Epidemiological study of autopsy cases of systemic lupus erythematosus (SLE), systemic sclerosis (SS), poly- and dermato-myositis (PD), and periarteritis nodosa (PN) was done by reviewing The Annual of Pathological Autopsy Cases (Nippon Boken Shuho) in Japan during a 7-year period (1972-1978). The result was summarized as follows . 1) Age and sex distribution of autopsy cases of SLE, SS, PD, and PN were well correlated to those of death cases in Vital Statistics Japan from 1972 until 1978 . 2) The total number of autopsy cases reviewed in these 7 years was 180, 350 (107, 931 male, 71, 256 femme; sex not described in 1, 163). Number of cases of collagen disease was calculated as follows. SLE; 90 males (0.08% in total autopsy cases), 667 females (0.94%), SS; 52 males (0.05%), 174 females (0.24%), PD; 99 males (0 .09%), 139 females (0.20%), PN; 72 males (0.07%), 75 females (0 .11%). 3) SLE was the highest in incidence among four groups. The second one was PD . PN was the lowest in incidence. 4) The female to male ratio was 7.9 for SLE, 4.7 for SS, 1.8 for PD, and 1.04 for PN, respectively. 5) The ratio of incompatibility between clinical and pathological diagnoses was the highest in PN. At autopsy, 35 cases (18 males, 17 females) (50.0%) were diagnosed of PN in 70 cases (39 males, 31 females) which were clinically diagnosed of PN. On the contrary, only 35 cases (18 males, 17 females) 23.8%) were clinically diagnosed of PN in 147 cases (72 males, 75 females) which were pathologically diagnosed of PN at autopsy. This result revealed that it was difficult to obtain an accurate clinical diagnosis of PN. 6) The highest incidence of cancer was found in PD, as a complication among all of four groups of collagen disease. Cancer was detected in 53.5% (53/99 males) and 25 .9% (36/139 females) of cases of PD, respectively. In patients older than 50 years of age cancer was recognized in the autopsies of 65.7% of males and 38.2% of females with PD. Secondly, patients with SS showed 9.6% (5/52 males) and 9.2% (15/174 females), respectively. 7) As side effect of steroid administration, atrophy of adrenals was frequently seen at autopsy, particularly in cases of SLE (19%). Opportunistic infection including miliary tuberculosis and fungus infection, also was found in a high incidence.
Although the epidemiological study on hypertension should be started by the investigation of blood pressure levels of population groups, i, t was started by the study on cerebrovascular disease in Japan, because the presence of hypertension is considered to play a relatively important role, as an underlying disease, in the occurrence of cerebrovascular disease. On the other hand, the epidemiological study was started by the study on heart disease in Europe and the United States of America. At all events, it has been proven by the studies carried out later that hypertension is closely related to cerebrovascular disease in Japan. The blood pressure level of Japanese varies with population groups within the country and is not uniform, but the authors have been interested in comparison of blood pressure levels between Japan and foreign countries. When the authors were engaged in the Asahan Health Improvement Project (Proyek Pengenbangan Kesehatan Asahan) conducted on North Sumatra in Indonesia, they had an opportunity to determine blood pressure of inhabitants in Medan City in cooperation with medical students of the North Sumatra University. This investigation was done together with a comprehensive health improvement action program by the Project.
While increasing medical expense has become a recognized social problem in recent years, dental care has not yet received the attention it deserves. In order to outline trends of demand and supply of dental care, analysis of numbers and distribution of dental protessionals (dentists, dental technicians, and dental hygienists) has been carried out. The results of the study are as follows:National Level 1. In the last 17 years, increase in the number of dental care professionals was greater than that of medical care professionals because of the rapid increase in the number of dental hygienists. 2. The rate of increase in number of dentists was higher than the rate of increase of dental patients.Community Level 1. The number of dentists per 100, 000 population was high in eight prefectures. 2. In areas where the number of dentists per 100, 000 population was low, the ratio of dental hygienists and technicians to dentists was high. 3. The ratio of dental hygienists to dentists was high in the west part of Japan. 4. Chiba and Saitama Prefectures, including the bedroom suburbs of the Tokyo metropolitan area, were found to be short on supply of dental care.