[in Japanese]

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[in Japanese]

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[in Japanese]

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　The effects of environmental risk including chemical compounds on the health of the children have gathered public concerns. Thus, epidemiological research on children's environmental health has been recommended as one of the priority projects. In Japan, the Advisory Committee of Epidemiological Research on Children's Environmental Health was established in 2007 and decided to start a nationwide birth cohort study following up children from pregnancy to 12 years old. The full−scale survey, Japan Environment and Children's Study will start in 2010. In this article, the objective and the method of this study were reviewed and discussed.

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　The purpose of this study was to examine reliability and validity for the Japanese version of the repeatable battery for the assessment of neuropsychological status (RBANS). The split−half reliability coefficients were calculated using the 371 standadized RBANS data. To examine the stability of RBANS, a Form A−Form A test−retest study was performed 30 participants who were tested twice. The test−retest interval ranged from 29 to 314 days. To examine equivalency of Form A and Form B, both tests were performed to 102 participants. Forty participants performed WAIS−R/WMS−R and RBANS to examine validity of external criterion. Consequently, the reliability for RBANS subtests and indexes were relatively high. It was clear the two Forms were equivalent. There were high correlations between WAIS−R/WMS−R subtests and RBANS subtests. Therefore, RBANS is a brief neuropsychological test, but it is obvious that RBANS has enough validity. From now on, it is expected that Japanese version of RBANS will be used in clinical situation.

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　Acrofacial dysostosis (AFD) is an extremely rare syndrome, characterized by severe mandibulofacial dysostosis and various limb anomalies. Based on the variation in limb deformities, two major types are recognized: (1) Nager−type AFD, presenting predominantly pre−axial anomalies; and (2) Miller−type AFD, presenting predominantly postaxial limb anomalies. Here, we report the case of a newborn female with AFD syndrome combined with Nager and Miller type, as delineated by Rodriguez et al. The infant presented with severe mandibulofacial dysostosis, pre− and postaxial deformities of the upper limbs, phocomelia of the left lower limb, and other anomalies.

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Background: To our knowledge, there is no previous report of repeated sulcus−fixated IOL captures occurring in patients with atopic dermatitis.
Case presentation: A 21−year−old man with atopic dermatitis since childhood underwent an uneventful phacoemulsification/aspiration procedure followed by implantation of a 3−piece intraocular lens (IOL) in the capsular bag due to atopic cataract. Two years later, the patient suddenly complained of decreased visual acuity and monocular diplopia in the right eye. On examination, dislocation of the unwrapped IOL and lens capsule into the vitreous cavity was noted in the right eye. A complete pars plana vitrectomy for removal of the luxated IOL with suturing sulcus fixation of a single−piece polymethylmethacrylate (PMMA) IOL was performed in the right eye. The intra−, and postoperative courses were uneventful. During the follow−up period of 12 months, five recurrent episodes of pupillary sulcus−fixated IOL captures were observed in the right eye.
Conclusion: Recurrences of sulcus fixated PC−IOL captures in a patient with atopic dermatitis may be rare.

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Purpose
　Recently, the results of elective surgery for abdominal aortic aneurysms have become safety, whereas those of emergency surgery for cases of rupture remain high mortality rate. In the present study, we investigated the risk factors of surgery for a ruptured abdominal aortic aneurysm.
Methods
　We studied 51 patients who underwent emergency surgery for a ruptured abdominal aneurysm from January 1979 to December 2006 at Toyama University Hospital. We analyzed preoperative and operative factors. The factors were analyzed using multivariate logistic regression analysis.
Results
　Fourteen patients died (hospital mortality 27.5%). The factors were examined using stepwise logistic analysis to investigate hospital deaths in cases with a ruptured abdominal aortic aneurysm, which revealed that Postoperative organ failure (OR 32.4, p=0.004), intraoperative bleeding of 5000 ml or more (OR 6.76, p=0.039), preoperative base excess in arterial blood of −5 or lower (OR 9.30, p=0.008), and diabetes mellitus (OR 9.02, p=0.062).
Conclusion
　Risk factors of death from direct surgery for ruptured abdominal aortic aneurysm were investigated by multivariate analysis, and complication by diabetes, postoperative organ failure,5000ml or more blood loss during surgery, and −5 or lower base excess in preoperative arterial blood were identified as highly associated factors.

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Background: The scheduled changing of antibiotics type (antibiotic cycling therapy) has been reported as an effective prophylaxis to reduce the incidence of antibiotic resistant bacteria. In this study, we aimed to clarify the preventive effects of antibiotic cycling therapy on surgical site infections after cardiac surgery.
Methods: 618 patients underwent elective cardiac surgery in our department. We examined the frequency of occurrence of SSI between different groups, Cycling group, using single antibiotics with changing the type every 3 months, and Combined group, using two types of antibiotics together at once.
Result: 284 patients was participated in Cycling group, 334 was in Combined group. 3 patients (1.1%) developed SSI after cardiac surgery in Cycling group, and 13 (3.9%) in Combined group (p= 0.027). Antibiotic cycling therapy was an independent factor of the risk of SSI with an odds ratio of 0.2 (confidence interval [CI]: 0.07−0.9, p=0.030), and the risk of SSI caused by antibiotic−resistant bacteria with an odds ratio of 0.2 (CI: 0.05−1.0, p=0.054).
Conclusion: Antibiotic cycling therapy reduced the incidence of antibiotic−resistant bacteria and SSI after cardiac surgery. The multiple logistic regression analysis showed, antibiotic cycling therapy was an independent factor to lower the occurrence of postoperative SSI and SSI related antibiotic−resistant bacteria.

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[in Japanese]

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