This paper reports the results of our factfinding survey of annual epidemics of respiratory syncytial virus infection, an important cause of inflammation of the lower respiratory tract in infants and young children, in Honjo City and the neighboring district of Yuri. Diagnosis of RS virus infection was performed with the RSV test pack.
Over the period of three years from January 1993 to December 1995, the number of patients with RS virus infection totaled 127 of whom 107 were hospitalized and 20 were treated as outpatients. The male-female ratio was 69: 58, 60: 47 and 9: 11, respectively. The total number of patients included 9 neonates, 15 one-month-old infants and 17 young children of one year or above.
The infectious disease rages from December through January every year. Of the total 127 people, 64 were infected with RS virus during the winter months.
The pediatric department of our hospital is visited by nearly 20, 000 outpatients annually each from Honjo City and the Yuri district. A check of the number of the outpatients diagnosed with RS virus infection showed that 70 people are from Honjo and 57 from Yuri. During the survey period, 4 boys and 2 girls required endotracheal intubation because of respiratory dysfunction. They consisted of 3 newborn infants and 3 1-month-olds. The occurrence of this infectious disease in the very early period of infancy and signs of pneumonia are considered to be risk factors for respiratory failure.

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We treated six patients with torsade de pointes (TdP) initiated by the prolonged QT interval in our hospital over the past five years. All the patients were on antiarrhythmic therapy ; one received procainamide, one received aprindine, one received pirmenol and the remaining three patients received disopyramide. In three of the six patients, the serum drug levels were within or below the therapeutic range. Three patients had hypokalemia as another precipitating factor. Two patients developed TdP after a long-term administration of the drugs. Great care must be exercised just in case TdP showed be developed by a conbination of precipitating factors even after the long-term administration of these antiarrhythmic drugs.

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Patient compliance with presciibed drug regimens may be improved by finding out incom-pliant patients and exhorting them to take their medicines, but it's not an easy task. We telephoned those who had not shown up at the pharmacy within 7 days after the preparation of their drugs to come and receive the dispensed drugs. When the dispensed drugs had to be disposed of after a long misplacement, we prepared a “patient compliance report” to inform the attending physicians about noncompliance by attaching it to the patient's visit history. Further, of when they visited the hospital again we gave guidance about drug compliance at the window to those whose dispensed drugs had been disposed.
We contacted 63 patients by telephone during the 3-month period from January to March 1995 of the patients who left their drugs at the pharmacy, and found 30.6% of them had some compliance problems. Telephone calls were effective for reducing the proportion of the patients whose dispensed drugs were disposed of to 0.03% from 0.11%, the percentage worked our during the 5-month period from August to December 1994 during which no telephone call was made. We reported 19 drug disposal cases to the physicians by means of the “patient compliance report”. All the physicians appreciated it as they were brought to a realizatopn of the drug compliance rate of their patients.
As there were some patients who did not know that their drugs were prescribed, we considered how to cope with the left dispensed drugs would not be a question of the pharmacy alone. It should be handled as a problem of the whole hospital from the stage ofconsultation to payment.

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The author participated in a joint project to investigate the health state and urination of people of advanced age. Under this project, commissioned by the National Mutual Insurance Federation of Agricultural Cooperatives (Zenkyoren), a questionnaire survey was carried out on a total of 1, 238 old people (mean age: 75.2 years) in a typical Japanese rural community in flatlands. The results brought out the realities about their health conditions and way of life in full relief.
Well over 90% of those living in their own homes were doing fairly well almost without depending on others, compared with 12.9% of those staying in old-age institution. The need of care for the aged in institutions stemmed mostly from sequela of strokes and bone fractures as well as psychiatric disorders such as nyctophobia, an obsessive, irrational fear of night.
Ambulatory old patients of general hospitals ware as good as those old people at home in terms of independence. Hospitalized old patients were largely between the old people at home and those institutionalized.
However, of those old people who look after themselves in daily life, it was, found, about 20% complained about loss of bladder control. The prevalence of urinary incontinence was 20.5% for men and 25.8% for women.
Geriatric troubles associated with voiding and urination would undermine the old people's quality of life and enervate their will to stand on their own two feet. Understanding the implications of these facts and establishing the countermeasures are crucial today when the nation is graying faster than any society in recent history.

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To determine the relationships among silent brain infarction (SBI), bone mineral density and milk consumption in elderly women, we studied 26 senile female outpatients with SBI in comparison with 18 age-matched controls.
There was a significant difference between the two groups in diastolic blood pressure (p<0.05), and a significantly larger number of individuals in the SBI group had a history of hypertension than in the control group (p<0.005). Bone mineral density at the ultradistal end of the radius tended to be lower in the SBI group than in the control group (0.05<p<0.1). Milk consumption was greater in the control group than in the SBI group (p<0.01), but milk consumption tended to correlate with a history of hypertension rather than with bone mineral density (0.05<p<0.1).
These finding indicated a close correlation between SBI and milk consumption habits in elderly women.

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Metastasis of ovarian malignancy to the central nervous system (CNS) is still rare.
We report a case of a 48-year-old woman with brain metastasis of serous cyst adenocar-cinoma of the ovary as the primary site. Metastasis occurred when postoperative combination chemotherapy and radiation therapy were being given to the patient after complete surgical removal of ovarian tumors. A review of the literature is also made.

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In our hospital, the primary modality of treatment for end-stage renal disease has been periodic dialysis. But in recent days there are an increaseing number of patients who prefer renal transplantation in thier eagerness to have their quality of life improved.The most serious problem after transplantation is immunological rejection. The incidence of acute rejection that occurs within three month after the operation is reported to be around 40%. In our hospital, the first kidney transplant from a living doner was performed on a male patient.
The first rejection episode occurred on the twelfth day after the operation. The patient became psychologically unstable not only because of physical distress but also because of the fear of the loss of the transplanted kidney. Then our nursing staff took care of him with a sympathetic attitude, listened to him cafelly and told him over and over what rejection is like in plain language. This approach made him feel at ease. We think it important that patients can verbalize their feelings thoroughly by themselves to overcome the difficulties they meet, and we should support and guide them to adjust to the postoperative changes of thier circumstances.

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