Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 37 , Issue 10
Showing 1-18 articles out of 18 articles from the selected issue
  • Masakazu Washio, Masatoshi Fujishima
    2000 Volume 37 Issue 10 Pages 759-762
    Published: October 25, 2000
    Released: November 24, 2009
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  • Mamoru Shibata, Hideyuki Okano
    2000 Volume 37 Issue 10 Pages 763-770
    Published: October 25, 2000
    Released: November 24, 2009
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  • Nobuo Yanagisawa, Hideo Tohgi
    2000 Volume 37 Issue 10 Pages 771
    Published: October 25, 2000
    Released: November 24, 2009
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  • Etsuro Mori
    2000 Volume 37 Issue 10 Pages 772-776
    Published: October 25, 2000
    Released: November 24, 2009
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    Dementia with Lewy bodies (DLB), the second most frequent cause of primary degenerative dementias following Alzheimer's disease, has been increasingly recognized since the proposal of the consensus name and clinical diagnostic criteria. Although DLB overlaps in clinical, pathological, and genetic features with Alzheimer's disease and Parkinson's disease, DLB should be understood as an entity with the essential feature of the presence of Lewy bodies in the brain stem and cerebral cortex. From the clinical point of view, DLB is characterized by the presence of progressive dementia without severe memory disorders at the early stage, with significant cognitive fluctuations, well-formed recurrent visual hallucinations, and spontaneous Parkinsonism. This article reviews recent clinical and research findings, including our own, to facilitate clinical recognition of DLB. In addition to the supportive features described in the consortium clinical diagnostic criteria for DLB such as falls and great sensitivity to neuroleptic drugs, our studies found other frequent disorders including disproportionately severe visuoconstructive and visuoperceptual disturbances, transitory alterations in consciousness with reduplication phenomena, misidentification delusions, and non-aphasic misnamings. Neuroimaging features include relatively preserved hippocampal volume on MRI and occipital involvement on metabolic and blood flow imagings. The correct diagnosis of DLB is important to administer adequate treatment, to avoid adverse eflects with neuroleptic drugs, and to establish precise prognosis. The present summary of the clinical features is hopefully helpful for clinical diagnosis of DLB. From a therapeutic point of view, cholinesterase inhibitors seemingly show some efficacy in the treatment of cognitive alterations. Further research would result in advances in diagnostic methods and therapeutic aproaches in the near future.
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  • Tetsuhiro Maruyama
    2000 Volume 37 Issue 10 Pages 777-779
    Published: October 25, 2000
    Released: November 24, 2009
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  • Tetsuyuki Kitamoto
    2000 Volume 37 Issue 10 Pages 780-781
    Published: October 25, 2000
    Released: November 24, 2009
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  • Jun Ogata, Takenori Yamaguchi, Masayuki Wakita, Masasi Tagaya
    2000 Volume 37 Issue 10 Pages 782-784
    Published: October 25, 2000
    Released: November 24, 2009
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  • Keiko Kamata, Atsushi Murai
    2000 Volume 37 Issue 10 Pages 785
    Published: October 25, 2000
    Released: November 24, 2009
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  • Kikuko Aso
    2000 Volume 37 Issue 10 Pages 786-789
    Published: October 25, 2000
    Released: November 24, 2009
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  • Kimiko Hamasuna
    2000 Volume 37 Issue 10 Pages 790-792
    Published: October 25, 2000
    Released: November 24, 2009
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  • Noriko Sakurai
    2000 Volume 37 Issue 10 Pages 793-795
    Published: October 25, 2000
    Released: November 24, 2009
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  • Tomoji Tanaka
    2000 Volume 37 Issue 10 Pages 796-798
    Published: October 25, 2000
    Released: November 24, 2009
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  • Akinori Hattori, Ayako Ouchi, Kiyoko Shibuya, Kazuko Sato, Ken-ichi Na ...
    2000 Volume 37 Issue 10 Pages 799-804
    Published: October 25, 2000
    Released: November 24, 2009
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    To relieve the stress of caregivers, it is critical to identify and classify the burden factors in the elderly patients. In order to determine the factors that exhaust caregivers, a cross sectional survey was done. The study employed a self-recording questionnaire form which included the Pines' burnout scale and the level of patient's basic activities of daily living (BADL). Seventy-three caregivers filled in the questionnaire. They reported the difficulty of care for an elderly patient in the home, and the degree of the difficulty correlated well with the burnout score (r=-0.517; p<0.001). The caregivers' burnout score did not correlate so well with the level of their patient's BADL (r=-307; p=0.014).
    Among the factors in BADL, aid for toilet use, feeding, sitting, and transferring raised the burnout scale. On the other hand, assistance for bathing and dressing did not correlate with the burnout score.
    On multiple regression analysis using the background factors for the burnout score as explanatory variables, aid for feeding and sitting were significant independent contributing factors.
    Since it became clear that the caregivers in the home were almost burnt out owing to the aid they need to give for the elderly person's BADL, attempts should be done to reduce their burden as soon as possible.
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  • Shigeki Ohgitani, Takuo Fujita
    2000 Volume 37 Issue 10 Pages 805-810
    Published: October 25, 2000
    Released: November 24, 2009
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    The effects of calcium supplementation on urinary oxalate excretion was tested in 9 normal subjects, 4 males and 5 females between 23 and 49 years of age. In a crossover study 800mg calcium was orally administered as active absorbable algal calcium (AAACa) (A) and calcium carbonate (B), and compared with non-calcium containing placebo (C).
    Calcium, oxalate, osmolality, creatinine and pH were measured in the first three morning urine samples and Ca/osmolality, Ca/osmolality/body weight, Ca/creatinine and oxalate/osmolality were calculated to correct for urine dilution. Ca×oxalate product was also calculated and Ca oxalate crystal in the sediment was microscopically examined and semiquantitatively estimated as-, +, ++, and +++ expressed as 0, 1, 2 and 3 respectively. Urinary Ca excretion was similar in A and B, but significantly larger than C, regardless of the method of correction for dilution. Urinary oxalate excretion tended to be lower in A than in B and C. Urine pH was similar among all three groups. Ca×oxalate product was higher in C than in A and B.
    AAACa, unlike calcium carbonate, appeared to decrease urinary oxalate excretion and Ca×oxalate product more efficiently than Ca carbonate, suggesting a possibility of inhibiting the formation of Ca×oxalate kidney stones. Formation of calcium oxalate was also tested in vitro by adding oxalate to urine samples and aqueous calcium solution.
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  • Toshihiko Iwamoto, Munerori Ami, Takeshi Shimizu, Yuriko Tanaka, Tsune ...
    2000 Volume 37 Issue 10 Pages 811-818
    Published: October 25, 2000
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    This study was conducted to evaluate the relationship between arteriosclerosis and lipoprotein (a) [Lp(a)] from the point of view of aging. A total of 354 patients (167 men) aged 60 or more were enrolled and serum Lp (a) levels, vascular risks, and complications were studied. Patients were divided into 3 groups according to age: group I (n=73: aged 60 to 69), group II (n=144: aged 70-79), and group III (n=137: aged 80 or more). Vascular complications were assessed by carotid ultrasonography (US), ECG, and ankle pressure index (API). US findings were stratified according to the distribution of plaque lesions in unilateral and bilateral lesions, while plaque types were subdivided based on the morphology and US echogenicity. Male patients with risk factors (diabetes, hypercholesterolemia, cigarette smoking) as well as stroke were frequent in group I, indicating some selection bias. However, there was no difference in Lp (a) level among the three groups. Carotid lesions, especially bilateral lesions with more thickened plaques, and low API were both significantly frequent in group III. Logistic regression analysis showed that carotid lesions were influenced not only by aging, but also independently by high Lp (a) levels in group III, and by hypertension in group II. A high Lp (a) level was related to hypercholesterolemia and hypoechoic plaque. These findings indicated that atherosclerosis, which developed in both the carotid and peripheral arteries with aging, was related to different risks in each decade of life. Furthermore, it seems that a long period of high Lp (a) levels may promote the formation of hypoechoic plaque.
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  • Michiya Igase, Yosikuni Yamamoto, Katsuhiko Kohara, Tetsuro Miki
    2000 Volume 37 Issue 10 Pages 819-822
    Published: October 25, 2000
    Released: November 24, 2009
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    An 84-year-old man was admitted to our hospital with right shoulder pain. He had been suffering from well-differentiated papillary thyroid carcinoma since1994, and had undergone surgery three times, including procedures due to recurrence. Since CT showed a right cervical tumor, recurrence of thyroid carcinoma was diagnosed. He died in September 1999 due to progressive respiratory failure. Autopsy was performed and pathological examination revealed the recurrent tumor and metastatic lesions had totally transformed to anaplastic thyroid carcinoma.
    Since anaplastic carcinoma is characterized by exceptionally rapid progression with dire prognosis, physicians should be aware of the major risk factors of anaplastic transformation in elderly males aged over 60 years old, with repeated relapses of differentiated carcinoma, and a history of tumor irradiation.
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  • Takako Mitsuoka, Yoshio Murata, Toshihide Harada, Fumiko Ishizaki, Shi ...
    2000 Volume 37 Issue 10 Pages 823-827
    Published: October 25, 2000
    Released: November 24, 2009
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    We report a 75-year-old man who had shown bilateral ballistic movements. He had suffered from pulmonary emphysema for about 35 years and was treated with oxygen therapy 3 years before. When he was 70 years old, involuntary movements appeared in bilateral limbs. His involuntary movements were ballistic, and become gradually worse. T2-weighted MRI after admission demonstrated high signal intensities in the bilateral pallidum, indicating multiple brain infarcts in the subcortical white matter.
    Ultrasonography showed 2 plaques in the left common carotid artery. Laboratory studies revealed blood coagulation abnormalities and hypoxia. Medication with clonazepam and tiapride together with oxygen therapy normalized blood gas levels and improved his involuntary movements. But after dischage, he stopped oxygen therapy and involuntary movement became worse again, associated with hypoxia demonstrated by his blood gas analysis. These findings suggest that not only cerebrovascular disease but hypoxia might play an important role in the appearance and exacerbation of involuntary movements.
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  • 2000 Volume 37 Issue 10 Pages 828-836
    Published: October 25, 2000
    Released: November 24, 2009
    JOURNALS FREE ACCESS
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