The aim of this study was to evaluate the relationship between severity of dementia and hand dexterity in patients with Alzheimer's disease (AD) using the Purdue Pegboard test including both simple and complex dexterity tasks. Eighty-four patients with AD and 32 non-demented subjects (controls) who were registered in a senior day-care center participated in this study. All of the subjects in this study were right-handed. The AD group consisted of 36 patients with a Clinical Dementia Rating of 1 (CDR 1), 35 with a CDR of 2 (CDR 2), and 13 with the CDR of 3 (CDR 3). For the simple task, right hand scores in the CDR 1, CDR 2, and CDR 3 groups were significantly lower than those of the controls whereas left hand scores were not lower than the controls. While the right hand scores were higher than the left hand scores in the controls and the CDR 1 group, no significant difference was observed between the right and left hand scores in the CDR 2 and 3 groups. Moreover, left hand scores were higher than right hand scores in 19 % of the CDR 1 group, 34% of the CDR 2 group, and 23 % of the CDR 3 group. Differences between right and left hand scores, which is a measure of handedness superiority, were decreased in order from the control group to the CDR 1 group and to the CDR 2 group. There was a relationship between “memory” subscale in the CDR and the differences in right and left hand scores. These results indicated that handedness superiority became unclear or disappeared as memory impairment progressed.

A regular check-up in a 69-year-old man showed normal blood chemistry values, except for elevated value of liver enzymes and inflammatory reactions. A computed tomography scan (CT) of the abdomen revealed a normal appearance of the liver, pancreas and spleen, but incidentally showed a tumor in the right atrium. The tumor (a blood cyst which contained white thrombus) was successfully excised. Blood cysts of the heart are extremely rare in adults. These tumors are incidently found at autopsy on cardiac valves in approximately 50% of infants under 2 months of age. The blood cyst in this case arose from the right atrial wall, which is also quite rare.

To clarify changes in body temperature during endurance exercise in patients with spinal cord injury (SCI), we measured tympanic temperature (Tty) and skin temperature in the head, arm, chest, thigh, shin and calf in 5 patients with SCI (T6-T 12) and 7 normal controls during 30 minutes arm cranking exercise (20 watts) from 10 minutes before the initiation of exercise until 10 minutes after the termination of exercise in an artificial climate room at a temperature of about 25°C with a relative humidity of about 50%. The Tty in the SCI group was lower than that in the control group from 10 minutes before the initiation of exercise to 10 minutes after the termination of exercise with a significant difference only at the initiation of exercise. The difference in Tty slightly decreased with continuation of exercise. The Tty in the SCI group at rest was 36.05-37.15°C. Four patients in this group showed a decrease of 0.04-0.12°C in the early stage and an increase of 0.66°C±0.19 (mean±SD) at the end of exercise over the value at the initiation of exercise.
The skin temperature was lower in the SCI group than in the control group in all sites excluding the arm. Significant differences were observed in the head in the early stage of exercise and after exercise, in the chest from 10 minutes before the initiation of exercise to 5 minutes after the termination of exercise, in the thigh from 10 minutes before the initiation of exercise to 10 minutes after the termination of exercise, in the shin 10 minutes and 5 minutes before the initiation of exercise, and in the calf from before to 15 minutes after the initiation of exercise. In the SCI group, marked individual differences were observed in the skin temperatures in the thigh, shin, and calf, suggesting specificity of the skin temperature response in and near the paralysis area.
Results in Tty in this study suggested no heat retention in the SCI patients. Therefore, the risk for heat disorders seems to be low during moderate or mild exercise under moderate temperature environment at a temperature of about 25°C with a relative humidity of about 50% even when the skin temperature is low, and thermolysis is not marked.

We have several choices against bleeding and obstruction in advanced gastric cancer patients such as surgical or endoscopic therapy. But we have few reports about palliative radiation. We conduct this study that we perform palliative radiation for unresectable advanced gastric cancer patients between April 2006 and March 2014 in single center. In the aim of the therapy, to stop gastric bleeding were 8, and to improve obstruction depend on gastric cancer were 4. Response rate of stop bleeding was 63％, and improve obstruction was 50％. Median duration of stop bleeding was 103 day, and improve obstruction was 52 day. Overall survival time was 567 day, survival time after the start of radiotherapy was 105days. Radiotherapy was limited in cases because onset time of response needed in comparison with surgical or endoscopic therapy. However, given minimally invasive therapy and a certain response, we can choice it so much more.

Superior mesenteric artery (SMA) aneurysms (SMAAs) are rare and account for approximately 7% of all visceral artery aneurysms. If the anatomical complexity permits and the patency of organ perfusion is allowed, then an endovascular approach is the first choice for minimally invasive procedures. We report the case of a 92-year-old female with a giant SMAA and challenging anatomy, including a short proximal sealing zone from the origin of the SMA and a short distal sealing zone from the hepatic artery bifurcation. In view of her advanced age, she was treated endovascularly with covered stents. Reintervention was required to correct a postoperative endoleak; however, a favorable outcome was achieved with endovascular therapy.

BACKGROUND: Allergic contact dermatitis (ACD), which is accelerated by interferon (IFN)-γ and suppressed by interleukin (IL)-10 as regulators, is generally self-limited after removal of the contact allergen. Adipose tissue-derived multipotent mesenchymal stem cells (ASCs) potentially exert immunomodulatory effects. Considering that subcutaneous adipose tissue is located close to the site of ACD and includes mesenchymal stem cells (MSCs), the MSCs in adipose tissue could contribute to the self-limiting course of ACD. OBJECTIVE: The aims of the present study were to elucidate the effects of MSCs in adipose tissue on ACD and to examine any cytokine-mediated mechanisms involved. METHODS: Ear thickness in a C57BL/6 mouse model of ACD using contact hypersensitivity (CHS) elicited by 2,4,6-trinitro-1-chlorobenzene was evaluated as a marker of inflammation level. Five and nine mice were injected with ASCs and phosphate-buffered saline (PBS), respectively. After ASC or PBS injection, real-time reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were performed. RESULTS: Histology showed that CHS was self-limited and ear thickness was suppressed by ASCs in a dose-dependent manner. IFN-γ expression in the elicited skin site and regional lymph nodes was significantly lower in ASC-treated mice than in control mice. IL-10 expression did not differ between treated and control mice. The suppressive effects of ASCs on CHS response did not differ between IL-10 knock-out C57BL/6 mice and wild-type mice. CONCLUSION: The present findings suggest that MSCs in adipose tissue may contribute to the self-limiting course of ACD through decreased expression of IFN-γ, but not through increased expression of IL-10.
Adipose Tissue* ; Animals ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Ear ; Enzyme-Linked Immunosorbent Assay ; Inflammation ; Interferons ; Interleukin-10 ; Interleukins ; Lymph Nodes ; Mesenchymal Stromal Cells* ; Mice ; Picryl Chloride ; Skin ; Subcutaneous Fat

The management of clozapine (CLZ)-induced adverse events affects patient prognoses. Akathisia is a relatively rare adverse event related to CLZ administration and thus the management of this syndrome is not well established. Here, we report a case of treatment-resistant schizophrenia wherein CLZ-induced akathisia was successfully managed with gabapentin enacarbil (GE). The patient was a 39-year-old woman who had been treated with atypical antipsychotics other than CLZ for three years with poor tolerability. Initiation of CLZ (400 mg/day) attenuated her psychotic symptoms, but was followed by moderate akathisia. Neither benzodiazepines nor biperiden improved the akathisia; however, akathisia was finally diminished with co-administration of GE. GE facilitated a dosage increase in CLZ (450 mg/day) for the improved management of pyschotic symptoms, and thus indirectly contributed to treatment of the patient’s schizophrenia. We suggest that GE is a useful candidate for the management of CLZ-induced akathisia. The improved management of treatment-induced akathisia and other adverse events can extend the potential application of CLZ for treatment-resistant schizophrenia.
Adult ; Antipsychotic Agents ; Benzodiazepines ; Biperiden ; Clozapine ; Female ; Humans ; Prognosis ; Psychomotor Agitation* ; Restless Legs Syndrome ; Schizophrenia

A 3-month alcoholism rehabilitation program at psychiatric hospitals is common in Japan for patients with alcohol use disorder (AUD). However, many AUD patients are often hospitalized for the treatment of digestive disorders due to alcohol-related liver diseases and pancreatitis. In this sense, AUD patients need to be better supported by professionals and departments in general hospitals. Here we analyzed the problems in alcohol-related medical care in Japan and examined the measures to be taken at general hospitals.