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This paper introduces the issues emerging in the context of recovery after the 2011 Great East Japan Earthquake. It considers the historical development of recovery planning in Japan and its influence on the present recovery strategies. The authors have tried to point out the insufficiencies of existing policies to deal with the unexpected magnitude of this disaster and identify a set of six principles for recovery which would enable a better equipped society both in terms of pre-disaster preparedness and post-disaster recovery.

A 48-year-old man visited another hospital because of a left knes joint pain, and was found to have a destructive osseous tumor in the left femur by plain X-ray, CT and MRI findings. Bone scintigraphy showed multiple scattered increased uptake areas. He was referred to the hospital. The femoral tumor was removed with a suspicion of some metastatic bone disease. But histopathologically, a brown tumor complicated with primary hyperparathyroidism was most probable. Blood chemical examination showed elevated levels of serum calcium, ALP and PTH-intact, and normal level of PTH-rH. The location of parathyroid tumor could be comfirmed by imagings such as ultrasonography, CT and subtraction scintigraphy of the neck. The parathyroid tumor was resected en bloc. Microscopically, the resected parathyroid tumor was benign adenoma. Measurements of PTH-intact and PTH-rH are valuable when diagnostic imagings are imposible to differentiate between metastatic bone disease with hypercalcemia and brown tumor complicated with primary hyperparathyroidism.

患者は15歳の男性. 家族歴に十二指腸潰瘍あり. 2年前より多発性胃十二指腸潰瘍および幽門部狭窄の治療中であったが, 嘔吐, 右側腹部痛のため当科初診. 急性虫垂炎と診断し, 虫垂切除術施行. 術後, 発熱, 幽門部閉塞のため再開腹し, 十二指腸後壁潰瘍穿孔による後腹膜膿瘍 (以下, 本症と略記) を認めた. 幽門側胃切除術とBillroth II法による再建術, およびドレナージを施行したが, 十二指腸球部は瘢痕化が著明で, 潰瘍穿孔部を切除しえなかった. 術後, 潰瘍穿孔部閉鎖を期待し血液凝固第XIII因子製剤を使用した. 本症の報告は少なく, 過去30年間に自験例を含め17例 (本邦2例, 欧米15例) であった. それらのうち術前に潰瘍の既往を認めたものは7例 (41.2%) に過ぎず, 術前診断がなされたのは3例 (17, 6%) のみであり, 約半数が死亡していた. 他の原因による後腹膜膿瘍と異なり, 本症は消化液が後腹膜腔に流入するため, 本症の見落としおよび治療の遅れは致命的となる.

A thin speaker having a magnetic circuit (2) disposed at the front of a cone-like diaphragm, wherein an internal magnetic type magnetic circuit (2) and a vibration system are supported by a sufficiently strong frame formed of two pieces having an outline of generally disk-shape and partly overlapped concentrically with each other, the acoustic characteristics are prevented from being deteriorated by preventing support bodies (7, 7A) for the magnetic circuit (2) from covering the forward of the sound emitting face of the cone-like diaphragm (3), and speaker component parts are formed so as to be assembled by stacking on one jig (1) from one direction with a specified procedure, whereby an assemblability can be improved.

The function of the external laryngeal muscles in laryngeal adjustment was experimentally investigated in the mongrel dog.Electrical stimulation was given to the nerve trunk innervating the pertinent muscle.oz muscle group.In someselected cases, sets of different muscle or muscle groups were simul-taneously stimulated.Positional changes in the laryngeal structures, especially of the laryngeal cartilages before and after stimulation were measured by means of double contrast roentgeno-graphy.Changes in the position and configuration of the vocal cord were observed by, simpl-taneous intralaryngeal photography.On the basis of the experimental data, biomechanical effects of the external laryngeal muscles on laryngeal adjustment were discussed.Through the present study, it was confirmed that the external laryngeal muscles imparted mechanical effects on the larynx basically in the following manner;1)the change in reciprocal positioning of the thyroid and cricoid cartilages, 2)the change in vertical position of the entire larynx, and 3)structural warp of the laryngeal frame-work.It was concluded that the change in the position and configuration of the vocal cord was induced by synergestic or antagonistic function of each external laryngeal muscle or muscle group, through the three basic pattern of the mechanisms mentioned above.