A decrease in swallowing function growth may lead to drooling and a diminished quality of life in patients with tongue cancer. Common ways to counteract drooling include a reduction of fluid intake, and the administration of anticholinergics. These actions, however, may not often suppress drooling sufficiently. Here we report how the application of the formulation of scopolamine ointment near the mastoid process behind the ear resulted in the alleviation of drooling in a tongue cancer patient, after continuous intravenous scopolamine butylbromide infusion was unsuccessful. Dry mouth was noted as an adverse event, which was not problematic. Also, the ointment could be used without local dermatitis. Scopolamine ointment is much more convenient to use than continuous injection, suggesting the improved treatment for drooling in patients with tongue cancer.

The effects of aging on adaptive force control of precision grip while manipulating a small object were compared between older (84.2±8.9 yrs, n=33) and young adults (19.1±0.24 yrs, n=18) from the following perspectives: (1) adaptation to an unfamiliar object with uncertain physical properties during 16 consecutive lifts ; (2) adaptation to an object with a non-slippery (sandpaper) surface during 12 consecutive lifts, followed by 12 consecutive lifts with a slippery (silk) surface ; and (3) adaptation to objects with different weights (0.49, 0.98, 1.96 and 2.94 N) during 24 lifts (6 consecutive lifts for each weight) .During each trial, grip and load forces were monitored. Safety margin force and slip force were evaluated from the data obtained.
The majority of older adults employed a considerably greater safety margin for an unfamiliar object in the initial trials than did young adults, while the minority of the older adults were able to adapt their safety margin force with a few trials, like the young adults. The older adults who overestimated the safety margin force, however, successfully adjusted their grip force to more optimal levels with repeated lifts, suggesting that the adaptive capability of grip force remained even at 90 years of age. The adaptation of older adults, however, was found to be slower (i. e., required more trials) than that of young adults. Upon encountering surface friction change, the safety margin forces in older adults were more strongly affected by the previous surface condition than those in the young adults. In addition, adaptation to a non-slippery surface seemed more difficult than that to a slippery surface with aging. Upon encountering weight change, older adults showed more difficulties in scaling their safety margin forces according to object weights.
Slower adaptation and difficulty in adaptation to the friction or weight change in older adults may reflect the agerelated decline of tactile sensitivity which impaired the signaling of frictional conditions and various discrete events in the hand. In addition, the lift repetition for force adaptation may possibly reflect the age-related deficit or slowing of central processing capacities related to grip force production.

We investigated the relationship between body weight reduction and intensity of daily physical activities assessed with 3-dimensional accelerometer during a 3-month exercise program. Twenty-six middle-aged women (58.1±7.4 yrs.) participated in this study. Participants underwent a 90-min endurance exercise intervention once a week, and a 3-dimensionsal accelerometer was attached through the program. Body weight (BW), body mass index, fat mass and percent body fat were reduced significantly (p<0.001), while diastolic blood pressure (p<0.01) and shuttle stamina walking test (p<0.05) improved significantly after the exercise intervention. Moreover, a significant negative correlation was observed between the changes in BW and total activity time (TAT) per day of more than 3METs (TAT≥3METs)(r=−0.580, p<0.01) and TAT≥4METs (r=−0.627, p<0.001). To the contrary, the daily steps and the TAT≥2METs were not related to the changes in BW. After adjusting daily steps, TAT≥3METs (β=−0.630, p<0.01) and TAT≥4METs (β=−0.659, p<0.01) were still significantly related to the changes in BW. These results indicate that weight reduction has a much closer relationship with exercise intensity than daily steps. It is important to keep both quantity and intensity of exercise in the unsupervised exercise program aimed at weight reduction.

Purpose: Accelerated atherosclerosis is a major complication in patients with end-stage renal disease and it plays an important role in the pathogenesis of erectile dysfunction (ED). However, the association between aortic calcification burden and the severity of ED remains unclear. The aim of the present study was to investigate this association in men undergoing dialysis. Materials and Methods: This cross-sectional study included 71 men undergoing peritoneal dialysis and/or hemodialysis between July 2016 and May 2018 at Mutsu General Hospital. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Aortic calcification index (ACI) was examined as a clinical indicator of abdominal aortic calcification. Multivariable logistic regression analysis was performed to identify the significant factors associated with severe ED. Results: The median age of the study participants was 64 years; all had ED, with 64.8% having severe ED. In the multivariable analyses, a slight association was observed between ankle-brachial index and severe ED (odds ratio [OR], 0.058; p=0.072), whereas ACI was significantly associated with severe ED (OR, 1.022; p=0.022). Conclusions Aortic calcification burden was independently associated with severe ED.

Purpose: To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis. Materials and Methods: This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated. Results: The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533–6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687–6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358–1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively). Conclusions ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.

Objective: In order to ensure the safety of nursing home residents, it is very important to implement appropriate assistance to ensure compliance with necessary medication. The purpose of this study is to identify issues and to plan solutions for medication assistance.Design: We conducted a workshop involving care workers (CWs), nurses and pharmacists together.Methods: Using the KJ method, participants extracted problems related to medication assistance and planned solutions in a mixed group of CWs, nurses and pharmacists. Questionnaire surveys were conducted for the participants before, immediately after, and 3 months after the workshop.Results: A number of important and urgent issues related to medication assistance were identified. There were differences in the recognition patterns of the importance and urgency of the issues among the three categories of participants. In addition, many possible solutions were proposed. Among these solutions, 25% had been implemented by at least two participants. More than 75 % of participants felt that their awareness of the value of cooperation in medication assistance had been improved by participating in the workshop.Conclusion: These results suggest that a workshop with a group of CWs, nurses and pharmacists in one place is a useful approach for extracting problems and planning effective solutions related to cooperation in medication assistance.

When treating finger, hand, and elbow trauma (hereinafter, surgically treated hand trauma) in self-employed farmers, it is also necessary to consider how the patient will be able to continue working in the family business. This study investigated return-to-work outcomes of self-employed farmers in the Tokachi area in Hokkaido, Japan after surgically treated hand trauma. A survey was conducted with 56 self-employed farmers (39 men and 17 women, median age 55 years). More than 80% of the farmers (n = 49) returned to their previous work, and most returned to work during the farming season while still experiencing functional impairment. Self-employed farmers with surgically treated hand trauma tend to return to work in time for the farming season regardless of the severity of functional impairment they are experiencing, and it is important for health care providers to recognize this fact and consider return-to-work support as part of the treatment plan in addition to treatment itself. Therefore, providers must understand the processes and details of tasks performed during each farming season and devise individualized measures to accommodate patients returning to work while still experiencing impairment. In cases where multiple treatments are required, such as two-stage functional reconstruction, it is also important that the treatment plan consider the farming season, for example, by having the patient temporarily return to work and then undergo surgery during the off season.