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Objective: Esophageal hiatal hernia is not such a rare disease in elderly people because they often have diaphragmatic muscle weakness and lumbar spondylosis. Patients with esophageal hiatal hernia sometimes have symptoms of gastroesophageal reflex disease (GERD), but most patients with esophageal hiatal hernia are asymptomatic. Design: A clinical study. Materials and Methods: We analysed 7 cases of esophageal hiatal hernia. Results: An 87-year old woman was admitted to our hospital because of chest discomfort and breathing difficulty after lunch. Chest X-ray and chest computed tomography (CT) demonstrated an enlarged stomach behind the heart. The respiratory symptoms were diagnosed as a secondary esophageal hiatal hernia. She was discharged from our hospital. She was well and in good condition after then. Conclusion: Remission of the respiratory symptoms caused by the hiatal hernia was achieved by conservative treatment. We should consider sliding hernia when we treat aged patients with these respiratory symptoms. [ABSTRACT FROM AUTHOR]

Identifying the cognitive capacities associated with the development of school readiness is indispensable to support children's successful school transition. It has been shown that executive function (EF) in preschoolers is associated with both concurrent preacademic and subsequent academic skills. However, most research has controlled for the effect of general cognitive ability (GCA), and little research has examined non-English speaking children, which hinders the understanding of the development of school readiness in culturally diverse contexts. In addition, behavioral genetic research on the genetic and environmental influences on this association has been conducted with school-age children. Thus, the genetic and environmental influences on associations between GCA, EF, and preacademic skills during preschool age are unknown. We conducted multivariate behavioral genetic analyses on two waves of longitudinal data at 42 and 60 months of age from 171 and 135 pairs of monozygotic and dizygotic Japanese twins. The findings suggested that a genetic factor influenced GCA at 42 months and mediated preacademic ability at 60 months. In addition, another genetic factor emerged by 60 months that genetically mediated EF and math ability, independent of GCA. Preacademic ability at 60 months was affected by shared environments that influenced EF, rather than GCA. at 42 months. Moreover, shared environments that influenced preacademic ability at 42 months affected later GCA at 60 months. Finally, nonshared environments that had emerged by 60 months mediated these relationships, though the magnitude of this effect was modest. [ABSTRACT FROM AUTHOR]