Concerning the bone structures of the mandible reconstructed by particular cellular bone and marrow (PCBM), platelet rich plasma (PRP) and tray, we have examined the possibility of implant insertion by clarifying the morphological conditions in each compact and cancellous bone on computed tomography (CT), and by observing the differences in their CT values.Using the computer software program Sim Plant (Materialize Dental, Leuven, Belgium), we morphologically observed 6 cases of implant inserted area after mandibular reconstruction and 11 cases of native bone, and examined the differences in their CT values. The osseointegration rate of each inserted implant was also evaluated.Compared with the native bone group, the PCBM reconstruction group had generally thin compact bone. In the over-3cm-length PCBM reconstruction group, the average CT value was 259.7 ± 94.4 HU (n = 3) in the cancellous bone, whereas in the native bone group, the average CT value was 528.9 ± 140.1 HU (n = 10). Therefore, the PCBM reconstruction group showed significantly lower CT value than the native bone group. However, in the under-3cm-length group, the PCBM reconstruction group showed no significant difference compared with the native bone group. The osseointegration rate of the inserted implants almost 6 months after insertion was 100% in the PCBM reconstruction group and 94.1% in the native bone group.Although the PCBM reconstructed bone had thinner cortical bone and showed lower CT value compared with the native bone, implant insertion was possible.

The purpose of this study was to examine the association between the hierarchy of higher-level functional capacity (instrumental self-competence, intellectual activity, social role) and the quantity of physical activity in older women (n = 175, 72.1 ± 5.8 years). Physical activity was estimated with a uniaxial accelerometer that calculated light-intensity physical activity (LPA), and moderate-to vigorous-intensity physical activity (MVPA). Higher-level functional capacity was assessed with the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. According to the three subscales (instrumental self-competence, intellectual activity, and social role) of the TMIG index, participants who reported a score of 1 or more below the respective full marks were categorized as a group with reduced status. Logistic regression analysis was conducted to examine association between the hierarchy of higher-level functional capacity and the quantity of physical activity divided by intensity of activity, adjusted by covariance. Only low MVPA showed a significantly lower odds ratio than high MVPA in reduced status of instrumental self-competence. Since instrumental self-competence was significantly related with only the quantity of MVPA, it may be more important to focus on “quantity” of physical activity to prevent reductions in higher-level functional capacity in advanced stages of declining functional capacity.

Fall-related factors (FRFs) are classified into intrinsic factors and extrinsic factors. Intervention programs, which focused on modifiable factors (MFs) among FRFs have been designed to prevent falls. The purpose of this study was to identify easily-measurable intrinsic MFs for falls and recurrent falls. Cross-sectional analysis was carried out on the data from 483 community-dwelling older adults, aged 65-92 years (73.7 ± 5.9 yr, 138 men, 345 women). We measured history of falls in the past year and 7 domains of FRFs. Of these, 20 items were selected as MFs. Analyses of FRFs and MFs were conducted by comparing (separated by sex) those who did not report a fall with those who reported any number of falls, and those who reported no falls or one fall with those who reported recurrent falls. Using the significant items as independent variables, multiple logistic regression analysis with forward selection method was performed. The prevalence of falls and recurrent falls was: in men, 24.6% and 14.5%; in women, 26.7% and 12.5%. There were no significant differences in prevalence of falls or recurrent falls between genders. The following items were selected as the MFs most strongly associated with falls: climbing 10 steps with difficulty and tandem walk; and associated with recurrent falls: climbing 10 steps with difficulty, sit and reach, and tandem walk. These results are useful in determining the focus of fall prevention programs to be used in future community-based interventions.

The purposes of this study were (i) to determine the characteristics of physical function for frail older adults, compared with those for the independent and the dependent, (ii) to examine validity of the “health check-up questionnaire” (Kihon Check-list: CL) for finding frail older adults. Five hundred thirty-nine older Japanese people (75.5 ± 7.0 years) were assigned to each one of the three categories: the independent, the frail and the dependent according to the classification criteria of long-term care insurance system. Physical function score (PFS) was estimated by principal components analysis. Logistic regression analysis was conducted to assess validity of the CL and to examine the screening tool for detecting frail older adults who have a higher risk for becoming the dependent. Significant differences were observed among the three groups in PFS (the independent, 0.580 ± 0.467; the frail, -0.309 ± 0.733; the dependent -1.347 ± 0.949). The Odds ratio (OR) of the dependent for older adults to whom the CL was applied was 2.4 (95% confidence interval (CI): 1.3 - 4.5), and the OR for those to whom both the CL and the hand-grip strength test were applied was 5.4 (2.6 - 11.5). These data suggest that the comprehensive status of physical function of frail older adults, which varied widely, was intermediate between the independent and the dependent. It is useful to add the hand-grip strength test to the CL as a screening tool to subdivide frail older adults.

BACKGROUND: The purpose of this study was to examine the association between habitual walking and multiple or injurious falls among community-dwelling older adults. METHODS: Cross-sectional analysis was conducted on the data from 708 community-dwelling older adults, aged 60-91 years (72.3 +/- 6.6 yr, 233 men and 475 women). Prevalence of falls between walkers and non-walkers was compared separately by the number of risk factors (Groups R0, R1, R2, R3 and R4+). Logistic regression analysis was used to assess the association between habitual walking and falls separately by lower (R<3) and higher (R3+) risk groups. An interaction between habitual walking and risk of falling was examined in logistic regression analysis among all participants. RESULTS: In Groups R0, R1 and R2, prevalence of falls was lower in walkers than non-walkers; however, in Groups R3 and R4+, prevalence of falls was higher in walkers. Logistic regression analysis showed that habitual walking was significantly associated with fewer falls (Odds ratio (OR): 0.44, 95% confidence interval (CI): 0.20-0.97) among the lower risk group, but significantly associated with greater falls (OR: 4.61, 95% CI: 1.32-16.09) among the higher risk group. The interaction between habitual walking and higher risk of falling was significant (P < 0.05). CONCLUSION: Habitual walking seems to positively affect the prevention of multiple or injurious falls but only in community-dwelling older adults who have less than three risk factors.

The purpose of this study was to determine whether hand-grip strength (HGS) can be a significant discrimination factor of mobility limitation (ML) among older adults. Cross-sectional analysis was conducted on data from 939 community-dwelling older adults, aged 65-96 years (74.4 ± 6.4 yr, 266 men, 673 women). ML was defined as self-reported difficulty in walking 400 m, climbing 10 steps, and rising from a chair. Trained testers assessed standardized measurements of HGS and lower extremity performance score (LEPS) calculated by four tests (i.e., tandem stance, 5-chair sit-to-stand, alternate step, and timed up & go). Receiver operating characteristic (ROC) analysis was conducted to identify discrimination power of HGS and LEPS for ML. The areas under the ROC curves (AUCs) of HGS and LEPS for ML were 0.82 and 0.87 in men; 0.70 and 0.85 in women, respectively. No significant difference was detected between the AUCs of HGS and LEPS (P = 0.12) in men, whereas in women, the AUC was significantly lower in HGS than LEPS (P < 0.001). The optimal HGS cut-off values for ML were 31.0 kg (sensitivity 75%, specificity 81%) for men and 19.6 kg (sensitivity 73%, specificity 57%) for women. In men, the HGS test could be as useful as LEPS for identifying ML. In women, discrimination power for ML by HGS alone was considered acceptable; however, a combination of HGS and lower extremity performance tests could be more useful for monitoring the hierarchical levels of physical frailty.

OBJECTIVE: Autistic spectrum traits are postulated to lie on a continuum that extends between individuals with autism and individuals with typical development. The present study was carried out to investigate functional and network abnormalities associated with autistic spectrum trait in healthy male subjects. METHODS: Subjects were 41 healthy male subjects who underwent the social responsiveness scale-adult (SRS-A) and magnetic resonance imaging. RESULTS: There was significant positive correlation between the total score of SRS-A and the regional cerebral blood flow (CBF) in posterior cingulate cortex (PCC). Also, there were changes in functional network such as in cingulate corti, insula and fusiform cortex. Further, we also found the significant difference of functional networks between the healthy male subjects with high or low autistic spectrum trait, and these points were congruent with the previous perceptions derived from autistic-spectrum disorders. CONCLUSION: These findings suggest a biological basis for the autistic spectrum trait and may be useful for the imaging marker of autism symptomatology.
Autism Spectrum Disorder ; Autistic Disorder ; Cerebrovascular Circulation* ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male* ; SRS-A