Today's one of the most important problems both in the industrial hygiene and the community health care is the health protection of farmers who are working in factories. There are many such farmers in the San'in rural districts. We surveyed the working conditions of 370 factories in Shimane Prefecture and found that they had many problems to be solved. The problems in the factories, mostly small-scale factories, are summarized as aging of workers, long working hours, insufficient rest, harmful work and night work.
Even in Sada-cho, where the local government is promoting the comprehensive community health care and encouraging the health care activity of inhabitants, the health care for factory workers is performed insufficiently. Some factories do not carry out even a periodical health examination of the workers.
We established the Sada-cho Occupational Health Association in cooperation with the local government, Izumo Health Center, Shimane Labor Standard Inspection Office and the factories in Sada-cho for the purpose of promoting the unified activity of the industrial hygiene and the community health care.

View full abstract

Patients with chronic liver diseases who were hospitalized into our clinic were studied. Chronic liver diseases consisted of three groups, namely chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Patients with peptic ulcer were studied as a control group. The mean age was the difference of 8.4 years between a group of chronic hepatitis and that of liver cirrhosis, but only 3.0 years between a group of liver cirrhosis and that of hepatocellular carcinoma. HBs antigen positive ratio was almostly same between a group of chronic hepatitis and that of liver cirrhosis, but about twice in a group of hepatocellular carcinoma. Ratio of hard drinker was lowest in a group of hepatocellular carcinoma, and therefore we considered that the effects of alcohol upon carcinogenesis were little. HBs antibody positive ratio was no difference among groups of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma.

View full abstract

Takasu-machi is a small rural community (population: about 7, 500) adjacent to Asahikawa, one of the largest cities in Hokkaido, Japan's nothernmost major island. Its economy is largely based on agriculture dominated by paddy rice growing. The only medical institution available here is a bedless clinic. To meet total health needs of the inhabitants, we have implemented a total health control program since 1975, with multiphasic screening as its main component. The objectives of of the program are prevention of disease by means of education, early detection and early treatment of disease, and establishment of a primary health care system.
Recently we have conducted a survey of the outcome of the program. The survey found that significant results have been obtained during the past decade.
(1) The number of untreated cases has fallen.
(2) The costs of medical care have been beld down.
(3) The relations between the hospital and practicing physicians have become closer.
(4) People have become health-conscious and aware of the significance of symptoms.
These findings suggest that the establishment of a primary health care system emphasising health screening will be conductive to the health of the medically underserved rural populace.

View full abstract

Investigation was made into the health care conditions in a rural district in Akita Prefecture. Topographically, the district is divided into two parts-one characterized by mountain and the other by flat terrain.
1. In remote, depopulated villages, per capita cost of public health is on the increase.
2. The number of health personell, particularly public health nurses, is not enough to carry on various health programs.
3. With the prospect of greater numbers of the aged in society, there is an urgent need for increased medical services along with the consolidation of primary health care. In order to meet the need, it is necessary to establish a regional community health system comprised of a hospital as a nucleus and neighborhood medical instituions such as clinics and health centers.

View full abstract

A survey concerning primary health care was taken in two mountainous villages (populations: 8, 600 and 5, 400) in Shizuoka Prefecture and two farming and fishing villages (12, 000 and 7, 100) in Chiba Prefecture. In these four communities, the aged account for more than 17% of the population. The crude death rate is high. The rate of population growth is below zero. The infant mortality rate and the stillbirth rate are low.
The major causes of death are malignant neoplasms, cerebrovascular diseases, and heart diseases. Pneumonia, accidents and suicide are above the national average. The annual revenue and expenditure of the national health insurance system are below the national average. Among the impatients, the rates of those suffering from mental disorder and circulatory diseases are high, while many cases of the outpatients are circulatory diseases.
Medical institutions have difficulty in meeting with the demand of inhabitants. Some town cannot bear the burden of medical expenditures and gets into financial trouble. Health and Welfare services are inadequate due to the shortage of personnel. Health activities among inhabitants are in the doldrums. Clinics do not function as a provider of family medicine.
These are the major findings of the survey. The establishment of primary health care is badly needed.

View full abstract

A survey was conducted on 117 agricultural cooperatives and 121 city, town and village offices in Nagano Prefecture to find out how they provide health care to the population. The following is a summary of the findigs of the questionnaire survey based on interviews.
1. Collaboration between agricultural co-ops and local public offices in health control activities has become closer. Nearly half of the agricultural co-ops plan and implement health screening programs jointly with city, town and village authorities. One of the favorable effects of the joint undertaking manifests itself in the form of improvement in the ratio of participants to the total populace. The average percentage of participation in the joint programs comes at 48.8% as against the prefectural average of some 22%. Moreover, the joint efforts bring about the desired effect on the implementation of after-screening guidance and other health promotion programs.
2. Of local health leaders, 87.2% said that they keep in contact with each other. Those who meet once in every one to three months account for 24.8% of the total. In the areas where health leaders have liaison meetings regularly, it is noted that there is close cooperation between medical insitutions and various health-related organizations, resulting in a marked improvement in the percentage of participation in health screenings. It is also noted that there is overall improvement in the attitude toward health control.
3. As regards the participation of inhabitants in health control activities, the women's, the young men's and the producers' associations have representatives to the health control promotion council of the agricultural cooperative in each region. Of the three associations, the women's association is the most enthusiastic with the participation ratio of 55.4%. Meanwhile, 67.8% of the agricultural co-ops send their representatives to the health promotion council of each municipal body. More representatives of agricultural co-ops and inhabitants should take part in the council in the interest of people's well-being.

View full abstract

In a farm village of Shimane Prefecture we conducted an investigation on the difference of nutrition between young, middle-aged and old generations. The result showed that nutrition was below the necessary level in the old generation, with many foods being scantily taken. Irrespective of generation the diet was of Japanese style. It will be necessary to guide people to the improvement of dietary life according to generations.
The dietary life of bedridden people and of those who attend to them was the worst of all. Some social measures to improve the situation, as well as the repletion of primary health care for old people are urgently required.
Women in rural communities generally have concrete demands for improvement of the dietary life. It is important to carry out the improvement in harmony with the actual condition of life in the community and the demand of inhabitants.

View full abstract

We have been delivering health care to the residents and investigating about their health administration in Yasu-machi of Fukuoka prefecture, since 1982. This study has suggested that the results of three examinations are useful to establish in primary health care of the rural area.
First, examination was carried out to evaluate their health consciousness and their attitude about treatment in 1982. Then we conducted their health needs from the data, which were gathered from questionaires of 1259 adults who were between 20 and 74 years of age.
Second, health statuses of 498 adults in objective group were certificated by medical examination including the data used for electrocardiograph and ophthalmofundoscope.
Third, we investigated both the case history and the medical cost utilizing the details of the medical expenses of national health insurance in the all area (26, 103 cases in 1982 and 27, 437 cases in 1983). For these data, we examined the difference in medical costs before the Health Service Law for the Aged was enforced and the medical costs after that. Further correlations between medical expenses and social factors such as family pattern and spouse presence were devised.
We conclude that the results of these three examinations provide basal materials which are useful to proceed further with the policy of primary health care in this area.

View full abstract

In this paper, we reported a case of congenital aplasia of dorsal pancreas. This case in 35th case in Japan. The case is 72-year-old male. He feels general fatigability as chief complaint and was taken Diabetes Mellitus. In ERP examination, it was found a short main pancreatic duct of about 4.5 cm length and defect of pancreatic body and tail in Ultrasonogram and Computed Tomogram. In arteriography, it was not found feeding artery to pancreatic body and tail. Accordingly, we diagnosed this case as congenital defect of pancreatic body and tail. This one was normal range for P. F. D. andnormal exocrine pancreatic function. But, this one was operated because of taking cholecystolithiasis. On Retroperitoneal space that shoud be originally pancreatic body and tail, we confirmed only fat tissue without inflammation, fibrosis and carcinomatous tissue. We could not be confirmed Langerhans islet and pancreatic tissue in the biopsy sections of fat tissue.

View full abstract