The fetus could not be considered a patient until ultrasonography stripped the fetus of his/her aura of mystery; until the origin and development of the fetus from embryo to neonate could be explained scientifically. Ultrasonographies enabled accurate delineation of normal and abnormal fetal anatomy with considerable detail and later on live moving pictures. Ultrasonographic imaging appears to have no harmful effect on the mother or on the fetus. The ability of prenatal ultrasonography to diagnose fetal abnormalities, both as a screening tool and for targeted examinations, has also been confirmed. The ability to perform invasive prenatal diagnostic procedures, such as amniocentesis, chorionic villus sampling, and cordocentesis as well as fetoscopy for fetal therapy has been significantly improved by real-time ultrasonography. Three-dimensional ultrasonography and MRI are now also available for fetal imaging. Recently, cell free fetal DNA released into maternal plasma is known as useful tool for non-invasive prenatal diagnosis of genetic diseases. The fetus may become our new patient in the near future.

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Although fear of falling is a common and serious problem among elderly people, little is known about the risk factors associated with fear of falling among frail elderly persons in Japan. To assess the fear of falling and investigate related factors, we conducted a study among 167 Japanese women aged 59 or older, who were receiving visiting nursing services. Fear of falling was measured by asking subjects about being afraid of falling (yes/no) and completing the Japanese version of Falls Efficacy Scale (FES). Fear of falling (being afraid of falling) was reported by 135 (80.8%) of the subjects. The overall FES score was significantly (p<0.01) lower in subjects who reported fear of falling (mean± standard deviation=19.8±5.5) than in those who did not (26.1±7.2). The Japanese version of FES effectively identified persons having a fear of falling. Multiple linear regression analysis showed that palsy, incontinence, and falls during the past year were significantly associated with an increase in fear of falling (measured by FES). The present study suggests that fear of falling is common among elderly women receiving visiting nursing services. Preventive strategies to reduce fear of falling and falls are needed, and would contribute to prevention of being bedridden and institutionalized for the frail elderly.

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The medical importance of free living amebas has been increasing as a worldwide problem. In Japan amebic keratitis caused by Acanthamoeba has caught the attention of ophthalmologists due to increasing risk of infection for soft-contact lens users. In the present work we examined the process of Acanthamoeba contamination in water placed indoors and outdoors under different conditions in Nagasaki city, Japan. The most frequently contaminated water was in coverless outdoor containers in the spring, and the next was in similar conditions, but in the autumn. The highest contamination of indoor water in coverless containers was found in the summer although the frequency was much lower than outdoors. When the containers were covered, complete protection for water bodies from Acanthamoeba contamination was obtained indoors, and nearly complete outdoors. Electrophoretic patterns of mitocondrial DNA fragments digested by two restriction enzymes indicated that Acanthamoeba contaminants seemed to be season-specific although the number of examined isolates was very small.

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The present paper focused on the analysis of data resulting from 50-year studies involving assessment of the hemopoiesis state in 2,739 Techa riverside residents chronically exposed to radiation in the range from low to intermediate doses. The highest bone marrow doses (mean value: 0.66 Sv) were due to intake of ⁹⁰Sr in drinking water and local food products, and to external γ-exposure. The status of peripheral blood and bone marrow has been monitored since 1951. Peripheral blood cell counts performed for exposed riverside residents during the period of maximum radiation exposures (1951-1953) displayed a significant (p<0.0001) decrease in the proportion of leukocytes (neutrophils and lymphocytes) and thrombocytes. Peripheral blood erythrocyte count was maintained at the normal level, owing to the efficacy of compensatory processes in the bone marrow, including increased rates of erythrocaryocyte proliferation and maturation. The development of peripheral blood granulocytopenia resulted from delay in the differentiation of neutrophilic bone marrow granulocytes, a marked increase in the frequency of lethal abnormalities in bone marrow neutrophils, pathological mitoses, and activation of apoptosis. The time necessary for the blood cell composition to return to normal varied significantly in different blood cell series, depending on exposure dose-rate, extent of the initial hemopoiesis inhibition and individual physiological characteristics of exposed individuals. Thus, under a combined chronic exposure at equivalent doses to red bone marrow reaching 1.79 Sv, a stable reduction of neutrophil, thrombocyte and lymphocyte counts was observed. Neutrophilic granulocyte series were noted to require the longest time (12-17 years) to recover.

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Sotos syndrome (SoS, OMIM #117550) is an autosomal dominant overgrowth syndrome with pre- and postnatal excessive growth, characteristic craniofacial features, and variable degrees of developmental delay. Haploinsufficiency of the nuclear receptor binding SET domain containing protein 1 (NSD1) gene causes SoS, as two thirds of SoS patients had either a whole-gene microdeletion or an intragenic point mutation. However, the etiology of other patients remains undetermined. In the present study, we analyzed 30 Japanese SoS patients on whether they have NSD1 intragenic deletions by NSD1-specific exon microarray comparative genomic hybridization (array CGH). Although the analysis suggested a deletion at the 5' region of NSD1 in 16 of the 30 patients, no such abnormalities were confirmed by subsequent quantitative fluorescent duplex PCR and fluorescence in situ hybridization. As no intragenic deletions have been identified in our series of SoS patients, other genetic aberrations need to be identified.

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We described a 75-year-old female with recurrent breast cancer that presented as stenosis of the ascending colon and right hydronephrosis. The patient underwent a left mastectomy for breast cancer and a right mastectomy for metachronous breast cancer at the ages of 45 and 69, respectively. Histological findings showed primary invasive ductal carcinoma (scirrhous carcinoma). At the age of 73, she suffered from right hydronephrosis, which was suspected to have been caused by metastasis to the ureter. Two years later, stenosis of the ascending colon occurred. Right hemicolectomy and partial resection of the ureter were performed. Resected specimens revealed infiltration of tumor cells in all layers of the colon and the ureter which resembled invasive ductal carcinoma of primary breast cancer. Metastatic breast cancer can manifest itself in a variety of recurrences, including ureteral and colonic metastatic sites.

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