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.

To evaluate a comparison for endovascular repair (EVAR) versus open repair (OR) for the treatment of abdominal aortic aneurysm (AAA). Data of all patients with infrarenal AAA treated electively, both with OR (107 cases) and EVAR (24 cases), at our institute between January 1999 and March 2004 were retrospectively reviewed. No difference was found between the 2 groups for sex, age, and AAA size. Cases of chronic obstructive pulmonary disease (20.8% vs 6.5%, p<0.04) and frequencies of laparotomy (25% vs 2.8%, p<0.001) were significantly more in the EVAR group than the OR group. In the initial results, deployment of the stent grafts was successful in all cases and complete thrombosis of the aneurysm was achieved in 21 cases (87.5%). One graft occlusion and a wound infection occurred in the EVAR group. OR was successfully performed in all cases. These were 6 cases of paralytic ileus, 1 of re-operation for hemorrhage, 1 of respiratory failure, and 1 of ischemic colitis in the OR group. One hospital death occurred in each group. Mean blood transfusion (0ml vs 238±345ml) and operation time (131±53min vs 250±76min) were significantly less in the EVAR group than the OR group. In the long term results, the cumulative survival rate was 88.0±6.5% at 1 and 2 years, 80.6±9.2% at 3 years in the EVAR group; 99.0±0.9% at 1 year, 94.1±2.6% at 2 years, 87.7±3.9% at 3 years in the OR group, with no difference between the 2 groups regarding survival rate. Four new endoleak and 3 graft infections were encountered in the EVAR group. Freedom from stent graft-related complications was 81.3±8.5% at 1 year, 61.4±11.9% at 2 years, 47.8±12.6% at 3 years in the EVAR group, but 100% at 1, 2 and 3 years in the OR group. Freedom from procedure-related complications in the EVAR group was significantly lower than that in OR group. In the long term results, EVAR was associated with more procedure-related complications. This finding may justify reappraisal of currently accepted EVAR for AAA management strategies.

This paper describes a clinical review of cases of gastric cancer treated surgically at the Department of Surgery of the Shirakawa Kosei General Hospital, the core medical institution in the southern part of Fukushima Prefecture.
During the period of 20 years from January 1981 through December 2000, a total of 1, 132 cases were operated on for gastric carcinoma. Surgical resection cases totaled 1, 023 (resection ratio: 90.4%); curative resection cases, 894 (curative resection ratio: 79.0%); 5-year survival rate for resection cases, 68.3%; and 5-year survival rate for curative resection cases, 75.6%. When the cases were divided into those treated during the first half of the 20 years nad those treated during the latter half of the 20 years, the number or resection cases was smaller during the latter than during the first half but the resection ratio was larger. The early stomach cancer cases in terms of the degree of progress, histological classification, depth and metastasis to lymph nodes have been increasing and the 5-year survival rate has been on the rise.