In recent years we have witnessed a remarkable progress in aging research using genetics in various model organisms, including yeast, nematodes, Drosophila, and mice. Causative genes for human premature aging syndromes have also been identified by positional cloning. In this review I have briefly summarized the recent topics on longevity genes.

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Supplementary 3D-MRI of the breast was offered to the patients with breast cancer ascertained resectable with breast conservation therapy (BCT) according to clinical findings, mammography and ultrasonography. 135 patients were offered the additional examination. In accordance with the 3D-MRI findings, the planned BCT of 29 patients were changed to mastectomy. Nine patients had widely spreaded extensive intraductal components (EIC), eleven patients had multiple lesion and four patients had widely spreaded interstitial invasion. However, five patients diagnosed as extensive cancer with 3 D-MRI had no other malignant lesion pathologically. Forty patients pref ered mastectomy, although 3D-MRI diagnosed as resectable with BCT. The supplementary 3D-MRI of the breast elevated the rate of the patients received BCT slightly. On the other hand, it suppressed the rate of the pathologically positive, margin of BCT specimens from 24.0 to 12.1% (p=0.16) and might be in-strumental imoproving the accuracy of the determination of adequate breast resection.

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It has been reported that SFD (small for date) infants are born to small mothers. But there have been surprisingly few reports dealing with the mechanism of SFD born to small mothers. The present study purposed to clarify these problems by examination for placenta and intrauterine growth at term according to maternal height. Birth rates of HFD, AFD, SFD more than 36 weeks of gestational age are 12%, 86%, 2% respectively. Though maternal heights of AFD, HFD and SFD infants are almost same, there are positive correlations between placental weight and birth weight.
In followup study of 6 SFD infants born to small mothers less than 145 cm or same. They all caught up growth to more than 1SD of height or weight till 2 years of age. Therefore, the present study suggests the fetal growth mainly due to placental growth.

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A 67 years old female was admitted to our hospital because of heart failure. Although she had an untreated hypertension and moderate diabetes mellitus, no cardiac hypertrophy and significant coronay stenosis were recognized. Scintigraphic study revealed normal myocardial perfusion by ²⁰Tl and no myocardial accumulation of ¹²³I-BMIPP. Recent study has demonstrated that CD 36 acts a direct signal transducer and a specific ligand of long-chain fatty acids, one of the major cardiac en-ergy substrate. Although we analyzed CD 36 expression in platelet and monocyte by flow cytometric analysis, this patient was identified as type I CD 36 deficiency expression level (platelet 0.3%, monocyte 7.0%). Using diuretics and vasodilators, heart failure in this patient was improved, but two dimensional echocardiography demonstrated no remarkable change of fractional shortening, and ejection fraction of left ventriculography was 28%. Since this patient has abnormality of ¹²³I-BMIPP accumulation and type I CD 36 deficiency, we suspected the association between cardiac metabolism and heart failure.

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We reported a case of recurrent phyllodes tumor with malignant transformation. A 59-year-old woman who had extirpated benign phyllodes tumor in the CA-region of right breast in September 1995 found a small nodule in the same region of right breast in May 1999. She visited our depart-ment on September 13 because of its rapid growth since July. The tumor was round, 7.0×7.2 cm in dimension, relatively well circumscribed and firm in consistency. Mammograms, echograms and aspiration biopsy cytology suspected benign phyllodes tumor, and enucleation of the tumor was performed in October. Histopathological diagnosis was malignant phyllodes tumor because surgi-cal specimens showed overgrowth of the glands by the sarcomatous stroma with marked nuclear atypia, umerous mitoses and inf iltrative growth. DNA ploidy pattern was diploid. The patient do not show any recurrence for the past 4 months after operation. The biological behavior of malig-nant phyllodes tumor of the breast seems to be characterized by a tendency for local recurrence but an extremerarity of distant metastases except for primary de novo malignancy.

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We describe a 66-year-old female who demonstrated esophageal achalasia-like syndrome and posi-tive anticentromere antibodies. The patient had heartburn, vomiting after meals, and weight loss. Esophagography and esophagoscopy findings were compatible with a diagnosis of esophageal achalasia. A surgical intervention (Jekler-Lhotka method) was performed and her complaints disappeared.
Histological examination of the resected esophageal wall did not show diminution or absence of Auerbach's plexus, but did show atrophy of the smooth muscle layers and replacement by increased connective tissue fibers, suggesting scleroderma rather than esophageal achalasia . Therefore, autoantibodies were examined and anticentromere antibodies were found to be positive. Since this autoantibody is found characteristically in patients with the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia) variant of systemic sclerosis, this was considered to be a rare case who is positive for anticentromere antibodies and has, so far, exhibited esophageal dysmotility as her only clinical finding, possibly because the disease is at an early stage.

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Feasibility of satellite communication for international medical cooperation was studied. The experimental communication with the use of satellite system was carried out between Thailand and Japan. Asean Institute for Health Development (AIHD) of Thailand and National Ohkura Hospitsl (NOH) of Japan were connected and the case of clonorchiasis who developed to hepatoma was in-troduced by AIHD to NOH. Doctors of both hospitals discussed about this case with the ultrasound images which were transferred to NOH from AIHD. Though there was a disadvantage on the frame rate of ultrasound images, sufficient discussion was possible for the case including ultrasound images.

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