With respect to statistics on out patients with senile psychiatric disorders, a few reports have thus far been made available by university hospitals in major urban areas but none from any rural general hospitals. This study is an attempt to grasp the real status of senile psychiatric disorders as observed in outpatient clinics.
1) There have been signs for a yearly rise in the prevalence rate of senile psychiatric diseases, and there is the possibility of diagnosing new patients at a rate of one to six aged people (60 years of age and over).
2) Of all the patients, 45% came directly to our hospital, whereas 55% either were referrals from other clinics or came to the hospital after their consultation with other clinics. Of the latter group, 55% were referred by other departments of the hospital, 38% by outside physicians in our district, and 7% by local administrative offices. This finding appears to suggest that the incidence of hypertension and other somatic complications is high among aged people and also that phsychiatric disorders may sometimes manifest due to somatic disorders.
3) A check of the prevalence by month reveals that the prevalence is highest in March, high from spring to summer, lowest in autumn and low in winter. In this respect, there exists a difference between the organic diseases and the functional diseases. In the former group, the prevalence is concentrated in spring and summer, whereas in the latter, the prevalence remains high from spring to early summer, low in summer and transiently becomes high in early autumn.
4) By sex, the prevalence rate is 52% for males and 48% for females. By age, the prevalence decreases with age and takes a sharp downturn after the age of 75.
By type of disease, senile organic diseases (Group A) account for 54.4%, functional diseases (Group B) 40.0%, and other organic diseases (Group C) 14.5%. Group A increases with age among males, whereas it is concentratedly high among males of 75 years of age and over. Group C is significantly greater among males.
5) A check of the trend of each disease group in the past 15 years indicates that there have been signs for a rise for each group but the rises are significant particularly for Groups B and C. In the latter half period, the percentage of Group B is greater than that of Group A. Against this background, there seems to be a rise in the incidence of psychiatric diseases among rural females.
6) The hospitalization rate stood at 17.5%. By sex, the rate was 20% for males and 15% for females. By type of disease, the ratio stood at 21% for Group C, 17% for Group A and 16% for Group B.
By place of residence, differences between the towns and the villages (27% for the towns and 9% for the villages) were observed in Group A of females, suggesting that many females in the towns are placed in the circumstances where difficult problems tend to crop up with respect to their matrimony or their sharing the same house with other members of their families. As regards clinical symptoms, it was found that there are many patients with severe auxiliary symptoms, such as delirium, hallucination and paranoid symptoms, in addition to advanced dementia.

BACKGROUND/AIMS: This study aimed to examine the diagnostic ability of endoscopic ultrasonography (EUS) for major vascular invasion in pancreatic cancer and to evaluate the relationship between EUS findings and pathological distance. METHODS: In total, 57 consecutive patients who underwent EUS for pancreatic cancer before surgery were retrospectively reviewed. EUS image findings were divided into four types according to the relationship between the tumor and major vessel (types 1 and 2: invasion, types 3 and 4: non-invasion). We also compared the EUS findings and pathologically measured distances between the tumors and evaluated vessels. RESULTS: The sensitivity, specificity, and accuracy of EUS diagnosis for vascular invasion were 89%, 92%, and 91%, respectively, in the veins and 83%, 94%, and 93%, respectively, in the arteries. The pathologically evaluated distances of cases with type 2 EUS findings were significantly shorter than those of cases with type 3 EUS findings in both the major veins (median [interquartile range], 96 [0–742] µm vs. 2,833 [1,076–5,694] µm, p=0.012) and arteries (623 [0–854] µm vs. 3,097 [1,396–6,000] µm, p=0.0061). All cases with a distance of ≥1,000 µm between the tumors and main vessels were correctly diagnosed. CONCLUSIONS: Tumors at a distance ≥1,000 µm from the main vessels were correctly diagnosed by EUS.
Arteries ; Diagnosis ; Endosonography ; Humans ; Pancreatic Neoplasms ; Retrospective Studies ; Sensitivity and Specificity ; Veins

Background/Aims: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA; EUS-FNA) allows for diagnostic tissue specimens from various regions to be analyzed. How-ever, diagnosing recurrent pancreaticobiliary cancer after surgery is sometimes difficult. We evaluated the efficacy of EUS-FNA in the diagnosis of local recurrence of pancreatico-biliary cancer and analyzed the factors associated with falsenegative results. Methods: Fifty-one consecutive patients who underwent EUS-FNA due to suspected recurrence of pancreaticobiliary cancer after surgery in an academic cen-ter were retrospectively analyzed. The criteria for EUS-FNA were a resected margin or remnant pancreas mass, round swollen lymph node (≥10 mm in diameter), and soft-tissue enhancement around a major artery. Patients with suspected liver metastasis or malignant ascites were excluded. Results: Thirty-nine of the 51 patients had pancreatic cancer; the remaining 12 had biliary cancer. The target sites for EUS-FNA were the soft tissue around a major artery (n=22, 43%), the resected margin or remnant pancreas (n=12, 24%), and the lymph nodes (n=17, 33%). The median size of the suspected recurrent lesions was 15 mm (range, 8 to 40 mm). The over-all sensitivity, specificity and accuracy of EUS-FNA for the diagnosis of recurrence was 84% (32/38), 100% (13/13), and 88% (45/51), respectively. FNA of the soft tissue around major arteries (odds ratio, 8.23; 95% confidence interval, 1.2 to 166.7; p=0.033) was significantly associated with a falsenegative diagnosis in the multivariate analysis. Conclusions EUS-FNA is useful for diagnosing recurrent cancer, even after pancreaticobiliary surgery. The diagnoses of recurrence at soft-tissue sites should be interpreted with caution.

We investigated the actual condition of patients treated by acupuncture and moxibution in Ibaragi Prefecture.
Subjects were 1823 patients (846 men, 977 women) under the treatment of 14 acupuncture clinics in September to November, 1985.
We prepared the evaluated list that consisted of 11 levels of activities of daily life and 8 degrees of pain.
In every treatment, we wrote down the patient's clinical progress in relation with the list.
The following results were obtained
1. There were many patients in thier forties and fifties.
2. There were many patients who received only one treatment.
3. The chief complaints were low back pains (509 patients), shoulder discomfort (273) knee joint pain (132), etc.
4. Most of the patients could still go on with thier daily lives in spite of the pains.
5. The effects of treatment were rated as follows; better 69.5%, no change 23.9%, worse 5.9%.

BACKGROUND/AIMS: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses. METHODS: This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information. RESULTS: A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively). CONCLUSIONS: The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection.
Biopsy, Fine-Needle ; Cross-Over Studies ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Epithelium ; Glass ; Humans ; Needles ; Pancreatic Ducts ; Pancreatic Neoplasms ; Prospective Studies ; Random Allocation