Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 42 , Issue 5
Showing 1-22 articles out of 22 articles from the selected issue
  • Kenji Kosaka
    2005 Volume 42 Issue 5 Pages 475-482
    Published: September 25, 2005
    Released: March 02, 2011
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  • Shigeo Murayama, Yuko Saito, Kazutomi Kanemaru, Aya Tokumaru, Kenji Is ...
    2005 Volume 42 Issue 5 Pages 483-489
    Published: September 25, 2005
    Released: March 02, 2011
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    We have established a brain bank for the prevention and treatment of aging-related movement and cognitive disturbances, as a joint project between a rural care hospital and a research institute. The resources of the bank are to be used for collaborative studies approved by the bank's committee. The collaborative investigators should also be qualified by the institute to conduct the research jointly. The collaborative studies require authorization by the institutional review board (IRB) of the institute, the hospital and each facility involved in collaborative studies. The bank continues to have the responsibility for the resources, after the transfer of the resources to the facilities of collaborative investigators, pursuant to Article 18 of the Cadaver Autopsy and Preservation Act. Thus, the status of resource utilization and outcomes from their use in studies will be monitored periodically (every 6 months). We shared the philosophy with the brain banks in the United States that the resources of the bank, donated on the basis of a charitable spirit, belong to the public domain and are regarded as public resources to be used to contribute to promoting public welfare.
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  • Kenji Ueshima
    2005 Volume 42 Issue 5 Pages 490-497
    Published: September 25, 2005
    Released: March 02, 2011
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  • Shinichi Ohshima
    2005 Volume 42 Issue 5 Pages 498-503
    Published: September 25, 2005
    Released: March 02, 2011
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  • Toshihiko Iwamoto
    2005 Volume 42 Issue 5 Pages 504-507
    Published: September 25, 2005
    Released: March 02, 2011
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  • Kentaro Shimokado
    2005 Volume 42 Issue 5 Pages 508-511
    Published: September 25, 2005
    Released: March 02, 2011
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  • Kenzo Oba
    2005 Volume 42 Issue 5 Pages 512-515
    Published: September 25, 2005
    Released: March 02, 2011
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  • Takahito Kondo
    2005 Volume 42 Issue 5 Pages 516-518
    Published: September 25, 2005
    Released: March 02, 2011
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  • Naoki Maruyama, Akihito Ishigami
    2005 Volume 42 Issue 5 Pages 519-522
    Published: September 25, 2005
    Released: March 02, 2011
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  • Takahide Nagase
    2005 Volume 42 Issue 5 Pages 523-525
    Published: September 25, 2005
    Released: March 02, 2011
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  • Hiroaki Tanaka
    2005 Volume 42 Issue 5 Pages 526-528
    Published: September 25, 2005
    Released: March 02, 2011
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  • Kenji Nakashima, Takashi Nomura, Kenichi Yasui, Michiro Kitayama, Yuic ...
    2005 Volume 42 Issue 5 Pages 529-531
    Published: September 25, 2005
    Released: March 02, 2011
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  • Kazuyuki Shimada
    2005 Volume 42 Issue 5 Pages 532-534
    Published: September 25, 2005
    Released: March 02, 2011
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  • Tetsunori Saikawa
    2005 Volume 42 Issue 5 Pages 535-536
    Published: September 25, 2005
    Released: March 02, 2011
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  • Junko Babasaki
    2005 Volume 42 Issue 5 Pages 537-539
    Published: September 25, 2005
    Released: March 02, 2011
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  • Yoshihisa Hirakawa, Yuichiro Masuda, Kazumasa Uemura, Masafumi Kuzuya, ...
    2005 Volume 42 Issue 5 Pages 540-545
    Published: September 25, 2005
    Released: March 02, 2011
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    AIM We conducted a national survey to examine the current status of programs to teach end-of-life care to undergraduates of Japanese medical and nursing schools in 2004.
    METHODS Our survey focused on the following areas: 1) the present status of curricula to teach end-of-life care, 2) topics covered in the curricula, 3) details of the timing of existing end-of-life care teaching programs and of departments responsible for it, 4) teaching methods, 5) education assessment tool, 6) reading list of textbooks.
    RESULTS 50.6% of the medical schools and 40.9% of the nursing schools participated. Most of the schools offered end-of-life care education programs, and 45% of the medical schools and 68.9% of the nursing schools offered education concerning end-of-life care for elderly. The most frequent teaching timing was the fourth year of medical school and the third year of nursing school. Broader end-of-life topics were covered in the curriculum in the nursing schools than the medical schools. One fourth of the nursing schools offered a separate course in end-of-life care. The mean number of teaching hours was 7.6 in the medical schools and 35.5 in the nursing schools. More nursing schools offered educational programs in which students can gain experience with end-of-life care than medical schools. A few institutions used practiced examinations to evaluate students' learning. A reading list of end-of-life care textbooks was provided in 10% of the medical schools and 35.6% of the nursing schools.
    CONCLUSION Our survey suggested that systematizing end-of-life care education and improvement in text content are on the way.
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  • Masaki Kondo, Kensuke Shiga, Toshiki Mizuno, Toshiharu Ijichi, Masanor ...
    2005 Volume 42 Issue 5 Pages 546-552
    Published: September 25, 2005
    Released: March 02, 2011
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    (Aim) To study the correlation between therapy and outcome of patients with late adult onset and ocular type myasthenia gravis (MG).
    (Methods) The 58MG patients admitted to our hospitals from 1991 to 2003 were classified into juvenile (younger than 20), early adult onset (20-64) and late adult onset (65 or older) groups, or also ocular and generalized types. We evaluated their therapeutic outcomes.
    (Results) The late adult onset group consisted of 11 patients, classified as 4 ocular and 7 generalized types. There were more women than men in both the late and early adult onset groups. Anti-acetylcholine receptor (anti-AchR) antibodies were positive in all patients. Four patients had thymus lesions. Ten patients received treatment as follows: steroid therapy in 6, thymectomy in 4 and only choline-esterase (ChE) inhibitor therapy in 4 patients. However 4 patients worsened after treatment because of inadequate steroid therapy, 2 of whom experienced myasthenic crisis.
    On the other hand 21 patients were ocular type, of whom anti-AchR antibodies were positive in 12. They received treatments of the 21, steroid therapy was given to 12, thymectomy was performed in 4 and only ChE inhibitor therapy was given to 8 patients. One ocular type patient progressed to the generalized type. Six of 16 improved patients showed distinct recovery.
    (Conclusion) In the late adult onset group careful assessment concerning timings of administration and reduction of steroid are required to avoid side effects and complications. One ocular type patient progressed to the generalized type and most patients had a good outcome, which might be related to steroid therapy.
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  • Hideki Ueda, Eiji Ishimura, Takami Miki, Nagakazu Shimada, Yoshiki Nis ...
    2005 Volume 42 Issue 5 Pages 553-556
    Published: September 25, 2005
    Released: March 02, 2011
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    Aim: To investigate the factors in the progression of renal failure in type 2 diabetes in elderly people.
    Materials and Methods: The subjects were 2, 034 patients hospitalized for type 2 diabetes therapy at Osaka City University Hospital from 1993 to 2000. Among them, 362 patients had diabetic non-dialyzed renal failure. Moreover, 93 patients reached the endpoint of doubling primary serum creatinine values. We analyzed the factors of progression for diabetic renal failure, and divided the cohorts into two groups. One group consisted of patients 65 years old or more (higher age group, HP), and the other of patients under 65 years old (lower age group, LP). We used the Kaplan-Meier methods and Cox proportional hazard models for the analysis of the cohorts with the endpoint of doubling the serum creatinine values.
    Results: There were no significant differences between HP and LP by the Kaplan-Meier methods for progression of renal failure. According to Cox monofactorial-analysis, hypoalbuminemia was determined to be a significant factor in the progression of renal failure in both HP and LP. In the Cox multifactorial-analysis, hypoalbuminemia was a independent significant factor in HP, but not in LP.
    Conclusion: Hypoalbuminemia is considered to be a significant factor in the progression of renal failure in type 2 diabetes regardless of age, and may be a more significant factor in elderly people.
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  • Kikuo Okamura, Yukihiko Washimi, Hidetoshi Endo, Haruhiko Tokuda, Yuki ...
    2005 Volume 42 Issue 5 Pages 557-563
    Published: September 25, 2005
    Released: March 02, 2011
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    Objectives: We performed a systematic review about whether high fluid intake can prevent cerebral and myocardial infarction.
    Materials and Methods: Previously published papers were searched for in PubMed using the combined terms of dehydration, hydration, water intake, fluid intake, cerebral infarction, cerebrovascular disease, apoplexy, myocardial infarction, angina pectoris, ischemic heart disease, blood viscosity and hemorheology.
    Results: Of 611 papers searched, twenty-two were selected. There was one prospective randomized study, four prospective non-randomized studies, eight epidemiologic (cohort or case-control) studies and nine retrospective descriptive studies, presenting the following points. Dehydration, which increases blood viscosity, is one of the causes of cerebral or myocardial infarction. Important factors other than dehydration can cause an increase in viscosity. Drinking water during the night can protect an increase in blood viscosity but there has been no evidence that drinking excessive amount of water prevents cerebral infarction. There was one report that the risk of myocardial infarction was lower in people drinking more than 5 glasses of water than those drinking less than 2.
    Conclusion: Since cerebral and myocardial infarction are primarily caused by atherosclerosis and atheroma plaque, it is essential to adjust life style for prophylaxis. There has been no direct evidence that decrease in viscosity due to high fluid intake can prevent cerebral infarction. Further studies regarding the relationship between fluid intake and ischemic diseases, and the appropriate fluid intake for the elderly to improve their QoL are needed.
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  • Hiroyasu Akatsu, Takayuki Yamamoto, Yusuke Suzuki, Jiro Kanie
    2005 Volume 42 Issue 5 Pages 564-566
    Published: September 25, 2005
    Released: March 02, 2011
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    We report on a 60-year old man who became bedridden after a cerebral infarction and was put on a regimen of percutaneous endoscopic gastrostomy (PEG) feedings. He developed such problems as intractable and prolonged diarrhea and leaking of nutrients from his gastric fistula, and also required frequent aspiration of his sputum. We then began treatment using half-solid nutrients. As a result, the diarrhea and leakage disappeared and the number of aspirations performed decreased.
    This patient has diabetes mellitus, with a high blood sugar level after feeding. After using half-solid nutrients, the peak became lower and appeared later, which is the same pattern seen with immuno-reactive insulin (IRI). This suggests that half-solid nutrients are useful in terms of blood sugar control.
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  • Aki Kato, Hitoshi Katayama, Hironobu Hamada, Tomoaki Nagao, Toru Kadow ...
    2005 Volume 42 Issue 5 Pages 567-570
    Published: September 25, 2005
    Released: March 02, 2011
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    An 83-year-old man was admitted with paraplegia and loss of all sensation below the level of umbilicus, with bowel and bladder dysfunction. Stage IV small cell lung cancer had been diagnosed two years ago and had received several courses of chemotherapies. A magnetic resonance imaging revealed an enhanced mass in the intramedullary spinal cord at the level of Th10-L1. Metastatic spinal tumor was diagnosed by clinical and radiological examinations. This is a rare case of small cell lung cancer with intramedullary spinal cord metastasis which caused various neurological symptoms.
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  • 2005 Volume 42 Issue 5 Pages 571-584
    Published: September 25, 2005
    Released: March 02, 2011
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