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Predecessor
Volume 43, Issue 2
Displaying 1-28 of 28 articles from this issue
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Hiromi Sanada2006 Volume 43 Issue 2 Pages 137-146
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
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Tomohiko Urano2006 Volume 43 Issue 2 Pages 147-151
Published: March 25, 2006
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Masayasu Matsumoto2006 Volume 43 Issue 2 Pages 152-154
Published: March 25, 2006
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Kazuhiko Koike2006 Volume 43 Issue 2 Pages 155-157
Published: March 25, 2006
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Akira Ueki2006 Volume 43 Issue 2 Pages 158-160
Published: March 25, 2006
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Shinichi Hitumoto2006 Volume 43 Issue 2 Pages 161-162
Published: March 25, 2006
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Machiko Sahara2006 Volume 43 Issue 2 Pages 163-165
Published: March 25, 2006
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from the standpoint of a community hospitalYusuke Mon2006 Volume 43 Issue 2 Pages 166-168
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSOur hospital receives elderly patients who are disabled and have dementia, dysphagia, infectious diseases, and/or decubitus from acute hospitals. We treat, rehabilitate, and return those patients to their home. For this purpose we have many rehabilitation staff and several teams such as a nutrition support team, an infection control team, and a decubitus control team. Hospitals treating acute conditions do not have enough rehabilitation staff, and frail elderly patients tend to suffer a decrease in their activities of daily living. Therefore a close relationship between hospitals treating acute conditions and rehabilitation hospitals is important to avoid disuse syndrome. We also treat in-home patients. Those patients are often more disabled and financially burdened than in previous years. Therefore they need more help from the medical and social welfare system of Japan.View full abstractDownload PDF (988K) -
Hiroyuki Tsutsui2006 Volume 43 Issue 2 Pages 169-171
Published: March 25, 2006
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Takeshi Yamashita2006 Volume 43 Issue 2 Pages 172-174
Published: March 25, 2006
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Jun Takata, Yoshinori Doi2006 Volume 43 Issue 2 Pages 175-178
Published: March 25, 2006
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Kenichi Nakahara2006 Volume 43 Issue 2 Pages 179-181
Published: March 25, 2006
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Masaharu Nakajima2006 Volume 43 Issue 2 Pages 182-183
Published: March 25, 2006
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Hiroshi Nomura2006 Volume 43 Issue 2 Pages 184-186
Published: March 25, 2006
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Hiroshi Nonaka2006 Volume 43 Issue 2 Pages 187-189
Published: March 25, 2006
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From the perspective of health economics and policyRyu Niki2006 Volume 43 Issue 2 Pages 190-192
Published: March 25, 2006
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Shigeto Morimoto2006 Volume 43 Issue 2 Pages 193-196
Published: March 25, 2006
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Hidenori Arai2006 Volume 43 Issue 2 Pages 197-199
Published: March 25, 2006
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Shinji Teramoto2006 Volume 43 Issue 2 Pages 200-202
Published: March 25, 2006
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Jiro Okochi2006 Volume 43 Issue 2 Pages 203-206
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAim: This study aims to describe the factors that must be considered for the construction of guidelines to prevent disability of the elderly.
Method: All community-dwelling residents aged 65 and over and without functional decline (n=1, 560) were assessed in 1996 and were followed annually until 2002. The prevalence and incidence of low to severe disability, and their association with chronic conditions present at the commencement of the study, was analyzed.
Result: An increase of mild functional decline was more prevalent than severe functional decline. The accumulation of mild disability was more prominent in women. The major chronic conditions associated with mild disability were chronic arthritis and diabetes in women, and cerebrovascular accident and malignancy in men.
Conclusions: The process of functional decline, gender and the endpoint outcome level must be taken into account on the development of preventive guideline for elderly disability.View full abstractDownload PDF (1074K) -
Hajime Takechi, Hiroko Yamada, Yuriko Sugihara, Toru Kita2006 Volume 43 Issue 2 Pages 207-216
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAim: The relationships among behavioral and psychological symptoms of dementia (BPSD), cognitive impairment of Alzheimer's disease (AD) patients and the caregiver burden of their caregivers were investigated in an outpatient memory clinic.
Methods: Forty-six pairs of AD patients and their family caregivers were involved in this study. Neuropsychiatry Inventory (NPI) was used to estimate BPSD, to which memory symptoms were added as a subcategory of BPSD. MMSE, word fluency, clock drawing test and category-cued memory test were used for cognitive measurement. Zarit burden interview (ZBI) and CES-D were used to assess caregiver burden.
Results: Among 11 BPSD subcategories, memory symptoms, apathy, depression, delusion, aggression and anxiety were prevalent. BPSD was a strong determinant of caregiver burden. Among BPSD symptoms, anxiety, aggression and aberrant motor behavior were significantly related to ZBI. In terms of the relationship between BPSD and cognitive impairment, the scores for delusion and apathy were significantly related to the cognitive decline. On the other hand, patients who showed symptoms related to memory and depression had higher cognitive function than those who did not.
Conclusion: These analyses will contribute to better assessment of AD patients and their caregivers, hopefully resulting in better support for them.View full abstractDownload PDF (1593K) -
Ichiro Wakabayashi, Hirosi Masuda2006 Volume 43 Issue 2 Pages 217-221
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAbstract: Aim: A new indicator of arterial stiffness, cardio-ankle vascular index (CAVI), has recently been developed, instead of conventional pulse wave velocity. CAVI is proposed as a blood pressure-independent indicator of atherosclerosis, however, there have been few studies on the association of CAVI with atherosclerosis. The purpose of this study was to investigate effects of age on the relationship between CAVI and atherosclerotic risk in patients with diabetes mellitus.
Methods: The relationship between CAVI and atherosclerotic risk was investigated in 105 subjects with type 2 diabetes mellitus (mean age, 65.1 years old). The mean intima-media thickness (IMT) of the carotid artery was used as an indicator of atherosclerotic progression.
Results: In 55.2% of the subjects, CAVI was abnormally high (≥9.0). In simple regression analysis, CAVI showed significant correlations with age, duration of diabetes and IMT. In logistic regression analysis, crude odds of abnormally high values of CAVI were significant for highest versus lowest tertile groups of mean arterial pressure (MAP) and IMT. Age-and sex-adjusted odds of abnormally high values of CAVI were significant for highest versus lowest tertile groups of mean arterial pressure (MAP) and serum total cholesterol. In multiple regression analysis, CAVI showed significant correlation with IMT independently of MAP but not independently of age, while the significant correlation of ankle-brachial pressure index (ABPI) with IMT was independent of age, sex and MAP.
Conclusions: CAVI reflects atherosclerotic risk and the relationship between CAVI and atherosclerotic progression is strongly confounded by age. Thus, age should be taken into account when CAVI is used as an indicator of atherosclerotic progression.View full abstractDownload PDF (788K) -
Kaori Ohno, Hiroshi Mikami, Yoji Takagi2006 Volume 43 Issue 2 Pages 222-229
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAim: This study was conducted to evaluate the nutrient intake and the nutritional state of elderly people who live independently in a region with an aging rate (percentage of the elderly 65 or above to the entire population) of 50% and to develop guidelines for nutritional improvement to extend the healthy lifespan in the upcoming ultra-aged society in which, by definition, aging rate exceeds 21%.
Methods: The study investigated the diet, physical constitution and blood biochemistry of 38 elderly people living in a region with an aging rate of 50% and compared the results with 23 elderly people living in a region with an aging rate of 18%.
Results: In the ultra-aged region the elderly people had a tendency for serum, triglyceride to be high and calcium to be low. The rate of the elderly living alone was high and the solitary elderly tended to have poor intake of vegetable fats, albumin, iron and zinc. The elderly men in the ultra-aged region had the lowest rate of recommended dietary intakes of calcium and vitamin B1.
Conclusions: The results indicated that extending a healthy lifespan in an ultra-aged society requires less intake of animal fats and more intake of vitamin B1 and calcium and a close assessment of the nutritional state of zinc, iron, and selenium. In order to prevent lifestyle-related diseases and to extend healthy life expectancy, the nutrition management of the elderly living alone is particularly important.View full abstractDownload PDF (1273K) -
Makoto Tanaka, Masayuki Yokode2006 Volume 43 Issue 2 Pages 230-235
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAim and methods: To provide quality medical service in a society with many elderly, university hospitals should clearly define their roles and contribute to the establishment of an integrated, comprehensive medical system. In this study, we conducted a questionnaire survey of doctors working at Kyoto University Hospital and at private practices in Kyoto about their attitude toward collaboration between the university hospital and private practices and asked their opinions on the role of university hospitals in the local medical community.
Results: The survey showed that doctors both at the university hospital and in private practice regarded close collaboration as important, but also highlighted obstacles and problems that block collaboration.
Conclusion: Overcoming these problems and constructing collaboration models will be a key for university hospitals to fully contribute to the establishment of a quality medical system.View full abstractDownload PDF (886K) -
Masayuki Kikukawa, Kaori Miyazaki, Akihiro Kiuchi, Shine Abe, Hiroko F ...2006 Volume 43 Issue 2 Pages 236-240
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAim: We examined the efficacy and adverse effects of rituximab with CHOP (cyclophosphamide, doxorubicin, vincristin, prednisone) or THP-COP (pirarubicin, cyclophosphamide, vincristin, prednisone) in previously untreated old-old and extremely old patients with diffuse large B cell lymphoma (DLBCL).
Methods: Subjects were 13 initial DLBCL patients consisting of 7 men and 8 women with a median age of 79 years (range 75-91 years). These patients received CHOP or THP-COP plus 375mg/m2 rituximab intravenously given on the day before each cycle. The dose was adjusted depending on the patient's age and associated complications. Administration was performed for 6 to 8 cycles, whenever possible.
Results: Seven patients (54%) achieved a complete response (CR), 4 (31%) achieved a partial response (PR), 2 (15%) failed to respond. The 2-year survival rates were 62%. The CR rate and survival rate were higher than in patients previously treated with CHOP alone in our hospital, but there was no statistically significant difference.
The most frequent adverse effect was bone marrow suppression, observed in 9 patients (69.2%). Adverse effects that seemed to be infusion reaction occurred in 4 patients (30.7%). These adverse effects related to infusion reaction disappeared by reducing or stopping rituximab. Four (30.7%) patients died and 3 of those died due to disease progression. One of those died 1.5 month after he began chemotherapy and the cause of death was unknown.
Conclusion: This result suggested that both CHOP and THP-COP combined with rituximab were safe and effective for old-old and extremely old patients.View full abstractDownload PDF (1977K) -
Hiroaki Fujita, Taizo Shiomi, Kazumi Arahata, Hideaki Ishibashi2006 Volume 43 Issue 2 Pages 241-245
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAim: To clarify the relationship between ADL and motor functions in 44 community-dwelling elderly patients with hip fracture.
Methods: The questionnaire comprised items on BADL, IADL, ability to walk, and certification for long-term care. The assessment of motor functions included grip strength, knee extension strength, 10m walking time, TUG, FRT, and Romberg rate and shift length of the center of gravity measured by a stabilometer. Based on these tests, relationships between the motor functions and ADL were evaluated in elderly patients after hip fracture.
Results: Significant correlations were found between BADL and grip strength, knee extension strength, and FRT. As for IADL, significant correlations were found with grip strength, knee extension strength, 10-m walking speed, TUG, FRT, and MMSE items. Similarly, regarding ability to walk and the certification of long-term care, significant correlations were shown with grip strength, knee extension strength, 10m walking speed, and MMSE items.
Conclusion: The relationships between ADL and motor functions were confirmed in community-dwelling elderly patients with hip fracture. The parameters related to muscle strength and balance ability that were assessed in this study are those that can be improved through constant training after discharge from hospital. The validity of these parameters as the indices for future intervention studies to assess the maintenance and improvement of ADL after discharge and prognosis was indicated.View full abstractDownload PDF (813K) -
Hiroshi Murai, Shigeto Morimoto, Isao Ohashi, Kohya Okaishi, Hiroshi T ...2006 Volume 43 Issue 2 Pages 246-251
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 98-year-old woman was admitted to our hospital complaining of anorexia, epigastralgia, and vomiting. An elastic hard tumor was palpable in her epigastric region. CT and US examination revealed a huge cystic lesion adjacent to the left lobe of the liver and the stomach. Her serum levels of CEA (13.6ng/ml), CA19-9 (95U/ml) and CA125 (99U/ml) were high. She suffered from aspiration pneumonia on the 10th day of admission, which progressed to acute respiratory distress syndrome. On the 20th day of admission, the epigastric tumor suddenly disappeared. She passed away on the 31st day due to respiratory failure. Autopsy revealed that she had a ruptured pancreatic anaplastic mucinous cystadenocarcinoma. To the best of our knowledge, this is the oldest reported case of ruptured pancreatic cystadenocarcinoma in the world.View full abstractDownload PDF (2871K) -
2006 Volume 43 Issue 2 Pages 252-263
Published: March 25, 2006
Released on J-STAGE: March 02, 2011
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