We report a 57-year-old male who suffered from ascending aortic aneurysmal dilatation complicated with acute localized dissection. He had received aortic valve replacement with a prosthesis for severe aortic regurgitation resulting from valve degeneration and annular dilatation 4 years previously at which time the maximal ascending aortic diameter had been 45mm so that a procedure for the aorta itself was not done. On the present occasion an aortogram showed a maximal aortic diameter of 90mm and localized dissection from above the right coronary ostium to near the connection to the brachiocephalic artery. A successful composite valve-graft replacement of the ascending aorta (Bentall procedure with Piehler's modification) was carried out on a semi-emergency basis. This experience with this case implies that certain intervention for associated moderate aortic dilatation should be considered when an aortic valve replacement is performed.

A study was made to elucidate growing health problems confronting women in rural communities today amidst drastic changes in agriculture.
From the standpoint of production structure, the area covered by our survey was divided into single-crop (paddy-rice), paddy-rice and fruits (apple), paddy-rice and water melon, and fishing village districts. In each of these districts, we conducted a survey by the use of a questionnaire and a health examination.
1, About 45 to 70 % of women engaged in farming complained that they could not take enough time to sleep. Especially in the paddy-rice and water melon producing district, the percentage was high.
2. Female farmers who complained of pains in the legs and the lower part of the back accounted for 40-60 % of the total. The rates were high in the rice producing district, and the paddy-rice and water melon producing district. This is probably due to the nature of farm work. However, the cause of the complaints was not always clear in the paddy-rice district.
3. Depending on the working postures (work on the stepladden in the orchard, work on hillsides, work in the supine position, etc.), the ailing region they complained about differed.
4. Those women who take care of supplementary work when machines are employed said that they feel they are subordinate to mechnization.
5. When pesticides are used, 10-20 % of the subjects showed toxic symptoms. In the paddy-rice and apple growing district, high ratios were recorded.
6. Of the total, 52.7 % were found negative in the mass health screening. The rate was the highest in the paddy-rice and water melon producing district.
7. The obesity rate rose in proportion to the rise in age.
8. The incidence of hypertension (WHO criteria) was the lowest in the fishing community, followed by the paddy-rice and apple district, and the rice producing district in that order.
9. As regards the hemoglobin level, those who showed less than 12.0 g/dl accounted for 11 to 32%. The level was lowest in the paddy-rice and apple producing district, followed by the paddy-rice district and the fishing village. There were few who need medical treatment immediately.
10. Abnormality of liver function was found among some 5 % of the examined. Serum cholesterol levels were lower in the paddy-rice district than in the other districts.

We report two cases of farm chemical poisoning which were treated successfully. Two elderly men separately swallowed down paraquat/diquat solutions in an attempt to kill themselves, and resultantly developed pulmonary fibrosis. After steroid therapy, clinical symptoms desappeared, although a slight degree of abnormality remained on chest X-rays. Case 1: a 57-year-old man; the amount of ingestion, 100 ml; hospitalized 2 hours after ingestion; shock, (-); urinary PQ reactoin, (2); serum PQ level, 1.14 ug/ml; pulmonary injury at first examinatoin, (-); pulmonary manifestation of symptoms, at day 3 after hospitalization; minimum Pao₂, 67.6 mmHg. Case 2: a 65-year-old man; the amount of ingestion, one gulp; hospitalized 27 minutes after ingestion ; shock, (-); urinary PQ reactoin, (3+); serum PQ level, 6.6ug/mg; pulmonary injury at first examination, (-); pulmonary manifestation of symptoms, at day 5 after hospitalization; minimum Pao₂, 58.3mmHg. For treatment, gastrointestinal lavage, forced diuresis and direct hemoperfusion were performed in both cases. Steroid pulse therapy was followed by repeated oral administration of large doses of steroid.
Hepatic and renal disorders were transient. Pao₂ was normal when the patients were discharged. The primary reasons we could save their lives are probably that the amount of PQ ingestion was relatively small, hemodialysis was performed repeatedly at early stages, and that large amounts of steroid were used immediately after the onset of pulmonary fibrosis.

BACKGROUND/AIMS: Caudal-related homeobox 2 (Cdx2) is expressed in the human intestinal metaplastic mucosa and induces intestinal metaplastic mucosa in the Cdx2 transgenic mouse stomach. Atrophic gastritis and intestinal metaplasia commonly lead to gastric achlorhydria, which predisposes the stomach to bacterial overgrowth. In the present study, we determined the differences in gut microbiota between normal and Cdx2 transgenic mice, using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). METHODS: Twelve normal (control) and 12 Cdx2 transgenic mice were sacrificed, and the gastric, jejunal, ileac, cecal and colonic mucosa, and feces were collected. To quantitate bacterial microbiota, we used real-time qRTPCR with 16S rRNA gene-targeted, species-specific primers. RESULTS: The total numbers of bacteria in the gastric, jejunal, ileac, cecal, and colonic mucosa of the Cdx2 transgenic mice were significantly higher than those of the normal mice. The Bacteroides fragilis group and also Prevotella were not detected in the stomach of the normal mice, although they were detected in the Cdx2 transgenic mice. Moreover, the Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragilis group, and Prevotella were not detected in the jejunum or ileum of the normal mice, although they were detected in the Cdx2 transgenic mice. The fecal microbiota of the normal mice was similar to that of the Cdx2 transgenic mice. CONCLUSIONS: Our results showed the differences in composition of gut microbiota between normal and Cdx2 transgenic mice, which may be caused by the development of gastric achlorhydria and intestinal metaplasia in Cdx2 transgenic mice.
Achlorhydria ; Animals ; Bacteria ; Bacteroides fragilis ; Clostridium ; Colon ; Feces ; Gastritis, Atrophic ; Genes, Homeobox* ; Humans ; Ileum ; Jejunum ; Metaplasia ; Mice ; Mice, Transgenic* ; Microbiota* ; Mucous Membrane ; Prevotella ; Stomach

Investigations were made into the actual working and living conditions of adults, both men and women, in the families engaged in mixed farming.
The working conditions were analyzed according to the types of crops farmers are growing. The work study was necessary to probe into the causes of farmers' health disturbances.
A questionnaire revealed that farmers are short of sleep during the busiest season. Especially housewives are forced to cut down on their sleeping hours.
It also found that some farmers spray pesticides in quantity and expose themselves to the potentially health injurious chemicals with alarming frequency.
There was evidence to show that some ailments, notably low back pain, had been reduced due to imporovements on farmwork and working environment.
Health checkups showed that the incidences of hypercholesterolemia and obesity remain high. There was imbalance between carolic intake and consumption.