記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: Identifying plasma molecules associated with skeletal muscle properties can elucidate the pathophysiology of sarcopenia. Because adipocytokines are a promising candidate marker, the current study aimed to clarify the possible associations between adiponectin and leptin levels and mid-thigh muscle cross-sectional area and mean attenuation value, which are indices of muscle mass and fat deposition in muscle, respectively. METHODS: The current study included 1440 older Japanese adults (mean age 69.3 years). Mid-thigh skeletal muscle cross-sectional area and mean attenuation value were evaluated through computed tomography scan. A low attenuation value showed a greater fat deposition in muscle. Circulating adiponectin and leptin levels were assessed using blood specimens collected during the baseline investigation. RESULTS: Plasma leptin level was inversely correlated with muscle cross-sectional area, but not with attenuation value. The association with cross-sectional area was independent of possible confounding factors including body size (Q1: reference; Q2: β = -0.032, P = 0.033; Q3: β = -0.064, P < 0.001; Q4: β = -0.111, P < 0.001). In contrast, adiponectin level was independently and inversely associated with attenuation value (Q1: reference; Q2: β = -0.044, P = 0.122; Q3: β = -0.080, P = 0.006; Q4: β = -0.159, P < 0.001), but not with cross-sectional area. These associations between adipocytokine levels and muscle properties were independent of abdominal fat area and insulin resistance. CONCLUSIONS: There were adiposity- and insulin resistance-independent associations between adipocytokines levels and skeletal muscle mass and fat deposition in muscle, suggesting an involvement of adipocytokines in muscle properties. Geriatr Gerontol Int 2023; ••: ••-••.

DOI： 10.1111/ggi.14582

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND & AIMS: Phase angle (PhA) calculated from the resistance and reactance measured using a bioimpedance device was suggested to represent the degree of fat deposition in muscle (myosteatosis), though no direct evidence is available. We aimed to clarify the possible association between PhA and skeletal muscle myosteatosis in community-dwelling middle-aged to older adults. METHODS: Participants consisted of 424 Japanese (aged ≥50 years). Leg PhA and skeletal muscle mass index (SMI) were obtained by bioelectrical impedance analysis. The mean attenuation values and cross-sectional area of the mid-thigh skeletal muscle were calculated from computed tomography images and considered as indexes of myosteatosis and skeletal muscle mass, respectively. RESULTS: Leg PhA was positively associated with SMI, and cross-sectional area and mean attenuation value at mid-thigh. Multiple regression analysis adjusted for possible covariates identified leg PhA (β = 0.214) and SMI (β = 0.260) as independent factors of mid-thigh muscle cross-sectional area (P < 0.001), while leg PhA (β = 0.349, P < 0.001) but not SMI (P = 0.645) was associated with mean attenuation value. Similar results were observed in the analysis in the older (≥65 years) subpopulation. The combination of low SMI and low leg PhA showed stepwise association with cross-sectional area, while only individuals with low leg PhA had lower mean attenuated value. CONCLUSIONS: Leg PhA was independently associated with mean attenuated value of the mid-thigh skeletal muscle, suggesting that the assessment of PhA in combination with SMI could provide additional information for the evaluation of muscle properties.

DOI： 10.1016/j.clnu.2023.03.016

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記述言語：英語  

Frontotemporal dementia and/or amyotrophic lateral sclerosis 6, also known as amyotrophic lateral sclerosis 14, is an autosomal dominant, progressive neurodegenerative disorder caused by various mutations in the valosin-containing protein gene. In this report, we examined a 51-year-old female Japanese patient with frontotemporal dementia and amyotrophic lateral sclerosis. The patient began noticing gait disturbances at the age of 45 years. Neurological examination at the age of 46 years met the Awaji criteria for clinically probable amyotrophic lateral sclerosis. At the age of 49 years, she tended to have poor mood and an aversion to activity. Her symptoms gradually worsened. She required a wheelchair for transport and had difficulty communicating with others because of poor comprehension. She then began to frequently exhibit irritability. Eventually, she was admitted to the psychiatric hospital because uncontrollable violent behavior throughout the day. Longitudinal brain magnetic resonance imaging revealed progressive brain atrophy with temporal dominance, non-progressive cerebellar atrophy, and some non-specific white matter intensities. Brain single photon emission computed tomography showed hypoperfusion in the bilateral temporal lobes and cerebellar hemispheres. Clinical exome sequencing revealed the presence of a heterozygous nonsynonymous variant (NM_007126.5, c.265C>T; p.Arg89Trp) in the valosin-containing protein gene, which was absent in the 1000 Genomes Project, the Exome Aggregation Consortium Database, and the Genome Aggregation Database, and was predicted to be "damaging" by PolyPhen-2 and "deleterious" using SIFT with a Combined Annotation Dependent Depletion score of 35. We also confirmed the absence of this variant in 505 Japanese control subjects. Therefore, we concluded that the variant in the valosin-containing protein gene was responsible for the symptoms of this patient.

DOI： 10.3389/fgene.2023.1155998

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   出版者・発行元：(一社)日本脳神経超音波学会  

下顎窓から測定した、内頸動脈(ICA)における脳血管反応性(CVR)診断の有用性について検討した。有効な側頭窓が確認された健常者25例(男性13例、女性12例、平均年齢39.9±13.7歳)を対象に、息こらえ試験を行い、CVR指標としてbreath holding index(BHI)を用い、息こらえ前後の平均血流速度からBHIを算出し、ICAで測定したBHI(BHIi)と同側中大脳動脈で測定したBHI(BHIm)との相関性を評価した。その結果、BHImおよびBHIiはそれぞれ平均0.93±0.29および平均0.92±0.32で、BHImとBHIiのSpearman相関係数は0.665であった。また、BHImにより決定されたCVR障害に対するBHIiのカットオフポイントは0.71で、感度と特異度はともに80%得られた。以上の結果から、側頭窓からの測定が不十分である場合には、下顎窓からのBHI測定が代替測定として有用であることが明らかにされた。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J02558&link_issn=&doc_id=20220113570003&doc_link_id=%2Fcn7neuro%2F2021%2F003403%2F003%2F0142-0147%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcn7neuro%2F2021%2F003403%2F003%2F0142-0147%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.msard.2021.103135

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background We assessed cases of incidental unruptured intracranial aneurysm (UIA) discovered on screening magnetic resonance angiography to identify hemodynamic and atherosclerotic risk factors. Methods and Results The data of 1376 healthy older subjects (age range, 31-91 years) without cerebro- or cardiovascular diseases who underwent brain magnetic resonance angiography as part of a medical checkup program at a health screening center were examined retrospectively. We looked for an increase in classical risk factors for UIAs (age, sex, hypertension, and smoking) and laboratory data related to lifestyle diseases among subjects with UIAs. Brachial-ankle pulse wave velocity, central systolic blood pressure, radial augmentation index, and carotid flow pulsatility index were also compared between those with and without UIAs. We found UIAs in 79 (5.7%) of the subjects. Mean age was 67.1±9.0 years, and 55 (70%) were women. Of the 79 aneurysms, 75 (95%) were in the anterior circulation, with a mean diameter of 3.1 mm (range, 2.0-8.0 mm). Subjects with UIAs were significantly older and had more severe hypertension. The carotid flow pulsatility index was significantly lower in subjects with UIAs and negatively and independently correlated with UIAs. Tertile analysis stratified by carotid flow pulsatility index revealed that subjects with lower indices had higher levels of low-density lipoprotein cholesterol. Conclusions The presence of UIAs correlated with lower carotid flow pulsatility index and elevated low-density lipoprotein cholesterol in the data from a population of healthy older volunteers. A reduced carotid flow pulsatility index may affect low-density lipoprotein cholesterol elevation by some molecular pathways and influence the development of cerebral aneurysms. This may guide aneurysm screening indications for institutions where magnetic resonance angiography is not routine.

DOI： 10.1161/JAHA.120.018626

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jamda.2021.06.033

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.ensci.2021.100346

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記述言語：日本語   出版者・発行元：日本脳神経超音波学会・日本栓子検出と治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Sarcopenia is a risk factor for poor outcomes in older adults. Identification of plasma markers may facilitate screening of sarcopenia. We previously reported that creatinine-to-cystatin C ratio is a simple marker of muscle mass. To further assess the clinical relevance of the creatinine-to-cystatin C ratio, we investigated its association with myosteatosis and physical performance. DESIGN: Observational study. SETTING AND PARTICIPANTS: Cross-sectional analysis of the dataset obtained from a Japanese population consisting of 1468 older (≥60 years of age) community residents. METHODS: The mean attenuation values of the skeletal muscle calculated from computed tomography images of the midthigh were used as an index of myosteatosis, while the cross-sectional area of the muscle was used as a proxy for muscle mass. Physical performance was assessed by 1-leg standing time. RESULTS: Creatinine-to-cystatin C ratio was positively associated with the cross-sectional area of muscle fiber-rich muscles, while it showed an inverse association with fat-rich muscle areas, resulting in the positive association between creatinine-to-cystatin C ratio and the mean attenuation value of the skeletal muscle [creatinine-to-cystatin C ratio quartiles (Q), Q1: 47.4 ± 4.8, Q2: 48.9 ± 4.4, Q3: 49.8 ± 4.1, Q4: 50.9 ± 3.7, P < .001]. The results of the linear regression analysis adjusted for major covariates (including muscle cross-sectional area) identified creatinine-to-cystatin C ratio as an independent determinant of the mean attenuation value (Q1: reference, Q2: β = 0.07, P = .019, Q3: β = 0.11, P < .001, Q4: β = 0.16, P < .001). Low creatinine-to-cystatin C ratio was independently associated with 1-leg standing time, although the association was attenuated substantially by adjusting for skeletal muscle cross-sectional area and mean attenuation value. CONCLUSION AND IMPLICATIONS: Creatinine-to-cystatin C ratio was associated with myosteatosis in older adults, independent of the muscle mass. Creatinine-to-cystatin C ratio may serve as a convenient marker of sarcopenia.

DOI： 10.1016/j.jamda.2021.03.021

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Glomus tumors are soft tissue neoplasms comprised of glomus cells, vasculature, and smooth muscle cells, which occur commonly in a single subungual area of the digits, and their main clinical features include severe paroxysmal pain, localized tenderness, and cold hypersensitivity. CASE PRESENTATION: A 47-year-old Japanese man had suffered from chronic progressive paroxysmal shooting pain in his right leg since childhood. He avoided putting weight on his right foot whenever he walked. The frequency of paroxysmal pain and the number of tender points both gradually increased with age, and his right leg gradually atrophied. Magnetic resonance imaging of the lower extremity demonstrated multiple gadolinium-enhanced nodules that corresponded with his tender points. Excisional biopsy relieved his pain and provided a histopathological diagnosis of glomus tumors. CONCLUSION: This case suggests that small glomus tumors located in deep tissue may cause disuse atrophy because of their long delay before diagnosis. Clinicians should consider the potential for glomus tumors when patients exhibit unilateral lower limb muscular atrophy with pain.

DOI： 10.1186/s13256-020-02616-1

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記述言語：日本語   出版者・発行元：(株)日本医事新報社  

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記述言語：英語  

We describe a 61-year-old woman with bilateral parkinsonism caused by unilateral infarction limited to the territory of the lenticulostriate arteries. Although dopamine transporter imaging with single-photon emission computed tomography (DaTSPECT) demonstrated reduced putaminal tracer binding concordant with the size and location of the vascular lesion, the specific binding ratio was within the normal range. Five months after onset, the patient was free from parkinsonism without the use of any antiparkinsonian agents. When patients show bilateral parkinsonism, it is important to consider infarction of the lenticulostriate arteries. Additionally, DaTSPECT might be useful for predicting the prognosis of parkinsonism caused by infarction.

DOI： 10.1016/j.ensci.2020.100291

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Casein hydrolysate has been shown to improve arterial stiffness as estimated by brachial-ankle pulse wave velocity in untreated hypertensive patients. Facial pigmentation is associated with atherosclerosis, both of which are supposed to be modulated by tissue accumulation of advanced glycation end products. However, effects of casein hydrolysate on facial pigmentation and advanced glycation end products remain largely unknown. This randomized, double-blind, placebo-controlled trial evaluated whether and how casein hydrolysate improves facial pigmentation in 80 non-hypertensive Japanese patients. Study participants were randomly assigned to receive either active tablets containing casein hydrolysate or placebo for 48 weeks. Facial pigmentation area, brachial-ankle pulse wave velocity, and skin accumulation levels of advanced glycation end products were evaluated by Robo Skin Analyzer RSA50S II, volume-plethysmographic apparatus, and AGE Reader, respectively at baseline and at the end of the intervention. Treatment with casein hydrolysate, but not placebo significantly reduced triglycerides and facial pigmentation area. There were significant differences of changes in triglycerides, facial pigmentation area, skin accumulation levels of advanced glycation end products, and brachial-ankle pulse wave velocity between the two groups. Furthermore, changes in triglycerides and skin accumulation levels of advanced glycation end products were positively and independently associated with those in facial pigmentation area, whereas changes in brachial-ankle pulse wave velocity were not. Our present study suggests that casein hydrolysate reduces facial pigmentation area in non-hypertensive participants partly by decreasing skin accumulation levels of advanced glycation end products.

DOI： 10.1089/rej.2020.2343

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is an autosomal dominant neurodegenerative disorder caused by mutations in the colony-stimulating factor 1 receptor (CSF1R) gene. We, herein, report the first Japanese case of ALSP caused by a de novo p.Phe849del mutation in CSF1R: a 44-year-old man who presented callosal disconnection symptoms. Brain MRI revealed dilation of the lateral ventricles, periventricular white matter hyperintensities, and thinning of the corpus callosum with hyperintensities on T2-weighted and FLAIR images. Brain single photon emission computed tomography (SPECT) showed hypoperfusion in the anterior corpus callosum. White matter lesions in MRI and hypoperfusion in SPECT increased with age. A brain biopsy at 44 years revealed axonal spheroids. Callosal disconnection symptoms and hypoperfusion in the anterior corpus callosum may be important indicators of ALSP, especially when caused by a p.Phe849del CSF1R mutation.

DOI： 10.1111/ncn3.12367

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.24659/gsr.6.2_75

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/s41598-018-26908-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Society for Bioscience Biotechnology and Agrochemistry  

We examined whether baPWV could be affected by pork collagen peptide (CP) ingestion. Seventy subjects were randomized into two groups (2.5 g/day CP and 2.5 g/day placebo). A significant reduction in baPWV was observed in the CP group compared to the placebo group. This study demonstrated that pork CP may contribute to the prevention of atherosclerosis in elderly.

DOI： 10.1080/09168451.2018.1434406

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Life Science Publishing Co. Ltd  

Objectives Although vaccination is effective method to prevent influenza infection, current influenza vaccines have inadequate efficacy in general populations. For these reasons a supplement that prevent influenza infection is keenly anticipated. In basic research, it is demonstrated that kuromoji (Lindera umbellate Thunb.) extract has an effectiveness preventing influenza infection. The aim of this study was to assess whether kuromoji extract has a protective effect on influenza infection in clinical settings. Methods In a randomized, double-blind, placebo-controlled, parallel-group study, 135 adult volunteers, they are healthy nursing staff and are met inclusion and exclusion criteria, partici-pated in this study. Sixty-seven participants received test candy (containing 67 mg/day of kuromoji extract), and another 68 participants received placebo candy. Results Test candy significantly reduced influenza infection after 12 weeks compared with placebo candy. Conclusions This is the first clinical study to assess the effectiveness of kuromoji extract in the prevention of influenza infection. Our results suggest that kuromoji extract is a safe supplement for the prevention of influenza infection.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley Blackwell  

Background: There is a close association between frailty and cognitive impairment. However, the underlying contribution of sarcopenia to the development of cognitive impairment is unclear. We investigated the possible association between muscle mass decline and cognitive impairment in a cross-sectional study of 1518 subjects aged 55 years or above. We also evaluated arterial stiffness and white matter hyperintensities (WMHs) as possible underlying mechanisms for this association. Methods: Two sarcopenic indices were measured: thigh muscle cross-sectional area (CSA
calculated by computed tomography) and skeletal muscle mass (bioelectric impedance). Muscle mass decline was defined as either the bottom 10% or 20% of participants for each sex. Cognitive function was assessed using the Touch Panel-type Dementia Assessment Scale, and brachial–ankle pulse wave velocity was measured as an index of arterial stiffness. Results: Both sarcopenic indices were modestly but significantly associated with brachial–ankle pulse wave velocity in male and female subjects. The presence of WMHs was significantly associated with low thigh muscle CSA in men and with low skeletal muscle mass in women. The Touch Panel-type Dementia Assessment Scale score was modestly but significantly and positively associated with thigh muscle CSA in men and skeletal muscle mass in women. Muscle mass decline in the bottom 10% of participants on both sarcopenic indices was significantly and independently related to cognitive impairment in women. Conclusions: Lower sarcopenic indices are significantly related to lower cognitive scores. Arterial stiffness and WMHs could account, at least in part, for this association.

DOI： 10.1002/jcsm.12195

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Background There is a close association between frailty and cognitive impairment. However, the underlying contribution of sarcopenia to the development of cognitive impairment is unclear. We investigated the possible association between muscle mass decline and cognitive impairment in a cross-sectional study of 1518 subjects aged 55 years or above. We also evaluated arterial stiffness and white matter hyperintensities (WMHs) as possible underlying mechanisms for this association.
Methods Two sarcopenic indices were measured: thigh muscle cross-sectional area (CSA; calculated by computed tomography) and skeletal muscle mass (bioelectric impedance). Muscle mass decline was defined as either the bottom 10% or 20% of participants for each sex. Cognitive function was assessed using the Touch Panel-type Dementia Assessment Scale, and brachial-ankle pulse wave velocity was measured as an index of arterial stiffness.
Results Both sarcopenic indices were modestly but significantly associated with brachial-ankle pulse wave velocity in male and female subjects. The presence of WMHs was significantly associated with low thigh muscle CSA in men and with low skeletal muscle mass in women. The Touch Panel-type Dementia Assessment Scale score was modestly but significantly and positively associated with thigh muscle CSA in men and skeletal muscle mass in women. Muscle mass decline in the bottom 10% of participants on both sarcopenic indices was significantly and independently related to cognitive impairment in women.
Conclusions Lower sarcopenic indices are significantly related to lower cognitive scores. Arterial stiffness and WMHs could account, at least in part, for this association.

DOI： 10.1002/jcsm.12195

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Frailty is associated with cognitive impairment and can be used to identify people at high risk for dementia. We developed a simple frailty (SF) score using a combination of low hand grip strength (&lt;32.5 kg in men, &lt;19.5 kg in women), and short one-leg standing time (&lt;20 seconds). These can be easily measured in the clinician's office when seeing patients. We investigated the possible association between SF score and mild cognitive impairment (MCI) in a cross-sectional study with 838 independent middle-aged to elderly participants (319 men, mean age 65.1years). In total, 118 participants were diagnosed with MCI. A SF score of 2 was significantly associated with the presence of MCI (odds ratio 4.6, 95% confidence interval: 1.9-6.9, p = 0.0001) even after adjustment for age and sex. Stepwise regression analyses showed that a SF score of 2 was associated with the presence of MCI, independently of central pulse pressure and silent cerebral infarcts. These findings indicate that the SF score is a useful frailty parameter to predict MCI in an apparently independent population.

DOI： 10.1038/srep46419

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3233/JAD-160917

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Background: Frailty, a geriatric syndrome reflecting a state of reduced physiological reserve and increased vulnerability, is an independent risk factor for cardiovascular morbidity and mortality. However, the relationship between frailty and hypertensive end-organ damage is not fully established.
Method and results: We performed a cross-sectional study to investigate the association between frailty and end-organ damage in 1125 apparently healthy middle-aged to elderly subjects. We performed a simple frailty ( SF) score that was easily obtainable in the office, in combination with low hand grip power and short one-leg standing (OLS) time. The association between SF score and hypertensive end-organ damage and other frailty-related parameters was evaluated. Odds ratio of SF score 1 to score 0 for the presence of hypertension was 1.9 [1.4-2.5, p &lt; .0001] and that of SF score 2 was 3.3 [2.1-5.3, p &lt; .0001]. SF score was also significantly associated with brachial-ankle pulse wave velocity (baPWV) and central pulse pressure (PP2). SF score was significantly associated with higher frailty index calculated from 21 parameters, lower cognitive test score, % vital capacity, skeletal muscle mass, and thigh muscle cross-sectional area. SF score was positively associated with stage of brain white matter hyperintenisty, plasma levels of B-type natriuretic peptide, and urinary protein excretion, even after correction for confounding parameters including baPWV and PP2.
Conclusions: These findings indicate that frailty is significantly associated with end-organ damage in elderly subjects. SF score may be a useful clinical tool to identify frail subjects and advanced end-organ damage in elderly subjects. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ijcard.2016.04.135

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Background and Purpose Arterial stiffness, a risk factor of brain small vessel diseases (SVD), causes hemodynamic changes. Mechanical stresses, circumferential wall tension (WT), and shear stress (SS) may change with arterial stiffness and be related to SVD. We investigated the associations between mechanical stresses and arterial stiffness and SVD.
Methods A total of 1296 subjects without apparent cardiovascular diseases were recruited. Brachial-to-ankle pulse wave velocity (baPWV) was measured as an arterial stiffness index. Silent lacunar infarction and deep subcortical white matter hyperintensity were evaluated as SVD indices. Circumferential WT and SS at peak systole and end diastole were measured at the common carotid artery. Second peak of systolic blood pressure was obtained from the radial waveform and used as a central systolic blood pressure substitute.
Results baPWV was associated positively with WT (P&lt;0.0001) and negatively with SS (P=0.0007) even after correction for confounding parameters including baPWV. SVD was associated with significantly higher WT (P&lt;0.0001) and lower SS (P&lt;0.0001). After adjustment for confounding parameters (including baPWV), second peak of systolic blood pressure WT (odds ratio, 1.30; P=0.0017) and end diastolic WT (odds ratio, 1.60; P=0.0038) were related to presence of silent lacunar infarction, whereas peak systolic (odds ratio, 0.95; P=0.014) and end diastolic SS (odds ratio, 0.94; P=0.014) were associated with presence of deep subcortical white matter hyperintensity grade &gt;3. Regression lines between blood pressure and WT were significantly steeper in subjects with SVD than without SVD (=0.02; P&lt;0.0001).
Conclusions These findings indicate that SVD is phenotype-specifically associated with alterations in WT and SS independently of arterial stiffness.

DOI： 10.1161/STROKEAHA.114.006539

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objective: Osteoporosis and atherosclerosis are the two most common diseases in postmenopausal women. In most cases, they are simultaneously present in the same individual and commonly lead to bone fracture or cardiovascular disease (CVD). Bisphosphonates (BPs) are frequently used in the treatment of osteoporosis and have the ability to increase lumbar spine bone mineral density (L-BMD). BPs may also protect against CVD. A single monthly 50-mg dose of minodronate (monthly minodronate) is now common practice and is highly anticipated to reduce the incidence of both bone fracture and CVD. A useful approach to independently predicting CVD is brachial-ankle pulse wave velocity (baPWV). Here, we directly compared the effects of monthly minodronate with those of a standard single weekly 35-mg dose of alendronate (weekly alendronate) on L-BMD and baPWV in postmenopausal women with osteoporosis across a 12-month period.
Methods: Thirty-eight postmenopausal women with osteoporosis were randomized into two treatment groups (group 1, weekly alendronate, n = 19; group 2, monthly minodronate, n = 19). L-BMD and baPWV were assessed at baseline and 12-month follow-up.
Results: At the end of the 12-month period, increases in L-BMD were similar between group 1 (7.6%) and group 2 (8.5%), but baPWV was significantly reduced in group 2 compared with group 1. The change in baPWV during the study period showed a significant negative correlation with the change in L-BMD.
Conclusions: Changes in L-BMD in the monthly minodronate and weekly alendronate groups are generally comparable. Good control of changes in L-BMD in the postmenopausal phase might be associated with regression of CVD. Monthly minodronate is a promising new BP and potential first-line drug for the treatment of osteoporosis in postmenopausal women.

DOI： 10.1097/gme.0000000000000197

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC  

A paradoxical negative association between obesity and the plasma B-type natriuretic peptide (BNP) level has been firmly established. An individual's fat mass increases and muscle mass decreases with aging. Because aging is a potent determinant of plasma BNP levels, BNP may be related not only to fat mass but also to muscle mass. However, no studies have evaluated the associations between body composition and plasma levels of BNP. We performed a crass-sectional study to investigate these associations in 1,431 apparently healthy middle-aged to elderly subjects. The abdominal visceral fat area and thigh muscle cross-sectional area (CSA) were quantified by computed tomography. Plasma adiponectin and leptin levels were measured as possible confounding parameters. The brachial-ankle pulse wave velocity was measured as an index of arterial stiffness, and the pulse pressure (PP) of the second peak of the radial systolic blood pressure waveform (PP2) was used as an estimate of the central PP. Plasma BNP levels were significantly and negatively associated with the visceral fat area (r = -0.13, p &lt;0.0001) and thigh muscle CSA (r = -0.25, p &lt;0.0001). Corrections with possible confounding parameters including age, gender, heart rate, mean blood pressure, body weight, body height, adiponectin, leptin, brachial-ankle pulse wave velocity, and PP2 eliminated the association of BNP with visceral fat area but not with thigh muscle CSA (beta = 0.27, p &lt;0.0001). These findings indicate that along with. adiposity, muscle mass is an independent determinant of plasma BNP. (C) 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.amjcard.2014.05.050

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Objective: The relationship between plasma levels of adiponectin and cardiovascular events is inconclusive. We evaluated the clinical characteristics of people with high plasma adiponectin and high plasma leptin levels.
Methods: Thousand seven hundred participants recruited from visitors to the Anti-Aging Doc were divided into four groups by combining the bipartiles of plasma adiponectin and leptin levels in men and women separately: AL, high adiponectin and high leptin; Al, high adiponectin and low leptin; al, low adiponectin and low leptin; aL, low adiponectin and high leptin. Body composition, including visceral fat area and thigh muscle cross-sectional area (CSA), brachial-ankle pulse wave velocity (baPWV), periventricular hyperintensity, and urinary albumin excretion, were determined.
Results: Twenty percent of the studied population fell within the AL group. This group had a significantly higher visceral fat area than the Al group. Thigh muscle CSA was lowest in the AL group among groups. baPWV, brain white matter lesions, and albuminuria findings in the AL group were significantly higher than those of the Al group. Multiple and logistic regression analyses with confounding parameters further confirmed that plasma adiponectin was not an independent determinant for brain and renal small vessel-related disease.
Conclusion: These findings suggest that the plasma level of adiponectin alone is not enough for the risk stratification of cardiovascular disease. Leptin resistance associated with skeletal muscle loss in addition to obesity may need to be addressed to identify high risk people with high plasma adiponectin levels. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.atherosclerosis.2014.05.940

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記述言語：英語   出版者・発行元：ELSEVIER IRELAND LTD  

DOI： 10.1016/j.ijcard.2014.03.194

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objective: Several large-scale studies have shed light on the primary preventive efficacy of statins against atherosclerotic diseases in the course of treatment of dyslipidemia. However, this efficacy in the management of dyslipidemia in relatively low-risk patients, particularly in women, has not been clarified. Here, we investigated the efficacy of dyslipidemia treatment with a statin on three indices that are widely used to assess atherosclerosis in postmenopausal women: carotid intima-media thickness (CIMT), arterial stiffness index beta of the common carotid artery (carotid stiffness beta), and brachial artery pulse wave velocity (baPWV).
Methods: The study enrolled 51 postmenopausal women aged 55 years or older with dyslipidemia. The participants were randomly divided into two treatment groups and received a single daily administration of 2.5 mg of rosuvastatin or no statin therapy as control.
Results: At baseline, the groups did not significantly differ with regard to the three indices. At the third and 12th months of treatment, both carotid stiffness beta and baPWV values were significantly lower than those of the control group. As for CIMT, the value was significantly lower in the statin group than in the control group at 12 months of treatment. These changes were in conjunction with a significant decrease in low-density lipoprotein cholesterol. Interestingly, changes in CIMT during the 12-month period were significantly correlated with changes in high-sensitivity C-reactive protein during the 3-month period independently of lipid profile.
Conclusions: The potent statin improves baPWV and carotid stiffness beta, in addition to CIMT (surrogate markers of coronary artery disease), in postmenopausal women with low-risk dyslipidemia. Further studies to clarify the common mechanisms underlying the link between cholesterol-lowering therapy and atherosclerosis in postmenopausal women are required.

DOI： 10.1097/gme.0b013e318259c04e

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記述言語：英語   出版者・発行元：ELSEVIER IRELAND LTD  

DOI： 10.1016/j.ijcard.2012.04.033

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 69-year-old woman was admitted because of unconsciousness and multiple cranial neuropathy. She had suffered diarrhea 2 weeks previously. On examination, she was noted to have total external and internal ophthalmoplegia, bilateral facial palsy, dysphagia, dysarthria, neck weakness, distal motor weakness of all limbs, and ataxia. She had also presented with hy-poreflexia and hypoesthesia, but with a bilateral pyramidal tract sign. A study of her cerebrospinal fluid revealed albumino-cytologic dissociation, and nerve conduction study revealed demyelination of her peripheral nerves. Moreover, electroen-cephalography findings were abnormal and anti-GQ1b antibody was positive. We diagnosed Fisher syndrome with Guillain-Barré syndrome and Bickerstaff brainstem encephalitis. We administered intravenous immunoglobulin treatment for 5 days and her symptoms gradually improved. However, her external ophthalmoplegia continued for several months. © 2012, The Japan Geriatrics Society. All rights reserved.

DOI： 10.3143/geriatrics.49.367

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PUBLIC LIBRARY SCIENCE  

The combination of sarcopenia, age-related loss of muscle strength and mass, and obesity has been recognized as a new category of obesity among the elderly. Given that leptin has been hypothesized to be involved in the pathogenesis of sarcopenic obesity, we investigated the relationship between plasma leptin levels and thigh muscle sarcopenia and visceral obesity. Thigh muscle cross-sectional area (CSA) and visceral fat area were measured using computed tomography as indices for muscle mass and visceral fat, respectively, in 782 middle-aged to elderly subjects (303 men and 479 women), participating in a medical check-up program. Visceral obesity was defined as visceral fat area &gt; 100 cm(2), and sarcopenia was defined as &lt; (one standard deviation - mean of thigh muscle CSA/body weight of young subjects [aged &lt;50 years]). Thigh muscle CSA was significantly and negatively associated with plasma levels of leptin in both men (beta = -0.28, p&lt;0.0001) and women (beta = -0.20, p&lt;0.0001), even after correcting for other confounding parameters, including age, body weight, body height, visceral fat area, blood pressure, homeostatic model assessment index, and high sensitive C reactive protein. Subjects were divided into four groups based on presence or absence of sarcopenia or visceral obesity. Plasma levels of leptin were higher in subjects with sarcopenic visceral obesity than in those with either sarcopenia or visceral obesity alone. These findings indicate that sarcopenic visceral obesity is a more advanced, and suggest that leptin may link visceral obesity and sarcopenia.

DOI： 10.1371/journal.pone.0024633

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Objective: Sarcopenia of legs is an important cause of physical dysfunctions, frailty and dependence. Many predisposing and underlying mechanisms of sarcopenia, including age, sedentary life style, oxidative stress, insulin resistance, and low testosterone levels, are also known to be related to atherosclerosis, which is another leading cause of morbidity and mortality in elderly subjects. In this study, we investigated our hypothesis that sarcopenia and atherosclerosis are associated with each other to facilitate mutual abnormalities.
Methods: Study was performed in apparently healthy 496 middle-aged to elderly persons recruited consecutively among the visitors to the medical check-up program, Anti-Aging Doc, in a University hospital, from March 2006 to December 2007. Mid-thigh muscle cross-sectional area (CSA) was measured by computed tomography and corrected by body weight (CSA/BW). Carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) were measured.
Results: Thigh muscle CSA/BW was significantly and negatively associated with carotid IMT and baPWV in men but not in women. After correction for other confounding parameters, baPWV was an independent risk for the presence of sarcopeniainmen (odds ratio of 1 m/s increase of baPWV=1.14,95% CI = 1.01-1.30, p &lt; 0.05) in addition to age, body height, low physical activity, free testosterone level. Conversely, thigh muscle CSA/BW was an independent determinant of baPWV (beta=-0.15, p &lt; 0.01) in addition to age, blood pressure, triglyceride, and antihypertensive drug use in men.
Conclusions: Arterial stiffness is related to thigh muscle volume in men. Sarcopenia and atherosclerosis may share a common pathway and interact with each other to facilitate mutual abnormalities. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.atherosclerosis.2010.05.026

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

BACKGROUND
Recent studies have reported the association between advanced arterial stiffness and brain small vessel diseases (SVDs). two possible hemodynamic mechanisms, increases in central blood pressure (BP) and pulsatile flow load to the brain, have been speculated to link arterial stiffness and SVD. the carotid flow augmentation index (AI) has been proposed as an index of pulsatile flow to the brain. We compared its association with brain SVD with that of central BP in a general population.
METHODS
Subjects were 500 individuals free from symptomatic cardiovascular diseases with a mean age of 66.9 +/- 8.4 years. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. Carotid flow AI was obtained by Doppler ultrasonography. the presence of silent cerebral lacunar infarcts (SCI) was determined as a manifestation of SVD by 3-tesla magnetic resonance imaging (MRI). second peak radial systolic BP (SBP2) and pulse pressure (PP2) were used as estimates of central BP.
RESULTS
baPWV was significantly associated with radial BP2 (r = 0.55, P &lt; 0.0001) but not with carotid flow AI (r = 0.03, P = 0.51). Radial BPs and baPWV, but not flow AI, were significantly higher in subjects with SCI. Radial SBP2 had higher odds ratio for the presence of sCI than brachial SBP, PP, and radial PP2. Logistic regression analysis showed that radial SBP2, but not flow AI, was independently related to the presence of sCI.
CONCLUSION
These findings indicate that the SBP2, an estimate of central SBP, is significantly associated with the presence of SVD in an apparently healthy general population.

DOI： 10.1038/ajh.2010.60

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Aim:
Aging shifts body composition to comprising more fat and less muscle. Sarcopenia, particularly in the knee extensors, and obesity, particularly visceral obesity, either alone or in combination, may exacerbate age-related physical disability. We investigated the association between age-related quadriceps (Qc) sarcopenia and visceral obesity, as measured by cross-sectional area (CSA), on postural instability.
Methods:
Mid-thigh muscle CSA and abdominal visceral and subcutaneous fat area at the level of the umbilicus were assessed from computed tomography (CT) images in 410 apparently healthy independent middle-aged to elderly subjects attending the medical check-up program in Ehime University Hospital. Static postural instability using a posturograph and one-leg standing time with eyes open were assessed.
Results:
Both abdominal visceral fat area and Qc muscle CSA corrected by body weight (BW) were associated with static postural instability, in addition to age and sex, while BW-corrected Qc muscle CSA predicted a short one-leg standing time. The combination of Qc sarcopenia, defined as greater than 1 standard deviation below the mean of a young group (age &lt; 60 years), and visceral obesity, defined as a visceral fat area of more than 100 cm2, were associated with static postural instability, while Qc sarcopenia was related to a higher prevalence of one-leg standing time of less than 30 s, irrespective of visceral obesity.
Conclusion:
Thigh Qc sarcopenia and visceral obesity are associated with postural instability in middle-aged to elderly subjects. These findings suggest that age-related, site-specific fat and muscle mass alterations are associated with functional impairment. Geriatr Gerontol Int 2010; 10: 233-243.

DOI： 10.1111/j.1447-0594.2010.00610.x

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 72-year-old woman was admitted to a local hospital with general fatigue, ptosis and dysarthria. Her anti-AchR antibody titer was high, so myasthenia gravis was diagnosed. She was given a cholinesterase inhibitor, but her symptoms did not improve. CT and MRI scans revealed a mass in the anterior mediastinum infiltrating the superior vena cava (SVC) and the right atrium (RA). The diagnosis was an invasive thymoma extending into the SVC and the RA. Moreover, there was a mass in the right middle lobe of her lung, which was suspected to be the result of metastasis of the thymoma. She was transferred to our hospital for medication and surgery for the invasive thymoma. Urgent surgery was performed without preoperative therapy, because the tumor was nearly obstructing her tricuspid valve. An expanded thymomectomy and a right middle lobectomy were performed. As the tumor had infiltrated into the SVC, the SVC was replaced with an artificial graft. The clinicopathological diagnosis of thymoma (Masaoka Stage IVb) was given. The patient had a myasthenic crisis for several weeks after surgery, so her breathing was controlled by an artificial respirator. Her symptoms improved after treatment with steroids, tacrolimus and a cholinesterase inhibitor. Although major surgery was required to prevent tumor embolism, the patient survived. Careful observation is necessary to detect signs of relapse of invasive thymoma.

DOI： 10.3143/geriatrics.47.158

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

A 64-year-old man presented with high fever, deep coma, neck stiffness and decorticate rigidity on admission to our hospital. Laboratory findings revealed liver dysfunction, and serial brain computer tomography revealed a right cerebellar hematoma, a small hemorrhage in the left frontal lobe and ischemia of the left corona radiata. Electroencephalogram (EEG) showed periodic synchronous discharge (PSD) patterns on the first occasion, but these disappeared in later EEG. Based on the cerebrospinal fluid findings of increased total protein (1183 mg/dL), increased cells (71/mu L) and decreased glucose concentration (1 mg/dL), and the culture result of pure growth of Streptococcus pneumoniae, he was diagnosed as having pneumococcal meningoencephalitis. PSD patterns, though seldom found in bacterial meningoencephalitis, presented in this case probably due to severe infection of the central nervous system and hepatic encephalopathy. We report this case to emphasize that PSD can emerge on EEG in the early stage of pneumococcal meningoencephalitis.

DOI： 10.1111/j.1447-0594.2007.00431.x

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記述言語：日本語   出版者・発行元：日本老年医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2008133540

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 54-year-old woman was admitted to our hospital because of diplopia, dysphagia, dropped head, and muscle weakness with easy fatigability. A neurological examination showed bilateral ptosis, ocular motility disorder, dysphagia, and weakness of the neck extensor muscles. Edrophonium and repetitive nerve stimulation tests of the thenar muscles showed positive results. The serum titer of anti-acetylcholine receptor antibody was negative. A thymoma was not detected in her chest CT. Finally, she was diagnosed with anti-MuSK antibody-positive myasthenia gravis based on the high serum titer of anti-MuSK antibody (239 nmol/l). Her symptoms improved after administration of prednisolone. However, the symptoms were aggravated when the prednisolone dosage was reduced, and the titer of anti-MuSK antibody rose at the same time. We evaluated the possible association between changes in the severity of her clinical symptoms and the titer of the antibody during prednisolone therapy. It was revealed that the titer of the antibody was correlated to the severity of clinical symptoms expressed by a QMG (Quantitative Myasthenia Gravis) score. These findings indicate that monitoring the titer of anti-MuSK antibody can be useful for assessing disease activity as well as decision making during treatment.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 60-year-old woman was admitted to our hospital because of pyrexia, headache, gait disturbance, and sensory disturbance in the lower part of the body four days after she received an epidural block for postherpetic neuralgia. Neurological tests revealed neck stiffness, flaccid paraparesis in the legs with absent deep tendon reflexes, and hyperesthesia below Th7. According to a cerebrospinal fluid examination, the protein concentration was 245 mg/dl and the cell count was 176/mm3. PCR analysis of the cerebrospinal fluid was positive for Epstein-Barr virus (EBV). Serological tests for EBV yielded mild increases of serum IgG antibodies against EBV nuclear antigen (EBNA) and IgG antibodies against EBV viral capsid antigen (VCA). In a spinal MRI, the inferior lumbar meninges showed gadolinium enhancement. Nerve conduction studies revealed a decreased F wave ratio in the bilateral tibial nerves. The patient was diagnosed with meningomyeloradiculitis caused by EBV. The symptoms improved after steroid pulse therapy, but relapses of transverse myelitis and diplopia due to disturbance of the bilateral abducent nerves and left trochlear nerve occurred 7, 12, 16, and 26 months after treatment. The relapses were sometimes accompanied by small fluctuations in cerebrospinal fluid protein concentration, cell count, or serum anti-EBV antibody titer. These findings suggest that the myelopathy and diplopia were induced by a secondary immune reaction after inflammation caused by EBV infection.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 64-years-old man developed cognitive impairment. A neurological examination showed hypereactive tendon reflex. A celebrospinal fluid (CSF) examination showed a mild increase in both the number of mononuclear cells (14 cells/mm3) and the protein level (45 mg/dl). An electroencephalogram showed diffuse slow wave activity. Brain MR images revealed multifocal lesions in the limbic area and white matter regions. He was suspected to have autoimmune encephalitis and his symptoms improved after treated with methylprednisolone (1g/day for 3 days). Despite this treatment, his mental disorders later relapsed. His condition improved after undergoing repeated treatment. Thereafter, he developed bacterial meningoencephalitis which had been caused by Listeria Monocytogenes during the period of the internal administration of steroids. Antibiotics successfully cured his Listeria meningoencephalitis. He thereafter developed conjunctivitis, polyarthritis, hearing difficulties, dizziness and auricular chondritis. Based on these findings, we diagnosed the patient to have relapsing polychondritis (RP). It was thus conceivable that his cognitive impairment has been caused by CNS vasculitis associated with RP. RP therefore should be carefully taken into consideration and be included in the differential diagnosis as a possible cause for CNS vasculitis.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Geriatrics Society  

A 52-year-old woman with diabetes mellitus (DM) complained of weakness of the arms and legs. She was referred to our hospital in November 2002 because of anemia, thyroid tumor and meningioma including DM. She was short in stature, juvenile bilateral cataract, intractable skin ulcers, clavus on the sole of her foot, a bird-like face and high-pitched voice. Typical physical features led to the final diagnosis of Werner's syndrome. Although the myelogram revealed no abnormal findings except erythroid hypoplasia, cytogenetic analysis of bone marrow cells showed deletion of chromosome 20 in 10% of the analyzed cells, which suggested the possibility of that myelodysplastic syndrome (MDS) or acute myeloblastic leukemia (AML) could occur. She had a thyroidectomy because both lobes of the thyroid gland were enlarged and caused hoarseness, In addition, it is common knowledge that the goiter could become malignant. We need to follow her carefully because she might be vulnerable to malignant disease, including leukemia and malignant meningioma.

DOI： 10.3143/geriatrics.43.639

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(公社)日本リハビリテーション医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：愛媛医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(株)日本医事新報社  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：大道学館出版部  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

試験飴は、砂糖、水飴、香料に1粒あたりクロモジエキスを配合し作製した。プラセボ飴は試験飴からクロモジエキスを除き、カラメルを配合し試験飴と同色に着色したものとした。インフルエンザの予防接種を受けた看護スタッフ135名を対象とし、無作為に試験飴摂取群67名(男性3名、平均37.9±11.9歳)、プラセボ飴摂取群67名(男性6名、平均37.4±10.0歳)に割り付けた。試験食品が起因する有害事象は認めなかった。インフルエンザ罹患者数は試験飴摂取群2名(3.0%)、プラセボ飴摂取群9名(13.4%)で、2群間に有意差を認めた。試験飴摂取群で罹患した2名はいずれもインフルエンザB型で、プラセボ飴摂取群では9名中A型が6名、B型は3名であった。罹患患者のうち複数回インフルエンザに罹患した者はなく、欠勤期間は試験飴摂取群4〜5日、プラセボ飴摂取群2〜6日で違いはみられなかった。インフルエンザに起因しない風邪症状においては、発熱、のど、鼻に症状が1回以上みられた人数、発症期間、発熱の有無、のど症状の有無、鼻症状の有無についてはいずれも群間に差は認めなかった。

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記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

試験飴は、砂糖、水飴、香料に1粒あたりクロモジエキスを配合し作製した。プラセボ飴は試験飴からクロモジエキスを除き、カラメルを配合し試験飴と同色に着色したものとした。インフルエンザの予防接種を受けた看護スタッフ135名を対象とし、無作為に試験飴摂取群67名(男性3名、平均37.9±11.9歳)、プラセボ飴摂取群67名(男性6名、平均37.4±10.0歳)に割り付けた。試験食品が起因する有害事象は認めなかった。インフルエンザ罹患者数は試験飴摂取群2名(3.0%)、プラセボ飴摂取群9名(13.4%)で、2群間に有意差を認めた。試験飴摂取群で罹患した2名はいずれもインフルエンザB型で、プラセボ飴摂取群では9名中A型が6名、B型は3名であった。罹患患者のうち複数回インフルエンザに罹患した者はなく、欠勤期間は試験飴摂取群4〜5日、プラセボ飴摂取群2〜6日で違いはみられなかった。インフルエンザに起因しない風邪症状においては、発熱、のど、鼻に症状が1回以上みられた人数、発症期間、発熱の有無、のど症状の有無、鼻症状の有無についてはいずれも群間に差は認めなかった。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01471&link_issn=&doc_id=20180906210013&doc_link_id=issn%3D0386-3603%26volume%3D46%26issue%3D8%26spage%3D1369&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0386-3603%26volume%3D46%26issue%3D8%26spage%3D1369&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

記述言語：日本語   出版者・発行元：(一社)日本脳神経超音波学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本抗加齢医学会  

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記述言語：日本語   出版者・発行元：愛媛医学会  

われわれは2006年から開始している抗加齢ドックのデータを基にした加齢に伴う認知症発症リスクに対する検討を行っている。根本的な治療薬のない現在「可能な限り早期に認知症および認知症予備群を発見して適切な生活への介入を行うこと」が求められている。近年、正常加齢と認知症の境界領域と考えられる軽度認知障害(Mild cognitive impairment:MCI)が注目されており、MCIと関連するファクターを探索し、それらに対する介入を試みることは臨床面からも有用であると考えられる。MCIは65歳以上の高齢者の約5%にみられ、年間約10-15%がADに移行することが知られている。われわれはMCIの診断には「MCI screen」を用いている。このテストを用いて2017年に2本の論文がpublishされた。論文1)高齢者のMCI診断におけるSAFの有用性 AGEs(Accumulation of advanced glycation endproducts)の蓄積と認知症の発症の関連性が示唆されている。しかしながら認知症発症の前段階と考えられるMCI(mild cognitive impairment)とAGEsの関連を検討した報告は少ない。そこで本研究では健常高齢者におけるMCIと皮膚に蓄積したAGEsとの関連について検討した。本研究から非侵襲的なAGEs測定法であるSAFは健常者におけるMCIスクリーニングを行う上で有用なバイオマーカーである可能性が示唆された。論文2)高齢者におけるエクオール産生能と認知機能低下の関連 豆イソフラボン摂取による心血管疾患の予防効果が知られているが、認知機能予防効果については愚論のあるところである。個人差がある原因として大豆イソフラボンの代謝産物である「エクオール」(Equol)産生能の有無が関連している可能性がある。本研究結果からは1)エクオール産生者では有意にタッチパネル式認知機能検査の点数が高い2)エクオール非産生者では有意にMCIの存在率が高い、ことからエクオール産生者では認知機能の予防効果がある可能性がある。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：日本神経免疫学会  

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記述言語：日本語   出版者・発行元：日本神経免疫学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：KARGER  

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(株)新興医学出版社  

＜ポイント＞フレイル、サルコペニア、動脈硬化の間には共通の機序を介した密接な関連がある。フレイルと心血管疾患は相互にリスク因子となりうる。フレイルと心血管疾患に共通する機序として炎症と血液凝固系因子が考えられている。フレイルを有する高齢者では高血圧などの治療介入に慎重な検討が必要である。(著者抄録)

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ELSEVIER IRELAND LTD  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本脳卒中学会  

症例は53歳男性、右上肢の感覚障害と脱力発作を繰り返し、脳梗塞を指摘され入院した。本態性血小板血症と診断され、JAK2遺伝子変異を有した。入院後も右上肢の脱力症状を繰り返し、急性期には低用量アスピリンと抗凝固薬の併用を要したが、骨髄抑制療法の効果発現後にはアスピリンが中止可能となった。JAK2遺伝子変異陽性例では、血小板数や機能の異常のみでなく、凝固因子の異常や血管内皮の機能障害を認めることが指摘されており、高齢、血栓塞栓症の既往などに加えて、本態性血小板血症における血栓塞栓症のリスク因子の一つであるといわれる。本症例はアテローム血栓性脳梗塞に類似した臨床経過を呈し、血管内皮の機能障害を背景とした血管壁の血栓易形成性が、脳梗塞発症に関連している可能性を推測した。本疾患における最適な抗血栓療法を検討する上で貴重な症例であると考えられ、報告する。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：KARGER  

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：日本神経免疫学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY-BLACKWELL  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：日本神経免疫学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：日本神経免疫学会  

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記述言語：日本語   出版者・発行元：(一社)日本抗加齢医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

症例は69歳女性で、起床時より、開眼、歩行が困難な状態がみられ、眼瞼下垂、四肢末梢の異常感覚が出現し入院した。構音・嚥下障害が出現し、意識レベルが低下した。体温36.1℃、脈拍82/分、血圧151/98mmHg、意識レベルJCS2ケタ、脳神経では全外眼筋麻痺があった。対光反射は直接・間接いずれも両側と消失していた。瞳孔は両側5mmと拡大、顔面の感覚は正常、聴力正常、咽頭反射低下口蓋垂挙上不良、挺舌困難であった。頸部筋力低下、四肢の筋緊張は正常であるが筋力はいずれも遠位結いでMMT4程度の筋力低下がみられた。免疫グロブリン大量静注療法を開始したところ数日で意識障害は改善した。症例はFisher症候群に多発性脳神経障害と脳波異常が合併していた。

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：日本語   出版者・発行元：愛媛医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：日本語   出版者・発行元：(株)新興医学出版社  

●高齢者の転倒は骨折を介して生命予後に重大な影響を与える。●加齢に伴う骨格筋量減少および筋力低下は、高齢者の転倒リスクの増加(転倒しやすさ)を介して将来の身体的な機能障害のリスクとなる可能性がある。●大腿四頭筋面積の低下(sarcopenia)は転倒しやすさにつながる。●内臓脂肪面積の増加(obesity)は転倒しやすさにつながる。●大腿四頭筋面積の低下と内臓脂肪面積の増加が重複した状態(sarcopenic obesity)は転倒リスクとしてもっとも重要である。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本頭痛学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本脳腫瘍病理学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：医歯薬出版(株)  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

72歳女。左眼瞼下垂、右眼瞼下垂、夕刻の易疲労感、鼻声、発語困難感を自覚し、近医へ入院した。臨床症状、テンシロンテスト陽性、抗アセチルコリンレセプター抗体陽性から、重症筋無力症と診断され、コリンエステラーゼ阻害薬内服を開始した。CT・MRI検査にて浸潤性胸腺腫を指摘され、精査・加療目的で入院した。コリンエステラーゼ阻害薬内服を継続し、軽度の右眼瞼下垂と易疲労感は残存するも、明らかな筋無力症状の増悪なく経過した。胸部造影CTおよびMRI検査所見から、前縦隔腫瘍は浸潤性胸腺腫が疑わしく、右肺中葉結節影は浸潤性胸腺腫の遠隔転移のほか既往歴から乳癌再発の可能性も考えられた。右中葉切除術、拡大胸腺摘出手術、人工血管バイパス術(体外循環補助下上大静脈再建)を施行した。自力での起立、歩行器での歩行が可能なまで改善した。

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本内科学会  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

55歳男。20歳時にvon Recklinghausen病(vR病)と診断された。51歳時には右大腿部腫瘍を指摘され、通院中であった。急激な右大腿部の腫脹、気分不良・意識レベルの低下で緊急入院となった。全身にcafe-au-lait spotと5mm大の腫瘍を多数認めた。大腿部CTでは右大腿部筋層内に著明な血腫を認めたが、造影剤の明らかな漏出は認められなかった。右外側大腿回旋動脈の分枝が責任動脈と考えられたが腫瘍内外の判別が困難であった。出血性ショックを呈しているため、ゼルフォームで塞栓術を施行した。入院時の大腿周径は著明に増大していたが、経過とともに縮小し、骨シンチ、腫瘍シンチ、造影MRIのいずれでも明らかな悪性所見は認めず、退院して定期的画像検査での経過観察となった。以上のことから、vR病における動脈出血の際には、血管造影による出血部位の同定、肝動脈塞栓療法による速やかな止血が重要と考えられた。

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

72歳男。患者は1990年に左腎細胞癌と診断され、左腎摘出術が施行された。この時に転移はみられず、経過観察されていた。しかし、2005年に右腋窩腫瘤を自覚し、入院時、右腋窩に小鶏卵大、弾性硬の腫瘤が触知された。血液検査上、腫瘍マーカーで異常は認められなかったものの、エコーでは26×24mmの辺縁平滑で血管豊富な腫瘤がみられた。また、胸部CTでは同部位に強く造影される境界明瞭な腫瘤を認め、腹部CTでは右腹直筋と膵鉤部に造影される腫瘤を認めた。右腋窩腫瘤の切除生検を施行したところ、病理組織所見では1990年の左腎細胞癌と一致し、腎細胞癌の異所性再発と診断された。全身状態が良好であったことから手術切除を選択し、膵および腹直筋腫瘍核出術を施行した結果、膵部の腫瘍は膵頭部にも再発巣を認めたが、主膵管に隣接しており剥離困難であった。術後は経過良好で、残置した膵頭部腫瘍も増大傾向はなく、新たな転移巣は認められていない。

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

24時間在宅医療専門診療所と共同し、訪問診療に携わった末期癌患者66名の初診時から離脱(死亡および紹介元への再入院)までのデータを分析して在宅医療を円滑に行う為に必要な要素を検討した。その結果、1)主介護者は7割が女性で、介護に携われる人数は一家庭あたり平均2.0人であった。2)50%の症例が介護保険を申請してなく、また紹介元病院との間では退院前のカンファレンスは21%しか行われていなかった。3)在宅医療開始後2週間で10%を越える患者が離脱しており、自宅で死亡した43例の死亡時刻は通常勤務帯以外が70%を占めていた。以上、これらのことからも、在宅診療を病院と遜色なく行うには、十分なスタッフ数を備えた24時間体制の診療所が必要であり、患者が家族とゆとりある時間を持つためには早期の在宅診療移行が必要である。そのためには、紹介元病院が可能な限り早期に在宅医療専門診療所を紹介し、両者間で退院前カンファレンスを行い、入院中に介護保険申請を速やかに行うよう指導する必要があると考えられた。

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2008133540

記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：日本皮膚科学会-西部支部  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

症例は60歳女性である。帯状疱疹後疼痛に対する硬膜外ブロックを受けた4日後から発熱、項部硬直、Th7レベルの横断性脊髄障害および腰髄神経根障害をみとめた。髄液検査で蛋白245mg/dl、細胞176/mm3と上昇があり、PCRでEBウイルスDNAが陽性であった。脊髄MRIでは、腰髄下部髄膜の造影効果をみとめた。ステロイドパルス療法にて改善したが7,12,16、および26ヵ月後に横断性脊髄炎の再増悪と複視(外転神経、滑車神経障害)の出現をみとめた。再発時に髄液蛋白・細胞、血清抗EBV抗体価の軽度の変動をともなうこともあった。EBV感染による直接の炎症と感染後の二次的免疫反応により再発性に神経障害をきたした可能性が示唆された。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

症例は64歳の男性である。進行性の見当識障害と計算力障害をみとめた。深部腱反射亢進、髄液検査で細胞数14/mm3(単核球優位)、蛋白45mg/dl、脳波検査でびまん性の徐波をみとめた。頭部MRIでは辺縁系や深部白質に多巣性の病変をみとめた。何らかの自己免疫性の脳炎と診断し、ステロイドパルス療法により改善し、退院したが、再発をきたし再入院した。再度パルス療法で改善した。その後細菌性髄膜炎を発症し、治療により軽快したが、結膜炎、多発関節炎、難聴、眩暈、耳介軟骨炎を発症したため、再発性多発軟骨炎と診断した。認知障害は本症にともなう中枢神経血管炎によるものと考えられた。中枢神経血管炎の原因として本症も考慮に入れる必要があると考えられた。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

症例は54歳女性である。眼瞼下垂、複視、構音・嚥下障害、首下がり、筋疲労にて発症した。エドロホニウム試験陽性かつ反復誘発筋電図検査でwanning現象をみとめた。抗アセチルコリン受容体抗体は陰性であったが、抗筋特異的チロシンキナーゼ(muscle-specific tyrosine kinase,MuSK)抗体価高値(239nmol/l)が判明し、抗MuSK抗体陽性重症筋無力症と診断した。Quantitative Myasthenia Gravis Score(QMG score)をもちいて、筋無力症状の重症度と抗体価の推移を観察したところ、本例では治療による重症筋無力症重症度の変化と抗体価の推移が相関していた。症例によっては、抗MuSK抗体価は治療方針決定の上で有用なマーカーであると考えられた。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

52歳女性。患者は四肢脱力感で近医を受診、糖尿病と診断されたが内服薬で軽快せず、紹介先の総合病院で四肢の筋萎縮、貧血、前頸部腫瘤、髄膜種を認め、著者らの施設へ紹介入院となった。所見では低身長、鳥様顔貌、両眼白内障、強皮症様皮膚、両足底の鶏眼・潰瘍と右前頸部腫瘤を認め、Werner症候群と診断された。また、四肢筋力低下と筋萎縮、感覚低下を認め、正球性正色素性貧血、血清鉄・フェリチンの低下が確認された。前頸部腫瘤は穿刺吸引細胞診で甲状腺腫と診断されたが、増大傾向と悪性転化を考え摘出術を行い、組織診断では濾胞腺腫であった。骨髄生検では赤芽球の低形成以外に異常細胞は認めなかったが、20細胞中2個(10%)で20番染色体の長腕欠失が認められた。食事療法で血糖コントロールは改善し退院し、目下、外来経過観察中である。

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2007074300

記述言語：日本語   出版者・発行元：公立学校共済組合近畿中央病院  

30歳女。患者は発熱、咳、痰を主訴とした。胸部CTでは原因不明の両肺の境界不鮮明な斑状すりガラス状陰影が散在していた。加療後、退院すると数日で発熱し、その後も入院すると解熱するが外泊すると発熱した。職場のカラオケバーに出かけると発熱することが判明し、職場での夏型過敏性肺臓炎を疑い、抗トリコスポロン抗体検査、気管支鏡・気管支肺胞洗浄を施行した。その結果、血清中のトリコスポロン抗体はセロタイプ2型が陽性であった。気管支洗浄液中ではCD8陽性リンパ球が優位であった。古いビルの一室にある職場の環境調査を行い、張り替えたクロスからトリコスポロンが発見された。汚染されたエアコン、腐木、排水設備等とともに、専門業者によって可能な限り職場の原因抗原除去を行った。治療はプレドニゾロン投与で外来管理とし、その後も繰返し臨床、血清学、放射線、肺機能検査を行って経過観察した。翌年夏、短期間、CRPの増加を伴った症状悪化が再びみられた。呼吸機能は無症状の時期にも肺拡散能の低下が続いている。

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記述言語：日本語   出版者・発行元：(一社)日本内科学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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