Objectives: This study examined whether cancer patients who received home care lived in the places they and their families preferred, and whether their preferences changed while receiving home care.Methods: We conducted a medical record survey of 111 cancer patients who received home care provided by a clinic in Japan, and examined the patients' and their families' preferred places to live in the case of their condition deteriorate (the patients and their families were asked when they began to receive home care, and whenever their and their families' conditions changed), and the actual places where the patients lived out their lives.Results: Among those who preferred home at the beginning of receiving home care, 95.6% of patients and 96.8% of families preferred home in the last survey period. Of those who did not prefer home at the beginning, 87.9% of patients and 84.8% of families preferred home by the last survey period. For 97.4% of patients and 97.2% of families, the actual places where the patients lived out their lives were consistent with their preferred places.Conclusion: We found that cancer patients receiving home care provided by the clinic and their families who preferred home from the beginning often still preferred home until the end of their lives, and that those who did not prefer home at the beginning often preferred home by the last survey period. Thus, most of the patients lived out their lives in the places they and their families preferred.

STUDY DESIGN: Multicenter, prospective study. PURPOSE: To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. OVERVIEW OF LITERATURE: To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (HbA1c) levels on surgical outcomes. METHODS: The participants were patients who underwent surgery for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. The 61 cases were evaluated preoperatively and 1 year postoperatively using the Japanese Orthopaedic Association (JOA) scores and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The study variables included fasting blood glucose and HbA1c levels measured preoperatively and at 1 week, 4 weeks, and 1 year postoperatively; the F-wave conduction velocity, latency, rate of occurrence, and M-wave latency in the ulnar and tibial nerves were measured preoperatively and at 1 year postoperatively. The patients were divided into a group without diabetes (N group, 42 patients) and a group with diabetes (DM group, 19 patients). We then assessed the associations between the surgical outcomes and each of the study variables. RESULTS: JOA scores significantly improved in both groups; however, no significant between-group differences were found. There was no significant improvement in the JOACMEQ scores, which assessed cervical function, upper and lower limb function, and bladder function in both groups. We then subdivided the DM group into those with a good control of HbA1c after 1 year (DMG group, 12 patients) and those with HbA1c deterioration after 1 year (DMB group, seven patients), prior to comparing the surgical outcomes. The JOACMEQ scores for upper and lower limb function significantly improved in the DMG group (p<0.01). Compared with the DMB group, there were no significant increases in upper or lower limb function scores in the DMG group. CONCLUSIONS: Poor glycemic control might prevent postoperative functional recovery of the spinal cord.
Asian Continental Ancestry Group ; Blood Glucose ; Diabetes Mellitus ; Electromyography ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Longitudinal Ligaments ; Lower Extremity ; Neck ; Prospective Studies ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Diseases ; Tibial Nerve ; Treatment Outcome ; Urinary Bladder

Iron deficiency in athletes induces negative effects on their athletic performances. The present study aimed to examine a possibility of non-invasive screening with urine ferritin value for iron deficiency by examining its association with serum ferritin value. A group of 30 male college soccer players,13 male endurance runners, 22 female volleyball players, and 9 female long distance runners voluntarily participated in this study. Blood samples were collected before breakfast. The urinary samples were collected to the special tube in the morning and analyzed by ELISA in accordance with the manufacture’s specification. The urinary ferritin value was significantly correlated with serum ferritin value (r=0.32, p<0.05). In addition, the corresponding association was improved in athletes whose urinary ferritin values were less than 2314 ng/gCre (n=52) (r=0.49, p<0.05). In each of male and female athletes, the results on the event-related differences in urinary ferritin had a similar trend as those on serum ferritin. In future studies, further testing should be accomplished using larger numbers of athletes for use the urine ferritin as non-invasive screening iron deficiency in athletes.

Objective: To describe the case of a patient with intraperitoneal bleeding from the gastroepiploic artery by endoscopic ultrasound who was successfully treated with transcatheter arterial coil embolization.Patient and Methods: An 87-year-old man was referred to our hospital for examination of a gallbladder tumor. Endoscopic ultrasonography was performed using an oblique-view echoendoscope. After the endoscopic ultrasound, the patient went into shock. Computed tomography revealed a huge intraperitoneal hematoma and an aneurysm in the right gastroepiploic artery that were not seen on previous computed tomography images. Thus, urgent catheter angiography was performed, which showed a pseudoaneurysm of the right gastroepiploic artery and extravasation of the contrast medium from the pseudoaneurysm.Results: Transcatheter arterial coil embolization was subsequently performed, and the bleeding stopped. Thereafter, his hemodynamics stabilized and his general condition improved. The patient was discharged 22 days post-treatment with an uneventful course.Conclusion: Observation-only endoscopic ultrasound without invasive procedures can cause intraperitoneal bleeding due to a ruptured splanchnic artery. Thus, endoscopic ultrasonography should be performed more carefully in elderly patients.

Objective: Retrieval is challenging once prophylactic pancreatic stents migrate deep into the pancreatic duct. Herein, we describe a case of successful endoscopic retrieval of a migrated prophylactic pancreatic stent using a basket catheter through a biliary plastic stent pusher tube.Patient: A 71 year-old man was referred to our hospital for removal of a straight-shaped migrated 5-Fr 3-cm prophylactic pancreatic stent with a flap on the duodenal side. There were no subjective symptoms at the time of the hospital visit.Results: During endoscopic retrograde cholangiopancreatography, we inserted an 8.5-Fr plastic biliary stent pusher tube in front of the migrated pancreatic stent. The stent was then grasped using a basket catheter for peroral cholangioscopy through the biliary stent pusher tube. The stent was pulled into the pusher tube and was successfully retrieved from the pancreatic duct. No complications were associated with endoscopic retrograde cholangiopancreatography.Conclusion: Although rare, prophylactic pancreatic duct stent migration after pancreatic duct guidewire placement should be noted. In our case, endoscopic retrieval of a migrated prophylactic pancreatic stent using a basket catheter for peroral cholangioscopy through the biliary plastic stent pusher tube was successful.