Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 35 , Issue 10
Showing 1-13 articles out of 13 articles from the selected issue
  • Tamotsu Matsuda
    1998 Volume 35 Issue 10 Pages 703-712
    Published: October 25, 1998
    Released: November 24, 2009
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  • Hiroto Okayama
    1998 Volume 35 Issue 10 Pages 713-716
    Published: October 25, 1998
    Released: November 24, 2009
    JOURNALS FREE ACCESS
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  • Takenori Yamaguchi, Hiroshi Yamanouchi
    1998 Volume 35 Issue 10 Pages 717
    Published: October 25, 1998
    Released: November 24, 2009
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  • Kenji Nakajima, Yoshiyuki Watanabe, Kazuo Suzuki
    1998 Volume 35 Issue 10 Pages 718-720
    Published: October 25, 1998
    Released: November 24, 2009
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  • Shotai Kobayashi
    1998 Volume 35 Issue 10 Pages 721-725
    Published: October 25, 1998
    Released: November 24, 2009
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  • Hiroshi Nagura
    1998 Volume 35 Issue 10 Pages 726-729
    Published: October 25, 1998
    Released: November 24, 2009
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  • Setsuro Ibayashi, Masayoshi Watanabe, Tsuyoshi Omae, Masatoshi Fujishi ...
    1998 Volume 35 Issue 10 Pages 730-734
    Published: October 25, 1998
    Released: November 24, 2009
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  • Masahiro Yasaka, Chiaki Yokota, Kazuo Minematsu, Takenori Yamaguchi
    1998 Volume 35 Issue 10 Pages 735-740
    Published: October 25, 1998
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    To elucidate the pathophysiologic mechanism of cardioembolic stroke in elderly people and to devise therapeutic strategies for it, was analyzed 120 consecutive patients (77 men and 43 women aged 65±13 years) with acute cardioembolic stroke who were admitted within 7 days of the stroke onset. We compared underlying heart diseases, NIH stroke scale on admission, lesion size on computed tomography (CT), the relation between anticoagulant therapy and recurrence, complications during admission, ADL at discharge, recurrence, and death during the follow up period in three groups: patients aged less than 65 years (the young group), those aged from 65 to 74 years (the“non-old”group), and those aged more than 75 years (the“old old”group).
    In the“old old”group, non valvular atrial fibrillation (75.8%) was the most common underlying heart disease and so was rheumatic heart disease (33.3%) in the“non-old”group. NIH stroke scale score (median, 11) and the proportion of patients with a large lesion (>3cm) on CT were higher in the“old old”group than in the other two groups. Immediate anticoagulation (A/C) within 14 days of onset was performed in more than 70% of the “non-old”and the“young old” groups but in only 57.6% of the“old old”group. Stroke recurred more often in 34 patients who did not receive immediate A/C than in the 86 who did (11.8% vs. 2.3%, Chi squate test, p=0.053). Hemorrhage during immediate A/C and other complications (infection and pulmonary embolism) were seen in 2 and 14 patients, respectively, in both the“young old”groups, but not in the“non-old”group. Good outcomes (able to walk with or without cane) were more common in the“non-old” group (78.9%) than the other groups (57.1%, Chi square test, p<0.01). A/C after the acute stage was done in more than 80% of those in the“non-old”and the“young old”groups, but in less than 30% of those in the“old old”group (Chi square test, p=0.0514). Survival without recurrence during the observation period (605±550 days) was significantly lower in the “old old”group than in the other two groups (log-rank test, p=0.0091).
    Cardioembolic atroke in the elderly may be characterized as follows: (1) non valvular atrial fibrillation is the most common, (2) severe neurologic deficits on admission and large lesions on CT are noted, (3) complications (infection and pulmonary embolism) often occur, (4) A/C in both acute and chronic stages are done infrequently. Therefore, the indication and intensity of A/C for primary and secondary prevention and prevention of complications are important in management of cardioembolic stroke in the edlerly.
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  • Hiroyuki Nozaki, Yumiko Nohara, Ryoko Zukeran, Ikuya Ashitomi, Tetsuya ...
    1998 Volume 35 Issue 10 Pages 741-747
    Published: October 25, 1998
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    The relationship between serum albumin level and activities of daily living was studied in 95 centenarians. There were 73 women (12 rank J: free-living, 18 rank A: unable to go outside without help, 20 rank B: bedridden but able to sit on the bed, 23 rank C: completely bedridden) and 22 men (9 rank J, 7 rank A, 6 rank B or C).
    The serum albumin level (mean±S.D. 4.0±0.4g/dl) of the rank J women was at the lower limit of normal for young adults. The albumin levels of rank A, rank B, and rank C were 3.7±0.4g/dl, 3.5±0.3g/dl, and 3.4±0.4g/dl, respectively. The levels of rank B and rank C women were significantly lower than that of rank J women. The albumin level of rank J men (3.9±0.3g/dl) was lower than that of young adults. The albumin level of ranks B and C men (3.1±0.3g/dl) was significantly lower than that of rank J men. The A/G ratio or albumin fraction (%) measured by serum electrophoresis was similar to that of the serum albumin level of centenarians of both sexes. There were no significant differences in the serum protein level or in the peripheral hemoglobin level between rank J centenarians and those of other ranks, for both sexes.
    The serum albumin level is a valuable indicator of the ability to perform activities of daily living and may be a useful prognostic index in centenarians.
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  • Tsunehisa Satoh, Kazuoki Otsuka, Izo Sakurai
    1998 Volume 35 Issue 10 Pages 748-756
    Published: October 25, 1998
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    We examined the quantitative measurement of platelet aggregation in 20 volunteers and 89 patients with ischemic heart disease (IHD). Subjects in whom platelet aggregation was induced by an adenosine diphosphate (ADP) and an epinephrine solution were clearly divided into two groups: “normal” and “accentuated”. We chose the maximum aggregation time for the ADP solution and the maximum transmission rate for the epinephrine solution for the quantitative measurement of platelet aggregation.
    The results were as follows. The maximum aggregation time with a 1.0μM ADP solution in the normal group of 13 volunteers was 0.71±0.12min, (mean±SD), in 50 IHD patients it was 0.91±0.49min, in the “accentuated” group of 7 volunteers it was 5.34±1.18min, in 39 IHD patients it was 6.01±1.22min. The maximum light transmission rate with a 0.1μM epinephrine solution in the normal group of 14 volunteers was 8.04±4.14%, in 52 IHD patients it was 13.74±5.75%, in the “accentuated” group of 6 volunteers it was 76.33±9.91%, and in 37 IHD patients it was 77.26±13.39%. The difference between the“normal” and “accentuated” groups was statistically significant (p<0.001), with the ADP and with the epinephrine solution. Next, we examined the effect of antiplatelet therapy (dipyridamole and aspirin) on 15 patients selected from among those with IHD who had accentuated platelet aggregation when the ADP solution was added. Their maximum aggregation time was 5.98±1.24min, and their maximum platelet aggregation rate when the epinephrine solution was added was 78.90±11.60% (10 patients), 20.00±3.24% (5 patients). After the therapies, the maximum aggregation time in 10 patients was 0.94±0.21min (return to normal condition), and in 5 patients it was 5.90±1.09min (not effective). The maximum platelet aggregation rate in 10 patients was 14.11±5.88% (normal condition), and in 5 patients it was 75.00±9.51% (not effective). Finally, we examined the long term effects of various antiplatelet drugs. Most of the patients in whom platelet aggregation was accentuated got well.
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  • Katsuki Sugiyama
    1998 Volume 35 Issue 10 Pages 757-764
    Published: October 25, 1998
    Released: November 24, 2009
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    Modification of DNA with aging has been proposed as a mechanism of cellular senescence. To test this hypothesis, we measured fluorescence of the DNA-Ethidium bromide (EB) complex in human peripheral lymphocytes.
    Lymphocytes were incubated in a medium containing phytohemagglutinin (PHA-P). EB was linked to lymphoblast-DNA.
    Healthy adults of three age groups were examined: 40-49 (N=14), 50-59 (N=16), 60-69 (N=8). Moreover, we studied lymphocytes from 17 patients (47-74 years old) with probable Alzheimer's disease.
    An aged-related linear decrease in fluorescence intensity was found in healthy controls (r=0.135, P<0.05), and for Alzheimer's disease patients (r=0.443, P<0.10). The regression equation are:
    Y=-0.0405X+7.164 (Healthy Contorols)
    Y=-0.121X+11.258 (Alzheimer's disease patients)
    where X and Y are age and fluorescence, respectively.
    These results indicate that the analysis of DNA-EB fluorescence in lymphocytes may be useful in the study of changes associated with aging, and also in the evaluation of the clinical diagnosis of Alzheimer's disease.
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  • Nobuo Suyama, Shotai Kobayashi, Shuhei Yamaguchi, Kazunori Okada, Kazu ...
    1998 Volume 35 Issue 10 Pages 765-770
    Published: October 25, 1998
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Purpose and Methods: To investigate the association between social environment and aging of the brain, we studied P300 event-related evoked potentials in 95 normal elderly subjects living in different social environments. The subjects were divided into two groups: 22 healthy people living in old-age homes (average age 76.5±5.6 years, average Hasegawa Dementia Scale-Revised 27.4±2.5), and 93 healthy people living in their own homes (average age 74.1±5.4 years, average Hasegawa Dementia Scale-Revised 28.3±2.3). Target and Novelty P300 were recorded by using an auditory oddball paradigm There were no differences in risk factors for strokes or in findings on magnetic resonance imaging between the two groups.
    Results: Cognitive function (Okabe's Score and Koh's Block Design Test) were lower in those living in an old-age home than in those living in their own homes. Both target and novelty N100 examinations showed no significant differences in amplitude or latencies between the two groups. However, P300 latencies were larger among those living in an old-age home than among those living in their own homes; P300 amplitudes in the two groups were similar. Those living in an old-age home also had greater age-associated declines in function, as shown by longer latencies in target P300 than in novelty P300. Conclusion: Social-environmental factors are closely associated with the aging of the brain.
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  • Kazuo Ichikawa, Tsuyoshi Kaneko, Satoru Suzuki, Mitsuhisa Komatsu, Kei ...
    1998 Volume 35 Issue 10 Pages 771-776
    Published: October 25, 1998
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Analysis of patients with persistent hypothyroidism due to Hashimoto's thyroiditis suggested that metabolism of thyroxine (T4), including deiodination to triiodothyronine (T3), was reduced in the elderly. The increase in the serum levels of T4 after oral administration of T4 was augmented in the elderly, whereas increase in the serum T3 level was not. Possibly due to the reduction in the pituitary deiodinase, suppression by T4 administration of serum thyrotropin (TSH) level was the same in elderly as in younger subjects despite a larger increase in the serum levels of T4 in the elderly. Consequently, the amount of T4 required to maintain a normal serum TSH level did not differ between elderly and younger subjects. Other characteristics of elderly patients with Hashimoto's thyroiditis were that goiter size was smaller, that hypothyroidism was more frequent, and that Graves'disease was less frequent.
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