In the present study, we undertook the annual investigation on health conditions of aged bedridden patients at home from 1971 to 1979 in Hiromi Cho, Ehime Prefecture. The incidence rate of bedridden patients in 1971 was 3.7 % in the population of 65 years old and over, and 0.499 % in the population of Hiromi Cho. Paticularly, the latter rate was very higher than that in urban areas. The bedridden patients had been caused by apoplexy, senility, loss of eyesight, fracture and rheumatoid arthritis. 66.7 % of bed rest were caused by apoplexy. The bedridden age was 70.1±7.1 years in men, 71.2±11.6 years in women. The bedridden age in rheumatoid arthritis women was 41.0±1.0 years. The activity of dayly life in the bedridden patients lowered with the period of bed rest, and was dependent on the original diseases of bedridden. Their mortality rate was about 50 % after 2 years and about 90 % after 8 years. Their relatives mainly cared the bedridden patients. The bedridden patients were not cared in full, because 70 % in their sick nurses had their jobs. We think that the best plan to bedridden patients is to prevent the diseases causing prolonged bed rest.
A questionnaire was sent to school health nurses in rural districts of Shimane Prefecture asking them about health conditions and emergency accidents of children, problems of the health care, and safety administration in schools. The health conditions of children in rural districts were almost common with those of children in cities of Japan. It was suggested that the increase of psychosomatic complaints and disorders of children was directly or indirectly affected by the changes of life conditions in households of side-work farmers, the inhumane competition in education and the drastic urbanization of life style. The cooperative approach to comprehensive health care of children by the participants of school health and community health is urgently needed to promote the health level.
Problems in the school health care system of children were studied in rural districts of Shimane Prefecture, Japan. Questionaires which were concerned with the policy and the evaluation of school health care, present situation of health examination in schools, and cooperative activities in the field of school health care between schools and communities were sent to school nurses. Owing to the recent changes of the general life conditions in rural districts, the life style and the health conditions of children in rural districts became somewhat similar to those in cities. Psychological complaints, psychosomatic diseases, school phobia, obesity and adult diseases such as peptic duodenal ulcer became common in many schools in rural districts. An inadequate understanding about school health care in teachers and in families, lack of specialists and school nurses in school health care system, few epidemiological studies on the health conditions of children, and the insufficient cooperative activities among schools, families and communities were revealed as important problems to be solved. The scientific health education in schools, adequate health counselling system and the complete health care should be established on the basis of actual living conditions of children and cooperation between school health care and community health care.
Our survey was conducted at 522 elementary schools and junior high schools in Akita prefecture in July 1981. Thus the survey was intended for 105, 137 elementary school pupils bnd 51, 029 junior high school pupils. Questionnaires were sent to teachers in charge at each school. The return rate of questionnaires wan 98.4 % for elementary school and 100.0 % for junior high school. The rate of bronchial asthma was 1.2 %(boy 1.5 %, girl 0.9 %) in elementary school pupils and 0.6 %(boy 0.8 %, girl 0.5 %) in junior high school pupils. The number of schools where pupils with bronchial asthma were found was 205 elementary schools (56.0 %) and 71 junior high schools (47.0 %). The rate of bronchial asthma in boys was greater than girls, by 1.7 times in case of elementary school and 1.6 times in junior high school. The rate of bronchial asthma in urban children was 1.2 %, while that in rural children was 0.8 %. Out of the children interpreted as bronchial asthma at the time of our survey 82.4 % of the elementary school children and 77.6 % of the junior high school children with bronchial asthma were or had been undergoing apropriate treatment. The rate of children who are absent from school due to asthma more than 10 days a year was 24.4 % in elementary school and 26.7 % in junior high school.
About 7, 000 workers migrated from Kochi Prefecture in 1965. Recently the number of patients with pneumoconiosis and vibration syndrome has increased among these persons who worked on constructing tunnels. To investigate the health status of these workers, we interviewed 73 of these workers with regard to history of migration, work situations, health condition and so on in Niyodo Village in Kochi Prefecture. Thirty workers were examined for pneumoconiosis and vibration syndrome. Geographical distribution of the areas from which these workers had migrated were also analysed by using the statistical data of Kochi Prefecture in 1965. The results were as follows: 1) Numerous migrant workers come from the mountain villages along the Shikoku Mountains. In the middle-northern areas, included Niyodo Village, the number of migrant workers was large. 2) Their working conditions in the tunnel were poor and measures for prevention of pneumoconiosis, such as wearing of a dust respirator and drilling the rock with water, were poorly carried out. Vibrating tools were also used for long periods of time. 3) Of 73 workers, 40 have been given the compensation follwing a diagnosis of pneumoconiosis or vibration syndrome. 4) In 23 examinees, silicosis was detected in the chest X-ray examination. Classifications included 13 of type 1, 7 of type 2, and 3 of type 4. Also examinees had subjective symptoms and/or objective findings of vibration syndrome. Eighty seven percent were classified as Grade III according to the criteria of Andreeva-Galanina. Thus, most of migrant workers involved in tunnel construction work had complications of pneumoconsosis and vibration syndrome.
Thirteen patients with primary hepatocellular carcinoma less than 5 cm in size were seen in our clinic during the past four years. Clinical data of these patients were evaluated to clarify the clinical significance of minute hepatocellular carcinoma. Eleven of these patients were male, and average age was 58 years old. Of these patients, ten (77%) were complicated by liver cirrhosis, and only one revealed positive HBs antigen in serum. The serum alpha-fetoprotein level showed more than 400 ng/ml in five patients (38%). And we thinked that ultrasonographic examinations were most effective to diagnose minute hepatocellular carcinoma in various diagnostic imaging methods. Most of patients exhibited a decreased functional reserve in the liver, but seven patients underwent hepatic resection. After operation, one patient died of acute hepatic insufficiency on the 8th day, and one died of the recurrence of tumor on the llth month. Other five patients have been alive now. It is suggested that the survival time of patients with minute hepatocellular carcinoma is fairly influenced by the condition of accompanied liver cirrhosis