Rikkunshito is known as a drug used for recovery from epigastric distress and loss of appetite. However, here we report four patients with symptoms involving non-gastrointestinal disorders successfully treated with rikkunshito. In Case 1 there was a complaint of erythema around the right eye, in Case 2 of hot flushes, in Case 3 of gonarthrosis, and in Case 4 of urticaria. After taking rikkunshito, these symptoms improved. The four cases were instances of hikyo, because in Cases 1, 3, 4 their disorders of the stomach were so severe that they couldn't take shishihakuhito, boiogito, jumihaidokuto and inchingoreisan, and in Case 2 there was poor appetite in summer. Thus we believe it is important to improve gastrointestinal symptoms with rikkunshito when various hikyo disorders arise.

Japan's food self-sufficiency rate has fallen off to around 40%. A questionnaire survey of residents of Toride-city reveals that 60% of the citizens are concerned about this low self-support rate. Even junior and senior high school students are anxious about this situation.
It is feared that world food production will not increase in proportion the rise in demand from now on by the influence of global warming. There is a possibility that foods supply could be temporarily cut off by the interruption of shipping lanes considering the unstable political conditions around Japan.
Although the decline in the self-sufficiency rate should be discussed as a fundamental subject of the country, the mass media of Japan do not take it up seriously. The mass media would not show how to deal with the food crisis, but only blame it as a result of the unreasonable agricultural policy.
Since 1993, Japan has approved minimum access of rice import, because the GATT and WTO put pressure on the Japanese government to approve the liberalization of the rice market. In 1999, rice tariffication was put into effect. The mass media and the government are afraid of the import restriction by foreign nation of industrial products from Japan as a result of the opposition to rice import in the name of food security.
The opening of the rice market will increase the imports of rice and the rice growers of Japan will sustain serious damage. Countries other than the U. S. and the Cairns Group will understand the Japanese assertion of food self-sufficiency as Japan is an island country. After reaching an agreement with the developing countries and NGO on this matter, Japan should revise the WTO agreement.
Although a farm village should retain some original scenery of Japan, housing styles and colors of a farm village in Japan are in total disarray. We want to propose to build 10-20 “model farm villages” in the country. If the model farm village retains Japanese original scenery, many city residents visit it and the image of an old farm village will give them a good impression, opening up the possibility of green tourism. If the model farm village gets a good reputation, the number of farm villages which hope to retain Japanese original scenery will increase and regain the rural beauty.
It is also important for a farm village to return to its original recycling life style. In Europe, it is a prevailing practice to recycle the garbage discharged from a farm village, including excretions of livestock, straw and so forth. And the technology, that changes biomass into methane or ethanol has been developed and become commercialized in Europe. It is important for a farm village to introduce such a technology and aim at a circulation style society more promptly than a city.
The Japanese Association of Rural Medicine should conduct a long-term prospective epidemiological survey to clarify whether the decrease in carbohydrate intake including rice and the increase in the ingestion of animal food have some relations with the recent rapid increase of diabetes. It will not be impossible to do so if collaboraion from medical examination centers across the country is obtained. If it becomes clear that the present eating habits are not good for our health, the rice-based diet revives and the demand for rice grows. And Japan's food self-sufficiency rate will go up in the long run.

Diagnosis is difficult in patients who complain of slight fever without objective abnormalities. It is not rare that patients without signs of typical Mycobacterium tuberculosis (TB) infection have a delayed TB diagnosis. It has been reported that the QuantiFERON TB-2G test is useful for diagnosing latent TB infection. We report a patient who suffered from sweating, body weight loss, and a fever of less than 37.5C without abnormalities in routine tests. Except for his complaints, only QuantiFERON TB-2G testing suggested his illness, after which he was successfully treated with isoniazid administration. QuantiFERON TB-2G testing might be useful to diagnose patients with slight fever when TB is suspected but a conventional workup is not diagnostic.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

The purpose of this study was to analyze the socioeconomic factors influencing patient discharge destination and the length of their hospital stay. We investigated 83 consecutive stroke patients admitted to our rehabilitation ward between January 1 and December 31, 2008. The mean age was 68.1 years old, the mean length of stay was 86.1 days, and 57% were men. The outcome for this study was the patient discharge destination, defined as home or a nursing home type of facility. To examine the predictors of the discharge destination, we collected data including patient age, sex, total Functional Independence Measure (FIM) scores at discharge, ‘living alone’, ‘over 65 years old’, ‘requiring public assistance’, and ‘having a family member at home who requires nursing care’. In all, 69 patients were able to return home, and 14 patients were discharged to a nursing home type of facility. The home group showed a higher total FIM score (p<0.001). Logistic regression analysis showed that two factors, ‘living alone’ and ‘having a family member at home who requires nursing care’, adversely affected patient discharge to home. Also, the length of stay was longer among those patients who required public assistance (p<0.01). This study suggests that it is harder for patients to be discharged back to their homes who have these factors : ‘having a family member at home who requires nursing care’ and ‘living alone’. Additionally, having the patient characteristic of ‘requiring public assistance’ could prolong the length of hospital stay.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

To confirm the safety and efficacy of a low-calorie mayonnaise supplemented with phytosterol esters (PEM) at a daily consumption dose of 884 mg given for 12 weeks with the goal of lowering serum low-density lipoprotein (LDL) cholesterol levels, we conducted a double-blind comparative study in healthy adults with marginally high serum levels of LDL cholesterol and total cholesterol using a mayonnaise without phytosterol esters supplementation (CM) as the control food. Serum LDL cholesterol levels decreased significantly in the PEM group as compared with the CM group during the 12-week intervention period (136.3 ± 16.4 vs. 145.0 ± 19.3 mg/dL at Week 8 (P < 0.05) and 135.0 ± 17.4 mg/dL vs. 144.9 ± 17.5 mg/dL at Week 12; P < 0.05). No observable adverse effects were observed due to the ingestion of PEM in this study. The safety of PEM was again confirmed by an additional clinical study in which healthy adult subjects ingested a 3-fold greater amount of PEM (2,652 mg of phytosterol esters as a daily dose) for 4 weeks. Thus, we concluded that PEM is effective in lowing serum levels of LDL cholesterol and is safe and well tolerated without any clinical problems.

　　With the aim of revamping hospital service as a pillar of our hospital reform movement, the Service Training Committee came into being in 2012.　　A questionnaire survey was conducted on the entire personnel and tenant suppliers (the entire personnel, tenants and contractors’ employees?). About 80% (705 people) of those queried replied. More than 90% of the respondents were of the view that an improvement in the manner of reception should enhance not only the prestige of the hospital, the evaluation its medical treatment and patients&rsauo; degree of satisfaction, but also hospital employees’ degree of satisfaction and their quality of life.　　On the other hand, some respondents said that there was much to be desired in the way hospital employees exchange greetings with their colleagues and in the manners or the language they use when they speak to patients.　　Most of the hospital staff seemed to understand the importance and meaning of service and hospitality very well. It was clear that the hospital employees were willing to join in our drive to improve the quality of service. They also understood the problems they should address to in earnest.　　We thought it was our task to make use of their positive attitude toward the quality improvement of service. What we have in view is to create a hospital culture that makes it seem natural to provide a high-quality service to visitors and patients. To this end, we will develop various activities and hold workshops.