Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 42 , Issue 6
Showing 1-27 articles out of 27 articles from the selected issue
  • Toshihiko Osawa
    2005 Volume 42 Issue 6 Pages 587-595
    Published: November 25, 2005
    Released: March 02, 2011
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  • Atsushi Harada, Yasumoto Matsui, Marie Takemura, Zenya Ito, Norimitsu ...
    2005 Volume 42 Issue 6 Pages 596-608
    Published: November 25, 2005
    Released: March 02, 2011
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  • Yoshimitsu Kuroyanagi
    2005 Volume 42 Issue 6 Pages 609-615
    Published: November 25, 2005
    Released: March 02, 2011
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    A typical engineered product is autologous cultured epidermal substitute, which is composed of stratified keratinocytes (in USA). There are two types of allogeneic cultured dermal substitute (CDS) composed of fibroblasts combined with a synthetic scaffold (in USA). Another product is allogeneic cultured skin substitute, which is composed of keratinocytes and fibroblasts combined with a collagen gel (in USA). Recently, however, the commercialization of these allogeneic products has been discontinued. There seem to be some problems in the design of these products. Kuroyanagi et al. developed an allogeneic CDS composed of a fibroblast combined with a 2-layered spongy matrix of hyaluronic acid and collagen. A multicenter clinical study on the use of allogeneic CDS was performed in 30 hospitals across Japan as the Regenerating Medical Millennium Project of the Ministry of Health, Labor and Welfare. The results of clinical study suggest that this type of allogeneic CDS can effectively promote the healing of full-thickness severe skin defects, such as chronic ulcers and burn injuries.
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  • Yasuyoshi Ouchi
    2005 Volume 42 Issue 6 Pages 616-623
    Published: November 25, 2005
    Released: March 02, 2011
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  • Ichiro Tsuji
    2005 Volume 42 Issue 6 Pages 624-626
    Published: November 25, 2005
    Released: March 02, 2011
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  • Koutaro Yokote
    2005 Volume 42 Issue 6 Pages 627-629
    Published: November 25, 2005
    Released: March 02, 2011
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  • Koichi Node
    2005 Volume 42 Issue 6 Pages 630-632
    Published: November 25, 2005
    Released: March 02, 2011
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  • Toshihiko Yanase, WuQiang Fan, Hajime Nawata
    2005 Volume 42 Issue 6 Pages 633-635
    Published: November 25, 2005
    Released: March 02, 2011
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  • Narihito Seki
    2005 Volume 42 Issue 6 Pages 636-638
    Published: November 25, 2005
    Released: March 02, 2011
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  • Katsuhiko Takabayashi
    2005 Volume 42 Issue 6 Pages 639-641
    Published: November 25, 2005
    Released: March 02, 2011
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    Most collagen diseases are more common in women except polyarteritis nodosa, but aging makes this gender difference smaller in some of the diseases. In systemic lupus erythematosus the incidence difference between men and women diminishes while Sjogren syndrome is more common in women at all ages. Diabetes mellitus and hyperlipidemia are also very common complications with steroid treatment. DM is more common in those aged over 45 years old. On the contrary, hyperlipidemia is common at all ages with the peak in those 45-54 years old and only 22% over 75 years old have hyperlipidemia. According to the introduction of aggressive therapy for rheumatoid arthritis, complications in the elderly should be carefully managed.
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  • Takayuki Hosoi
    2005 Volume 42 Issue 6 Pages 642-644
    Published: November 25, 2005
    Released: March 02, 2011
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  • Toshiki Ota, Atsushi Harada, Yukihiko Washimi, Hiroyasu Okuizumi, Yata ...
    2005 Volume 42 Issue 6 Pages 645-647
    Published: November 25, 2005
    Released: March 02, 2011
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  • Yoshinori Doi
    2005 Volume 42 Issue 6 Pages 648-650
    Published: November 25, 2005
    Released: March 02, 2011
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  • Takeshi Iwatsubo
    2005 Volume 42 Issue 6 Pages 651-654
    Published: November 25, 2005
    Released: March 02, 2011
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  • Jun Nakajima
    2005 Volume 42 Issue 6 Pages 655-658
    Published: November 25, 2005
    Released: March 02, 2011
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  • Koichi Kozaki
    2005 Volume 42 Issue 6 Pages 659-661
    Published: November 25, 2005
    Released: March 02, 2011
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    Vascular calcification, such as coronary and aortic calcification, is a significant feature of vascular pathology. Two distinct forms of vascular calcification are well recognized. One is medial calcification, which occurs between the cell layers of smooth muscle cells, and is related to aging, diabetes and chronic renal failure. The other is atherosclerotic calcification, which occurs in the intima during the development of atheromatous disease. It has been shown that statins inhibit the progression of calcification in the aortic valve and the coronary artery. We have found that statins inhibit calcification of human aortic smooth muscle cells, which is induced by incubating the cells in high-phosphate medium. We also found that this is mediated by inhibiting cellular apoptosis, an essential mechanism for calcification, not by inhibiting inorganic phosphate (Pi) uptake by sodium-dependent phosphate cotransporter (NPC). Besides apoptosis and Pi uptake, such proteins as osteoprotegerin (OPG), matrix Gla protein (MGP), Klotho, fetuin-A, and apoE have been shown to negatively affect vascular calcification. Many previous reports suggest that vascular calcification appears to be regulated by promoting factors, such as Pi, apoptosis, modified LDL, advanced glycation end products, oxidative stress, vitaminD3, glucocorticoid, cbfa-1, osteopontin, and inhibitory factors, such as OPG, MGP, Klotho, fetuin-A, PTH/PTHrP, pyrophosphate, statins, and bisphosphonates. The precise mechanism of vascular calcification is of interest.
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  • Motoya Nakagawa
    2005 Volume 42 Issue 6 Pages 662-663
    Published: November 25, 2005
    Released: March 02, 2011
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  • Nobuyoshi Hirose, Toshio Kojima, Yasuyuki Gondo, Yasumichi Arai
    2005 Volume 42 Issue 6 Pages 664-665
    Published: November 25, 2005
    Released: March 02, 2011
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  • Wataru Kimura
    2005 Volume 42 Issue 6 Pages 666-668
    Published: November 25, 2005
    Released: March 02, 2011
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  • Kumiko Fujita, Masahiro Kawagoe, Fumio Eto
    2005 Volume 42 Issue 6 Pages 669-676
    Published: November 25, 2005
    Released: March 02, 2011
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    Aim: To describe fundamental cognitive function and change in the elderly and examine interaction between cognition and ADL. Methods: We investigated the mental and physical condition of 12, 140 persons aged 65 years or over in 2000 and 2002 according to the Eligibility Survey Questionnaire for Long-term Care Insurance. The percentage correct and correlation coefficients of six items in the Questionnaire concerning “Understanding”: “Understands daily activities”, “Answers date of birth and age”, “Remembers what the subject did before interview”, “Says own name”, “Knows what season it is now”, “Knows the place where the subject is” were determined. The interaction between these six items and ADL were also examined. Results: The percentage correct of “name” was .89, “date of birth and age” .78, “place” .75, “season” .66, “daily activities” .59, “Remembers before interview” .58. The item with high percentages of correct answer in 2000 higher tended to remain high in 2002. Those who were not impaired physically but unable to understand cognitive items tended to require significantly more support for A DL such as “Dressing and undressing”, and “Personal hygiene”, “Taking medication”. Conclusion: The percentage correct of each item was considered to be associated with a classical model of memory process: encoding, retention and retrieval. It seemed to require the whole memory process to “Understand daily activities” and “Remember before interview”, since the contents were changeable. On the other hand, “name” and“date of birth and age” were relatively well preserved, since these items were encoded and stored in the early stage of life and retrieved repeatedly. “Place” and “Season” were between these two groups.
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  • Hajime Iwasa, Chieko Kawai, Yasuyuki Gondo, Hiroki Inagaki, Takao Suzu ...
    2005 Volume 42 Issue 6 Pages 677-683
    Published: November 25, 2005
    Released: March 02, 2011
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    [Aim] We examined the relationship between subjective well-being and all-cause mortality among middle-aged and elderly people, using a population-based prospective approach (Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging).
    [Methods] The participants were 1, 034 men and 1, 413 women aged 52 to 77 years, living in an urban Japanese community.
    The baseline data on age, gender, number of years of education, hospitalization, lifestyle-related illness, subjective health status, living alone and subjective well-being (measured by Philadelphia Geriatric Center Morale Scale) were collected in 1993.
    [Results] Mean subjective well-being scores for men and women were 12.3±3.2 and 11.9±3.5, respectively. Analysis of covariance controlling for age, the number of years of education, hospitalization, lifestyle-related illness and living alone, revealed no inter-gender difference in subjective well-being. Multiple regression analysis to explore factors related to subjective well-being showed that age in men, and the number of years of education in both genders were significantly, independently and positively associated with subjective well-being, and that hospitalization, lifestyle-related illness and living alone in both genders were significantly, independently and negatively related to subjective well-being.
    From 1993 to 2000, there were 183 deaths and 258 dropouts. In Cox's multivariate hazard model adjusted for age, the number of years of education, hospitalization, lifestyle-related illness and living alone, there was a significant and independent association between a low level of subjective well-being and the risk for all-cause mortality in both genders.
    [Conclusion] Satisfaction with life is an important factor affecting longevity among middle-aged and elderly people.
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  • Kentaro Watanabe, Tatsuya Suzuki, Hiroshi Nakano, Kenzo Oba
    2005 Volume 42 Issue 6 Pages 684-690
    Published: November 25, 2005
    Released: March 02, 2011
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    AIM: Many studies have reported that carotid parameters measured by ultrasonography were predictors for stroke. The aim of this study was to investigate by cross-sectional study in elderly people having cardiovascular risk factors whether those carotid parameters are markers for atherothrombotic infarction (AI) and lacunar infarction (LI). METHODS: Subjects of this study were 314 patients aged 65 years or older who had controlled cardiovascular risk factors and assessed carotid artery by ultrasonography. Subjects were categorized into control, AI and LI group. Clinical characteristics (biochemical analysis, body mass index, systolic/diastolic blood pressure, smoking habits, hypertension, diabetes mellitus and statin therapy) and carotid parameters (maximum intima-media thickness (Max-IMT), plaque score (PLQ-S) and Maximum pulsatility index (Max-PI)) were compared among three groups. RESULTS; PLQ-S, Max-PI, frequency of PLQ-S≥10mm and frequency of Max-PI≥2.0 in the AI group were significantly higher than in the control group. There were no significant differences between control and LI group concerning those carotid parameters. Multivariate logistic regression analysis showed that there were significant correlations between AI and PLQ-S≥10mm (odds ratio 2.980; P=0.011), AI and Max-PI≥2.0 (odds ratio 2.458; P=0.038), but there was no significant correlation between those carotid parameters and LI. CONCLU-SION; This study suggests that in high risk elderly people, PLQ-S and PI are better markers for AI than IMT, but those carotid parameters have poor associations with LI.
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  • Yoshimi Tanimoto
    2005 Volume 42 Issue 6 Pages 691-697
    Published: November 25, 2005
    Released: March 02, 2011
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    Aim The purpose of this study is to determine whether skeletal muscle mass measured by bioelectrical impedance analysis can be associated with health conditions for elderly men and women in the community.
    Methods This study described the characteristics of the appendicular and total skeletal muscle mass by sex and age. In addition, the relationship between muscle mass and usual walking speed, instrumental activities of daily living (IADL) and life-styles, diet and exercise of 394 elderly persons who use a community center and live in a metropolitan suburb was examined.
    Result This study showed that both appendicular and total skeletal muscle mass decreases with age in both men and women, and that men have greater skeletal muscle mass than women in all age groups. Both appendicular and total skeletal muscle mass had a significant positive correlation with usual walking speed in men and women. Men with efficient IADL had greater skeletal muscle mass than those with inefficient IADL, while there was no significant difference for women. In men the skeletal muscle mass was related to efficiency in IADL and life-styles, diet and exercise.
    Conclusion These findings may also suggest that the skeletal muscle mass can reflect health conditions in community-dwelling elderly persons in Japan.
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  • Jiro Kanie, Hiroyasu Akatsu, Yusuke Suzuki
    2005 Volume 42 Issue 6 Pages 698-701
    Published: November 25, 2005
    Released: March 02, 2011
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    We report a case of a 53-year-old man, who had been bed-ridden due to the progression of spinocerebellar degeneration and had been relying on percutaneous endoscopic gastrostomy (PEG) feeding for long-term nutritional support at home. The patient was referred to our clinic from his local GP because of suspected misinsertion of the PEG tube into the abdominal cavity on regular exchange of the tube. We performed emergent gastric endoscopy. First we induced the biopsy forceps through an endoscopic fiber, and pulled the forceps out through the injured fistula to the surface. Then the loop wire used for PEG placement was inserted through the fistula to the stomach using the forceps. The PEG tube was then inserted per oral and replacement was completed according to the usual pull-method. This procedure enabled the replaced PEG tube to cover the perforated site as well as to reduce intragastric pressure, thereby prevented the occurrence of panperitonitis, a common severe complication expected in case of perforated fistula, caused by the leakage of intragastric contents. The patient showed no signs of complications, and could continue to receive in-home care without being admitted to the hospital for acute care.
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  • Takeshi Kawarabayashi, Etsuro Matsubara, Isao Nagano, Mikio Shoji, Koj ...
    2005 Volume 42 Issue 6 Pages 702-707
    Published: November 25, 2005
    Released: March 02, 2011
    JOURNALS FREE ACCESS
    A 65-year-old woman began to experience slowly progressive speech disturbance from 2001. She was admitted to our hospital for examination on May 2003. She had dysprosody, paragraphia, and mild disturbance in comprehension of spoken language. Repetition was preserved. No clear paraphasia was found. Calculation was disturbed, but there were no other neurological abnormalities including apraxia and agnosia. Brain MRI showed atrophy of the left frontal and parietal lobes. 99mTc-ECD SPECT showed decreased blood flow in the left frontal lobe and parietal lobe, especially in the Broca area and supplemental motor cortex. Primary progressive aphasia was diagnosed, because aphasia lasted for 2 years without other neurological deficits, and her daily activity was well preserved. During follow up, facial apraxia appeared from December 2003, and limb apraxia appeared from May 2004, followed by rigidity predominantly in the right upper limb and dementia. She was diagnosed as having corticobasal degeneration (CBD). The second SPECT on December 2004 showed progression of the decrease in cerebral flow at the same area showed by the first SPECT. SPECT is useful examination to predict the progress of the disease because the decrease of blood flow was recognized before the progression to CBD.
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  • Akiko Morita, Shuji Kobayashi, Koji Hamanaka, Sawako Miyoshi, Setsu Ii ...
    2005 Volume 42 Issue 6 Pages 708-711
    Published: November 25, 2005
    Released: March 02, 2011
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    The long-term prognosis of unilateral spatial neglect (USN) in three elderly patients with stroke was investigated. Case 1 was a 62-year-old man who had suffered from right putaminal hemorrhage three years ago. Obvious right USN was found soon after the onset. After 6 months of rehabilitation he recovered and became independent in ADL without USN signs in daily circumstances. However, left USN signs appeared in some stressful situations such as traditional poetry-based competition or driving an electrical wheelchair on crowded roads. Case 2 was a 62-year-old man who had suffered from cerebral hemorrhage in the right putamen 6 years ago. He showed left USN soon after the onset, but it disappeared gradually. Cerebral infarction in the left basal ganglia occurred 6 years after the first attack. He showed decline of general attention accompanying left USN. Case 3 was a 70-year-old man who had showed left USN signs 7 years previously. He became independent and disappeared USN signs. However his activities of daily living declined gradually, and mental status became worse. Left USN signs were observed again on USN tests.
    Left USN was observed in three cases soon after the onset of the first stroke and then disappeared. However, USN signs became obvious in some specific situations. The appearance or disappearance of USN seemed to depend on the relationship among severity of USN, physical and mental functions, and circumstances in which USN was evaluated.
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  • 2005 Volume 42 Issue 6 Pages 712-719
    Published: November 25, 2005
    Released: March 02, 2011
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