Introduction: We investigated the end-of-life care preferences of patients with mild dementia and compared them with the hopes of caregivers regarding end-of-life care for patients.Methods: A questionnaire survey was conducted among outpatients with mild dementia or mild cognitive impairment and their family caregivers who visited the Medical Center for Dementia.Results: We analyzed 50 pairs of dementia patients and their family caregivers. Of people with dementia, 24 respondents (48.0%) preferred "antibiotics and infusions for pneumonia" at the end of life. Eleven respondents (22.0%) preferred "central parenteral nutrition". Eight respondents (16.0%) preferred "resuscitation". For each end-of-life care item, the concordance rate between patients and caregivers on "prefer" / "do not prefer" was 0%-76%. Patients and their families who discussed end-of-life care had a significantly higher concordance rate for "resuscitation" preference than those who did not.Conclusion: For patients and their families to be able to make decisions they do not regret, it is important to promote discussions about end-of-life medical care before the patient's condition becomes severe.

We have developed two novel cell co-culture system, without any on cell type combination limitation, utilizing a polymer surface which is temperature-sensitive with respect to its cell adhesion characteristics. One system involves a patterned co-culture of primary hepatocytes with endothelial cells utilizing patterned masked of the electron-beam cured, temperature-responsive polymer, poly (N-isopropylacrylamide) (PIPAAm) by masked electron beam irradiation. Hepatocytes were cultured to confluency at 37 degrees C on these surfaces. When the culture temperature was reduced below 32 degrees C, cells detached from the PIPAAm-grafted areas without any need for trypsin. Endothelial cells were then seeded onto the same surfaces at 37 degrees C. These subsequently seeded endothelial cells adhered only to the now-exposed PIPAAm-grafted domains and could be co-cultured with the hepatocytes initially seeded at 37 degrees C in well-ordered patterns. The other system involves a double layered co-culture obtained by overlaying endothelial cell sheets of the designed shape onto hepatocyte monolayers. The endothelial cells adhered and proliferated on the PIPAAm-grafted surface, as on polystyrene tissue culture dishes at 37 degrees C. By reducing the temperature, confluent monolayers of cells detached from the PIPAAm surfaces without trypsin. Because the recovered cells maintaed intact cell-cell junctions together with deposited extracellular matrix, the harvested endothelial cell sheets, with designed shapes, were transferable and readily adhered to hepatocyte monolayers. Stable double layered cell sheets could be co-cultivated. These two co-culture methods enabled long-term co-culture of primary hepatocytes with endothelial cells. Hepatocytes so co-cultured with endothelial cells maintained their differentiated functions, such as albumin synthesis for unexpectedly long periods. These novel two co-culture systems offer promising techniques for basic biologic researches upon intercellular communications, and for the clinical applications of tissue engineered constructs.
Acrylic Resins/chemistry* ; Animal ; Coculture ; Cytological Techniques* ; Endothelium/cytology* ; Human ; Surface Properties ; Temperature*