Takuma Nakagawa

Relation between incidence of pneumonia and protective reflexes in post‐stroke patients with oral or tube feeding

Abstract. Nakajoh K, Nakagawa T, Sekizawa K, Matsui T, Arai H, Sasaki H (Tohoku University School of Medicine, Sendai, Japan). Relation between incidence of pneumonia and protective reflexes in post‐stroke patients with oral or tube feeding. J Intern Med 2000; 247: 39–42.

Silent cerebral infarction: a potential risk for pneumonia in the elderly.

Abstract. Nakagawa T, Sekizawa K, Nakajoh K, Tanji H, Arai H, Sasaki H (Tohoku University, Sendai, Japan). Silent cerebral infarction: a potential risk factor for development of pneumonia in the elderly. J Intern Med 2000; 247: 255–259.

The apolipoprotein E gene in Binswanger's disease and vascular dementia

We investigated the polymorphism of the apolipoprotein E (ApoE) gene using a PCR‐RFLP method in patients with Binswangers disease (BD), non‐BD vascular dementia, or Alzheimers disease (AD). The frequency of the e4 allele of the ApoE (ApoE4) in BD patients and non‐BD vascular dementia patients did not differ from that observed in the non‐demented elderly controls, but it was significantly lower than the frequency in AD patients. These results and other recent observations suggest that one or more factors other than the ApoE gene contribute to the pathogenesis of dementia in BD and non‐BD vascular dementia.

Effect of Genetic Risk Factors and Disease Progression on the Cerebrospinal Fluid Tau Levels in Alzheimer's Disease

OBJECTIVE: This study was undertaken to gain insights into the clinical utility of measuring cerebrospinal fluid tau protein (CSF‐tau) to aid in the diagnosis of Alzheimers disease (AD).

Pupil dilatation assay by tropicamide is modulated by apolipoprotein E epsilon 4 allele dosage in Alzheimer's disease.

The mydriatic response to dilute tropicamide was studied in 25 Japanese patients with Alzheimers disease (AD), 13 patients with non-AD neurological diseases (non-AD) and 11 normal elderly‘ subjects (control). Although the changes in resting pupil diameter and area over baseline were significantly greater (p < 0.05) in AD patients than in non-AD patients and controls, there was considerable overlap between the three groups. The change in resting pupil area was significantly greater (p < 0.05) in AD patients homozygous for ApoE 4 than in AD patients heterozygous for or without this allele. Despite a limited sample size in the present study, our results indicate that the pupil dilation assay by tropicamide is not an effective diagnostic tool for AD, and it may be modulated by different gene dosage of ApoE 4.

ELEVATED CEREBROSPINAL FLUID TAU LEVELS: IMPLICATIONS FOR THE EARLY DIAGNOSIS OF ALZHEIMER'S DISEASE

Hiroyuki Arai, MD, PhD

SURVIVAL OF BED‐RIDDEN OLDER PATIENTS

tion, we did not find that the IPA-model HMO program (Evercare) described in our article required greater physician participation than the other three staffor group-model HMOs. We believe that the level of physician participation is based on the type of patient served (postacute vs subacute vs custodial) and not the type of HMO. We agree with many of the other comments, most of which make comparisons between their program and the programs we presented.