Successful laparoscopic resection for giant mature cystic teratoma of the pancreas: a case report and surgical refinements.

Background: Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a case of a giant mature cystic teratoma of the pancreas that was successfully resected via complete laparoscopic distal pancreatectomy (LDP).

Case Presentation: A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor.

Laparoscopic repair and total gastrectomy for delayed traumatic diaphragmatic hernia complicated by intrathoracic gastric perforation with tension empyema: a case report.

Background: Blunt traumatic diaphragmatic hernia (TDH) is a complication of blunt diaphragmatic injury. If missed, it could lead to critical presentations, such as incarceration or strangulation of the herniated intra-abdominal organs, and thus, early surgical repair is required. Methods of the operative approach against delayed TDH remain unclear.

[A case of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in an elderly woman].

An 84-year-old woman who had diabetes mellitus and atrial fibrillation presented to our hospital with appetite loss and difficulty in standing up. Her cervical, axillary, and mediastinal lymph nodes were swollen. At first, malignant lymphoma was suspected, but positron emission tomography-computed tomography and cervical lymph node biopsy did not support this diagnosis.

[A homebound status is related to a reduction of meal intake in older outpatients, independent depressive mood and their physical function].

Aim: We aimed to investigate the relationship between the frequency at which patients went out and the reduction of meal intake among older outpatients who did not require care.

Methods: The subjects were outpatients of ≥65 years of age who visited the department of geriatric medicine in our hospital for the first time. We analyzed 463 subjects (male, n=184; female, n=279), after excluding patients who had dementia, required care, lived in a nursing home, or had an acute disease.

Electromagnetic signatures of the preclinical and prodromal stages of Alzheimer's disease.

Biomarkers useful for the predementia stages of Alzheimer's disease are needed. Electroencephalography and magnetoencephalography (MEG) are expected to provide potential biomarker candidates for evaluating the predementia stages of Alzheimer's disease. However, the physiological relevance of EEG/MEG signal changes and their role in pathophysiological processes such as amyloid-β deposition and neurodegeneration need to be elucidated.

Pressure ulcers induced by drug administration: A new concept and report of four cases in elderly patients.

Drug-induced akinesia is a potential cause of pressure ulcers. However, pressure ulcers that are caused by drug-induced akinesia are not considered an adverse drug reaction (ADR). We propose that drug-induced pressure ulcers (DIPU) are pressure ulcers that are caused by an external force that is experienced after drug administration, and we considered resolution of these ulcers after drug discontinuation to be a supportive finding.

Validity of the Kihon Checklist for assessing frailty status.

Aim: The Kihon Checklist is extensively used in Japan to identify elderly persons who are at risk of requiring support/care. We aimed to determine whether or not the Kihon Checklist can estimate frailty status defined by the Cardiovascular Health Study criteria.

Methods: This cross-sectional study evaluated the Kihon Checklist and activities of daily living based on self-records maintained with the assistance of nurses in a convenience sample of 164 elderly outpatients who lived without care or support.

Developing an interdisciplinary program of educational support for early-stage dementia patients and their family members: an investigation based on learning needs and attitude changes.

Aim: The National Center for Geriatrics and Gerontology has begun to provide educational support for family caregivers through interdisciplinary programs focusing on patients in the early stage of dementia. These interdisciplinary programs have established two domains for the purpose of "educational support": cure domains (medical care, medication) and care domains (nursing care, welfare). In the present study, we examined the learning needs and post-learning attitude changes of patients and their families who participated in these programs in order to assess the effectiveness of an interdisciplinary program of educational support in each of these domains.

Early detection of cognitive impairment in the elderly based on Bayesian mining using speech prosody and cerebral blood flow activation.

With the aim of providing computer aided diagnosis of dementia, we have developed a non-invasive screening system of the elderly with cognitive impairment. In our previous research, we have studied two data-mining approaches by focusing on speech-prosody and cerebral blood flow (CBF) activation during cognitive tests. On the power of these research results, this paper presents a prosody-CBF hybrid screening system of the elderly with cognitive impairment based on a Bayesian approach.

[Palliative care in patients without cancer: Impact of the end-of-life care team].

Palliative care improves the quality of life of patients and their families facing problems associated with life-threatening illnesses by promoting the prevention and relief of suffering. Palliative care in Japan has been developed mainly for cancer patients. At the National Center for Geriatrics and Gerontology, an end-of-life care team (EOLCT) has been developed to promote palliative care for patients without cancer.

Burden reduction of caregivers for users of care services provided by the public long-term care insurance system in Japan.

We surveyed the care burden of family caregivers, their satisfaction with the services, and whether their care burden was reduced by the introduction of the LTCI care services. We randomly enrolled 3000 of 43,250 residents of Nagoya City aged 65 and over who had been certified as requiring long-term care and who used at least one type of service provided by the public LTCI; 1835 (61.2%) subjects returned the survey.

Intensive rehabilitation for dementia improved cognitive function and reduced behavioral disturbance in geriatric health service facilities in Japan.

Aim: To examine the efficacy of rehabilitation for elderly individuals with dementia at intermediate facilities between hospitals and home, based on the policies for elderly individuals to promote community-based care at home and dehospitalization.

Methods: Participants were older adults with dementia newly admitted to intermediate facilities. A total of 158 in the intervention group who claimed Long-Term Care Insurance for three consecutive months, and 54 in the control group were included in the analysis.

A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment.

Background: To examine the effect of multicomponent exercise program on memory function in older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions.

Methodology/principal Findings: Subjects were 100 older adults (mean age, 75 years) with MCI. The subjects were classified to an amnestic MCI group (n = 50) with neuroimaging measures, and other MCI group (n = 50) before the randomization.

Priorities of health care outcomes for the elderly.

Objectives: Physicians are uncertain about what medical services should be provided to older and/or disabled patients. Better understanding of health outcome prioritization among health care providers and recipients may help the process of decision- and policy-making. For this purpose, surveys were conducted on priorities of health care outcomes for the elderly.

[Usefulness of support from end-of-life care teams in difficult decision-making].

It is unclear how hospitals should support a patient's decision to return home to die. Thus, we retrospectively examined the usefulness of support from an End-Of-Life Care Team in such difficult decision making. The subjects included non-cancer patients and the elderly.

Cognitive impairments and functional declines in older adults at high risk for care needs.

Aim: Functional status of those who have very mild cognitive impairment have not been sufficiently investigated. In the current study, we analyzed the characteristics of functional awareness in older adults who had cognitive impairment and were at high risk of requiring support/care (termed as specified elderly at high risk for care needs in the long-term care insurance scheme).

Methods: The answers of a health check, which is provided by the local municipal government for those aged 75 years or older who have not been certified as eligible for care services, were analyzed.

Characteristics of cognitive function in early and late stages of amnestic mild cognitive impairment.

Aim: The detection of the early stages in amnesic mild cognitive impairment (aMCI) is considered important in diagnosing progression to Alzheimer's disease. The current study sought to investigate differences in cognitive function between control subjects with no memory loss (control), and subjects in the early stage of aMCI (EMCI) and late stage of aMCI (LMCI).

Methods: A total of 100 community-dwelling older adults aged 65 years and over were recruited from 1543 potential subjects.

The relationship between atrophy of the medial temporal area and daily activities in older adults with mild cognitive impairment.

Background And Aims: Many studies have suggested that social network, leisure activity, and physical activity can have protective effects against dementia and Alzheimer's disease. However, previous studies have not examined the relationship between daily activities and brain atrophy in older adults. This study aimed to explore what kind of daily activities were associated with atrophy of the medial temporal area including the entorhinal cortex (MTA-ERC) in older adults.

Relationship between atrophy of the medial temporal areas and cognitive functions in elderly adults with mild cognitive impairment.

Aim: The current study sought to determine which types of cognitive function are related to atrophy of the bilateral medial temporal areas including the entorhinal cortex (MTA-ERC) in elderly adults.

Methods: The subjects were 96 elderly adults (mean age 75.3 years) with mild cognitive impairment.