Aim and background: Chronic insomnia in elderly patients significantly affects their health and quality of life (QOL). Nocturia also worsens sleep condition. The aim of this study was to evaluate the improvement effects of quazepam, a long-term acting benzodiazepine, on insomnia and nocturia in elderly patients. Method: Forty-one elderly outpatients (mean age 77.1 ± 5.6 yr) suffering from chronic insomnia while on regular a short- or ultra-short-acting hypnotic treatment were enrolled. We prescribed 7.5-15 mg of quazepam, which was administered regularly by the subjects before bedtime. A questionnaire was used to compared changes in quality of sleep and frequency of nocturia for before treatment and at 2 and 4 weeks after initiation of treatment. QOL was also examined using the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36). Results: Thirty-seven subjects (90.2%) completed the study. All subscales of the sleep quality questionnaire improved significantly (p<0.001) after 2 weeks, as did the total scores (p<0.001) after 4 weeks. Frequency of nocturia decreased significantly from 3.6 ± 1.7 times to 1.5 ± 0.8 (p<0.001) and 1.2 ± 1.0 times (p<0.001) after 2 and 4 weeks, respectively. Every SF-36 subscale also showed significant improvement after 4 weeks. The total SF-36 scores of the group showing a decrease in the frequency of nocturia (>/= 2 times) improved significantly compared with that with a frequency of < 2 times (p=0.016). Conclusion: Quazepam significantly improves sleep, QOL and nocturia in elderly patients that respond poorly to short-acting or ultra-short-acting hypnotics.
Nycturia ; Elderly ; week ; lower case pea ; Sleep

We performed this study to evaluate the chronic effect of training on neutrophil functions in humans. Twenty-six university students (14 males and 12 females) with a mean age of 19.1±0.8 years were divided into the athlete group and the control group based on answers given to a written questionnaire. The capacity of circulating neutrophils to ingest bacteria (phagocytosis) and to produce superoxide (nitroblue tetrazolium reduction) was measured under resting conditions in the absence of training activities. In addition, we measured hematological and serum biochemical parameters. The present analyses revealed that the frequency of subjective symptoms concerning susceptibility to infections (sum of males and females) was higher in the athlete group than in the control group (p<0.05). In the investigation of males, hemoglobin and serum protein levels of the athlete group were lower than that of the control group (p<0.01, p<0.05, respectively). Although total and differential leukocyte counts, and phagocytic activity of neutrophils were not significantly different between the groups, superoxide productivity of neutrophils in the male athlete group was higher than that in the control group (p<0.05). Since significant differences were observed in hemoglobin and serum protein levels in the male athletes, the training is considered to have been intense. An increase was noted in the neutrophil superoxide production along with these changes, but no significant difference was observed in the phagocytic activity. Therefore, there is the possibility of superoxide overproduction, which may lead to tissue damage.
Neutrophils ; Training ; lower case pea ; athlete ; Superoxides

In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.
Minute of time ; lower case pea ; Tissues ; lower case aitch ; Powders

The physical status and serum mineral concentrations for people aged 10 to 68 years living in an agricultural southern region of Nepal were determined. Systolic (SBP) and diastolic blood pressure (DBP) for both sexes in the 10−14 year age group were low (p<0.05, vs the other age groups) and those for the over 50−year−olds tended to be higher than the other age groups. The mean values of total proteins (TP) (8.6±0.5 g/dl for males and 8.7±0.6 g/dl for females) were high due to an increase of globulin (3.9±0.4 g/dl for males and 4.1±0.5 g/dl for females). More than three−fourths of the subjects of both sexes showed calcium (Ca) levels of 9.0−11.2 mg/dl and about 65% of them showed potassium (K) Ievels of 4.8−5.4 mEq/l. A significant positive correlation between DBP and serum K was observed (p<0.05). Serum inorganic phosphorus (IP) correlated with age (p<0.001) and body mass index (BMI) (p<0.001). The serum Ca levels correlated with TP (r=0.31, p<0.001), albumin (Alb) (r=0.50, p<0.001), IP (r=0.31, p<0.001), K (r=0.32, p<0.001) and chlorine (Cl)(r=−0.37, p<0.001). Cl was associated with TP (r=−0.21, p<0.05), Alb (r=−0.36, p<0.001) and IP (r= −0.21, p<0.05). These results suggested that Ca intake for the subjects seemed to be insufficient although their serum Ca level was within normal.
lower case pea ; Lower case are ; Serum ; L ; g/d

We examined the usefulness of serum leptin concentration as an index for the diagnosis of fatty liver. Twenty-two patients diagnosed with fatty liver by abdominal ultrasonography, participated in this study together with 7 indinduels as controls. As laboratory findings showed, body fat percentage (29.5±1.4 vs 19.1±1.6%, P<0.001), BMI (25.7±0.7 vs 20.8±1.0 kg/m2, P<0.005), procollagen III peptide (P III P) (0.58±0.04 vs 0.42±0.04 U/ml, P<0.05), and serum leptin levels (7.3±1.0 vs 2.9±0.5 ng/ml, P<0.001) were significantly higher in the fatty liver group than in the control group. Serum leptin levels were correlated significantly with body fat percentage (r=0.76, P<0.0001) and BMI (r=0.61, P<0.001), though there was a significant correlation between serum leptin levels and liver-kidney contrast (r=0.47, P<0.05) only in males. In addition, when the fatty liver group was classified into two groups by GPT levels, m-GOT (mitochondrial glutamate-oxaloacetate transaminase) (8.6±1.0 vs 5.7±1.0 IU/l/37°C, P<0.05) and P III P (0.65±0.06 vs 0.49±0.04 U/ml, P<0.05) were significantly higher in the elevated GPT group than in the normal GPT group.These results suggest that serum leptin levels may be indicative of fatty liver and that fatty liver is not always a reversible disease.
upper case pea ; Fatty Liver ; Leptin ; Serum ; Lower case are

Objective: The purpose of this study was to evaluate the efficacy of risedronate for the improvement of the quality of life (QOL) in patients with primary osteoporosis.Methods: Twenty-seven Japanese patients who had receutly been diagnosed with primary osteoporosis (mean age: 73.8 ± 9.1yr, 18 men and 9 women) were the subjects of this study. Using the Japan Osteoporosis Society Quality of Life Questionnaire (JOQOL), each patient's QOL was evaluated before treatment with oral risedronate 2.5mg once daily, and 3, 6, and 12 months during treatment. We also measured the bone mineral density (BMD), serum bone-specific alkaline phosphatase (BAP), and serum N-terminal telopeptide of type I collagen (NTx) before treatment and at 6 and 12 months.Results: The JOQOL total score gradually increased and significantly improved after 12 months of treatment in both male (p=0.026) and female patient groups (p=0.021). The pain scores in the female group first improved significantly at 3 months (p=0.018) and continued to improve over the remaining 9 months of the study, while improvement in the male group reached a significant level at 12 months (p=0.048). Along with the improved pain scores, the other five scores (assessment of activities of daily living, entertainment and social activity, overall health, posture, and falls and anxiety) also tended to improve. Although risedronate did not significantly improve the BMD over the 12 months of this study, the serum BAP levels decreased over the 12 months period and significantly decreased in male (p=0.004) and female groups (p<0.001) at 6 months. The serum NTx level also decreased significantly in male (p=0.003) and female groups (p=0.046) at 12 months.Conclusion: The administration of risedronate for 12 months significantly improved the QOL in patients with primary osteoporosis and resulted in improved bone metabolism. The JOQOL may be an efficacious index for judging the outcome of osteoporosis treatment.
month ; lower case pea ; Osteoporosis ; Risedronate ; therapeutic aspects

Goreisan, a well-known hydrostatic modulating formulation, is used clinically in the treatment of edematous disorders. In this study, in order to clarify hydrostatic modulation in the intestine, we analyzed the effect of Goreisan in an experimental diarrhea model created with the single oral pretreatment of magnesium sulfate in mice. Ninjinto (166mg/kg, p.o.) did not lead to improvements in this model, whereas Goreisan (133mg/kg, p.o.) significantly abated the diarrhea.The warm Goreisan extraction (at 37°C, for 0.5hr) showed anti-diarrheal activity that was significantly stronger than the decoction. On investigating the anti-diarrheal activity of Goreisan by comparing the difference in crude drugs made from Atractylodis Rhizoma (Byakujutsu) and Atractylodis Lanceae Rhizoma (Sojutsu), no distinction between Byakujutsu-Goreisan and Sojutsu-Goreisan was recognized. Atractylodis Rhizoma, Polyporus, Poria, and Cinnamomi Cortex, which were administered singly, showed anti-diarrheal activities, but these were weak in comparison with Goreisan. Concoctions in which either Atractylodis Rhizoma, Polyporus, Poria, Alismatis Rhizoma, or Cinnamomi Cortex were omitted from Goreisan showed decreased anti-diarrheal activity as compared with Goreisan. The anti-diarrheal activity was clearly lower in the concoctions of warm extractions whereby the five kinds of crude drugs were extracted separately, compared with the warm extraction of Goreisan in which all crude drugs were extracted simultaneously.These findings suggest that the anti-diarrheal activity of Goreisan in this model was not dependent on a specific crude drug, it being optimal to extract the five kinds of crude drug simultaneously.
Diarrhea ; Models ; Chemical extraction ; cortex bone disorders ; lower case pea

An audit of neonatal care at Modilon Hospital, Madang was performed using obstetric and neonatal data for the five years 1995-1999. The overall perinatal mortality rate (PNMR) was 51.1 per 1000 total births with an early neonatal mortality rate (ENNMR) of 12.7 and a stillbirth rate (SBR) of 38.5. 839 neonates aged 0-28 days were admitted to the Special Care Nursery. The male to female ratio was 1.3:1. 186 babies (22%) died. The case fatality rate was higher in males than females (p<0.001). Babies born at health centres or born before arrival had a significantly higher fatality rate than hospital-born babies (p<0.001). The case fatality rate was highest in babies born preterm and declined with increasing birthweight from less than 1000 to 3999 g. The major recorded causes of admission were neonatal sepsis, prematurity, neonatal jaundice, birth asphyxia, respiratory distress and meconium aspiration syndrome. 60% of deaths occurred within 48 hours of admission, 32% between 48 hours and 7 days and 8% at 7 days or older. The proportion of deaths occurring during the afternoon and night shifts was significantly higher than that during the morning shift (p<0.001). This was most likely to be related to staffing levels. The major causes of death were prematurity or low birthweight (27%), sepsis (23%) and birth asphyxia (17%). Other causes of death included congenital abnormalities, meconium aspiration and meningitis. Antenatal care is still not universally available for Papua New Guinean women. Home delivery of high-risk mothers is commonplace, and women delivering in hospital often present in established labour. Perinatal and neonatal problems are therefore frequent. Newborn babies have the right to the best available care. This can only be provided if hospitals and health facilities understand the basic requirements of neonatal care and provide designated space, adequate staffing and proper equipment.
Neon ; Hospitals ; lower case pea ; etiology ; 48 hours

Of all Papua New Guinea provinces, Enga has the largest proportion of people living at altitudes that preclude malaria transmission. However, the first systematic surveys in 1979 showed that malaria was endemic in lower-lying valleys to the north and east of the province. A series of new surveys conducted in both wet and dry seasons showed that these areas remain the main malaria focus in Enga. However, over the last 25 years the risk of malarial infections has increased substantially in areas < 1200 m (from 10% to 37-41%). In these low-lying areas people acquire substantial antimalarial immunity and most infections are asymptomatic. However, people in villages in these areas had significantly lower mean haemoglobin levels (13.0 vs 14.0 g/dl, p < 0.001) than in areas above 1200 m, where overall prevalence rates (0-9%) have not changed much. In areas between 1200 and 1600 m epidemics with parasite prevalence rates in excess of 20% have been found to occur. Malaria was a significant cause of febrile illness only in endemic areas or during outbreaks. Although rarely used, sleeping under a bednet was associated with a significant reduction in risk of malaria infection (adjusted OR = 0.45, p = 0.01). On the other hand, sleeping in garden houses away from the main villages increased the risk of malaria infection (adjusted OR = 1.6, p = 0.03). Malaria control in outlying, malarious areas of Enga province could therefore be based on the distribution of long-lasting impregnated bednets, while at the same time addressing the additional risks posed by the high mobility of many of these populations through targeted health education.
Malaria ; meter ; lower case pea ; Risk ; Papua New Guinea

Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in ‘ESBL’ than in ‘non-ESBL’ group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians.
Extended-spectrum beta lactamase ; Hospitals ; Adult ; Respiratory ; lower case pea