We have already reported that the levels of TIMP-1 (Tissue inhibitor of metalloproteinase) in saliva and Zn²⁺ in serum were significantly lower in patients with taste disorder than in healthy subjects. This decrease in the level of TIMP-1 was often accompanied by a decrease of zinc in serum. In this study, to test whether administration of zinc is effective in the taste disorder and to establish a method for diagnosis, we have measured and compared TIMP-1 level in saliva before and after treatment for patients with taste disorder. Seven patients (aged 52-82 years) who presented with hypoguesia or loss of taste and were suspected of having zinc deficiency were selected. In these patients, saliva which was secreted by stimulation for 5 minutes was collected and its supernatant was used as the sample to determine TIMP-1 level by Sandwich-Enzyme-Immunoassay (Sandwich EIA) system. The level of TIMP-1 was 130.7±S .D. 57.4ng/ml before treatment and 192.2±S.D. 42.6 ng/ml after treatment (resolution of symptoms), showing a significant difference (p<0.01). These results indicate that taste disorder due to zinc deficiency (including latent zinc deficiency) was related to the decrease of TIMP-1 level in saliva and this was improved by the treatment with zinc administration. Improved symptoms were confirmed by the gustatory test.

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In present-day Japan, discussion of nutritional management tends to be focused on overnutrition, which is commonly associated with diabetes mellitus, obesity, hyperlipidemia and other disorders. On the other hand, the risk of undernutrition in the frail elderly should not be neglected.
The purpose of this study is to evaluate the relationship of the oral, cognitive and physical functions to the nutritional status in the frail elderly, since these functions might be involved in the undernutrition of frail elderly peopleliving in nursing homes for the aged. The subjects were 145 frail elderly people with an average age of 83.2±8 (29 men with an average age of 79.5±8.4 and 116 women with an average age of 84.1±7.7), living in three nursing homes for the aged.
The body mass index (kg/m²) (BMI) was employed as the nutritional parameter. The diet at the homes were examined. Activities of daily living (ADL) and the cognitive function were evaluated.
The occlusal support area and swallowing functions were evaluated.
The results of this study are as follows:
The BMI of the subjects averaged 19.1±3.6 (kg/m²). As the diet changed toward soft diets, the BMI decreased (p<0.01). As the ADL declined, the BMI tended to decrease. The BMI decreased in proportion to the seriousness of dementia (p<0.01). No relationship wasnoticed between the occlusal support area and the BMI. The BMI decreased in proportion to the decline in the swallowing function (p<0.01). This study revealed that the cognitive and physical functionsinfluenced the nutritional status of the frail elderly. Although no relationship of the occlusal support area and dentures to the nutritional status was noted, the study suggested that the swallowing function was strongly related to the nutritional status.
We conclude that due attention should be paid to the whole oral function including deglutition as well as mastication, when one considers improving the nutritional status of the frail elderly.

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The number of complete denture wearers will increase with the increase in the number of elderly persons. Long-term use of ill-fitting dentures causes mechanical injury and deformation of the basal seat mucosa. Tissue conditioners are used to restore the deformed unhealthy basal seat mucosa and to return it to the nomal position by distributing the load applied at mastication. The compliance of these materials after gelation influences their efficacy. The purpose of this study was to compare compliance and the changes with time after gelation using a penetration test. Eight commercial tissue conditioners (Visco-Gel (VG), COE-Comfort (CC), Hydro-Cast (HC), Fitt (F), Soft-Liner (SL), Shofu Tissue Conditioner (STC), Bosworth Trusoft (BT) and Bosworth Softone (BS)) were used in this study. The depth of penetration at two hours after mixing, and the depth of penetration at seven days of each material were measured by a penetrometer. The order of depth of penetration at two hours was: VG (1.15±0.05mm), BT (1.17±0.09mm), F (1.22±0.09mm), SL (1.23±0.14mm), STC (1.69±0.16mm), BS (2.01±0.09mm), HC (3.00±0mm) and CC (3.00±0mm). The order of depth of penetration at seven days was: F (0.80±0.05mm), VG (0.98±0.08mm), SL (0.99±0.08mm), BT (1.05±0.03mm), STC (1.21±0.05mm), BS (1.32±0.02mm), HC (1.82±0.20mm) and CC (2.83±0.09mm). The differences among materials were significant, except for VG, BT, F and SL of the depth of penetration at two hours, and HC and CC of the depth of penetration at two hours, VG, SL and BT of the depth of penetration at seven days, and STC and BS of the depth of penetration at seven days (p<0.05) (ANOVA and Tukey's method).

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[in Japanese]

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Radical operation has been more frequently applied to elderly patients with oral cancer, as a rezult of recent development in medical treatment In general, informed consent is important for patients to choose their treatment, but in Japan elderly patients with cancer have not usually been informed of their diagnosis. We studied elderly patients with oral cancer clinically, with special reference to the current trend of informed consent including cancer disclosure.
The subjects of this study were 16 patients over 75 with oral cancer who were treated at our hospital between 2000 and 2002. Most of them had rather advanced cancer of stage III-IV. Fourteen of the 16 patients had some associated diseases, such as dimentia, hypertension, heart disease, cerebral infarction, lung disease, kidney disease, and rheumatism. Performance status (PS) was 0-1 in 6 patients, and 2-3 in 10 patients.
50% of the patients older than 75 years were informed of their diagnosis, while the disclosure rate for those younger than 75 years was 90.5%. The reasons for non-disclosure were mental disturbance by dimentia in 2 patients and patient's request in one, while in 5 patients cancer was not disclosed because of their advanced age, advanced stage, family's preference, or the former doctor's policy.
Surgery was performed in 10 patients, radiotherapy in 1, and chemotherapy in 1. Four patients did not undergo any therapy because of their highly advanced stage, poor general condition, or of their family's refusal. Seven of 10 patients who underwent surgery survived in good health and recovered to the level of preoperative ADL, although 1 patient died of neck metastasis, 1 of distant metastasis, and 1 was not followed up.

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