We examined ambulatory clinical training for patients with dementia conducted by residents at a university hospital and instructors at a psychiatric hospital who mainly treat patients with dementia in the General Internal Medicine Department of a regional hospital. Residents experienced dementia treatment in the context of primary care, and performed in-depth learning about dementia with the guidance of psychiatrists. It is hoped that dementia treatment will be provided by family doctors. Moreover, it is expected that doctors who have undergone this training will contribute to dementia treatment.

A 2-month-old girl had been urgently seen on postnatal day 10 due to poor weight gain and tachypnea. Echocardiography showed congenital valvular aortic stenosis (AS), ventricular septal defect (VSD), atrial septal defect (ASD), and aortic valve dysplasia, but no cyst image was seen at the aortic valve level. Aortography revealed a dysplastic aortic valve along with coarctation of aorta (CoA) and patent ductus arterious (PDA). Balloon aortic valvotomy (BAV) was performed on day 53. Ballooning was satisfactory, but there was no change in gradient. Operation was performed on day 70 under a diagnosis of congenital AS and CoA complex. After cardiopulmonary bypass was established, the ascending aorta was transected. The blood cyst originated from the center of the anterior leaflet and was resected. The pressure gradient at the aortic valve decreased to 22.5mmHg. The patient was discharged 25 days after surgery.

Preservation is essential for successful cell transplantation. 1) Control group (n=13); Cells isolated from human right atrial tissues were cultured for 15 days. 2) Cell-cryopreservation (C. P.) group (n=23), Tissue-C. P. group (n=29); Human heart cells and minced tissues were cryopreserved in freezing medium containing 70% IMDM, 20% FBS, and 10% DMSO at a rate of 1°C/min. to -80°C by a programmed freezer and stored in liquid nitrogen (-196°C) for 1 week. After cryapreservation, the tissues and cells were thawed rapidly at 37°C. The cells, cryopreserved cells and cells isolated from cryopreserved tissues were cultured as passage 1, 2, and 3 for 15 days each. Cell proliferation was compared with a control group by determining growth curves, and 2-day proliferation rates. A growth factor, biochemical features and cell cycle were measured pre and post-cryopreservation. The cryopreserved group proliferated much more than the control group within 15 days at passage 1, 2, and 3 (1.7, 2.1, and 3.1 times, p<0.0001) respectively. The 2-day proliferation rates of cryopreservation group were higher than the control group in 15 days (p<0.05). The bFGF release after cryopreservation was on average 46.8 and 6.8 times greater than before cryopreservation for the Cell-C. P. and Tissue-C. P. groups, respectively. The TGF-β1 release was also accelerated by cryopreservation (Cell-C.P. group: 1.78 times, Tissue-C. P. group: 1.45 times in average) after cryopreservation. The cell cycle of human heart cells shifted to G2+M from the G1+G0 period by cryopreservation. Human atrial tissues and cells can be cultured and cryopreserved. The cryopreserved cells and cells isolated from cryopreserved tissue proliferate much more than non-cryopreserved cells at all cell ages. Cryopreservation enables human tissues and cells to proliferate more because of the greater release of growth factors and changing cell cycle.