Yabakei Town is an underpopulated rural area in Oita Prefecture. Eight workers of the Shimogo Clinic interviewed all the people who were more than 70 years old and lived alone in this town. All the 92 subjects who were interviwed responded to this survey. Among them, 81 subjects (88 percent of the interviewees) answered that they chose to live alone as they preferred a life free from restraint, and 28 subjects (30 percent) answered they did not want to leave the place where they were born and lived for a long time.
A modified Face Scale revealed that among the 92 subjects surveyed, 43 subjects (47 percent) felt that they were “complacent” or “very complacent” about their lives as a whole, and 46 subjects (50 percent) answered “not so bad, ” while only three subjects (3 percent) answered “not complacent.” Neither physical dysfunction nor the degree of complacency toward their families was correlated with the satisfaction about their lives. Only the relationship with their neighborhood and/or friends correlated significantly with the satisfaction level in their lives.
As for their futures, only nine people (10 percent of the respondents) replied they were “anxious” or “very anxious.” Howerver, in a question asking them what they would do if they definitely needed someone's help, for example, by accidental injruy of gradual deterioration of their health status, 32 subjects (35 percent of the respondents) answered they had no idea what to do, while another 32 subjects (35 percent) expected their families would help them in some way without much assurance.
On the whole, the aged people were rather complacent about their present lives. But, thinking of their future, it seemed that fragility of their lives was undeniable.

Local residents were screened for colorectal cancer, and the results during six year period are reported. The two-day immunological fecal occult blood test was used as the first screening method. The barium enema radiography was used as the secondary screening method even if only one of the occult blood reactions was positive. Images were acquired in varius directions from rectum to the sigmoid colon (the most common site of colorectal cancer) and at least anterior-posterior images in two directions were obtained another sites as well. Barium enema radiography is less distressing to patients than the endoscopy of entire large intestine and can be carried out quickly. In addition, its accuracy is considered comparable to that of endoscopy, and the results of our study were no poorer than that obtained in institutions where only endoscopy was carried out.
Diagnostic radiologic examination ; Endoscopy ; Enema Solution ; Aspects of disease screening ; Barium enema, NOS

Students and general long distance runners carried out 1600m run for 24 hours and their physical functions were measured with lapse of the relay. Following results were obtained.
1) Prolongation of mean running time of student long distance runners in 1600m runs appeared at about 8th-10th runs, 12.8-16.0km, but that of general long distance runners did at 5th-6th runs, 8-9.6km.
2) There was plus correlation between mean of running time and its standard deviation in 1600m runs. It was r=0.55 and its regression equation was Y=0.58X-162.3. But these of general long distance runners were r=0.53 and Y=0.358X-97.3, respectively.
3) Decreased body weight from 1st-8th run was great and succesive, and occupied about 30%-70% of final decreased body weight. Thereafter, increase or decrease of the body weight was repeated and the time course became slow. There were some runners who showed large and succesive decreased body weight with the runs through the competition. The decreased body weight during the competition was influenced by the wind velocity, which supressed it considerably.
4) Heart rate of a student long distance runner during 1600m run reached 180-189 beats per minute every run. Resting heart rate of general and student long distance groups showed circadian rhythm during the competition, but that of student runners was higher through the competition and their systolic pressure shows a tendency to below in later period of the competition.
5) Threshold of knee jerk was low in the initial few runs and thereafter showed circadian rhythm. Reaction time to light was also facilitated in the initial runs and there-after prolonged about 30msec and maintained till the end of the competition. Frequency of subjective symptoms increased with number of the runs. At middle of the competition, it came over Sakai's standard and the A, B and C symptoms at the end of the competition were 33.0%, 20.0% and 25.0%, respectively.
6) Calorie intake per day of the student long distance runners was in the range of 1240-2540Cal. Total energy consumption was estimated 7457Cal. per day.
7) Blood glucose of the student long distance runners mostly unchanged through the competition, but serum triglyceride and total phospholipids significantly decreased and inversely serum free fatty acids prolongly mobilized.

In Japan, tuberculosis (TB) control activities are conducted by public health centres (PHCs) and treatment support is provided by public health nurses (PHNs). This study describes the TB situation in the affected areas and assesses the effectiveness of Japan’s TB control efforts after the disaster.

Objective : There are two types of studies on the relationship between adverse events and genetic background and the relationship between constitution and genetic background.  To investigate the relationship between adverse events and constitution retrospectively, we first reviewed the appearance of the constitution responsible for the adverse events in the relevant sources of information.
Methods : Fifty two pharmaceutical interview sheets, 150 case reports and two manuals; “jyudaina fukusayou kaihi notameno fukuyaku sidou jyouhousyu”, “jyutoku fukusayou sikanbetu manual” were selected for review.
Results : Fourteen items about the constitution were found in the pharmaceutical interview sheets.  No items about the constitution were found in the case reports and manuals.
Conclusion : Rules for the preparation of pharmaceutical interview sheets and case reports to use the constitution information is necessary for retrospective analysis of this issue.

A 74-year-old man undergone mitral valve plasty. After cessation of cardiopulmonary bypass, bleeding persisted from the cardioplegia injection site and dilatation of the ascending aorta with discoloration was observed. The diagnosis of type A aortic dissection extending to the descending aorta was made by transesophageal echocardiogram. Replacement of the ascending aorta was performed under deep hypothermic circulatory arrest. The postoperative course was uneventful. The false lumen of the aortic arch and descending aorta was thrombosed completely on postoperative computed tomography. Intraoperative aortic dissection is a rare but fatal complication of cardiopulmonary bypass. Prompt recognition and appropriate surgical management are of prime importance.

　　As part of the special study project of the Japanese Association of Rural Medicine (JARM), a questionnaire survey was conducted to probe into the attitude of rural people toward their eating habits and health. Most of the people surveyed had received health checkups carried out by medical facilities affiliated with the JARM.　　Questionnaires were distributed to a total of 5,397 people (2,588 men; 2,809 women) living in and around provincial cities. Mean age was 53.4 for men and 53.8 for women. More than half of those questioned were farmers or had experienced in farming. The people aged 80 and older accounted for 3.2% of the total.　　Eighty percent of the total said they felt happy, and those who felt short of exercise also represented 80%, but with advancing age, the ratio decreased. Those over the age of 70 who said they had a habit of taking exercise made up as high as 60%.　　Many said they were satisfied with food in terms of quantity, but not a few people expressed uneasiness about food safety, dietary life and supply of food. Regarding favorite foodstuffs, many gave rice, vegetables and dairy products. There was a tendency for older people to eat meat less. It was found that, with increasing age, people took to eat dairy products, soybeans, vegetables, fruits and fish were ranked among the most popular foodstuffs.　　A study of factors related to local production for local consumption and commitment to agriculture found that a significantly large number of people were interested in social participation, eating breakfast, securing food supply and purchasing foodstuffs at outlet stores run by local agricultural cooperatives.　　From these findings, it was suggested that many residents in and around provincial cities oriented themselves to healthy eating habits and lifestyle, and were very interested in social participation, local economy, agricultural production and consumption of local farm produce.

Objective: To identify the clinical and epidemiological characteristics of pernicious anemia (PA) in patients treated at Miyagami hospital on Tokunoshima Island.

Methods: We evaluated 14 patients with PA who were enrolled and treated from March 2009 to May 2014.

Results: The majority of patients were older than 50 years of age and primarily consisted of elderly women. Routine medical examinations revealed macrocytic anemia in 6 of the 14 patients (43%), although they were clinically asymptomatic and subsequently diagnosed with PA. The average number of patients per year was reported to be 3 (95% confidence interval [CI]: 1.25-3.42).

Conclusions: The annual incidence of PA per 100,000 individuals on Tokunoshima Island is possibly much higher than that previously reported in Japan. An increase in the elderly population, a negligence of the disease, and an ethnic and regional diversity may explain this discrepancy. As the annual incidence of PA may be higher than that previously reported, anemia must be carefully evaluated in the differential diagnosis of PA.

An 80-year-old male patient had complained of left abdominal pain since 1990, and an abdominal aortic aneurysm (AAA) 5.3cm in diameter was diagnosed by computed tomography (CT). The patient was NYHA class III with complaints of chest pain during exercise. Coronary arteriography showed that he had three-vessel disease. At that time, aneurysmectomy was not anticipated due to his age and because the AAA showed no tendency to enlarge. However, in October 1993, CT showed that the AAA rapidly enlarged to 6.8cm in diameter. Due to the greater risk of rupture of the AAA, aneurysmectomy was considered necessary. The operative mortality associated with aneurysmectomy in patients with coronary artery disease (CAD) is higher than that in patients without CAD. Therefore, coronary artery bypass grafting (CABG) was indicated prior to aneurysmectomy. The patient underwent CABG (two vessels) in December 1993, and aneurysmectomy was successfully performed in February 1994. He was discharged uneventfully 17 days after the operation.