Objectives:To evaluate the effect of a self-controlled vocal exercise in elderly people with glottal closure insufficiency.Design:Parallel-arm, individual randomized controlled trial.Methods:Patients who visited one of 10 medical centers under the National Hospital Organization group in Japan for the first time, aged 60 years or older, complaining of aspiration or hoarseness, and endoscopically confirmed to have glottal closure insufficiency owing to vocal cord atrophy, were enrolled in this study. They were randomly assigned to an intervention or a control group. The patients of the intervention group were given guidance and a DVD about a self-controlled vocal exercise. The maximum phonation time which is a measure of glottal closure was evaluated, and the number of patients who developed pneumonia during the six months was compared between the two groups.Results:Of the 543 patients enrolled in this trial, 259 were allocated into the intervention group and 284 into the control; 60 of the intervention group and 75 of the control were not able to continue the trial. A total of 199 patients (age 73.9 ±7.25 years) in the intervention group and 209 (73.3 ±6.68 years) in the control completed the six-month trial. Intervention of the self-controlled vocal exercise extended the maximum phonation time significantly (p < 0.001). There were two hospitalizations for pneumonia in the intervention group and 18 in the control group, representing a significant difference (p < 0.001).Conclusion:The self-controlled vocal exercise allowed patients to achieve vocal cord adduction and improve glottal closure insufficiency, which reduced the rate of hospitalization for pneumonia significantly.Clinical Trial.gov Identifier-UMIN000015567

The results suggest that a high BSI (≥1.0) is an independent predictor of poor ADL in patients with NSCLC, while showing no correlation with the overall survival.

Left hand apraxia is known as a unique symptom of callosal apraxia, but lower limb symptoms are rarely mentioned. We report a patient who experienced left ideomotor apraxia affecting both the upper and lower limbs after a stroke in the territory of the right anterior cerebral artery. His spontaneous gait was normal, but he was unable to move his left leg intentionally either by verbal command or by imitation. His leg symptoms gradually improved over time. We evaluated the change in cerebral blood flow in this patient using single-photon emission computed tomography. The results showed an increase in blood flow in the posterior corpus callosum; therefore, we suggested that the callosal pathway might contribute to left leg as well as left hand volitional movement.

Background: Rice wine lees (RWL), a Japanese traditional fermented product, is a rich source of one-carbon metabolism-related nutrients, which may have beneficial effects on cognitive function. Objectives: We aimed to examine the effect of the RWL on cognitive function in community-dwelling physically active older adults. Design: Double-blind, randomized, placebo-controlled study (clinical trial number: UMIN 000027158). Setting: Community-based intervention including assessments conducted at the University of Hyogo and a public liberal arts school in Himeji City, Japan. Participants: A total of 35 community-dwelling older adults (68–80 years) who performed mild exercise before and during the trial were assigned to either the RWL (n=17) or the placebo group (n=18). Intervention: Daily consumption of 50 g RWL powder, which contained one-carbon metabolism-related nutrients, or the placebo powder (made from soy protein and dextrin) for 12 weeks. Both supplements included equivalent amounts of energy and protein. Measurements: Montreal Cognitive Assessment, computerized cognitive function test, and measurements of serum predictive biomarkers (transthyretin, apolipoprotein A1, and complement C3) were conducted at baseline and follow-up. Results: Visual selective attention and serum transthyretin significantly improved in the RWL group, whereas there was no significant change in the placebo group. No significant group difference was observed in the remaining cognitive performance tests. Conclusions: RWL supplements seem to have a few effects on cognitive function in community-dwelling physically active older adults. However, the impact was limited; therefore, further studies with sufficient sample size are warranted to elucidate this issue.

We investigated relation of disability and independency in housework. Objects are 84 women who worked as housekeepers before the onset of stroke. The items of house works which are investigated are cooking, cleaning, washing, and shopping. The results are as follows: 16 women do all items, and 22 women do no items, and 46 women do partial items. According to the statistic evaluation, ability of ambulance and severity of upper extremity function most influence on the ability of house work. And higher cortical dysfunction without severe dementia make a minor influence on the ability. The patients who act as housekeepers have a normal intellectual ability, ability of outdoor walking, and mild damage of upper extremity function. Many women are given assistance by other home members, and many assistance are given if women's ability is lower. (Jpn J Rehabil Med 1999; 36: 644-648)