Background：Although octreotide is effective in the relief of symptoms of gastrointestinal obstruction, it is also effective for gastrointestinal bleeding. It has been reported that octreotide reduced the splanchnic blood flow, and reduced the bleeding from esophageal varices, peptic ulcer and the tumor of gastrointestinal tract. We experienced four cases of end―stage cancer patients admitted to a palliative care unit whose symptoms of gastrointestinal bleeding were alleviated by octreotide（300μg／day）. Case：Case 1；A 75―year―old woman with gastric cancer developed melena and received octreotide. After octreotide was discontinued, melena and hematemesis recurred. Octreotide was restarted subsequently, and hematemesis resolved. Case 2；An 87―year―old woman with gastric cancer received octreotide for increase of bloody drainage from a stomach tube. She had epigastric pain and emotional distress from the blood. These symptoms were alleviated following the administration of octreotide. Cases 3 and 4；A 76―year―old man with gastric cancer and a 62―year―old man with bile duct cancer received octreotide for massive vomiting of blood. After the administration of octreotide, there was no reoccurrence of hematemesis in both patients. Conclusion：Octreotide may alleviate symptoms of gastrointestinal bleeding in end―stage cancer patients.

Environmental contaminations caused by the organochlorine pesticides (=OCPs) such as BHC and DDT, as well as PCB, are an important ecological problem relevant to their residue or accumulation in the human body.
In the present study, β-BHC, total DDT and PCB levels in the plasma of farmers in Japan, Korea and Nepal were analysed using the gaschromatograph with electron-capture detector, to know how the levels relate to the history of using those pesticides in each country.
The analysed blood samples are as follows:
1) 82 samples obtained from the farmers living in the four districts in Kyushu of Japan where the use of OCPs were forbidden about 10 years before the time of blood sampling.
2) 9 samples from the farmers living in Risen district near Seoul of Korea where OCPs were being used at the time of blood sampling.
3) 20 samples from the farmers living in Katmandu of Nepal where OCPs were being used at the time of blood sampling.
The obtained results were as follows:
1) Percentage of the samples showing the β-BHC level higher than 10 ppb was 48% for the Japanese, 0% for the Korean, and 0% for the Nepalese.
2) That of the samples showing the total DDT level higher than 15 ppb was 26%, 0% and 100% for the respective country in the above order.
3) That of the samples shnwing the PCB level higher than 5 ppb was 60%, 12% and 0% for the respective country.
Based on the results, relations between the OCPs or PCB level and the history of the use of OCPs or the eating habits in each country were discussed.

Purpose: We report a case in which oral sodium valproate through a percutaneous endoscopic gastrostomy (PEG) tube for palliative decompression drainage in inoperable ileus achieved an effective drug concentration and ameliorated delirium and extrapyramidal side effects. Case Report: The patient was a male in his seventies who suffered from bladder cancer. He underwent PEG because of paralytic ileus with cancerous peritonitis. He had been receiving continuous intravenous infusion of haloperidol for the management of delirium, but needed to discontinue treatment with this agent due to tremor, an extrapyramidal side effect of haloperidol. Oral sodium valproate was therefore administered through the PEG tube for palliative decompression drainage. Plasma valproate concentrations showed effective levels, and his irritability was relieved. A good combination of sodium valproate and quetiapine fumarate allowed successful reduction of and eventual withdrawal from haloperidol, and tremor then improved. Conclusion: We often encounter difficulty with symptom control for patients who cannot use oral medications. When medication by other routes is difficult, this case suggests that sodium valproate through a PEG tube for palliative decompression drainage may be useful as a last resort for improving delirium.

With an aim at making future community health services more effective, the authors have attempted surveys of the living and health conditions of yellowtail fish breeders for Tarumi Fishermen's Cooperative Association over the past three years.
1st February 25, 1982 54 persons
2nd January 31, 1983 70 persons
3rd January 30, 1984 55 persons
In the last survey, 21 persons out of 55 were the same persons who had taken part in the 1982 and 1983 surveys.
Conclusion
(1) Fishermen get up earlier in the morning and set to work, many skipping breakfast. In the afternoon, they are relatively free. However, none use their leisure hours for promoting physical wellbeing.
(2) Many are liable to catch cold and suffer from lower back pain. Obesity, byperlipemia and liver dysfunction due to excessive alcohol intake are notable.
(3) Compared with farmers, they are youg, but many are out of condition.
(4) Health conditions of those who have undergone medical checkups for the therr years running showed some improovement in obesity and high blood pressure, but the cases of ECC disorder and liver dysfunction have increased.
(5) Bad health conditions derived from personal habtis could be rectified if long-term educational measures and others were implemented.

We evaluated decreases in glycosylated hemoglobin (HbA1c) achieved by reducing carbohydrate from various sources in type 2 diabetes mellitus patients.

Background: We evaluated decreases in glycosylated hemoglobin (HbA1c) achieved by reducing carbohydrate from various sources in type 2 diabetes mellitus patients. Methods: We followed up 138 male and 107 female outpatients on a moderate low-carbohydrate diet without diabetic medication for 6 months. Changes in carbohydrate sources (Δcarbohydrate) were assessed from 3-day dietary records at baseline and 6 months, and associations with changes in HbA1c (ΔHbA1c) were examined with Spearman’s correlation coefficients (rs) and multiple regression analysis. Results: ΔHbA1c was –1.5%±1.6% in men and –0.9%±1.3% in women, while Δtotal carbohydrate was –115.3±103.7 g/day in men and –63.6±71.1 g/day in women. Positive associations with ΔHbA1c were found for Δtotal carbohydrate (rs =0.584), Δcarbohydrate from soft drinks (0.368), confectionery (0.361), rice (0.325), bread (0.221), Chinese soup noodles (0.199) in men, and Δtotal carbohydrate (0.547) and Δcarbohydrate from rice (0.376) and confectionery (0.195) in women. Reducing carbohydrate sources by 50 g achieved decreases in HbA1c of 0.43% for total carbohydrate, 1.33% for soft drinks, 0.88% for confectionery, 0.63% for bread, 0.82% for Chinese soup noodles and 0.34% for rice in men and 0.45% for total carbohydrate, 0.67% for confectionery and 0.34% for rice in women, although mean reductions in carbohydrate from these sources were much smaller than that from rice. Conclusion Decreases in HbA1c achieved by reducing carbohydrate from soft drinks, confectionery, bread and Chinese soup noodles were 2- to 4-fold greater than that for rice. Our results will enable patients to decrease HbA1c efficiently (UMIN000009866).

We evaluated decreases in glycosylated hemoglobin (HbA1c) achieved by reducing carbohydrate from various sources in type 2 diabetes mellitus patients.

We report two cases of patients with intractable upper abdominal pain and histories of injury or surgery. The patients' pains were successfully treated with tokishigyakukagoshuyushokyoto (TSG). Case 1 involved a 59-year-old woman with left upper abdominal and thoracodorsal pain lasting 5 years. Kampo drugs such as tokito or prescriptions containing saiko were ineffective. Two years after her first visit, we noticed an injury scar from childhood that passed near the left hikon (pi-gen, ExB4) and induration and tenderness of the left hikon. TSG was administered, and the pain promptly improved. Case 2 involved a 66-year-old woman. She complained of epigastric, right­-upper-­quadrant abdominal and back pain lasting 7 years. Two years before presentation, the pain had worsened, but the cause was unclear. Although keishibukuryogan or Kampo drugs containing saiko were ineffective, her pain improved when TSG plus bushi was administered. A wound from a cholecystectomy was observed on her right abdomen. Induration and tenderness of the right hikon were demonstrated. The combination of past history of injury or surgery of the upper abdomen or back and induration of hikon can be associated with development of indications for TSG.

Introduction
Essential hypertension is one of the leading causes of hypertension; responsible for more than 90% of such cases. Diet cure or drug treatment are usually prescribed for this disease. We drew notice to the antihypertensive effects of acupuncture.
Method
Subjects were healthy persons as well as patients complainig of simple essential hypertension. According to the WHO method, they were divided into three groups, e. g. normal, limitaneus, hypertensive. In situ needles were inserted in the antihypertensive points of both auricular sides for one week.
Effect
This treatment gave immediate results in 70% of the limitaneus and hypertensive groups. There was no observable effect for the balance. A number of these subjects were obese; a factor to be considered.
Evaluation
This method is very uncomplex and takes but minimal amount of time to treat patients.

  We previously reported that in patients with Alzheimer’s disease (AD), the number of baths that patients report taking at their first evaluation at a memory clinic was significantly decreased in comparison to before the onset of dementia. Based on this research, we thought further longitudinal evaluation was needed regarding the relationship between the number of baths, cognitive impairment and depression state after AD progression. In the present study, we reevaluate the number of baths; cognitive function tests (Hasegawa’s Dementia Scale-Revised [HDS-R], Mini Mental State Examination [MMSE] and Wechsler Adult Intelligence Scale-Revised [WAIS-R]); and the depression assessment (Zung Self-rating Depression Scale [SDS]) 1 year after first evaluation.   At the first evaluation, the average number of baths taken by 65 AD patients (16 male, 49 female; range: 64-90 years, average: 79.5±5.6 years), was 5.6±1.6 bathsweek. At the reevaluation, this number had decreased to 4.9±1.9 bathsweek. In the WAIS-R, a significant positive correlation was found between the score change in number of baths and the change in performance intelligence quotient (PIQ) and total intelligence quotient (TIQ). However, no significant correlation was found between the score change in number of baths and the change in HDS-R, MMSE, or verbal intelligence quotient in WAIS-R or SDS.   We further evaluated the present series by dividing the study population into two subtypes: a group of patients in which the number of baths decreased 1 year after the first evaluation, and a group in which there was no change. There were no significant differences in background factors (e.g. average age at first evaluation) between the groups. Although, no significant difference was observed between the groups in number of baths before dementia onset (both were 6.7 timesweek), a significant difference was found at the first evaluation (5.3 bathsweek vs 5.9 bathsweek, respectively). No significant differences were observed between the groups in cognitive function test or depression assessment at the first evaluation. However, on reevaluation the group with the decreased number of baths showed significantly lower PIQ and TIQ scores in WAIS-R and a significantly higher SDS score.   The results of the present study suggested that number of baths decreased along with the progression of AD and the greatest participating factor was the practical dysfunction reflected by the PIQ score in WAIS-R. Furthermore, we considered the existence of two subtypes: patients in whom the number of baths decreases with AD progression and those in whom there is no change.