The outstanding feature of the drift of population observed in our country of late is understood in terms of the population exodus from rural areas into urban or industrial areas, which brings about. a conspicuous decrease in rural population especially in that of the younger working age bracket. with a view to clarifying an aspect of such wide-ranging migration of population, a study was made in the three remote mountain villages in the Chilbu District, where people are living on an extremely low economic level Investigation conducted for eacch respective economic level revealed an even. abnormally advanced decrease in the population of such younger generation, far advanced than in average rural areas. Thus the unfavorable topogra-phical conditions, lack of cultivating lands, low income, etc.were considered to be responsible for the acceleration of such population exodus. Attention was also drawn to the fact that not only the surplus labor power but even many of the eldest sons. who are the successors to their fathers' occupations are turning to urban areas for employ-ment, threatening the possibility of the replenishment of agricultural labor power and the development of agricultural economics, as well as the future reproduction of population in rural areas.

In the five communities of Urakawa, Sakuma-machi, Shizuoka Prefecture, we have taken measures to Prevent and exterminate ascaris infection, and at the same time studied the causes of infection chiefly from the point of view of environmental conditions. The percentages of ascaris egg-carriers showed a significant difference between 1) farmers and non-farmers; 2) families with and without night-soil; 3) amounts of detergent used for cleaning vegetables; 4) persons with and without experience of anthelmintic treatment.
The group of families that showed extremely high rate of positivity were the farmers not provided with night-soil stores, and the farmers provided with such stores showed about the same rate of positivity as non farmers a fact evidences the appreciatng effect of night-soil stores. On the other hand, the rate of positivity among familis that have no night-soil stores but are in the habit of cleaning vegetables with detergent showed no significant difference as compared with the families provided with night-soil storesa positive evidence of the good effect of detergent.

Examination of feces and deworming were carried out five times every other month between May 1962 to February 1963 in 5 communities (a total of 202 households, 1, 050 inhabitants) of Urakawa, Sakumamachi, Shizuoka Prefecture. After about a year has elapsed, in which no countermeasures were taken, examination of feces was carried out again in January 1964 to study a change in the rate of positivity. Examination was carried out by the cellophane thick layer smear method (values obtained with two sheets).
(1) The rate of positivity for Ascaris eggs ranged from 13.7% to 55.1%, with an average of 28.0% in the initial examination. The rate was higher in two commnities in the mountainous district. By sex and age, the rate was high among infants, school boys and adult females.
(2) A study of the change in the rate of positivity during the two years has shown that the rates of reinfection and new infcction were higher in communities where the rate of positivity was higher in the initial examination, indicating how difficult it is to exterminate Ascaris infection. On the contrary, there was no substantial rise in the rate of positivity in communities where the rate of positivity in the initial examination was under 10%(3 out of 5 communities), even though no countermeasures were taken during the period of one year. This seems to show that it is not required to carry out deworming frequently.
It has been found that the rate of Ascaris infection was lower in communities where persons positive for unfertilized eggs alone accounted for higher percentages among the total of persons positive for Ascaris eggs, there being a marked inverse corelation between persons positive for unfertilized eggs alone and persons positive for all kinds of Ascaris eggs. There has been a marked tendency to familial concentration of Ascaris infection.
(3) The results of the present study have shown that, in taking measures to exterminate Ascaris infection, it is necessary to take into consideration the rate of positivity for Ascaris eggs, the ratio of persons positive for unfertilized Ascaris eggs to persons positive for all kinds of Ascaris eggs, and a tendency to familial concentration of infection in the community.

Studying the causes of death among inhabitants in mountain villages located alongside the middle stream of the Tenryu River, and farming-fishing villages located along Tokyo Bay, we found that the death rate from lung cancer was high in the former, and that from stomach cancer was high in the latter. So, in those two districts, we carried out case-control studies about both kinds of cancer. Investigation was made into the dead cases from lung cancer, 84 male cases and 168 male controls, and the dead cases from stomach cancer, 83 male and 39 female cases and the same number of controls. We selected these controls, matching district, sex, age, and year of death, and studied occupation and smoking in lung cancer cases ; occupation, eating habits, kinds of food, drinking and smoking in stomach cancer cases. The odds ratio concerning to lung cancer was as low as 0.40 among people engaged in agriculture, forestry or fishery. But that was as high as 3.25 among people exposed to metal dust, and also as high as 3.10 among those exposed to wood dust. The multiplier effect could be suggested between smoking and metal or wood dust exposure. The odds ratio concerning to stomach cancer was as low as 0.69 among males engaged in agriculture, forestry or fishery. Regarding eating habits, ‘rapid eating’ was as high as 2.57 in males, 3.00 in females. Concerning the kinds of food, ‘salted fish’ was as high as 1.90 in males, and ‘white vegetables’ was as low as 0.36 in females. No assocciation was found between stomach cancer and smoking or drinking.

We reviewed twenty patients with mechanical prosthetic heart valves who underwent noncardiac operations which were performed in the presence of continual anticoagulant therapy. Prosthetic valves used were the SJM valve in nineteen patients and the Björk-Shiley valve in one. Twenty dental extractions in ten patients were performed with no reduction of warfarin, or the mean thrombotest value of 16%. Seven nonlaparotomy operations (polypectomy of the vocal cord in one patient, total hip joint replacement in one, insertion of a CAPD tube in one, pacemaker implantation in one, cataract operation in two and repair of tibial fracture in one) and three laparotomy operations (partial gastrectomy in two and hysterectomy in one) were performed under the thrombotest value of around 40% with partial reduction of warfarin. There was no difficulty in hemostasis during these operations. The only hemorrhagic complication in this series was bleeding from the abdominal wound in one patient two days after the gastrectomy when subcutaneous injections of heparin prolonged the ACT over 200sec. There were no thromboembolic complications. We conclude that dental extractions in patients with prosthetic heart valves can be safely performed with no reduction of warfarin and that the coagulability of thrombotest value of 40% is sufficient for hemostasis even in laparotomy operations.

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation(VM). Based on the patient’s clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.
Anesthesia, General ; Buttocks ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Transplants

Mandibular cortical erosion detected on dental panoramic radiographs is associated with increased risk of osteoporosis in older adults. Additionally, many reports have demonstrated an association between decreased number of teeth present and osteoporosis. However, whether mandibular cortical erosion is associated with a decreased number of teeth remains unclear. The purpose of this study, therefore, was to clarify the association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older. Among patients who visited our university hospital and underwent dental panoramic radiography for the diagnosis of dental diseases, 839 patients (293 men and 546 women) aged 40–89 years (mean [SD], 63.7 [10.6] years) participated in this study. Multiple regression analysis revealed that mildly to moderately eroded cortex (p = 0.007) and severe eroded cortex (p < 0.001) were significantly associated with a decreased number of teeth present. Analysis of covariance adjusted for covariates revealed a significant association between mandibular cortical erosion category and number of teeth present (p < 0.001). Subjects with a severely eroded cortex had significantly fewer teeth present than those with a normal cortex (mean [SE], 20.7 [0.5] vs. 23.4 [0.3], p < 0.001) or mildly to moderately eroded cortex (22.2 [0.4], p = 0.04). Subjects with a mildly to moderately eroded cortex had significantly fewer teeth present than those with a normal cortex (p = 0.033). Our results suggest the significant association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older.
Adult ; Asian Continental Ancestry Group* ; Cross-Sectional Studies* ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Female ; Humans ; Male ; Mandible ; Osteoporosis ; Radiography, Panoramic ; Stomatognathic Diseases ; Tooth*

BACKGROUND/AIMS: Tacrolimus is effective for refractory ulcerative colitis in adults, while data for children is sparse. We aimed to evaluate the effectiveness and safety of tacrolimus for induction and maintenance therapy in Japanese children with ulcerative colitis.METHODS: We retrospectively reviewed the multicenter survey data of 67 patients with ulcerative colitis aged < 17 years treated with tacrolimus between 2000 and 2012. Patients’ characteristics, disease activity, Pediatric Ulcerative Colitis Activity Index (PUCAI) score, initial oral tacrolimus dose, short-term (2-week) and long-term (1-year) outcomes, steroid-sparing effects, and adverse events were evaluated. Clinical remission was defined as a PUCAI score < 10; treatment response was defined as a PUCAI score reduction of ≥ 20 points compared with baseline.RESULTS: Patients included 35 boys and 32 girls (median [interquartile range] at admission: 13 [11–15] years). Thirty-nine patients were steroid-dependent and 26 were steroidrefractory; 20 had severe colitis and 43 had moderate colitis. The initial tacrolimus dose was 0.09 mg/kg/day (range, 0.05–0.12 mg/kg/day). The short-term clinical remission rate was 47.8%, and the clinical response rate was 37.3%. The mean prednisolone dose was reduced from 19.2 mg/day at tacrolimus initiation to 5.7 mg/day at week 8 (P< 0.001). The adverse event rate was 53.7%; 6 patients required discontinuation of tacrolimus therapy.CONCLUSIONS: Tacrolimus was a safe and effective second-line induction therapy for steroid-dependent and steroid-refractory ulcerative colitis in Japanese children.
Adult ; Asian Continental Ancestry Group ; Biological Factors ; Child ; Colectomy ; Colitis ; Colitis, Ulcerative ; Female ; Humans ; Immunologic Factors ; Japan ; Prednisolone ; Remission Induction ; Retrospective Studies ; Tacrolimus ; Ulcer