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Predecessor
Volume 40, Issue 3
Displaying 1-23 of 23 articles from this issue
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Masafumi Kuzuya2003 Volume 40 Issue 3 Pages 199-203
Published: May 25, 2003
Released on J-STAGE: March 02, 2011
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Takashi Inuzuka2003 Volume 40 Issue 3 Pages 204-209
Published: May 25, 2003
Released on J-STAGE: March 02, 2011
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Yasushi Saito2003 Volume 40 Issue 3 Pages 210-212
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Kazuaki Shimamoto2003 Volume 40 Issue 3 Pages 213-215
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Tamio Teramoto2003 Volume 40 Issue 3 Pages 216-218
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Yoshinori Doi2003 Volume 40 Issue 3 Pages 219-222
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Takenori Yamaguchi2003 Volume 40 Issue 3 Pages 223-227
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Takayuki Hosoi2003 Volume 40 Issue 3 Pages 228-230
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Takamasa Tsuchida, Yukio Mano2003 Volume 40 Issue 3 Pages 231-233
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSWe surveyed patients with Parkinson's disease living at home and elderly persons in hospital to find out causes of falls. In Parkinson's disease, the number of falls during the previous year increased with the progress of the grade of Hoehn and Yahr stage. The ratio of patients who had fractures due to falls was 0% in stage I & II, 30.2% in stage III, and 36.1% in stage IV. The ratio of patients who attached handrails was 30.1% in Hoehn and Yahr stage III, and 37.1% in stage IV; remodeling of hte bathroom was done in 30.7% and 51.0% remodeling of the lavotory was done in 42.5% and 53.8%, and bed adjustment in 24.3% and 43.8%. To prevent falls, we should advise patients to arrage the surroundings in which they spend the daytime such as their living room or bedroom. From the result of the ratios of patients in hospital who had falls and fractures due to falls, some associated risk factors of falls which could be prevented were found out. The ratio of patients who fell in the morning was reduced by interventions of nurses. The frequency of patients who fell was 41.5% in cerebrovascular disease, 29.5% in dementia, 11.2% in bone and joint disease, and 9.0% in Parkinson's disease, however the frequency in hospitalized patients was 56.9%, 11.3%, 7.3%, 6.3% respectively. Patients who had dementia had a tendency to fall. Further study is needed to help prevent of falls in dementia patients.View full abstractDownload PDF (520K) -
Toshitaka Nakamura2003 Volume 40 Issue 3 Pages 234-236
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Ryutaro Takahashi, Akiko Kanemaru2003 Volume 40 Issue 3 Pages 237-239
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Yasuhiro Kawabata2003 Volume 40 Issue 3 Pages 240-241
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Hideki Ito2003 Volume 40 Issue 3 Pages 242-244
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Masahiro Sasaki2003 Volume 40 Issue 3 Pages 245-247
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Yutaka Mizuno2003 Volume 40 Issue 3 Pages 248-251
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSA long-term care insurance system went into effect in April 2000 in Japan. In the previous welfare system, the government could provide services (“take due measures”) unilaterally regardless of the desires of the person receiving the care. In this framework, therefore, services could be provided even if the person did not have the ability to make judgments. Under the new system, however, the arrangement has changed so that the user (person requiring care) enters a contract directly with the service provider. Thus, whether or not the user has the ability to judge (enter a contract), or the degree of that ability, has become an issue.
However, medical research on this judgment ability has been lacking in Japan, in contrast to other countries, where there have been intensive studies on the decisional capacity for informed consent, treatment, and participating research.
The development of the tools to assess such judgment abilities is proceeding in other nations. In Japan, assessment of the judgment abilities of demented elderly persons should be similarly investigated. Based on such studies, we look forward to the day when there will be appropriate respect for the right of self-determination and care.View full abstractDownload PDF (1124K) -
Naoaki Kouchi2003 Volume 40 Issue 3 Pages 252-253
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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Hirofumi Tasaki, Chiaki Ueyama, Akiko Irita, Akihiko Miyagawa, Kouei K ...2003 Volume 40 Issue 3 Pages 254-260
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSFew researchers have conducted 24-hour total heart beat (THB) studies in patients with bradycardia, and its prevalence and significance in the elderly remain controversial. The aim of this study was to compare of distribution of THB, underlying diseases and effects of medication on THB in inpatients with bradycardia less than 80, 000 beats/24hrs between elderly and young patients. There were 303 Holter monitorings of bradycardia out of 7, 687 consecutive monitorings, with only the earliest monitoring registered when duplicating. The age distribution of these 303 patients with bradycardia showed a two-peak pattern: a large peak at age 65-70 and a small peak at age 15-20. Thus we divided them into a young group aged under 65 (194 patients; mean 49.1) and an elderly group aged 65 or more (109 patients; mean 71.0) . There was no difference in mean THB or distribution of THB between the two age groups, irrespective of medication which had a side effect of bradycardia. Underlying diseases included three bradyarrhythmias; such as sinus bradycardia, sick sinus syndrome and II or III degree AV block, long QT syndrome, ischemic heart disease, cardiomyopathy, valvular disease and others. There was no difference in mean THB or distribution of THB between the two age groups in each disease group. Moreover, with respect to bradyarrhythmias, there was a small distribution of THB between 75, 000 and 70, 000 beats/24hrs in patients without medication while there was a sparse distribution of THB in patients with medication.View full abstractDownload PDF (1111K) -
Yuriko Tanaka, Haruo Hanyu, Hirofumi Sakurai, Soichiro Shimizu, Masaru ...2003 Volume 40 Issue 3 Pages 261-266
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSWe attempted to investigate whether morphological features as shown on magnetic resonance imaging (MRI) predict response to donepezil treatment in patients with Alzheimer's disease (AD). Sixty-three patients with AD were divided into responders (n=16) and non-responders (n=47) based on the changes in the MMSE score between baseline and endpoint. Atrophy of the substantia innominata was more pronounced in responders than non-responders. Although no significant difference in the medial temporal lobe atrophy between responders and non-responders was found, magnetization transfer ratios (MTRs) of the hippocampus and parahippocampus, indicators of structural damage, in the non-responder group were significantly reduced compared to those in the responder group. There were no significant differences in the severity of white matter lesions between the two groups. Logistic regression analysis revealed that the overall discrimination rate was 81%, with 85% of non-responders and 69% of responders, through measurement of the thickness of the substantia innominata and MTR of the hippocampus and parahippocampus. These results suggest that AD patients who show more severe cholinergic dysfunction and less severe structural damage of the hippocampus and parahippocampus as shown on MRI are likely to respond to donepezil treatment.View full abstractDownload PDF (3328K) -
Shunichi Koyama, Yuko Saito, Hiroshi Yamanouchi, Hiroshi Nagura, Kouji ...2003 Volume 40 Issue 3 Pages 267-273
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSWe conducted comparative studies on intracranial atherosclerosis and coronary artery stenosis over the past 28 years. Two-year consecutive autopsy case studies from an urban geriatric hospital between 1974-1975 (Group I, 484 cases), 1986-1987 (Group II, 504 cases) and 2000-2001 (Group III, 273 cases) were employed. Atherosclerotic changes of the bilateral middle cerebral arteries and basilar artery were semiquantitatively evaluated as none (0), mild (1), moderate (2) and severe (3) and values of the 3 arteries were totalled to give a value of 0-9 which was taken as the intracranial atherosclerotic index (ICAI). The coronary stenotic index was calculated as previously reported (Sugiura et al 1969). ICAI and CSI were directly compared with each other, together with risk factors for each, including mean blood pressure (BP), serum level of total cholesterol (Tch) and the history of diabetes mellitus (DM+). Chronologically ICAI decreased dramatically but CSI did not change at all. There was continuous lowering of BP, elevation of Tch and increased incidence of DM+. There was a significant positive correlation in BP in relation to both ICAI and CSI (p<0.01), DM+vs. CSI (p<0.01) and ICAI (p<0.05), and Tch vs. CSI (p<0.01) but not ICAI. Regression analysis highlighted age and BP as major risk factors for ICAI. Our study provides the first morphological confirmation of marked decrease of the intracranial atherosclerosis in the recent 28 years, in contrast with unchanged coronary stenosis in Japanese elderly subjects.View full abstractDownload PDF (1167K) -
Ayako Machida, Sachi Baba, Aya Hirata, Akiko Nagasawa, Setsu Iijima, M ...2003 Volume 40 Issue 3 Pages 274-281
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSTo evaluate verbal communication ability in the elderly, we developed a new portable “mini-communication test (MCT)” with 13 sub-scales, which was constructively validated based on 45 items from other reported scales.
Clinical reliability and validity were tested in 354 inpatients in a long-term care hospital (81.9±8.3years old) and 124 inpatients (80.39±8.1 years old) and 34 outpatients (76.5±7.0 years old) in Kyorin University Hospital.
All patients were evaluated in approximately 7 minutes each. The test-retest correlation coefficient was 0.99. Inter-rater coefficient of variation was 0.107. The Cronbach α value of the test was 0.93. MCT positively correlated with the Barthel Index (r=0.65, p<0.01), Hasegawa Dementia Scale Revised version (r=0.93, p<0.001) and Vitality Index (r=0.66, p<0.01). MCT could be a new tool to assess communication ability in elderly patients with or without dementia.View full abstractDownload PDF (1074K) -
Harukiyo Kawamura, Hiroki Tsuchida, Yoshiro Maezawa, Kazuki Kobayashi, ...2003 Volume 40 Issue 3 Pages 282-286
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
JOURNAL FREE ACCESSA 54-year-old man was found to have hypertension at age 32, and a diagnosis of Werner's Syndrome was made at age 36 when he was examined for hyperlipidemia. Diabetes mellitus was found at age 42. Proteinuria appeared at age 49, and microscopic hematuria was seen at age 50. At age 51, serum creatinin level began to rise and atrophy of bilateral kidneys was observed by abdominal CT. There after, the renal function gradually worsened. At age 53, the serum creatinin level rose to 8.3mg/dl, and systemic edema as well as loss of appetite appeared, resulting in the initiation of hemodialysis. In Werner's syndrome, though arteriosclerosis arises frequently, case reports with chronic renal failure are extremely rare. To investigate the cause of the renal dysfunction, renal biopsy was performed and the samples were histologically examined, revealing the presence of hypertensive glomerular changes. It is, thus, conceivable that hypertension had played a major role in the progression of renal failure in this case.View full abstractDownload PDF (6319K) -
2003 Volume 40 Issue 3 Pages 287-289
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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2003 Volume 40 Issue 3 Pages 289-299
Published: May 25, 2003
Released on J-STAGE: February 24, 2011
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