We reviewed a total of 23 cases of multiple myeloma that were treated in our hospital during the six-year period between January 1978 and December 1983. It was found that the majority of the multiple myeloma patients (52.2%) had complained of pain in the lumbar spine area when they visited our office. It was also made clear that it had taken considerably long before definitive diagnosis for those patients with low back pain when compared with the patients with other complaints.
Furthermore, we went over the results of some of the routine tests conducted at their first visits. These tests are often included in the mass health screening program.
We found that ZTT levels were abnormal in 90.9% of the multiple myeloma patients, Ch-E in 82.6% and A/G ratio in 73.9%.
These resuits suggest that doctors should suspect multiple myeloma and indicate further examinations when ZTT values were found abnormally high or low among elderly people complaining of low back pain by clinial or mass health examination.

The Ibaraki Prefectural University of Health Sciences has introduced an integrated education management system to improve the quality of education. The management system was implemented by the Academic Affairs Committee and is run by the newly-created Kyouiku Suishin Shitsu (Educational Development Services). The management system evaluated past curricula and coordinated the introduction of new courses and integrated curricula designed to stimulate selflearning by students. The management system also integrated the student evaluation system and simultaneously coordinated faculty development workshops for all university staff to improve teaching skills. Several questionnaires showed that the new curricula met students' learning needs and provided a more objective evaluation system. The integrated education management system functions as a positive component in the improvement of the education system for students of allied health professions.