Many of lifestyle-induced, or diseases of the sort which progressively becomes degenerative with an advance in senility, have something to do significantly with the everyday life-style. Their secondary prevention is extensively in effect, having brought about considerablesuccesses. But studies on the primary prevention can hardly be described as adequate. It is a fact that, of people in whom no specific abnormalities were detected in a conventional mass health screening, or those for whom no significant signs of degeneration were declared latent, 25 percent were found to have some systemic abnormality or the other a few years later. For more successful achievements from the primary prevention of lifestyle-induced, it will presumably be of more effect to select from among the persons in whom no specific abnormalities were detected in a conventional health screening the highly risky persons for whom the possibility is high for a drop in the status of their health several years later and to enthusiastically provide education and guidance for improvements in the everyday life-style. For a study on the selection parameters (risk parameters), the criteria for selection of subjects were so arranged as to include the ages at 20 to 69, the systolic blood pressure level at less than 160mmHg, diastolic blood pressure level at downwards of 95mmHg, BMI level at 18.1-25.9kg/m², serum cholesterol level at 120-220mg/dl, fasting plasma glucose level at downwards of 120mg/dI and casual plasma glucose level at 160mg/d1 or under. Retrospective cohort studies were perfomed on 6, 771 subjects who met those conditions and could be observed year after year. As a result, it was concluded that the systolic blood pressure level at 130mmHg, diastolic blood pressure level at 85mmHg, BMI at 24.Okg/m², serum cholesterol level at 200mg/dl, fasting plasma glucose level at llOmg/dl and casual plasma glucose level at 180mg/d1 should be appropriate as selection parameters (risk parameters).

A survey has been conducted on the incidence of pain in the lower back among persons engaged in farming in suburban areas in Hiroshima Prefecture. A summary of the findings is as follows:
Overwhelmingly large numbers of full-time farmers and those with history of neurosis or neurotic tendencies complained of lower back pains. Working posture, carrying of heavy objects, habitual bodily movement and coldness, among others, can be given as the exciting causes of the lumbargo.
A study of the living and working conditions of these farmers suggested that the amount of labor, protein intake deficiency, abortion and way of going to and from farm fields have some bearing on the occurrence of lower backaches.
Orthopedic examination showed that aging was exclusively responsible for the backache.
With all these risk factors in mind, we encouraged the farmers to practice prophylactic exercises. The results are not certain yet to say that the practice is effective.
Under proper guidance, the patients could get over the pain. What is important is farmers' health consciousness.

The prevalence of non-insulin-dependent diabetes mellitus (NIDDM) as defined by WHO criteria was studied in a rural community of Hiroshima. All the inhabitants over the age of 30 were asked to participate in this study, during the month of December in 1990 and 1991. Eventually, 307 males (23.2%) and 620 females (41.5%) agreed to participate and had an oral glucose tolerance test (75g of glucose).
The crude prevalence rates of NIDDM were 11.4% for males and 6.9% for females, and the adjusted prevalence rates by population in 1985 were 9.5% for males and 4.5% for females, respectively.
The results suggest that both males and females over the age of 50 showed a higher-rate of prevalence than those under the age of 50.

We evaluated the therapeutic results of cancers in the bile duct, the pancreas head region and the liver and cirrhosis.
The former two types were examined in a total of 49 cases: 10 cholecystocarcinomas, 18 cholangiocarcinomas, 6 papillocarcinomas, and 15 pancreas head cancers. Radical surgery was performed in only 9 cases: 1 cholecystocarcinoma, 1 cholangiocarcinoma, 5 papillocarcinomas and 2 pancreas head cancers. The surgical success rate was satisfactory 83%(5/6) for papillocarcinoma, yet showed 18.4% overall.
Liver cancer and cirrhosis were examined in 102 cases: 78 cirrhoses and 24 livercancers. Of the former, 15% were viral cirrhosis, 44% alcoholic, 1% specific and 40% unknown. Ofthe latter, 29% were viral liver cancer, 29% alcoholic and 42% unknown.
Treatment of these cancers, with the exception of one type, was unfavorable. To increase the surgical success rate, cancers will have to be discovered earlier using such recent, highly-advanced technological means as endoscopy, ultrasonography, angiography and computerized tomography. At the same time, radical surgery should be actively applied in a broader range of cases.
In cirrhosis, bleeding in the upper digestive tract and complicating liver cancer are increasing in frequency due to prolonged life expectancy. How to manage this increase remains subject for further study in the future.

In order to assess the influence of habitual alcohol consumption on hepatic and pancreatic function, and on the disposal of carbohydrate and lipid, determination of serum hepatic and pancreatic enzyme levels, and serum glucose, insulin and triglyceride on oral glucose challenge was made in relation with the amount of consumed alcohol.
1. GOT, GPT and γ-GTP levels increased correlated with daily alcohol consumption, and γ-GTP was the most sensitive marker for alcohol consumption.
2. Habitual alcohol consumption reduced serum amylase and increased elastase 1 and trypsin, while the excursion of these enzyme levels remained within normal range. Because people with elastase 1 or trypsin levels beyond normal range was found more frequently than with amylase, the former two pancreatic enzymes might be better marker of alcoholic pancreatic injury than the latter one.
3. Alcohol dependency in daily caloric requirement elevated serum glucose and triglyceride in fasting and 2 hours after glucose challenge. Hyperinsulinemia after glucose challenge might indicate that moderate daily alcohol consumption induces insulin resistance resulting in deteriorated glucose disposal.

A questionnaire was conducted on the living and working conditions of inhabitants in the suburbs of a city in Hiroshima Prefecture. Respondents received medical and nutritional examinations. A summary of our findings is as follows:
Those persons who are apparently overworking themselves eke out their energy deficiency by taking diets rich in carbohydrate complex. Their major health problems are hypertension, ischemic changes in ECG, anemia and lower cholinesterase activity.
There were indications that agricultural chemicals have harmful effects on the health of the examinees.
In contrast, many of those who work less consume large-even excessive-amounts of animal proteins and fats. Among them prevail liver failxure and metabolic disorders.
In either group of the people examined, there was amundant evidence to show that they are at risk of developing arteriosclerosis.
These findings should be taken into consideration when a health control program is implemnted.

An investigation was made into the health conditions of oyster farmers in Hiroshima Bay with reference to their job requirements and way of life. The findings are as follows:
Their working conditions are harsh. However, compared with those engaged in agriculture, the oyster farmers eat fairly large amounts of calorific foods, especially animal products. Their alcoholic consumption is also large. They get enough sleep and rest on a regular basis.
Mild obesity, hypertension and hyperlipidemia are prevalent among men, and tendency of obesity is more common among women. Furthermore, those with the risk factors for arteriosclerosis account for more than 50% of the people examined.
From these findings, it could be said that their health is at risk. Appropriate and effective measures should be taken promptly so as to reduce the risks, particularly those risks associated with arteriosclerotic damage. Mechanization will be one of the measures against the health resks that oyster famers are now exposed to. Without preventive measures, there might be an outbreak of the diseases originating in the blood vessels.

The future of Japanese agriculture depends a great deal on the young adult. In this study, preventive health strategies for young people living in a farming area are discussed. The following is a summary of the conclusions we have arrived at.
1. There is much to be desired in their eating habits. Hence, the necessity of drawing up adequate guidelines and educational programs.
2. Young men must be dissuaded from smoking cigarettes and drinking a lot.
3. There is too much stress in living and working environments.
4. Overworking must be avoided.
5. Individuals must realize the importance of protecting and promoting their own health.

Epidemiological investigations were made on carcinoembryonic antigen (CEA) levels in 3, 259 rural inhabitants and 3, 200 urban inhabitants. Abonormally high CEA levels were found in 12.0% of male rural inhabitants and 6.8% of male urban inhabitants. For women, the percentage was 2.4% in rural areas and 1.6% in urban areas. Correlations between high CEA levels and age were noted in men. However, cigarette smokers had higher CEA levels than non-smokers in both rural and urban areas irrespective of age. Smokers' CEA levels were higher rural areas than in urban areas. These disparites in CEA levels between rural and urban inhabitants were studied, but remain unaccounted for.