Cross-sectional web-based survey among haematologists and gastroenterologists in Japan to identify the key factors for early diagnosis of Gaucher disease.

BACKGROUND: Gaucher disease (GD) is a rare, inherited metabolic disorder resulting from glucocerebrosidase deficiency. Patients benefit from early treatment as complications can arise from delayed diagnosis. AIMS: To measure GD awareness among Japanese haematologists and gastroenterologists, who are the specialists most likely to encounter patients with symptoms recognised in the Gaucher Earlier Diagnosis Consensus (GED-C), such as hepatosplenomegaly and thrombocytopenia. Additionally, we aimed to determine key signs from the GED-C associated with early diagnosis. METHODS: A quantitative web survey assessed Japanese haematologists and gastroenterologists for their (i) basic awareness of GD, (ii) explicit awareness of GD signs, (iii) explicit awareness of GD treatments and (iv) accuracy in suspecting GD in model patients. RESULTS: Survey results from 160 haematologists and 166 gastroenterologists indicated that more than 50% of haematologists were aware of GD symptoms, diagnostic criteria and/or treatments, and 38% of them had experienced or suspected GD. The majority of gastroenterologists were unaware of GD or knew the disease only by name, with 20% experiencing or suspecting GD in practice. Almost 70% of haematologists knew of enzyme replacement therapy, while 47% of gastroenterologists were not aware of any treatments for GD. Of the GED-C items, an awareness of bone-associated signs was correlated with accurate GD diagnosis in model patients and this awareness was greater among haematologists than gastroenterologists. CONCLUSIONS: The present study showed that haematologists had greater awareness of GD than gastroenterologists, and that bone pain may be a key sign of GD to enhance early diagnosis.

Postmortem magnetic resonance imaging findings of tricuspid atresia with ventricular and atrial septal defects and subvalvular pulmonic stenosis in a Japanese native Noma horse.

The necropsy of a 2-day-old Noma horse that died of weakness showed an enlarged cardiac base and a narrow cardiac apex, suggesting cardiac malformation. The excised heart underwent imaging to investigate its luminal structure. On three-dimensional magnetic resonance imaging, the right atrium and right ventricle were discontinuous. The right atrium communicated with the left atrium and the left ventricle communicated with the right ventricle. The lumen narrowed near the pulmonary artery valve. Since the same findings were observed on gross examination, the foal was diagnosed with tricuspid atresia with ventricular and atrial septal defects, along with subvalvular pulmonic stenosis.

Relationships between the age and blood test results or body sizes in Noma horses.

The objective of this study is to analyze the relationships between the age and blood test results or body sizes in Noma horses by using the results of periodical health examination. Out of 45 hematological or physical items examined, statistically significant, but loose correlations were observed in 14 items. Red blood cell count, activities of aspartate aminotransferase, alkaline phosphatase, and creatinine kinase, concentrations of calcium and inorganic phosphorus decreased with aging. Conversely, mean corpuscular volume, mean corpuscular hemoglobin, lipase activity, γ-globulin and chloride concentrations, body height, chest circumference and cannon bone circumference increased with aging. The changes in a few items seemed unique to Noma horse. However, most age-related changes found in this study might be considered as a common trend in horse breeds rather than distinctive characteristic in Noma horse.

Effect of seasons and sex on the physical, hematological, and blood biochemical parameters of Noma horses.

This study aimed to evaluate the influence of seasons and sex on body size and hematological and biochemistry parameters of Noma horses, a native Japanese breed. Body size was larger in winter than in summer. Laboratory testing variables, including erythrocytic parameters and urea nitrogen, total cholesterol, and creatinine kinase levels, were higher in winter, while the eosinophil count was higher in summer. These seasonal differences may be related to increased energy consumption of horses due to heat stress. The higher eosinophil counts may have been related to the dermatitis observed in summer. Stallions tended to have smaller bodies compared with mares. Future studies are necessary to investigate the effect of stress in seasonal and sex-based groups.

Association between somatic cell count or morbidity of chronic subclinical mastitis and longevity in dairy herds in Eastern Hokkaido, Japan: a cross-sectional study.

An epidemiological analysis was conducted on production records in Hokkaido, Japan, to investigate the potential association between improved milk quality and longevity outcomes. The study found significant variations in herd somatic cell count levels and chronic subclinical mastitis morbidity based on geographical area and herd size. The analysis also revealed a positive correlation between herd somatic cell count and chronic subclinical mastitis morbidity. Although the hypothesis of a causal link between milk quality and longevity was examined, no such association was found. However, intensive assistance for identified high-risk areas and farms is expected to enhance overall milk quality.

Effect of 2% meloxicam injection in Holstein dairy cows on acute clinical mastitis without systemic symptoms.

This study aimed the efficacy of meloxicam (MX) in treating acute clinical mastitis (ACM) without systemic symptoms in Holstein cows by studying improvement in udder pain, changes in prostaglandin E2(PGE2) and bradykinin (BK) levels in the milk, and milk yield (MY) after healing. Forty-two cows with ACM were randomly assigned to the MX treatment group (T group; n=21) and the control group (C group; n=21). At onset of illness (day 0), the T group received a 0.5 mg/kg subcutaneous (SC) injection of MX whereas the C group received 15 mL SC of saline solution as a placebo. Udder tenderness (UT) was measured, and milk samples were collected on days 0-3. There was little change in the MY of the T group before and after healing, whereas MY in the C group was significantly lower than after healing. UT on day 3 in the T group was significantly lower than that in the C group. PGE2 levels significantly decreased from day 0 to day 3 in both groups. A significant negative correlation between PGE2 and linear score was observed on day 1 in the T group, but not in the C group. In ACM without systemic symptoms, the administration MX may be useful for restoring MY and reducing udder pain after healing.

Physician awareness and understanding of primary immunodeficiency disorders: a web-based study in Japan.

Primary immunodeficiencies (PIDs)/Inborn errors of immunity (IEI) consist of a complex genetic group of disorders that cause susceptibility to infections, inflammation, immune dysregulation, autoimmunity, and malignancy. One of the key steps to reach an early diagnosis is improving knowledge of PID among the medical community. In this study, a web-based survey was conducted among 355 Japanese physicians, consisting of 121 pediatricians, 116 hematologists, and 118 general internal medicine physicians, to assess their awareness and knowledge about the diagnostic flow of PID. One of the major problems this study identified was the unawareness of optimal IgG trough levels among the physicians, while around half the physicians knew about the symptoms of PID. Results from the hypothetical case study revealed that over 70% of physicians considered PID after obtaining the past medical history of patients and 75.2% of physicians showed interest in gaining more knowledge about PID. The survey findings revealed that proper questioning to understand the exact medical history of patients may lead to basic immunological examination. There is a need to improve knowledge about PID, e.g., the '10 warning signs of PID' and '4 stages of testing for PID', and to motivate physicians to ensure earlier diagnosis of PID.

Efficiency of immunocastration with an anti-gonadotropin-releasing hormone vaccine on cryptorchid bulls.

Cryptorchid bulls have low economic value owing to the effects of masculinization. Moreover, surgical removal of an ectopic testis is difficult in certain clinical cases. Recently, immunocastration has garnered popularity as a nonsurgical castration method in pig farming; however, the effects of immunocastration on cryptorchid bulls are yet to be yet. Herein, we investigated endocrine changes due to immunocastration in cryptorchid bulls and studied its effectiveness. This study included 13 Holstein bulls diagnosed with cryptorchidism and classified into two groups based on pubertal period: <8 months of age (pregroup) and ≥8 months of age (postgroup). Antigonadotropin-releasing hormone (GnRH) vaccine was used for immunocastration, and two vaccine doses were administered. Blood testosterone and anti-Müllerian hormone (AMH) levels were measured and analyzed for endocrine evaluation. The testosterone levels significantly decreased following the start of immunocastration in both groups, thereby confirming the efficacy of antiGnRH vaccination in cryptorchid bulls. The AMH levels significantly increased in the pregroup with two antiGnRH vaccination, suggesting a compensatory response via the neutralization of GnRH antibodies. The AMH levels did not significantly change in the postgroup, indicating the partial suppression of AMH secretion in Sertoli cells during sexual maturation and failure of Sertoli cell maturation. Thus, we successfully restrained the serum testosterone levels in cryptorchid bulls using antiGnRH vaccine. The testosterone levels are a useful indicator of the immunocastration effect on cryptorchid bulls. Hereafter, a vaccine program that can sustain the castration effect on cryptorchid bulls is necessary.

An observational study to investigate the relationship between plasma glucosylsphingosine (lyso-Gb1) concentration and treatment outcomes of patients with Gaucher disease in Japan.

BACKGROUND: Gaucher disease (GD) is an autosomal recessive disease caused by GBA1 mutations resulting in glucosylceramide accumulation in macrophages. GD is characterized by hepatosplenomegaly, anemia, thrombocytopenia, bone complications, and neurological complications. Glucosylsphingosine (lyso-Gb1), a deacylated form of glucosylceramide, has been identified as a promising biomarker for the diagnosis and treatment response in GD. The aim of this study was to examine the relationship between plasma lyso-Gb1 and therapeutic goals for GD (improvements in hepatomegaly, splenomegaly, anemia, thrombocytopenia, bone pain, and bone crisis), as well as disease type and GBA1 mutation type, in Japanese patients with GD receiving velaglucerase alfa, an enzyme replacement therapy (ERT). Furthermore, this study compared the plasma lyso-Gb1 concentration observed in Japanese patients included in this study with that observed in a previous non-Japanese clinical study. RESULTS: This non-interventional, open-label, multicenter observational cohort study (October 2020 to March 2021) included a total of 20 patients (of any age) with GD (type 1: n = 8; type 2: n = 9; type 3: n = 3) treated with velaglucerase alfa for ≥ 3 months. Median (minimum-maximum) duration of velaglucerase alfa treatment was 49.5 (3-107) months. A total of 14 (70.0%) patients achieved all therapeutic goals (i.e., 100% achievement; improvements in hepatomegaly, splenomegaly, anemia, thrombocytopenia, bone pain, and bone crisis). Overall, median (minimum-maximum) lyso-Gb1 concentration was 24.3 (2.1-150) ng/mL. Although not statistically significant, numerically lower plasma lyso-Gb1 concentrations were observed in patients with 100% achievement compared with those without; no statistically significant difference in plasma lyso-Gb1 concentration was observed between patients with different disease type or mutation type. Furthermore, lyso-Gb1 concentrations observed in Japanese patients were numerically lower than that observed in a previous study of non-Japanese patients with GD receiving ERT. CONCLUSIONS: In this study, high achievement rates of therapeutic goals with low lyso-Gb1 concentration were observed, demonstrating a correlation between therapeutic goals and lower plasma lyso-Gb1 concentration in Japanese patients with GD treated with velaglucerase alfa. This study further suggests that plasma lyso-Gb1 concentration may be a useful biomarker for treatment response in patients with GD.

The relationships between environmental parameters in livestock pen and physiological parameters of Holstein dairy cows.

There has been an increase in temperature and the incidence of extreme weather events, such as heat wave, due to global warming, which has promoted the incidence of livestock diseases. Therefore, it is important to examine the effect of changes in environmental parameters on livestock performance. The aim of this study was to examine the relationship between ambient environmental conditions in livestock pen and the physiological parameters of Holstein dairy cows. The results showed that there was a decrease in the red blood cell counts, hemoglobin concentrations, and mean corpuscular hemoglobin concentration of the cows with increasing pen temperature, wet bulb globe temperature (WBGT), and temperature humidity index (THI). Additionally, high daily variation in temperature caused a decrease in the serum albumin levels of the cows. Moreover, the lowest serum calcium, inorganic phosphorus, and magnesium concentrations were observed in November, and were negatively correlated with the 24-hr temperature, WBGT, and THI range of the pen prior to sampling. Multiple regression analysis showed a positive correlation between serum cortisol concentration and 24-hr WBGT range of the pen prior to samplings and packed cell volume. However, serum cortisol and total protein concentrations were negatively correlated. Overall, the findings of the study suggest that large variation in temperature induced stress in the cows, which could be overcome by increased water consumption and improved protein digestion and absorption by the animals, and the addition of minerals, such as calcium to the diet.

An anatomical study of the skull, the dorsal and ventral nasal conchal bullae and paranasal sinuses in normal Noma horses: Computed tomographic anatomical and morphometric findings.

Noma horses have the smallest body size among native Japanese horses and are classified as pony breeds by their size. Additionally, the Japanese horse breeds are classified into a single lineage, which includes Mongolian horses. Great intraspecific differences reportedly exist in the head shapes of domesticated horses, which have been investigated in various horse breeds. The present study aimed to evaluate the size of the nasal conchal bullae, and the paranasal sinuses of Noma horses in relation to the skull dimensions using computed tomography. Reconstructed images of the heads of five adult Noma horses were used. Skull and paranasal sinus parameters were measured and analysed in relation to each other and were compared with the data in the literature on the skulls of various horse breeds. In comparison with pony breed, Shetland ponies and donkeys had a shorter nasal length than cranial length, while Noma horses had a longer nasal length than cranial length, similar to the larger breeds. In the nasal conchal bullae, Shetland ponies showed a negative correlation between the head and bullae size, while Noma horses, similar to larger breeds, had a positive correlation. In conclusion, our findings suggest that Noma horses, despite having a body size that belongs to the pony breed, had a distinguishing ratio of the skull and paranasal sinuses similar to that of the larger breeds. Our results provide information on the physiological morphology of the head and comparative anatomy based on genetic diversity in horses.

Severe thyroid-associated orbitopathy in Hashimoto's thyroiditis. Report of 2 cases.

Thyroid-associated orbitopathy (TAO) is characterized by immune-mediated inflammation of the extraocular muscles surrounding orbital connective tissue and adipose tissue. Severe orbitopathy related to autoimmune thyroid disease often occurs in patients with Grave's disease, but it is rare in patients with Hashimoto's thyroiditis. The pathogenesis of TAO is unclear. Several studies have noted a strong correlation between the levels of antibodies to thyrotropin receptor antibody (TRAb) and TAO in Graves' disease. Mild upper eyelid retraction has been reported to be common in Hashimoto's thyroiditis patients, however severe orbitopathy is rare. We report two cases of severe TAO in patients with Hashimoto's thyroiditis who required systemic glucocorticoid therapy and orbital irradiation to treat the TAO. The activity of the TAO was high in both patients, because their clinical activity scores (CAS) for the orbitopathy were high, and magnetic resonance imaging (MRI) showed enlargement of the extraocular muscles and an increase in T2 signal intensity and prolonged T2 relaxation time which indicate an active stage of inflammation. We tested the presence of TRAb by three different assays and were negative in both patients. Since the eye muscle damage cannot be due to TSH receptor antibodies, other pathogenetic mechanisms may be responsible for the orbitopathy in patients with Hashimoto's thyroiditis.

Rapid Nitriding of Titanium Alloy with Fine Grains at Room Temperature.

Multifunctional surfaces are required to design safe engineering products for human lives. Heating in a nitrogen atmosphere (nitriding) improves the tribological properties but reduces the strength of titanium (Ti) alloys owing to grain coarsening. A rapid nitriding method for Ti alloys forms the nitrided layer on the surface of a Ti alloy by bombarding with commercially pure Ti fine particles with a nitrided phase at room temperature within a short period. Furthermore, fine grains of Ti alloy are formed in the nitrided layer because of the impact of the Ti particles. These results reveal that this room-temperature method resolves the trade-off between the rapid formation of a nitrided layer and the suppression of grain coarsening for Ti alloys.

Treatment of Thoracolumbar Spinal Fracture Accompanied by Diffuse Idiopathic Skeletal Hyperostosis Using Transdiscal Screws for Diffuse Idiopathic Skeletal Hyperostosis: Preliminary Results.

STUDY DESIGN: This retrospective case series enrolled 13 patients who underwent posterior fixation with both transdiscal screws for diffuse idiopathic skeletal hyperostosis (TSDs) and pedicle screws (PSs) to treat spinal injury accompanied by diffuse idiopathic skeletal hyperostosis (DISH). PURPOSE: To describe the usefulness, feasibility, and biomechanics of TSD. OVERVIEW OF LITERATURE: Vertebral bodies accompanied by DISH generally have lower bone mineral density than normal vertebral bodies because of the stress shielding effect. This phenomenon tends to makes screw fixation challenging. To our knowledge, solutions for this issue have not previously been reported. METHODS: Patients were assessed using the data on surgical time, estimated intraoperative blood loss, mean number of stabilized intervertebral segments, number of screws used, perioperative complications, union rate, and the three-level EuroQol five-dimensional questionnaire (EQ5D-3L) score at the final follow-up. The Hounsfield unit (HU) values of the screw trajectory area, and the actual intraoperative screw insertion torque of TSDs and PSs were also analyzed and compared. RESULTS: The surgical time and estimated intraoperative blood loss were 165.9±45.5 minutes and 71.0±53.4 mL, respectively. The mean number of stabilized intervertebral segments was 4.6±1.0. The number of screws used was 4.9±1.3 for TSDs and 3.0±1.4 for PSs. One death occurred after surgery. The union rate and EQ5D-3L scores were 100% and 0.608±0.128, respectively. The HU value and actual intraoperative screw insertion torque of TSDs were significantly better than those of PSs (p<0.001, p=0.033). CONCLUSIONS: We were able to achieve stable surgical outcomes using the combination of TSDs and PSs. The HU value and actual intraoperative screw insertion torque were significantly higher for TSDs than for PSs. Based on these results, when treating thoracolumbar spinal fractures accompanied by DISH in elderly populations, the TSD could be a stronger anchor than the PS.

Forestomach developmental failure in an 11-month-old Japanese Black steer with severely retarded growth and chronic ruminal tympany.

This study reports findings from the pathological examination of the forestomach of an 11-month-old Japanese Black steer with severely retarded growth (41% of expected weight) and chronic ruminal tympany. The ruminal papillae were weakly formed (0.3-0.5 cm long) and unevenly distributed. The cellulae and cristae reticuli were underdeveloped; the cristae were 0.4-0.7 cm in height and milky white. The keratinized layer in the stratified squamous epithelium was thickened. Ruminal pH was 5.25, and ruminal volatile fatty acid concentration was 11.7 mM. The steer's severely retarded growth was considered to be caused by malnutrition due to developmental and functional failure of the forestomach.

Proptosis in dysthyroid ophthalmopathy: a case series of 10,931 Japanese cases.

PURPOSE: This observational case series investigated the occurrence and distribution of proptosis in Japanese patients with dysthyroid ophthalmopathy (DO). The relationship among lid retraction, lid swelling, and enlargement of extraocular muscles was also analyzed. METHODS: From 1993 to 2002, 10 931 patients (2240 men and 8691 women, average age; 39.9 ± 14.0 years) with abnormal thyroid function were examined for proptosis. Proptosis was measured using a Hertel exophthalmometer, and lid swelling and retraction were classified. Orbital magnetic resonance imaging or computed tomography was used to quantify enlargement of the extraocular muscles. RESULTS: Clinically significant proptosis (≥15 mm) was present in 74.2% patients and was classified as mild (15-17 mm, 39.1%), moderate (18-20 mm, 25.9%), or severe (>20 mm, 9.2%). The average exophthalmometer reading was 17.2 ± 3.2 mm, with proptosis less pronounced with age (p < 0.001) and more pronounced in men than women (18.2 ± 3.4 mm vs. 17.0 ± 3.1 mm; p < 0.001). Lid retraction was present in 57.7% of patients, lid swelling in 46.9%, and muscle enlargement in 40.8% of patients. Multiple regression analysis revealed proptosis was strongly correlated with a young age and the male gender, followed by extraocular muscle enlargement and lid retraction and swelling (p < 0.001). CONCLUSIONS: This study assessed the measurable features of proptosis in Japanese patients with DO and contributes to the understanding by correlating symptoms and signs of DO.

[Cytotoxicity of antiglaucoma ophthalmic solutions for human corneal endothelial cells].

PURPOSE: The cytotoxicity of a range of commercial antiglaucoma ophthalmic solutions was assessed in human corneal endothelial cells using in vitro techniques. METHODS: Cell survival was measured using the WST-1 assay for endothelial cells and the MTT assay for epithelial cells. Commercially available timolol, carteolol, latanoplast, unoprostone, levobunolol, bunazosine, betaxolol, nipradiol, dorzolamide, brinzolamide, and pilocarpine were assessed. The survival of cells exposed to test ophthalmic solutions was expressed as a percentage of cell survival in the control solution (distilled water added to media) after 48 hours exposure. RESULTS: Survival was lower in prostagrandines and in medications containing benzalkonium. It increased to more than 85% after dilution of 1000-fold or more dilution. CONCLUSIONS: Antiglaucoma ophthalmic solutions have corneal endothelial toxicity. The toxicity significantly decreases after dilution of 1000-fold or more dilution and toxicity seems to be due mostly to benzalkonium chloride.

[A case of depression whose symptoms cured by setting her psychological base on the transcendent level].

We report the case of a female in her 40s diagnosed with depression. She was raised by an eccentric father, suspected of having pervasive developmental disorder, and a dominant mother. After graduating from high school, she worked as a clerk in a company for twenty years or so; however, a change in her work environment made her fall into a depressive state. Her worsening depression caused her impulsive resignation and disappearance for about four months. She spent the duration of her disappearance traveling the country, with no dissociative episodes. After returning, she received treatment for depression as an inpatient for about four months. During the first month of hospitalization, she mainly complained of a depressive mood and anxiety over the prognosis of her disorder, while she made scarcely any progress in introspection. In the second month, she gradually advanced with introspective work, but, as her introspection progressed, her depressive mood became aggravated. The therapist avoided intervention to modify her cognition, and told her the following: "it is better not to persist in managing your depressive mood itself because curing depression does not mean resolving the superficial depressive mood, but to achieve a condition not directly influenced by mood." Then, at the beginning of the third month, she became aware of "the presence of God" and, at the same time, her depressive mood greatly improved. She extended her sympathy to her mother with her unfortunate life history, and expected her mother to change as she herself had experienced, but, disappointed by her mother, she experienced anxiety attacks and came to realize her own internal rage against significant persons in her life including her mother. After "the Great being" experience, she, who had formerly attended Christian church for a short time, started to read the Bible, but she still hesitated about committing herself to "religious following." One day during the last month of hospitalization, as she prayed to God for healing when she read a part in the Bible about a woman suffering from a hemorrhage for twelve years who touched the hem of Jesus' garment and was healed immediately (Matthew 9:20-22 and Luke 8:43-48), the patient suddenly experienced "the salvation of God" and realized what trust really meant. Through the experience, her clinical problems became totally cured, and the therapy concluded with her discharge from hospital. Several months later, she sent the therapist a letter including the following message: "I am grateful to the Lord for salvation from anxiety and irritation, but to the therapist for helping me realize it." This clinical course can be understood based on the patient's clinical problems (e.g., despair, anxiety, and depression), arising from the breakdown of her efforts to maintain stability by founding her psychological base on her feelings of omnipotence, avoiding facing her internal negative psychological factors (e.g., rage), and these were automatically resolved when her psychological base was switched to the transcendent level through "the Great being" experience and "the salvation of God." Such a sudden, marked improvement resembles what Miller and C'de Baca reported as "quantum change," of which the characteristics are vividness, surprise, benevolence, and permanence. The therapist paid attention to maintain a constant psychological distance from the patient, not persisting in modifying her cognition, with the transcendent level being the basis for the entire therapy. This stance of the therapist itself was considered to prompt her transcendence and bring about her eventual cure. This clinical course seemed to be highly suggestive of a psychotherapeutic mechanism, indicating the close relationship between the transcendent level and basic trust.

Limited directed seed dispersal in the canopy as one of the determinants of the low hemi-epiphytic figs' recruitments in Bornean rainforests.

Ficus species are keystone plants in tropical rainforests, and hemi-epiphytic figs play a notably important role in forest ecosystems. Because hemi-epiphytic figs have strict germination requirements, germination and establishment stages regulate their populations. Despite the ecological importance of hemi-epiphytic figs in the rainforests, seed dispersal systems by fig-eating animals under natural conditions remain unknown because of the difficulty in tracing the destiny of dispersed seeds in the canopy. Therefore, seed dispersal effectiveness (SDE) has never been evaluated for hemi-epiphytic figs. We evaluated the SDE of hemi-epiphytic figs using qualitative and quantitative components by three relatively large-sized (> 3 kg) arboreal and volant animals in Bornean rainforests that largely depend on fig fruits in their diets: binturongs Arctictis binturong, Mueller's gibbons Hylobates muelleri, and helmeted hornbills Rhinoplax vigil. The SDE values of binturongs was by far the highest among the three study animals. Meanwhile, successful seed dispersal of hemi-epiphytic figs by gibbons and helmeted hornbills is aleatory and rare. Given that seed deposition determines the fate of hemi-epiphytic figs, the defecatory habits of binturongs, depositing feces on specific microsites in the canopy, is the most reliable dispersal method, compared to scattering feces from the air or upper canopy. We showed that reliable directed dispersal of hemi-epiphytic figs occurs in high and uneven canopy of Bornean rainforests. This type of dispersal is limited to specific animal species, and therefore it may become one of the main factors regulating low-success hemi-epiphytic fig recruitment in Bornean rainforests.

[Tajimi Study review].

The results of The Tajimi Study (a population-based prevalence survey of glaucoma in Tajimi City performed by the Japan Glaucoma Society) are summarized. The Tajimi Study was carried out from September, 2000 to October, 2001 to investigate the prevalence of glaucoma among residents aged 40 years old or over in Tajimi. Seventy-eight point one % of 3,870 eligible people from 4,000 subjects who had been randomly selected from the 54,165 over 40 years old residents in Tajimi participated in the study. Estimated prevalence of all glaucoma and glaucoma/suspected glaucoma were 5.0 (95% confidence interval [CI], 4.2-5.8)% and 7.5 (95% CI, 6.5-8.4)%. The prevalence of primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG), and secondary glaucoma (SG) were 3.9 (95% CI, 3.2-4.6)%, 0.6 (95% CI, 0.4-0.9)%, and 0.5 (95% CI, 0.2-0.7)%, respectively. Including suspected cases, the prevalence of POAG, PACG, and SG was 6.0 (5.1-6.8)%, 0.8 (0.5-1.2)%, 0.7 (0.4-1.0)%. High intraocular pressure, myopia, and older age were shown to be statistically significant risk factors for POAG. It was suggested that the Frequency Doubling Technology is a good candidate as a screening test for glaucoma. The leading cause of low vision was cataracts. Investigation of refractive status showed that the prevalence of myopia(spherical equivalence [SE] < 0.5 diopters) and high myopia (SE < -5.0 diopters) was 41.8 (40.0-43.6)% and 8.2 (7.2-9.2)%, respectively.