We have embarked on a project to help old people finding something to live for. The project was worked out as we found that more than half of the elderly we queried said that they preferred to stay at home rather than go out because there was nothing to do.　　Years ago, an ad hoc committee, comprised of hospital employees, was organized to think up how to use facilities in our hospital effectively for the benefit of the health of the stay- at-home elderly. Based on the ideas proposed by the committee, a total of eight health classes came into existence. They included the exercise class with an aim to prevent locomotive syndrome, the brain training course for maintaining or improving cognitive abilities, the beauty salon dealing with cosmetic treatments and the karaoke club. Each club had a membership of 10 to 30 persons. More than 80% were women. The average age was around 75 years. The club dues range from \0 to \500. Later on, some clubs raised fees, but the number of participants remained almost the same. Many participants in the one-year brain training course had their cognitive abilities improved significantly.　　It has been found that there are many people living far from the hospital wish to join these clubs but their wish remains unfulfilled. This is one of the tasks we have to tackle with together with the problem that there are too few male participants. In any way, as part of our efforts to revitalize regional communities, we think that it is important to expand our project from now on to have activities built into the daily lives of the elderly.

　　Mountainous areas facing such demographic problems as depopulation and aging, have yet to get over difficulties in securing a means of transportation for people to visit medical facilities. Asuke Hospital, located in a mountainous district of Mikawa, Aichi Prefecture, has worked on the project to improve living conditions for years with a view to laying the foundations for the inhabitants to continue to lead a healthy life. As part of the project, we started shuttle services on a trial basis in 2010 and 2011. As a result, we reaffirmed that there was a pressing need of door-to-door services on the part of patients and members of their families. It was also made clear that, if transportation services are to be an economically feasible project, there must be more users and that users would have to pay a certain amount of money as a fare on the user-pays principle.

We report two cases of paraganglioma originating in the paraseller region (case 1) and in the urinary bladder (case 2). The subject in case 1 was a 59-year-old man who was admitted into the hospital with dizziness, muscular weakness of the left extremities and cold sweating. Magnetic resonance imaging (MRI) revealed a tumor in the parasellar region. The subject in case 2 was a 39-year-old man who was hospitalized because he had a sense of residual urine. Computed tomography and MRI showed a mass of tumor tissue in the posterior region of the left ureteric orifice of the bladder. Imprint cytology of both tumors showed isolated, loosely attached sheet-like cells with abundant cytoplasm and round or oval nuclei. Histologically, both tumors consisted of round or polygonal cells in small packets separated by vascular fibrous septa. Immunohistochemically, both tumor cells were positive for NSE, S-100 protein, chromogranin A, and synaptophysin. Electron microscopic examination revealed neurosectretory granules in the cytoplasm of tumor cells in either of these two cases.

No abstract available.
Rupture ; Transcatheter Aortic Valve Replacement