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Purpose: The purpose of this study was to compare the morphology of the central and peripheral choroid of eyes with central serous chorioretinopathy (CSC) to that of normal eyes using ultra-widefield optical coherence tomography (UWF-OCT)., Methods: We reviewed the medical records of 29 eyes of 25 patients (23 men, 2 women; average age 44.4 years) with CSC and 34 eyes of 22 healthy subjects (19 men, 3 women; average age, 49.5 years) with normal eyes. The images obtained by a prototype swept source UWF-OCT (Topcon, Tokyo, Japan) of about 31.5-mm wide and a depth of 10.9 mm were analyzed. The choroidal thickness was measured for each sector of the eye using the conventional automated layer analysis method. The local morphological differences were quantified by the maximum steepness (µm/deg) which was obtained by differentiating the changes in the choroidal thickness from the periphery to the fovea. Only the vertical scans were evaluated to avoid the influence of the optic disc., Results: The choroid was thicker in the macular area than the peripheral area in both normal and CSC eyes. The choroid at the subfovea was significantly thicker in the CSC eyes than that of the normal eyes (P < 0.0001); however, the difference at the periphery was not significant. The mean of the maximum steepness of the choroidal thickness was 20.8 ± 3.8 µm/deg in the CSC eyes which was significantly steeper than the 16.0 ± 4.6 µm/deg in healthy eyes (P < 0.0001)., Conclusion: The choroid in CSC eyes has a steeper slope around the posterior pole. UWF-OCT can be used to evaluate the abnormalities of the choroidal structures from the posterior pole to the periphery in eyes with CSC., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We encountered a fetal pig with eventration of the diaphragm and pulmonary hypoplasia accompanied by phrenic nerve agenesis. The fetal pig was female measuring 34 cm in crown-rump length and about 1500 g in body weight. The diaphragm was a complete continuous sheet, but comprised a translucent membrane with residual muscular tissue only at the dorsolateral area of the right leaf of the diaphragm. The left leaf protruded extraordinarily toward the thoracic cavity. The left phrenic nerve was completely absent, while there was a slight remnant of the right phrenic nerve that supplied the dorsolateral muscular area of the right leaf. Both lungs were small, and the number of smaller bronchioles arising from the bronchioles was decreased to about half of that of the normal lung. Additionally, the right and left subclavius muscles and nerves could not be identified. These findings imply that the diaphragm, the subclavius muscle and nerves innervating them comprise a developmental module, which would secondarily affect lung development. It is considered that the present case is analogous to the animal model of congenital eventration of the diaphragm in humans.

In Japan, under Article 721 of the Civil Law 1896, a child who is born disabled is able to file a claim against the person who injured him or her in the mother's womb. On the other hand, there are no legal rights for a stillborn child who died in the mother's womb as it is traditionally considered that a foetus is not a person. Consequently, the parents of a stillborn child are not able to recover damages as administrators for the wrongful death of their child. They are only able to recover damages for pain and suffering related to the stillbirth of their child. This study compares the legal status of a disabled live-birth child and a stillborn child in Japan with those in a similar situation in the U.K. and U.S.A.

Blood samples need to be stored for forensic examination using CO-oximeter in case immediate analysis is not possible at autopsy, or re-examinations are expected. In this study, we examined the condition for storage (temperature and air contact) to keep the initial values of hemoglobin derivatives unchanged for a long period. Fresh venous blood samples were divided into two groups; one group was stored without air and the other group with air headspace above the sample. The samples of each group were stored at 37 degrees C, room temperature (ca. 20-25 degrees C), ca. 4 degrees C and ca. -20 degrees C, respectively. They were analyzed with the use of CO-oximeter (CIBA-CORNING 270) a number of times during 6 weeks. And changes in the values of oxyhemoglobin (O2Hb), methemoglobin (MetHb), carboxyhemoglobin (COHb), deoxyhemoglobin (HHb) and total hemoglobin (THb) were examined. Also, another group of blood samples which were made high in COHb experimentally were stored without air at room temperature, ca. 4 degrees C and ca. -20 degrees C, and changes in the percentages of COHb of these samples were examined during 6 months. Our results indicated the following: When the purpose of storage is preservation of O2Hb, MetHb, COHb or HHb, storage at ca. 4 degrees C is considered appropriate, which can keep initial values for up to 2 weeks. As far as COHb is concerned, longer (at least 6 months) storage is possible at ca. 4 degrees C. And no contact with air is desirable in these storages. For THb, frozen storage may be best, which keeps the initial values for up to at least 4 to 6 weeks. In conclusion, when blood samples are stored for CO-oximeter analysis, the temperature and the period of storage should be decided according to the durability of each objective hemoglobin derivative.

Wrongful birth claim is generally defined as a claim by the parents of a child born alive but with a disability that a doctor was negligent in permitting the pregnancy to continue to birth. There have been four cases relating to congenital rubella syndrome and one case relating to Down's syndrome held in Japan. The claims brought by the mothers were that, but for the negligence of the doctor in managing the pregnancy, the mother would have had a lawful abortion and the child would not have been born to suffer a disability. As we do not have the provision of foetal indication for abortion in Japan, wrongful birth claim by parents is founded upon a breach of doctors' duty in advising of the probability of a disabled child. We compare the lawful nature of wrongful birth claims in Japan with those in the United States and the United Kingdom.

We reported an autopsy case in which premortem and postmortem radiographs of the spine were available for comparison and provided a basis for making an identification. As the elderly often lives alone and has no relatives, one of our tasks is sometimes ascertaining the personal identity of him or her. Osteophytes of the vertebra are valid for establishing a positive personal identification in human remains.

We reported an autopsy case of a child born with a caul. The infant was a female and seemed to be full-term. No remarkable pathological findings for disease or anomalies were observed. The floating test of lungs was partially positive. And on the gastro-intestinal floating test, only stomach floated. In histological examination, the alveoli in the lungs were partially slightly open. We thought that those were due to the cardio-pulmonary resuscitation. Pulmonary surfactant was positive immunohistochemically. And the stable microbubble test on the liquid in her stomach was very strong. Even if a child is born alive, he or she will soon die due to asphyxia but for the production of surfactant in the lungs. We can evaluate more precisely the potential respiratory ability of a neonate died due to asphyxia by means of stable microbubble test on newborn gastric contents and immunohistochemical staining of surfactant in lungs.

Objective: The aim of this study was to establish the risk of postpartum thyroid dysfunction (PPTD) in women who had normal thyroid function during pregnancy and no history of thyroid disease., Design: Four thousand and twenty-two consecutive pregnant women were screened for thyroid function and antithyroid antibody. Among women with normal thyroid function during pregnancy and no history of thyroid disease, thyroid function were assessed in 131 of 388 antithyroid antibody positive (Group I) and 1030 of 3503 antibody negative (Group II) women at 1 and 3 months postpartum. In Group I women who experienced PPTD, the frequency of later manifestation of Hashimoto's disease was compared according to titres of antithyroid antibodies., Measurements: Blood samples in early pregnancy, and at 1 month and 3 months postpartum were obtained using the dried blood spot method. Levels of fT4 were measured by RIA, TSH by fluoroimmunoassay or ELISA, antimicrosome antibody (AMC) and antithyroglobulin antibody (ATG) by indirect agglutination reactions., Results: The prevalence of PPTD at 1 month and 3 months postpartum were found to be 6.9% and 21.3% in Group I, and 5.3% and 4.7% in Group II, respectively. The prevalence of PPTD was significantly higher at 3 months postpartum in Group I (P<0.05). 27.3% of women with PPTD in Group I were later found to have Hashimoto's disease and 9.1% manifested hypothyroidism without goitre. A high AMC titre (> or = 25600) at 3 months postpartum in women with PPTD was related to the manifestation of Hashimoto's disease. AMC titres of PPTD women and women who developed Hashimoto's disease were significantly higher than those of control women who did not experience PPTD., Conclusion: A high prevalence of PPTD was found in women with antithyroid antibodies who were euthyroid during pregnancy. Prolonged follow-up of the subsequent thyroid function may be needed in women who experience PPTD and/or show a high titre of antithyroid antibody.

Resistance to conventional chemotherapy including CDDP is the most important therapeutic problem in ovarian cancer. The combination chemotherapy of 5-FU (civ) and low-dose CDDP (i.v.) was applied to a patient with recurrent ovarian clear cell adenocarcinoma (stage IIa), which is often more resistant to systemic chemotherapy than other ovarian adenocarcinomas and is a poor prognostic factor. The patient underwent cytoreductive surgery. Then, 5-FU 375 mg/m2/day civ (days 1-5, 8-12, 15-19, 22-26) and CDDP 3.75 mg/m2/day i.v. (days 1-5, 8-12, 15-19, 22-26) were administered. After four courses of this treatment, there is no sign of recurrence. This result indicates that the combination of 5-FU and CDDP is useful in the treatment of recurrent ovarian cancers.