Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
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Nihon Ronen Igakkai Zasshi · Sep 1998
Case Reports[Bilateral homonymous hemianopsia with atrial fibrillation].
We encountered an 80-year-old man with sudden bilateral visual disturbance. When he was admitted to the hospital, his blood pressure was 138/70 mmHg, and an ECG revealed atrial fibrillation. Neurological examination showed only bilateral homonymous hemianopsia with no nystagmus or impairment of eye movement. ⋯ Magnetic resonance imaging of the brain showed cerebral infarctions in both occipital lobes. Perimetry showed bilateral homonymous hemianopsia; the left side of the macula was spared. The lack of neurological deficit other than bilateral homonymous hemianopsia indicates that only the right and left cortical branches of the posterior cerebral artery were occluded.
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Nihon Ronen Igakkai Zasshi · Jun 1997
Case Reports[Use of hemostatic clips for endoscopic hemostasis and closure of an esophageal laceration caused by a fish bone].
An 82-year-old woman was admitted to our hospital because of hematemesis. She had had a feeling of a foreign substance in her throat for one week after having eaten fish. On admission she had a fever of 38 degrees C, Hb of 5.8 g/dl, CRP level of 8.8 mg/dl, and bilateral pleural effusions. ⋯ Endoscopic hemostasis and closure of the laceration was done with hemostatic clips. The esophageal injury seemed to have been caused by a fish bone. After the treatments described here were carried out, the patient's condition rapidly improved.
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Nihon Ronen Igakkai Zasshi · Jun 1996
[University education in geriatrics: medical student's opinions on gerontology and geriatric medicine].
With the aging of Japan's population, physicians need to be aware of advances in geriatric medicine. To assess the status of geriatric medicine in undergraduate education, we surveyed of medical student's opinions on gerontology and geriatric medicine. A questionnaire was sent to six-year medical students at a total of 20 schools that did not include geriatric medicine in their curriculum. ⋯ The corresponding data for medical students in schools with classes in geriatric medicine were dementia (77%), cerebral vascular accidents (44%), osteoporosis (29%), and cancer (16%). Undergraduate medical students seem to be exposed to widely differing curricula with regard to geriatric medicine. We found a lack of uniformity in the teaching of gerontology and geriatric medicine to undergraduate medical students in Japan.
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Nihon Ronen Igakkai Zasshi · May 1996
[University education in geriatrics. Present status and future plans of universities regarding the development of a program in geriatrics].
Because the number of people who reach an advanced age has been increasing at an unprecedented rate in Japan, geriatricians are expected to play a central role in health care for the elderly. However, only 16 out of 80 medical schools (20 percent) now have departments of geriatrics for undergraduate education. To develop undergraduate education in the field of geriatrics, a survey was sponsored by the Research Projects on Aging and Health (Health Science Research Grant the Ministry of Health and Welfare of Japan). ⋯ Institutions, nursing homes, and geriatric hospitals outside medical schools be easily accessible. It was generally agreed that geriatrics should be taught in advanced classes. In conclusion, medical schools in Japan regard undergraduate education in geriatrics as necessary and agree on the optimal curriculum, but it is not universally implemented.
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Nihon Ronen Igakkai Zasshi · Apr 1996
Comparative Study[Ischemic stroke in elderly patients with paroxysmal atrial fibrillation].
We compared the rate of ischemic strokes in elderly patients (those aged 65 years or more) who had paroxysmal atrial fibrillation (E-PAf) with those of younger patients (less than 65) with paroxysmal atrial fibrillation (Y-PAf) and of elderly patients with chronic atrial fibrillation (E-CAf) in a retrospective study. A total of 95 E-PAf patients (mean age 73.6), 79 Y-PAf patients (mean age 52.4), and 95 E-CAf patients (mean age 73.6) were studied. The incidence of all ischemic strokes in E-PAf patients (4.8%/yr) was significantly lower than in E-CAf patients (8.3%/yr) and higher than in Y-PAf patients (2.5%/yr) (p < .01). ⋯ Fifty-seven E-PAf patients had only one attack of atrial fibrillation and the remaining 38 had more than two attacks. Patients with many attacks of atrial fibrillation had significantly higher rate of brain embolism than did those who had only one attack (4.6 v.s. 0.8%/yr) (p < .005). Those two groups did not differ with regard to the rate of brain thrombosis.