A 63-year-old man suffered from multisystem trauma including pelvic bone fracture and lung contusion caused by a traffic accident. Chest CT revealed mediastinum and periaortic hematoma. Because of hemorrhagic complications, a emergency operation was avoided, and conservative therapy was decided on. Though his blood pressure was controlled strictly, re-bleeding appeared. An urgent operation was performed 4 days after the injury. Under partial cardiopulmonary bypass, the aortic isthmus disruption was resected and replaced with an artificial graft. The postoperative course was uneventful. In cases of traumatic aortic disruption with multisystem trauma, the delayed operation is more common than urgent operation. However, there is always the possibility of rupture. It is extremely important to appropriately judge the timing of the operation.

The number of people who participate in our mass screening program for the detection of colorectal neoplasms has been increasing year by year. Regrettably, though, only 60% to 70% of those screened with positive tests have complied with doctors' exhortations about receiving workup.
To improve the low attendance ratio of colon cancer candidates, the first thing we did was to hold classes for public health nurses at city, town and village levels to update their knowledge as professional health supervisors and to perceive the need to enlighten the public.
Following these classes, we sponsored educational lectures directed to the inhabitants in various districts with the cooperation of public health nurses there. Emphasis was placed on the importance of regular physicals and the need of workup in the case of positive screenings. Using slides, lecturers presented eveyday health-related data and explained the procedures and the medical equipment used in the screening and testing processes, using plain language.
As a result of these efforts, the workup attendance ratio is on the rise in every district, with the average ratio now reaching 80%.

Objectives : High and medium-dose combination hormone agents have long been used in their off-label use as oral contraceptives. Oral contraceptives (the low-dose pill) are expected to be approved by the standing committee of the Central Pharmaceutical Affairs Council in June 1999, and are expected to be on the market by autumn, available to anyone bearing a doctor's prescription. A survey was conducted of pharmacy students to determine their acceptance and their perceptions of oral contraceptives (the low-dose pill). The results are discussed along with ways of dealing with the scientific information on the possible soon to be approved oral contraceptives (the low-dose pill), and some proposals are made for the future.
Methods : The survey was conducted by distributing questionnaire sheets to female pharmacy college students in September 1996. Of the 670 subjects, 98 responded positively to the use of oral contraceptives (the positive group), while 572 preferred not to use them (the negative group). The two groups were compared and the data was analyzed. Mantel-Haenszel test was used to evaluate demographic and background data, their views on using oral contraceptives (the low-dose pill) and ways of obtaining necessary information.
Results : In the responses to the questions on how the subjects feel about oral contraceptives (the low-dose pill), the positive group gave these reasons more frequently than those in the negative group : simple to use (p<0.001), a method with a high contraceptive rate (p<0.001), a means of contraception controlled by the woman (p<0.001). On the other hand, the reasons given more frequently by the negative group : feeling concerned about adverse drug reactions (p<0.001), a method allowing sexually transmitted diseases to propagate (p=0.009), a method increasing the burden on the woman (p<0.001).
In terms of the subjects' knowledge of oral contraceptives (the low-dose pill), although there has been some improvement observed during their four-year college life, they did not seen to understand accurate information.
Conclusion : The surveyed subjects had not understood accurate information, and this lack of knowledge may have formed their biased views on oral contraceptives (the low-dose pill). Given such results, it is anticipated that such misconceptions may affect their own decision-making in their use of the drug, and that it would cause inefficiency in providing future users with accurate information when these students become pharmacists. In the near future, there is expected to be a deluge of information concerning the low-dose pill. It is clearly necessary in pharmaceutical education to provide proper training of pharmacy students for self-education so as to increase efficiency when considering and evaluating information.

Staged arterial switch operation without homologous blood transfusion was successfully performed in 5 patients weighing 4.1-11.0kg (double outlet right ventricle: 2 cases, transposition of great arteries: 3 cases). The postoperative hemodynamics and respiratory status were uneventful in all patients (initial central venous pressure after ICU admission: 9.0-14.5cmH₂O, mean 12.5cmH₂O, duration of intubation: 3.5-18.0h, mean 7.8h). Autologous blood donation immediately after induction of anesthesia and minimization of bypass circuit were effective methods for open heart surgery without homologous blood transfusion, particularly in staged arterial switch operation requiring prolonged cardiopulmonary bypass.

We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

We encountered a probable case ofloiasis in a returned traveler from Central Africa. A 52-year-old Japanese womanpresented to our hospital complaining of discomfort in her eyes and skin. She reportedhaving frequently visited Central Africa over many years and having been extensivelyexposed to the rainforest climate and ecosystem. Although no microfilariae werefound in her blood, there was an elevated level of IgG antibodies against thecrude antigens of Brugia pahangi,which have cross-reactivity with Loa loa.She was treated with albendazole for 21 days, after which the antigen-specificIgG level decreased and no relapse occurred.

BACKGROUNDIn an earlier study, we identified a locus for Moyamoya disease (MMD) on 17q25.3.

METHODSLinkage analysis and fine mapping were conducted for two new families in additional to the previously studied 15 families. Three genes, CARD14, Raptor, and AATK, were selected based on key words, namely, "inflammation", "apoptosis", "proliferation", and "vascular system", for further sequencing. A segregation analysis of 34 pedigrees was performed, followed by a case-control study in Japanese (90 cases vs. 384 controls), Korean (41 cases vs. 223 controls), Chinese (23 cases and 100 controls), and Caucasian (25 cases and 164 controls) populations.

RESULTSLinkage analysis increased the LOD score from 8.07 to 9.67 on 17q25.3. Fine mapping narrowed the linkage signal to a 2.1-Mb region. Sequencing revealed that only one newly identified polymorphism, ss161110142, which was located at position -1480 from the transcription site of the Raptor gene, was common to all four unrelated sequenced familial affected individuals. ss161110142 was then shown to segregate in the 34 pedigrees studied, resulting in a two-point LOD score of 14.2 (P = 3.89 × 10(-8)). Its penetrance was estimated to be 74.0%. Among the Asian populations tested (Japanese, Korean, and Chinese), the rare allele was much more frequent in cases (26, 33, and 4%, respectively) than in controls (1, 1, and 0%, respectively) and was associated with an increased odds ratio of 52.2 (95% confidence interval 27.2-100.2) (P = 2.5 × 10(-49)). This allele was, however, not detected in the Caucasian samples. Its population attributable risk was estimated to be 49% in the Japanese population, 66% in the Korean population, and 9% in the Chinese population.

CONCLUSIONss161110142 may confer susceptibility to MMD among East Asian populations.

ELECTRONIC SUPPLEMENTARY MATERIALThe online version of this article (doi:10.1007/s12199-009-0116-7) contains supplementary material, which is available to authorized users.