Background: The relationships between the postpartum subacute ruminal acidosis (SARA) occurrence and predicted bacterial functions during the periparturient period are still not clear in Holstein cows. Objectives: The present study was performed to investigate the alterations of rumen fermentation, bacterial community structure, and predicted bacterial functional pathways in Holstein cows. Methods: Holstein cows were divided into the SARA (n = 6) or non-SARA (n = 4) groups, depending on whether they developed SARA during the first 2 weeks after parturition.Reticulo-ruminal pH was measured continuously during the study period. Reticulo-ruminal fluid samples were collected 3 weeks prepartum, and 2 and 6 weeks postpartum, and blood samples were collected 3 weeks before, 0, 2, 4 and 6 weeks postpartum. Results: The postpartum decline in 7-day mean reticulo-ruminal pH was more severe and longer-lasting in the SARA group compared with the non-SARA group. Changes in predicted functional pathways were identified in the SARA group. A significant upregulation of pathway “PWY-6383” associated with Mycobacteriaceae species was identified at 3 weeks after parturition in the SARA group. Significantly identified pathways involved in denitrification (DENITRIFICATION-PWY and PWY-7084), detoxification of reactive oxygen and nitrogen species (PWY1G-0), and starch degradation (PWY-622) in the SARA group were downregulated. Conclusions The postpartum SARA occurrence is likely related to the predicted functions of rumen bacterial community rather than the alterations of rumen fermentation or fluid bacterial community structure. Therefore, our result suggests the underlying mechanisms, namely functional adaptation of bacterial community, causing postpartum SARA in Holstein cows during the periparturient period.

The case was a 77-year-old man. He had dizziness and dysphagia for 2 years, and underwent detailed screening at the internal medicine department for general malaise and bloody sputum. He was hospitalized for aspiration pneumonia due to dysphagia of unknown origin. This time, he visited a local doctor with palpitations and shortness of breath. Echocardiography indicated a left atrial tumor involving the mitral valve and arrhythmia. Emergency surgery was performed to remove the left atrial myxoma and close the patch at our hospital's cardiovascular surgery department. After the excision, swallowing function was restored, and the patient was diagnosed with postoperative Ortner's syndrome. We report a case where echocardiography was considered important as a detailed investigation of the cause of swallowing dysfunction and dizziness.

X-linked severe combined immunodeficiency (X-SCID) is a rare, life-threatening immune disorder, caused by mutations in the gamma c chain gene, which encodes an essential component of the cytokine receptors for interleukin-2 (IL-2), IL-4, IL-7, IL-9, IL-15, and IL-21. A 13-month-old boy with recurrent infections who had reduced serum immunoglobulin levels and decreased numbers of CD3, CD16/56 cells was evaluated for gamma c chain gene mutation and protein expression. The patient had a C-to-T point mutation at nucleotide position 690, one of the hot spots, resulting in a single amino acid substitution of cysteine for arginine (R226C), as determined by direct sequencing and PCR-RFLP. The patient's mother was a heterozygous carrier. Percutaneous umbilical cord blood sampling was performed at the 6-month of gestation in a subsequent pregnancy. As the immunophenotype of the fetus showed an identical pattern, the pregnancy was terminated and genetic analysis of the abortus confirmed recurrence. This is the first report of the molecular diagnosis of X-SCID in Korea. Genetic analysis of the gamma c chain gene is useful for definite diagnosis and genetic counseling for X-SCID.
Arginine/chemistry ; Cysteine/chemistry ; DNA/metabolism ; DNA Mutational Analysis ; Female ; Flow Cytometry ; Genetic Counseling/*methods ; Heterozygote ; Human ; Immunoglobulins/metabolism ; Immunophenotyping/methods ; Korea ; *Linkage (Genetics) ; Male ; *Mutation ; Pedigree ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Receptors, Immunologic/*genetics ; Sequence Analysis, DNA ; Severe Combined Immunodeficiency/*diagnosis/*genetics ; Support, Non-U.S. Gov't ; Time Factors ; *X Chromosome

In Japan, the number of people 65 and over is increasing while the number of children is decreasing. A greater number of senior citizens live by themselves or husband and wife alone than before.
To realize comfortable and independent life for aged people, it is important to prepare housing and environment which have special services for them.
We would like to explain two housing projects which were planned and are being put into execution in Japan. One is ‘Silver Housing’ multiunit dwellings for the aged built by the Ministry of Construction and the Ministry of Health and Welfare since 1987. The other is ‘Silver Peer’ project which has been pushed forward by the Tokyo Metropolitan Government since 1987.

The need for medical team care is increasing because of advances in medical care and changing national needs. For more than 20 years medical students at the University of Tsukuba have participated in medical team care practice before bedside learning during the third trimester of their 4th year. The objective of this practice is to understand patients from the nurses' point of view and to learn cooperation between doctors and co-medical staff. We analyzed students reports to study what they had learned. A total of 326 items in 11 categories were specified in the free-response part of the reports. The largest category was “nursing/nurses” and the second largest was “communication/human relations.” The results show that the students learned points other than the General Instruction Objectives and that the practice was extremely effective.

Measurement of bone mass (BM), especially in the lumbar vertebrae, is very important for diagnosis of osteoporosis. In this study, we compared BM values measured by computed X-ray densitometry (CXD) with those by quantitative computed tomography (QCT), and discussed differences between the two methods.
The subjects were 90 women and 3 men, aged 42-86 years, who visited our outpatient department of osteoporosis. Metacarpal bone density (ΣGS/D) and metacarpal index (MCI) in the second metacarpal bone were measured by CXD. QCT was uesd for measurement of bone mineral density (BMD) in the lumbar trabecular bone, where pronounced osteoporotic changes occur early. The mineral values of L3 were expressed as mineral equivalent of CaCO³ in mg/ cm³, and≤75 mg/cm³ of L3 values were judged to be loss of lumbar BMD.
There were negative correlations between age and ΣGS/D, MCI or L3 value, and positive correlations were found between ΣGS/D or MCI and L3 value. Based on the above criterion of lumbar BMD loss, sensitivity and specificity of ΣGS/D for lumbar bone loss were examined. If ΣGS /D of 2.30 (T score -2.7) was used as the cut-off point, the sensitivity was 69.8% and the specificity was 75.0%, and if ΣGS/D of 2.37 (T score -2.3) and 2.40 (T score -2.1) were employed, the sensitivity was 79.1% and 79.1%, while the specificity was 64.5% and 62.5%, respectively. We concluded that BM values of cortical bone and trabecular bone decrease with age, and that sensitivity and specificity of GS/D for diagnosis of lumbar BMD loss are not very high.

Every local government in Japan is seeking to have an integrated health, medical and welfare system to take care of an increasing number of the elderly.
An attempt to develop such a model system called ‘Fukushi no Mori’ was begun in 1987 in Koga City, Ibaraki Prefecture. It was not until 1993 that the land for the project was acquired and the final plans for the arrangement of facilities were drawn up. In March 1994 construction got under way.
This paper discusses the strategies for developing an integrated health, medical and welfare system in this city. The results of a number of detailed research studies undertaken by the authors are also described and discussed.

Every local government in Japan is seeking to have an integrated health, medical and welfare system to take care of an increasing number of the elderly.
An attempt to develop such a model system called ‘Fukushi no Mori’ was begun in 1987 in Koga City, Ibaraki Prefecture. It was not until 1993 that the land for the project was acquired and the final plans for the arrangement of facilities were drawn up. In March 1994 construction got under way.
This paper discusses the strategies for developing an integrated health, medical and welfare system in this city. The results of a number of detailed research studies undertaken by the authors are also described and discussed.

Every local government in Japan is seeking to have an integrated health, medical and welfare system to take care of an increasing number of the elderly.
An attempt to develop such a model system called ‘Fukushi no Mori’ was begun in 1987 in Koga City, Ibaraki Prefecture. It was not until 1993 that the land for the project was acquired and the final plans for the arrangement of facilities were drawn up. In March 1994 construction got under way.
This paper discusses the strategies for developing an integrated health, medical and welfare system in this city. The results of a number of detailed research studies undertaken by the authors are also described and discussed.

Every local government in Japan is seeking to have an integrated health, medical and welfare system to take care of an increasing number of the elderly.
An attempt to develop such a model system called ‘Fukushi no Mori’ was begun in 1987 in Koga City, Ibaraki Prefecture. It was not until 1993 that the land for the project was acquired and the final plans for the arrangement of facilities were drawn up. In March 1994 construction got under way.
This paper discusses the strategies for developing an integrated health, medical and welfare system in this city. The results of a number of detailed research studies undertaken by the authors are also described and discussed.