Treatment of hepatocellular carcinoma by subsegmental transcatheter arterial embolization

Local medical treatment, primarily using subsegmental TAE, was attempted as the initial treatment for overt HCC. Local responses, local tumor recurrence and survival rates were analyzed for 56 patients who underwent this treatment after 1991. Of the 56 patients, 51 (91 %) showed satisfactory local responses to the therapy. For 4 patients (8%), tumor recurred locally during the approximately 22 months follow up period, although the diagnostic images taken soon after treatment had suggested adequate local responses. Multiple tumor recurrence was found in 19 cases (34%). Seventeen patients were retreated. The cumulative survival rate was 89% after one year, 70% after 3 years, 47% after 5 years and 23% after 8 years. Considering that the subjects of this study included patients with poor hepatic reserves and patients with extensive HCC, the results of this therapy can be deemed to be comparable or superior to the outcome of surgical treatment. Therefore local therapy using IVR is expected to be useful for treating HCC

Factors Related to Positive Feelings of Caregivers Who Provide Home-Based Long-Term Care for Their Family Members in Japan

Background. The objective is to elucidate the factors related to the positive feelings of family caregivers who are engaged in home-based elderly care. Methods. The study utilized the data of a cross-sectional citywide survey in Japan. The survey was conducted with 1,821 subjects and the final analysis was performed on 435 subjects. Questions for recipients such as those on their care levels, causes of care, whereas the primary caregivers were asked about whether they had positive feelings toward caregiving, and whether their opinion was reflected in care policies. Results. The factors s that showed a positive association with positive feelings were “the caregiver’s opinion is reflected in care policies” (OR: 5.05, 95% CI: 2.60–9.87) and “the caregiver is in good health condition” (OR: 2.02, 95% CI: 1.02–3.93). The factors that showed a negative association were “the caregiver is a daughter-in-law of the care recipient” (OR: 0.42, 95% CI: 0.21–0.82) and “the care recipient is an elderly person with cognitive impairment” (OR: 0.36, 95% CI: 0.18–0.70). Conclusions. The study suggests the necessity of providing support for caregivers in terms of empowerment and health management. Furthermore, they suggest that special attention should be paid to caregivers at risk of being unable to sustain positive feelings toward caregiving

Predictors of volunteerism: A study of older adults in Japan

Volunteerism has risen steadily as a viable activity at old age in Japan for it gives older adults ways to contribute to society as well as enhancing their quality of life. It has also been addressed by the national government and adopted by many local municipalities under the long-term care insurance program as a health promotion and preventive care activity. However, studies examining why older adults volunteer and why some don’t are limited. Using a modified version of Baltes and colleagues’ model of competence, this study examines the predictors of volunteerism among older adults in Japan. Data from a city located northeast of Tokyo was used (n=703). Results indicated that basic competence does not predict volunteerism, but rather competence gained from experiences. To increase the number of older volunteers, the study suggests that civic engagement must start at an earlier age coupled with financial stability. Keywords: volunteerism, older adults, Japan, competence, long-term care insuranc

DENSIDADE DE PLANTIO NA CULTURA DO QUIABO

O quiabeiro cultivado em espaçamentos maiores caracteriza-se pela emissão de ramificações laterais, o que é menos frequente quando se aumenta a densidade de plantas. Pelo exposto o objetivo deste trabalho foi avaliar a influência de diferentes espaçamentos entre linhas e entre plantas sobre o desenvolvimento vegetativo e produção das cultivares de quiabeiro ‘Santa Cruz 47’ e ‘Colhe Bem IAC’. Empregou-se delineamento em blocos casualizados em esquema fatorial 2x2x4, compreendendo duas cultivares (‘Santa Cruz 47’ e ‘Colhe Bem IAC’), dois espaçamentos entre linhas (1,00 e 1,20 m) e quatro espaçamentos entre plantas (0,10; 0,20; 0,30; 0,40 m), constituindo 16 tratamentos com três repetições. O espaçamento entre plantas afetou o desenvolvimento vegetativo das plantas e também a produção de frutos. A maior densidade de plantas reduziu o número de hastes produtivas e consequentemente resultou em menor massa e número de frutos por planta, no entanto, proporcionou as maiores produtividades

Chromosome 1p36 deletion syndrome detected by NGS

Although chromosome 1p36 deletion syndrome is considered clinically recognizable based on characteristic features, the clinical manifestations of patients during infancy are often not consistent with those observed later in life. We report a 4-month-old girl who showed multiple congenital anomalies and developmental delay, but no clinical signs of syndromic disease caused by a terminal deletion in 1p36.32-p36.33 that was first identified by targeted-exome sequencing for molecular diagnosis

Historical changes of hospitalization in patients with hepatocellular carcinoma considering for clinical path preparation

We examined the hospitalization time in 346 patients with hepatocellular carcinoma who were treated between January 1991 and March 2002 (486 admissions). A newly introduced IVR CT system and an advanced catheter shortened the mean time from 65.0 (1991) to 35.6 (2001) days in patients who underwent transcatheter arterial embolization (TAE). For patients having TAE combined with percutaneous ethanol infusion (PEI), the mean time was shortened from 156.5 to 48.7 days. In those who underwent PEI, the values were 56.0 and 36.8 days, respectively. In those who underwent radio frequency ablation (RFA), the mean time in 2001 was 25.3 days. Overall, the mean time was shortened from 60.5 to 38.0 days. In particular, the mean time (41.0 days) after 1999, when the IVR CT system and RFA were introduced, was significantly shorter than that before their introduction (58.9 days). Advances in instruments and procedures for TAE have greatly shortened the hospitalization period. In patients who underwent PEI, the rate of decrease in the mean time was small and it is difficult decrease their length of hospital stay ; therefore, RFA may be frequently employed in the future