We examined the relationship between Type A behavior and the results of a health screeningexamination in subjects who work in T town office.
A screening test for type A behavior (Tagawa et al.) was given to 65 subjects (42 males and 23females) with a mean age of 38.5 years.
There were 20 Type A2, 10 Type Al, 6 Type B1 and 19 Type B2 subjects. There was a significant correlation between type A score and diastolic blood pressure. Subjects with hepatic dysfunction had higher type A scores than those with normal hepatic function.
Our results suggest that there is a close relationship between type A behavior and both diastolic blood pressure and hapatic dysfunction.

The mental health of nurses was surveyed using the Japanese version of the 60-item General Health Questionnaire (GHQ). A total of 48 nurses responded to the survey.
There was no significant correlation between GHQ score and age in all the respondents. There were no significant differences in GHQ score among the outpatient nurses, those who worked in the surgical ward and those who worked in the internal medicine department and those in the care of geriatrics inpatient. Scores over 17 were marked by 45.5 % of the outpatient nurses, 58.8 % of those who worked in the surgical ward, 35 % of those in the internal medicine departmentand 35 % of those in the geriatrics ward. However, the percentage of those who had subjective symptoms was higher among the nurses in the surgical ward than the nurses in any other wards (p≤0.05).
Our results suggest that more thought should be given to the mental health of nurses and methods be developed to improve it.

The relationship between the willingness to attend school and serum lipid levels was examined in high-school students. A total of 83 students were divided into two groups: the school group (n=48, 13 boys, 35 girls) consisting of students motivated to go to school, and the refuser group (n=35, 18 boys, 17 girls) of those who did not want to attend school. There were no significant differences between the two groups with respect to body mass index, total cholesterol level, triglycerides level, LDL-cholesterol level and atherogenic index, but the refuser group and lower HDL-cholesterol levels than the school group (p=0.0401). In addition, the refuser group had significantly lower scores on the shortened Zung's self-rating depression scale than the school group (p=0.0077). Furthermore, the students in the refuser group utilized the first-aid health room more often than those in the school group (p=0.0192).
These results suggest that there is a close relationship between the willingness to attend school and HDL-cholesterol level in high school students.

Psychosomatic health conditions and the cost of care were examined in 22 families tendering the sick and provided with visiting nurse services. To evaluate the state of psychosomatic health and the cost of care, the General Health Questionnaire (GHQ) and the Cost of Care Index (CCI, Kosberg et al.) were used. The results of the GHQ showed that factors relating to somatic symptoms, anxiety and sleep disturbance, and social dysfunction are significantly correlated with calculated CCIs. However, activitis of daily living scores of the patients were not correlated with GHQ findings or CCIs. Also, there was no relationship between GHQ results and CCIs and duration of care or the types of care that givers. The GHQ results also revealed elements of social dysfunction in families of a single care giver are marked significantly higher than in those of two or more care givers. There was no correlation between subjects who were given welfare services and those who were not.
These data suggested that we should give more attention to the aspect of health and the cost of care in care givers.

This study was carried out to clarify the relationship between aggression and feelings of well-being in 37 patients with diabetes mellitus. They were 15 irritable and 22 non-irritable subjects. There were no differences between the two groups in glucose control and therapy. But the morale scale in irritable subjects was significantly lower than in non-irritable subjects (p≤0.0005).
We conclude that there may be a close relationship between anger and feeling of well-being in patient with diabetes mellitus.

The aim of this study was to determine the relationship between age and changes in serum lipid levels during a period of 4 years in a Japanese fishing village.
Total cholesterol (TC), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were measured in inhabitants (53 males and 130 females) of the Chibu Village on Oki Island, Shimane in 1988 and again in 1992. The subjects were divided into four age groups of respectively, 40-49 years (n=30), 50-59 years (n=35), 60-90 years (n=65), and 70 years or over (n=53).
TC and TG levels did not change in any age group over the 4-year interval. However, the HDL-C level increased significantly in men aged 40-49 years, women aged 50-59 years, and women aged 60-69 years.
There are no differences of TC in men and women in 1988 and 1992. TG in men aged over 70 years was significantly lower than that in women aged over 70 years in 1988, but TG in men aged 40-49 years was significantly higher than that in women aged 40-49 years in 1992.HDL-C in men aged 40-49 years in 1988 and 50-59 years in 1992 was significantly lower than that in women aged 40-49 years in 1988 and 50-59 years in 1992.
The body mass index (BMI) was significantly positively correlated with TC in 1988, and positively correlated with TG and negatively correlated with HDL-C in both 1988 and 1992.
In this small Japanese fishing village, we found TC and TG did not increase with age, but HDL-C increased with age. Our results suggest that high TG and low HDL-C are important factors in causing obesity.

We examined the relationship between the change to a type A behavior pattern and the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in subjects who work in T town communities.
A screening test was performed to determine which subjects had a type A behavior (Tagawa et al.). Between 1994 and 1995 there were 10 subjects in whom the pattern changed from type B2 to type A2 (Changed Group) and 11 subjects in whom the pattern stayed in type B2 (Unchanged Group).
The rate of change to type A score [(type A score in 1995-type A score in 1994)/type A score in 1994×100] was correlated with the rate of change in SBP [(SBP in 1995-SBP in 1994)/SBP in 1994] and DBP [(DBP in 1995-DBP in 1994)/DBP in 1994×100].
In the Changed Group, SBP and DBP levels in 1994 were significantly higher than those in 1995. However, in the Unchanged Group, there were no significant differences in SBP or DBP level between 1994 and 1995. Furthermore, there were no significant differences in SBP or DBP level between the Changed and Unchanged Groups in 1994 and 1995.
Our results suggest that type A behavior and blood pressure are closely related.

We investigated the relationship between obesity and lipids in elderly women in a rural area with primary hyperlipidemia after one year of follow-up. Thirty women aged 61 to 89 (mean age, 72.5 years) with primary hyperlipidemia were enrolled in this study. They were all given lipid-lowering dietary by a dietitian (s) and general physicians at the time of entry.
Total serum cholesterol (TCHO), high-density lipoprotein cholesterol (HDL-C), blood pressure and body mass index (BMI) did not change significantly over the past one year however, triglyceride level (TG) significantly decreased during the period. BMI at the time of enrollment was not significantly correlated with the reduction rate of TCHO or HDL-C, but was significantly correlated with the reduction rate of TG.
Thus, BMI may be useful as a predictor of TG change when only dietary therapy is given to eldery suburban women.

To determine the relationships among silent brain infarction (SBI), bone mineral density and milk consumption in elderly women, we studied 26 senile female outpatients with SBI in comparison with 18 age-matched controls.
There was a significant difference between the two groups in diastolic blood pressure (p<0.05), and a significantly larger number of individuals in the SBI group had a history of hypertension than in the control group (p<0.005). Bone mineral density at the ultradistal end of the radius tended to be lower in the SBI group than in the control group (0.05These finding indicated a close correlation between SBI and milk consumption habits in elderly women.

We present herein a case of disc fracture of a Björk-Shiley valve prosthesis in the mitral position. A 69-year-old woman was admitted to our hospital with a sudden onset of dyspnea followed by deep shock. An echocardiography showed a severe degree of mitral regurgitation and moderate degree of tricuspid regurgitation. Forty-three years previously she had undergone a mitral valve replacement (MVR) for stenosis with the original version of a Björk-Shiley valve prosthesis in another institute. Emergency redo MVR was performed with a bioprosthesis and tricuspid annuloplasty with a semirigid ring. The disc of the extracted Björk-Shiley valve was found to have escaped from the metal housing with two intact struts. Although Björk-Shiley valve dysfunction due to Delrin disk abration has been rarely reported, complete disk fracuture is extremely rare. The important role of regular echocardiographic follow-up should be emphasized to prevent fatal valve fracture.