In the present study, screening results at 1 month of age resembled the final diagnosis obtained at 6 months of age; out of 31 REFER cases, 26 cases were diagnosed with hearing loss. In contrast, in the multiple institutional study, both unilateral and bilateral REFER rates were much higher than the rates of final hearing loss. Concerning the final diagnoses of bilateral hearing loss, the authors' results (0.10%) and the multiple institutional studies' results (0.05% in low-risk and 2.19% in high-risk neonates) were comparable to the results reported in the USA. To expand the newborn hearing screening program, it is crucial that authority and institutions concerned promote the development of a national or prefecture-based early hearing loss identification and intervention network.

The DTC system used in the present study seemed technically satisfactory and useful in improving medical care in remote sites of Japan.

) were compared with those before inclusion of laboratory data (October 1 -December 31, 2010). The rate of prescription questions was significantly higher after compared with before the inclusion of laboratory data (2.30％ vs 2.04％, respectively; P = 0.020). In particular, the number of prescription questions referring to laboratory data showed a 3.5-fold greater increase after the inclusion of laboratory data on inhospital prescriptions (P < 0.001). Prescription questions referring to laboratory data included on prescriptions were associated with a prescription revision rate of 65.6％. Prescription questions referring to laboratory data involved clarification of the doses of medications, such as levofloxacin and famotidine, in patients with impaired renal function. These results indicate that the inclusion of laboratory data on in-hospital prescriptions is useful for efficiently extracting those requiring clarification.

A 15-month-old girl with Langerhans cell histiocytosis (LCH), Letterer-Siwe disease, was referred to our hospital in 1984. Whilst on treatment with cytotoxic drugs, a perirenal mass was detected and hydronephrosis became evident when she was 29 months old. Percutaneous nephrostomy tubes were placed in the pelvis, bilaterally and replaced every 6 months. The mass was not completely controlled and chronic pyelonephritis continued. Biopsy of the mass convoluted kidney hilus revealed histiocytic invasion. Although multiple organ systems are involved in LCH and abdominal malignant tumours may be accompanied by hydronephrosis, to our knowledge, this is the first case report of abdominal LCH and the ensuing hydronephrosis. Percutaneous nephrostomy tubes proved useful, but more convenient, less painful and infection-limited approaches need to be designed.

No abstract