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Anna Satake,1 Wataru Kobayashi,1 Yoshihiro Tamura,1 Toshiaki Oyama,1 Haruka Fukuta,1 Akinari Inui,2 Kahori Sawada,2 Kazunari Ihara,2 Takao Noguchi,1 Koichi Murashita,3 Shigeyuki Nakaji2 1Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan; 2Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan; 3COI Research Initiatives Organization, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, JapanCorrespondence: Anna SatakeDepartment of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, 53 Honcho, Hirosaki-shi, Aomori, JapanTel +81 172 39 5127Fax +81 17 239 5128Email anna12@hirosaki-u.ac.jpPurpose: Oral frailty or the loss of oral functionality can be a symptomatic precursor of overall frailty. Previous studies have suggested that decreased tongue pressure causes a decline in ingesting and swallowing function and poor nutrition. This study investigated what factor(s) contribute to tongue pressure, thereby leading to frailty.Patients and methods: For the purposes of the present study, 467 residents of Hirosaki city in northern Japan aged≥60 years who completed a questionnaire about frailty and underwent an intraoral assessment, which included number of teeth, presence or absence of periodontitis, tongue pressure, and oral diadochokinesis (ODK) were recruited.Results: Of the 467 participants with complete data sets, frailty was identified in 13 (7.5%) of 173 males and in 34 (11.6%) of 294 females. Significantly fewer teeth, lower tongue pressure, and a reduced diadochokinetic syllable rate were more prevalent among frail than among healthy residents. Multivariable logistic regression analysis revealed that age, body mass index, number of teeth, and tongue pressure significantly contributed to frailty, whereas ODK did not. Multiple regression analysis showed that tongue pressure was positively associated with muscle index and number of teeth.Conclusion: The results of the present study suggest that fewer teeth and lower tongue pressure, but not ODK function, are risk factors for developing overall frailty among older residents.Keywords: aging, low nutrition, number of teeth, oral diadochokinesis

Ken Nishihara,1 Hisashi Kawai,2 Takeshi Kera,2,3 Hirohiko Hirano,4 Yutaka Watanabe,2 Yoshinori Fujiwara,2 Kazushige Ihara,5 Hunkyung Kim,2 Masashi Tanaka,4 Shuichi Obuchi2 1Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan; 2Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; 3Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan; 4Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan; 5Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan Purpose: The purpose of this study was to clarify the reference values of muscle thicknesses by age and to elucidate the association of muscle thickness with physical function in a large group of community-dwelling elderly individuals.Participants and methods: The muscle thicknesses of the rectus femoris (RF), vastus intermedius (VI), and quadriceps femoris (QF) in 777 of 831 enrolled elderly individuals were measured by ultrasonography, and physical function was measured using knee extension strength (KES), one-legged stance, walking, Timed Up and Go, and grip strength tests. Muscle thickness data were divided by sex and categorized into 5-year age groups. Differences in muscle thickness and KES among the age groups were examined, and correlations between muscle thickness and physical function test results were compared by age. The non-parametric independent two-sample Mann–Whitney U-test, Kruskal-Wallis test, and Spearman’s correlation coefficients were used in the statistical analysis.Results: Thickness of the RF showed fewer significant differences among all groups and less decreases compared to thickness of the VI in older age groups, especially in men. Thicknesses of the RF, VI, and QF correlated with KES in almost all the thicknesses of muscles in the 65–69 and 70–74 years age groups in men and in almost all age groups in women. The decrease in muscle thicknesses and degree of correlations with aging were different between men and women.Conclusions: Reductions in the thicknesses of the muscles and KES differed by age group and sex. Our results could be used for prescribing exercise in community-dwelling elderly individuals of varying ages. Keywords: community-dwelling elderly individual, physical function, muscle thickness, ultrasonogram

Mihoko Kawabata,1 Yasuhiro Yokoyama,1 Takeshi Sasaki,1 Susumu Tao,1 Kensuke Ihara,1 Yasuhiro Shirai,1 Tetsuo Sasano,2 Masahiko Goya,1 Tetsushi Furukawa,3 Mitsuaki Isobe,4 Kenzo Hirao1 1Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan; 2Department of Biofunctional Informatics, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan; 3Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan; 4Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan Purpose: Drug-induced bradycardia is common during antiarrhythmic therapy; the major culprits are beta-blockers. However, whether other antiarrhythmic drugs are also a significant cause of this, alone or in combination with beta-blockers, is not well known. Methods: We retrospectively investigated the records of all patients hospitalized at our institution for drug-related bradycardia from the years 2004 to 2012. Patients with cardiac disease and electrolytic or hormonal abnormalities that could cause bradyarrhythmias were excluded. Results: Eight patients were identified (mean age, 79±5 years; range, 71–85 years; 6 women). Three patients were taking only beta-blockers (hereafter referred to as the BB group), while five patients were on both beta-blockers and Na channel blockers (hereafter referred to as the BB + Na group). Heart rates ranged from 20~49 beats/minute on arrival. The initial electrocardiogram showed sinus bradycardia (n=6) or sinus arrest with escape beats (n=2). QRS duration was 80–100 ms. The clinical presentation of the BB + Na group was considerably worse than that of the BB group, and included cardiogenic shock and heart failure. Four of the BB + Na patients had been on their medications for over 300 days. The BB group recovered solely with drug discontinuation, while 4 of the 5 patients in the BB + Na group needed additional treatments, such as intravenous administration of atropine or adrenergic agonist and temporary pacing. Bradycardia did not recur during follow-up (median, 687 days). Conclusion: Although wide QRS ventricular tachyarrhythmia is a better known proarrhythmic effect of Na channel blockers, life-threatening bradycardia may also occur in combination with beta-blockers in the elderly, even months after the start of medication, and at plasma concentrations that do not prolong QRS width. Keywords: proarrhythmia, elderly, QRS duration

It has been possible to develop a simple method to measure droplet size compared with the quality of water/oil (W/O) food product emulsions. This approach did not confirm the observation that, in general, emulsions with a large dispersed droplet size are less stable. It was shown that it is possible to use the membrane emulsification method to prepare W/O emulsions of nearly exactly the same level of stability with a dispersed droplet diameter of between 4 micro-m and 12 micro-m.