We attempted to determine compounds in human urine which, differing from cortisol (17-OHCS), show high values in healthy individuals, decrease with failing health, clearly decline with advancing disease and finally reach very low values in severe disease. We have eventually established that 17-ketosteroid sulfate conjugates (17-KS-S) are the compounds we were searching for. Hans Selye regarded stress as the rate of wear and tear and 17-OHCS as its indicator, but we considered that, differing from inanimate objects, living organisms consume energy to cope with stress and "repair" "wear and tear" of the tissue and "recover" its function. This concept led us to determine the organism's requirement for two mechanisms: "Wear and tear" which could be represented by the secretion of 17-OHCS (Selye), and "repair and recovery", which could be determined by the amounts of 17-KS-S derived from dehydroepiandrosterone (DHEA)-sulfate, a product of the adrenal cortex, which enhances neuronal survival, Iongterm memory, maintains the function of peripheral tissues, and stimulates immune system (17-KS mainly consits of 17-KS-S and 17-KS glucuronides 17-KS-G, the latter derived from cortisol, DHEA and testosterone). We hold that stress response is a series of biological process, beginning from CRH・ACTH and catecholamines, cortisol (17-OHCS), followed by insulin, acting as an anabolic agent and finally DHEA (17-KS-S) Ieads the tissues to repair by utilizing produced energy. Balanced changes of hormones, such as 17-KS-S, 17-OHCS, cortisol, catecholamines and insulin are seen in healthy individuals under healthy lifestyles and disruption of the balance brings apparent reduction in 17-KS-S. From this standpoint, we wish to develop research in interrelations between biologically antagonistic 17-KS-S and 17-OHCS, focusing particularly at 17-KS-S, which represents a contact point for mind and body, the healthy state of which is kept by appropriate sleeping and exercise programs on the basis of adequate food intake. The above three factors, 17-KS-S, 17-OHCS, and 17-KS-G, are expressed in creatinine ratio (mg/g creatinine).

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We evaluated functional disabilities of disabled workers at vocational aid facilities and a social welfare factory to reveal whether evaluation of the functional disabilities is useful for occupational health care activities. Subjects were 121 persons with a physical disability working at Fukuoka Colony (FC workers) and 35 persons with mental retardation working at Nanomi Kogei (NK workers). The Self-Rating Barthel Index, Self-Rating Frenchay Activities Index, and Satisfaction in Daily Life (SDL) were used for the evaluation of basic activities of daily living (ADL), lifestyle, and subjective domain of quality of life, respectively. The FC workers were almost independent in basic ADL: had a high capability in self-care activities and moderately disturbed capability in mobility activities, and had a more active lifestyle than the NK workers. The total SDL score indicated that the FC workers were less satisfied with overall daily life, although not significant, and were less satisfied with the SDL items of physical health, gait, house facilities, and having a job than the NK workers. Because these results indicated the features of disabled workers and gave an occupational health physician valuable information about disabilities, the evaluations used in this study can be regarded as useful for occupational health care activities.

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The carcinogen-resistant inbred DRH rat strain was developed from the carcinogen-sensitive Donryu rat and showed a remarkably lower incidence of liver tumors than the latter after administration of either 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB) or 2-acetylaminofluorene (2-AAF). In the present study, we examined the tolerance of DRH rat to another type of hepatocarcinogen, that is, N-nitrosodimethylamine (DMN). Male DRH and Donryu rats, 3 weeks of age, were given a single i.p. injection of 10 mg/kg body weight DMN and were sacrificed 1 year later. Five of 11 Donryu rats (45%) had macroscopically detectable tumors: 9 liver tumors in 4 rats and 1 urinary bladder tumor in the other rat. On the contrary, no tumors were detectable in the livers or other organs of 10 DRH rats under the same conditions. These results and other circumstantial evidence indicate that the different susceptibility of chemical carcinogenesis between DRH and Donryu rats is independent of individual pathways of metabolic activation of carcinogens.

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Pentachlorophenol (PCP) increased oxygen consumption and lowered the respiratory control ratio (RCR) in mitochondria from rat liver. These effects of PCP were lessened by 1 mM L-carnitine but not by D-carnitine. In contrast, up to 150 mM of pentylenetetrazol (PTZ) added at state 4 of respiration did not accelerate oxygen consumption. When mitochondria were incubated with 3.3 mM of PTZ, oxygen consumption, RCR and ADP/O ratio were all decreased. Moreover, these could not be suppressed even by high concentrations (－20 mM) of L-carnitine. Thus while L-carnitine could suppress effects of PCP, it could not counteract PTZ in mitochondria. It appears that anticonvulsive effects of carnitine in PTZ-induced seizures may not be due to mitochondrial protection.

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The author has been engaged in the education of around 950 students who have returned from studies overseas for more than a dozen years. Generally speaking, the students who have returned from Great Britain are superior to those from other countries and create a unique and gentle atmosphere. They also have the potential for post-graduation careers. Do these characteristics stem from individual personalities? Or does British education or the school culture and the social system have an affect on them? The author examined, analyzed and studied various factors. With regard to three out of six factors that the author selected through factor analysis for evaluating students' awareness, a significant difference was observed between the students who have returned from Great Britain and those from other countries. The three factors include responsibility, independence and discipline. Similar results were obtained through other analysis. The British school system is a multiple-track system, while the Japanese school system is a single-track one. In addition, British school education has two other major characteristics: a flexible curriculum coordinated to each individual's capabilities and learning speed, and educational organizations independent of the central authorities. The author studied these characteristics based on experiences of students who have returned from Great Britain.

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Pirmenol hydrochloride is a new orally effective, long-acting antiarrhythmic agent currently used in patients with supraventricular and ventricular tachyarrhythmias. We report on a 56-year-old female who exhibited drug refractory paroxysmal atrial fibrillation, in which marked prolongation of the QT interval and T wave inversion on electrocardiogram was demonstrated reproducibly shortly after the administration of oral pirmenol therapy. The plasma concentration of pirmenol was at a subtherapeutic level and the lymphocyte stimulation test was positive in this patient. Thus, an immunological mechanism might be involved in the mechanism of pirmenol-induced QT prolongation and T wave inversion on the electrocardiogram.

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A 3-year-old girl with rare and unique myelin abnormality in the sural nerve is described. Her parents are first cousins. Her clinical features were similar to those of HMSN Ⅰ. Therefore, a diagnosis of autosomal recessive form of HMSN was made. However, in histopathologic studies of the sural nerve, it was observed that the folded myelin did not extend into the axon but into the outer portion of Schwann cell cytoplasm, so called excessive myelin outfolding. The density of both the myelinated and unmyelinated fibers was less in the patient than in controls. In recent years, the patient described above is usually classified under HMSN ⅣB or (Charcot-Marie-Tooth disease) CMT4B, and molecular genetic studies are now in progress.

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In this report, the authors present the pneumoconiosis problem among Vietnamese coal mine workers. As coal is one of the most important products for export, its production has been intensified recently. With the strong incentive for rapid economic development, health problems of miners tend to take second place. As shown in the present report, miners' working conditions are very bad, and health protection measures are not sufficiently implemented. It is apparent that official statistics underestimate the actual situation because of the inadequacy of the reporting system. Because the financial barrier to establishing a sufficient reporting system for pneumoconiosis is enormous, an epidemiologic study is the most effective way to assess the actual situation. It is also useful to conduct epidemiologic studies as part of an international collaborative project, in order to transfer necessary knowledge and epidemiologic skills from the developed countries to Vietnam.

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During the last several decades we have experienced the emerging and reemerging of infectious pathogens and diseases. The outbreaks of infection due to these pathogens sometimes occur via the sources and/or routes which have not been recognized during previous studies on epidemiology and pathogenesis of the diseases. There are many factors contributing to the increase in infectious diseases. Namely, medical progress often results in an increasing number of immunocompromised patients. Common, usually avirulent, commensal and environmental organisms become pathogens to these patients. The evolution of organisms acquiring resistance to antimicrobial agents, disinfectants, and environmental stimuli also relates to the high incidence of nosocominal (hospital-acquired) infections as well as to the clinical situation of the patients. Because of these tendencies, as risks of nosocominal infections, are characteristic especially in major health care centers such as large teaching hospitals, most health care workers are obliged to participate actively in control and preventive efforts in addition to their traditional roles. In this review I discuss the recent characteristics of nosocominal pathogens and the environments surrounding the hospitalized patients to design effective strategies for and to facilitate the infection control activities.

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