The national health insurance record is an important source of information regarding the trend of morbidity throughout Japan. Using the record, we clarified the characteristics and annual trends of morbidity for main diseases in municipalities in Ibaraki Prefecture.
Age-adjusted morbidity rates in each municipality were calculated from the number of patients actually covered by the national health insurance and the number of the insured population from 1980 to 1992. To classify municipalities by the degree of urbanization, the proportions of farming population were used. Eighty-seven municipalities were classified into the three groups; urban group (UG), middle group (MG) and rural group (RG).
According to the pattern of annual morbidity in the three groups (UG, MG, RG) from 1980 to 1992, main diseases were classified as follows. The diseases for which the rates in UG were always higher than that in RG during the study period: Total morbidity rate in UG was about 10% higher than other two groups. Diabetes, heart disease and liver disease were included in this category, and especially, morbidity rate for allergic rhinitis in UG was nearly twice as much as that in other groups. The diseases for which the rates in RG are higher than UG during the study period: Only hypertension was included in the category. The diseases for which the rates in RG were higher than that in UG in the beginning while the rate intersected in the study period: Cerebral hemorrhage and cerebral infarction were included in this category.
There were no differences between UG and RG in morbidity rates for gastric cancer, intestinal cancer and lung cancer.
The results were confirmed by classifying the maps of municipalities into the three categorieswith 12-year average morbidity rates for main diseases.

828 female agricultural workers were studied. Their age, blood pressure, Broca index, hemoglobin content, serum total cholesterol, activity of serum cholinesterase and transaminase (GOT and GPT) was measured. The distribution of each factor was examined in the sample of agricultural workers. The data for mean blood pressure, total cholesterol, activity of cholinesterase, GOT and GPT showed a log normal distribution.
For the screening of the data, Mahalanobis's distance was calculated and the abnormal data (P<0.01) was compared with the worker's medical record. The data of non healthy women was excluded from the following calculation.
The correlation coefficients between the activity of cholinesterase and other factors (age, Broca index, mean blood pressure, hemoglobin content, GOT and GPT) were statistically significant. This result indicates that the activity of cholinesterase somewhat depends on these factors.
It is important to investigate the relationships between the activity of cholinesterase and some biochemical factors, and to establish the standard value of its activity in order to estimate the effect of pesticides.

A system for making prolonged measurements of oxygen uptake without the use of mask or mouthpiece is described. A subject wears a hood through which air is drawn by a exhaust pump located on the end of hoses. The flow rate of main stream is measured by a pulsed wire flowmeter located between flexible hose and rigid hose. The flow rate is essentially constant during a run. One sample pump bypasses small amount of mixed air from the main stream. The other pump draws the room air. Two sample pumps operate alternatively at 2 min interval. The sample gas is dried by passing through molecular sieve desiccant and is delivered to in-line oxygen analyzer. Both signals of flow rate and oxygen concentrations of room air and mixed air are converted to digital quantities and then stores in memory devices at 5 min interval. All measuring devices were assembled to small package which the subject carries on his back. The weight was about 7 kg. The memory chip is removed from the device after experiment and oxygen uptake is estimated by connecting the memory chip to a microcomputer. This measurement compared favorably with measurement with Douglas bag collection and gas analysis.

Respiratory and dermal exposures of the sprayman to pesticide sprayed by a dilute spray machine (speed sprayer) were studied in fruits orchards. Aerial concentration change of pesticide in the air were also investigated. The degrees of respiratory and dermal exposures were nearly independent on the size of machine, while they were higher in spring than in summer. The degree of respiratory exposure of pesticide was proportional to that of dermal exposure. The dermal exposure of sprayman was greatly reduced by the use of the machine equipped with a hood, which was not so effective against his respiratory exposure.
Serum choline esterase activity of the sprayman was almost unchanged after pesticide spraying. The pesticide in orchard air was detected more than 3 hours after spraying. When pesticide was sprayed by the speed sprayer, the pesticide mist drifted into the house near the orchard.

High concentration of airborne particles was detected in greenhouse air after suspended particulate pesticide spraying. The reduction of aerial concentration of resprirable particulate pesticide was relatively slow.
To study the potential health effects of inhaled pesticide, the animals were exposed to the pesticide, methidathion particles in the inhalation exposure chamber. The exposed pesticide particles were approximately 2.16 μm mass median diameter.
The animals exposed to suspended particulate pesticide had a considerable amount of particles within alveolar macropharges and alveolar epithelia. The serious lesion of alveolar epithelia and capillary endothelia of the animals occured after inhalation of methidathion particles.
The vacuolar degeneration of hepatic cell was also cytosol decreased significantly after inhalation of methidathione particles.
The exposure to suspended particulate methidathion induced production of thiobarbituric acid reacting substances (TBARS) in hepatic cells of the exposed animals. The induction of TBARS formation in hepatic cells was remarkable at early period of exposure.
The change of serum transaminase (GOT) activities after exposure to methidathion particle was remarkable. GOT activities also markedly increased at early period of exposure.

The regression analysis between the activity of serum cholinesterase and some biochemical factors of female agricultural workers was examined.
To normalize the value of the factors, logarithmic value was calculated. Multiple regression analysis between the activity of cholinesterase and the factors related to liver function, such as the activity of GOT, GPT and total cholesterol content were calculated. The most significant factor related to cholinesterase was total cholesterol content, and the activity of GPT was the second. The Multiple regression coefficients of the equation between the cholinesterase and total cholesterol and GPT were from 9.7 to 18.3.
Using all biochemical factors as independent variables, the most suitable equation was determined from calculating the predictive sum of square (PSS). The activity of cholinesterase (ln (ChE)) depends upon the following factors, age, ln (GPT), ln (TCh) and Broca index. Hemoglobin content could also be added as a variable. The equation is;
ln (ChE) =0.002126 (age) +0.04028 ln (GPT) +0.2112 ln (TCh) +0.002188 (Broca index)-1.5687+α Where α is the parameter of each population.
From this equation, the standard value of the activity of cholinesterase of each woman was calculated. The estimate of cholinesterase activity may be useful to examine the inhibitory effect of pesticides on cholinesterase.

Mediastinitis following graft replacement of the ascending and total arch aorta is a fatal complication of cardiac surgery. When graft infection is suspected, one choice of treatment is to remove the infected prosthesis and replace it with a new one. However such a procedure seems to be very risky. We report 2 successfully treated cases of mediastinitis following graft replacement of the ascending and total arch aorta. In one case, we treated with primary sternal closure after debridement and omental flap implant. In another case, the wound was left open and irrigation with iodine solution was undertaken for 6 days. The sternum was closed with pectoralis major muscle flap implantation. When graft infection is not suspected, primary sternal closure with implantation of tissue flaps is recommended. When graft infection is strongly suspected, we prefer secondary sternal closure after open irrigation.

A 44-year-old man underwent total arch replacement for acute type A aortic dissection. He was treated postoperatively in the intensive care unit for acute renal failure and respiratory failure. Although recovery of organ functions was seen, an unexpected fall in platelet count (PLT) occurred abruptly on postoperative day (POD) 7. The patient was treated with gabexate mesilate and platelet transfusion because disseminated intravascular coagulation (DIC) was initially suspected. Nevertheless, PLT dropped rapidly below 1.0×10⁴/μl. We suspected heparin-induced thrombocytopenia (HIT) and stopped all heparin administration including flush solution for pressure monitoring lines. The platelet factor 4-reactive HIT antibody test was performed and we began to give intravenous argatroban, 60mg/day. However, PLT did not increase at all. Multiple organ failure developed and metabolic acidosis deteriorated rapidly resulting in death on POD 15. HIT antibody was positive on POD 13 and a definitive diagnosed of HIT was made. For those patients treated with heparin continuously or repeatedly, HIT may occur and increase the mortality risk if the diagnosis is delayed.

We have carried out a health developing project for three years at two flat rural areas in Ibaraki prefecture, O in Ushiku town and N in Iwai city, taking female farmers as the subjects.
As a result, people in these areas obtained by developing reciprocal assistance a belief in selfsupport and knowledge of diseases, which lead to remarkable progress of their health such as improvement of nutrition and cosolidation of agricultural and life environment. Some observations in the study are discussed below.
1) In the two areas, the number of people with no abnormality increased while those requiring care decreased, The number of people to be treated or under treatment was nearly unchanged, probably because of chronic deseases. No death and complication occured during the three years.
2) Owing to the difference between O and N areas in the age structure of examinees, areal characteristics and types of agricultural products, the results of health examinations in these two areas were somewhat different.
3) The health developing project will become more effective if male farmers participate together with the female farmers.
4) Continuation of the health care activity in these areas will establish voluntary organizations of residents.

To study the potential health effects of suspended particulate pesticide-Supracide FD, the animals were exposed to the pesticide particle in the inhalation exposure chamber. The suspended particulate pesticide was approximately 2.16μm mass median diameter.
The animals exposed to suspended particulate pesticide had a considerable amount of particles throughout the alveolar region.The particles deposited mainly within alveolar macropharge and alveolar epithelium. The epithelial lesion of the pulmonary tissue and the vacuolar degeneration of hepatic cell of the animals occured after inhalation of pesticide particle.
The exposure to Supracide FD induced production of more thiobarbituric acid reacting substances (TBARS) in comparison to the controls. The change of serum GOT and LDH activities after exposure to pesticide particle was also remarkable. The exposure to the pesticide particle caused no significant effect on the serum cholinesterase activity.