surgical procedure in both patients was splenectomy coupled with distal pancreatectomy. Thrombus formation was confirmed by venous dissection at surgery.     

Twenty-Seven-Year Follow-up of Arrhythmogenic Right Ventricular Dysplasia

OBATA, H., et al. : Twenty-Seven-Year Follow-up of Arrhythmogenic Right Ventricular Dysplasia. This case report describes clinical features, especially of surface ECG changes, observed for 27 years in a patient with arrhythmogenic right ventricular dysplasia (ARVD). The course of this patient was characterized by progressive deterioration of right ventricular function and progression of delayed potentials (so-called epsilon waves) following QRS complexes. However, the relation between ventricular arrhythmias and ECG changes or the degree of right ventricular abnormality was difficult to discern.     

THE DIFFERENTIAL DIAGNOSIS OF CYSTIC NECK MASSES BY THE DETERMINATION OF THYROGLOBULIN CONCENTRATIONS IN THE ASPIRATES

Thyroglobulin (Tg) concentrations in the aspirates of various types of cystic neck masses were measured by RIA to assess the usefulness of this determination in differential diagnosis. The subjects consisted of 16 patients, whose final diagnoses were all established on the basis of operative results; three patients had follicular thyroid adenomas (F-Ad), 11 had papillary thyroid carcinomas (P-Ca), one had a thyroglossal duct cyst (TDC) and one had a lateral cervical cyst (LCC). Tg concentrations in the cyst fluids of F-Ad and P-Ca were very high (0·042–2·83 mg/ml) compared with serum Tg concentrations. There was no difference in Tg concentrations in the fluids of P-Ca between primary lesions (n= 5) and metastatic lesions (n= 6). On the other hand, Tg concentrations of TDC and LCC were very low (< 100 ng/ml). Difficulty was experienced in diagnosing three patients, even though they had been examined by all nonsurgical diagnostic techniques. However, an occult thyroid carcinoma with lymph node metastasis was diagnosed by demonstrating a high Tg concentration in the aspirate of the cystic lymph node. T3 concentrations in cyst fluids of F-Ad were higher than those of P-Ca. T3 concentrations in the fluids of P-Ca, TDC and LCC did not differ, and were similar to serum T3 levels. Cytology of cyst fluids was positive in four of 10 patients examined with P-Ca. In conclusion, we can clearly confirm the thyroid origin of a cystic neck mass by demonstrating a high Tg concentration in the aspirate. This is especially useful for diagnosis in patients with thyroid carcinoma, including occult thyroid carcinomas with cystic lymph node metastasis.     

Functioning paraganglioma in the organ of Zuckerkandl associated with esophagus carcinoma: A case report

A case of extrameduflary pheochromocytoma in the organ of Zuckerkandl is reported. Moderately differentiated squamous cell carcinoma of the esophagus was found concomitantly. Despite the significant elevation of catecholamine levels in the plasma and urine, the value of vanillylmandelic acid was only slightly elevated.