Nihon Rinsho. Japanese Journal Of Clinical Medicine[JOURNAL]
Sun
200 papers
[Clinical pharmacy services to patients of immunomodulatory drugs].
Nihon Rinsho · 2016 Jul · PMID 30714706
Abstract loading — click title to view on PubMed.
[Classification of angina pectoris].
Suzuki H
Nihon Rinsho · 2016 Aug · PMID 30540151
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[Paroxysmal limb intolerable pain (infantile pain episodes associated with novel Nav1.9 mutations in familial episodic pain syndrome)].
Noguchi A, Takahashi T, Okuda H … +2 more , Kobayashi H, Koizumi A
Nihon Rinsho · 2017 Apr · PMID 30549873
Painful peripheral neuropathy has been correlated with various voltage-gated sodium channel mutations in sensory neurons. Recently Navl.9, a voltage-gated sodium channel sub- type, has been established as a genetic influ...
Painful peripheral neuropathy has been correlated with various voltage-gated sodium channel mutations in sensory neurons. Recently Navl.9, a voltage-gated sodium channel sub- type, has been established as a genetic influence for certain peripheral pain syndromes. Herein, we performed a genetic study in six unrelated, multigenerational Japanese families with episodic pain syndrome. Affected participants were characterized by infantile recurrent pain episodes, with spontaneous mitigation around adolescence. The affected joints, in an in- creasing order of frequency, include those in the knees, ankles, wrists, and elbows. The pain typically lasts for 15-30 min and recurs several times a day. The pain is often induced by fa- tigue and is a prelude of bad weather. The affected regions feel cold in the patients, and warming the lesions relieves the symptoms. This unique phenotype was inherited in an autosomal-dominant mode. Two missense var- iants, p.R222S and p.R222H, were identified in SCN11A by linkage analysis and exome analy- sis. Next, we generated a knock-in mouse model harboring one of the mutations (p.R222S). Behavioral tests showed that p.R222S mice were significantly more hypersensitive to hot and cold stimuli. Electrophysiological studies using dorsal ganglion neurons showed significant increase of input impedance and firing frequency of evoked action potentials in p.R222S mice. These results suggest that the novel mutation reported herein is a gain-of-function mu- tation that causes infantile familial episodic pain.
[Continence care with high QOL(quality of life) for the aged].
Suzuki Y, Furuta A, Koike Y
Nihon Rinsho · 2017 Apr · PMID 30549872
At the time to select methods for continence care, doctors should consider not only scien- tific factors but also quality of life. Functions of lower urinary tract are storage and voiding. Urine is waste of human body, s...
At the time to select methods for continence care, doctors should consider not only scien- tific factors but also quality of life. Functions of lower urinary tract are storage and voiding. Urine is waste of human body, so it is essential to void urine perfectly in a view point of to keep homeostasis. All patients who have been using a indwelling urethral catheter for more than a few days have complicated urinary tract infection. A trick of increasing good points of urethral catheter is a use in a limited period. If patients who have lost voiding function can perform clean intermittent self-catheterization, they will be able to enjoy continence without infection.
[Development of continence care system for the elderly in a community].
Gotoh M
Nihon Rinsho · 2017 Apr · PMID 30549871
The majority of fragile elderly individuals, such as the elderly in institutions for the elderly and those in home care use diaper or indwelling urethral catheters without careful considera- tion. Lower urinary tract dys...
The majority of fragile elderly individuals, such as the elderly in institutions for the elderly and those in home care use diaper or indwelling urethral catheters without careful considera- tion. Lower urinary tract dysfunction is hardly life threatening, but it impairs the dignity and quality of life of individuals. Inappropriate urinary management of elderly individuals leads to adverse changes in immobilization and dementia, and would ultimately render the disease untreatable. In order to build up the urinary management care system in a community, spe- cialist team collaboration among primary care physicians, urologists, nurses, care-workers, care-attendants, etc. is mandatory. We report our efforts for improving the urinary manage- ment for elderly individuals coordinating with government officials, residents, and university and suggest the important factors to promote urinary care system in a community.
[A fact and problems of the anticancer chemotherapy for elderly patients].
Hara I
Nihon Rinsho · 2017 Apr · PMID 30549870
Since the rate of elderly patients in cancer death is continuously increasing, elderly pa- tients are not special, but ordinary population in daily clinical settings. Geriatric assessment (GA) is recommended to evaluate...
Since the rate of elderly patients in cancer death is continuously increasing, elderly pa- tients are not special, but ordinary population in daily clinical settings. Geriatric assessment (GA) is recommended to evaluate elderly patients when they undergo anticancer chemother- apy. Geriatric 8 (G8) is an excellent screening tool to evaluate physical and mental function of elderly patients. By such screening tools, elderly patients are divided into 3 categories; "fit": standard regimen for non-elderly patients are applicable, "vulnerable": some modified regi- men should be needed since moderate dysfunction due to aging is recognized, "frail": best supportive care rather than standard therapy should be considered. Thus, individualization of anticancer therapy seems to be most important point for elderly patients.
[Current multidisciplinary approaches for metastatic prostate cancer].
Satoh T, Ishiyama H
Nihon Rinsho · 2017 Apr · PMID 30549869
Prostate cancer incidences in most Asian populations have rapidly increased, and prostate cancer ranks as the highest incidence of male cancer in Japan since 2015. Androgen depriva- tion therapy (ADT) remains the main fi...
Prostate cancer incidences in most Asian populations have rapidly increased, and prostate cancer ranks as the highest incidence of male cancer in Japan since 2015. Androgen depriva- tion therapy (ADT) remains the main first-line treatment for patients with metastatic prostate cancer (mPCa). However, treatment benefits last for 3-5 years when disease transforms into metastatic castration-resistant prostate cancer (mCRPC). Currently, management paradigms for mPCa are dramatically changing. Two multicenter, randomized trials have redefined first-line treatment, with the demonstration of improved overall survival with the addition of docetaxel chemotherapy to ADT. Several data have re- ported the impact on survival of radiotherapy of the prostate even in patients diagnosed with mPCa. The objective of this review is to summarize an overview of current multidisciplinary approaches for mPCa and mCRPC.
[Chemotherapy against bladder cancer in geriatric patients].
Nagao K, Matsuyama H
Nihon Rinsho · 2017 Apr · PMID 30549868
The number of geriatric bladder cancer patients is now increasing in spite of little is known regarding the safety and efficacy of standard treatment for the patients due to luck of data in geriatric patients. Although t...
The number of geriatric bladder cancer patients is now increasing in spite of little is known regarding the safety and efficacy of standard treatment for the patients due to luck of data in geriatric patients. Although they should be treated by modified standard treatment adjusted for their deteriorated physical activity, such treatment regimens are not established. Bladder preservation therapy could be recommended for geriatric patients with invasive bladder can- cer, which shows comparable survival benefit with radical cystectomy. Although chemother- apy could be a treatment option for geriatric patients, geriatric assessment before treatment is recommended to choose appropriate candidates to modify therapeutic regimens. Standard treatment for geriatric patients with cancer would be established based on clinical trials in- volving geriatric assessment.
[Surgical treatment of bladder cancer in the geriatric patients].
Koie T, Hatakeyama S, Ohyama C
Nihon Rinsho · 2017 Apr · PMID 30549867
As bladder cancer is an age-related disease and an increase in patients with MIBC seems inevitable because of the aging population in Japan, muscle-invasive bladder cancer (MIBC) care in the elderly is likely to become a...
As bladder cancer is an age-related disease and an increase in patients with MIBC seems inevitable because of the aging population in Japan, muscle-invasive bladder cancer (MIBC) care in the elderly is likely to become a very common problem in daily practice. The gold standard for patients with MIBC is radical cystectomy (RC). However, elderly patients present with several comorbidities, and the geriatric patients with MIBC were not given po- tentially curative treatments, including RC. The optimal therapy for elderly MIBC patients may become a crucial issue. To achieve a better oncologic outcome in the neoadjuvant set- ting, the chemotherapy regimen should be less toxic to prevent any treatment-related delay between chemotherapy and RC. In addition, minimally invasive surgical approaches for the elderly patients with MIBC have been rapidly adopted for the treatment of MIBC, improving perioperative morbidity and ease of recovery.
[Pathogenesis and treatment of upper urinary tract cancer].
Sakai Y
Nihon Rinsho · 2017 Apr · PMID 30549866
Upper urinary tract cancer originates in the renal pelvis or ureter and is relatively uncom- mon. The predilection age is 65 to 79 years in Japan. Currently, a diagnosis is usually con- firmed using computed tomography u...
Upper urinary tract cancer originates in the renal pelvis or ureter and is relatively uncom- mon. The predilection age is 65 to 79 years in Japan. Currently, a diagnosis is usually con- firmed using computed tomography urography. Although radical nephroureterectomy with bladder cuff excision is the gold standard treatment for localized disease, nephron-sparing surgery using a transureteroscopic approach has also been performed for unifocal, small, and low-grade tumors. For advanced disease, platinum-based combination chemotherapy is administered, but there is little known about its effect, unlike for bladder cancer, which is a lower urinary tract cancer. Although older age is reported as one of the prognostic factors in upper urinary tract cancer, age alone should not prevent curative treatment.
[Drug therapy for renal cell carcinoma in the elderly].
Miyake H, Ozono S
Nihon Rinsho · 2017 Apr · PMID 30549865
The incidence of renal cell carcinoma (RCC) peaks between 60 and 70 years, and > 25% of newly diagnosed patients are > 75 years. However, clinical trials for the evaluation of drug therapy for metastatic RCC (mRCC) have...
The incidence of renal cell carcinoma (RCC) peaks between 60 and 70 years, and > 25% of newly diagnosed patients are > 75 years. However, clinical trials for the evaluation of drug therapy for metastatic RCC (mRCC) have generally under-represented the actual proportion of elderly patients in the general population of mRCC patients; therefore, limited data remain available with respect to the efficacy as well as safety of drug therapy for elderly mRCC pa- tients. In this review, therefore, we attempted to summarize the current status of drug ther- apy for mRCC in the elderly based on both the available findings as well as our experience, and to discuss the future prospect of this therapy considering characteristics specific to eld- erly mRCC patients.
[Ablation therapy for renal cell cancer of elderly patients].
Kanda H, Arima K, Sugimura Y
Nihon Rinsho · 2017 Apr · PMID 30549864
Japanese Urological Association reported that 3,648 patients of renal cell carcinoma were diagnosed in 2007 from 340 institutions and 70 years old or more accounted for 35.5% of pa- tients and 8.3% were more than 80 year...
Japanese Urological Association reported that 3,648 patients of renal cell carcinoma were diagnosed in 2007 from 340 institutions and 70 years old or more accounted for 35.5% of pa- tients and 8.3% were more than 80 years old. If the elderly patients are frail and have severe comorbidity, surveillance might be taken for small renal cancer. However, relatively large tu- mor or rapid tumor growth rate lead to disease progression. Because percutaneous ablation to renal cell carcinoma is less invasive treatment than surgery and is superior in quality of life maintenance, it will be suitable treatment for small renal carcinoma of elderly patients. We showed results of the radiofrequency ablation of renal cell carcinoma of elderly patients 80 years or older. Among 17 patients, four patients were dead of other causes and the death due to renal carcinoma was absent. Only one patient had local tumor progression and needed re- ablation. Renal function preservation after treatment was good.
[Surgical therapy for the elderly patients with renal cell carcinoma].
Kinoshita H, Matsuda T
Nihon Rinsho · 2017 Apr · PMID 30549863
It is controversial whether the definitive therapies are really required to the elderly with kidney cancer. This issue may be complicated because many factors, such as the definition of the elderly, function in daily lif...
It is controversial whether the definitive therapies are really required to the elderly with kidney cancer. This issue may be complicated because many factors, such as the definition of the elderly, function in daily life, tumor size, selected therapy, influence the decision of renal tumor management. Herein we reviewed the role of the various therapeutic options for the non-advanced renal tumors among the elderly.
[LOH (late-onset hypogonadism) syndrome].
Chiba K, Fujisawa M
Nihon Rinsho · 2017 Apr · PMID 30549862
Testosterone deficiency has recently drawn wide attention due to the high prevalence of hypo-gonadal symptoms in the aging male population. A number of studies have reported the beneficial effects of testosterone replace...
Testosterone deficiency has recently drawn wide attention due to the high prevalence of hypo-gonadal symptoms in the aging male population. A number of studies have reported the beneficial effects of testosterone replacement therapy for men with late-onset hypogonadism (LOH) syndrome. Based on the study evaluating the age distribution of serum testosterone concentration, serum free testosterone less than 8.5 pg/mL is considered as a good indica- tion for testosterone replacement therapy among the Japanese population. However, at present, testosterone enanthate is the only drug that is covered by health insurance in Japan. Further studies are needed to establish more suitable treatment in men with LOH syndrome among Japanese population.
[Erectile dysfunction].
Nagai A
Nihon Rinsho · 2017 Apr · PMID 30549861
Aging is the biggest risk factor of erectile dysfunction (ED). Seventy-one percent of Japanese men aged 70 to 79 years reported suffering from ED. Blood vessels and nerves related to erection are damaged by various risk...
Aging is the biggest risk factor of erectile dysfunction (ED). Seventy-one percent of Japanese men aged 70 to 79 years reported suffering from ED. Blood vessels and nerves related to erection are damaged by various risk factors as well as histological change in a corpus cavernosum penis, decreased testosterone level, and various complexed factors. Phosphodiesterase 5 inhibitors are the first-line choice for both on-demand and chronic treat- ment of ED. Late-onset hypogonadism (LOH) is diagnosed when declining testosterone con- centrations in the aging male cause ED and the metabolic syndrome (MetS). Testosterone replacement therapy for these patients has beneficial effect on ED and MetS and improves quality of sexual life.
[Urinary incontinence].
Yoshizawa T, Takahashi S
Nihon Rinsho · 2017 Apr · PMID 30549860
Urinary incontinence (UT) has considerable impacts on quality of life (QOL) and the num- ber of patients of it increases by age. Classifying UT based on the pathophysiology, it includes stress urinary incontinence (SUI),...
Urinary incontinence (UT) has considerable impacts on quality of life (QOL) and the num- ber of patients of it increases by age. Classifying UT based on the pathophysiology, it includes stress urinary incontinence (SUI), urgency urinary incontinence (UUI), overflow incontinence and functional urinary incontinence. SUI alone is the most common among female with UI, followed by mixed urinary incontinence of SUI and UUI, and UUI alone. Among male with UI, UUI and overflow incontinence associated with benign prostatic hyperplasia are fre- quently observed. In this article, the pathophysiology and treatment of UI are described and discussed.
[Overactive bladder].
Nagai T, Ogawa N, Ishizuka O
Nihon Rinsho · 2017 Apr · PMID 30549859
Overactive bladder (OAB) is a storage symptom complex that includes urinary urgency with or without urge incontinence, urinary frequency and nocturia. OAB is common symp- tom complex and its morbidity is high and increas...
Overactive bladder (OAB) is a storage symptom complex that includes urinary urgency with or without urge incontinence, urinary frequency and nocturia. OAB is common symp- tom complex and its morbidity is high and increased with age. Although many factors cause OAB, we can classify them as neurogenic or non-neurogenic. To diagnose OAB, we need to ask a patient about his condition using Overactive Bladder Symptom Score (OABSS), exam- ine physical findings and urinalysis. And we also need to exclude other urinary tract diseases that make bladder irritation. Pharmacotherapy and behavior therapy are useful for improving OAB symptoms. Anticholinergic agents are utilized for OAB treatment but we need to pay attention to the adverse effects.
[Diagnosis and treatment of benign prostatic hyperplasia in the elderly].
Kajiwara M, Nishida K, Takemoto K … +1 more , Nakahara M
Nihon Rinsho · 2017 Apr · PMID 30549858
Elderly people are at a high risk of experiencing problems with drug therapy due to age- related changes in the body, as well as exposure to many medications owing to multiple health problems. Medication-related adverse...
Elderly people are at a high risk of experiencing problems with drug therapy due to age- related changes in the body, as well as exposure to many medications owing to multiple health problems. Medication-related adverse events are common amongst the elderly. Pharmacotherapy for benign prostatic hyperplasia or overactive bladder can generally im- prove lower urinary tract symptoms, whilst also improving the quality of life. However,;these drugs also have the potential to cause dangerous adverse events. For this reason, a great deal of caution should be taken when prescribing medication for elderly patients who are suffer- ing from lower urinary tract symptoms.
[Urogenital infections].
Yasuda M
Nihon Rinsho · 2017 Apr · PMID 30549857
Complicated pyelonephritis, acute epididymitis and acute prostatitis are febrile urogenital infections. Because the elderly person often has an underlying disease, urogenital tract infec- tions of the elderly persons are...
Complicated pyelonephritis, acute epididymitis and acute prostatitis are febrile urogenital infections. Because the elderly person often has an underlying disease, urogenital tract infec- tions of the elderly persons are complicated urinary tract infections in most cases. However, in the elderly people, clear findings that are characteristic of urogenital infections are not often obtained in the physical examination. If the clear findings of urogenital infections with pyuria and bacteriuria by urinalysis were not obtained, we should treat the infections accord- ing to guidelines as the urogenital infections after having denied other site of infection such as the respiratory tract infections or biliary tract infections. It is important to never diagnose the urogenital infections only by the urinalysis not to be possible of the regional diagnosis.
[Urinary disturbance in elder patients -Characteristic and problems based on the sex-].
Fukumori T
Nihon Rinsho · 2017 Apr · PMID 30549856
In the elderly person, various urinary symptoms are developed regardless of man and woman by a physical change with the aging. In elder men, we often recognize the progress of the urinary disturbance with the progress of...
In the elderly person, various urinary symptoms are developed regardless of man and woman by a physical change with the aging. In elder men, we often recognize the progress of the urinary disturbance with the progress of benign prostatic hyperplasia (BPH). Based on the recent increase of prostate cancer patients, the number of elder patients treated with radi- cal prostatectomy or radiotherapy for prostate is increasing. After treatment for prostate can- cer, the elderly patients with stress urinary incontinence after the radical prostatectomy and urinary disturbance after radiotherapy such as brachytherapy or external beam radiation are increasing. In elder women, stress urinary incontinence and pelvic organ prolapse associated with the weakening of the pelvic floor are increasing. In this report, I focused on elderly men's and women's characteristic of the urinary disturbance, and also reviewed the present features and problems of these diseases.
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