The activities of the community based environmental forum over the past 7 years to maintain the Hii River-Shinji Lake ecosystem were reviewed. The network formation model for environmental safeguard developed in local communities in Shimane and the action targets of a healthy city project were evaluated.
1. Interaction between the development of theme and the increased participation of people from all walks of life.
In 1991, the communities launched “The Chironomidae-outbreak counterplan” named “Shinji Lake Forum” with the participation of various classes of inhabitants around Shinji Lake, including fishermen, biologists and environmental health researchers. The participatory action spread from residents around Shinji Lake to other communities along Hii River, resulting in the formation of an enlarged community network and inter disciplinary research network. The action targets developed as follows:
(1) the Chironomidae-outbreak counterplan, (2) water quality preservation of Shinji Lake, (3) community class for ecology, (4) a community network encompassing the river-lake basin, (5) a healthy city project aimed at cultural development.
2. The objective of the healthy city project
Now the participatory action is developing into the movement of “The Harmony of natural ecosystems”. With linkages between development and ecosystem protection, the healthy city project aimed at cultural development could be pursued in harmony with natural environment.
3. “The network formation model that has gone through processes of opposition and sharing” and participatory action research
In this paper we discuss the formation process of environmental safeguard network. At first, opposition structure such as the fishermen and the agriculturalists, the citizens and the administration, the upperstream area residents and the downstream area residents, was made obvious by making clear differences in interest concerning the environment and living well-being. And the common goals to achieve and roles individuals have to play become clear through the process of sharing a thought on the natural ecosystem and the process of recognizing the different standpoints again. The importance of the cooperation of residents, administrations and researchers, together with participatory action research using the network formation model, was emphasized in order to settle variously complicated problems of ecosystems.

Objective : To investigate the safety and effects of long-term administration of denopamine, β-1 stimulant, on the activities of daily living in heart failure patients.
Design : Case-series.
Methods : One hundred forty patients with mild to moderate chronic heart failure were administered denopamine at dose of 5 to 10 mg three times daily for 24 weeks. Concomitant circulatory system drugs such as digitalis, diuretics, vasodilator drugs, etc., were used without changing the administration method and dose. However, the use of a concomitant β-blocker was prohibited.
Results : Following administration of denopamine, the NYHA cardiac function classification improved by one degree or more in 50 patients (35.7%). The body weight decreased significantly from 54.9± 10.2kg (mean±SD) before administration to 54.0±10.2kg after administration (P<0.05), and the cardiothoracic ratio also decreased from 58.0±7.3% to 56.6±7.2% (P<0.001). No significant changes were observed in the heart rate, systolic blood pressure, or diastolic blood pressure. The activities of daily living improved by one level or more for 49 patients (51.6%). There were 36 withdrawal or dropout cases (patients' own convenience : 12 cases ; complications/accidental symptoms : 7 cases) during the investigation period. Four patients (2.9%) exhibited adverse reactions.
Conclusion : Denopamine seemed to improve the quality of life, which is one of the therapeutic purposes for patients with chronic cardiac failure. A large-scale study including investigation of the long-term prognosis for such patients needs to be performed.

BACKGROUND/AIMS: The objective of this study was to compare the clinical characteristics of patients with autoimmune pancreatitis (AIP) with or without Mikulicz's disease (MD) and with MD alone. METHODS: We investigated the clinical findings in 15 AIP patients with MD (group A+M), 49 AIP only patients (group A), and 14 MD only patients (group M). RESULTS: The male-female ratio was significantly higher in group A+M (73%, p<0.05) and group A (78%, p<0.01) than group M (21%). Serum immunoglobulin G (IgG) levels were significantly higher in group A+M than in group A (p<0.01) and group M (p<0.05). Serum IgG4 levels were significantly higher in group A+M than in group A (p<0.01). Other organ involvement was observed in 73% (11/15) of patients in group A+M. The number of patients with diabetes mellitus was significantly higher in group A+M (66%, p<0.01) and group A (51%, p<0.05) than in group M (7%). All of the patients responded well to steroid therapy, but the relapse rate in group A+M (33%) was significantly higher than that in group A (3%, p<0.01). Salivary gland function was impaired in all groups compared with the control group, but the degree of dysfunction was less in group A compared with group A+M and group M. CONCLUSIONS: The relapse rate of AIP in MD patients was significantly higher than that of AIP in patients without MD.
Diabetes Mellitus ; Humans ; Immunoglobulin G ; Mikulicz' Disease ; Pancreatitis ; Recurrence ; Salivary Glands