Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 39 , Issue 3
Showing 1-20 articles out of 20 articles from the selected issue
  • Motoo Tsushima
    2002 Volume 39 Issue 3 Pages 237-245
    Published: May 25, 2002
    Released: November 24, 2009
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  • Koichi Akashi
    2002 Volume 39 Issue 3 Pages 246-252
    Published: May 25, 2002
    Released: November 24, 2009
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  • Yoshio Mino
    2002 Volume 39 Issue 3 Pages 253-256
    Published: May 25, 2002
    Released: November 24, 2009
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  • Hideki Ito
    2002 Volume 39 Issue 3 Pages 257-260
    Published: May 25, 2002
    Released: November 24, 2009
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  • Kazuya Yamashita, Shotai Kobayashi, Hiroaki Oguro
    2002 Volume 39 Issue 3 Pages 261-263
    Published: May 25, 2002
    Released: November 24, 2009
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  • Noriaki Kume
    2002 Volume 39 Issue 3 Pages 264-267
    Published: May 25, 2002
    Released: November 24, 2009
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    Oxidized low density lipoprotein (Ox-LDL) appears to play key roles in atherosclerotic progression and plaque rupture. Biological effects of Ox-LDL on vascular cells may, at least in part, be mediated by cell surface receptors for Ox-LDL. Lectin-like oxidized LDL receptor (LOX)-1 and scavenger receptor for phosphatidylserine and oxidized lipoprotein (SR-PSOX) are type II and I membrane glycoprtoeins, respectively, both of which can act as cell-surface endocytosis receptors for atherogenic oxidized LDL (Ox-LDL). LOX-1 expression can dynamically be induced by proinflammatory stimuli, and is detectable in cultured macrophages and activated vascular smooth muscle cells (VSMC), in addition to endothelial cells. LOX-1-dependent uptake of Ox-LDL induced apoptosis of cultured VSMC. In vivo, endothelial cells that cover early atherosclerotic lesions, and intimal macrophages and VSMC in advanced atherosclerotic plaques dominantly express LOX-1. LOX-1 expressed on the cellsurface can be cleaved, in part, and released as soluble molecules, suggesting the diagnostic significance of plasma soluble LOX-1 levels. SR-PSOX appeared to be identical to CXCL16, a novel membrane-anchored chemokine directed to CXCR6-positive lymphocytes, suggesting another role of SR-PSOX as T-cell chemoattractant. In contrast to LOX-1 expressed by a variety of cell types, SR-PSOX expression appeared relatively confined to macrophages in atherogenesis. Taken together, LOX-1 and SR-PSOX may play important roles in atherogenesis and athrosclerotic plaque rupture.
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  • Takashi Abe, Hideo Tohgi
    2002 Volume 39 Issue 3 Pages 268-270
    Published: May 25, 2002
    Released: November 24, 2009
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  • Susumu Yamakado
    2002 Volume 39 Issue 3 Pages 271-273
    Published: May 25, 2002
    Released: November 24, 2009
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    Antibiotic-associated colitis (AAC) is a relatively frequent disorder in the senile population. Because of the change of life style in the elderly, the clinical pattern of AAC may be varied. The causative antibiotics, duration of adminisration, duration from taking antibiotics to onset of symptoms, background disorders, symptoms, laboratory data, therapies and prognosis in patients with AAC were investigated retrospectively in 54 cases of averaging 80.5 year old in this hospital. The patients with pseudomembranous colitis (PMC) are older and with a greater preponderance of female gender than patients with acute hemorrhagic colitis. Antimicrobial agents that frequently induced AAC are cephalosporins and penicillins. Symptoms in patients with PMC are diarrhea, abdominal cramping pain and fever. The most common background diseases were neurological and psychiatric disorders. Furthermore, recent advances in understanding the mechanism of toxin A-mediated colinic inflammation, and the management of AAC are reported.
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  • Hiroshi Shimokata, Fujiko Ando
    2002 Volume 39 Issue 3 Pages 275-278
    Published: May 25, 2002
    Released: November 24, 2009
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    The number of patients with geriatric diseases will rapidly increase in our aging society. Geriatric diseases tend to progress chronically and disturb the daily activity of the elderly patients. Care for the elderly patients requires a great deal of manpower. The prevention and treatment of geriatric disease are urgent issues that must be addressed. A comprehensive longitudinal study of aging and geriatric disease was started at the National Institute for Longevity Sciences (NILS) in 1997. The participants of the NILS longitudinal study of aging (NILS-LSA) were 2, 267 men and women from a local community population. The participants are examined at the NILS and followed up every two years. An outline of the system and examinations of the NILS-LSA is shown. The latest results from the NILS-LSA research including geriatric disease-related genotypes and risk factors for mild cognitive impairment (MCI) are also presented.
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  • Masanori Nishinaga
    2002 Volume 39 Issue 3 Pages 279-281
    Published: May 25, 2002
    Released: November 24, 2009
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  • Hajime Takechi
    2002 Volume 39 Issue 3 Pages 282-285
    Published: May 25, 2002
    Released: November 24, 2009
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    Since the start of long term care insurance and the availability of cholinesterase inhibitor as a prescription drug in Japan, detection and diagnosis of dementia in the early stage of the disease has become an important issue. Neuropsychological screening and imaging tools usually employed for diagnosis are insufficient. The use of diagnostic criteria to designate early stage patients is still controversial. Several disease entities, including mild cognitive impairment (MCI) and age-associated memory impairment (AAMI), are not clearly defined in Japan. To study the prognosis of early stage dementia, it is important to define the diagnostic criteria. Clear identification and diagnosis of early stage dementia is important to support patients and their family members. The early detection of dementia and cognitive decline has other important aspects. One is the implication of disease diagnosis in the community; people often hesitate to use the name dementia in the early stage, even when the patients fulfill the criteria for dementia. Another aspect is the longer term follow up of the patients after early detection. For these purposes, it will become more important to emphasize a team approach consisting of medical doctors, nurses, neuropsycologists, clinical psycologists, occupational therapists and sociateam workers.
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  • Masahiro Akishita
    2002 Volume 39 Issue 3 Pages 286-288
    Published: May 25, 2002
    Released: November 24, 2009
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  • Kiyohisa Sekizawa
    2002 Volume 39 Issue 3 Pages 289-290
    Published: May 25, 2002
    Released: November 24, 2009
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  • Hiroshi Fujimaki, Yutaka Kasuya, Shiro Koga, Tokuji Hirashima, Sachiko ...
    2002 Volume 39 Issue 3 Pages 291-295
    Published: May 25, 2002
    Released: November 24, 2009
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    We investigated differences in features between young-old and old-old patients beginning dialysis.
    Patients aged over 60 years who had newly started dialysis (121 cases) were studied. These were 71 men and 50 women. The age was 74±7 years (mean±standard deviation). The patients were divided into the young-old group (aged 60 to 74 years) and the old-old group (aged over 75 years). 64 patients were young-old and 57 were old-old.
    In every patient, the cause of renal failure (non-diabetes/diabetes), body indexes, comorbid conditions, laboratory data of nutritional status, ambulation, cognitive function, and psychosocial status (acceptance of dialysis therapy, marital status, younger cohabitants, and engagement in work) were surveyed. Data were assessed in each group. Intergroup comparisons were made using Student's t-test, the χ2 test, and the Mann-Whitney's U-test.
    Diabetes was frequent in the young-old group. The results concerning body indexes, comorbid conditions, and laboratory data reflected age-related phenomena or skew distribution of diabetic patients.
    Though differences were not statistically significant, both the percentage of patients with inability to walk and the percentage of patients with impaired cognitive function were lower in the old-old. These results could not be interpreted as agerelated phenomena or skew distribution of diabetic patients. From the data of psychosocial indexes, it would speculate that the young-old had some advantage over the old-old for initiation of dialysis. We look for the explanation to psychosocial aspects of dialysis therapy.
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  • Akiko Hagiwara, Katsuko Kanagawa
    2002 Volume 39 Issue 3 Pages 296-302
    Published: May 25, 2002
    Released: November 24, 2009
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    Cardiovascular responses during bed-to-wheelchair transfers were measured in 22 frail elderly subjects (mean age, 79.7 years) and 11 healthy elderly subjects (mean age, 79.8 years) living at home. The frail elderly subjects were divided into two groups, based on the method of transfer: the dependent group consisted of 11 subjects who required additional help during all stages of the transfer, and the partially dependent or independent group consisted of 11 subjects who could perform the transfer with some help or independently. In the healthy elderly subjects, diastolic blood pressure increased significantly 15 minutes after the transfer compared to the pre-transfer measurement (p<0.05). In the dependent group, there was no significant change in blood pressure, and mean blood pressure (MBP) decreased gradually after the transfer in 3 subjects. Only 4 subjects exhibited a normal change in heart rate variability after the transfer. These results suggest the existence of poor cardiovascular responsiveness in most of these subjects. In the partially dependent or independent group, there was a significant increase in blood pressure just after the transfer (p<0.05), in 3 subjects, the blood pressure reached the WHO's defined hypertension threshold (SBP>160mmHg or DBP>95mmHg). In these subjects, performing the bed-to-wheelchair transfer independently may result in cardiac overload. The change in MBP in the dependent group was significantly lower than that of the partially dependent or independent group from just before the transfer to 15 minutes after the transfer (p<0.05). Blood pressure responses during bed-to-wheelchair transfers in frail elderly subjects living at home may differ according to the method of transfer.
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  • Takayoshi Tsutamoto, Keiko Maeda, Naoko Mabuchi, Takashi Tsutsui, Masa ...
    2002 Volume 39 Issue 3 Pages 303-307
    Published: May 25, 2002
    Released: November 24, 2009
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    This study investigated the comparative effects of losartan and amlodipine on the activation of the sympathetic nervous system, renin-angiotensin-aldosterone system (R-A-A system) and brain natriuretic peptide (BNP) in patients with essential hypertension. Twenty-four elderly patients who had received more than 12 months of antihypertensive treatment with amlodipine participated in this study. The treatment regimen of 5mg/day amlodipine was changed to 50mg day losartan. Plasma catecholamines (norepinephrine, epinephrine and dopamine), active renin, aldosterone and BNP concentration were measured before and after an average of 5 months of losartan treatment. After losartan treatment, blood pressures were not changed, suggesting the comparable effect of 50mg losartan and 5mg amlodipine on elevated blood pressure. Losartan significantly reduced norepinephrine (799±277pg/mL vs. 692±268pg/mL, p<0.05) and aldosterone concentration (81.2±35.3 pg/mL vs. 55.2±17.7pg/mL, p<0.01), whereas there were not any changes in BNP concentrations. These findings suggested that losartan might be superior to amlodipine in prevention of chronic or intermittent sympathetic hyperactivity and enhanced R-A-A system.
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  • Takeo Ishii, Shinji Teramoto, Akira Miyashita, Yoshiaki Ishigatsubo, H ...
    2002 Volume 39 Issue 3 Pages 308-313
    Published: May 25, 2002
    Released: November 24, 2009
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    Smoking status, the extent of recognition of the relationship between smoking and COPD, and actual nature of education for smoking cessation by physicians have not yet been fully elucidated.
    To investigate perceptions about education for smoking cessation in the elderly by physicians who work in the clinic, questionnaires were sent to the 1, 012 physicians who belong to the Yokohama City Medical Association. Of these, 311 respond and their data (31%) were included in the analysis. The questionnaire included questions on the importance of smoking cessation in the elderly, on the perception about the relationship between smoking and various diseases, and actual education for smoking cessation. The smoking status of the physicians themselves was also investigated.
    The distribution of current smokers, ex-smokers, and non-smokers among the physicians was 13%, 33%, and 54%, respectively. Seventy-five percent of ex-smokers answered that their experience of smoking cessation influenced their patient education for smoking cessation, and 39% of smokers answered that their smoking status did not influence it. Only 53% of the physicians replied that they actually performed education for smoking cessation to the elderly, and 8% of them replied that they hardly perform any or do not perform it.
    Smoking cessation is thought to be the only way to prevent the development of COPD. However, only a half of physicians recognized the importance of smoking cessation for the treatment and control of COPD in the elderly. In addition, less than one third of physicians perform nicotine replacement therapy for smoking cessation. Enlightenment for physicians should be needed to make them perform education for smoking cessation more aggressively.
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  • Hisanori Morimoto, Hidetoshi Hashida, Toshio Honda, Yasushi Aibara
    2002 Volume 39 Issue 3 Pages 314-317
    Published: May 25, 2002
    Released: November 24, 2009
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    A 67-year-old man was admitted with abdominal pain on April 23, 2000. Continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis was diagnosed. Administration of antibiotics for five days obtained no improvement. Therefore the peritoneal catheter was removed on April 28th. Although his condition became settled, C-reactive protein remained positive. Moreover, two kinds of bacilli were detected from the CAPD fluid, just before the catheter was removed. As abnormalities in the colon were possible, an enema examination was performed on May 23rd. A constriction and several diverticula of the sigmoid colon were detected. High grade fever appeared on May 23rd, and the patient complained of abdominal pain the next day. As there was no improvement, we performed enhanced computed tomography and detected an abscess in the Douglas pouch on May 29th. The abscess was resected on the same day, and he was discharged.
    The number of patients with chronic renal failure has increased in recent years. Although hemodialysis has been the treatment of choice, peritoneal dialysis should be considered. More investigations into complications created by peritoneal dialysis are required, especially in elderly people who seldom show symptoms of CAPD-related peritonitis until they reach a critical condition. If peritoneal dialysis is being performed and inflammation reactions continue, it is necessary to examine the patient for perforated peritonitis and abscess formation.
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  • Kie Honjo, Yasuyo Mimori, Hiroyuki Morino, Sadao Katayama, Shigenobu N ...
    2002 Volume 39 Issue 3 Pages 318-321
    Published: May 25, 2002
    Released: November 24, 2009
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    A 68-year-old woman was admitted with dysesthesia on both soles, hands and buttocks. She first noticed the dysesthesia in the left first toe two years before admission. One year before admission, serum creatine kinase and lactate dehydrogenase levels were elevated but she had no clinical symptoms suggesting myopathy. Nerve conduction study showed no apparent abnormalities, and an electromyogram showed mild myogenic change. Computed tomography of the muscle showed fatty degeneration of the trunk, major gluteus muscle, and biceps femoris muscle and atrophic change of the biceps femoris muscle. Muscle biopsy revealed a slight variation in fiber size, the presence of cytochrome c oxidase (CCO)-negative fibers by CCO staining, ragged-red fibers by Gomori trichrome staining, and mild denervation fiber by neuron specific enolase (NSE) staining. Analysis of her mitochondrial DNA (mtDNA) revealed a large deletion of mtDNA (-8.5Kb), and mitochondrial neuromyophy was diagnosed. The frequency of mtDNA deletion increases with aging. Although her mtDNA abnormality was compatible with chronic progressive external ophthalmoplegia (CPEO), we speculate that the aging process may be contributed to the mtDNA abnormality, which would be related to the late onset of her symptoms. As the phenotype of this mitochondrial disorder shows a wide variation and mtDNA abnormality is more frequent among elderly people, we should consider the possibility of mitochondrial disorders even in elderly people.
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  • T. Ogihara, K. Hiwada, H. Matsuoka, M. Matsumoto, S. Takishita, K. Shi ...
    2002 Volume 39 Issue 3 Pages 322-351
    Published: May 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
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