Education for Disaster Prevention in England : Analysis of Secondary Geography Textbooks

The purpose of this study is to clarify the aims, contents and activities of education for disaster prevention on geographical education in England, by analysis of secondary textbooks. Thereby, we want to contribute the improvement of Japanese geographical education. As a result, we clarified the following: 1) when students study a natural disaster in UK, they learn a plurality of cases including domestic and foreign regions, 2) all textbooks contain activities that students can form attitudes and decide what to do for disaster prevention. On the basis of these results, we suggest improvements of education for disaster prevention. The first is to develop a clear understanding of a natural disaster with multi-area including Japan. The second is to place contents and activities for forming a value relevant to awareness of disaster prevention into Japanese geography textbook. The third is to set an activity to learn practical strategies for disaster prevention in the real world

Aplastic or Twig-Like Middle Cerebral Artery Presenting with Intracerebral Hemorrhage During Pregnancy: Report of Two Cases

Background: An aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare congenital anomaly that can present with both ischemic and hemorrhagic stroke. The etiology of this pathology has remained unclear. Here, we report 2 cases of intracerebral hemorrhage (ICH) owing to an Ap/T-MCA in pregnant patients. Case Description: In both patients, cerebral angiography revealed a steno-occlusive lesion and an abnormal arterial network on the unilateral middle cerebral artery. One patient was treated conservatively for a putaminal hemorrhage, and a cesarean section was performed uneventfully 6 months after onset of the ICH. The other patient underwent a craniotomy for evacuation of the lobar hemorrhage. Subsequently, a cesarean section was performed uneventfully. Both patients gradually recovered without significant disabilities. Conclusions: An Ap/T-MCA is a rare congenital anomaly and is a potential cause of ICH for pregnant patients. A cesarean section is a useful option for pregnant patients with this condition. Key words: Cesarean section, Intracerebral hemorrhage, Middle cerebral artery, Moyamoya disease, Pregnancy, Twig-like MC

A Case of Perianal Mucinous Adenocarcinoma Arising from an Anorectal Fistula Successfully Resected after Preoperative Radiotherapy

A case of mucinous adenocarcinoma arising on a long-standing anorectal fistula is described. A 60-year-old man with a long history of mucinous discharge, pain and perianal induration underwent a biopsy of the external opening of the fistula that showed a mucinous infiltrating adenocarcinoma. Due to the large size of the tumor and the fact that it had extended into the surrounding tissue, preoperative radiotherapy was performed. Radiotherapy was given with 40 Gy in 25 fractions for 5 weeks through posterior and bilateral portals. After radiotherapy the tumor was markedly shrunk and the serum level of carcinoembryonic antigen was also improved. Abdominoperineal resection was performed 8 weeks after the termination of radiotherapy. Histological examination of the resected specimen revealed that the invasion of the tumor remained within the sphincter muscle and that no cancer cells were present on the surgical margin. The histological effect of radiotherapy was judged as grade 1b. This treatment can result in downstaging and R0 resection, which also has a possibility to prevent local recurrence. This case suggests that preoperative radiotherapy may play an important role in the definitive treatment of locally advanced perianal mucinous adenocarcinoma