We report a case of vascular parkinsonism mainly treated at the patients' home with thyrotropin-releasing hormone (TRH). The patient was a 77-year-old male who had an attack of cerebral bleeding in the left posterior lobe in 1990. Thereafter, dysarthria, dysphagia and gait disturbance gradually developed. He had rigidity in the neck, and upper and lower extremities, but no tremor, and walked with short strides (marche a petit pas). We diagnosed the case as vascular parkinsonism, by his history and those symptomes.
We treated him mainly at his home since 1994. At first, we used combinations of levodopa, bromocriptine, amantadin, and anti-chorinergic drugs, but symptomes and signs of vascular parkinsonism did not disappear.
Finally, we used TRH 0.5 mg by an intravenous or intramuscular injection for 10-14 days a month. Thereafter, he became able to eat, speak and walk a little more, and we continued this therapy for about one year. He died in 1996 of asphyxia at a meal. We think TRH was effective for chronic stage of vascular parkinsonism even if treated at home.

  In Brunei Darussalam, obesity and diabetes mellitus are serious national health challenges, and there is an urgent, nationwide need to develop measures against these diseases. This project provides training in various efforts unique to Japan aimed at preventing lifestyle-related diseases mainly through specific medical check-ups and health guidance. The objective of this project is to form a basis for introducing a Japanese-style system in Brunei Darussalam.  In this training program, the Bruneian staff learned specific medical check-ups, strategies for applying the results of these check-ups, actual and detailed contents of the specific counselling guidance, and so forth. We can reasonably expect that implementation of these practices and the skills acquired in Brunei will enable the Bruneian staff to more effectively prevent and control diabetes and obesity.  Moreover, this project not only contributes to health promotion for Bruneian citizens, but can also be expected to have a spillover effect on neighboring Muslim countries with similar problems (e.g., Malaysia and Indonesia). The prevalence of obesity and diabetes mellitus is increasing globally in both developed and developing countries, and preventive measures are urgently needed worldwide. It seems that recognition and introduction of the efforts made in Japan are extremely meaningful and important for solving international issues.

BACKGROUND: Slow-motion training, an exercise marked by extremely slow movements, yields a training effect like that of a highly intense training, even when the applied load is small. This study evaluated the effects of low-intensity bodyweight training with slow movement on motor function in frail, elderly patients. METHODS: Ninety-seven elderly men and women aged 65 years or older, whose level of nursing care was classified as either support required (1 and 2) or long-term care required (care level 1 and 2), volunteered to participate. Two facilities were used. Participants in the first facility used low-intensity bodyweight training with slow movement (the LST group, n = 65), and participants in another facility used machine training (the control group, n = 31). Exercises were conducted for 3 months, once or twice a week, depending on the required level of nursing care. Changes in motor function were examined. RESULTS: Post-exercise measurements showed significant improvements from the pre-exercise levels after 3 months, based on the results of the Timed Up and Go test (p = 0.0263) and chair-stand test (p = 0.0016) in the low-intensity exercise with slow movement and tonic force generation (LST) group. Although the ability to stand on one leg with eyes open tended to improve, no significant change was found (p = 0.0964). CONCLUSIONS: We confirmed that carrying out LST bodyweight training for 3 months led to improvements in ambulatory function and lower-limb muscle strength. In this way, it is possible that LST training performed by holding a bar or by staying seated on a chair contributes to improved motor function in elderly patients within a short time. TRIAL REGISTRATION UMIN000030853 . Registered 17 January 2018. (retrospectively registered).
Aged ; Aged, 80 and over ; Female ; Frail Elderly ; Humans ; Long-Term Care ; Male ; Motor Activity ; Movement ; Prospective Studies ; Resistance Training ; methods

BACKGROUND: The number of adults aged over 65 years is rapidly increasing in several Southeast Asian countries. Muscle mass decreases with age, leading to sarcopenia. The primary objective of this study was to determine whether differences exist in the body composition and physical strength, according to ethnicity, among community-dwelling Japanese and Thai older adults living in Chiang Mai Province, Thailand. METHODS: A survey was conducted in February and March 2019. Japanese and Thai adults aged ≥ 60 years living in Chiang Mai Province were recruited through community clubs. Participants completed a self-administered questionnaire that enabled collection of data on age, sex, educational background, marital status, annual income, current medical conditions, smoking and alcohol consumption, and exercise habits. Measurements were collected on height, weight, body composition, blood pressure, hand grip, and walking speed for 6 m. Body composition was measured using a standing-posture 8-electrode multifrequency bioimpedance analysis analyzer. Hand grip of each hand was measured with the patient in the standing position using a digital grip dynamometer. Multivariable logistic regression was used to determine factors associated with skeletal muscle mass index (SMI). RESULTS: Of the total 119 participants, 47 were Japanese (26 men, 21 women) and 72 were Thai (16 men, 56 women). The prevalence of a low SMI was 3/26 (12%), 1/21 (5%), 6/16 (38%), and 5/56 (9%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. The prevalence of low muscle strength was 2/26 (8%), 2/21 (10%), 3/16 (19%), and 13/56 (23%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. There were significant differences between ethnic groups in body mass index for both sexes, percentage body fat in women, SMI in men, and average grip strength in men. Ethnic group, sex, age, and body mass index were independent predictors of SMI. CONCLUSIONS Ethnicity had a clinically important effect on body composition and physical strength among older Japanese and Thai adults living in a similar environment.
Aged ; Aging/physiology* ; Asians/ethnology* ; Body Composition ; Body Mass Index ; Cross-Sectional Studies ; Electric Impedance ; Ethnicity ; Female ; Hand Strength ; Humans ; Independent Living ; Male ; Middle Aged ; Muscle Strength ; Thailand/ethnology* ; Walking Speed