Although the "Total Health Promotion Plan (THP)" drawn up by the Labor Ministry includes a self-administered stress checklist (THP-SC) as a health measurement, THP-SC has not been utilized in the way that it had been planned. Hence, we studied the usefulness of this list by comparing it with the General Health Questionnaire (GHQ). We made a questionnaire that included both THP-SC and the 60-item GHQ, and collected answers from 261 white-collar workers (male, average age 43.7). The GHQ was evaluated using the Goldberg's method. When analyzing THP-SC, the number of answers indicating stress was counted, and the respondents were divided into two groups based on the cut-off points of 75 percentile or 90 percentile. In the 60-item GHQ, 48 respondents out of 243 with valid answers had a higher score than the cut-off point, and in the 12-item GHQ, 77 out of 256 had a higher score. The average number of THP-SC was 5.67±3.19. Concerning the relationship with GHQ, many items of the 'A' section of THP-SC were significant. The comparison also suggested that four or more items checked in 'A' section or seven or more items checked in the whole list would mean that a respondent may be under stress.

View full abstract

For the purpose of evaluating the significance of obesity as a risk factor toward various chronic geriatric diseases, a multiple regression analysis was performed on the annual physical checkup data of UOEH employees in 1991. The following results were obtained. (1) The average obesity index of the UOEH employees showed a progressive and significant increase in the 10 years from 1981 to 1991. (2) A close relation between the obesity index and serum GPT was recognized by elevation of the standard partial regression coefficients of serum GPT to obesity index and that of the obesity index to serum GPT when the data from all 1591 UOEH employees were analysed in one group. This finding was derived from a significant contribution of obesity to the liver dysfunction in the young male obese population under 30 years of age. (3) Systolic blood pressure was related to age rather than the obesity index, indicating that the development of hypertension is more closely related to aging than obesity. (4) No significant relation was found between the serum total cholesterol level and the obesity index in any group analysed. From the above findings, it can be suggested that the obesity in young male employees is more closely related to liver dysfunction than other abnormalities.

View full abstract

Multipule pulmonary nodules were found in a patient who had an occupational history of coal mining for eleven years and road construction for fifteen years. An open lung biopsy was performed, because nodules had increased in size compared to previous ones and a trasbronchial biopsy was not diagnostic. The nodules were composed of dense concentric lamellar collagenous structures with a serpentine pattern surrounded by an infiltration of histiocytes, lymphocytes and plasma cells with Russel bodies. These findings are compatible with pulmonary hyalinizing granuloma (PHG) named by Liebow A. A. The etiopathogenetic mechanism and the difference between PHG and silicotic nodule is discussed.

View full abstract

A 30-year-old male clinico-pathological case survived for 1 year and 9 months after being hit by a truck while riding on his motorbike on Aug. 21, 1988. On admission, his consciousness level was 5 according to the Glasgow Coma Scale, and a traumatic intraventricular hemorrhage and cerebral contusion were revealed by CT scanning. He underwent immediately an operation in order to drain blood from the ventricles at which time a right side dominant quadriplegia was noted. He made a gradual improvement and by January 1989 was able to tell us his name and address correctly. However, he remained incontinent and bedridden owing to the contracture of joints. He was put on rehabilitation exercises in March 1989 which trained him to operate a wheelchair. In April 1990 he regained urinary control, but was remarkably devoid of will power, perseverance and memory. He expired of pneumonia on May 11, 1990. At autopsy, his brain weighed 1180 g. The cerebral convexity was discolored, especially the rectal gyri and bilateral olfactory bulbs were brownish-yellow. Old gross contusional scars were observed on the left rectal and orbital gyri, and the 3rd ventricle and inferior horns of the lateral ventricles were enlarged. Holzer's method revealed fibrillary gliosis in the corpus callosum, fornix, cingulate gyrus and a part of the caudate nucleus adjacent to the thalamus. Microscopically, axons were seen to be disrupted in the corpus callosum as well as in the anterior commissure, having the appearance of macrophages. A myelin pallor was noted in the bilateral pyramidal tracts below the level of the midbrain, and there was a slight myelin pallor in the deep cerebral white matter. The medial part of the cerebrum was almost exclusively affected, whereas the damage of the superficial part was relatively minimal. Such a distribution of lesions suggests that the brain had sustained injury by revolving acceleration at the time of the accident. However, a mild change of white matter without any axonal disruption prevented us from concluding that this was a DAI (diffuse axonal injury) case. In the hitherto reported cases of DAI, including the authors' cases, a variety of white matter lesions were seen: mild myelin pallor as in this case, little or dense gliosis, widespread axonal disruption, gliding contusion, etc. The degree of intensity of gliosis might depend upon intracranial pressure or the functional state of the astrocytes. The protracted comatous state and the absence of fracture suggest clinically Diffuse Brain Injury (DBI), but it is important to distinguish the "clinical" DBI and the "histological" DAI. Furthermore, it would be worth re-examining whether all the white matter lesions seen in so-called DAI occur at the time of injury.

View full abstract