We examined exposure to polycyclic aromatic hydrocarbons (PAHs) among non-smoking office workers in 2 countries living in the vicinity of a coke-oven factory by measuring their levels of urinary 1-OHP, a known metabolite of PAHs. Subjects included 10 non-smoking office workers in Kitakyushu city (Japan) and 20 workers in Thai Nguyen city (Vietnam). Measurement was optimized by using the high-performance liquid chromatography (HPLC) method developed by Jongeneelen et al. This method required only a small amount of urine and had a short incubation time, and its detection limit was very low (0.00448 ng/ml), which was practical and highly sensitive.The median urinary 1-OHP concentration in the Vietnamese subjects (0.417 ng/mg creatinine) was six times as high as that in the Japanese subjects (0.069 ng/mg creatinine) (P < 0.001). However, both concentrations were significantly below the guideline level, below which there is no genotoxic effect, implying a low probability of any adverse health effects.Our measurements from both countries showed higher urinary 1-OHP concentrations than in previous studies from locations without factories, indicating that ambient air pollution from industrial emissions is an important source of PAH exposure. Finally, the urinary 1-OHP concentrations did not correlate with gender or lifestyle factors.

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A significant relationship between lactate clearance and mortality rates in cardiac arrest cases has been reported. However, the relationship between lactate clearance and neurologic outcomes in cardiac arrest cases is not clear. We examined lactate clearance in cardiac arrest cases induced by ventricular fibrillation. We investigated 13 patients with cardiac arrest induced by ventricular fibrillation from April, 2006 to March, 2012 in which therapeutic hypothermia was performed. Patients were classified into two groups: those with a favorable neurologic outcome (n=7) and those with a poor outcome (n=6). We compared lactate clearance levels between the two groups. There was no significant difference in lactate concentrations at admission and 8 or 24 hours lactate clearance between the two groups 8 or 24 hours after admission. This result suggests we may not predict the neurologic outcome of cardiac arrest cases induced by ventricular fibrillation using lactate clearance.

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Handwashing is the most basic method of preventing infection. Hand rubbing with an alcohol-based handrub, is the most efficient and popular method. We found in several case studies that 3 minutes of dry hand rubbing without any disinfectant decreases the number of hand bacteria. In this study of 54 samples taken from 47 test subjects, we tried to determine how effectively this method decreases hand bacterial numbers. Except for 12 samples that were indeterminate, the number of hand bacteria in 36 (85.7%) out of 42 samples decreased. The average rate of decrease was 49.4% and the maximum rate was 98.3%. Although the most effective duration of dry hand rubbing varied among individuals, we estimated that 2 minutes is optimal. As dry hand rubbing without disinfectants decreases hand bacteria, we suggest that it can be an effective alternate method in emergency situations when water, soap or disinfectants are unavailable.

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In the year following Röntgen`s discovery of X-rays in 1895, approximately 60 cases of hand dermatitis and hair loss induced by radiation were reported. People using X-rays in their occupation, including X-ray tube manufacturers, physicians, and engineers, experienced chronic radiation dermatitis and were the first to be diagnosed with occupational radiation exposure. Reports of later appearing disorders, including skin cancer, suffered by doctors and engineers, were regarded as serious occupational diseases. In the 1910ʼs, blood disorders, including leukemia, in people with occupational exposure to radiation came into focus. Dial painters applying radium to watches with a luminous dial clock face suffered osteomyelitis from about 1914. Other radiation damage reports include radiation death and carcinogenesis in the Chernobyl nuclear power plant accident in 1986, and radiation death in the Tokai-mura JCO accident in 1999. The details of radiation damage in the Fukushima Daiichi Nuclear Power Plant in 2011 have not yet been reported, but must be followed in the future.

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A 59-year-old employed man was recommended to have surgical treatment for symptomatic left middle cerebral arterial stenosis. He refused surgical treatment for social reasons but was given conservative therapy for the prevention of the recurrence of cerebral infarction. Immediately after he retired, he had severe recurrent cerebral infarction with severe anemia and low blood pressure due to gastroduodenal ulcer bleeding. It was inferred from MRI findings that this recurrent cerebral infarction was related to a hemodynamic mechanism and mental stress due to the gastroduodenal ulcer. The influence of occupational mental stress has been reported to be a risk factor of gastroduodenal ulcer. The occupational situation of a patient should be an important factor in consideration of the prevention of cerebral apoplexy.

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Home-based stroke hemiplegia patients tend to fall easily. Poor toe clearance is reported to be one of the causes of falling, although there are many other related factors. We developed a low-priced insole type portable foot pressure measurement device, and measured the foot pressure distribution and the foot pressure-time curve of 20 chronic hemiplegia patients and compared them with 36 healthy controls. We also analyzed the outdoor gait of a chronic hemiplegia patient on flat ground, on rough terrain, walking up stairs and on a downward slope. The result was that the load rate of the unaffected heel was significantly increased in hemiplegic gait, and there was a significant negative correlation between the affected side stance phase rate and gait time for 10 m distance (r = -0.73, P < 0.01). The primary role of the unaffected side and the poor toe clearance on the affected side were assured in the uneven ground gait, and it was suggested that chronic hemiplegia patients tend to be highly dependent on their unaffected side during indoor and outdoor gait.

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Iwate Prefecture has the second largest area and the second lowest population density in Japan, therefore needing a system that can supply medical service efficiently. Although there are nine Secondary Medical Districts (SMD) and fourteen hospitals subject to the Diagnosis Procedure Combination (DPC hospitals) in Iwate, four of the DPC hospitals are concentrated in Morioka SMD, the biggest area and administrative center in Iwate, and the other areas have only a few DPC hospitals. To consider the whole concept of cancer care in Iwate, we analyzed lung, stomach, liver, colon, and breast cancer from DPC data published by the Ministry of Health, Labor and Welfare (MHLW). We analyzed the monthly number of patients and estimated the number of patients that each SMD and DPC hospital was capable of receiving, finding that the trend of consultation is different depending on the type of cancer. We consider that the DPC hospitals should think strategically about their functional compartmentalization, and that the local government should revise the regional health care planning.

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