Low well-being is an independent predictor for stroke in elderly patients with diabetes mellitus.

Objectives: To examine whether psychological factors are risk factors for the development of stroke in elderly diabetic patients.

Design: Prospective cohort study.

Setting: Outpatient clinic.

Hypermethylation of the hMLH1 promoter with absent hMLH1 expression in medullary-type poorly differentiated colorectal adenocarcinoma in the elderly.

To clarify the significance of hMLH1 promoter hypermethylation in the development of medullary-type poorly differentiated colorectal adenocarcinoma, we studied the status of promoter methylation and hMLH1 expression in 23 medullary-type and 12 pleomorphic-type carcinomas, as well as the pathology and microsatellite status. In medullary-type carcinomas, the percentages of cases with promoter methylation (83%) and an absence of hMLH1 expression (91%) were significantly higher than in pleomorphic-type carcinomas (14 and 17%), respectively. The rate of microsatellite instability in the medullary type was significantly higher than that of the pleomorphic type (87 vs 40%, P<0.

A clinical study of idiopathic pulmonary fibrosis based on autopsy studies in elderly patients.

Objectives: The prevalence of idiopathic pulmonary fibrosis (IPF) tends to be greater in the elderly although the precise outcome is not known. The present study investigated the outcome of IPF in elderly patients whose pathological diagnosis corresponded to usual interstitial pneumonia (UIP) on autopsy findings.

Methods: In a consecutive autopsy series, (n = 4,554 cases), complete information was obtained in 86 cases in which the clinical and pathological diagnosis was IPF and UIP, respectively.

Age-related mitochondrial DNA deletion in human heart: its relationship with cardiovascular diseases.

Background And Aims: Accumulation of damage to mitochondrial DNA (mtDNA) occurs in myocardial tissue with advancing age. However, despite higher incidence of cardiac diseases in the elderly, little attempt has been made to detect deletions of mtDNA in the myocardial tissue of aged individuals. The aim of the present study was to clarify the relationship between aging, mtDNA deletion and cardiovascular (CV) diseases.

Association of natural tooth loss with genetic variation at the human matrix Gla protein locus in elderly women.

Natural tooth loss represents a major medical issue within the elderly population, since it impairs masticatory function critical for oral intake of essential nutrition. Contribution of genetic factors has been implicated in the determination of natural tooth loss; degree of reduction in number of natural teeth remaining intact (NTI) varies among individuals; thus, heterogeneity in NTI might reflect genetic variation within the population. One candidate gene, the matrix Gla protein gene (MGP), has been implicated in the pathogenesis of bone loss through a repression of bone/tooth formation.

[An elderly case of non-Hodgkin's lymphoma (NHL) with hypercalcemia].

A 93 year-old woman was admitted due to anorexia and unconsciousness. Biochemical examination of serum showed hypercalcemia (corrected Ca; 16.6 mg/dl).

[Pathogenesis of osteoporosis--overview].

Pathogenesis of osteoporosis was overviewed from standpoints of individual level, organ level and cellular level, respectively. As for the individual level, it is important to discriminate the pathogenetic factors related to low BMD or fractures. Independent from BMD, age, previous fractures, bone geometry, microstructure of the bone are related to fractures by influencing the bone quality.

A comparison of bone mineral density in elderly female patients with COPD and bronchial asthma.

Background: A recent study has shown that osteoporosis and vertebral fractures are quite common in patients with advanced COPD and showed a significant relationship to the mortality of these patients. These results suggested that management of osteoporosis in advanced COPD is an important intervention. But whether patients with COPD who had never received chronic systemic corticosteroids have a high incidence of osteoporosis and whether these patients require treatment strategies to decrease osteoporotic fracture is not yet known.

[Usefulness of cardiac troponin I in patients with acute myocardial infarction].

Cardiac troponin(cTn) is a sensitive marker for acute myocardial infarction(AMI). However, some cases of renal failure have been reported to show false positive results for cardiac troponin T(cTnT). Recently, it has been reported that heart-type fatty acid-binding protein(H-FABP) is a sensitive marker for AMI in the early phase.

[Comprehensive geriatric assessment and treatment of elderly diabetic patients].

Because of diversities of physical, mental, and psychological functions as well as clinical and social backgrounds, comprehensive geriatric assessment (CGA) is of great importance in treating elderly diabetic patients. We addressed three issues as to functions important for the CGA. First, we assessed several domains of cognitive function in 213 elderly diabetic patients.

[An epidemic of rotavirus infection in a nursing home for the elderly in Japan].

An outbreak of diarrheal disease in a Japanese home for aged is reported. Out of 202 residents, 47 cases complained of diarrhea (23.3%) during a month.

[A case of infected bulla caused by Mycobacterium gordonae].

A 65-year-old man was admitted to Tokyo Metropolitan Geriatric Medical Center because of dyspnea on effort, loss of appetite and general fatigue. Chest radiography on admission showed niveau formation in, and infiltration around, the bulla. Percutaneous drainage of the intrabullous fluid was performed and Mycobacterium gordonae was repeatedly cultured from it.

[Therapeutic application for the aged with CML].

Therapeutic application for elderly CML patients had been restricted to use of alkylating or antimetabolite agents. In order to improve quality of life in the aged with CML interferon-alpha therapy is now first choice for treatment of elderly chronic phase of CML patients under appropriate informed consent. This treatment provided long term survival with cytological and cytogenetic responses even in the aged.

New insights into the thrombopoietic status of patients on dialysis through the evaluation of megakaryocytopoiesis in bone marrow and of endogenous thrombopoietin levels.

The thrombopoietic status of patients with uremia remains unclear. This issue was addressed with particular reference to marrow megakaryocytopoiesis and endogenous thrombopoietin (TPO) levels. A study was conducted in 114 patients on hemodialysis, 43 patients on continuous ambulatory peritoneal dialysis, and 48 age-matched controls.

[Clinical study on penicillin insusceptible/resistant Streptococcus pneumoniae in the elderly patients].

Clinical features of respiratory infection in the elderly with penicillin insusceptible (31 cases) and resistant (7 cases) Streptococcus pneumonia (PSSP/PRSP) are compared to those with penicillin sensitive S. pneumoniae (PSSP) (29 cases). Incidence of bacteremia and pneumonia was higher in the PSSP group.

Elevated serum interleukin-6 in POEMS syndrome reflects the activity of the disease.

In patients with POEMS syndrome, which often accompanies plasma cell dyscrasia, the roles of interleukin-6 (IL-6) and other acute phase cytokines are unknown. Serum IL-6, interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) were measured by the enzyme-linked immunosorbent assay technique in 16 patients with POEMS syndrome and in patients with other neurological diseases (OND) as control. Serum IL-6 was more frequently detected and higher in active POEMS than in stable POEMS or in OND patients.

[Adult-onset dementia with abundant neurofibrillary tangles resembling progressive supranuclear palsy].

We described an autopsy case of 79-year-old woman with clinically unclassified senile dementia. The patient developed forgetfulness at the age of 73, and later, persecution mania, apathy and episodic stupor, but no extrapyramidal symptoms. Neuropathological examination revealed severe neuronal loss and gliosis of substantia nigra, moderate neuronal loss and marked grumose degeneration of dentate nucleus, and mild astrocytosis of subthalamic nucleus.

Double mutations at codon 180 and codon 232 of the PRNP gene in an apparently sporadic case of Creutzfeldt-Jakob disease.

Several polymorphisms of the prion protein gene are associated with the occurrence of familial Creutzfeldt-Jakob disease. We described a 84-year-old Japanese man with neuropathologically verified Creutzfeldt-Jakob disease of apparently sporadic type. His clinical presentation was atypical in point of a very late age at onset and absence of periodic synchronous discharge on electroencephalography.

Administration of elastase blocks the formation of fragmented elastic fibers in aorta of rabbit.

Fragmented elastic fibers are known to be associated with atherosclerotic lesions, angitis and age-related changes of the vessel wall. We produced fragmented elastic fibers in the thoracic aorta by immunizing rabbits with elastin peptides. Fragmented elastic fibers in the media were associated with degenerative smooth muscle cells, and the number of fine elastic fibers beneath the endothelium was decreased.