The severity of carotid arteriosclerosis was evaluated by two-dimensional carotid echography, and the relationship with coronary artery disease and asymptomatic cerebral infarction was studied.
Carotid arteriosclerosis was classified into four types (Category I to IV) by the method of J. T. Salonen et al. The thickness of the carotid intima and media tended to increase with age in healthy individuals, but it almost never exceeded 1 mm even in the elderly.
When the incidende of carotid artery lesions and asymptomatic cerebrel infarction were investigated in 156 subjects, they were present in one out of four Category I subjects, six out of 37 Category II subjects, 49 out of 81 Category III subjects, and 19 out of 27 Category IV. A high incidence of asymptomatic cerebrel infarction was seen in subjects who were Category III or higher.
Coronary artery disease was compared with carotid artery lesions in 118 subjects undergoing coronary angiography. An increase in the severity of carotid arteriosclerosis was associated with an increase in the presence of significant coronary artery stenosis and also with an increase in multivessel coronary disease. There was no difference in the prevalence of carotid arteriosclerosis between subjects with effort angina or myocardial infarction who had only singlevessel disease, but among subjects with multivessel disease those who had effort angina showed more advanced carotid lesions than those with myocardial infarction.
These results indicated a relationship between the severity of carotid arteriosclerosis determined using twodimensional echography and the presence of cerebral infarction and coronary artery disease, suggesting that it is possible to predict the existence of these disease to some extent.

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I'd like to speak from the standpoint of view in both recently applicable diagnosis of coagulofibrinosis, hepatic fibrosis and hepatitis-related virus markers and the therapy of abnormal coagulofibrinolysis, plasma aminoacids, also as of Interferon.
The coagulofibrinolysis-related tests ought to be more highly appreciated from the pathophysiological standpoint of diagnosis, prediction of severity and prognosis of liver diseases (eg. DIC). Such as thrombomodulin, thrombin-antithrombin complex (TAT), tissue-plasminogen activator (t-PA), plasmin-plasmin inhivitor (PIP) are included.
As to the therapy, methyl gabexate (FOY^®) which has both pharmatheutical effects of antithrombin and anti-plasmin is better to be used to prevent the development to severe liver damage from the earlier stage.
Prolyl hydroxylase, procollagen typeIII peptide (PIIIP), typeIV collagen are excellent parametersto reflect directly the hepatic fibrogenesis and fibrosis, instead of ZTT, γ-globulin
In cases of severe liver diseases, aromatic aminoacid (AAA) is decresed, on the other hand branched amino acid (BCAA) is increased, resulting to decrease in BCAA/AAA ratio. BCAA is synthesized to glutamine in the muscle and metabolized to alanine and ammonia. BCAA administration improves the plasma aminoacid unbalance, albumin, Ch-E, total cholesterol and levels conciousness disturbance in chronic severe liver diseases.
The effects of Interferon on chronic B, C-hepatitis are influenced with the factors of virus copies, genotype, variation (hypervariable region) from virus side, and from host side, hepatic tissue stage, age, immunological responce.
On the administration, above mentioned factors shoud be taken into a consideration comprehensively.

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With aging in progress, the increase of the elderly with disorders and their care has become a serious regional problem. To step up regional care in an efficient manner, there is the need for well-organized activities with the involvement of all sorts of local people, such as medical workers (physicians, nurses, etc.), health workers (public health nurses, home helpers, medical social workers (MSW), etc.), volunteers and other people in the neighborhood in a system of coordination with various local institutions (hospitals, general practitioners' clinics, municipalities, welfare offices, social security councils, etc.) and facilities (homes for the elderly and health service facilities for the aged). Given this necessity, I have studied the efficient way in which a regional care system ought to be and the way we should wrestle with this issue in order to upgrade the delivery of regional careto old people with disorders.
In a system for the delivery of regional care, the first necessary step is to prepare a place for information and liaison among various regional institutions. In this study, it has become evident that local liaison meetings, round-table discussions and research meetings are enthusiastically held to produce significant effects. For studies on actual cases of regional care, welfare service teams for the elderly are organized, but it is necessary for them to involve field personnel, such as municipal officials, medical institution officials, murses on call, home helpers, volunteers, social security council officials, agricultural cooperative officials and workers at health service facilities fore the aged.
In the process of helping at-home care, the coordination of local medical institution workers, public health nurses and officials of welfare offices is particularly required. More than anything else, it is necessary for medical institutions to have an in-house division in charge of at-home care for the offer of over-the-counter services. Presumably, there are a wide variety of forms and methods for the creation of a local network. As each district has its own conditions and circumstances, the most efficient method should be worked out for each district.
With the aging of subject patients, there are sure signs of an increase in the delivery of care by nurses on call, and the responses have become all the more compolicated. The necessity of care by hospital nurses on call is greater than ever. On the other hand, there are many calls for a doctor's visit. Particularly in rural communities where enough physicians are not available, it is an urgent task to establish a system of home calls while coordinating with local general practitioners and sharing roles with them.
Health service facilities for the aged play a role in supplementing care at home, but those facilities which are not established side by side with hospitals have to render on-call services, whereas when it comes to hospitals without health service facilities for the aged, it is desirable for them to establish day care facilities. Attempts are already under way at various places to integrate health, medical and welfare facilities in one area so that high hopes may be pinned on significant effects both in terms of hardware and software. In this situation, it is necessary for medical institutions to play a significant role. It is necessary to step up support to the reversion to society of people given care at home and the training of volunteers as one of those medical institutions' principal roles.

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Age-corrected mortality due to ischemic heart diseases was low in mountainous rural areas but high in rural areas near large cities in Japan. Total cholesterol levels, a risk factor of ischemic heart diseases, were high in rural areas near large cities but no clearly significant increases were seen in mountainous rural areas. HDL cholesterol levels showed negative correlation with prevalence of ischemic heart diseases and positive correlation with the atherogenic index in typical mountainous rural areas in Akita, Nagano and Shimane Prefectures. Nationwide data on the degree of lesions, determined by coronary angiography, when compared with that on serum lipid levels, showed positive correlation with total cholesterol, LDL-cholesterol, atherogenic index, Apo-A₁, Apo-B, Apo-B/Apo-A₁ and negative correlation with HDL-cholesterol. TG showed positive correlation only in females. The lack of significant differences in TG in males is thought to be partly due to large variability in males due to their life-style, e. g. eating habits and alcohol consumption patterns. Eating habits change not only with time and geography but with age as well, and people show a tendency to like fish and shellfish as they get older, making it difficult to determine fatty acid-related risk factors of arteriosclerosis. In addition, fatty acid levels are likely to be affected by meals taken on the previous day. It will therefore be necessary to compare the date on fatty acid obtained with that on fatty acid composition in phospolipid fractions, which is less influenced by meals.
The findings obtained in the present study suggest that low calorie and low serum albumin levels contribute to the progression of coronary arterial lesions.

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