Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 39 , Issue 5
Showing 1-19 articles out of 19 articles from the selected issue
  • Toshiki Ota, Atsushi Harada, Haruhiko Tokuda
    2002 Volume 39 Issue 5 Pages 483-488
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
  • Kiyotoshi Kaneko
    2002 Volume 39 Issue 5 Pages 489-493
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (2239K)
  • Masaru Takasaki, Kiyotaka Yanagawa, Kazushi Shinozaki, Hiroko Fujii, T ...
    2002 Volume 39 Issue 5 Pages 494-500
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    We investigated the pathophysiological significance in biomembranes of the redox dynamics of Vitamin E (α-tocopherol) which is lipophilic radical scavenger related to aging or pathologic status such as non-insulin-dependent diabetes mellitus or primary hyperlipidemia. Vitamin E eliminates lipid peroxyl radicals by the peroxidation chain reaction of the membrane lipid, and it becomes Vitamin E radical. Furthermore, the Vitamin E radical becomes Vitamin E quinone which is an oxidic metabolite of Vitamin E. Therefore, it was needed to determine the α-tocopherol and α-tocopherolquinone simultaneously to evaluate the antioxidative status of α-tocopherol in biomembranes exactly. For this purpose, we developed the assay method for the simultaneous determination of the two substances using HPLC system. Then we applied this method to basic and clinical research.
    1) For the simultaneous determination of α-tocopherol and α-tocopherolquinone, highly-sensitive measurement system by HPLC-multiple coulometric ECD was developed. This system is useful to estimate the redox dynamics of α-tocopherol in biomembranes.
    2) The utilization rate of α-tocopherol in the erythrocyte membrane of 10-to 120-week-old rats was significantly increased, whereas α-tocopherol uptake in the erythrocyte membrane decreased age-dependently. Furthermore, a significant increase in lipid hydroperoxide content and a marked decrease in the fluidity of the erythrocyte membrane were seen with age.
    3) There was a strongly significant positive correlation between age and the utilization rate of α-tocopherol in the erythrocyte membrane of healthy volunteers aged between 23 and 103.
    4) The α-tocopherol uptake in erythrocyte membrane was significantly lower in elderly non-insulin-dependent diabetes mellitus patients (average 68.1 years old) than in healthy subjects (average 71.8 years old).
    5) The utilization rate of α-tocopherol in erythrocyte membrane and the α-tocopherol uptake in erythrocyte membrane were significant lower in elderly patients with primary hyperlipidemia (average 74.1 years old) compared to healthy subjects average 71.2 years old).
    These findings suggest that the redox dynamics of α-tocopherol in biomembranes should be investigated with special regard to the onset, aggravation and complications of several diseases or aging as a result of oxidative stress. In addition redox dynamics were suggested to be useful to evaluate the grade of aging.
    Download PDF (1812K)
  • Tadao Bamba
    2002 Volume 39 Issue 5 Pages 501-503
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (480K)
  • Masayuki Matsumoto, Kunimitsu Iwai
    2002 Volume 39 Issue 5 Pages 504-506
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (842K)
  • Naoichi Chino
    2002 Volume 39 Issue 5 Pages 507-508
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (366K)
  • Mamoru Suzuki
    2002 Volume 39 Issue 5 Pages 509-510
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (316K)
  • Ryuzo Saito
    2002 Volume 39 Issue 5 Pages 511-512
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (340K)
  • Yasufumi Hayashi
    2002 Volume 39 Issue 5 Pages 513-515
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    As a current attention of the medical treatment has been paid to improve guality of the life rather than to save the life of the patient, so the treatment of bone and joint diseases, which are not ordinarily fatal and deteriorate quality of the life of the patient, would become important in the aged society of 21 century.
    In a strategy to improve the quality of life in the patient with osteoarthritis, disease modifying anti-osteothritis drugs are investigated for primary prevention and complete recovery of osteoarthritis. In osteoporosis, a characteristic bone disease of the aged, aims of the treatment have been changed from freeing of pain in the nineteen sixties, increase of bone mass in the nineteen eighties and reduction of the fracture rate in the nineteen nineties to improve of quality of the life through decrease of pain and fracture in 21 century, In conclusion, current management for bone and joint diseases in the elderly is finally designed to enjoy a healthy life of long span by medical intervention.
    Download PDF (388K)
  • Toshihiko Iwamoto
    2002 Volume 39 Issue 5 Pages 516-519
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (538K)
  • Shogo Murakami, Takashi Yamanaka, Yutaka Kubo, Taizo Wada, Shoki Yano, ...
    2002 Volume 39 Issue 5 Pages 520-526
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Background: Although heart rate variability (HRV) has been found to be associated with increased mortality in the elderly, the association of HRV and cognitive function and activity of daily living (ADL) capacity in the very elderly are not clear.
    Methods: A sample of very elderly people (N=138), aged 75 years and older, living in Urausu, Hokkaido, participated in this study. Participants were classified into three groups: normal, borderline, and dementia. Time and frequency domain measures of HRV were compared with behavioral and cognitive functions.
    Results: HRV components, except for the LF/HF ratio, did not correlate with age in the very elderly. The LF component showed a statistically significant correlation with all the variables of behavioral functions. Most HRV components showed statistically significant and positive correlations with the flexibility of the back. The LF and LF/HF ratio were significantly lower in the dementia group than in the normal group.
    Conclusion: Although the meaning of the LF component is still controversial, we foundadefinite relationship between the LF component and behavioral functions. A positive relationship between most HRV components and the flexibility of the back may suggest that reduced flexibility leads to deteriorated cardiopulmonary function and reduced HRV. A further prospective study is needed to examine whether HRV and neurobehavioral functions are independent predictors of morbidity and mortality in very elderly people.
    Download PDF (967K)
  • Mitsuko Takahashi, Atsushi Araki, Hideki Ito
    2002 Volume 39 Issue 5 Pages 527-532
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Some elderly diabetic patients find it difficult to understand conventional dietary and nutritional education using a Japanese food exchange list. We developed a new method for simple dietary education including several dietary instructions. We compared the effects of simple dietary education on food intake, nutritional components, and glycemic control with conventional dietary education, using a randomized control trial. We randomly allocated 30 new elderly diabetic outpatients and 38 outpatients who had been visiting our clinic for a long time to the simple education group and the conventional education group. Before, and 2 or 3 months after simple or conventional education, we assessed food intake and nutritional components for a week using Yoshimura's food frequency questionnaire. In the new diabetic patients, simple and conventional nutritional education similarly reduced HbA1c levels as well as intakes of total energy, sweets, and fruits after the education. However, patients who had been visiting for a long time had no significant differences in total energy intake and HbA1c levels between before and after education in both the simple and conventional groups. Our results suggest that simple dietary education is useful and effective for elderly diabetic patients on their first visit.
    Download PDF (937K)
  • Toshiyasu Ogata, Masahiro Yasaka, Kazuyuki Nagatsuka, Kazuo Minematsu, ...
    2002 Volume 39 Issue 5 Pages 533-536
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Although it has been suggested that an increase in arterial diameter is related to atherosclerotic risk factors, there are only a few reports about the relationship between the diameter of the common carotid artery (CCA) and the presence of aortic aneurysm (AA). We measured CCA diameters by carotid ultrasonography in 132 consecutive AA patients over 40 years of age (aneurysm group), and in 414 consecutive subjects over 40 years of age without AA (control group). We also studied the size of AA based on CT, MRA or surgical findings. We compared CCA diameters with atherosclerotic risk factors between the two groups, and studied the relationship between the CCA diameters and AA size by types of aneurysm. In the aneurysm group, men (85% vs 69%, p<0.001), hypertension (88% vs 67%, p<0.001) and smoking (63% vs 46%, p<0.001) were more frequent, and the diameter of the CCA (right, 7.0±1.1mm vs 6.3±1.0mm, p<0.001; left, 6.7±1.1mm vs 6.1±1.0 mm, p<0.001) was significantly larger than those in the control group. Multiple logistic regression analysis indicated that dilatation of CCA on either side was a significant risk factor for AA (right, odds ratio 1.69, p<0.001, left, odds ratio 1.48, p<0.001) as well as hypertension and smoking. There were no differences in size of the CCA according to the site of aneurysm. However the CCA diameter was significantly related to the size of the thoracic AA (r=0.350, p<0.05 for the right CCA) and dissecting AA (r=0.506, p<0.05 for the left CCA). In conclusion, the increase in CCA diameter may suggest the presence of AA, and CCA diameter appears to be related to AA size.
    Download PDF (567K)
  • Yasuichi Sakai, Satoru Mori, Kenji Nakajima
    2002 Volume 39 Issue 5 Pages 537-544
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    In long-term care insurance, the required care level of the disabled elderly is calculated from the results of the basic investigation. However, this calculation involves complex mathematical processes, and the estimation of the required care level at small facilities is difficult. We, therefore, developed a tree model that allows simple estimation of the required care level from the state of noticeable disabilities in daily activities. The model was prepared separately for dementia and physical disabilities. From the patients being cared for at Higashiyama Geriatric Hospital for the Elderly who had undergone primary rating, a total of 240 individuals consisting of 20 each in each of the 6 required care levels for both dementia and physical disabilities were selected, and the results of their primary rating were reviewed. “Putting on and taking off a jacket” and “care after urination”, in which the required care levels increase relatively consistently as the investigation items progressed from those for “independent” to those for “totally assisted”, were selected as the first selection items in dementia and physical disability models respectively. In a dementia model, the state of “putting on and taking off a jacket” and “care after urination” were matched for various required care levels as follows: “Independent”→assistance needed, “observation needed” and “independent” in “standing up”→required care level 1, “observation needed” and “not independent” in “standing up” →required care level 2, “partly assisted”→required care level 3, “totally assisted” and “not totally assisted” in “eating”→required care level 4, and “totally assisted” and “totally assisted” in “eating”→required care level 5. In a physical disability model, the state of “care after urination” was matched for various required care levels as follows: “Independent” and “independent” in “walking”→assistance needed, “independent” and “not independent” in “walking”→required care level 1, “direct or indirect assistance”→required care level 2, “totally assisted” and “independent” or “observation needed” in “eating” →required care level 3, “totally assisted” and “partly assisted” in “eating”→required care level 4, “totally assisted” and “totally assisted” in “eating”→required care level 5. The accuracy rate, i. e. the frequency of complete matching betweeen the estimation of the required care level using this tree and that of the primary rating, was 71.1% in those with dementia and 66.7% in those with physical disabilities. The near accuracy rate, i. e. the frequency of matching between the two estimations within one rank higher or lower was 98.3% in those with dementia and 99.2% in those with physical disabilities. From these results, this tree model is considered to be useful for clinical rating.
    Download PDF (1074K)
  • Keiko Imamura, Hisanori Kowa, Masayoshi Kusumi, Kenichi Yasui, Takao T ...
    2002 Volume 39 Issue 5 Pages 545-548
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 68-year-old woman with Parkinson's disease (PD) was admitted due to aspiration pneumonia. The symptoms improved partly by administration of antimicrobial agents and a steroid-pulse treatment, but she suffered repeated MRSA pneumonia, which caused a long-term bed confinement. Shoulder pain that appeared after she started rehabilitation did not improve on administration of NSAIDs. We suspected pyogenic spondylitis in the cervical vertebraes based on the cervical X-rays and the cervical MRI. Patients of PD often have a shoulder pain due to various causes. When a patient with PD has a severe shoulder pain, we should suspect pyogenic spondylitis in the cervical vertebraes as one of the differential diagnoses. It is necessary to do immediately thorough imaging examinations.
    Download PDF (1958K)
  • Ichiro Watanabe, Hayato Yamauchi, Kikue Iwamasa, Masashi Kohno, Kiyono ...
    2002 Volume 39 Issue 5 Pages 549-553
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    An 86-year-old woman was admitted because of right lower abdominal pain. A 7 by 6cm tumor palpable in the right lower quadrant was poorly mobile. Abdominal CT scan showed a huge tumor with a strong enhancement effect. Barium enema and colonoscopic examination revealed a submucosal tumor located from the cecum to the ascending colon on the oral side. An undifferentiated adenocarcinoma was suspected after examination of the biopsy specimen, right hemicolectomy was performed. The tumor invaded the retroperitoneal membrane. Histological examination showed a very atypical carcinoid tumor with central necrosis invading the veins. Pathohistologically, the huge tumor was diagnosed as endocrine cell carcinoma or atypical carcinoid. Furthermore, an elevated lesion, 2.5cm in size, was revealed in the cecum closed to the huge tumor. Histological examination showed that the polypoid lesion was early moderately differentiated adenocarcinoma. There was no transition between the two tumors. The patient was discharged, but died of local recurrence 9 months after the surgery. Endocrine cell carcinoma of the large bowel is rare, in particular of the ileocecal region. Endocrine cell carcinoma of the ileocecal region adjacent to an adenocarcinoma without transition had not been reported previously in Japan.
    Download PDF (2248K)
  • Junko Yamamoto, Shigeru Yamano, Kimihiko Nakatani, Yasuhiro Akai, Hide ...
    2002 Volume 39 Issue 5 Pages 554-557
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    A 74-year-old man was admitted because of appetite loss in November 1999. A gastric ulcer was diagnosed, and a H2 blocker was given. He had had appetite loss since July 1997 and had experienced epigastric discomfort since October of 1997.
    On admission, hepatic and pancreatic lymph node swelling was detected by ultrasonography of the abdomen. Physical examination revealed a palpable mass in the middle region of the upper abdomen as well as gynecomastia. Laboratory findings showed high serum levels of hCG (11, 700mIU/ml) and high urinary levels of hCG (1, 600mIU/ml). Upper gastrointestinal endoscopy showed a gastric cancer of Borrmann type 3 in the posterior wall of the middle body. A biopsy revealed a moderately differetiated adenocarcinoma. hCG immunoreactivity was not seen in the cancer tissue. A contrast-enhanced CT scan of the abdomen revealed multiple lymph node swelling in the hepatic and pancreatic lymph nodes. There was a low-density area suggesting liver metastases. No other primary carcinomas were not detected. We believe that the gynecomastia was due to the hCG-producing tumor. The patient died 2 months after diagnosis.
    Download PDF (1972K)
  • 2002 Volume 39 Issue 5 Pages 558-571
    Published: September 25, 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (2831K)
  • 2002 Volume 39 Issue 5 Pages 572
    Published: 2002
    Released: November 24, 2009
    JOURNALS FREE ACCESS
    Download PDF (98K)
feedback
Top