Various problems associated with handling of autopsied human organs are discussed based on the results of questionnaires distributed to major hospitals in Gunma and adjacent prefectures. Organs were cremated in many hospitals, which is the most appropriate way of handling. However, formalin, designated as a poisonous chemical by law, was directly drained in many hospitals. We proposed a simple and effective method to neutralize formalin using lime (calcium hydroxide). Autopsy is encouraged to check the quality of medical care, and several autopsy cases are required for designation of training hospitals approved by the Ministry of Health and Welfare and for some medical associations. Various issues relating to autopsy should be also discussed among government officials and clinicians in addition to pathologists.

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Dilated cardiomyopathy (DCM) is defined echocardiographic analysis by a dilated left ventricle with globally reduced systolic function. Echocardiographic investigation of mitral and tricuspid regurgitation was made in patients with different stages of DCM. The purpose of this study was evaluated the grade of valvula regurgitation by echocardiographic analysis in 190 patients with DCM. The mean left ventricular end systolic dimension, mean left ventricular end diastolic dimension, and percent of mean left ventricular ejection fraction, were significantly (P <0.05) worse in nonsurvivors than insurvivors after 5 year observation. Although the grade of mitral and tricuspid regurgitation were significantly worse in nonsurvivors than in survivors, the regurgitation of aortic or pulmonary valuewere not different between the two groups. The regurgitation of mitral and tricuspid valve appears to be an important prognostic indicator for patients with DCM.

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CDP-diacylglycerol synthase (CDS) catalyzes the reaction of CTP and phosphatidic acid to form CDP-diacylglycerol and inorganic pyrophosphate. In this study, we isolated and sequenced a rat CDS clone that encodes an amino acid sequence highly homologous to the human CDS sequence. With the use of the cloned cDNA, we investigated the distribution of the mRNA in the adult rat central nervous system by in situ hybridization. The CDS transcript was widely distributed throughout the brain, although signal intensities were somewhat variable. The mRNA was moderately expressed in the mitral cell layer of the olfactory bulb, pirform cortex, neocortex layer V/VI, dentate gyrus, CAl-4 regions of hippocampus, Purkinje cell layer of the cerebellum, and dorsal root ganglion. In neocortex layers II/III and IV, amygdala, hypothalamus, and granule cells of the cerebellum were relatively few, but significant levels of the CDS transcript were observed. We also studied the developmental changes in the expression of the CDS mRNA in the olfactory bulb, hippocampus, cerebellum and spinal cord by the method of reverse transcription-polymerase chain reaction. Dramatic increases in the expression of the CDS mRNA were seen during the early stage of postnatal growth.

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Lower i.v. doses of vasoactive histamine-rgic, catecholamine-rgic, and choline-rgic drugs increased stimulus-reward learning during strong sustained static muscle work in squirrel monkeys. Conditioned response of microvasculature after i.v. drugs is considered to have an important role for the establishment of behavioral performance.

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Suicide death rates among prefectures in Japan or among municipalities in Gunma Prefecture differ from region to region. According to the mortality rates reported by Ministry Welfare, rate of death due to swiside increases with advancing age. The age adjusted suicide death rate of female aged 70 years was highest in Akita snd Gunma Prefectures. To clarify factors affecting suicide death rates, correlation coefficient and multiple regression analysis between suicide death rates and geographical features were investigated. Meteorological conditions and per capita annual income in males, and meteorological conditions and imcreased age in females were significantly associated with swicide death.
In Gunma Prefecture, advanced age was the main background to suicide death rate.

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Ninety two students enrolled in the liberal arts class “Stress and Health” were surveyed with informed consent to identify the level of stress of students at entrance to university. The questionnaire was composed of questions and open comments. The stressful events for them at entering university were entrance examination, extracurricular club activities and interpersonal relationship with friends. Five months later stressful events were friends, academic work and driving lessons. Correlation was r=-0.37 between self-esteem and burnout, r=-0.31 between burnout and the number of support persons.Burnout scores were higher among students in the School of Social Informatics than those in the School of Education (p < 0.05). Somatic symptoms related to stress were more prominent among students in the School of Education than those in the School of Engineering (p < 0.05).
The study revealed the level of stress the students experience in entering university and gave us insights into future student guidance.

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The purpose of this study was to find types of professional assistance needed by focusing on difficulties in daily living in relation to lesions of cerebrovascular diseases and by understanding the types of care given to disabled persons and their families at home. Ten care givers who belong to Stroke Support Groups in M City, Tokyo were interviewed. Classifying difficulties in daily living by the impairment and disability associated with cerebrovascular lesions allowed us to identify types of assistance the patients need. The classification included : 1) frontal lobe symptoms, declining spontaneity and memory disorders and related fabulation ; 2) left hemisphere symptoms, aphasia and cognitive disorders ; and 3) right hemisphere symptoms, left unilateral spatial neglect and agnosia. In home environment we have to view the difficulties the patients of cerebrovascular diseases and their families encounter from the perspective of daily living activities so that we can obtain more specific and concrete ideas on how they can be supported.
It can be concluded that the cerebrovascular patients and their families need sufficient information concerning challenges and difficulties in daily living caused by the impairment specific to the disease, especially by the impairment of higher brain. It is also necessary to provide specific instruction on how their daily living should be adapted.

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The purpose of this study was to understand expected daily living after hospital discharge of elderly patients of myocardial infarction and life style change after three months.
The subjects were 9 patients with first attack of myocardial infarction over 65 years of age. They were interviewed 3 times, at discharge 1 month and 3 months after discharge. The Index of Social Activities for the Elderly was measured before the onset of the diseases and 3 months after discharge from the hospital.
There were 5 categories of expected living conditions, cessation or reduction of life activities, review of life style and attitude, creation of new life style for recuperation, emergency response, and continuation of previous life activities.
The subjects' review of life style was affected by life activities and hobbies they had had before the onset of the disease, social role, ADL and age of the subjects.
ISAE in subjects who had expected to review their life activities was reduced from 13.7 to 7.6 and their level of satisfaction was low.
Whereassubjects who had expected to continue their previous life style showed no change in ISAE and a high level of satisfaction. Their scope of activities become wider than that before onset.

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The purposes of this study were to produce a Japanese version of Herth Hope Index (HHI) developed as a tool to assess hope and to evaluate its reliability and validity as a psychological measurement tool for Japanese elderly persons. HHI composed of 12 items were thus translated into Japanese and used to assess 87 elderly persons who visited a Welfare Center for the Aged. The internal consistency alpha coefficient was 0.86. Criterion-related construct validity was established by correlating the Japanese version of HHI to the revised PGC morale scale, r = 0.53 (P < 0.01). Factor analysis, however, did not give clear decomposition into 3 factors fitting to the conceptual model for scale development as in the case of the original HHI factor analysis. However the analysis allowed extraction of two factors, (1) sense of relatedness and emotions in the hoping process and (2) self-confidence positive readiness and expectancy to hope. This was considered to reflect the characteristics associated with aging of the subjects. The scale was found to be reliable and valid and to be applicable to surveys of elderly persons.

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A 65-year-old woman noted a lump in her left breast, although fine needle aspiration cytology showed no carcinoma cells in the serous yellow fluid of the lump. Excisional biopsy revealed intracystic papillary carcinoma with a small invasion to the stroma in the cyst wall. Breast conserving surgery with irradiation to the residual breast tissue was performed. Intracystic carcinoma of the breast is a rare form of breast disease. An oval-shaped shadow with a partially irregular margin in the mammogram and cystic mass with an irregular inner wall in the echogram suggest a higher probability of this disease. Excisional biopsy is required for a pathological diagnosis prior to an appropriate treatment. Due to the generally favorable prognosis and unlikely chance of metastasis, breast conserving surgery is the proper treatment for the disease.

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A 66-year-old woman with an autonomously functioning thyroid nodule (AFTN) showed low serum levels of triiodothyronine (T₃) and no response of thyroid stimulating hormone (TSH) to thyrotropin releasing hormone (TRH). After administration of methimazole, TSH level increased from 0.1 to 19μ/U/ml. After surgical removal of the thyroid nodule, both TSH and T₃ levels increased to normal and the response of TSH to TRH stimulation became normal. These findings suggest that the AFTN may be associated with low T₃ concentrations and that certain substances released by the AFTN may be responsible for the inhibition of pituitary TSH response to TRH stimulation.

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