Today, rural communities in Japan are on the brink of a ruin, and the rapidly deteriorating social conditions there have exerted a harmful influence on the health of farmers.
During the work for protecting health of the inhabitants in a village of Ehime Prefecture, it was noticed that a considerably low level of community health has reflected on the high frequency of anemia.
It is noteworthy that most of the anemic cases result from overwork and unbalanced nutrition caused by poverty.
In our last investigation on 1389 inhabitants, anemia was found in 28.0% of the male adults, 25.7% of the female adults, 40% of the old people. The mean hemoglobin level was 14.58±1.63 in the male adults, and 12.57±1.51 in the female adults.
It is urgently necessary to take effective measures to correct the situation.
As causal factors, we can enumerate distorted dietary life, overwork, and physiological phenomena peculiar to women, such as pregnancy and delivery, in the case of women; and overwork, a general decline of bone marrow functions, and the secondary anemia caused by other diseases in the case of old people. The establishment of a system of community health control is needed more than anything else.

An examination of anemia has been carried out for 466 pupils of Aiji Elementary School and Aiji Lower Secondary School in Hiromicho, Ehime Prefecture.
The cases of anemia became more and more frequent as the age of the pupils advanced, and this, we think, is closely connected with the distorted dietary life which is forced upon the people in rural areas in Japan by the repid change of living conditions there.
For measures to counter the frequent occurrence of anemia among pupils it is most important to establish a close cooperation between the school health protection and the community health protection and to pursue the community program of health protection.

In the present study, we undertook the annual investigation on health conditions of aged bedridden patients at home from 1971 to 1979 in Hiromi Cho, Ehime Prefecture.
The incidence rate of bedridden patients in 1971 was 3.7 % in the population of 65 years old and over, and 0.499 % in the population of Hiromi Cho. Paticularly, the latter rate was very higher than that in urban areas. The bedridden patients had been caused by apoplexy, senility, loss of eyesight, fracture and rheumatoid arthritis. 66.7 % of bed rest were caused by apoplexy. The bedridden age was 70.1±7.1 years in men, 71.2±11.6 years in women. The bedridden age in rheumatoid arthritis women was 41.0±1.0 years. The activity of dayly life in the bedridden patients lowered with the period of bed rest, and was dependent on the original diseases of bedridden. Their mortality rate was about 50 % after 2 years and about 90 % after 8 years. Their relatives mainly cared the bedridden patients. The bedridden patients were not cared in full, because 70 % in their sick nurses had their jobs.
We think that the best plan to bedridden patients is to prevent the diseases causing prolonged bed rest.

Today, many villages in Japan are rapidly declining as a result of the policy of the Japanese government aiming at the growth of monopoly capital.
Shimo-Ono is one of such villages, with 184 houses and 731 inhabitants. We would report the progress of the regional examinations carried out in this village for these nine years and discuss about the necessity of the communal system of health protection, the actual state of health destruction and the countermeasures to be taken against this, and the problems imposed upon future regional examinations.

BACKGROUNDTo summarize the effect of Iressa for refractory patients with advanced non small cell lung cancer (NSCLC) failed to prior chemotherapy.

METHODSThirty-one patients, with unresectable stage IIIB or IV NSCLC who had disease progression or relapse after prior chemotherapy using platinum-based regimen for at least 2 cycles, were admitted to the Osaka Prefectural Hobikino Hospital. Iressa 250 mg was administered once a day until disease progression was noted. Weekly chest x-ray and monthly CT scan were performed for response assessment each month.

RESULTSAmong the 31 patients, one complete response (CR) and 7 partial responses (PR) were observed. CR rate was 3.2% (95% confidence interval: 0-17%), PR rate 22.6% (95% confidence interval: 10%-41%), disease control rate including both tumor responses and stable disease was 80.6% (95% confidence interval: 52%-92%). The rate of symptoms relieves was 51.6% (95% confidence interval: 33%-70%), the most effective symptoms being cough and pain. The median time to improved symptoms was 14 days. The most common adverse events were grade I or II skin rash and diarrhea which were readily manageable and reversible. No patients were withdrawn due to the adverse events

CONCLUSIONSMonotherapy using Iressa is effective and tolerable for the patients with advanced NSCLC who failed prior chemotherapy.