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A critical factor for preventing osteoporosis after menopause is attenuation of the accelerated turnover rate of bone metabolism. The present randomized controlled study was conducted to clarify the effects of a lemon beverage with calcium (Ca) supplementation that makes use of the chelating action of citric acid. Comprehensive evaluations of bone were performed by assessments of bone mineral density (BMD) and biomarkers related to bone turnover. Seventy-nine postmenopausal women were enrolled and asked to participate in an 11-month continuous intake of the test beverages. The subjects were divided into three groups: those who consumed a lemon beverage containing citric acid with Ca supplementation (LECA group), those who consumed a lemon beverage containing citric acid without Ca supplementation (LE group), and those who consumed no test beverage (control group). Using a double-blind protocol, subjects in the LECA and LE groups consumed one bottle containing 290 mL of the test beverage each day. The ratio of change in BMD after 11 months was significantly higher in the LECA group as compared to the control and LE groups. The LECA group also showed significant decreases in concentrations of tartrate-resistant acid phosphatase 5b (TRACP-5b), a bone resorption marker, and bone alkaline phosphatase (BAP) as compared to the other groups, as well as a significant decrease in concentration of osteocalcin (OC), a bone formation marker, as compared to the LE group. Based on our findings, we speculated that bone resorption and bone formation in postmenopausal women might be suppressed along with an increase in Ca resorption caused by chelation of citric acid in association with continuous ingestion of a Ca-supplemented lemon beverage containing citric acid, resulting in suppression of high bone metabolic turnover. In addition, the results provide information regarding BMD maintenance in the bones of the trunk, including the lumbar spine and proximal femur.

Objective: Parkinsonian lumbago is usually caused by lesions of the thalamus or spinothalamocortical pathways. Decreased lumbago directly improved quality of life. Materials and Methods: We succeeded to treat Parkinsonian lumbago of elderly patients. Results: One patient could walk independently during outpatient care and enjoy ground golf, even though near 24 years have passed since the onset of Parkinson's disease (PD). Conclusion: Safe habits and hobbies for the elderly of whole-body exercise such as ground golf exercise habits, rehabilitation, medications and Neurotropin are suspected to be favorable for long-term prognosis of PD. [ABSTRACT FROM AUTHOR]

Objective: Goat therapy, music therapy and naming therapy is widely used and recognized for the medical benefits. Design: A clinical study. Materials and Methods: We analyzed effect of goat therapy, music therapy and naming therapy. Results: Many of the patients had experience interacting with therapy goats and were interested in and favorable toward interacting with the stationed therapy goats. Accelerated plethysmography (APG) revealed that low frequency (LF) and LF/high frequency (HF) ratio decreased after enjoying classic music. The patient having a deficit of specific phonological function successfully responded to phonological therapy without any efficacy in semantic therapy. Conclusions: Our study suggested that the combination of goat therapy, music therapy and naming therapy is important. [ABSTRACT FROM AUTHOR]

Objective: Goat therapy is widely used and recognized for the medical benefits. Design: A clinical study. Materials and Methods: We analyzed companion goat ownership on the physical and psychological health of subjects. At the same time, we have stationed the trained therapy goats under a specialist handler. Results: Many of the patients had experience interacting with therapy goats and were interested in and favorable toward interacting with the stationed therapy goats. Conclusions: Contracting lemon producing farmers allows patients regular goat contact at relatively low costs to the institution. In addition, this creates a new economic niche for a number of the lemon producing farmers. [ABSTRACT FROM AUTHOR]

Objective: Esophageal hiatal hernia is not such a rare disease in aged patients because they often have diaphragmatic muscle weakness and lumbar spondylosis. Design: A clinical study. Materials and Methods: We analysed 16 cases of esophageal hiatal hernia and 2 cases of esophageal hiatal hernia with Mallory-Weiss syndrome. Results: An 87-year old woman was admitted to our hospital because of chest discomfort and breathing difficulty after lunch. Chest X-ray and chest computed tomography (CT) demonstrated an enlarged stomach behind the heart. The respiratory symptoms were diagnosed as a secondary esophageal hiatal hernia. She was discharged from our hospital. She was well and in good condition after then. Conclusions: Mallory-Weiss syndrome refers to bleeding from a laceration in the mucosa at the junction of the stomach and esophagus. There is some evidence that presence of a hiatal hernia is a predisposing condition. [ABSTRACT FROM AUTHOR]

Objective: Goat-assisted therapy is widely used and recognized for the medical benefits. Design: An experimental study. Materials and Methods: Tokara, Alpine, Saanen, Shiba and Korean therapy goats (age under 11 year-old) were used. We cooperated with 6 therapy goat farms. We intercrossed Tokara male goat with Tokara, Alpine, Saanen, Shiba and Korean goats. Results: White daughter F1 hybrid backcross with Tokara father goat (white) bore white grandson and black granddaughter BC1 hybrids just 8 months after her birth. Tokara goat kept peculiar characteristics, namely colored coat, horns, supernumerary teats, no wattles. Discussions: Some Tokara goats are supposing Saanen breed crossing and the genetic variation differed from the native Tokara goats. Conclusions: Nevertheless, just about any breed of goat can be a therapy goat. [ABSTRACT FROM AUTHOR]

Objective: Animal-assisted therapy is widely used and recognized for the medical benefits. Design: A clinical study. Materials and Methods: We analyzed companion animal ownership on the physical and psychological health of subjects. At the same time, we have stationed the trained therapy animals under a specialist handler. We investigated changes in the moods when interacting with the companion animals in the long span. Results: Many of the patients had experience interacting with animals and were interested in and favorable toward interact- ing with the stationed therapy animals. Conclusions: Quality of life (QOL) of patients in the elderly nursing home, elementary and high school and preschool chil- dren and stuffs was improved. The therapy animals indicated an increased mood effect on rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Goat therapy is widely used and recognized for the medical benefits. Design: A clinical study. Materials and Methods: We intercrossed Tokara male goat with Alpine, Saanen, Shiba and Korean goat. At the same time, we have stationed the trained therapy goat under a specialist handler. We investigated changes in the moods when interacting with the therapy goat. Results: Many of the patients had experience interacting with goat and were interested in and favorable toward interacting with the stationed therapy goat. Conclusions: Quality of life of people in the elderly nursing home, elementary and high school and preschool children was improved. The therapy goat indicated an increased mood effect on rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Goats gave us a happy distraction, helped us forget that we were in pain and kept us from feeling depressed. Design: Experimental study. Materials and Methods: We intercrossed Tokara male goat with Alpine, Saanen, Shiba and Korean goat. At the same time, the pathological lesions and behavioral tasks were assessed by Tokara goat characters, therapy goat spiritually enriching effects, physical test and blood examination respectively. Results: White daughter FI hybrid backcross with Tokara father goat (white) bore white grandson and black granddaughter BC1 hybrids just 8 months after her birth. Tokara goat keeps peculiar characteristics, namely colored coat, horns, supernumerary teats, no wattles. Conclusions: Some Tokara goats are supposing Saanen breed crossing and the genetic variation differed from the native goats. Nevertheless, just about any breed of goat can be a therapy goat. [ABSTRACT FROM AUTHOR]

Objective: The spiritually enriching effects of spending time together with goats are gaining the recognition from the public. Design: A clinical study. Materials and Methods: The research participants were elderlies hospitalized in the elderly nursing home, elementary and high school students and preschool children. We have stationed the trained therapy goat under a specialist handler. We investigated changes in the moods when interacting with the therapy goat. Results: Many of the patients had experience interacting with goat and were interested in and favorable toward interacting with the stationed therapy goat. Quality of life of stuffs in the elderly nursing home, elementary and high school and preschool children was improved. Conclusion: White female F1 intercross with Tokara goat(white) bore white male and black female F2 just 8 months after her birth. The therapy goat indicated an increased mood effect. [ABSTRACT FROM AUTHOR]

Objective: The present investigation was designed to examine if high-resolution music box audio influences postural stability. Design: A clinical study. Materials and Methods: 21 healthy young adults were instrumented for the measurement of stabilometry (Twin Gravicorder G-5500, Anima Co. Ltd.). They were exposed to high-resolution music box audio. Results: Total locus length of both leg stand with eye open significantly decreased with exposure of high-resolution music box audio (p = 0.034). Total locus length of both leg stand decreased with exposure of high-resolution music box audio than that of high-cut music box audio (p = 0.316). Conclusions: Our study suggests that high-resolution music box audio improved balance ability and that high-resolution music box audio reduces the incidence of falls. [ABSTRACT FROM AUTHOR]

Objective: Music makes the expansion of the range of the attention and concentration of the attention. The quality of digital high-resolution audio has increased since 2010. Design: A clinical study. Materials and Methods: The present study used a spectral analysis of heart rate variability (HRV) to determine the effects of 24 and 16 bit headphone high-resolution music box audio. Results: The sympathetic and parasympathetic nervous function was activated more by 24 than 16 bit headphone high-resolution audio. Conclusions: The effects of high-resolution audio on the activation of attention and concentration in relaxed humans are excellent. [ABSTRACT FROM AUTHOR]

Objective: Music makes the expansion of the range of the attention and concentration of the attention. The quality of digital high-resolution audio has increased since 2010. Design: A clinical study. Materials and Methods: The present study used a spectral analysis of heart rate variability (HRV) to determine the effects of high-resolution audio on the autonomic nervous function. Results: The sympathetic and parasympathetic nervous function was activated more by high-resolution than high-cut audio. Conclusions: The effects of high-resolution audio on the activation of attention and concentration in relaxed humans are excellent. [ABSTRACT FROM AUTHOR]

Introduction: The effects of Nordic walking have increasingly been reported in recent years. However, the majority of previous studies focused on physical activities or the muscle strength, and they rarely examined the effectiveness of such walking to improve lifestyle-related diseases. Therefore, the present study examined the effects of Nordic walking-based intervention on the physical strength, motor ability, lifestyle-related disease indices, and bone mineral density levels. Materials and Methods: Subjects were 20 middle-aged and elderly females (aged 66.6 ± 7.6), dividing them into 2 groups: normal (n = 11) and Nordic (n = 9) walking. The period of intervention was 6 months, and changes in the physical strength, motor ability, lifestyle-related disease indices, and bone mineral density level during this were compared between the 2 groups. Results and Conclusion: Significant differences were observed in the hand grip strength and step length, supporting the effectiveness of Nordic walking to improve these items. [ABSTRACT FROM AUTHOR]

Objective: Japanese women became the top class for average life span. We performed this study to clarify the reasons that contribute to the top class for average life span. Design: A clinical study. Materials and Methods: In this study we focused on the daily eating habit. Subjects are middle-aged and elderly women of Mihara and Hiroshima. We have done medical lecture, examination and questionnaire in Mihara over IS years ago as one of open campus projects. We compared the result of questionnaire between 1998 and 2012 in Mihara as longitudinal study. We compared the result of same questionnaire in Hiroshima as cross-sectional study in 2012. Results: Mihara women at both times had the same good eating habit of taking much vegetable, calcium actively and fish. Milk consumption has decreased and yogurt has increased as calcium resources. Calcium resources have changed yogurt from milk at now in Mihara. Demands of imported materials as coffee and wine have increased for IS years. Both area women kept the same good eating habit of taking much vegetable and calcium actively. Conclusions: In this our epidemiological study we speculated that food habit of Japanese women have become much richer and that this is one of the reasons that contribute to the top class for average life span. [ABSTRACT FROM AUTHOR]

Objective: Psychological stressor can contribute to health. This study was performed to reveal new objective biomarkers of psychological stressor. Design: A clinical study. Materials and methods: The subjects were 31 healthy university students. As a psychological stressor, we performed a Raven's Colored Progressive Materices for 2 min. Accelerated plethysmography (APC) was performed using a pulsimeter with the sensor positioned on the tip of the ventral side of the index finger. Heart rate variability (HRV) was determined in all subjects using the spectral analysis. Maximum entropy method (MEM) and fast fourier transform (FFT) low (LF) and high frequency (HF) component powers and LF/HF ratio were determined. Peripheral vein width was estimated using near-infrared spectrophotoscopy of Sysmex Astrim SU. Results: MEM and FFT HF component powers decreased significantly. The increases of MEM LF/HF ratio after psychological stressor were statistically significant. The increases of FFT LF/HF ratio after psychological stressor were statistically significant. Peripheral vein width negative correlated with the MEM and FFT LF/HF ratio after psychological stressor. Conclusions: These results suggest that determining MEM and FFT LF and HF component powers and the LF/HF ratio using spectral analysis and estimating peripheral vein width using near-infrared spectrophotoscopy prove useful in objective observing psychological stressor. [ABSTRACT FROM AUTHOR]

Objective: Thyroid cyst is a well recognized disease of the thyroid gland. We report here an exceptionally large thyroid cyst, which we successfully treated by aspiration. Design: A clinical study. Materials and Methods: We analysed 2 cases of large thyroid cysts, which we successfully treated by aspiration. Results: A 59-year old man consulted our hospital because of his large goitre. He had his striking appearance of his right neck. We planned partial thyroidectomy. Two aspirations, followed by a lifetime program of feeding desiccated thyroid, sufficed in the patient to remove completely the palpable nodule. Conclusion: His father also had the same large thyroid cyst, which we successfully treated by two aspirations when his father was of his age. [ABSTRACT FROM AUTHOR]

Objective: The effects of high-resolution audio on autonomie function were examined using headphones. Design: A clinical study. Materials and Methods: The subjects were healthy young persons. The heart rate of each individual was determined using a pulsimeter with the sensor placed on the ventral tip of the index finger and acceleration plethysmography (APG). Heart rate variability (HRV) was determined in all participants using spectral analysis. Results: Sympathetic and parasympathetic nerve activities were significantly more activated by headphone high-resolution audio than headphone high-cut audio. Conclusions: Headphone high-resolution audio increases attention and concentration in relaxed humans. [ABSTRACT FROM AUTHOR]

Objective: The present investigation was designed to examine if tai chi influences postural stability. Design: A clinical study. Materials and Methods: 12 men and 12 women were instrumented for the measurement of stabilometry (Twin Gravicorder G-5500, Anima Co. Ltd.) before and after tai chi for 40 minutes. Results: Movement strength of tai chi was 6.6 ± 9.0%. Total locus length of one leg stand significantly decreased after tai chi (p < 0.05). Conclusions: Tai chi improved balance ability. Our study suggests that tai chi reduces the incidence of falls in elderly people and patients with Parkinson's disease. [ABSTRACT FROM AUTHOR]

Objective: The present investigation was designed to examine if handgrip exercise influences peripheral vascular metabolic change. Design: A clinical study. Materials and Methods: 12 men and 8 women were instrumented for the measurement of venous oxygenation index (VOI) and width of peripheral vein by near infrared spectroscopy, heart rate and blood pressure. Subjects performed sustained and rhythmic handgrip exercise of dominant hand. Results: VOI of non-exercise hand significantly increased after sustained and rhythmic handgrip exercise (p < 0.05 and p < 0.01 respectively). Conclusions: Our study suggested the possibility that handgrip exercise of healthy side of cerebrovascular disease patients contribute the beneficial effect of peripheral vascular metabolism of cerebrovascular disease patients. [ABSTRACT FROM AUTHOR]

Objective: In the operation and rehabilitation room, we use the background music. Design: A clinical study. Materials and methods: The subjects were young healthy women and men. We studied the autonomic nerve functions with listening to "Joyful-provoking music (J music)" or "Anxiety-provoking music (A music)". Accelerated plethysmography (APG) was performed using a pulsimeter. Heart rate variability (HRV) was determined using the spectral analysis. Maximum entropy method low (M-LF) and high frequency (M-HF) component powers, LF/HF and the coefficient of variation of A-A intervals (CVa-a, %) were estimated. Results: Sympathetic nervous system activities were decreased with J music. Conclusions: Because most of the patients hold mental stress. When rehabilitation is done, J music, such as classical music, is expected additional effect on rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Some of classic musics make both relaxation and adequate stress. In brain cortex some classic musics make fruitful concentration and attention. Design: A clinical study. Materials and methods: The subjects were healthy young 1 man and 19 women. We did them Tomita's stress questionnaire. They enjoyed classic music CD with headphone. Accelerated plethysmography (APG) was performed using a pulsimeter with the sensor positioned on the tip of the ventral side of the index finger. Peripheral venous circulation was monitored with venous oxygenation index (VOI) and width of peripheral vein. Results: Tomita's stress questionnaire scores were significantly correlated with low frequency (LF) component powers (maximum entropy method (MEM) and fast fourier transform (FFT)). LF and LF/HF decreased after enjoying classic music. VOI was significantly positive correlated with LF/HF before enjoying classic music. Conclusions: These results suggest that APG, VOI and width of peripheral vein is useful for objective evaluation of psychological stress and relaxation. [ABSTRACT FROM AUTHOR]

Objective: An 87-year-old female diagnosed with Parkinson's disease consulted our clinic presenting with gait disturbance and lumbago. Design: A clinical study. Materials and methods: The patient had hypokinesia, a stooped posture and walking with short steps. And in the "off" periods, slow movement, gait disturbance and lumbago became worse. She was diagnosed with Parkinson's disease at modified Hoehn & Yahr (HY) stage 4. The total unified Parkinson's disease rating scale (UPDRS) and revised version of Hasegawa's dementia scale (HDS-R) became 71 and 25 respectively. Results: Her visual analogue scale (VAS) score for lumbago was 52 mm on a 0-100 mm scale. We started the treatment with 624 mg/day of Neurotropin tablets. After treatment with Neurotropin, her lumbago dramatically improved. Conclusions: Neurotropin may be useful for the clinical management of lumbago of Parkinson's disease. [ABSTRACT FROM AUTHOR]

Objective: High-resolution compared with CD sounds are characterized by higher frequencies and greater amplitudes. Design: A clinical study. Materials and methods: This study examined the influences of high-resolution sounds on the autonomic nervous and vascular systems. The brachial-ankle pulse wave velocity (baPWV) and coefficient of variation of R-R intervals (CVRR) were measured under 3 conditions (soundless, high-cut, and high-resolution), involving 22 healthy university students (age: 21.5 ± 0.67). Results: The CVRR was significantly higher with an increased baPWV under the high-resolution compared with the other 2 conditions, indicating that the parasympathetic nervous system was activated, and the arterial blood flow rate markedly increased when hearing a high-resolution sound. Conclusions: Based on this, high-resolution sounds are likely to promote parasympathetic nervous system activity, leading to peripheral vasodilation or a decreased peripheral vascular resistance level on a body-wide basis, and consequently increase the arterial blood flow rate. [ABSTRACT FROM AUTHOR]

Objective: The quality of digital high-resolution audio has increased since 2010. Design: A clinical study. Materials and Methods: The present study used a spectral analysis of heart rate variability in 45 healthy Japanese individuals (age, 26.5 ± 5.7 y) to determine the effects of high-resolution audio on the function of the autonomic nervous system. Highcut audio (audible range, < 20 kHz; audio resolution, 24 bits) and high-resolution audio (audible and inaudible range, > 20 kHz; audio resolution, 24 bits) was used. The heart rate of each individual was determined using a pulsimeter with the sensor placed on the ventral tip of the index finger and acceleration plethysmography (APG). Heart rate variability (HRV) was determined in all participants using spectral analysis. Results: The results showed that the sympathetic and parasympathetic nervous systems were activated more by high-resolution, than high-cut audio. Conclusions: We plan to investigate the effects of high-resolution audio on the activation of attention and concentration in relaxed humans. [ABSTRACT FROM AUTHOR]

Objective: High-resolution audio music box sound has the possibility of music therapy with positive hypersonic effect. Design: A clinical study. Materials and Methods: Subjects were healthy young adults. They underwent EEG. They were exposed high-resolution audio music box sound. Topographical EEG mapping was done with using VitalTracer and ATAMAPII programs as a new topographical brain mapping approach. Results: α2 and β1 wave band power significantly increased with high-resolution audio music box sound, a wave band power increased with high-resolution audio music box sound. Conclusions: These results suspect that high-resolution audio music box sound has the effect of increasing of vigilance and relaxation of the brain. [ABSTRACT FROM AUTHOR]

Objective: This study was performed to retrospectively compare changes in the levels of seasonal changes in peripheral venous circulation, arteriosclerosis and physical characteristics in middle and elderly females. Design: A clinical study. Materials and Methods: We evaluated 52 middle and elderly females during June and December. Brachial-ankle pulse wave velocity (baPWV), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, height, weight, % body fat mass (%FM), body mass index (BMI), basal metabolic rate (BMR), lean body mass (LBM), width of small vein and venous oxygenation index (VOI) were studied in June and December. Results: The levels of baPWV in June showed significantly lower than those of December. The levels of DBP in June were significantly higher than those in December. These results may suggest the progress of the arteriosclerosis by aging. The levels of %FM in June decreased significantly than those in December. The levels of LBM and BMR in June increased significantly than those in December. These results were considered aging changes rather than seasonal changes. The levels of VOI in June showed significantly higher than those in December. However, no significant difference was seen in the levels of width of small vein. These results may suggest that peripheral venous metabolic change occurred, even if morphological change of the peripheral vein was not seen in December. Conclusions: It is necessary to study VOI among middle and elderly females from the viewpoint of analyzing peripheral venous metabolic change. [ABSTRACT FROM AUTHOR]

Objective: Essential thrombocythaemia is a rare disease. Design: A clinical study. Materials and Methods: An 86-year-old man had marked thrombocytosis, increased leukocyte count and anemia. Analysis of the Janus Activating Kinase 2 (JAK2) V617F (GTC→TTC) gene from his leukocytes demonstrated the JAK2 mutation (V617F GTC→TTC, G1849T, exon 14). Results: A diagnosis of essential Thrombocythaemia was made. Conclusions: He has been good in health without chemotherapy since then. [ABSTRACT FROM AUTHOR]

Objective: Total situs inversus is called Kartagener syndrome. Design: A clinical study. Materials and Methods: We experienced an 83-year-old female and a 95-year-old male with total situs inversus. Chest x-ray revealed dextrocardia. Abdominal ultrasonography showed situs inversus totalis. Abdominal CT showed left-sided liver, right-sided stomach. Results: Situs inversus is a rare congenital disease. Conclusion: Situs inversus is a rare congenital disease and often has several complicated anomalies. Although our cases had no complicated anomalies, and were alive for long term with no major events due to dextrocardia. [ABSTRACT FROM AUTHOR]

Objective: Esophageal hiatal hernia is not such a rare disease in elderly people because they often have diaphragmatic muscle weakness and lumbar spondylosis. Patients with esophageal hiatal hernia sometimes have symptoms of gastroesophageal reflex disease (GERD), but most patients with esophageal hiatal hernia are asymptomatic. Design: A clinical study. Materials and Methods: We analysed 7 cases of esophageal hiatal hernia. Results: An 87-year old woman was admitted to our hospital because of chest discomfort and breathing difficulty after lunch. Chest X-ray and chest computed tomography (CT) demonstrated an enlarged stomach behind the heart. The respiratory symptoms were diagnosed as a secondary esophageal hiatal hernia. She was discharged from our hospital. She was well and in good condition after then. Conclusion: Remission of the respiratory symptoms caused by the hiatal hernia was achieved by conservative treatment. We should consider sliding hernia when we treat aged patients with these respiratory symptoms. [ABSTRACT FROM AUTHOR]

Objective: To compare changes in physical characteristics, peripheral venous circulation, and arteriosclerosis among women in different age groups. Design: An observational study. Materials and Methods: This study involved 91 women. Of these, 28 were designated as young (21.1 ± 0.8, years old) and the other 63 were designated as middle aged and elderly (63.7 ±7.1, years old). Physical characteristics included height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, percentage of body fat mass (%FM), body mass index (BMI), waist circumference (WC), and basal metabolic rate (BMR). Arteriosclerosis was studied using brachial-ankle pulse wave velocity (baPWV). Peripheral venous circulation was monitored using venous oxygenation index (VOI) and width of peripheral veins. Results: Physical characteristics were different among the groups. Specifically, baPWV of all young women was less than 14.0 m/s compared with that of 38 (60.3%) middle aged and elderly women, which was greater than 14.0m/s. This was an indication of arteriosclerosis due to aging. VOI of middle aged and elderly women tended to be lower than that of younger women (p = 0.095). Width of peripheral veins was not significantly different in each group. Conclusions: In this study, baPWV proved to be a better marker of age-related arteriosclerosis than VOI or width of peripheral veins among women of different ages. [ABSTRACT FROM AUTHOR]