The characteristics and prevalence of patent foramen ovale in Japanese people: a study using material from forensic autopsies.

Racial and ethnic differences in the prevalence of patent foramen ovale have been suggested, but there are insufficient data to confirm the situation. Studies have also not investigated detailed morphological changes in the fossa ovalis by age. This study therefore aimed to clarify the characteristics of the fossa ovalis and determine the frequency of patent foramen ovale in Japanese people, using materials from forensic autopsies. A total of 359 hearts were obtained during forensic autopsies (from 223 males and 136 females, aged from 0 to 94 years). Overall, prevalence of patent foramen ovale was 12.5%, but it was significantly higher among those under 20 years old (66.7% in males, 38.5% in females). The area of the fossa ovalis linearly increased with age in both sexes. The prevalence of patent foramen ovale was lower in Japanese adults than previously found in either White or Black people. The ratio of the area of the fossa ovalis to the heart weight was nearly constant.

Classification of Support Needs for Elderly Outpatients with Diabetes Who Live Alone.

OBJECTIVES: To investigate the support needs of elderly patients with diabetes and to classify elderly patients with diabetes living alone on the basis of support needs. METHODS: Support needs were derived from a literature review of relevant journals and interviews of outpatients as well as expert nurses in the field of diabetes to prepare a 45-item questionnaire. Each item was analyzed on a 4-point Likert scale. The study included 634 elderly patients with diabetes who were recruited from 3 hospitals in Japan. Exploratory factor analysis was performed to determine the underlying structure of support needs, followed by hierarchical cluster analysis to clarify the characteristics of patients living alone (n=104) who had common support needs. RESULTS: Exploratory factor analysis suggested a 5-factor solution with 23 items: (1) hope for class and gatherings, (2) hope for personal advice including emergency response, (3) supportlessness and hopelessness, (4) barriers to food preparation, (5) hope of safe medical therapy. The hierarchical cluster analysis of subjects yielded 7 clusters, including a no special-support needs group, a collective support group, a self-care support group, a personal-support focus group, a life-support group, a food-preparation support group and a healthcare-environment support group. CONCLUSIONS: The support needs of elderly patients with diabetes who live alone can be divided into 2 categories: life and self-care support. Implementation of these categories in outpatient-management programs in which contact time with patients is limited is important in the overall management of elderly patients with diabetes who are living alone.

Differences in emotional distress among inpatients with type 1, obese type 2, and non-obese type 2 diabetes mellitus.

Objective The purpose of this study was to determine the differences in emotional distress among three groups of inpatients with type 1, obese type 2, and non-obese type 2 diabetes during hospitalization. Methods The 42 participating inpatients were divided into three groups: type 1 diabetes (n=11), obese type 2 diabetes [body mass index (BMI) ≥25 kg/m(2); n=24], and non-obese type 2 diabetes (BMI <25 kg/m(2); n=7). The Problem Areas in Diabetes (PAID) scale, which is a self-administered questionnaire to assess emotional distress in the patients with diabetes, was performed at admission and discharge. Results The total PAID score was similar and tended to improve during hospitalization in all three groups, although there were differences among the groups in the scores of particular questions. At admission, the score of the question "worrying about low blood sugar reactions?" was significantly different among the three groups and highest in the patients with type 1 diabetes. At discharge, the score of "not accepting diabetes?" was significantly different among the three groups and highest in the patients with non-obese type 2 diabetes, while that of "feeling unsatisfied with your diabetes physician?" was significantly different among the three groups and highest in the patients with obese type 2 diabetes. The score of "feelings of deprivation regarding food and meals?" significantly worsened in the patients with obese type 2 diabetes during hospitalization compared with the patients in with non-obese type 2 diabetes. Conclusion The characteristics of emotional distress during hospitalization varied among the patients with the three types of diabetes, thus emphasizing the importance of tailoring support according to the type of diabetes.

Reliability and Validity of a Shortened Version of an Instrument for Diabetes Self-Care Agency.

PURPOSE: The purpose of this study was to develop a shortened version of the Instrument of Diabetes Self-Care Agency (IDSCA). METHODS: In the development of the shortened version of IDSCA, intraclass correlation coefficient 2 (ICC2) analysis was done to determine items to be deleted. However, the 7 subscales were retained. The shortened IDSCA was evaluated for internal consistency, reproducibility, concurrent validity, criterion-related validity, and goodness of fit. RESULTS: The shortened IDSCA included 35 items addressing 7 subscales. High ICC2 (.804) and a high Cronbach's alpha (.89) indicate internal consistency and reproducibility. A high correlation (.62) between the shortened version of the IDSCA and the Self-Care Agency Questionnaire indicated concurrent validity. CONCLUSION: The shortened IDSCA provides a reliable and valid measure of self-care agency of individuals with diabetes.

Light and scanning electron microscopic study on the tongue and lingual papillae of the common raccoon, Procyon lotor.

We observed the external surface and connective tissue cores (CTCs), after exfoliation of the epithelium of the lingual papillae (filiform, fungiform, foliate and vallate papillae) of the common raccoon (Procyon lotor) using scanning electron microscopy and light microscopy. The tongue was elongated and their two-third width was almost fixed. Numerous filiform papillae were distributed along the anterior two-thirds of the tongue and fungiform papillae were distributed between the filiform papillae. Eight vallate papillae that had a weak circumferential ridge were distributed in a V-shape in the posterior part of the tongue and numerous taste buds were observable in the circumferential furrows of vallate papillae. Weak fold-like foliate papillae were observable at the lateral edge in the posterior part of the tongue and a few salivary duct orifices were observable beneath the foliate papillae. An islet-like structure with numerous taste buds, was observable on the deep part of the salivary duct of foliate papillae. Large conical papillae were distributed at the posterior part and root of the tongue. After removal of epithelium, filiform papillae of CTCs were appeared to be a thumb or cone-like main core and associating several finger-like short accessory cores. These cores were surrounded an oval concavity. The main core was situated behind the concavity and associated with accessory cores. CTCs of fungiform papillae were cylinder-like with numerous vertically running ridges and with a few concavities seen at the top of the cores. CTCs of vallate papillae and their surrounded circumferential ridge were covered with numerous pimple-like protrusions. The lingual papillae of Common raccoon's tongue had morphological feature of carnivore species.

Scanning electron microscopic study on the tongue and lingual papillae of the adult Spotted seal, Phoca largha.

We observed the external surface and connective tissue cores (CTCs) of the lingual papillae (filiform, fungiform and vallate papillae) of adult Spotted seals (Phoca largha) using SEM and light microscopy. The tongue was V-shaped and its apex was rather rounded. On the dorsal surface from apex to the one-third posterior of the tongue, the lingual mucosa was densely covered by filiform papillae, with a scatted distribution of dome-like fungiform papillae, which have orthokeratinized epithelium. At the posterior part of the tongue, filiform papillae were totally diminished and their epithelium was parakeratinized. Approximately 6-7 vallate papillae were arranged in a V-shape on the posterior of the tongue. After removal of the epithelium, the CTCs of the filiform papillae that were distributed at apex consisted of a primary core and approximately 5-6 rod-shaped small accessory cores. The CTCs of filiform papillae that were distributed at anterior part of the tongue lacked primary protrusions and possessed approximately 10-15 rod shaped small accessory cores that were arranged in a horseshoe manner. The CTCs offungiform papillae had cylindrical primary cores and were fringed with accessory protrusion. In the Vallate papillae, taste buds were only seen at the dorsal epithelium.