Attitudes toward ill-health associated with the workplace are inevitably closely linked to attitudes toward disease occurring generally, and these have evolved remarkably slowly since the Middle Ages. By the nineteenth century in western countries, at least, people considered disease as a retribution for sins against God, or as a result of bad luck. Certainly this attitude was a factor in why the advent of the germ theory was followed only very slowly by measures aimed at preventing infections brought about from water, food, or airborne sources, even when methods for doing so were well understood. Today, attention is directed toward chronic degenerative diseases and cancer, with their long periods of development, and preventive approaches to these diseases are similarly slow to be applied. In part because the U. S. A. is a relatively young country, with a rapid influx of immigrant labor in this century, the contribution of occupations to injury, ill health and disease has been too seldom recognized. Doctors or nurses working in industries have usually focussed their attention on traditional health care techniques. In the U. S. A there has recently been, however, a change, at least by ordinary citizens, toward recognizing the importance of prevention of disease. In the context of work-related illness, this recognition has been accelerated by recent legislation which makes employers legally responsible for detecting adverse effects on health of workers and the general public arising from their operations. Paradoxically the Occupational Safety and Health Act of 1970 has been less effective in bringing about a change of awareness of occupational disease than has the Toxic Substances Control Act of 1977. As a result of well-publicized situations in which serious effects of new chemical agents on workers have been discovered, the public and its representatives have led the way in these changes. But attitudes toward workplace diseases and injuries have been slow to change, as it is commonly said that worker protection is in conflict with economic viability of industries. Nevertheless, at least in large companies managers have recognized their vulnerability to huge compensation losses, and the role of occupational health professionals has become much more significant. Social, political and economic forces still act to delay application of knowledge of occupational disease causation and prevention of workplace diseases and injuries.

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It is difficult to examine the physical strength of patients with rheumatoid arthritis (RA). The graded exercise testing by bicycle ergometer was used for RA patients. The following factors were measured: 1) lactic acid in blood, 2) heart rate, 3) blood pressure and 4) expired gas analysis. Generally speaking, the index of physical strength of healthy human beings is attributed to the maximum oxygen consumption, aerobic threshold or anaerobic threshold Although none of the nine patients' maximum oxygen consumption was able to be measured, three patients' anaerobic threshold and seven patients' aerobic threshold were measured. In this series the results suggested that aerobic threshold was useful as an index for physical strength Three of the nine patients were treated by kinesitherapy at the aerobic threshold work load using a bicycle ergometer. The effect of kinesitherapy is discussed.

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We studied the irreversible change of myocardium on coronary artery occlusion using mongrel dogs. These dogs were divided into 2 groups. One group was administered CoQ₁₀ before and after coronary artery occlusion and the other received placebo. Results are summarized as follows. 1) In both groups the hemodynamic change showed no significant change. 2) In the biochemical studies there was no significant difference between both groups, but in the infarction group, serum GPT and pyruvic acid in a sampling of blood taken from the coronary sinus were significantly higher than in the non-infarction group (Ρ<0.05, 0.025). 3) By the triphenyl tetrazolium chloride (TTC) technique for the myocardial infarction, infarction did not apear in the CoQ₁₀ group until 90 minutes after coronary occlusion but in the placebo group infarction appeared as early as 60 minutes. 4) In the ultrastructural studies of myocardium the electron microscopy detected irreversible change of mitochondrias when the TTC technique identified infarction. In conclusion, the administration of CoQ₁₀ has a protective effect for the irreversible change of ischemic myocardium.

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The purpose of this study is to demonstrate renal injuries by gold sodium thiomalate (G) with ultrastructual changes and gold deposition in kidney tissue using X-ray energy dispersive analysis (XEDA). Twenty-five mg of G containing 12.1 mg of Au was injected into rats intraperitoneally. The rats were divided into 5 groups. Group 1 was sacrificed 6 hours after the injection of G, and group 2 after 24 hours, group 3 after 72 hours and group 4 after 144 hours. Group 5 consisted of the control-rats which were provided with injections of saline. Gold contents in kidneys, liver, lungs and spleen were measured using the flameless atomic absorption method. XEDA was also performed in order to confirm the gold deposition in tissue. Among the organs, only the kidney showed remarkable changes with increased weight. Group 1 already showed marked azotemia which reached to the maximum level in group 3. The amount of gold content in the organs did not change significantly in spite of a marked reduction of serum gold concentration among the 4 groups. Histological examinations revealed marked degeneration and necrosis of pars recta in proximal tubules, although no prominent abnormalities of glomeruli could be observed. Using an electron microscope, many electron dense particles in lysosome were noticed, mainly in proximal tubules. We also found these particles in lysosome of glomerular epithelial cells. Using XEDA, these electron dense particles were demonstrated to be gold, since characteristic energy of gold was found. In conclusion, (1) the kidney was shown to be the most accumulative organ of gold. (2) G caused acute extensive necrosis of proximal tubules. (3) Gold was demonstrated as electron dense particles in lysosomes mainly in proximal tubules, but also partly in glomeruli. (4) Therefore, it was confirmed that a large amount of G had a strong nephrotoxic effect in rats.

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When radioacitivities of doubly-labeled phospholipids adsorbed on silica gel are measured by the liquid-scintilation method, because of the shift of the β-ray spectrum, the counts of radiation from higher-energy nuclide are included in the measurement in the lower-energy level channel. This phenomenon is not able to be detected by the external standard ratio (ESR) method. To overcome this problem, the phospholipid was eluted by suspending the phospholipid-adsorbed silica gel in a commercial detergent-containing liquid scintilator, to which one-tenth of water was added. Complete elution required 3 days for a commercial "hard" silica gel plate and 1 or 2 hr for "soft" silica gel plates, The "soft" silica gel plates were not suitable for separating phospholipids containing the diester or diether form of phosphatidylserine because those lipids showed anomolous behavior on the plates.

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Study was made on the distribution pattern of Austropeplea ollula, a snail, as intermediate host of dermatitis-producing cercaria of avian schistosome. Distribution was analyzed for 3 populations of the host snail, i.e., 1) overwintering population found in rice stubbles in dried rice field, 2) large snail population which grew after overwintering in the rice stubbles, and 3) small snail population newly produced by the large snails in early summer. All the 3 populations were distributed not randomly but unevenly following the negative binomial distribution model. The degree of unevenness was large in the order of newly born > overwintering > large snail populations. Judging from the above distribution pattern and degree of unevenness, the over-wintering population seemed to leave the rice stubbles in the following spring, and to spread out to the periphery of the rice field after maturing and laying eggs around the central part of the paddy. Small snails born in autumn were thought to survive winter in dried rice fields by crawling into underground rice stubbles at watery places. Surface soil including more fine sand was proven to be moister than that with less fine sand.

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The existences of doublets (twin primes), triplets and quadruplets of prime numbers are well known. In this report multiplets are treated in a more general way, The multiplets are n primes (k, k+2, k+6, k+8, k+12, ･･･) corresponding to (11, 13, 17, 19, 23, ･･･). It can be shown easily that in certain cases some kinds of multiplets possibly exist. In fact some examples of multiplets have been found. For example, except in the trivial case of k=11, only two décuplets (k=33081664151 and k=83122625471) exist for values of k less than 2×10¹¹. But it is an unsolved problem whether multiplets of n primes exist or not for any n.

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The purpose of this study is to analyse the cause of itching and explore the relationships between pruritus senilis and various stimuli. Sample of 132 men and 238 women with ages ranging from 60 to 96 years were used in our study. Pruritus senilis is not significantly related to cosmetics and soap. Nevertheless, statistically significant correlations were found between pruritus senilis and physical stimuli (e. g., warmth, coldness, dryness). These observations could suggest that pruritus senilis is caused by changes of temperature.

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The echographic characteristics and ultrasonic tissue characterization of malignant lymphoma are reported. The patient was a 72-year-old man with stage IV malignant lymphoma of medium cell type and had lymphomatous involvements in the liver, the spleen, and peripancreatic, para-aortic, hepatic and splenic hilar lymph nodes. The echo-characteristics were hypoechoic in nature in ail these involved lesions and the histologic specimen at the border between the lymphoma lesion and the liver was examined as well as the peripancreatic lymph node from the viewpoint of the ultrasonic tissue characterization. It was concluded that the rich cellularity in the homogeneous nature when compared with the surrounding structure, can produce hypoechoic lesion in routine clinical echograms.

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Bronchial mucosal biopsy is considered to be a useful procedure for the diagnosis of sarcoidosis in Europe and the USA. However, bronchial involvement of sarcoidosis has seldom been reported in Japan. We report an interesting case of sarcoidosis with marked bronchial changes. A 40-year-old symptom free woman visited our hospital to seek a diagnosis concerning a diffuse reticulonodular shadow in her chest X-ray film. Bronchofiberscopy showed multiple nodules, yellow white plaques and hypervascularity of the thickened edematous mucosa with severe stenosis and deformity of the lober or segmental bronchi. Bronchial mucosal biopsy as well as TBLB revealed typical non-caseating epithelioid granulomas. A pulmonary function test showed restrictive ventilatory disturbance with impaired diffusing capacity and small airway dysfunction. After corticosteroid therapy, bronchial mucosal changes disappeared and chest radiological and pulmonary function abnormalities were improved. After reviewing the bron-chofiberscopic findings of 11 cases of sarcoidosis, we found bronchial mucosal changes in 8 cases. Bronchial mucosal biopsy should be regarded as an important procedure for the diagnosis of sarcoidosis.

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A 46-year-old woman was admitted to our hospital because of fever of unknown origin. Her fever continued with a daily rise to around 38℃ to 40℃ for more than six months, occasionally accompanied by polyarthralgia, erythematous rash and cervical lymphadenopathy. The erythrocyte sedimentation rate was 75 mm per hour and CRP was over 6+. The white-cell count was 15,100 with 21 percent band forms and the α₂-globulin was 18.8 percent of total protein. The tests for autoantibodies were negative. Clinical course and laboratory findings in this case were most compatible with adult Still's disease. A radionucleotide bone scan with ^99mTc showed a greatly increased uptake of the radionucleotide at the large joints of the whole body, and a gallium scan also revealed accumulation of the radionucleotide at the bone marrow of the sternum. These findings were recognized during high fever and disappeared when the body temperature returned to normal. These examinations might be useful for investigating the active site of inflammation and for studying the pathogenesis of adult Still's disease.

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In this review, only studies conducted under natural desert conditions have been examined. In desert heat, sweat "fatigue" was not evident even when the duration of the experiment was 5-hr. Total body sweat rate is not affected by dehydration, drinking water or electrolyte solutions, nor by age or race. However, men had a higher sweat rate than women working at the same percentage of aerobic capacity. The volume of water consumed to satisfy thirst is closely correlated with concentration of electrolytes, i. e. NaCI, in sweat. Prevention of hypohydration during desert walks may be achieved if body water loss does not exceed 1.5% per hr by instructing the individual to drink periodically (every 10-15 minutes) an amount of salt solution that balances his salt and water losses in sweat. If body water loss exceeds 3%, water and/or salt replenishments may reduce hypohydration no more than 50%.

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Mass screening for cancer of the uterine cervix was performed mainly in a screening car or by a gynecological practitioner in Fukuoka Prefecture. In 1983, 114,000 women were screened for cervix cancer, and 102 cervix cancers were detected. Cytology activity index was 110. To reduce deaths from cervix cancer, 400,000 women should be screened by cytology Detection of cancer in the population with abnormal cytology was not satisfactory in some departments. The gynecologists in these departments should be trained for colposcopic practice. The training of cytotechnologists is also necessary for the elimination of false negative cytology. These trainings are now being done under the law of health for the elderly.

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The doctor-patient relationship is one of the central problems of medical ethics. Whenever a physician while examining his patient, reflects on his attitude towards him, he realizes there is a difference between his true feelings and those he shows to the patient, or between his scientific and humanistic attitudes His attempt to be thouroughly humanistic is frustrated by the fact that he can never feel the same pain as the one he is treating. The doctor should realize that his only possible way of showing human love in his daily practice is to become good friends with his patients, while at the same time keeping a minimal distance. If the doctor does not keep this distance, grief, which may hinder his work, is inevitable. Ancient Greeks called this kind of love "philia" (friendliness).From the social point of view, the physician's dominance over the patient in the U. S. A. has been replaced by patient's rights. Last year a declaration of the patient's rights was also drawn up in Japan. However, the direct importing of current tendencies in foreign countries will prove to be premature because our national character is dominated by the feeling of "Amae" (dependency). To overcome this feeling of "Amae", the ideal doctor-patient relationship in Japan should be one where both parties strive for an equal, adult relationship based on a high respect for each other's unique individuality.

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