Chronic adverse effects on human bodies from pesticide exposure are far-reaching. They eventually cause neuropsychological disorders, organ disorders, oncogenesis, unwonted pregnancy outcomes, developmental disorders, and so forth. This paper reviewed the literature published in recent years on the relationships between pesticide exposures and pregnancy outcomes.
  Many studies from North America and Europe documented a link between adverse pregnancy outcomes and exposures to pesticides used in agriculture, gardening, and in everyday life. The adverse pregnancy outcomes were birth defect, spontaneous abortion, stillbirth, preterm birth, depressed birth size, and the imbalanced male/female ratio of newborns. The majority of the reports described significant relations. Significant increases in the incidence of birth defect were reported also by the majority of the reports, and specific malformations such as anencephaly were significantly related to pesticide exposure. Hypospadias and cryptorchism were found to be significantly closely related to exposure to various kinds of pesticide and the residue of chlordanes rather than residual DDT.
  Two pieces of research carried out in the Philippines and South Africa revealed a close association between agricultural pesticide use and birth defect and spontaneous abortion. In the developing countries of the tropical and sub-tropical regions, the protect gears were scarcely used for the reason of climate and a high cost. Consequently, the risk of exposure was high. The situation in these regions needs further study from an epidemiological standpoint. Some activities and administrative measures are simultaneously necessary, including the education in order to decrease the risk of pesticide exposure and use pesticides with low toxicity.
  Regrettably, few epidemiological studies have been carried out in Japan, and the Japanese Association of Rural Medicine is responsible for promoting epidemiological research in this nation. Furthermore, it should contribute to the activities and administrative measures to lower the risk of pesticide exposure in Southeast Asian countries.

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  In Akita Prefecture, there are nine hospitals established by the Akita Prefectural Federation of Agricultural Cooperatives for Health and Welfare (Koseiren). Half of the stroke patients in the prefecture were treated in these Koseiren hospitals, and half of the mass screening projects for the prevention of cardio vascular diseases were undertaken by these hospitals. A retrospective cohort study was done using mass-screening data (age, sex, past history of diabetes mellitus, blood pressure, body mass index, smoking and drinking habits) of 175,033 cases stored at these hospitals from 1988 to 1999, and the prefecture-wide stroke data of 2,520 initial stroke events registered from 1988 to 2003. The number of stroke cases was broken down into 1,428 cases of cerebral infarction (57%, CI), 693 cases of cerebral hemorrhage (27%, CH) and 399 cases of subarachnoid hemorrhage (16%, SAH). The subjects were also divided into five age groups:30-49, 50-59, 60-69, 70-79 and 80-89. Blood pressure (BP) was classified into six categories according to the JNC 6 criteria. Risk factors were determined using the Cox analysis. The hazard ratio for CI and CH was increasing with advancing age. CI showed a higher hazard ratio in men than women (hazard ratio for men was 1.8). The hazard ratio was increasing as BP became higher in any of three stroke subtypes, and especially CH showed the strongest correlation with BP. Uncontrollable risk factors were very closely associated with the attack of CI. On the other hand, BP (controllable risk) was closely linked with the attack of CH. Our results showed the prevention of CI was not easy. Controlling BP may be the most effective strategy for preventing hemorrhagic stroke (CH and SAH).

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  The purpose of this study was to investigate an optimal 25-hydroxyvitamin D3 [25(OH)D] level for Japanese frail elderly people aged 65 and above from the standpoint of quality of life, functional capacity, and physical function. A longitudinal study was conducted in two towns (latitude 36 degrees north) from 2006 to 2008. The subjects were 125 frail elderly individuals living in a rural setting and attending a 3-month exercise class for prevention of age-related diseases in order that they could do without receiving nursing care. An interview was conducted based on a questionnaire, and blood data, and physical fitness tests were administered to them at baseline and at the end of the 3-month exercise class. Functional capacity and physical fitness were compared on the basis of 25(OH)D≥50 nmol/L as a usual cut-off point, and 25(OH)D≥75 nmol/L as a severer cut-off point. A comparison of changes in physical fitness between before and after exercise class was done. The mean 25(OH)D level (±SD) was 58.9±13.6 nmol/L at baseline. The ratios of 25(OH)D level less than 50.0 nmol/L and less than 75.0 nmol/L were 23.9%, and 87.2%, respectively. The rates of house-bound subjects and those with worse scores of QOL were significantly higher in the group with 25(OH)D<50.0 nmol/L compared with the group with 25(OH)D≥50 nmol/L. The rate of those with superior functional capacity was significantly higher in the group with 25(OH)D≥75 nmol/L than the group with 25(OH)D<75 nmol/L. At the end of the 3-month exercise, Timed Up & Go indicating walking ability improved significantly in the group with 25(OH)D≥50 nmol/L, and an alternate step test indicating lower extremity strength significantly improved in the group with 25(OH)D≥75 nmol/L. From these findings, it was suggested that 25(OH)D level more than 50 nmol/L would be needed to maintain walking ability of the Japanese frail elderly and that 25(OH)D level more than 75 nmol/L would be needed to maintain lower extremity strength or functional capacity.

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  Among the bacteria isolated from clinical specimens of hospitalized patients, one of the most intractable species was Pseudomonas aeruginosa, the causative agent of P. aeruginosa. It resists a variety of antibacterial agents. Carbapenem is known as one of a few that are efficacious for P. aeruginosa infections. Maintaining the drug susceptibility of pathogens leads to the favorable clinical outcome in patients with infections diseases. The excessive use of carbapenem and other antimicrobial agents results in the increase of drug-resistant mutants of P. aeruginosa. At a meeting of the Health Ministry's infectious disease control committee in June 2007, the necessity of using antibacterial agents in more rational ways was highlighted on the suggestion of some member pharmacists. Incidentally, during the periods from January to June and from July to December 2007, we studied the antimicrobial use density (AUD) of carbapenem agents and the occurrence ratio of carbapenem-resistant mutamts of P. aeruginosa. The results showed that the occurrence of drug-resistant mutants decreased in proportion to the decrease of AUD. We believe the investigation of the AUD of any antibacterial agents is an important task pharmacists should take upon themselves to control infectious diseases. By reporting the results of our investigation on a regular basis, we are going to make a modest contribution toward the optimum use of antimicrobial agents.

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  The Saku Central Hospital classified muscular relaxants, potassium products and the like as “high-risk medicines”, but when it came to insulin, did not take any standardized measure against it to prevent accidents. Having organized a team of personnel from a wide variety of job, our hospital has recently carried out a campaign for improvements in medical care. With pharmacists playing a leading role, we grappled with measures for the prevention of errors in the administration of insulin using quality control (QC) methods. As a consequence, the campaign served to decrease the number of medical mistakes. As there still occur many incidents involving medication, the role played in risk management by pharmacists remains significant. In future, pharmacists will hopefully play a constructive role in risk management to prevent medical incidents involving medical supplies. That said, a campaign for improvements inmedical care through the practical use of QC methods seems likely to bring about favorable results.

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