[Regional Differences in Selecting a Place for Recuperation].

I studied a case that let me to consider the regional medical differences in Akita Prefecture. The patient was 85-year-old and female. After she was rushed to an acute care hospital in Yuri-Honjo Nikaho district, she was diagnosed with right leg acute artery obstruction and treated with thrombectomy.

[Integrated Community Care from the Perspective of Patients Receiving End-of-Life Treatment].

I studied patients who had received end-of-life care at our clinic and investigated integrated community care based on these experiences. Atotal of 543 patients received end-of-life care at our clinic from October of 2007 to December of 2012. The number of those who received such care at home showed a growing trend while the number of patients receiving such care at hospitals tended to decrease.

[The Present Conditions of a Provincial City].

The goal of community-based comprehensive care is to improve the quality of life(QOL)of patients by accommodating their individual values and by making full use of inter-professional collaboration. Since the number of individuals over the age of 65 years in provincial cities has already reached its peak, any future increase in the number of individuals over the age of 65 years will be due to a decrease in the working-age population. As there is no time to spare, immediate actions must be taken to promote collaboration among nursing and welfare facilities.

[An examination of home care for patients over age 85 after surgery].

To examine home care for patients over age 85 after surgery, we made comparisons across postoperative courses for their effects on disuse syndrome based on the duration of home care and the duration of survival. The duration of home care was long in surgical cases of patients aged under 74 and patients aged 75-84, and it was short in surgical cases of patients aged over 85. Although having trust in surgeons may delay the transition to home care, early transition is desirable.

Bio-amplifier with Driven Shield Inputs to Reduce Electrical Noise and its Application to Laboratory Teaching of Electrophysiology.

We describe a custom-designed bio-amplifier and its use in teaching neurophysiology to undergraduate students. The amplifier has the following features: 1) differential amplification with driven shield inputs, which makes it workable even in electrically unshielded environments, 2) high input impedance to allow recordings of small signals through high signal source impedance, 3) dual fixed frequency bandpass filters (1-340Hz for surface EMG, EEG, local field potential etc and 320Hz - 3.4kHz for neuronal action potential recording) and independent gain controllers (up to x107,000) to allow the recording of different signals from the same source (e.

[Comparison of home-care and welfare facilities].

Postoperative care conditions for elderly patients were examined. The present case is that of an 86-year-old man who underwent rectal amputation and colostomy owing to rectal cancer. Because he developed cerebral infarction and his disuse syndrome also advanced during postoperative hospitalization, he left the hospital with intravenous hyperalimentation.

[A case of a patient with rheumatoid vasculitis who was successfully transferred to home-care services through regional cooperation].

We investigated a case of a patient with rheumatoid vasculitis who was successfully transferred to home-care services through regional cooperation. The patient was a 63-year-old woman with rheumatoid vasculitis complicated by small bowel necrosis, cerebral infarction, heart failure, scleritis, etc. In the present system, admission of such patients to acute or long-term care hospitals is difficult.

[A case of a patient in welfare facilities in whom relief from sharp pain was difficult to achieve].

Because of the declining availability of hospital beds due to increasing demand, patients with terminal cancer are entering welfare facilities. A patient in whom relief from sharp pain was difficult to achieve in welfare facilities was referred to our clinic. He was an 87-year-old man who had undergone resection and colostomy for advanced rectal and bladder cancers.

[Medical cooperation for enabling a smooth shift to remote medical treatment].

To raise awareness of remote medical treatment, seminars are held and patients are invited to participate in medical treatment in a short-term care hospital, a hospice, or a long-term care hospital. The first and second halves of the home treatment period in this clinic were individually examined. The results showed that the home treatment period was extended, which was considered to be the effect of cooperation.

[Home should be "a place for cancer patient to live a better life"].

There is still a perception that the home is a place for cancer patient to return to die when no treatment is left any more. However, home chemotherapy can be a useful option for symptom control. Thus, the perception of going home when no treatment is available sounds odd.

[Home chemotherapy].

We report the case of a male gastric cancer patient who had undergone outpatient chemotherapy with TAXOTAL+TS-1 for adrenal and lung metastases.The disease was in progress.Next, we performed home chemotherapy with TAXOL.

[The present situation of home-care in Akita].

Akita home-care clinic was developed as the first specialized clinic for home-care in Akita prefecture in October 2007. This report focuses on the progress of our clinic from the opening to the present. Since the covering area for home-care was quite wide, a novel cooperation was essential to be established between our clinic and hospitals, to provide home-care with a certain backup for a sudden change.

Stent placement is effective on both postoperative hepatic arterial pseudoaneurysm and subsequent portal vein stricture: a case report.

To treat postoperative bleeding after hepato-pancreato-biliary surgery, interventional radiology has become essential. We report a case of coincidental pseudoaneurysm and jejunal varices that were both successfully treated by stent-grafts. After a pancreaticoduodenectomy, the patient developed a pseudoaneurysm in the hepatic artery and a stenosis in its periphery.

[A clinical study of hepatic arterial infusion chemotherapy with 5-FU and leucovorin for liver metastases].

We followed patients who underwent hepatic arterial infusion chemotherapy (HAI) with 5-FU and Leucovorin for liver metastases. Since CR (complete response) and PR (partial response) were achieved, this therapy seems to be effective. 5-FU metabolized on its first pass through the liver, and the hepatic extraction with rapid HAI is lower than that with slow HAI.