Psychosomatic health conditions and the cost of care were examined in 22 families tendering the sick and provided with visiting nurse services. To evaluate the state of psychosomatic health and the cost of care, the General Health Questionnaire (GHQ) and the Cost of Care Index (CCI, Kosberg et al.) were used. The results of the GHQ showed that factors relating to somatic symptoms, anxiety and sleep disturbance, and social dysfunction are significantly correlated with calculated CCIs. However, activitis of daily living scores of the patients were not correlated with GHQ findings or CCIs. Also, there was no relationship between GHQ results and CCIs and duration of care or the types of care that givers. The GHQ results also revealed elements of social dysfunction in families of a single care giver are marked significantly higher than in those of two or more care givers. There was no correlation between subjects who were given welfare services and those who were not.
These data suggested that we should give more attention to the aspect of health and the cost of care in care givers.

This study was carried out to clarify the relationship between aggression and feelings of well-being in 37 patients with diabetes mellitus. They were 15 irritable and 22 non-irritable subjects. There were no differences between the two groups in glucose control and therapy. But the morale scale in irritable subjects was significantly lower than in non-irritable subjects (p≤0.0005).
We conclude that there may be a close relationship between anger and feeling of well-being in patient with diabetes mellitus.

We examined the relationship between the change to a type A behavior pattern and the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in subjects who work in T town communities.
A screening test was performed to determine which subjects had a type A behavior (Tagawa et al.). Between 1994 and 1995 there were 10 subjects in whom the pattern changed from type B2 to type A2 (Changed Group) and 11 subjects in whom the pattern stayed in type B2 (Unchanged Group).
The rate of change to type A score [(type A score in 1995-type A score in 1994)/type A score in 1994×100] was correlated with the rate of change in SBP [(SBP in 1995-SBP in 1994)/SBP in 1994] and DBP [(DBP in 1995-DBP in 1994)/DBP in 1994×100].
In the Changed Group, SBP and DBP levels in 1994 were significantly higher than those in 1995. However, in the Unchanged Group, there were no significant differences in SBP or DBP level between 1994 and 1995. Furthermore, there were no significant differences in SBP or DBP level between the Changed and Unchanged Groups in 1994 and 1995.
Our results suggest that type A behavior and blood pressure are closely related.

We investigated the relationship between obesity and lipids in elderly women in a rural area with primary hyperlipidemia after one year of follow-up. Thirty women aged 61 to 89 (mean age, 72.5 years) with primary hyperlipidemia were enrolled in this study. They were all given lipid-lowering dietary by a dietitian (s) and general physicians at the time of entry.
Total serum cholesterol (TCHO), high-density lipoprotein cholesterol (HDL-C), blood pressure and body mass index (BMI) did not change significantly over the past one year however, triglyceride level (TG) significantly decreased during the period. BMI at the time of enrollment was not significantly correlated with the reduction rate of TCHO or HDL-C, but was significantly correlated with the reduction rate of TG.
Thus, BMI may be useful as a predictor of TG change when only dietary therapy is given to eldery suburban women.

To determine the relationships among silent brain infarction (SBI), bone mineral density and milk consumption in elderly women, we studied 26 senile female outpatients with SBI in comparison with 18 age-matched controls.
There was a significant difference between the two groups in diastolic blood pressure (p<0.05), and a significantly larger number of individuals in the SBI group had a history of hypertension than in the control group (p<0.005). Bone mineral density at the ultradistal end of the radius tended to be lower in the SBI group than in the control group (0.05These finding indicated a close correlation between SBI and milk consumption habits in elderly women.

Objective: Bile duct tumor thrombosis in hepatocellular carcinoma (HCC) is a relatively rare event with a poor prognosis. Furthermore, bile duct tumor thrombus in HCC may be misdiagnosed when only imaging modalities are used. The efficiency of peroral cholangioscopy (POCS) in evaluating bile duct lesions has been reported.Patients: We present three cases of HCC with bile duct strictures in which POCS was performed as a preoperative evaluation.Results: In these three cases, diagnosing whether the lesion was a bile duct tumor thrombus on CT and endoscopic retrograde cholangiopancreatography was difficult. We performed POCS in three cases and were able to diagnose the presence of bile duct tumor thrombus of HCC, including differentiation from extrinsic compression of the bile duct.Conclusion: POCS for HCC with bile duct features is useful for the preoperative diagnosis of bile duct tumor thrombus, especially in cases where the surgical procedure depends on the presence of bile duct tumor thrombus.