We report three elderly patients in the extended care unit who were successfully treated orally with Chotosan. Case 1 was an 84-year-old male who was hospitalized for lowered volition after aspiration pneumonia in 1999. He received nutrition through a stomach fistula. Administration of Choto-san increased his volition, and he resumed eating normally after practicing swallowing. Case 2 was a 99-year-old woman who was hospitalized for lower volition after a thighbone fracture in 2000. She also could not eat orally, and received nutrition via nasal-tube feeding. After the administration of Choto-san, she developed a will to eat, and she could again have meals orally. Case 3 was an 84-year-old woman who was hospitalized for lowered volition after aspiration pneumonia in 1999. She had pressure ulcers and was often feverish, so she was fed by nasal tube. She was treated with Choto-san, and was able to eat normally again after practicing swallowing. Her pressure ulcers were cured. This suggests that the administration of Choto-san may be successfully utilized as part of a strategy for overcoming swallowing trouble in the elderly.

We report two elderly cases in the extended care unit who were successfully treated for emitting a strange squealing sound with Sansonin-to. Case 1 was a 97-year-old female who was hospitalized with a strange squeal after repeated aspiration pneumonia. She made this strange sound especially during the night. This sound disappeared with the administration of Sansonin-to (TJ-103: 7.5g/day) except at the times of position change and diaper change, and she also became able to eat after practicing swallowing. Case 2 was an 80-year-old female who was hospitalized after a cerebral hemorrhage. She also made a strange squealing sound during the night. After administration of Sansonin-to, this sound was decreased, and she became able to sleep well at night and live actively with rehabilitation training in the daytime. With an aging society, troublesome behaviors due to dementia will be an increasing problem. These cases suggest that there may be certain conditions of elderly nighttime delirium that are treatable with Sansonin-to.

Objective: To assess the relationships between phase angle and muscle mass, strength, and physical function in patients with heart failure. Methods: This study used a cross-sectional design. The analysis included 51 patients with heart failure. The Short Physical Performance Battery, one-leg standing time, handgrip strength, phase angle, and skeletal muscle index were measured. To identify explanatory variables of phase angle, hierarchical multiple regression analysis was performed. Results: Handgrip strength was found to be an explanatory variable of phase angle independent of age, sex, and body mass index. This model was able to explain 30.4% of the model variance for phase angle. Conclusion In patients with heart failure, improving muscle strength rather than muscle mass or physical function might be more important for improving phase angle. Handgrip strength is an important outcome for improving prognosis in patients with heart failure.