A new HP_1C (high performance liquid chromatography) method with a cation-exchange column using non-porous polymer gel for the determination of glycated hemoglobin (HbA_1C) was developed. The HP_1Ccan clearly separate stable HbA_1C (s-A_1C) and labile HbA_1C (l-A_1C) after glucose loading in vivo (OGTT) and in vitro. This HP_1C method also shows acceptable precision and reproducibility within 5.0 % of CV. The reference interval, determined for 200 healthy individuals, was 5.22±0.44%. The correlation coefficient between s-A_1C and blood sugar, simultaneously determined, was 0.508 (n=75) and two dissociation cases had high l-A _1Cvalues indicating not fasting. Correlation of coefficients between s-A_1Cand 1 month or 2 months before determination were 0.509 and 0.467, respectively. Correlation of coefficients of the suspected glucose values from 3 different months (0, 1, 2 months before) had a more significant number of coefficient correlation, r=0.589. A significant correlation was detected between s-bA_1Cand fructosamine, r=0.849.

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To investigate the occurence of transverse lines (Harris) in the humerus, we examined 105 chest X-ray photographs including the proximal area of the humerus. In addition, the frequency of TLs was compared with that of other bones. The following results were obtained :
1. Transverse lines were observed in 16.8 % of 173 humerus on the proximal areas and were higher in females than in males. The number of TLs observed was 3 on average; this number was higher in females than in males.
2. The frequency of individuals with TLs in the proximal humerus was nearly the same as those with TLs in the tibia and femur.
3. Over 60 % of individuals with TLs in the proximal humerus had confirmed TLs also in other bones.
4. Almost all females with TLs were over 80 years of age; most were of small body size.

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To provide effective and integrated care services by health care professionals and families, we attempted to quantitatively evaluate the present obtainable services and also estimate the proper level of nursing services in consideration of what is desirable. In this study, 78 handicapped persons who were receiving nursing care at home because of sequela of cerebral apoplexy and their family members were used as the subjects to investigate the quantity of nursing care which was for the most part being performed by the families and nursing professionals such as home helpers, visiting nurses and public health nurses (demands) ; in addition, we investigated the quantity of care which was thought to be necessary. Based on the views of family members concerning the present conditions of nursing care, it was indicated that the rates of contribution of such care by families and nursing professionals were 97.4 % and 2.6 %, respectively. In particular, for independent-living persons and bedridden patients, the contributions of family members were 98.2 and 97.0 %, respectively, indicating that the family burden is considerably large in home care nursing.
When compared with the demands asked by the families, the needs evaluated by the professionals were greater. Thus, there were large differences between the demands and the needs especially for independent-living persons.
Next, the estimated numbers of nursing professionals in this region to support nursing care at home for independent-living and bedridden persons with sequela of apoplexy were as follows : 6.5 and 9.6 home helpers, 4.7 and 7.3 visiting nurses and 10.7 and 11.5 public health nurses, respectively.

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Following ischemia and reperf usion (I/R) of the lower limb, multiple organ failure including lung edema may occur. It is suggested that lung edema is associated with iron cascade. This study was designed to determine whether the iron cherator, def eroxamine, could ameliorate lung edema following I/R of the lower limb using a rabbit in-vivo model. Arterial blood gas (ABG) was analyzed including PaO₂, PaCO₂, and pH during the 1-hour ischemia and 2-hour reperf usion. After lower limb reperf usion, a wet/dry weight ratio (W / D) and an electromicroscopic histological study (EM) of the lung were performed. Immediately after reperf usion, def eroxamine (DFO group), iron-cherated DFO (DFO + Fe group), iron (Fe group), and saline (control group) were infused intravenously in each group. ABG was not significantly different between the DFO, DFO + Fe and the control groups ; however, W/D was significantly lower in the DFO group than in the other groups. EM showed that edematous change of the lungs was more reduced in the DFO group than in the control group. These results suggest that lung edema may occur before the ABG shows abnormal data and may be reduced by DFO administration.

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The authors attempted to elucidate the main causes of asthma death. Forty-nine cases of asthma death in our department over the last 20 years were analyzed in detail. The most important cause of bronchial asthma death was chronic undermedication of inhaled steroids. Many cases of undermedication were caused by patients, but the general treatment protocol of using steroids and of the timing of hospitalization was inadequate. A second major cause was delayed treatment due to the excessive use of inhaled beta agonists during severe asthma attacks. Therefore, to prevent asthma deaths, we must educate patients, re-evaluate treatment protocols, and re-educate physicians. By implementing the above measures, our department has succeeded in reducing the number of asthma deaths to zero since 1996.

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