Use of Robotic Pets in Providing Stimulation for Nursing Home Residents with Dementia.

Trial experiments utilized robotic pets to facilitate self-reliance in nursing home residents. A remote-control robot modeled clear and meaningful behaviors to elderly residents. Special attention was paid to its effects on mental and social domains. Employing the robot as a gaze target and center of attention created a cue to initiate a communication channel between residents who normally show no interest in each other. The Sony AIBO robot in this study uses commercially available wireless equipment, and all its components are easily accessible to any medical or welfare institution interested in additional practice of these activities.

An autopsy case of pancreatic and ectopic nesidioblastosis.

We report an autopsy case of pancreatic and ectopic nesidioblastosis. A five-month-old Japanese girl was born at 35 weeks gestation, and showed clinical symptoms of hyper-insulinemic hypoglycemia before death. At autopsy a tumorous nodule was observed at the portion of the jejunum, 90 cm from Treitz's ligament. The nodule measured 30 x 20 x 20 mm. The ectopic pancreas, also revealed nesidioblastosis histologically. Immunohistologically, both nesidioblastoses were stained positive for chromogranin A, insulin, glucagon and somatostatin. The proliferating cell nuclear antigen (PCNA) and Ki-67 indices were less than 4% in the nesidioblastosis. To our knowledge, this is the first reported case of nesidioblastosis demonstrating proliferating activity with PCNA and Ki-67, and is the third reported case of nesidioblastosis arising in the pancreas and ectopic pancreas.

A patient with type 2 diabetes mellitus associated with mutations in calcium sensing receptor gene and mitochondrial DNA.

A 44-year-old female with familial hypocalciuric hypercalcemia (FHH) due to a homozygous missense mutation (Pro40Ala) in calcium sensing receptor (CaSR) gene has type 2 diabetes mellitus. The identical heterozygous mutation of CaSR gene was observed in consanguineous parents and all other family members examined except her two sisters. Many subjects with abnormal glucose tolerance were observed in this family, which is compatible with maternal inheritance. Mitochondrial function of complex I (NADH-coenzyme Q reductase) activity in cybrid cells between mitochondrial DNA (mtDNA)-deleted (rho(0)) HeLa cells and mtDNA from the proband was decreased by 35%. The proband has eight substitutions and among these 4833 A/G is a missense substitution in NADH dehydrogenase 2 gene and may probably be a major pathogenic mutation of impaired complex I activity. These results suggest that coexistence of nuclear gene and mtDNA mutations may have caused or modified the development of abnormal glucose tolerance in this family.

A new mitochondrial DNA mutation at 14577 T/C is probably a major pathogenic mutation for maternally inherited type 2 diabetes.

From a family of 16 diabetic patients with typical maternal inheritance, we investigated a 69-year-old woman with type 2 diabetes. The proband showed no major deletions in the mitochondrial DNA (mtDNA). Direct sequencing revealed 7 missense and 5 ribosomal RNA homoplasmic nucleotide substitutions when compared with the Cambridge Sequence and its recent revision. When compared with the control cybrid cells, the proband cybrid cells showed 6 nucleotide substitutions. Among these, 14577 T/C, which turned out to be 98.9% heteroplasmic, is a new missense substitution in the NADH dehydrogenase 6 gene. We also observed 2 other patients with 14577 T/C substitution from another group of 252 unrelated diabetic patients, whereas no individual from a group of 529 control subjects had 14577 T/C substitution. Furthermore, these 6 substitutions were in linkage disequilibrium. Mitochondrial respiratory chain complex I activity and O2 consumption rates of the proband cybrid cells, which were obtained by the fusion of mtDNA-deleted (rho0) HeLa cells and mtDNA from the proband, showed 64.5 and 61.5% reductions, respectively, compared with control cybrid cells. The present study strongly indicates that the new mtDNA mutation at 14577 T/C is probably a major pathogenic mutation for type 2 diabetes in this family.

Benign mesenchymoma of the cheek: report of a case and review of the literature.

Benign mesenchymoma is a soft tissue neoplasm that contains 2 or more differentiated mesenchymal components in addition to fibrous tissue. A rare case of benign mesenchymoma of the cheek in a 6-year-old boy is presented. The literature pertaining to mesenchymoma in the head and neck region is reviewed and discussed.

Adrenal hemorrhage associated with Klebsiella oxytoca bacteremia.

Septic adrenal hemorrhage is classically caused by meningococcemia. An autopsied case is presented of a 45-year-old man with adrenal hemorrhage due to Klebsiella oxytoca bacteremia following placement of a central venous catheter. He died 5 hours after developing disseminated intravascular coagulation (DIC). The bacterial entry site may have been the catheter. The cause of death was considered to be pulmonary edema due to bacteremia rather than adrenal insufficiency due to hemorrhage. Septic adrenal hemorrhage should be recognized as a subtype of sepsis rather than adrenal insufficiency, and may be caused in conditions of severe sepsis with DIC, independent of the microorganic variety.

Endovascular papillary angioendothelioma (Dabska tumor) in an elderly woman.

A patient with endovascular papillary angioendothelioma with a low grade of malignancy showing papillary proliferation of endothelioid cells is presented. The patient, an 83-year-old woman, underwent resection of a tumor of the neck. At operation a 9 x 7 cm cystic tumor containing yellow transparent liquid with clots was found in the subcutaneous tissue. Histological studies showed endothelioid cells with spindle-shaped nuclei proliferated in layers around the fibrovascular cores, which showed the characteristic appearance of papillary proliferation. These cells were immunohistochemically positive for CD31, CD34 and factor VIII-related antigen. Based on these observations, the tumor was considered to be an endovascular papillary angioendothelioma (Dabska tumor). Dabska tumor is a vascular tumor with a low grade of malignancy and usually occurs in infants and young children. About 13 cases of Dabska tumor have been reported. The occurrence of a Dabska tumor in an aged patient is considered to be rare.

Craniofacial fibrous dysplasia with rapidly increasing proptosis due to a mucocele behind the globe.

A 16-year-old male with fibrous dysplasia, in which rapidly increasing proptosis of the left eye was induced by a mucocele behind the globe, is reported. The mucocele was removed and the expanded bone was completely recontoured back to normal dimensions with the aid of an acrylic skull replica fabricated preoperatively by laser lithography on the basis of computed tomographic data. The result was satisfactory and no recurrence of bony swelling or proptosis has been detected for 2 years and 9 months.

Detection of inflammatory cytokines in psoriatic skin.

Recent investigations have revealed the involvement of cytokines in the pathogenesis of psoriasis. This study examined the amount of inflammatory cytokines--interleukin-1 (IL-1), interleukin-6 (IL-6) and granulocyte macrophage colony-stimulating factor (GM-CSF)--released into the supernatants of organ cultures of involved and uninvolved skin from psoriatic patients and normal skin from healthy individuals. Bioassays were employed to detect the activities of IL-1 and IL-6. Enzyme-linked immunosorbent assay (ELISA) methods were used to quantitate immunoreactive IL-1 alpha, IL-1 beta, IL-6 and GM-CSF. The activity of IL-1 in uninvolved psoriatic skin was found to be increased relative to that in involved and normal skin, while immunoreactive IL-1 beta was found only in involved skin. A neutralization experiment showed that bioactive IL-1 was mostly attributable to IL-1 alpha. Uninvolved psoriatic skin also secreted higher amounts of both bioactive and immunoreactive IL-6 compared with involved skin. Immunoreactive GM-CSF was detected in uninvolved skin only. These cytokines detected in uninvolved skin may have been released from epidermal or mesenchymal cells, since uninvolved skin contained fewer inflammatory infiltrates. Our results offer additional evidence that increased amounts of inflammatory cytokines in uninvolved skin may provide a preliminary condition and play important roles in the initial events in the evolution of psoriatic lesions.

Restoration of the anterior neck surface in the burned patient by free groin flap.

In treating extensive burn contractures of the anterior neck, we obtained good results using free flaps. Ninety-nine patients with neck contractures were treated with free flaps. The ages of the patients range from 2 to 64 years. We used 84 free groin flaps, 10 free latissimus dorsi musculocutaneous flaps, 2 free deltopectoral flaps, 2 free scapular flaps, and 1 free anterolateral thigh flap. In all patients, contractures were sufficiently released and no recurrences followed after a mean follow-up of 8.7 years. After defatting procedures, natural profiles and good appearances were restored, especially in patients in whom groin flaps were used.

[Basic studies on hard direct reline resins. Part 1. Adhesive strength].

Direct relining methods has come to occupy an important position in removable denture prosthodontics. The purpose of this study was to investigate the effect of various experimental conditions on the adhesive strength of hard direct reline resins to denture base resin. The experimental conditions were as follows: 1) immersion time of denture base resin before relining, 2) amount of load at relining, 3) roughness of adhesive surface, 4) immersion time of relined resin. The following results were obtained: 1. The adhesive strength of Rebaron was the highest, followed by that of TRIAD and KOOLiner. 2. The immersion times of denture base resin did not appreciably affect the adhesive strength. 3. With the rougher adhesive surface, Rebaron and KOOLiner showed a tendency to increase adhesive strength. 4. The adhesive strength was not appreciably affected by load. 5. We did not find a definitive correlation between adhesive strength and immersion times of relined resin.