Purpose : This study aimed to explore the factors which interfere with advance decision-making with regards to artificial hydration and nutrition (AHN) in the senescent population.
Methods : Subjects were local residents aged 60 years or older who were leading an independent life and who could go out by themselves. A cross-sectional study using a self-administered questionnaire was conducted from August to November 2011. Valid responses were obtained from 116 subjects, for a valid response rate of 90.6%. Advance AHN decisions, knowledge about AHN, intentions regarding advance directives and end-of-life care, experience providing long-term care, in addition to other questions, were analyzed using a multiple logistic regression model.
Results : With respect to advance decisions regarding AHN, 25 respondents (21.6%) indicated that they could not make a decision, while 91 respondents (78.4%) could. Sixteen respondents (13.8%) desired some component of AHN, while 75 respondents (64.7%) did not desire any AHN. Factors related to difficulty with advance decisions regarding AHN were : 1) lack of adverse experiences associated with decreased cognitive function (“experience of failure”) (OR=12.0, 95%CI=1.42-100.41, p<.022), 2) lack of experience providing long-term care for a family member (“experience of caring”) (OR=3.0, 95%CI=1.04-8.53, p<.042), and 3) desire to defer such decisions to others in the event of unconsciousness or other incompetency rather than an advance decision (“reliance on others”) (OR=5.6, 95%CI=1.95-16.24, p<.001).
Conclusion : Factors related to difficulty with advance decisions regarding AHN in the senescent population were lack of adverse experiences associated with decreased cognitive function, lack of experience providing long-term care for a family member, and desire to defer such decisions to others in the event of unconsciousness or other incompetency rather than an advance decision.

The purpose of this study was to determine sway characteristics of a supported leg during a lateral stepping over obstacle task with different obstacle height and movement patterns, using a small triaxial accelerometer. We examined 20 healthy young adults to assess their trochanter malleolar distance traveled during a lateral stepping over obstacle task with obstacle heights of 30%, 50%, and 70%. The lateral stepping over tasks revealed flexion and extension patterns. We directed the subjects to grasp a forward handrail, perform the lateral step, and subsequently step over to the side. We calculated synthetic acceleration (SA) from acceleration data measured using two small triaxial accelerometers and two web cameras. We calculated supporting leg sway; RMS phases of X-, Y-, and Z-axes; and SA data. The subjects showed increased RMS of Y-axis and SA according to the obstacle height for the flexion pattern; however, they did not show change in RMS of Y-axis and SA according to the obstacle height for the extension pattern. During lateral stepping over, the RMS of Y-axis and SA for the flexion pattern were higher than for the extension pattern. The findings for the flexion pattern suggest that the center of gravity shifts higher according to increased obstacle height; consequently, the supporting leg becomes unstable. The findings for the extension pattern suggest that the “screw-home” rotation effect of the supporting leg during movement can support lateral stepping over better than the flexion pattern.

Intermittent cold blood cardioplegia with retrograde coronary perfusion was demonstrated in 11 CABG cases and the effects of myocardial protections were compared with 11 cases of antegrade perfusion. We evaluated the effects from the assistant perfusion time after aortic declamping, the incidence of occurrence of spontaneous beating, the dose of catecholamin required after CPB, and the changes in myocardial enzyme values. The two groups were similar in age, ejection fractions, and the extent of coronary artery disease. There were no cases of death and no PMI in all 22 cases, and the mean number of grafts and aortic clamping time were similar in the two groups. Concerning the effects of myocardial protections, there were no significant differences in any items in the two groups. We conclude that intermittent cold blood cardioplegia with retrograde coronary perfusion provides the same myocardial protective effects as the antegrade perfusion in CABG cases.

Two patients with spondylosis deformans and three patients with psychosomatic disease were treated by partial bathing with artificial spring of sodium sulfate. Fifteen minutes a day of bathing in artificial spring water prepared by dissolving 1000mg of sodium sulfate into 1 liter of 38°C-tap water was continued for one month.
Based on the findings on thermography, temperature changes were classified into four types. Correlation was found in three types as follows: p<0.01 in the crossing type, p<0.01 in the converging type, p<0.001 and p<0.05 in the ascending type. No correlation was found in the diffusing type. Plethysmography revealed a significant difference in the converging type and also a difference of p<0.01 in the diffusing type. MCV disclosed a slower change in temperature on the affected side than on the normal side. Blood gas analysis revealed a slight increase in PO₂, SATO₂ after one month of bathing. Subjective symptoms were improved from point 9 to point 3 to 4 on the VAS scale. Numbness changed from the trembling stage to the slightly smarting sensation stage. Psychroesthesia disappeared from all patients.
A combination of nerve block therapy and warm bath cure with sodium sulfate brought good therapeutic results in patients with chronic pain including psychosomatic disease.