Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 41 , Issue 6
Showing 1-26 articles out of 26 articles from the selected issue
  • Takeshi Tabira
    2004 Volume 41 Issue 6 Pages 579-581
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
  • Shinsuke Ohba, Kazuyo Igawa, Kozo Nakamura, Hiroshi Kawaguchi, Tsuyosh ...
    2004 Volume 41 Issue 6 Pages 582-588
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    Regenerative medicine, which takes advantage of the unique capacity of stem cells, is a novel medical strategy to cure irreversible organ failure. There are three important elements in regenerative medicine: cells, scaffolds and signals. Although substantial progress regarding each element has been made in the past few years, it still falls short of clinical applications. In the geriatric field, osteoporosis, osteoarthritis and periodontitis are the major targets of regenerative medicine. They are usually not life-threatening, but often severely affect QOL of elderly patients. Since elderly people have already reduced number of stem cells in bone and cartilage, we need to know the sufficient conditions for osteogenesis and chondrogenesis by comprehensively screening various conditions. We developed a marker gene system expressing green fluorescence protein (GFP) under the control of osteoblast-and chondrocyte-specific promoters. This system helps us monitor osteoblast and chondrocyte differentiation easily, precisely and non-invasively. Using this system, we are now trying to find the sufficient conditions for osteogenesis and chondrogenesis, and to discover osteogenic and chondrogenic small compounds.
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  • Mitsunori Morimatsu
    2004 Volume 41 Issue 6 Pages 589-593
    Published: November 25, 2004
    Released: March 02, 2011
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    Among the diseases causing parkinsonism, drug-induced parkinsonism is important because physicians often use antidopaminergic drugs such as benzamides for gastrointestinal disorders. In 28 patients with drug-induced parkinsonism, 13 (47%) showed persistent parkinsonism even 6 months after the cessation of the causative drugs. This means antidopaminergic drugs may bring subclinical parkinsonism to the clinical level especially in the elderly.
    Progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) and multiple system atrophy including striatonigral degeneration were recognized in 2003 as specific diseases by the National Health Insurance of Japan. The diagnostic criteria of PSP (the modification of NINDS-SPSP criteria) made by the study group of the Ministry of Health, Welfare and Labour (MHWL) of Japan has demonstrated that their sensitivity was 83% and specificity 97% in “probable PSP”. Patients with CBD were surveyed among the main neurologic institutions in Japan using the provisional diagnostic criteria. There were 151 patients with “probable CBD” and 13 with “definite CBD”. Based on these data, the number of patients with PSP and CBD in 2001 was estimated as 6, 400 (5.03per 100, 000) and 2, 500 (1.93per 100, 000), respectively, in Japan.
    Neuroprotective drugs hold hope for the treatment of neurodegenerative diseases. Although many agents were reported to be neuroprotective for Parkinson's disease from in vitro studies, pramipexole, a dopamine agonist, is the only one with good clinical evidence based on neuroimaging. Other dopamine agonists as well as various nerve trophic factors may also have the same effects, though further confirmatory studies are necessary.
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  • Masanori Umeda
    2004 Volume 41 Issue 6 Pages 594-597
    Published: November 25, 2004
    Released: March 02, 2011
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    Hematopoietic and immune function tend to deteriorate in the elderly. The incidence of hematologic diseases in the elderly is increasing as the percentage of elderly people in the whole population increases. Acute leukemia, myelodysplastic syndrome, malignant lymphoma, multiple myeloma, and myelodysplastic syndromes are commonly seen in the elderly.
    Malignant lymphomas are frequently seen in the elderly, and many elderly patients have poor performance status, and because they are more likely to suffer from impaired cardiac, respiratory, hepatic and renal function, as well as glucose intolerance, they are also more likely to suffer side effects due to chemotherapy. Particularly in patients aged over 80 years, to avoid side effects it is essential to adjust dosage and route of administration of chemotherapy. Although age is a significant negative prognostic factor for non-Hodgkin's lymphoma, it is possible for patients to enter complete remission with improvement of host-side factors. The clinical application of Rituximab is expected to improve chemotherapy outcomes in elderly B-cell lymphoma.
    The median age at the time of initial diagnosis of multiple myeloma (MM) is 60-70 years, and age is a negative prognostic factor. Clinically, higher rates of infection and heavy comorbidity are characteristic of this condition in the elderly. Although the incidence of bony lesions in elderly patients with MM is not different from the non-elderly, they do have a higher incidence of bone pain and pathologic fractures compared with the non-elderly patients. As the response to chemotherapy is good in the elderly, it is worth trying chemotherapy for MM.
    Polycythemia vera must be treated in the elderly, because chemotherapy decreases the incidence of thrombosis.
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  • Satoshi Itami
    2004 Volume 41 Issue 6 Pages 598-600
    Published: November 25, 2004
    Released: March 02, 2011
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    Hair follicles are composed primarily of epithelial and dermal components that develop from embryonic ectoderm and mesoderm respectively. The hair growth cycle is coordinated with complex processes that are dependent on the interactions of epithelial and dermal components. Beard and frontal scalp dermal papilla cells (DPCs) show the characteristics of androgen target cells. These DPCs expressed androgen receptor and type II 5α-reductase mRNA. To understand the mode of androgen action in human hair follicles, we developed an in vitro co-culture system using DPCs and follicular keratinocytes. Androgen significantly stimulated the proliferation of keratinocytes co-cultured with beard DPCs, suggesting that these DPCs produce androgen-dependent diffusible growth factors. Insulin-like growth factor-I (IGF-I) was identified as one of the androgen dependent paracrine growth factors from beard DPCs. On the other hand, we identified inhibitory roles of androgen on the growth of keratinocytes co-cultured with DPCs from human balding frontal scalp, when DPCs were transfected with the AR expression vector. This inhibitory effect was mediated by TGF-β1 from the DPCs. Minoxidil and Finasteride were recently introduced for the treatment of androgenetic alopecia in Japan, and TGF-β1 is the next target for innovative treatment.
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  • Yasushi Suga
    2004 Volume 41 Issue 6 Pages 601-603
    Published: November 25, 2004
    Released: March 02, 2011
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  • Shigeru Kinoshita, Hideki Kanai, Toru Ikushima, Eiichi Sekiyama, Kazuh ...
    2004 Volume 41 Issue 6 Pages 604-606
    Published: November 25, 2004
    Released: March 02, 2011
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  • Takayuki Nakagawa
    2004 Volume 41 Issue 6 Pages 607-609
    Published: November 25, 2004
    Released: March 02, 2011
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    Hearing impairment is the most frequent disability in elderly individuals; however, we have limited options for treatment of age-associated hearing loss. To establish novel strategies for the treatment of age-associated hearing loss, it is crucial to elucidate the mechanisms of age-associated hearing loss. Studies on animal models and human temporal bones have indicated a close relationship between degeneration of the spiral ganglion neurons and stria vascularis and age-associated hearing loss. We have developed a drug delivery system using biodegradable gel for the inner ear to protect inner ears against aging. In addition, recent studies on cell therapy for the inner ear have suggested the efficacy of cell transplantation for restoration of hearing.
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  • Koji Ikezoe
    2004 Volume 41 Issue 6 Pages 610-611
    Published: November 25, 2004
    Released: March 02, 2011
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  • Hiroshi Kawaguchi
    2004 Volume 41 Issue 6 Pages 612-615
    Published: November 25, 2004
    Released: March 02, 2011
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    Bone loss by ageing has been investigated from standpoints of systemic abnormality and some deficiency in osteoblastic bone formation. This seminar summarizes the involvements of a key molecule of adipocytic differentiation PPAR-gamma, essential IGF-I signaling molecules IRS-1 and IRS-2, and an anti-aging gene klotho in the pathophysiology of age-related osteoporosis.
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  • Takuji Sirasawa
    2004 Volume 41 Issue 6 Pages 616-618
    Published: November 25, 2004
    Released: March 02, 2011
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  • Yuzuru Imai
    2004 Volume 41 Issue 6 Pages 619-621
    Published: November 25, 2004
    Released: March 02, 2011
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  • Yasuhiro Takeuchi
    2004 Volume 41 Issue 6 Pages 622-624
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
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  • Juro Sakai
    2004 Volume 41 Issue 6 Pages 625-628
    Published: November 25, 2004
    Released: March 02, 2011
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  • Hajime Orimo
    2004 Volume 41 Issue 6 Pages 629-632
    Published: November 25, 2004
    Released: March 02, 2011
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  • Kenji Kuroda
    2004 Volume 41 Issue 6 Pages 633-636
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
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  • Hiroshi Haga
    2004 Volume 41 Issue 6 Pages 637-639
    Published: November 25, 2004
    Released: March 02, 2011
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  • Nobufumi Yasuda
    2004 Volume 41 Issue 6 Pages 640-642
    Published: November 25, 2004
    Released: March 02, 2011
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  • Seiji Yasumura
    2004 Volume 41 Issue 6 Pages 643-645
    Published: November 25, 2004
    Released: March 02, 2011
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  • Nariaki Shiraishi, Chiemi Mizutani, Masafumi Menjho, Akira Deguchi, Ko ...
    2004 Volume 41 Issue 6 Pages 646-652
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    We investigated changes in the Activities of Daily Living (ADL) of stroke patients in a convalescent rehabilitation ward and a general ward using a Functional Independent Measure (FIM). The subjects were 109 patients hospitalized for rehabilitation purposes at the Oyamada Memorial Spa Hospital. The change in FIM at the time of hospitalization and that at 1 week later was investigated in 81 patients in the convalescent rehabilitation group (CRG) and 28 patients in the control group (CG). In addition, the CRG was investigated again after one month. Intensive rehabilitation service based on ADL and worksheets was introduced in the CRG. On the other hand, these were not introduced in the CG. The total score of FIM increased significantly (p<0.01) in the first week after hospitalization in both groups. The FIM-gain after one week in the CRG was high. With regard to each item, a significant improvement was observed in patients' motor skills while eating, grooming, bathing, dressing the upper body, dressing the lower body, toilet, bladder management, transfer bed/chair, toilet and tub, and walking/wheelchair (11/13). Multiple regressions were used to assess the relationships between FIM-gain (one week, one month), age, rehabilitation intensity and other predictive variables. Better rehabilitation outcomes were observed in patients with lower level of dementia and high rehabilitation intensity. It was thought that planned rehabilitation based on ADL was effective in the CRG, and it was suggested that the CRG's system is effective in the rehabilitation of stroke patients.
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  • Hiroshi Fujimaki, Yutaka Kasuya, Shino Hara, Sachiko Kawaguchi, Shiro ...
    2004 Volume 41 Issue 6 Pages 653-659
    Published: November 25, 2004
    Released: March 02, 2011
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    In our previous studies, relevant factors concerning the main phenomena related to the process of initiating dialysis were examined in elderly patients with chronic renal failure. Examined phenomena were as follows: (1) the acceptance of dialysis; (2) the urgency of initiating dialysis; (3) short-term outcome; (4) returning home. Multivariate logistic regression analysis was used to determine relevant factors. Although we speculated that age should be a relevant factor for each phenomenon, the phenomenon on which age had some impact was only the first. We suspected the existence of a pitfall, through which the relation of age was lost in the second, the third, or the fourth phenomenon.
    The fact that every phenomenon had its own relevant factors was thought to be an important clue to the discovery of pitfalls. Relevant factors were derived from both the number of dropout-patients and their demographic and clinical status. From the viewpoint of nondropout-patients, the progression of the process of initiating dialysis might alter the characteristics of subjects for successive phenomena. In this study, we set out to investigate whether alterations in the characteristics of subjects were pitfalls.
    Alterations were regarded as a fall of the mean age, an increment of the rate of the patients with ability to walk, and an increment of the rate of the patients with normal cognitive function. In addition, the old-old patients tended to have limited numbers of those who had the ability to walk and normal cognitive function. In other words, aging changes in ambulatory and cognitive function were not brought to subjects. These alterations may cause the loss of the relation of age to each phenomenon. Thus, we presumed these alterations to be pitfalls. We must clarify whether aging changes are brought to subjects beforehand in analyses that include the old-old patients as subjects.
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  • Wataru Kimura, Masaomi Mizutani, Akira Fuse
    2004 Volume 41 Issue 6 Pages 660-665
    Published: November 25, 2004
    Released: March 02, 2011
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    Aim: To study the problems and therapeutic strategies for emergency abdominal operations in elderly patients by comparing aged and non-aged who underwent an emergency operations for abdominal diseases.
    Materials and methods: The patients were divided into two groups: those 70 years old or more (85 cases, elderly) and those under 70 years old (228 cases, non-elderly). The type of disease, preoperative complications, postoperative course and outcome of main diseases such as ileus and perforation peritonitis were investigated.
    Results: Regarding emergency diseases in the aged group, ileus, peritonitis and acute appendicitis were frequently found, in that order, and accounted for 79% of the cases. Incarceration of hernia was more frequently found than in the non-elderly group. On the contrary, acute appendicitis was more frequently found in the non-elderly group. Preoperative complications were found in 46 cases (54%), and were most prevalent in hypertension, cardiac diseases, and diabetes mellitus in this order. In the non-elderly group, preoperative complications were found in 59 cases (26%). Postoperative complications were found in 52 cases (61%) in the elderly group and in 21 (9%) in the non-elderly group. Respiratory complications were found most frequently, and were seen in 32% of the elderly cases. Respiratory complications were significantly more frequent in the elderly group than in the non-elderly group. Death following the operation was found in 9% in the aged group which was mostly due to ileus and peritonitis.
    Conclusion: With regard to the acute abdominal diseases in the elderly patients, both diagnosis and indications of surgery for ileus and peritonitis should be adequately done. Preparation for postoperative respiratory complications and cardiovascular diseases might help to save lives of the elderly.
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  • Michiko Takamine Tanaka, Miyuki Kajitani, Akiko Matsuda, Toshiko Hoshi ...
    2004 Volume 41 Issue 6 Pages 666-669
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    To determine the factors involved in prolonged hospital stay of elderly patients (over 60 years old) with community-acquired pneumonia (CAP), we investigated: (1) the age, (2) underlying diseases, (3) severity of pneumonia, and (4) length of hospital stay etc. of such cases at a 19-bed local facility. Of the 30 elderly patients with CAP, 20 had no underlying diseases (Group A). The mean length of hospital stay for these patients was about 10 days (mean age 69.1 years). The other 10 patients examined had some chronic underlying diseases, and these patients were assigned to Group B. The mean length of hospital stay in this group was 17 days (mean age was 71.2 years).
    The finding that the mean length of hospital stay was significantly shorter in Group A than in Group B indicates that prolonged stay of elderly patients with CAP is associated with the presence of underlying chronic diseases.
    When the severity of pneumonia of patients with underlying chronic diseases increased by one level according to the Guidelines of the Japanese Respiratory Society (2000), the number of patients with moderate pneumonia was 13, and the mean length of hospital stay was 16 days. The number of patients with mild pneumonia was 17, and the mean length of hospital stay was 10 days.
    Thus, the length of hospitalization was significantly shorter in the mild group than in the moderate group.
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  • Chikako Ono, Terunao Ashida, Takao Sugiyama, Jun Fujii, Sakae Homma, A ...
    2004 Volume 41 Issue 6 Pages 670-674
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    A Japanese man who died at age 86 had been followed since the age of 58, when he presented with hypertension of 150/95mmHg. The patient remained socially active until he died suddenly of a ruptured thoracic aortic aneurysm, although he experienced angina pectoris in August 1974, and myocardial infarction was identified on electrocardiography in October 1974. He underwent operation for rectal cancer in 1987, and an abdominal aortic aneurysm 38mm in diameter was identified at that time. The patient underwent an operation for rupture of the abdominal aortic aneurysm in 1991. A thoracic aneurysm of 40mm diameter was identified in 1995, and this expanded to 53mm by 1997. Autopsy revealed a thoracic aortic aneurysm in the arch (8×5×5cm) and descending aorta (7×7×8cm). A large volume (2, 080ml) of bloody pleural fluid was present.
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  • Hitoshi Katayama, Hironobu Hamada, Akihito Yokoyama, Toru Kadowaki, Ry ...
    2004 Volume 41 Issue 6 Pages 675-678
    Published: November 25, 2004
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    A 74-year-old woman was admitted to the hospital of Ehime University School of Medicine because of slight fever, dry cough and dyspnea on exertion. Chest X-ray films on admission showed diffuse infiltrations in both lungs. Drug-induced pneumonia due to the herbal medicine Gosha-jinki-gan was suspected, as Gosha-jinki-gan had been administered for 5 months for the treatment of a right knee pain. Her symptoms and the X-ray abnormality improved after cessation of administration. The lymphocyte stimulation test against Gosha-jinki-gan was positive. To the best of our knowledge, this is the first case of interstitial pneumonia caused by Gosha-jinki-gan.
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  • 2004 Volume 41 Issue 6 Pages 679-687
    Published: November 25, 2004
    Released: March 02, 2011
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