BACKGROUND: Japanese family physicians have limited psychiatric training, see a large volume of patients, and would benefit from the use of a mental-health screening tool. This study was an initial investigation into the feasibility and validity of using the Patient Health Questionnaire (PHQ) in the primary care setting in Japan.
METHODS: Feasibility was determined by surveying 149 patients from three primary care practices. Of this sample, a Japanese psychiatrist interviewed 98 participants to assess the validity of the PHQ. Based on the psychiatrist's results, sensitivity, specificity, positive predictive value, kappa statistic and the Likelihood Ratio were examined.
RESULTS: Some 83% of patients reported being “comfortable” in filling out the PHQ. Physicians (82%) reported that the information provided was “valuable” in understanding and treating the patient. The sensitivity of the PHQ in detecting any mental diagnosis was 93%, specificity was 81%, and the positive predictive value was 47%. In subjects with mood disorders, sensitivity was 75%, specificity was 88%, and the positive predictive value was 47%. The kappa reliability coefficients between the PHQ and psychiatrist diagnoses were 0.53 for any mental disorder and 0.51 for any mood disorder. In the case of any mental disorder, the Likelihood Ratio of a positive test (LR+) for the PHQ was 4.8. In the case of any mood disorder, the LR+ for the PHQ was 6.5.
CONCLUSIONS: The Japanese version of the PHQ was useful for detecting mental and mood disorders.

To demonstrate delayed neuro-toxicity of organophosphate, we administered 13 types of organophosphorous pesticide to hens. Initially, a screening test was performed with nine varieties of the chemical product. Later, four types were given to the fowls. Those hens dosed with S-Seven and Surecide developed ataxia and other neurophatic symptoms in the lower limbs.
After 50 days of observation, all the hens were killed and anatomized. Phathohistological examination revealed various changes in the hens that developed neuropathic symptoms: atrophy, diminution and disappearance of nerve cells in the anterior horn of the spinal cord ; edematous changes in the myelin; swelling of the neuroglia ; atrophy and vaculolar degeneration of liver cells; and necrobiosis of nepaticlobures.
It was found that these changes are closely related with the development of ataxia and doses of the chemical.
It was also found that the pathotistological changes occurred to a less extent in those hens which did not develop toxicoses.

We investigated the content of NO₃-N in the well water of the eastern, middle and nothern districts of Nagano Prefecture. The NO₃-N content seasonally changes and takes on the pattern of a high in summer and a low in winter.
Rain is considered to dilute the contaminated well water, but it lets NO₃-N flow from the soil into the.well water, when the rain is poured by a typhoon. As a result, a high content of NO₃-N is measured in the well water.
The water sample of 25 out of 85 wells in Matsukawa Town exceeded the tolerance level of NO₃-N (10 ppm, but 44.3 ppm in terms of NO₃^-).
By crop area, the amount of NO₃-N was highest in the fruitgrowing area, which was followed in order of the vegetable-growing area, the flower-growing and the rice planting area.
We consider that the contamination of well water is caused both by chemical fertilizers and the less absorbility of the soil.

A survey was conducted on 117 agricultural cooperatives and 121 city, town and village offices in Nagano Prefecture to find out how they provide health care to the population. The following is a summary of the findigs of the questionnaire survey based on interviews.
1. Collaboration between agricultural co-ops and local public offices in health control activities has become closer. Nearly half of the agricultural co-ops plan and implement health screening programs jointly with city, town and village authorities. One of the favorable effects of the joint undertaking manifests itself in the form of improvement in the ratio of participants to the total populace. The average percentage of participation in the joint programs comes at 48.8% as against the prefectural average of some 22%. Moreover, the joint efforts bring about the desired effect on the implementation of after-screening guidance and other health promotion programs.
2. Of local health leaders, 87.2% said that they keep in contact with each other. Those who meet once in every one to three months account for 24.8% of the total. In the areas where health leaders have liaison meetings regularly, it is noted that there is close cooperation between medical insitutions and various health-related organizations, resulting in a marked improvement in the percentage of participation in health screenings. It is also noted that there is overall improvement in the attitude toward health control.
3. As regards the participation of inhabitants in health control activities, the women's, the young men's and the producers' associations have representatives to the health control promotion council of the agricultural cooperative in each region. Of the three associations, the women's association is the most enthusiastic with the participation ratio of 55.4%. Meanwhile, 67.8% of the agricultural co-ops send their representatives to the health promotion council of each municipal body. More representatives of agricultural co-ops and inhabitants should take part in the council in the interest of people's well-being.

[Objective]Mie University Hospital Department of Anesthesiology established an integrated acupuncture care clinic in April 2010. A total of 8 incidents and accidents occurred during a period of eight months from commencement in April through November of 2010.
Re-examination of the issues from the incident and accident reports, led to the creation of a clinical manual for the acupuncture clinic as a means to improve the safety of the acupuncture clinic.
[Methods]Based on the contents of the reported incidents, which were collected from electronic medical records up to November 1st 2010, a safety manual was created for the prevention of recurring incidents and accidents. Following a request for approval to the Safety Division of Mie University Hospital, the safety manual underwent screening and inspection and was eventually approved.
After the introduction of the manual, the occurrence of incidents and accidents, was tracked using electronic medical records for a period of four months from December 2010 to March 2011.
[Results]The incidents and accidents that occurred before the creation of the manual were all related to acupuncture (dropped acupuncture needles: 5, needles taken home: 1, and leaving needles inserted: 2). Incidents and accidents have not been reported since the introduction of the manual, that is, for a period of four months from December 2010 to March 2011.
[Conclusion]Clinical practice based on the manual suggests the possibility of preventing incidents and accidents, as none have been reported since the introduction of the manual. The safety manual is still incomplete, as it emphasizes mainly the management of acupuncture and not its entire context. If any further negative incidents or accidents occur, a review and improvement of the present manual will be required. In order to deal with any new negative incidents or accidents, organizing a team will be indispensable.
Since Mie University Hospital has an established Safety Division, soliciting the cooperation of the infectious disease control and medical safety experts to ensure safe clinical practices in the acupuncture core clinic should also be arranged.
The results suggest that the creation of a safety manual can be a means of preventing the occurrence of incidents and accidents.

An 83-year-old man had acute type B aortic dissection combined with a large athelosclerotic abdominal aortic aneurysm (AAA) over 8cm in diameter. The dissection advanced into the wall of the AAA. The patient was treated with strict medical therapy for two months and successfully underwent an early elective abdominal aortic repair concomitant with off-pump aortocoronary bypass grafting. This strategy of meticulous medical management may improve clinical outcome for the acute phase in such rare cases.

Two hundred and thirty adipose tissues were collected from inpatients, who had undergone an operation and an autopsy in the Saku Central Hospital from 1980 to 1982. Organochlorine pesticides were extracted from the adipose tissues and determined by gas-liquid chromatography with an electron-capture detector.
The mean value was 1, 429 ppm for total BHC among males, and 1.665 ppm among females, 4.893 ppm and 3.791 ppm for total DDT, 1.082 ppm and 0.782 ppm for PCB, respectively. Regression analysis between the total BHC residue and the ages of patients indicated a positive correlation for both sexs. As for the relation between the rate of obesity and the residues, low rates of obesity (-10%--19%) were most significantly correlated with high values of total BHC, total DDT and PCB.
We also discussed relations between cancerous diseases and the residues.

Over the past eight years, small doses of an organophosphorous insecticide known in Japan as Sumithion (fenitrothion) have been administered weekly to rehsus monkeys and beagles. In this report, the results obtained during the past three years are discussed.
During the period, two monkeys and one hound died. Pathohistological examination revealed degeneration and disappearance-regeneration of liver tissues, edema of oculomotor muscle stomas, spinal cords and oculomotorius nerve fibers, and atrophy of limph nodes. These are considered the effects of the insecticide.
The surviving animals did not develop any abnormal changes or signs associated with Sumithion-induced disorders. Weight loss was not observed. Routine blood tests were negative. However, serum chemical analyses conducted in the seventh year showed that there are statistically significant differences in GPT, LDH and cholinestrase activity among the animals.

Paraquat is one the most popular herbicides in agriculture in Japan. To study the chronic toxicological effects of paraquat on animals, rats were fed a paraquat-containing diet for 1 year and 2 months (1, 5, 25mg/kg of body weight/day). Paraquat administration induced serious histochemical changes in various organs, such as the lung, heart, kidney and liver in rast. Pulmonary fibrosis occurred in the group of rats given 1mg paraquat/kg of body weight/day in diet.
The alkaline phosphatase activity and creatinine content in the blood serum significantly increased. The concentrations of cholesterol, triglyceride and phospholipid in the serum decreased significantly.
A significant increase of lipid peroxidation was observed in the brain, kidney and liver.

Many researchers report that cigarette smoking by parents adversely affects their children. We carried out a survey about cigarette puffing by distributing questionnaires to mothers of sucklings and little children. The survey found that mothers and family members were not well aware of the health consequences of passive smoking. It was also found that children frequently exposed to smoking are at high risk of contracting infections of the respiratory tract. The average weight at birth was less in babies borned by smoking mothers than by those who do not smoke. Furthermore, it was revealed that a larger number of smoking mothers had given birth to low birth weight infants than nonsmoking mothers had.
These findings suggested that passive cigarette smoking is linked to low birth weight and respiratory tract infection. We think it is incumbent on us, health-care professionals, to bring home to mothers and the rest of the family members how serious the consequences of passive smoking are.