Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 41 , Issue 3
Showing 1-25 articles out of 25 articles from the selected issue
  • Shigeki Kuzuhara
    2004 Volume 41 Issue 3 Pages 245-253
    Published: May 25, 2004
    Released: March 02, 2011
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  • Shigeo Murata, Keiji Tanaka
    2004 Volume 41 Issue 3 Pages 254-262
    Published: May 25, 2004
    Released: March 02, 2011
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  • Yutaka Shimizu
    2004 Volume 41 Issue 3 Pages 263-265
    Published: May 25, 2004
    Released: March 02, 2011
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  • Nozomu Mori
    2004 Volume 41 Issue 3 Pages 266-270
    Published: May 25, 2004
    Released: March 02, 2011
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  • Shuichi Nomura
    2004 Volume 41 Issue 3 Pages 271-274
    Published: May 25, 2004
    Released: March 02, 2011
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  • Shunsaku Hirai
    2004 Volume 41 Issue 3 Pages 275-277
    Published: May 25, 2004
    Released: March 02, 2011
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  • Masakazu Shirasawa
    2004 Volume 41 Issue 3 Pages 278-280
    Published: May 25, 2004
    Released: March 02, 2011
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  • Ichiro Tsuji
    2004 Volume 41 Issue 3 Pages 281-283
    Published: May 25, 2004
    Released: March 02, 2011
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  • Kimio Aoyagi
    2004 Volume 41 Issue 3 Pages 284-285
    Published: May 25, 2004
    Released: March 02, 2011
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  • Yutaka Mizuno
    2004 Volume 41 Issue 3 Pages 286-289
    Published: May 25, 2004
    Released: March 02, 2011
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    The long-term care insurance system targets people who require support because of mental or physical disturbances due to aging. This overlaps in many areas with the field of geriatric psychiatry, which is expected to play a significant role in diagnosis and hospitalization in the long-term care insurance system.
    Representative of the former is the forgetfulness clinic, and representative of the latter is the “senile dementia disorder center”. When a person at home or in a nursing facility becomes seriously demented or suffers serious physical illness, he is generally hospitalized. However, there is an ongoing project which allows group homes to care for the seriously demented or physically damaged elderly. Under the long-term care insurance system, there are many problems that should be dealt with by geriatric psychiatry.
    One essential issue is the lack of basic research on judgment abilities and mental competency, even though users are expected to select services and make their own decisions under this system. Once there is a social support system for the carerequiring elderly, it is necessary to assess the decision-making ability of individual elderly. If this ability is sufficiently maintained it should be respected to the utmost. If it is impaired, we must have a viewpoint on how to provide care through a social system. A consensus has yet to be reached on informed consent for the demented elderly, and this issue should be considered with a focus on geriatric psychiatry.
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  • Masaji Maezawa
    2004 Volume 41 Issue 3 Pages 290-291
    Published: May 25, 2004
    Released: March 02, 2011
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  • Hideki Ito
    2004 Volume 41 Issue 3 Pages 292-293
    Published: May 25, 2004
    Released: March 02, 2011
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  • Toshio Hayashi
    2004 Volume 41 Issue 3 Pages 294-297
    Published: May 25, 2004
    Released: March 02, 2011
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    Because Japanese society has increasing elderly persons and also has a low birth rate. Medical treatments and benefits will be severely limited in the future because of economic problems. I would like to look back on the history of Japanese Geriatrics Society and the many studies on geriatrics in Japan. The first annual meeting of Japanese Geriatric Society were held in 1959 and the Japanese Gerontology Society meeting was also held in the same year by Geriatric Society and Geriatric Sociology Association. It was held every two years, and now it consists of 6 associations, that is Geriatrics, Geriatric Sociology, Basic Gerontology, Geriatric Dentistry, Geriatric Psychiatry and Care Management Associations. I will introduce the activities of these associations, and also introduce the contribution of departments of geriatrics in Japanese universities. I will also show the system of medical examinations and treatment, the education curriculum for medical students and residency, and research composing of various theme such as basic gene therapy as well as the evaluation of terminal care for the elderly in our Department of Geriatrics, Nagoya University Graduate School of Medicine. Finally, I would like to propose future research plan between departments of geriatrics in Japanese Universities and the National Institute for Longevity Sciences, which will open next March.
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  • Teruo Hirose
    2004 Volume 41 Issue 3 Pages 298-300
    Published: May 25, 2004
    Released: March 02, 2011
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  • Takashi Aoyagi
    2004 Volume 41 Issue 3 Pages 301-302
    Published: May 25, 2004
    Released: March 02, 2011
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  • Masahiro Akishita, Shinji Teramoto, Hidenori Arai, Hiroyuki Arai, Kats ...
    2004 Volume 41 Issue 3 Pages 303-306
    Published: May 25, 2004
    Released: March 02, 2011
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    Adverse drug reactions (ADR) in elderly people, which have been shown to increase with age, are often attributed to functional decline and polypharmacy. A multi-institutional retrospective survey was undertaken to investigate the current status of ADR in geriatric wards of university hospitals. The inpatient database from 2000 to 2002 in 5 university hospitals was studied, and a total of 1, 289 patients were analyzed. The incidence of ADR, as determined by attending physicians, was 9.2% on the whole but varied from 6.3% to 15.8% among the institutions. The factors significantly related to ADR were number of diagnoses, number of geriatric syndromes, number of prescribed drugs, increase of more than two drugs during admission, longer hospital stay, emergency admission, depression and apathy. These results are mostly consistent with previous reports and will provide important information on pharmacotherapy in elderly people.
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  • Hidenori Arai
    2004 Volume 41 Issue 3 Pages 307-309
    Published: May 25, 2004
    Released: March 02, 2011
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  • Hiroyuki Arai
    2004 Volume 41 Issue 3 Pages 310-313
    Published: May 25, 2004
    Released: March 02, 2011
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    Currently, cholinergic therapies for Alzheimer's disease (AD) have been developed and widely accepted based upon an observation that presynaptic cholinergic neurons in the basal nucleus of Meynert that widely project to the cerebral cortices are consistently damaged in AD brains. Since it is likely that the loss of central cholinergic activity may be associated with cognitive worsening in patients with AD, it is hypothesized that cholinergic augmentation could improve the cognitive ability of patients with AD. Cholinesterase inhibitors represent one way of implementing this strategy by inhibiting the breakdown of acetylcholine and increasing its availability in synapses. Indeed, several recent clinical trials of donepezil, galanthamine and rivastigmine have come to the conclusion that these cholinesterase inhibitors have overall beneficial effects in cognitive as well as global functions. American Academy of Neurology recommended a use of cholinesterase inhibitors as a first choice medicine in the treatment of AD. All 3 major studies of Donepezil from USA, Europe and Japan have reached the same conclusion favoring Donepezil in the treatment of mild to moderate AD. Donepezil can also be used as a safe and efficacious drug in the elderly aged 85 or older. Clinical trial of galantamine is in progress in Japan. Moreover, herbal medicines named kami-untan-to and hachimi-jiou-gan have been shown to be beneficial in some priority studies with a small sample size. It is critically needed to widen therapeutic windows in the treatment of AD.
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  • Shigeto Morimoto
    2004 Volume 41 Issue 3 Pages 314-317
    Published: May 25, 2004
    Released: March 02, 2011
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  • Takayuki Hosoi
    2004 Volume 41 Issue 3 Pages 318-320
    Published: May 25, 2004
    Released: March 02, 2011
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  • Shuichi Obuchi, Motonaga Kojima, Yoshitaka Shiba, Hiroyuki Shimada, Ta ...
    2004 Volume 41 Issue 3 Pages 321-327
    Published: May 25, 2004
    Released: March 02, 2011
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    We had developed a gait perturbation system based on a treadmill composed of two separate walking belts. The servomotors in this treadmill are controlled by a personal computer. A falling perturbation can be generated by the sudden and random deceleration of the walking belts. The purpose of this study was to determine, in a cohort of community dwelling elderly subjects, whether our treadmill training with the perturbation would improve balance performance. The 29 participants aged over 65 years were randomly assigned to receive either perturbed treadmill training or ordinary treadmill training. The single leg standing time with the eyes opened and closed, the functional reach test (FR), the timed up and go test (TUG), the 10m maximum gait speed and the latency of the bilateral tibialis anterior muscle (LTA) were measured at the pre training period and after the 4-week training period. These indexes were measured again one month after the training period. There were no significant differences between the perturbed training subjects and the ordinary training subjects in these indexes in the pre-training period.
    Following training period, the perturbed training subjects were improved in FR (mean±SD; pre 30.3±5.0cm, post 33.5±5.0cm, p<.01), TUG (mean±SD; pre 5.13±.68sec, post 4.86±.53sec, p<.05) and LTA (the perturbed side, mean±SD; pre 134±30msec, post 116±22msec, p<.01, the non-perturbed side, mean±SD; pre 132±35msec, post 114±27msec, p<.05). On the other hand, the ordinary training subjects were improved only in TUG (mean±SD; pre 4.93±.52sec, post 4.60±.39sec, p<.01). Additionally, the improvements of the LTA on the perturbed training subjects were retained one month after the training period (the perturbed side, mean±SD; pre 134±30msec, after 1-month 117±19mse, p<.01, the non-perturbed side, mean±SD; pre 132±35msec, after 1-month 115±24msec, p<.05). The improvements of LTA may represent the improvements of the ability of the stepping reaction which is one of the important factors to avoid the falling.
    Our treadmill training with perturbation improves the balance performance and may decrease the risk of falling in the community dwelling elderly subjects.
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  • Takeshi Isobe, Shigeyuki Saitoh, Satoru Takagi, Hirofumi Ohnishi, Juni ...
    2004 Volume 41 Issue 3 Pages 328-333
    Published: May 25, 2004
    Released: March 02, 2011
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    [Aim] To determine the relationship between adiponectin level and coronary risk factors in men.
    [Methods] The subjects were 395 elderly men in two rural communities (Tanno, Sobetsu) in Japan. Blood pressure in the sitting position (SBP/DBP), after overnight fasting, plasma glucose level (FPG), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL) and serum adiponectin were measured. The subjects were divided into two adiponectin level groups, a high adiponectin level (≥7.94μg/ml) group (H-Adipo group) and a normal adiponectin level (<7.94μg/ml) group (N-Adipo group), and into two age groups, 70 years of age or older (70 or older group) and less than 70 years of age (under 70 group).
    [Results] Adiponectin showed negative correlations with BMI, FPG, TC and TG and positive correlations with age, SBP and HDL. In multiple regression analysis using adiponectin as a dependent variable, BMI, SBP, FPG, TG and HDL were selected as independent variables. Age and HDL in the H-Adipo group were significantly higher than those in the N-Adipo group, and BMI, FPG, TC and TG in the H-Adipo group were significantly lower than those in the N-Adipo group. In the 70 or older group, SBP and adiponectin were significantly higher and BMI, DBP, FPG, TC and TG were significantly lower than those in the under 70 group. The mean number of total coronary risk factors in the 70 or older group (1.71) was significantly lower than that in the under 70 group (2.06).
    [Conclusions] Coronary risk factors other than systolic blood pressure were significantly reduced in the older subjects.
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  • Souichirou Fujii, Akira Miyata, Takeshi Kikuchi, Masayoshi Kibata
    2004 Volume 41 Issue 3 Pages 334-338
    Published: May 25, 2004
    Released: March 02, 2011
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    A 72-year-old man with acute myelocytic leukemia (AML) suffered relapsing massive bleeding from gastric angiodysplasia. He was referred to our hospital in February 2000 because of anemia and thrombocytopenia. He had hypercellular (nudeated cell count 42×104l) bone marrow with 90% myeloblasts, and AML (FAB:M1) was diagnosed. Remission induction therapy by BHAC/DM regimen failed. While considering subsequent regimens, massive hematemesis from a solitary gastric angiodysplasia developed. In April, after re-remission induction by CAG regimen, hematemesis from the same lesion reccurred. Hemostasis was achieved by topical transendoscopic injection of polidocanol. After achievement of complete remission by CAG therapy, he was treated on an outpatient basis. In July, his AML relapsed and he was treated mainly by transfusion therapy. In September, hematemesis recurred resulting in hemostasis with the same procedure. In the course of endoscopic injections, his mucosal lesion became difficult to observe. Gastric angiodysplasia is occasionally observed in the elderly, but massive bleeding is a rare complication. In this case, topical injection of polidocanol was an effective procedure for the massive bleeding from it even in an elderly patient with the complication of thrombocytopenia due to AML.
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  • Kyoko Maruta, Yoshito Sonoda, Ryuji Saigo, Takako Yoshioka, Hidetoshi ...
    2004 Volume 41 Issue 3 Pages 339-343
    Published: May 25, 2004
    Released: March 02, 2011
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    A 72-year-old woman with von Recklinghausen's disease was referred to our hospital because of pain and muscle weakness in her thighs.
    She had elevated serum values of creatine kinase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and aldolase. Based on these results, a diagnosis of polymyositis was made. Treatment with prednisolone improved muscle strength, and laboratory values returned to normal. Computed tomography, magnetic resonance imaging of the abdomen, and 131I-metaiodobenzyl guanidine MIBG scintigraphy demonstrated a tumor 3cm in diameter in the region of the left adrenal gland. Endocrinologic investigation disclosed elevation of serum and urine catecholamines. Since the blood pressure was normal, nonfunctioning pheochromocytoma was diagnosed clinically. The nonhypertensive course was attributed to reduced vascular response to noradrenaline.
    Serum lactate dehydrogenase, alkaline phosphatase, and asparate aminotransferase became elevated, and abdominal computed tomography showed a well-defined mass measuring 13×12×10cm in the right lobe of the liver. The patient underwent right trisegmentectomy and left adrenalectomy.
    Histologically the adrenal tumor was a typical pheochromocytoma. The hepatic tumor was a leiomyosarcoma consisting of elongated spindle-shaped atypical cells arranged in intersecting bundles. Immunohistochemically, the cells of this tumor were reactive for α-smooth muscle actin and vimentin.
    The leiomyosarcoma recurred and metastasized to the liver. Eight months after onset of symptom, the patient developed hepatic coma and died.
    The mean age at presentation with pheochromocytoma in von Recklinghausen's disease patients age is 42 years. Our patient was considerably older. To the best of our knowledge this is the first report of a patient with von Recklinghausen's disease developing polymyositis, asymptomatic pheochromocytoma, and primary hepatic leiomyosarcoma and illustrates the need to remain aware of the possibility of cancer in von Recklinghausen's disease.
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  • 2004 Volume 41 Issue 3 Pages 344-354
    Published: May 25, 2004
    Released: March 02, 2011
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