A study was conducted to determine the effect of aging on motor ability and to establish a test battery for physical fitness in the elderly. The subjects were 150 men aged 18 to 83 years. The test items examined were selected, according to Fleishman's list of motor abilities; (1) trunk flexion, (2) grip and isometric knee extension strength, (3) postural sway with eyes open and closed, (4) step test, (5) walking test at preferred and maximum speeds, (6) simple visual reaction time, (7) peg-board test, (8) finger tapping test at maximum rate and in time to metronome sounds. Performances for the test items, except for preferred walking speed and coefficient of variation in finger tapping at 5 Hz, showed significant decreases with aging. The decrease in motor performance at age 80 years relative to the level at age 20 years was less than 30% for finger dexterity and reaction time, 40-60% for muscle strength, maximum walking speed and the step test, and over 70% for trunk flexion and postural sway with eyes closed. A test battery composed of trunk flexion, grip strength, knee extension, step test, walking as fast as possible, postural sway with eyes closed, and finger tapping, is therefore recommended for assessing the effect of aging on physical fitness.

A motor performance test was administered to elderly adults in Koganei City and Nangai Village of Japan as the baseline study of Tokyo Metropolitan Institute of Gerontology, Longitudinal Interdisciplinary Study on Aging (TMIG-LISA) . The participants in this study totaled 405 (183 males and 222 females) aged 65 to 84 from Koganei City, and 734 (295 males and 439 females) aged 65 and over from Nangai Village. The test consisted of measurement of grip strength, one-leg stand-ing, walking at preferred and maximum speeds, and finger-tapping. All motor performances examined were higher among males than females, and they all deteriorated with aging. A regional difference was found in terms of motion speed abilities: finger-tapping rate and walking speed were higher among urban residents than rural residents. Individual differences (coefficient of variation) in the motor ability increased with aging, and reached 106% (maximum tapping rate in female) to 290% (maximum walking speed in female) of those in the twenties. Significant correlations between motor abilities were detected indicating that the specificity of the motor ability found in the young may not account for older adults.

The purpose of this study was to investigate the cross-sectional development characteristics of body composition, lower-leg multi-joint power output and sprint running in non-elite junior and youth soccer players. The leg extension power, counter-movement vertical jump(CMJ), and 30m-sprint time for eighty male soccer players aged 13.8-18.1 yrs were measured. Junior and youth soccer players were compared with sedentary normal identical aged boys. Statistical analysis was used by one-way ANOVA and multiple comparisons of variance were performed on the basis of the Tukey-Kramer HSD test. Statistical significance was accepted at level of p < 0.05. Relative increases from 14 yrs to 18 yrs players were significantly (p < 0.05) indicated; body height (7.7%), leg extension power (87.8%), CMJ (35.3%), 30m-sprint (8.7%). 10m-sprint time was negatively correlated with both leg extension power (r = -0.52) and CMJ (r = -0.60). Comparison of relative values of increase from 14 to 18 yrs in junior and youth soccer players to those in sedentary normal boys were as follows; 2.3 (body height), 2.5 (leg extension power), 3.0 (CMJ), 2.1 (sprint ability). It might be suggested that consistent regular soccer training from junior and youth aged might prompt developmental gains not only largely for lower-leg multi-joint power but also not a little for sprint ability.

We report three cases with somatoform disorder which were considered as “Hontonki” disease, successfully treated with keishikakeito. Case1 was a 34-year old male who was suffering from headache and palpitation. He said ‘Something pierces and it goes up from the chest to the head.' We considered his complaint as Hontonki disease and administered keishikakeito. After one week, the headache disappeared and four weeks later, palpitation and tinnitus were definitely improved. Case2 was a 22-year old male. His complaints were excessive strain and general fatigue. Because he had coldness of lower extremities and spasmodic headache, we interpreted these symptoms Hontonki disease and administered keishikakeito. After that these symptoms and his psychological test scores improved markedly. Case 3 was a 75-year old female. Severe headache and palpitations presented after remodeling her home. Three weeks later taking keishikakeito, her symptoms had disappeared dramatically. Recently, Hontonki disease are often compared with panic disorder, and it is possible that some somatoform disorder cases include Hontonki disease. It is important to consider the possibility of Hontonki disease behind the physical complaints such as headache and palpitation, when we use keishikakeito.

Rapidly increasing numbers of acupuncturists in Japan has caused our places of activity to become increasingly important.
A symposium was held by acupuncturists who play an active role in various areas of acupuncture. We all came together with the purpose of examining our clinical conditions and to make recommendations for the future. The necessity of how to expand the capacity and locations of acupuncture practice cannot be overestimated.
The chairperson of the symposium reported that due to the increasing number of acupuncturists, it is hard to find employment for graduates, and reported the results of a questionnaire (initiated by The Japanese Journal of Acupuncture & Manual Therapies (IDO NO NIPPON-SHI) demonstrating that some practitioners are changing the conditions of their professions.
The first panelist, who had experienced practicing acupuncture in a hospital, reported on the role and characteristics of acupuncture practice and ways to maintain relationships with doctors, nurses and other medical care staff members. Also he addressed the issue of prospects for the future among other topics.
The second panelist, who had not been able to find a useful place for on-the-job training following graduation, told of her experience making home-visits and practicing at a clinic. At first, she had found attracting patients to her home-visits quite difficult, so she advertised herself with a local TV station to increase her name recognition, and then she succeed to practice her own clinic. Now she thinks it is necessary to acquire clinical and academic knowledge as well as technical skills.
The third panelist, who specialized in acupuncture in the field of sports disorders, was eager to improve and expand the methods and techniques in this field to better demonstrate the merits of acupuncture treatment for sports disorders. Moreover, he insisted on the importance of acquiring knowledge concerning athletic rehabilitation and technical skills. Also, clinical practice is imperative.
The last panelist, a university teacher, suggested that it is necessary to set up high educational standards and faculty development activities supported by the school. Accordingly, improved standards at schools as well as more research justifying acupuncture efficacy would facilitate greater social demand for acupuncture and thereby setting reasonable expectations for patients and other medical professionals.
In addition, two other acupuncturists and a student from an acupuncture school made speechesabout theirmisgivings regarding their future prospects. One has been working in a hospital for two years since his graduation; the other is a student at a teacher training institution. The student entering her second-year of acupuncture school became a mother. These acupuncturists and a student all expressed their concerns and hopes for the future of their profession.

Objective: The objective of this study was to validate the Japanese version of the STOP-Bang test for risk assessment of obstructive sleep apnea syndrome (OSAS).Methods: We retrospectively evaluated inpatients who underwent nocturnal pulse oximetry for OSAS screening at the internal medical wards.Results: One hundred and forty-four subjects were included the study, and 57 subjects who had a 3% oxygen desaturation index ≥10/hr underwent polysomnography. Seventeen and 29 subjects were diagnosed with moderate and severe OSAS, respectively. According to the receiver operating characteristic (ROC) curve analysis, the STOP-Bang test had a higher diagnostic value using a cutoff of 30 kg/m2 for BMI than using a cutoff of 35 kg/m2. A STOP-Bang score of 3 or greater had a sensitivity of 95.7% and specificity of 42.9% for detecting moderate-to-severe OSAS.Conclusion: The STOP-Bang test is a simple and useful tool for the risk assessment of OSAS.

　　The aim of this study was to examine topophilia in the elderly living in mountainous areas. Topophilia, which is the geographical concept invented by Yi-Fu Tuan in 1999, is defined as the affective bond between people and place or environmental setting. A total of 120 elderly subjects living in a mountainous area responded to a standardized, validated 9-item Life Satisfaction Index K (subjective well-being) developed by Wataru Koyano and a new structured 6-item questionnaire on topophilia. Factor analyses revealed two domains of topophilia (public emotion and private emotion toward the living place). Public emotion was the emotion of being hard to leave the living place. Private emotion was the emotion of not loving the living place. There were areas where the elderly had a lesser degree of attachment toward the present state of the elderly could hardly have a sense of well-being and attachments to the current domicile. It is considered that not only physical but also mental approach is necessary to support the daily life of the elderly living in the mountainous area. Also, we examined the influences of aging and the living place on a subjective well-being and topophilia. There was no significant correlation between age and subjective well-being, but there was significant positive correlation between age and the degree of topophilia (r＝0.234, p‹0.01). On the other hand, the degree of subjective well-being by the place of residence was significantly different (p‹0.001; ANOVA), and the degree of topophilia by the place of residence was not significantly different. These findings suggest that subjective well-being is not influenced by age but influenced by the place of residence, and topophillia is not influenced by the place of residence but influenced by age.

The nuclear hormone receptor PPARgamma is activated by several agonists, including members of the thiazolidinedione group of insulin sensitizers. Pleiotropic beneficial effects of these agonists, independent of their blood glucose-lowering effects, have recently been demonstrated in the vasculature. PPARgamma agonists have been shown to lower blood pressure in animals and humans, perhaps by suppressing the renin-angiotensin (Ang)-aldosterone system (RAAS), including the inhibition of Ang II type 1 receptor expression, Ang-II-mediated signaling pathways, and Ang-II-induced adrenal aldosterone synthesis/secretion. PPARgamma agonists also inhibit the progression of atherosclerosis in animals and humans, possibly through a pathway involving the suppression of RAAS and the thromboxane A2 system, as well as the protection of endothelial function. Moreover, PPARgamma-agonist-mediated renal protection, especially the reduction of albuminuria, has been observed in diabetic nephropathy, including animal models of the disease, and in non-diabetic renal dysfunction. The renal protective activities may reflect, at least in part, the ability of PPARgamma agonists to lower blood pressure, protect endothelial function, and cause vasodilation of the glomerular efferent arterioles. Additionally, anti-neoplastic effects of PPARgamma agonists have recently been described. Based on the multiple therapeutic actions of PPARgamma agonists, they will no doubt lead to novel approaches in the treatment of lifestyle-related and other diseases.
Animals ; Atherosclerosis/prevention & control ; Humans ; Hypertension/drug therapy ; Hypoglycemic Agents/*pharmacology ; Kidney Diseases/etiology ; PPAR gamma/*agonists ; PPAR-beta/agonists

Objective: In 2000, the Ministry of Health and Welfare issued an advisory that recommended intake of 0.4mg of folic acid in dietary supplements to reduce the risk of development of neural tube defects.  Since subsequent reports of questionnaire surveys by various investigators showed a low in the intake rate, we surveyed and evaluated the folic acid intake rate among the pregnant women consulting the Japan Drug Information Institute in Pregnancy.
Methods: We evaluated differences in folic acid intake rate according to the consulting women’s background factors. i.e., age, pregnancy planning, pregnancy history, and taking of anticonvulsant drugs in the 1053 women capable of participating in the survey among the 1061 pregnant women who requested a consultation with the Japan Drug Information Institute in Pregnancy between April 2006 and August 2008.
Results: According to the result of our survey, the intake rate of folic acid was 29% of the 1053 pregnant women.  The only 3 women of the 42 pregnant women taking anticonvulsant drugs took folic acid before they got pregnant.
Conclusion: Even now, 8 years after the Ministry of Health and Welfare advisory, the folic acid intake rate is low.  Drawing upon successful measures promoting intake in the U.S. and Canada,we play a vital role in delivering this critical health information to pregnant women.

BACKGROUND/AIMS: In recent years, endoscopic snare papillectomy has been performed to treat tumors of the ampulla of Vater. This procedure requires accurate preoperative evaluation. In this study, we diagnosed the focal extension of such tumors by using endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS), and examined the indications for endoscopic snare papillectomy. METHODS: The subjects were 48 patients with a papillary tumor (13 patients, surgical resection; 35 patients, endoscopic snare papillectomy) who were evaluated preoperatively with EUS and IDUS. The tumor-node-metastasis classification was used for the endosonographic evaluation and pathological diagnosis of these tumors. RESULTS: The diagnostic accuracy of EUS was 97% for diagnosing adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 50% for pT3-4 tumors, for an overall accuracy of 85% for T-staging. The diagnostic accuracy of IDUS was 94% for adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 100% for pT3-4 tumors, for an overall accuracy of 80% for T-staging. CONCLUSIONS: EUS and IDUS are highly capable of evaluating tumors of the ampulla of Vater preoperatively. However, these techniques are not sufficient for evaluating the focal extension of carcinomas preoperatively. Currently, endoscopic snare papillectomy is adequate for treating adenomas and pTis tumors.
Adenoma ; Ampulla of Vater* ; Classification ; Diagnosis ; Endosonography* ; Humans ; SNARE Proteins ; Ultrasonography*