Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 37 , Issue 7
Showing 1-15 articles out of 15 articles from the selected issue
  • Kanao Tsuji
    2000 Volume 37 Issue 7 Pages 501-506
    Published: July 25, 2000
    Released: November 24, 2009
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  • Masato Kita, Shingo Fujii
    2000 Volume 37 Issue 7 Pages 507-510
    Published: July 25, 2000
    Released: November 24, 2009
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  • Kenji Toba, Hidetoshi Endo
    2000 Volume 37 Issue 7 Pages 511
    Published: July 25, 2000
    Released: November 24, 2009
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  • Hidetoshi Endo
    2000 Volume 37 Issue 7 Pages 512-514
    Published: July 25, 2000
    Released: November 24, 2009
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  • Mariko Abe Foulk
    2000 Volume 37 Issue 7 Pages 515-518
    Published: July 25, 2000
    Released: November 24, 2009
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  • Ryu Niki
    2000 Volume 37 Issue 7 Pages 519-522
    Published: July 25, 2000
    Released: November 24, 2009
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  • Setsu Iijima
    2000 Volume 37 Issue 7 Pages 523-527
    Published: July 25, 2000
    Released: November 24, 2009
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  • Manabu Ikeda, Kazuhiko Hokoishi, Naruhiko Maki, Hirotaka Tanabe
    2000 Volume 37 Issue 7 Pages 528-531
    Published: July 25, 2000
    Released: November 24, 2009
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  • Koji Miura
    2000 Volume 37 Issue 7 Pages 532-534
    Published: July 25, 2000
    Released: November 24, 2009
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  • Naoko Mabuchi, Takayoshi Tsutamoto, Keiko Maeda, Masahiko Kinoshita
    2000 Volume 37 Issue 7 Pages 535-540
    Published: July 25, 2000
    Released: November 24, 2009
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    We designed this study to evaluate the relationship between plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels and recurrence of atrial fibrillation (AF) after direct current cardioversion (DC) and the differences with aging. Fifty patients with mild congestive heart failure (CHF) undergoing elective DC of AF were included in this study (New York Heart Association (NYHA) functional class II: n=42, III=8). Patients who failed to show restoration of sinus rhythm or those with mitral valve stenosis were excluded. Before successful DC, we measured plasma levels of ANP and BNP and evaluated left atrial dimension (LAD), left ventricular end-diastolic dimension (LVDd), and left ventricular ejection fraction (EF) by echocardiography. Twenty-one patients had recurrence of AF within 2 months after DC (average 9.05 days). We followed up the other 29 patients for 580.5 days. By Cox stepwise multivariate analysis, history of AF (p=0.007), low plasma levels of ANP (p=0.003), and high plasma levels of BNP (p=0.0003) were found to be independent predictors of recurrent AF. High plasma BNP levels indicating ventricular dysfunction and low plasma ANP levels may be due to atrial histological change such as fibrosis. In these patients, plasma ratios of ANP and BNP (ANP/BNP) less than 0.43 were predictive factors for AF recurrence (sensitivity 70%, specificity 62%), especially in patients who were older than 70 years (sensitivity 100%, specificity 80%). Relatively low plasma ANP level compared to BNP is an independent risk factor of AF recurrence in patients with CHF, especially in elderly patients, suggesting that plasma cardiac natriuretic peptides are important biochemical markers of AF recurrence in elderly patients with CHF.
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  • Naomi Shibuya, Hisao Tachibana, Bungo Okuda, Minoru Sugita
    2000 Volume 37 Issue 7 Pages 541-547
    Published: July 25, 2000
    Released: November 24, 2009
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    We conducted a neuropsychological comparison among cases with corticobasal degeneration (CBD; n=8), those with progressive supranuclear palsy (PSP; n=5) and healthy control subjects (n=12) using an extensive neuropsychological battery assessing memory and executive functions. There were no significant differences among three groups for age, education, scores on the Mini-Mental State Examination and Zung's self-rating depression scale. Both patient groups showed retrieval impairment without recognition difficulties, and a dysexecutive syndrome. Along with those similarities, we observed some differences between CBD and PSP patients. Memory impairments in CBD patients were more marked than PSP patients in Rey's complex figure test, while they were less prominent in Rey's auditory verbal learning test. Perseverative errors of Nelson in Wisconsin card sorting test (Keio version) were more marked in CBD patients than in PSP patients. These two diseases showed memory and executive dysfunctions probably due to subcortico-frontal dysfunction. Some neuropsychological differences may help to distinguish CBD clinically from PSP.
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  • Tatsuro Ishizaki, Shuichiro Watanabe, Takao Suzuki, Hideyo Yoshida, Hi ...
    2000 Volume 37 Issue 7 Pages 548-553
    Published: July 25, 2000
    Released: November 24, 2009
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    This study observed the status of independence in behavioral competence among older people who have any disability in basic activities of daily living (BADL) living in a rural community in Japan. Study participants (N=76) who were regarded as bedridden were surveyed by means of a questionnaire in July to August 1996. The independence variables were age, sex, BADL status, hearing impairment, visual impairment, history of stroke, and cognitive impairment. The dependent variable was each item of the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence, which is a multidimensional 13-item index of behavioral competence. Percentages of subjects who were independent in each item of the TMIG Index of Competence varied from 1% to 36%. Multiple logistic regression analyses revealed that BADL status was independently associated with independence in using a telephone, being interested in news stories or programs dealing with health, being called on for advice, and initiating conversations with young people, after adjustment for age, sex, hearing impairment, visual impairment, history of stroke, and cognitive impairment. These findings suggest that programs for preventing decline in behavioral competence of older people with BADL disability might be important as well as physical therapy for them.
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  • Fumio Eto, Takushi Sakata
    2000 Volume 37 Issue 7 Pages 554-560
    Published: July 25, 2000
    Released: November 24, 2009
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    A mail survey was conducted to elucidate the influential factors on heath-related quality of life (HRQOL) after cerebral vascular disease. Questionnaires for clinicians and their patients were mailed to 2, 587 hospitals with more than 100 beds, which have at least one of the following departments: neurosurgery, neurology, psychiatry or rehabilitation. Each mailing contained a request to the clinician and questionnaires for 5 cases. 378 effective questionnaires could be collected, meaning the collection rate was 2.9%. The questions for the physicians concerned diagnosis (cerebral infarction or hemorrhage), duration of illness, activities of daily living (ADL), manifestation of paralysis and psychiatric symptoms and so forth. The questionnaire for the patients was composed of items from the EuroQol clinical version (EuroQol), Geriatric Depression Scale short form (GDS) and inquiries concerning family living with the patients, their housekeeping and so on. A visual analogue scale (VAS) concerning health state of the EuroQol was used as a measure of HRQOL. Coefficients of determination between VAS and other inquiries were calculated by regression analysis or ANOVA, revealing that “anxiety/depression”, “GDS” and 16 other items were statistically significant on VAS (p<0.05). General linear model (GLM) analysis using VAS as a criterion variable and these 18 items as predictor variables showed that “sleep disturbance” and GDS score were most influential on VAS according to the F value of the type 3 sum of squares. “Health state today compared to that during the past one year”, “shopping as housekeeping”, “ADL” and “pain/discomfort” also have some influence on VAS. In conclusion, sleep disturbance and depression had the most deleterious effect on HRQOL.
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  • Miho Matsubara, Katsuhiko Kohara, Michiya Igase, Kinji Uemura, Keiko T ...
    2000 Volume 37 Issue 7 Pages 561-564
    Published: July 25, 2000
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 91-year-old man was admitted with colliquative diarrhea, anorexia and weight loss. He had a histry of healed tuberculosis, hypertension and atherosclerotic abdominal aortic aneurysms.
    On admission, shortness of breath without cough, exertional dyspnea, and ascites were also noticed. His chest X-ray and CT showed almost normal findings in the lung fields except for calcified old pleurisy. Since laboratory tests revealed thrombocytopenia, low fibrinogen, and increased CA19-9, DIC induced by an unknown cancer was diagnosed. He died on the eighth day due to progressive respiratory failure which did not respond to oxygen therapy.
    Autopsy revealed that he had a poorly differentiated adenocarcinoma in the cecum complicated with pulmonary lymphangitis carcinomatosa. Lymphangitis should be considered in the case of unexplained progressive respiratory failure developing in patient with cancer, even in the absence of X-ray findings.
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  • Kouji Nishida, Seiji Kawazoe, Masayoshi Higashijima, Korehiko Takagi, ...
    2000 Volume 37 Issue 7 Pages 565-570
    Published: July 25, 2000
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 76-year-old woman was admitted with obstructive jaundice. US and MR cholangiopancreatography (MRCP) revealed an inoperative cholangiocarcinoma, 3cm in diameter at the hilum of the liver, the obstruction of the hepatic duct bifurcation and the separation of bilateral hepatic bile ducts. Percutaneous transhepatic biliary drainage (PTBD) was performed from bilateral hepatic bile ducts. The right PTBD tube was spontaneously extubated. We could not succeed in performing internal biliary drainage across the hilar malignant stricture from a left hepatic bile duct, because of bad angulation. Transpapillary insertion into the common bile duct (CBD) was extremely difficult due to the collapse of the CBD. Endoscopic sphincterotomy (EST) after precutting method was performed. Although we performed the ballooned dilatation of malignant stricture and the insertion of a self-expandable metallic stent (EMS) into a right hepatic bile duct transpapillary. After dilatation of the hilar malignant stricture by the initial EMS, we inserted a guidewire into the CBD through the wire mesh of a stent from the left PTBD tube. We could insert the second EMS from a left hepatic bile duct to the CBD transhepatically, using a dilator and a dilating balloon. Finally, we performed the ballooned dilatation from bilateral hepatic bile ducts to the CBD transpapillary. She was discharged after bilateral internal biliary drainages, successfully.
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