How to choose pictures in the rooms of seriously ill patients? The individual order-made pleasing pictures can be cost effective? -A pilot study was made.
Methods : Thirty-five terminally ill inpatients individually chose a pleasing picture to look at for 15 minutes. Before and after observation of the chosen picture, Profile of Mood States questionnaires (POMS), pulse, blood pressure, chromogranin A in the saliva, natural killer (NK) cell activity, and adrenocorticotropic hormone (ACTH) were provided.
Results : The overall characters of pictures were bright-colored, gentle-lined, representational, which were often landscapes, with a positive content. The scores of POMS indicated ; the observation decreased tension-anxiety, depression, anger, fatigue and confusion, increased vigor, decreased salivary chromogranin A concentrations. Natural killer cell activity was associated with picture types.
Conclusion : Viewing self-selected pleasing pictures improved patients' psychological state, and may have reduced sympathetic nervous system tone, but did not statistically enhance immunity. Pictures in the rooms of seriously ill patients should be chosen to enhance their physiological and psychological well-being but not give memories which may modulate activity of adrenocorticotropic hormone axis. Individual order-made pleasing pictures have high potential to be cost effective. Further research should be required to investigate.

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Background : The improvement of healthcare surroundings for seriously ill inpatients has often been ignored. Plants are getting to be recognized as a good healing resource. However, in Japan they are utilized mostly in outpatient areas to compensate for outpatient complaints created by long waiting times, and few plants are utilized for inpatients. Furthermore, to extend health service resources, artificial plants could also be beneficial. However, little is known on psychological, physiological, and immunological effects of artificial plants for their implementation to hospital environments for those inpatients.
Subjects : 24 healthy college students. They were divided into two groups evenly (male =10, female = 2 in each group) .
Methods : The first group was brought to Rainforest Cafe, Chiba, Japan. The second group was brought to Tanzawa Forest, Kanagawa, Japan. Subjects in both groups were instructed to sit silently in the surroundings for 60 minutes. Psychological, physiological, and immunological data were taken at three time points : at baseline ; immediately after the intervention ; 60 minutes after the intervention.
Analysis : Student's t, ANOVA were utilized in the condition of α=0.05.
Results, Discussion and Conclusion : In both forest environments, all markers were improved, though the natural forest environment was statistically better than artificial forest environment. Artificial plants could be considered as a helpful health resource in hospitals too. Further study is recommended to compare artificial forest environment with non forest environment, for example, hospital rooms, to remove the effect of just sitting.

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橋本病の臨床経過を検討した。130例 (男性2例, 女性128例) を, 過去の診療録からretrospectiveに解析した。橋本病の診断は, びまん性甲状腺腫の存在と甲状腺自己抗体 (サイロイドテスト, マイクロゾームテスト) 陽性に基づいて行われた。観察期間中に, 130例中44例では機能低下に陥り, その44例中37例では甲状腺ホルモン剤による補充療法が行われた。一方, 残りの86例は機能正常を維持した。130例中13例では, 血清TSH濃度が測定感度以下に低下した。このようにTSHが測定感度以下に抑制される現象を, “TSH suppression”と定義した。13例中12例では, “TSH suppression”は一過性であった。“TSH suppression”後, 8例は甲状腺機能正常に回復した。残りの4例は顕性の機能低下に陥り, 補充療法が開始された。13例中1例では“TSH suppression”が持続し, バセドウ病を発症した。本研究では, 130例の橋本病症例中37例, すなわち, わずか28%の症例でしか補充療法を必要としなかったことが示された。また, “TSH suppression”が10%の橋本病症例で観察され, “TSH suppression”がみられたら, その後TSHが上昇する可能性が高いことが示された。橋本病の経過観察中に“TSH suppression”が観察された場合には, 特に慎重に甲状腺機能を検査する必要がある。そして, 甲状腺機能正常の橋本病は“甲状腺機能異常症未病”としてとらえ, 慎重に経過を追う必要がある。過剰な治療を避けると同時に, 治療が必要な症例を見逃さないことが重要であり, そのためにはTSHの定期的な測定が大切である。

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