The authors reviewed the English language papers concerning chronic health effects of agricultural chemicals, focusing on the incidence of cancer in pesticide users. These papers were collected using MEDLINE between 1988 and 1998 as a referencetool. According to the standard study design, the epidemiological literature is classified into cohort studies and case-control studies. These studies suggested the association between pesticides and various types of cancer such as soft tissue sarcoma, non-Hodgkin's lymphoma, lung cancer, and breast cancer. Categories of pesticides included in these studies, varied greatly, including herbicides and insecticides.
In this paper, we discussed about such problems as the selection of control groups and the assessment of pesticide exposure levels, which may pose some problems in conducting epidemiological research on the relationship between pesticides and cancer.
A model for a method of epidemiological study of health hazards due to pesticide exposure was also presented.

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The purpose of this study was to establish by way of trial reference interval of serum lipids (TC, HDL-C, TG and LDL-C) for old people aged 65 or over based on the document published by America's National Committee for Clinical Laboratory Standards. For this purpose, we used the results of the mass health screening tests run on a total of 14, 738 residents in Shimane Prefecture. We selected reference sample groups by excluding those examinees who had been undergoing medical treatment, those who had taken their meal less than 12 hours before, habitual drinkers and smokers, and those whose systolic blood pressure was more than 160mmHg, diastolic blood pressure upwards of 95mmHg, obesity level downwards -20% or upwards of +20%.
T-C values peaked in the age group of 50s for men, while for women in the age group of 60s. Regarding HDL-C values, women were generally high compared withmen, but mean values for women in their 60s were significantly low (p<0.01) compared with those for women in their 50s. TG values were higher in men than in women. LDLC levels showed the same tendency as T-C levels.
We compared the mean values of adults aged 64 or below and elders aged 65 or above. In the elders, the mean values for T-C, TG and LDL-C were significantly higher (p<0.01) than in the adults, and the mean HDL-C values were significantly lower (p<0.01) than in the adults.
These results indicated that the reference interval of elders of T-C, HDL-C, TG and LDL-C could be from 147 to 289mg/dl, from 37 to 99mg/dl, from 40 to 209mg/dl and from 70 to 200mg/dl, respectively.

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We studied the relationship between the personal background of participants (365 individuals) in health promotion activities, in a rural community and the factors which affect effectiveness of their health promotion activities. Information gathered included education, whether or not employed, economic status, level of interest in participating in volunteer/welfare work, participation in other group activities, self-ratedhealth status, degree of satisfaction from the activities, self-esteem, self-efficacy, and self-actualization value.
The results were as follows:
1. The age and level of interest in volunteer/welfare work were related to an increased
degree of satisfaction from helth promotion the activities.
2. The degree of satisfaction from the activities and affluent circumstances are related to an increased degree of self-esteem.
3. The level of interest in volunteer/welfare work and participation in other group activities were related to the degree of self-efficacy.
4. The greater the age the less the degree of self-actualization value. On the other hand, the greater satisfaction from the activities, higher education and higher living standards were related to an increased degree of self-actualization value.

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Recently, allogeneic bone marrow transplantation (allo-BMT) has been established for the treatment of hematological disorders. Fifteen patients had recieved allo-BMT at Tsuchiura Kyodo General Hospital as of April 1999. In this paper, we analyzedthe results and the problems of allo-BMT at our institution. The mean age of patients was 29.2years. Seven patients had AML, 5 ALL, 1 CML, 1 non-Hodgkin's lymphoma and one had severe aplastic anemia. Bone marrow donors were all HLA-identical siblings. Most of the patients were conditioned with a combination of busulfan or totalbody irradiation, cyclophosphamide and etoposide. To prevent GVHD, cyclosporine A and methotrexate were mainly used. Patients with acute GVHD were 4 and patients with chronic GVHD were only two. Three grade I patients with acute GVHD and all with chronic GVHD did not require therapy. In spite of small numbers of transfused cells, no cases of transplant rejection were found. All these engrafted patients achieved a WBC≥1×10³μl after a median of 19.5days and a Plt≥5×10⁴/μEl after a median of 38.1days. Five of the 14 engrafted patient relapsed in a median of 6.7months and all died in a median of 9.6months. Eight are alive in complete remission for 0.2 to 39.4 months (median 21.7months). For the improvement of the disease-free survival rate after allo-BMT, the prevention of relapse and prophylaxis of GVHD and infection are important. At our institution, especially the former is important. The conditioning regimens were stronger than usual but acute and chronic GVHD was very mild, therefore GVL would be weak. If prophylaxis of GVHD is weaken and mild GVHD ans GVL occur frequently, relapse will be prevented and better results will be obtained.

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Ischemic peripheral circulatory disorders have been observed more and more frequently in maintenance hemodialysis patients in recent years. This tendency is associated with the progression of arteriosclerosis characteristic of such patients. In the present study, we made inquiries about the presence or absence of subjective symptoms of ischemic peripheral circulatory disorders in maintenance hemodialysis patients and examined pulsation of dorsal artery and cyanosis of foot to make early diagnosis of the circulatory disorders possible. Furthermore, we measured the ankle brachial pressure index (API) and examined the calcification in thoracic and abdominal aortae on X-rays. According to clinical symptoms, the subjects were classified into no clinical symptom, sensory disorder, and motor disorder. Of the participants in the present study, 31.0% had API below 1.0. The mean age and hemodialysis period of the patients with API below 1.0 were more than those of the patients with API 1.0 or over. However, the differences were not significant. Of the patients with no clinical symptom, 21.2% had API below 1.0. We found a patient with no clinical symtom who had no pulsation of dorsal artery and cyanosis of foot. Of the patients who complained sensory and motor disorders, 35.0% and 45.5%, respectively, had API below 1.0. In the examination of calcification of thoracic and abdominal aortae, 23.8% of the patients with no calcification, 22.2% of the patients with the calcification in thoracic aorta alone, 27.8% of the patients with the calcification in abdominal aorta alone, and 29.6% of the patients with the calcification in both thoracic and abdominal aortae had API below 1.0. We believe that these results will make for early diagnosis and care treatment of ischemic peripheral circulatory disorders in hemodialysis patients.

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At present, the disclosure of medical information to patients is mainly the release of their medical records. In surgery, however, as a patient usually lies unconscious during operation, the disclosure of surgical information is one of the most difficult tasks. Oral explanation after surgery is often inadequate even with drawings. Thus, in order to make a more precise disclosure, we edited the images taken by a digital camera in the operating theatre, and handed the print to the patients and their family members.
Questionnaires were sent to 33 patients who were given the print (disclosed group), and to another 33 patients who were not given (non-disclosed group). Seventynine percent of the questionnaires could be collected from the disclosed group, and in the non-disclosed group 91% were recovered.
Indication of the operation was understood in all the patients in the disclosed group, but in the non-disclosed group the rate was 93%. Proposed operative procedures were understood in 91% of the patients in the disclosed group, whereas the rate was 93% in the non-disclosed group. After operation, there was no difference between two groups concerning understanding of the explanation. However, while all the patients in the disclosed group remembered the postoperative diagnoses and operative procedures, only 83% of the patients in the non-disclosed group did (chi-square test, P=0.0397). Eighty-three percent of the patients in the disclosed group and 93% of the patients in the non-disclosed group were satisfied with the outcome of the operation. In the disclosed group, 83% of the patients could understand the contents of the print, and 96% of them mentioned that it was a good trial.
In conclusion, the disclosure of the information about surgical operations was effective when a print was used togethr with images taken by a digital camera. This trial contributed greatly to the improvement of patients' understanding of the details of surgical operations and the precise memory of the postoperative diagnoses and procedures.

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