Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 36 , Issue 9
Showing 1-14 articles out of 14 articles from the selected issue
  • Takashi Haneda, Kenjiro Kikuchi
    1999 Volume 36 Issue 9 Pages 605-612
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
  • Naoaki Ishii
    1999 Volume 36 Issue 9 Pages 613-619
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
  • Toshio Ogihara
    1999 Volume 36 Issue 9 Pages 620-622
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (541K)
  • Atsushi Murai
    1999 Volume 36 Issue 9 Pages 623-626
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (630K)
  • Fumio Eto
    1999 Volume 36 Issue 9 Pages 627-630
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (968K)
  • Kiyotaro Kondo, Koichi Shido, Takamasa Kato, Takehiko Ohura, Yoshimori ...
    1999 Volume 36 Issue 9 Pages 631-637
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A Minimum Data Set (MDS) was recorded in two geriatric hospitals every 4 months for about 5 years. The initial records were available in a total of 1, 735 disabled elderly. In MDS, about 360 trigger items were recorded. A selection was made to determine whether there were problems of care in 18 areas of Resident Assessment Protocols. We analyzed errors and biases in selection of the diagnosis in the chapter E of MDS disclosing that; 1) they were almost satisfactorily made in diseases except dementias, 2) diagnosis of dementias was biased in several ways, paticularly Alzheimer's disease was overselected, and 3) preprinted diagnostic options in MDS were not suited with the Japanese practice and were insufficient for comprehensive medical/nursing service and caregiving.
    Download PDF (1139K)
  • Masaru Takasaki, Nobuo Tsurumi, Mitsuyoshi Harada, Norihito Rokugo, Yo ...
    1999 Volume 36 Issue 9 Pages 638-643
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    The purpose of this study was to investigate the mechanism of so-called senile anemia. Using bone marrow tissue specimens prepared from 168 patients autopsied at the Second Department of Pathology of Tokyo Medical University, we measured the area of fatty marrow tissue and the luminal cros-sectional area of feeding arteries for the marrow to assess the relationship of these parameters with aging. Conversion to fatty marrow progressed with aging, and fatty marrow made up more than 50% of the overall bone marrow area in patients aged over 60 years. The nucleated cell count decreased significantly (p<0.01) in patients aged over 60 years. Furthermore, the luminal cross-sectional area of bone marrow feeding arteries also decreased gradually with aging, declining by 18% to 26% in patients aged over 50 years compared with patients in their third decade.
    A significant negative correlation (r=-0.228; p<0.001) was found between the area of fatty marrow and the luminal cross-sectional area of the bone marrow feeding arteries.
    In conclusion, we suggest that artherosclerotic changes associated with aging in the bone marrow have an impact on hematopoietic function and may be one of the factors involved in the development of senile anemia.
    Download PDF (1583K)
  • Toshiro Nakazawa, Kenta Suzuki, Isao Kobayashi
    1999 Volume 36 Issue 9 Pages 644-647
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    From May 1996 through August 1998, endoscopic papillary balloon dilation (EPBD) was performed to remove common bile duct stones in 17 elderly patients, aged 75 to 87 (average 81.9), including 7 with juxtapapillary diverticulum. The balloon-tipped biliary catheter for EPBD was inflated at a pressure of 10atm. for 2 minutes, and the maximum diameter of the inflated balloon reached 8 or 10mm.
    After one or two ERCP sessions using EPBD alone, the bile duct stones were removed in 16 (94.1%) of 17 patients, and endoscopic mechanical lithotripsy was required in 6 (35.3%) patients. Another patient required additional sphincterotomy for removal of the stone.
    Massive bleeding or intestinal perforation, which can be major complications of EPBD, did not occur, and while the minor complication of transient abdominal pain was observed in 3 patients but there was no case of pancreatitis.
    The clearance rates of stones and complication rates in our EPBD procedure were similar to other reports and to those of our data in younger patients, aged under 75. EPBD was a safe and effective technique for the extraction of the common bile duct stones in elderly patients.
    Download PDF (702K)
  • Harukiyo Kawamura, Seijiro Mori, Shunichi Murano, Koutaro Yokote, Ken ...
    1999 Volume 36 Issue 9 Pages 648-651
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 56-year-old woman with Werner's syndrome was admitted to our hospital because of intractable foot ulcer and malnutrition. She presented dementia consisting of childish behaviour, loss of intelligence, and severe amnesia. Brain CT revealed diffuse periventricular low density areas, and brain MRI also disclosed periventricular high intensity areas under T2-intensified conditions. These findings gave a diagnosis of progressive subcortical vascular encephalopathy of the Binswanger type, which seemed to be the cause of her dementia. She finally died of heart failure due to acute myocardial infarction. Mild to moderate demyelinization was found in the subcortical area of the autopsied cerebrum, confirming the clinical diagnosis. Generalized atherosclerosis characteristic of Werner's syndrome may have predisposed this patient to Binswanger's encephalopathy.
    Download PDF (2315K)
  • Takashi Oguni, Takaaki Doi, Akihiro Yamada, Ryuichi Kawamoto
    1999 Volume 36 Issue 9 Pages 652-656
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 72-year-old woman had been treated for hypertension and hyperthyroidism by a local doctor. In May 1998, she came to this institution with a chief complaint of leg edema. Based on the clinical findings, she was diagnosed as having nephrotic syndrome with massive proteinurea, hypoproteinemia and hyperlipidemia. Renal biopsy findings showed minimal change nephrotic syndrome (MCNS). No substantial improvement was obtained by steroid therapy. We therefore additionally administered angiotensin-converting enzyme inhibitor (enalapril maleate). The urinary protein concentration significantly decreased. On decreasing the dose of steroids, the urinary protein concentration increased. Cyclophosphamide helped us to decrease the steroid dosage. This treatment resulted in type II incomplete remission. The final diagnosis was refractory MCNS. During steroid therapy, she developed hyperglycemia. She had no histology of diabetes mellitus. There is therefore a possibility that steroids can induce hyperglycemia even in patients without a history of diabetes mellitus. These results suggest that careful monitoring of plasma glucose is necessary during steroid therapy and that the administration of an angiotensin-converting enzyme inhibitor is effective in elderly patients with refractory primary nephrotic syndrome.
    Download PDF (1593K)
  • Yuishin Izumi, Katsuhiko Sakaguchi, Fukashi Udaka, Takahiro Tsujimura, ...
    1999 Volume 36 Issue 9 Pages 657-662
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 68-year-old man with disturbed consciousness had repeatedly developed light-headedness and dizziness since the summer of 1996 and was admitted to a hospital for detailed examinations on October 8, 1996. On admission, he weighed 49kg and showed subclinical hypothyroidism with low T3 syndrome. The adrenal function and serum electrolytes were normal. Since the stool samples were positive for occult blood, gastroscopy was performed. Examination of the biopsy specimens demonstrated gastric cancer. On October 21, blood examination showed hyponatremia (127mEq/l). On October 22, marked disturbance of consciousness developed. On October 24, the serum Na level further decreased to 116mEq/l. On November 8, he was referred to our hospital. On admission, his skin and tongue showed marked dehydration, and severe disturbance of consciousness and neck stiffness were observed. The central venous pressure was 4cmH2O. In the cerebrospinal fluid, atypical cells were observed, and a diagnosis of meningeal carcinomatosis was made. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was excluded because of marked dehydration, a normal blood ADH level, and because plasma osmotic pressure was greater than urinary osmotic pressure. Considering the possibility of cerebral salt wasting syndrome (CSWS) or hypoadrenocorticism, Na supplementation and drip infusion of prednisolone (20mg/day) were performed. The serum Na has normalized (140.1mEq/l), and his consciousness improved. He died of aggravation of the general condition on December 16. Pathological examination demonstrated a small metastatic lesion in the infundibular part of the pituitary gland and a small metastatic lesion in the parenchyma of the bilateral adrenal glands. However, since neither hypotension nor hypoglycemia was observed before treatment, and the blood cortisol level and the serum K level were normal, hypoadrenocorticism was excluded. Hypoaldosteronism was also excluded because of a normal serum K level. CSWS has been reported to be caused by head trauma, subarachnoid hemorrhage, or trans-sphenoidal pituitary operation. This patient is a rare case of CSWS developed in the presence of meningeal carcinomatosis accompanied by a small pituitary metastatic lesion from gastric cancer. The aged with decreased ability to retain water and sodium in the body are more susceptible to CSWS than the young. In the aged with central hyponatremia, the possibility of CSWS should be considered, and early diagnosis and treatment are necessary.
    Download PDF (1624K)
  • M. Ikeda, K. Hokoishi, N. Maki, K. Komori, H. Tanabe, M. Nomura, C. Ma ...
    1999 Volume 36 Issue 9 Pages 663-665
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (441K)
  • Japan NGO Conference for 1999
    1999 Volume 36 Issue 9 Pages 666-672
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (1152K)
  • 1999 Volume 36 Issue 9 Pages 673-679
    Published: September 25, 1999
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (1317K)
feedback
Top