Because falls occur not only in the forward direction, but also in the lateral direction, lateral postural instability may contribute to the risk of fall accidents of community-dwelling elderly adults. The purpose of this study was to determine the relationship between lateral reach (LR) and the lateral excursion of the center of pressure (COP), and their association with self-reported fall incidences.The COP stability limits in LR were recorded using a force plate for 83 community-dwelling elderly people aged 70 years and over with reduced physical functions, who answered a questionnaire for fall incidences in the previous six months. LR was significantly correlated with bi-directional COP stability limits (r=0.57～0.70, p<0.0001). The sum of bi-directional LR was significantly correlated with that of bi-directional COP stability limits (r=0.62, p<0.0001). In the full sample (n=83), people whose LR was equal to or less than 30.1 cm are about 4 times more likely to fall (odds ratio [OR] of fall incidence = 4.15, 95% confidence interval [CI] = 1.31～15.95) than people whose LR was more than 30.1 cm. After adjustments for age, sex, and height, the OR =4.08, 95 %CI =1.11～18.05,(p<0.05).The LR test was found to be a simple and easy evaluation method for lateral balance. LR is associated with fall incidence. Thus, the LR test may be a useful clinical measure for detecting the fall risk of elderly adults.

We evaluated the influence of a twice-weekly group exercise program on visceral fat area (VFA) and plasma adiponectin (APN) in the elderly. Thirty-three community-dwelling elderly (age : 72.4±6.9 yrs) participated in a 12-week supervised, geriatric exercise training program (GET) followed by a 12-week unsupervised GET (u-GET), which included stretching, strengthening, and balance-training exercises. Participants were evaluated for physical fitness, blood glucose, HbA1c, triglyceride, cholesterol, insulin, and APN. VFA was measured by computed tomography. All measurements were taken before the GET (TR1), after 12-weeks of GET (TR2), and at the end of the u-GET (TR3). Twelve weeks of GET produced significant increases in physical function measures. Both walking speed and functional mobility values at TR3 were significantly higher than TR1 values. A significant reduction in VFA was seen at TR3 in men. APN progressively elevated from TR1 to TR3 in women. In the frail elderly, 12 weeks of GET effectively increased functional ability and APN. The beneficial effects on VFA and APN were sustained following the participation in the unsupervised setting, suggesting that the frail elderly should be encouraged to participate and maintain a resistance training routine to achieve preferable effects on both functional ability and cardiovascular risk factors.

The purpose of this study was to determine whether improved physical fitness through a new exercise program intervention including elements of Tai Chi Chuan and Kung Fu gymnastics among elderly people who have lower physical. Eighty older adults with less physical strength aged 71-89 (mean age±SD=77.3±3.9), recruited from Tsurugaya area of Sendai, participated in a 3-month randomized controlled trial, with allocation to a new exercise program or well-accepted exercise program control. Physical performance measures included the timed up and go test (TUGT), the functional reach test, a 6 min continuous walking test, and the sit-and-reach test were conducted before and after the intervention. Data were analyzed through on-treatment-analysis of variance. After training, although no significant between-groups differences were observed for all the measures, TUGT, which is recommended as a simple screening tool to identify those at risk of falling was improved in both groups following the intervention (P<0.05). The findings revealed that the new exercise program including Tai Chi Chuan and Kung Fu gymnastics element could improve physical fitness to a similar level as the well-accepted exercise program.

Objective: The utility of topotecan monotherapy for relapsed small-cell lung cancer (SCLC) after failure of amrubicin monotherapy has not been evaluated. We aimed to investigate the efficacy and safety of topotecan monotherapy in patients with relapsed SCLC after amrubicin monotherapy.Patients and Methods: We retrospectively analyzed data from 16 patients with relapsed SCLC who were treated with topotecan monotherapy after amrubicin monotherapy at our hospital.Results: The response rate, progression-free survival, and overall survival were 0%, 32.5 days (95% confidence interval [CI] = 18–51), and 112 days (95% CI = 55–267), respectively. The most common adverse events (grade ≥3) were leukopenia (31.3%) and thrombocytopenia (31.3%), followed by anemia, anorexia, edema, and lung infections.Conclusion: The efficacy of topotecan monotherapy for relapsed SCLC after amrubicin monotherapy is inconclusive. Therefore, further studies are warranted.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is useful for diagnosing mediastinal lymph node lesions. Cell blocks prepared from the needle washing fluid and flow cytometry of tissue samples are helpful in making the diagnosis, but the combination of both examinations is not routinely performed. A 77-year-old woman with fever, dyspnea, and anorexia was admitted to our hospital. Computed tomography showed enlarged mediastinal lymph nodes with calcification and left ureteral calculus; however, no focus of infection was identified. We suspected lymph node tuberculosis or malignant lymphoma, and EBUS-TBNA was performed to evaluate the mediastinal lymph node lesions. Because a cell block prepared from the needle rinse fluid was suspicious for malignant lymphoma, we changed the puncture needle from 22 G to 19 G and performed a second EBUS-TBNA. Diffuse large B-cell lymphoma (DLBCL) was diagnosed based on the results of flow cytometry of the EBUS-TBNA samples. Here we report this case of DLBCL in which mediastinal lymph node tuberculosis was suspected and cell block preparation and flow cytometry using EBUS-TBNA specimens were useful for the diagnosis.

BACKGROUND: The Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study was launched to investigate risk factors for osteoporotic fractures, interactions of osteoporosis with other non-communicable chronic diseases, and effects of fracture on QOL and mortality. METHODS: FORMEN baseline study participants (in 2007 and 2008) included 2012 community-dwelling men (aged 65-93 years) in Nara prefecture, Japan. Clinical follow-up surveys were conducted 5 and 10 years after the baseline survey, and 1539 and 906 men completed them, respectively. Supplemental mail, telephone, and visit surveys were conducted with non-participants to obtain outcome information. Survival and fracture outcomes were determined for 2006 men, with 566 deaths identified and 1233 men remaining in the cohort at 10-year follow-up. COMMENTS The baseline survey covered a wide range of bone health-related indices including bone mineral density, trabecular microarchitecture assessment, vertebral imaging for detecting vertebral fractures, and biochemical markers of bone turnover, as well as comprehensive geriatric assessment items. Follow-up surveys were conducted to obtain outcomes including osteoporotic fracture, cardiovascular diseases, initiation of long-term care, and mortality. A complete list of publications relating to the FORMEN study can be found at https://www.med.kindai.ac.jp/pubheal/FORMEN/Publications.html .
Aged ; Bone Density ; Cardiovascular Diseases/etiology* ; Cohort Studies ; Geriatric Assessment ; Humans ; Independent Living ; Japan/epidemiology* ; Long-Term Care/statistics & numerical data* ; Male ; Middle Aged ; Osteoporosis/etiology* ; Osteoporotic Fractures/etiology* ; Risk Factors