Using the method specified in the WHO-MONICA Project, we monitored the incidence of myocardial infarction (MI) in the Saku district. When it comes to the trends over a period of 10 years from 1989, we did not observe significant changes, nor did we witness an increase in the incidence, which is ascribable to the aging of population. The average age of women with MI remained unchanged, whereas there were signs of a slight rise for men. Sudden death is more likely to occur in patients with the severest case of MI, so that community based studies in which the local public health center takes the lead are required to come to grips with the full particulars. In the meantime, there is the need for studies in which whether farm workers are involved is spotlighted, and it would be significant if the trends in MI mortality and morbidity in the farming populace were taken up as a research theme for our Association.

A China-Japan joint project was carried out to study the incidence of fluorosis caused by coal burning in China from 1995 to 1997.
The health survey covered a control area and two flourosis areas. In those research areas, drinking water was not polluted with fluorides. The survey was designed to analyze the health status of people exposed to fluorides and evaluate the relationships between the dose and incidence of fluorosis. The concentration of airborne pollutants in both indoor and outdoor air was measured. The concentration of fluoride in the urine was analyzed and definite diagnoses for dental fluorosis and skeletal fluorosis were determined.
As a result, the incidence of coal burning fluorosis was confirmed in studied areas. Moreover, the fluorosis was caused not only by the direct inhalation of the airbone fluorides in indoor air but also by the intake of cereals polluted with fluorides. Fluoride was contained in both coal and soil. Therefore the mixture of coal and soil used for the adjustment of fire energy contributed to the air pollution to a great extent. The typical polluted crops were red pepper, corn and potato. An extremely high concentration of fluoride in the urine of residents in the polluted areas was detected.

Background/Aims: Detailed evaluations of overlapping constipation and gastroesophageal reflux disease (GERD) have not been conducted in Japan. The REACTION-J2 study examined the overlap of these diseases in Japan. Methods: This internet-based survey recruited participants from general public survey panels. Questions included demographic and medical data and assessments based on validated measures for constipation and GERD. Associations between background factors affecting constipation/GERD overlap, disease measures, and treatment were also evaluated. Results: Among 10 000 survey responses received, functional constipation (Rome IV diagnostic criteria) was reported by 439 participants; chronic constipation (Japanese guidelines) by 3804 participants; and subjective constipation symptoms by 2563 participants. The number of participants with constipation/GERD overlap ranged from 73 to 1533 depending on the criteria used. Regardless of the definition used, all GERD groups had significantly higher odds of being constipated than non-GERD participants: the OR (95% CI) for all 9 combinations of definitions ranged between 1.56 (1.21, 2.01) and 2.67 (2.44, 2.92) (all P ≤ 0.001). Straining, hard stools, and sensations of incomplete evacuation and anorectal obstruction/blockage, according to chronic constipation criteria, were common.Participants with constipation/GERD overlap had poorer quality of life (P < 0.001) and worse GERD symptom scores (P < 0.001). The frequency of abnormal stools was highest (P < 0.001) in the constipation/GERD overlap group. In the overlap group, 52.4% and 26.0% used gastric and constipation medication, respectively. Conclusion Individuals with constipation/GERD overlap tend to have worsened symptoms and quality of life.

Background/Aims: Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population. Methods: This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor).Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors. Results: The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (allP < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep. Conclusions Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.

Background/Aims: Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population. Methods: This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor).Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors. Results: The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (allP < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep. Conclusions Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.

Background: A 30-60 min rest after exercising is generally recommended before taking a bath. Although this was considered an appropriate bathing method, effects of pre-bath rest on recovery from exercise fatigue remain unclear. Here, we aimed to examine the effects on fatigue recovery of pre-bath rest after a workload, with the focus on changes in lactic acid levels. Methods and Results: Ten healthy adult men increased their blood lactic acid levels through a treadmill workload performed in accordance with the Bruce method, then took either a 60-min post-workload rest followed by a 10-min full-immersion 38°C bath (Experiment A) or a 10-min full-immersion 38°C bath followed by a 60-min rest (Experiment B). Body temperature, blood pressure, pulse rate, and blood lactic acid level were measured at three time points: before workload (Test 1), after workload (Test 2), and after bathing/resting (Test 3). Decreases and percent decreases in blood lactic acid levels were calculated by comparing Test 3 results with Test 2 results. These calculated values and the measured values in three tests were compared between Experiment A and Experiment B using paired-t test. There were no significant differences in maximum systolic blood pressure, maximum diastolic blood pressure, maximum workload attained, and maximum pulse rate measurements between Experiment A and Experiment B. Differences in systolic blood pressure and diastolic blood pressure measurements in Tests 1, 2, and 3 were not significant. The pulse rates measured at the final measurement (Test 3) were significantly higher in Experiment A than in Experiment B (90.4 ± 18.2 bpm vs 79.6 ± 11.6 bpm, p = 0.04). No significant differences were observed in other measurement timings. The body temperature measurements at the final measurement were slightly higher in Experiment A than in Experiment B (36.4 ± 0.4 vs 36.1 ± 0.3°C, p = 0.05). No significant differences were observed in other measurements. Blood lactic acid levels before workload (Test 1) were significantly higher in Experiment A (6.6 ± 4.7mmol/L) than in Experiment B (2.0 ± 1.4 mmol/L, p = 0.02), but those at other measurement points (Test 2 and Test 3) were similar. Neither decreases nor percentage decreases in blood lactic acid levels differed between Experiment A and Experiment B. Conclusions: Resting before a post-exercise bath did not change the decreases or percent decreases in blood lactic acid levels after bathing at 38°C, suggesting negligible effects of pre-bath resting on recovery from exercise fatigue.