Background: In North America, the incidence and mortality of prostate cancer has been declining since the early 1990s. We calculated the age-adjusted death rates, age-specific death rates and standardized mortality ratio (SMR) for prostate cancer in Japan and analyzed their features. Methods: Yearly age-adjusted death rates for prostate cancer were calculated by dividing the number of events by the population at risk, with direct standardization to the world population. Agespecific death rates were calculated for the 1970s, 1980s and 1990s and which age group showed the highest rate of increase was examined. The SMR in each prefecture was also calculated for each period. Results:The respective number of deaths and the age-adjusted death rate was 1107 and 2.29 in 1973 and 6251 and 5.15 in 1997. The age-specific death rates showed an exponential increase with age in all three periods and the rate of increase was higher in older age groups. The distribution of SMR showed the same tendency in all three periods. The prefectures with significantly high or low SMR were distributed in clusters. Conclusions:The prostate cancer death rate is increasing rapidly in Japan. However, the ageadjusted death rate has remained stable from 1996 to 1997. How this figure will change and whether the prostate cancer death rate in Japan will begin to decline, like in North America, is of interest. The prefectures with significantly high or low SMR showed a characteristic clustered distribution pattern.
Objective: To analyze the effects of respiratory rehabilitation on the activities of daily living (ADL) and quality of life (QOL) in community-dwelling frail elderly.Design: Pilot intervention study after a one-year period of observation.Setting: Day care facility in a rehabilitation hospital.Subjects: Thirty community-dwelling frail elderly using rehabilitation services Intervention: After a one-year observation period of usual rehabilitation, 30 participants were given 12 rehabilitation sessions that included respiratory rehabilitation (three sessions a week for four weeks). Journal of General and Family Medicine 2016, vol. 17, no. 4, p. 289-298. Original Articles -289 -evaluation), prior to training (pre-training evaluation), and after the sessions (post-training evaluation). Primary outcome measures included: respiratory function, swallowing function, ADL, and QOL. Secondary outcome measures included: depressive score, exercise tolerance, 6-minute walk distance, thorax flexibility, and muscle strength (knee extension, grip, and abdominal). QOL were estimated using questionnaires.Results: Swallowing function, ADL, QOL (SF8 physical and mental summary score), respiratory function, and physical function were significantly reduced during usual rehabilitation (between the initial evaluation and pre-training evaluation), whereas swallowing function, ADL, QOL (SF8 physical component summary score [PCS]), respiratory function, exercise tolerance, 6-minute walk distance, thorax flexibility, and muscle strength (knee extension) were significantly improved during respiratory rehabilitation (between the pre-training evaluation and post-training evaluation). Conclusions:Our results suggest that a usual rehabilitation program without respiratory training is not sufficient for the frail elderly to maintain their ADL and QOL, and furthermore that respiratory rehabilitation can help improve their ADL and QOL as well as their swallowing and respiratory function.
We investigated venous blood drainage from the prostate into the vertebral vein system by cineangiography in five mongrel dogs and measured intraabdominal pressure and venous blood pressure in the dog or human to study the role of intraabdominal pressure in the drainage. The averages of intraabdominal pressure and caudal vena caval pressure in the dog were 32.2 +/- 3.0 and 12.8 +/- 1.3 mmHg, respectively, in the supine position, and 39.2 +/- 3.0 and 23.8 +/- 4.0 mmHg, respectively, in the head-up tilt position, when the radiopaque medium injected into the dorsal penile vein appeared in the vertebral vein system. Intraabdominal pressure in the head-up tilt position was significantly higher than that in the supine position when the venous drainage into the vertebral veins happened. In eight continuous ambulatory peritoneal dialysis patients, intraabdominal pressure showed 8.1 +/- 2.4 mmHg in the supine position, 24.6 +/- 4.3 mmHg in the sitting position, and 30.4 +/- 4.9 mmHg in the standing position at rest. During voluntary contraction of the abdominal muscles, the pressure was increased up to 50.6 +/- 21.6 mmHg in the supine position, 69.3 +/- 19.8 mmHg in the sitting position, and 73.8 +/- 19.8 mmHg in the standing position. These pressure values in the human were significantly higher than those observed at the time when the radiopaque medium appeared in the vertebral veins in both supine and head-up tilt positions in the canine. These results suggest that the increase of intraabdominal pressure causes inflow of prostatic venous blood into the vertebral veins via the inferior vena cava, common iliac vein, or internal iliac vein.
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