Measures of lifestyle-related diseases affecting and younger citizens need to viewed in different lights.
1) BMI: The survival rate was lower among slimmer men. Among elderly men, this was also true even if those who died of cancer were excluded. 2) Serum total cholesterol level: The survival rate curve showed only minor differences in the middle-aged male group, but the survival rate was significantly lower in those with low cholesterol levesl (170mg/dl or less) than in those with higher cholesterol levels. However, these differences were negligible when residents who died of cancer were excluded, indicating that the differences were due to the effects of cancer. In the elderly male group, the survival rate in those with low serum total cholesterol levels was apparently lower than in the middle-aged group, and this trend was not changed after exclusion of residents who died of cancer within five years. This finding indicates that the same dietary guidance provided to younger patients should not be provided to elderly hypercholesterolemia patients discovered in basic medical examinations. 3) Serum albumin and serum total cholesterol levels: A significant positive correlation was noted in both men and women regardless of age, even if residents who died of cancer were excluded. The correlation increased with age. This finding also indicates that the same dietary guidance should not be given to the elderly and younger groups.

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We made a random sampling survey of medical institutions in Japan on progress in systematization of discharge planning. The results indicated that only 20% of the medical institutes surveyed had a discharge planning specialist. For the purpose of promoting the quality of care in the future, Japanese medical institutions had to tackle problems associated with systemization of discharge planning, setting-up of discharge planning specialists and department of discharge planning, planning and correcting discharge plan with patients and their family, disclosure of information on social resources, servicing of effective screening, monitoring and follow-up, reconsideration of the outpatient system, setting-up and amelioration of home nursing care services, and strengthening the collaboration with related facilities.

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Pesticide poisoning is one of the most inportant health issues associated with rural medicine, and chronic nervous and mental disorders are its importnat sequelae. We investigated suquela cases nationwide, and reviewed chronic nervous and mental disorders from a clinical and epidemiological point of view.
Our nationwide survey found one reported case of delayed neuropathy. The patient ingested organophosphorus insecticides, and showed delayed neuropathy dozens days after.
Cases of delayed neuropathy attributable to Mipafox was reported in1951.This disease is mainly caused by organophosphorus insecticides. Carbamate insecticides are also known as the agents to induce delayed neuropathy. Herbicide Glufosinate (Basta^TM) was put on the market in 1984. The case reports published during the 1990's pointed out that some Glufosinate poisonings cause amnesia and disorientation. Thesecases were reviewed according to the types of pesticides or their groups.
An epidemiological investigation of neurological and psychiatric desorders among such workers exposed to several types of pesticides as plantation workers and sheep dippers was made. These exposed workers were at high risk of mild cognitive dysfunction, tremor, weakness, and so on to a significant extent. Those children who were exposed to organochlorine insecticide and pollutant via placenta or milk were also surveyed whether they had impairments of nervous and mental development. Highly exposed children were significantly slow in development relative to their peers. The results of these investigations were also reviewed.

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Following the 2000-2001 season, we summed up what we have done, prophylactically and clinically, to cope with influenza during the 2001-2002 season in the Department of Pediatrics, Mito Kyodo General Hospital. Vaccination was effective against the infections. A new rapid test kit, which can distinguish types of influenza virus, was helpful. Administration of ZANAMIVIR by means of the nebulizer was effective.
We treated some severe cases including three cases of suspected influenza encephalopathy. Most of the patients with influenza were not vaccinated before the season. It is expected that technological advances, especially in diagnosis and treatment, will be made from now on. It is more importnt, however, that the vaccination rate should be improved from the viewpoint of disease prevention.

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Background: Lung cancer screening by chest X-rays and/or cytological tests of sputum has been practiced for many years. Nonetheless the number of deaths from lung cancer was kept increasing all this while. We wanted to find a way to decrease the mortality from lung cancer by investigating the screening methods or lifestyle to prevent the lung cancer.
Methods: I. The detection rate of lung cancer was investigated according to each method of screening-helical CT, chest X-rays or sputum tests, from 1998 to 2000.
II. Seventy-nine cases of lung cancer detected by the screening carried from 1995 to 2000 at our institute were compared with control cases matched with respect to age, sex and seasons of screening.
Results: I. The detection rate by helical CT in 1998, 1999, and 2000 was 0.29%, 0.24%, and 0.19%, respectively, while the detection rate by chest X-rays was 0.01%, 0.02% and 0.2%. There was no detection of lung cancer by sputum tests in those three years.
II. The ingestion of vegetables was the only one statistical difference between the lung cancer group and the control group. A lesser ingestion of vegetables increased the risk for lung cancer.
Conclusions: The detection rate of lung cancer by helical CT is remarkably higher than chest X-rays or cytological tests of sputum. People who eat a lot of vegetables have a lesser chance to suffer from lung cancer.

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OBJECTIVES: The purpose of this study was to evaluate the relationship between circulating serum leptin concentrations and regulation of body weight longitudinally among Japanese men and women. DESIGN: Ten-year retrospective study. SUBJECTS: A total of 328 Japanese men and women, who at baseline (2000) were 40-65 years of age, were free of hypertension, cardiovascular diseases, diabetes mellitus and hypercholesterolemia. They completed detailed lifestyle questionnaires. MEASUREMENTS: Baseline serum leptin concentrations and 10-year weight changes. RESULTS: The average levels of serum leptin were 2.93±1.47ng/ml in men and 5.67±3.00ng/ml in women. Subsequently weight gain was observed among 52% of men and 46% of women. The average gain in weight per year was 1.0±0.8kg in men and 1.3±0.9 kg in women. The observed association between weight gain and leptin concentration was limited to men with body mass index (BMI) of 18.5-25.0kg/m² in 1990, among whom a significant correlation was observed between log-transformed leptin levels and weight gain (r=0.281, p=0.002). CONCLUSION: These results suggest that elevated serum leptin concentrations among normal weight men may be used as an indicator of both leptin resistance and subsequent weight gain.

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[in Japanese]

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