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The aim of this study is to identify the potency of land price as a general indicator of the homebound tendency of neighbourhoods. For this purpose, we focus on the associations between land price and older adults' going-out frequency, while considering the similarities and differences from factors associated with walkability. The study targets are 19,270 individuals living in the Tokyo metropolitan area who are aged 65 years or older who are not certified as needing public long-term care insurance. This study uses a two-step procedure: a) the land price of each neighbourhood is estimated using rent price data from 2010 to 2019 collected by an official Japanese realtor organization; b) the associations between older adults' goingout frequency, according to the 2016 Japan Gerontological Evaluation Study, and the estimated land price of their neighbourhoods is identified using multilevel analysis. The results indicate that land price has strong negative associations with older adults' going-out frequency. Associations between land price or other walkability-associated factors, such as population density, ratio of commercial area, and proximity to the nearest train station, only appear when these factors and land price are included within the same model. The results suggest that, when inspecting homebound tendency in some neighbourhoods, factors relating to the built environment must be considered alongside land prices. Furthermore, the homebound status of older adults is a pressing challenge, especially in neighbourhoods with high land prices., Competing Interests: Declaration of Competing Interest We confirm that this manuscript has not been published elsewhere and is not under consideration in whole or in part by another journal. All authors have approved the manuscript and agree with submission to the Archives of Gerontology and Geriatrics. The authors have no conflicts of interest to declare., (Copyright © 2023. Published by Elsevier B.V.)

One serious complication in implant surgery is displacement of the implant body into the surrounding tissue. This occurs only rarely in the mandible, however. This report describes a case of an implant body displacing into the medullary cavity of the mandible and discusses this in reference to the literature. The patient was a 72-year-old woman who was referred to our department at Tokyo Dental College Chiba Hospital (now Chiba Dental Center) by her regular dentist after an implant inserted in the left mandible in 2010 showed loosening in October 2016. Panoramic X-rays obtained at the initial examination revealed that 2 implants had been inserted into the left mandible, one on top of the other. Removal of both was recommended to prevent infection at the implant site and any potential effects on the alveolar nerve. In the absence of subjective symptoms other than implant loosening, however, the patient did not consent to this proposal. Therefore, only the broken abutment was removed. The patient was instructed to contact us immediately should infection or any other symptoms appear once the mucosa had healed, and the dental clinic that had referred her to us was requested to make her a set of dentures. To our knowledge, only 11 reports have been published to date describing displacement of an implant body into the mandible, and these address a total of just 20 cases. The possibility that an implant body in the mandible may become displaced must be kept in mind during treatment.

Background: Case-controlled studies have produced conflicting results on the relief of depression following attempted suicide. This study examined the impact of attempted suicide on the symptoms and course of mood disorders., Method: Of 2800 inpatients reviewed retrospectively, 40 depressed patients who had attempted suicide immediately before admission and 40 depressed but nonsuicidal control patients satisfied entry criteria for the study. The overall severity of their depression had been rated by the treating psychiatrists before the attempted suicide or at admission using the DSM-III-R (or DSM-IV) severity scale. The severity of depression at 1 week after admission was evaluated by reviewing medical records. For categorical analysis, improvement was defined as a reduction of one or more categories on the DSM-III-R (or DSM-IV) severity scale. We assigned scores of 1-6 to this scale to enable quantitative comparisons., Results: Both categorical and dimensional analyses demonstrated that depression was significantly (p <.05) more likely to improve within 1 week of admission among suicidal unipolar patients than among nonsuicidal unipolar patients. Logistic regression analyses revealed that a unipolar course was significantly (p =.023) associated with the improvement of depression. Of the 15 patients showing postsuicidal improvement of depression, 5 (33%) relapsed within 1 month. No significant predictors of their relapses were detected. Of 7 patients with postsuicidal manic switching, 4 (57%) experienced a switch-down into depression., Conclusion: This study suggests that unipolar depression is significantly improved after attempted suicide, but also that depressed patients showing postsuicidal improvement or manic switching are likely to undergo relapse or switch-down into depression within a short period.

In this study, data on walking speed, step numbers, cadence of natural walking were collected and their relations to foot wear, clothing, luggage carried and time of the day as well as crowdedness were investigated. This survey was held in Shinjuku, Tokyo in 1991. Six thousand three hundred and seventy nine walking people were observed from 10:00 am to 5:00 pm. Ten students who were trained to observe the walking were employed for the data collection. The observed subjects were divided into three age groups, namely young (less than 30 years), middle (31-60 years) and elder (over 61 years), and their age groups were decided by the students based on their appearance. For the analysis, they were further classified into male and female groups. The factors which affect walking speed, step number and cadence were taken into consideration. It was found that young people were more sensitive to their factors in their natural walking and old people showed lower flexibility to these factors.

A long-term observation has been made in 58 patients (30 males and 28 females) with severe sequelae of neonatal anoxic encephalopathy. They aged from 8 months to 65 years. All of them had motor disturbances and profound mental retardation. Motor function was improved in 4 patients with aging. In contrast, motor activity deteriorated in 11 cases, of which 4 showed a mental regression. Among them, patients who had originally better motor ability than sitting were likely to deteriorate by uncontrollable epilepsy and/or excessive administration of anticonvulsants. Regression of the patients with worse motor ability like bedridden appeared to attributable hypertonia of muscles and bodily deformation. Fifteen cases showed an exacerbation of general condition which originated predominantly to respiratory distress. Twelve patients died including 6 exacerbated cases. Exacerbation or death may have occurred frequently in specific periods of infancy, adolescence and youth with the patients who showed very low motor function such as bedridden and no locomotion.

Among 848 cases of profound mental retardation with motor disturbance admitted to Metropolitan Medical Center of Severely Handicapped in the last 20 years, 98 died. The 94 cases whose cause of death was determined were clinically investigated. There was no difference in sex, and 72% of the patients died before the age of 15 years. Half of the patients died of pneumonia; sudden death occurred in 9, and ileus in 8. These three were thought to be the most important and characteristic causes of death in severely handicapped patients. In recent years, deaths due to pneumonia have decreased and those due to ileus have disappeared, but deaths due to malignant neoplasm have begun to be recognized. There were also some deaths from intracranial hemorrhage in young children, and some deaths from tracheal bleeding in those who had tracheal tubes. These two were also important causes of death in the patients. Sudden death had certain characteristics: most cases were adolescent or young patients with mixed quadriplegia who were sensitive to environmental changes and often showed marked hypertonia by athetosis, and in addition, all of their acute changes occurred between 5 and 8 a.m. or between 6 and 9 p.m.