A 47-year-old man, having undergone mitral valve replacement in another hospital 9 years ago, suffered from sudden dyspnea and was transferred to our hospital immediately. On admission, disturbance of consciousness, severe dyspnea, marked hypotension (60/40) and hypo-oxygenation were noted. Under assisted ventilation with endotracheal intubation, diagnosis was confirmed by chest X-ray. The patient was transferred to the operation room after initiation of percutaneous cardiopulmonary support (PCPS). The emergency re-operation was started 7 hours after the onset of the symptoms. Left atriotomy was performed following total cardiopulmonary bypass and cardioplegic solution infusion. The pyrolite disc and the minor strut were missing and could not be found in the cardiac cavity. The fractured prosthesis was removed and replaced with a 29mm Carbomedics prosthesis. He was weaned from cardiopulmonary bypass with large doses of pressor amines. The disc and the strut were removed from the abdominal aorta and right deep femoral artery respectively 4 weeks after re-MVR surgery. The patient was discharged after 8 weeks' admission, and has been doing well so far. Although it is obvious that prompt diagnosis and early operation to replace the fractured prosthesis are essential for patient survival, percutaneous cardio-pulmonary support is helpful to maintain patient's hemodynamics during rediagnosis and preparation for surgery.

The amount of pesticide residues in the soil was investigated in two fields. About 0.05-0.14μg/g-dry of fungicide procymidone (Sumirex^TM) were detected from the soil, where fuming with procymidone had been ceased for about a year.
Measurements have been carried out for the subsequent three years with the result that the second half-life of procymidone in the soil was estimated at about 1.5 years.
Procymidone residues ranging from 0.005 to 0.017μg/g-raw were detected in the vegetables grown in these fields, but not in strawberries.
These data suggested that procymidone falls under the category of long-lived organo-chlorine pesticides.
It is necessary to study further on the environmental behavior and the toxity of procymidone, as procymidone residues in foodstuffs are reported repeatedly and the chemical is still on the market.

The'Toyonoka' variety increased rapidly in the market of strawberry in southwest Japan. But this variety has no resistance to powdery mildew (Sphaerotheca hurnuli), and the farmers are at their wit's end, not knowing how to control the fungi.
Multi-residue analytical method was established for 3 dicarboximides (vinclozolin, procymidone and iprodione) and 7 fungicides to control powdery mildew (triadimefon, pyrifenox, chinomethionate, fenarimol, myclobutanil, bitertanol and triflumizole). The recovery rates of 13 chemicals were 76-93%, and detection limits were below 0.01μg/g-raw with HPLC-DAD and GC-ECD.
Nine fungicides except vinclozolin were detected in strawberries on the market, and 12 chemicals detected were qualified with HPLC-DAD and GC-MS. All the detected cases were below the maximum residue levels in Japan.
Dicarboximides were detected 60-70% of strawberry samples both in ‘Toyonoka’ and ‘Nyohou’. On the other hand, the fungicides to control powdery mildew were detected often and complexly in ‘Toyonoka’ than ‘Nyohou’. It is necessary to consider to exchange the 'Toyonoka' variety for more tolerant one to control powdery mildew.

A regional care system for ill or disabled elderly people, with a non-governmental general hospital playing a central role in providing health and medical services, was investigated in a rural area. In the southern part of Oita City, the Hetsugi Hospital is such a central medical institution. Attached to the hospital, there are the geriatric intermediate care facilities and the home-care service unit for the elederly with two full-time nurses. Organizationally independent, the hospital, the health facilities and the home-care service unit are united in their efforts to deliver comprehensive services ranging from emergency service to home health care. As a result of improvements in residential and home care activities, the average number of days the elderly patients spent in the hospital has decreased by some 10 days in the past 7 years. Our survey also found that most of the old people andtheir families are satisfied with day health-care services provided to them. In a rural setting where health, medical and welfare resources are wanting, we considered, the system in this region could serve as a model for the practical and effective care system for the disabled elederly.

While the importance of domestic agriculture is stressed, Japan's imports of agricultural products are increasing year by year. From the standpoint of public health, what matters most is pesticide residues in imported agricultural products, in particular, the residues of chemicals applied after harvest for long-distance transport and long-term conservation.
Recentv, we have completed a simultaneous analytical method to detect two sprout inhibitors-maleic hydrazide and chlorpropham-in potato chips. The recovery rates and detection limits of maleic hydrazide and chlorpropham by this method were worked out at 81±5, 79±4%, 0.1, 0.01μg/g-raw, respectively.
A residue survey was carried out in potato chips on the market. The detection rate of maleic hydrazide was 25% with the maximum amount of 0.3μg/g-raw. The detection rate of chlorpropham was 45% with the maximum amount of 0.11μg/g-raw.