Cases of focal necrotic pancreatitis and gizzard erosion in chickens are reported. Intranuclear inclusion bodies were seen in necrotic pancreatic acinar cells and necrotic epithelial cells of the gizzard, and electron microscopy demonstrated virus particles in affected gizzard epithelium. Adenovirus antigens were detected immunohistochemically in these intranuclear inclusion bodies. These findings suggest that the necrotizing pancreatitis and gizzard erosion were associated with adenovirus infection.

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Patients and healthcare professionals are believed to differ in their perspectives on illness and medical treatment.1) These unique perspectives on the cause, progression, and treatment of diseases are called explanatory models.2) It has been sug- The objective of this study was to grasp patients＇ thoughts and feelings that are directly linked to their medication nonadherence. We provided communication skill training to pharmacists, focusing on observation of patients＇ expressions. The training encourages pharmacists to observe patients while providing explanations and ask openended questions in response to changes in the patient＇s expressions. The participants were 51 pharmacists. Significant improvements were seen after the training in both the recognition rate of changes in patients＇ expressions and the acquisition rate of new data from patients after asking open-ended questions. Open-ended questions accompanied by observation led to a significantly higher acquisition rate of new patient data compared with open-ended questions alone. More detailed data regarding problem-oriented medical record was provided in patients＇ subjective data after the training, and consequently, significantly improved the quality of pharmacists＇ care; for instance, this improvement included encouraging the development of more suitable care plans for patients. In addition, the results of the patient questionnaire showed almost all patients, including those who said that they were not normally able to do so, could ask questions or consult the pharmacist after the training. The most common reason given for this was that "the atmosphere was conducive to asking questions and there were opportunities to do so." These findings suggest that when pharmacists observe changes in patients＇ expressions for the purpose of asking open-ended questions, more attention is given to the patients, thereby promoting a more comfortable atmosphere and creating more opportunities for patients to ask questions.

Aims: To study the relationship between myocardial release of cTnI and myocardial cell death as assessed by the amount of apoptosis and necrosis after cardiac surgery. Methods: Eighteen young pigs were operated on with standardized cardiopulmonary bypass (CPB). Release of cTnI in the cardiac lymph (CL), coronary sinus (CS), and arterial blood (A) was related to postoperative myocardial cell death by both necrosis and apoptosis. Apoptotic cells were detected by a TUNEL detection kit. Necrotic cells were counted by light microscopy. Results: In all animals, cTnI was significantly released and reached peak values observed simultaneously in A (cTnI, 20.1±2.6 ng/ml) (mean ±SEM), CS (19.5±3.2 ng/ml) and CL (5202±2500 ng/ml). Percentage of total myocardial cell death was 3.1±0.5%, including 1.2±0.35% necrosis and 1.9±0.5% apoptosis. cTnI release during and after CPB did not correlate with the degree of myocardial apoptosis or necrosis. Conclusion: Cardiac operations with CPB are related to myocardial cell damage including myocardial cell death due to both necrosis and apoptosis. As the loss of cTnI is not related to the amount of cell death, our results suggest that increased cardiac myocyte membrane permeability more than cell death is responsible for intraoperative and postoperative cTnI release.

Disaster preparedness is one of the national priorities. In Japan, disaster medicine is defined as a part of the national medical plan initiated by Ministry of Health, Welfare and Labor. The Japan Medical Association is the largest professional physicians' group in Japan, and has contributed to all kinds of disaster relief work regionally and nation-wide for years. Based on past successes, the Japan Medical Association proposes a new disaster action plan named Japan Medical Association Team (JMAT). The primary mission of JMAT is to deploy to the disaster scene requested and work for disaster relief. JMAT covers the acute to sub-acute phase of disaster response, and also collaborate with other agencies. In the preparation and mitigation phases, the Japan Medical Association work for establishing mutual disaster aid partnerships, disaster plans, networks with other agencies, team building, disaster medicine training and education, etc. In Japan, the Disaster Medical Assistant Team (DMAT) has been established based on the experience of the 1995 Kobe Earthquake, when lots of preventable trauma deaths occurred because of delayed medical response. The mission of DMAT is to deploy to the scene immediately and triage/transfer the most serious disaster victims outside the scene for advanced medical care. DMAT covers the first 48 hours of disaster response phase, and then JMAT takes charge of the work. JMAT will also respond to chemical, biological, radiological and nuclear disasters, and international humanitarian work. The present issues of establishing JMAT are 1.training and education for Japan Medical Association members, 2.establising cooperation with other agencies, and 3.having presence at the Central Disaster Committee, Cabinet Office, Government of Japan.