The far-advanced age ratio ([population above 90years] / [poplulation above 65 years] × 100) was calculated by investgating each perfecture in japan in 1995, and each district within Gunma Prefecture from 1995 to 1997.
In the nation-wide study, this ratio increased more in women than in men in every precture, and the disparity of this rate between the sexes is expected to extend to the future. Multiple regression analysis revealed that the main variables explainting this finding were heiht at age 14 and mean temperature. The former seems to reflect the adolescent age.
With regard to the study within Gunma Prefcture, we cannot assume that the short-term change in this rate in the less density populated districts, accurately reflects the long-term trend. This ratio was recalculated by summarizing the data from 1992 to 1997, and the far-advanced age areas were reevaluated. Regarding to the background information with a high far-advanced age rate district, we have no new findings.

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The author report his clinical experiences of heart and lung transplantation at the University of Pittsburgh, a world famous medical center apecializing in organ transplantation of the heart, lung, liver, kidney and so on. Organ transplantation has become an acceptable treatment for patients with end-stage organ failure.
However, a recentl donor shortage has decreased the number of transplantations. As a solution to shortage of donated organs, better management of patients using artificial hearts and unilateral lung tranplantations has been actively recommended at the University of Pittsburgh. The author also discusses the medical and social problems of resuming of organ transplantation in Japan, while referring to the present status in the United States of America.

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Recently, many people have become interested in pillows because head pillows whose heights are inadequate influece sleep, and sometimes induce several physical symptoms. In this study, the Committee of Examination of Nursing Materials in Gunma University Hospital discussed the introduction of the model pillows, and the questionnaire that was conducted for the purpose of examining pillow adequacy. The subjects of this study were 74 in-patients, who were hospitalized in one of seven adult units in sun hospital. We considered the relation between the cervical vertebral curve and the pillow height, and questioned subjects as to how they felt when using either the former or the model pillows. Evaluation of the former and the model pillows related to the depth of the cervical vertebral curve. Most subjects, including those whose cervical vertebral curves were deep, rated the model pillows high, and complaints of physical symptoms and insomnia related to the pillows were reduced. We believe that the way to fit pillow is related to the appraisal of pillow height.

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Purpose : A clinical trial of intestinal transplantation (ITx) under tarolimus and prednisone immunosuppression was initiated in June 1990 in patients with irreversible intestinal failure, and who were dependent on total parenteral nutrition (TPN)
Methods : Sixty-four patients (33 girls, 31 boys) with a median age of 3.5 years (range, 0.5 to 18 years) received 68 intestinal transplants that included isolated small bowel (SB) (n=19), liver and small bowel (LSB) (n=39), and multivisceral (MV) (n=10) allografts. Indication for Itx included : volvulus (n=18), gastroschisis (n=16), intestinal atresia (n= 8), necrotizing enterocolitis (n= 7), chronic intestinal psuedo-obstruction (n= 6), Hirschprung's disease (n= 4), microvillous inclusion disease (n= 3), multiple polyposis (n= 1), and trauma (n= 1).
Results : Currently 36 patients and 33 grafts are alive. Patient and graft survival at 5-year was 59% and 53%, respectively. Graft survival at 5-year in SB, LSB and MV was 67%, 46%, and 35%, respectively. Five-year graft survival of patients more than 10 years old was 89%. Immunological complications included liver allograft rejection (n=18), intestinal allograft rejection (n=64), and graft-versus-host disease (GVHD) (n=10). Steroid resistant rejection defined as OKT3 administration was more frequent in the patients received SB. Exfoliative rejection occurred in 12 patients and 14 grafts, and of thess 4 patients with 3 grafts survived. Ten grafts were removed because of rejection (n= 7), and because of posttransplant lymphoproliferative disease (PTLD), pancreatitis and hepatic arterial thrombosis, one each. There were five retransplants (SB, n= 1 ; LSB, n= 4), and of these three failed. GVHD was occurred in 10 grafts. Graft loss occurred as a result of rejection (n= 9), PTLD (n = 9), infection (n=7), technical complication (n=6), rejection and PTLD (n = 3), and pancreatitis and unknown cause one each. At present, 94% (31/33 grafts) were functional and was exclusively orally fed.
Conclusions : Intestinal transplantation is a valid therapeutic option for patients with intestinal failure suffaring, and who have complications of TPN. The complex clinical and immunological course of these patients after transplantations reflected in a higher complication rate as well as patient and graft loss than seen after heart, liver, and kidney transplantation, although better than after lung transplantation.

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A 74-year-old male with repetitive cardiac failure due to isch_??_mic heart disease successfully underwent endoventricular patch plasty by Dor's procedure. After surgery, the left ventricular volume was reduced with the improvement in morphological features. The left ventricular ejection fraction increased from 28% to 43%. Cardiac rhythms returned from atrial fibrillation to sinus rhythm. This procedure is a treatment of choice for ischemic end-stage cardiac failure and may become an alternative or a bridge to heart transplantation.

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