Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 27 , Issue 5
Showing 1-17 articles out of 17 articles from the selected issue
  • T. Yamamoto
    1990 Volume 27 Issue 5 Pages 537-539
    Published: September 30, 1990
    Released: November 24, 2009
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  • Y. Majima
    1990 Volume 27 Issue 5 Pages 540-544
    Published: September 30, 1990
    Released: November 24, 2009
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  • Hideto Niwa, Noriyuki Yanagita
    1990 Volume 27 Issue 5 Pages 545-549
    Published: September 30, 1990
    Released: November 24, 2009
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    Presbyacusis is senescence in the auditory system. Currently, the etiology of presbyacusis is thought to be mainly due to enviromental noise and arterial sclerosis. Cumulative effects of socialnoise influence the auditory function gradually. Sclerotic change of arteries in the brain occurs along the total auditory pathway. Histopathological findings reveal characteristic changes in all parts of the auditory pathway in elderly persons. Alterations include thickening of the ear drum, sclerotic change of the ossicles joint, decreasing number of hair cells, degeneration of the eighth nerve and of the neurons in the auditory center. Pure tone audiograms show gradually progressive sensoryneural hearing loss at high frequencies due to lesions characteristic of senescence. During the 30's the threshold at 8KHz increases a little, but in the 60's the pure tone threshold increases over all frequencies. The maximum speech discrimination parallels the drop in the pure tone threshold level. In contrast to the normal speech discrimination score, the speech discrimination score using frequncey distorted words is very low in senile persons. There is no known therapy for presbyacusis. Hearing aids compensate hearing impariment to some extent, but patient's adaptation to hearing aids is undetermined.
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  • Yasunobu Fukushima
    1990 Volume 27 Issue 5 Pages 550-554
    Published: September 30, 1990
    Released: November 24, 2009
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    It is certainly difficult to understand the clinical significance of dyspnea or breathlessness among the elderly, though this symptom is quite routine. Setting a conjugate of the dyspnea index as an indicator of ventilatory reserve ratio, its distribution was tested along an age abscissa upon the twenty senile dyspnics and demonstrated almost all of them below the 30% level. Their arterial blood oxygen tensions were grouped onto the severiy rank of dyspnea, clarifing that some seniles lived of no complaint by the blood oxygen tensions whithin the range of pulmonary insufficiency, despite there some reluctants by the normal blood gas tensions. In order to comprehend this evidence, the dyspnea was dissected into several raising factors, each of which was examined the manner how a set of organs in the respiratory system of the elderly to be concerned under aging effects and to be detected in measurement. Respiratory center drive behaves in response to the efficacy of ventilation apparatus, so in resting state it supports by minimum activity without sensation of breathing difficulty, but at needs it works more even in dyspnea, the sensation of which deepens less iteself together with increment of oxygen consumption. Considerable causes of this symptom for the senile may be due to hyperventilation syndrome, lung embolism after bone fracture, diabetic pulmonary capillopathy and hypophosphatemia. The treatments of senile dyspnea shall require the exact estimation of causal seriousness and not only attain improvement of pulmonary impairments and its accessory setups but also psychophysical rehabilitations upon rational nutrient preservation.
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  • Kazuo Kubota, Toshio Sakurai, Kyoumi Nakazato, Toyoho Morita, Takuo Sh ...
    1990 Volume 27 Issue 5 Pages 555-558
    Published: September 30, 1990
    Released: November 24, 2009
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    The effect of green tea on iron absorption from tablets containing sodium ferrous citrate was investigated in four elderly patients with iron deficiency anemia and in eleven normal elderly subjects. In both groups, the serum iron level reached a maximum value from 2 to 4 hours after taking iron tablets and returned to the baseline value after 24 hours. No inhibitory effect of green tea on iron absorption was recognized.
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  • Makoto Hamamoto, Takaya Tsushima, Takuzou Miyazaki, Akiro Terashi
    1990 Volume 27 Issue 5 Pages 559-563
    Published: September 30, 1990
    Released: November 24, 2009
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    Excessive antihypertensive therapy can create a risk of brain damage in the aged. Furthermore, no conclusion has been reached regarding treatment goals for systolic blood pressure (SBP). Two hundred elderly people with hypertension (SBP>170mmHg, average age 74 years) were studied, among them 40 age-sex mateched pairs (80 people) were selected for further examination. They were then divided into two groups, and antihypertensive therapy was conducted on each group with systolic blood pressure level goals of 140mmHg and 160mmHg, respectively. To set a goal for antihypertensive therapy, we examined Hasegawa's dementia rating scale (HDS) and bilateral common carotid arterial blood flow (CCF), which were measured using the Doppler method. In the group in which the blood pressure was reduced to 160mmHg level, changes were observed only in right CCF, and there was no change in HDS, but in the group in which the blood pressure was reduced to the 140mmHg level, changes were observed in both bilateral CCF and HDS. It is recommended that the systolic blood pressure should be set at the 160mmHg level to maintain the psychological function in the elderly.
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  • Yuzo Sato, Kunio Yamanouchi, Hirohisa Nakajima, Takashi Shinozaki, Sat ...
    1990 Volume 27 Issue 5 Pages 564-569
    Published: September 30, 1990
    Released: November 24, 2009
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    It has been well documented that glucose intolerance is associated with aging, but it is not yet clear whether this phenomenon is due to the aging process itself or is secondary to the appearance of other age-related conditions among which physical inactivity is one of most important variables. To evaluate the effect of aging process and/or physical inactivity on insulin action, this study was undertaken using the euglycemic insulin clamp technique and the oral glucose tolerance test (OGTT). Subjects without diabetes mellitus and other serious diseases consisted of 14 non-obese aged individuals and 10 young controls (YC group), ranging in age from 63 to 85yrs, and from 19 to 21yrs, respectively. The aged individuals were further divided into two groups (one was termed as the AS group, in which 7 aged subjects had been confined to bed for at least 3 months and the other was termed as the AC group in which 7 aged controls kept their daily physical activity such as walking). The results of OGTT did not show any remarkable differences between AC and YC groups. In the AS group, however, glucose intolerance and low insulin response during OGTT were observed. In view of the tissue insulin action, MCR, which is thought as a reliable marker for tissue insulin action, evaluated by euglycemic insulin clamp was 5.31±0.68, 8.57±1.20, 9.60±0.35ml/kg/min in the AS, AC and YC groups, respectively (AS<AC, p<0.05, AS<YC, p<0.01, AC<YCM, N.S.). These data are consistent with the view that the aging process itself might slightly decrease tissue insulin action without any remarkable changes in OGTT. However physical inactivity added to age could be a more prominant factor which causes both glucose intolerance and peripheral tissue insulin resistance.
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  • Atsuhiro Otsuka, Hiroshi Mikami, Katsutoshi Katahira, Toshio Ogihara
    1990 Volume 27 Issue 5 Pages 570-572
    Published: September 30, 1990
    Released: November 24, 2009
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    We evaluated the circadian changes of blood pressure in the elderly with Alzheimer's type dementia with ambulatory blood pressure monitoring (ABPM-630, Nihon Colin, Aichi, Japan). Blood pressure and heart rate were high in the daytime and low in the nighttime in the elderly without dementia. Blood pressure did not decrease in the nighttime in the elderly with dementia, although heart rate decreased. Thus, the circadian rhythm of blood pressure was selectively impaired in the elderly with Alzheimer's type dementia.
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  • Yuh Kaneshige, Hiroyuki Matsumoto, Susumu Chiba, Hiroshi Noro, Yukiko ...
    1990 Volume 27 Issue 5 Pages 573-577
    Published: September 30, 1990
    Released: November 24, 2009
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    In order to establish the age-related changes of vibration perception thresholds (VPTs) and somatosensory evoked potentials (SEPs), which are known to share a common afferent pathyway in the central nervous system, 119 normal subjects ranging in age from the 20s to the 90s were studied. The VPTs of the index fingertip were measured at 63Hz, 125Hz and 250Hz by a Rion vibrometer, nd the latencies of the SEPs to the median nerve stimulation (N9, N13 and N20) were simultaneously evaluated. The VPT, tended to elevate from the 40s, became increased towords higher frequencies (63Hz<125Hz<250Hz) in the 80s to the 90s, whereas the VPT in younger ages showed just an opposite pattern (63Hz>125Hz>250Hz). None of the height-corrected latencies of N9, N13, N20 and central conduction time (N20-N13) revealed a significant correlation between the VPTs at any frequencies. The age-related decline of vibration sense, therefore, could not be explained solely by the degenerative changes of he posterior column and/or the delay of the peripheral nerve conduction velocity. This phenomenon was rather thought to be compatible with an age-associated characteristics of Pacinian corpuscles.
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  • Yoji Kobayashi, Toshimichi Shibuya, Yoshihiro Fukuo, Akiro Terashi
    1990 Volume 27 Issue 5 Pages 578-583
    Published: September 30, 1990
    Released: November 24, 2009
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    It is well known that abnormality of the coagulation-fibrinolytic system and serum lipids plays an important role in the development of thrombi and atherosclerotic disease. In the present study, the correlation between the activity of tissue plasminogen activator (TPA), the levels of tissue plasminogen activator inhibitor (PAI-1) and serum lipids (TC, TG, β-Lp, HDLC, LDLC and apolipoproteins) were studied in 102 healthy subjects. The activity of TPA showed negative correlation with the obesity rate (r=-0.21, p<0.05) but levels of PAI-1 antigen showed a positive correlation with the obesity rate (r=0.182, p<0.1). The activity of TPA showed no correlation with serum lipids including apolipoproteins, while the levels of PAI-1 antigen showed a positive correlation between TG and β-Lp (r=0.292, p<0.01, r=0.211, p<0.05). The levels of PAI-1 antigen showed a negative correlation with HDLC (r=-0.286, p<0.01). These results indicate that TPA and PAI-1 play an important role in the development of thrombotic disease and atherosclerotic disease.
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  • Motomi Katayama, Kiyotaka Yamazumi, Kenji Kino, Masanobu Tsuru, Toshio ...
    1990 Volume 27 Issue 5 Pages 584-588
    Published: September 30, 1990
    Released: November 24, 2009
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    To elucidate the effect of aging on liver weight in the elderly, 582 elderly cases (male 291, female 291), were selected from 2000 elderly autopsied cases on the basis of being free from pathological findings affecting liver weight. Both liver weight and its ratio to body weight decreased with age, and influenced by obesity; the former increased and the latter decreased in obese cases. Analysis according to the degeee of obesity also showed decrese of liver weight and is ratio to body weight with age. Comparison between males and females of the same decade revealed the tendency that in females the liver weight was low, while liver weight·body weight ratio was high. The same results were obtained by analysis based on the degree of obesity.
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  • Yoshiro Tanizaki, Michiyasu Sudo, Hikaru Kitani, Kazuhisa Kawauchi, Ta ...
    1990 Volume 27 Issue 5 Pages 589-594
    Published: September 30, 1990
    Released: November 24, 2009
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    Cellular responses in the airways of bronchial asthma, which might be affected with aging, were compared between 28 elderly (60 years old or more) and 28 younger (40 years old or less) patients with bronchial asthma. The cellular responses were observed to differentiate 500 cells in bronchoalveolar lavage fluid (BALF), excluding epithelial cells. The average frequency of each type of cell in the BALF of the elderly asthmatics was 65.7% for macrophages, 15.5% for lymphocytes, 8.9% for neutrophils and 9.5% for eosinophils. In the younger asthmatics the average frequency was 61.8% for macrophages, 17.1% for lymphocytes, 4.1% for neutrophils and 16.1% for eosinophils. A significant increase in the frequency of neutrohils in BALF of the elderly cases was observed in steroid-dependent intractable asthmatics compared to the younger cases (p<0.05). An increase in frequency of eosinophils in the younger cases was also observed, although the difference in the frequency was not significant between the elderly and the younger intractable cases. A significant difference in the frequency of each type of cell in the clinical type of bronchial asthma was not present between the elderly and the younger cases. However, the frequency of neutrophils in elderly cases was significantly increased in Ib. bronchospasm+hypersecretion type compared to Ia. bronchospams type (p<0.05), and was more elevated in II. bronchiolar obstruction type (p<0.01). The frequency of neutrophils was markedly more increased in the elderly cases with poor prognosis than in the younger cases (p<0.05). A marked increase in the frequency of eosinophils was observed in younger cases with poor prognosis, although it was not significantly different from elderly cases.
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  • Kouji Chida, Shin-ichiro Ohkawa, Shigeru Maeda, Kenji Kuboki, Tamotsu ...
    1990 Volume 27 Issue 5 Pages 595-604
    Published: September 30, 1990
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Seven elderly patients with hypertrophic obstructive cardiomyopathy (HOCM), who had the three following characteristics on echocardiograms 1) extremely thickened septum, 2) systolic anterior motion of the mitral valve, 3) mid systolic semi-closure of the aortic valve, were clinically evaluated. Ages ranged from 73 to 86 years old (average 78.9 yr.) and all were women. None had not a family history of hypertrophic cardiomyopathy but they had mild hypertension. Six patients showed a significant high voltage on the ST-segment and T-wave abnormalities (“strain” pattern). The left ventricular posterior wall as well as the septum was thickened in 5 and the remaining 2 showed asymmetrical septal hypertrophy (ASH) on echocardiograms. The left ventricular caviy was narrowed due to left ventricular hypertrophy and the shape of the left ventricular cavity was ovoid in all patients. The aorto-septal angles in these 7 patients were 80° to 120°. In addition, proximal septal bulge in all and anterior displacement of the mitral posterior leaflet due to the mitral ring calcification (MRC) in some patients contributed to the narrowing of the left ventricular outflow tract, and the mitral valve was pulled up toward the septum because of the good left ventricular systolic function (ejection fraction: 70 to 94% by echocardiography) and blood was ejected at a high velocity through a narrowed outflow tract (Venturi effect). Pressure gradients in the left ventricular outflow tract was 38 to 146mmHg in 5 examined by cardiac catheterization. Biopsy specimens were obtained from 2 patients, showing hyertrophic myocytes (diameter: 20 to 30 micron) in 2 and mild disarray in 1. In conclusion, hypertrophic obstrucitve cardiomyopathy in elderly patients may be a multifactorial disease possessing abovemenioned morphological characteristics of the left ventricle.
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  • Nobuyuki Sugihara, Masunori Matsuzaki, Yukiko Kato
    1990 Volume 27 Issue 5 Pages 605-615
    Published: September 30, 1990
    Released: November 24, 2009
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    We assessed the effect of bone mineral metabolism on mitral annular calcification (MAC) and aortic valve sclerosis or calcification (AVS) in elderly patients. Both MAC and AVS were derived by 2-D echocardiography, and bone mineral content (BMC) of vertebral bodies was obtained by quantitative computed tomography using a calibrated phantom system. The calcium (Ca), phosphate (P), parathyroid hormone (PTH-c), calcitonin (CLT), vitamin-D (25-(OH)D) and osteocalcin (OC) in serum were examined within a period of one month. The 265 patients were classified into three groups according to the echocardiographic findings. The control (CNT) group consisted of 122 patients (44 males, 78 females) without MAC or AVS, the MAC group consisted of 64 patients (16 males, 48 females) with MAC, and the AVS group consisted of 79 patients (31 males, 48 females) with AVS. 1) The incidences of MAC and AVS in both males and females were found to increase in proportion to aging. 2) The incidence of MAC in females (28%) was higher than that of males (18%). 3) AVS in males (34%) was more frequent than in females (27%). 4) In females of the eighth and ninth decade of age, BMC in the MAC group was significantly less than in the CNT group (eighth p<0.05, ninth p<0.01), but no difference was seen in males. 5) In both males and females, BMC in the AVS group was not significantly different from that in the CNT group. 6) In all subjects of the eighth and ninth decades, the serum levels of Ca and P were within normal ranges. PTH-c, CLT and 25-(OH)D showed subnormal or lower normal values, while OC showed supernormal or upper normal values. However, there was no difference among the three groups. These results suggest that MAC may be attributed to ectopic calcium deposit, probably related to decalcification from bone in postmenopausal osteoporosis. However, in the present study, there was no relation between the incidence of MAC and humoral factors of calcium metabolism. On the other hand, AVS may be caused by other factors, mainly prolonged and sustained pressure or stress loading.
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  • H. Inomata, T. Kanda, H. Maruyama, S. Kaneko, Y. Tazaki
    1990 Volume 27 Issue 5 Pages 616-617
    Published: September 30, 1990
    Released: November 24, 2009
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  • 1990 Volume 27 Issue 5 Pages 618-659
    Published: September 30, 1990
    Released: November 24, 2009
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  • 1990 Volume 27 Issue 5 Pages 660-671
    Published: September 30, 1990
    Released: November 24, 2009
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