Recently paraquat poisoning cases are increasing, and vicious crimes such as suicides and accidental troubles are now serious social problems.
We experienced 59 paraquat poisoning cases for the last four years and the number of deaths were 39. We changed the treatrents of paraquat poisoning from September 1982. In consequence the lifesaving rate was improved from 7.1 percent to 42.2 percent. But the mortality of the paraquat poisoning cases is still much higher than that of poisoning due to other agricultural chemicals.
We made questionnaire inquiries about paraquat poisoning in the rural population in Kumamoto in June and July 1984. As a result of this investigation we found that they can buy the paraquat liquid easily but receive no explanation about the toxic effects. Moreover they neglect severe custody. These factors are promoting the increase of paraquat poisoning.
It seems to be dangerous to use the paraquat liquid without strong prescriptions. We hope administrative measures to be done without delay

The paraquat liquid is a kind of herbicides which have extremely high mortality rate. A few years ago, such crimes as the paraquat liquid is poured into soft drinks occurred frequently and paraquat poisoning became a serious social problem. And now the lower concentrated paraquat liquid is on sale.
We experienced 190 paraquat poisoning cases for the past twelve years in Kumamoto Red Cross Hospital. Although the treatments of paraquat poisoning were improved at 1982, the mortality rate is extremely high (63.7%) as ever. Moreover paraquat poisoning cases have not been decreased for the last few years.
Judging from the latest trend of paraquat poisoning cases, miss-drinking cases and accidental cases during agricultural works are decreasing. This fact shows improvement of the knowledge about paraquat poisoning in the population. However suicide cases are increasing. On the other hand, paraguat poisoning occurred in the same frequency between farmers and non-farmers. Moreover accidents by former products, which are discontinued selling, are frequent as before. From these facts, we feel sales control and supervision of the paraquat liquid is unsatisfactory. But the fact that former products were not collected and the use of them was not forbidden is one of more important problems. The lower concentrated paraquat liquid still have high mortarity rate (70.0%) in addition.
There is no certain treatment for paraquat poisoning. And paraquat poisoning include many problems which cannot be solved only by the consciousness of the users and the administrative advices. From now on, it is natural to make efforts to solve various problems we are faced. Moreover it seems to be necessary to reconsider the worth of the paraquat liquid for preventing social crimes, too.

Kikusui, situated in the northwestern part of Kumamoto Prefecture, is famous for its remains of ancient Japan and at the same time known as a town blessed with the natural environment. As is the case with many other rural areas in this country, graying in population has been progressing at a fast clip here in recent years. To cope with the situation, Kikusui Town has taken uponitself to implement a comprehensive geriatric health care scheme since 1973 that covers not the physical aspect alone but also the mental aspect of the lives of the senior members of the population. During the period, the social welfare council and the societies of old people linked up with public health nurses. Later, the town hospital and its health control center joined with them to establish a home visit system to take care of the aged at home with the support of the government. Further, a nursing home for old people was built on the premises of the town hospital and started the day care services to back up the home care system. Various programs for home care were carried out in the main by visiting nurses. From the standpoint of the medical institution, cooperation with welfare workers was vital. Moreover, it was important for the residents of Kikusui Town to participate in this project. In the present paper, we will report on how the home care system for old people came into being.

In 1991, the committee on postgraduate clinical training proposed revised behavioral objectives for basic clinical training in the initial two years. We present here a model for a clinical training program that should enable most residents to attain these objectives within two years.
The program begins with orientation for 1-2 weeks, including a workshop on team care, and nursing practice.
Basic clinical skills for primary care and emergency managements should be learned by experience during rotations through various clinical specialities. All staff members, even senior residents, should participate in teaching beginning residents in hospitals.