A statistical investigation was carried out into about 3, 000 patients who visited our department from 1977 to 1983. The results were as follows:
1. Allergic rhinitis and bronchial asthma were the most important allergic diseases in the rural area.
2. The number of patients with allergic rhinitis especially caused by pollen (so called “pollinosis”) was markedly increased in recent years.
3. Japanese cedar, orchard grass and mugwort were the most important causative agents of pollinosis in this area.
4. The number of patients of each pollinosis was largely changed by climate or other unknown factors in each year.
5. The number of patients of bronchial asthma caused by molds' spores gradually decreased.
6. An occupational pear and apple pollinosis caused by artificial pollination was considered to be the most inportant allergic disease due to farm work. Further investigations are required on this problem.

An epidemiological examination was carried out on 330 farmers engaged in pear and apple cultivation. First, all examinees answered questions about the presence of allergic symptoms. To those who have had any allergic symptoms, the intradermal skin reaction tests with pollen extracts (Japanese pear, apple, cedar and orchard grass) and house dust were performed.
The results were as follows:
1. 35.8% of all examinees manifested some allergic symptoms during the bloom of pear and apple (from April to May).
2. Nasal or ocular symptoms were observed in 28.5% and 27.3% respectively. About three-fourth (20.3%) of them manifested both symptoms.
3. The rate of farmers with allergic symptoms was higher in younger generations and many of these symptoms occurred within these five years.
4. The rate of positive skin reactions of each allergen extracts were 40.5% for Japanese pear pollens, 63.8% for apple pollens, 30.5% for cedar pollens, 6.7% for orchard grass pollens and 10.5% for house dust.
From a pollen calender of Nagano Prefecture, high rate of allergic symptons during the bloom of pear and apple and the results of the intradermal skin reaction tests, it may, be suggested that a considerable number of farmers possibly suffer from pear and apple pollinosis. The rates showed above are much higher than reported so far.

Using various types of monoclonal antibodies and flow cytometer, whole blood analysis were conducted on subsets of lymphocytes taken from peripheral blood samples of healthy persons and umbilical cord blood samples of mature babies.
The findings were as follows:
(1) Normal values of healthy persons (Mean ± SD) were: T-cell phenotypes-OKT3⁺: 66.2 ± 9.4%, OKT4⁺: 40.9±8.3%, OKT8⁺: 28.2±6.6%, OKT11⁺: 80.1±4.8%, OKT4/OKT8 ratio: 1.57±0.60; B-cell phenotype-SmIg (polyvalent) ⁺: 15.9±6.5%; others-OKTal⁺: 12.9±3.2%, Leu7⁺: 16.2±8.9%.
(2) Of the healthy persons, 17% showed 1.0 or below and 6.5% showed 2.5 or above, in the OKT4/OKT8 ratio.
(3) The OKT4+ OKT8/OKT3 ratio was significantly high (P<0.001) in the babies and persons of 40 years and over.
(4) Physiologic variations were noted in some degree in children and the aged, and between men and women. The individual values of the lymphocyte subsets were almost constant, but the difference between individuals was large. It is suggested that the difference of the immune response of each individual or each family partly depends on the different values of the lymphocyte subsets.

We have established NICU (Neonatal Intensive Care Unit) in our hospital and have made efforts to improve the contents of medical treatment since 1976 in order to establish a regionalization of neonatal medical treatment.
Thus are main items of the improvement:
1. Completed the apparatuses and equipments needed in Intensive Care.
2. Promoted the communication with regional facilities of delivery so as to enable immature or stressed mature babies to be transported to our hospital at all hours.
3. Made Pediatrician attend all the deliveries with high risk factors and treat the asphyxiated newborn right after the delivery.
We have recorded the results of comparison of the death rate of immature babies at different birth weight treated in our hospital, and of the perinatal mortality in our Obstetric Department in the pie-improvement period of 5 years (1971-1975) and in the post-improvement period of 4 years (1976-1979) respectively.
The results are as follows:
1. A comparison of the death rate of immature babies at different birth weight.
In comparison of pre and post improvement, under 1, 000 g we haven't had enough cases to compare, besides most of the babies have died. However, at the weight between 1, 001-1, 500 g, the death rate has decreased from 39.4% down to 14.3%, at between 1, 501-2, 000g it has decreased from 11.4% down to 8.9%, and at between 2, 001-2, 500 g, from 6.9% to 1.1%.
2. A comparison of the perinatal mortality in our Obstetric Department.
The perinatal mortality has decreased from 18.5% down to 11.8% when we compare pre and post improvement. This result of the decrease depends on the decrease of fetal death at delivery and baby's death in the early neonatal period. Items of the causes of early neonatal death reveals that the deaths of immature babies and asphyxiated mature babies have decreased significantly.
From these results, we are fully realized the benefit of the regionalization of the neonatal medical treatment and I think we ought to promote such regionalization especially in rural area.

We have established NICU (Neonatal Intensive Care Unit) in our hospital and concentrated our efforts on improving the contents of medical treatment since 1976 in order to accomplish a regionalization of neonatal medical treatment in our district.
Thereafter, the mortality rate of low birth weight infants at different weight have decreased markedly. During this period, we have gathered information by means of questinnaire concerning the prognosis of low birth weight (below 2, 000 g) infants whowere admitted in our hospital in the preimprovement period of five years (1971 through 1975, Group 1; N =110) and in the post-improvement period of five years (1976 through 1980, Group 2; N = 96).
The results were as follows:
1, In terms of height and weight, both groups revealed to be no less than those of normal infants.
2. The occurrence of cerebral palsy in Group 2 (2.2%) decreased to below one third of Group 1 (7.5%).
3. There were two infants with blindness resulting from retrolental fibloplasia in Group 1 and one in Group 2.
4. As regards the occurrence rate of epilepsy, there were two children with it in Group 1 (1.98%) and one in Group 2 (1.1%), whereas four children in Group 1 had episodes of afebrile convulsion.
5. Five (5.4%) of 92 grade-school pupils in Group 1 were attending a clss for handicapped.
From these results, it may be concluded that the improvement of neonatal medical treatment brought about a decrease of death rate of low birth weight infants and the improvement of theirprognosis as well.