A survey has been under way on the incidence of cerebral apoplexy among the inhabitants (pop. 105, 185, National Census, 1970) of the Saku district of Nagano Prefecture since April 1972.
This survey, which constitutes a WHO cooperative study, has been under way with cooperation rendered by the local Medical Association, Association of Public Health Nurses in Saku District and Saku Public Health Center with the Saku Central Hospital acting as the survey center.
In the period of two years till March 1974, 585 persons were registered as having been seized with cerebral apoplexy. The annual incidence rate stood at 265 per 100, 000 population. Classified by types of cerebral apoplexy, cerebral hemorrhage accounted for 26%, cerebral thrombosis for 57%, cerebral embolism for 3%, subarachnoid hemorrhage for 9%, and other types for 5%.
By sexes, the incidence rate among males was 1.3 times higher than among females. By ages, the incidence was highest in the seventies.
When the prognosis of cerebral apoplexy is viewed in terms of deaths in the early period of less than three weeks after the onset, the mortality rate stood at 45%.
The hospitalization rate of patients seized with cerebral apoplexy was 55%. There was a significant difference in the mortality rate between inpatients (with 28%) and outpatients (65%).
The ratio of concurrence of autopsy and clinical diagnosis stood at 83% with Okinaka's criteria and 79% with Ikeda's CVD index.
The incidence of hypertension before the onset of cerebral apoplexy was extremely high among the patients seized with cerebral hemorrhage and cerebral infarction.With respect to the treatment of hypertension, the discontinuance of treatment and the failure to undergo it are high in percentage among the patients seized with cerebral hemorrhage. With reference to cerebral infarction patients of 70 years and older in age, there is little defference between the group who discontinued or failed to undergo treatment and the group who underwent it.
The recurrence of cerebral apoplexy stood at 11% for cerebral hemorrhage, 19% for cerebral infarction, and 11% for subarachnoid hemorrhage.

Introduction: This report describes a case of hyperactive delirium induced by tapenatadol whose symptoms were successfully managed with opioid-switching to oxycodon. Case: A 67-year-old female, who had been treated with chemotherapy for malignant thymoma, had to stop chemotherapy because of her carcinomatous pericarditis. Tapentadol 200 mg per day was administrated for her unbearable chest wall tumor invasion-related somatic pain. After a while, insomnia, visual hallucination, thought disturbance, and attention disturbance were appeared. We diagnosed as hyperactive delirium. Because her somatic pain was favorably controlled by tapentadol, we additionally administered quetiapine 50 mg per day instead of replacing tapentadol. Unfortunately, quetiapine was not effective for the delirium. We therefore switched opioids from tapentadol to oxycodon. The delirium was remitted soon after the switching without relapsing of the pain. Conclusion: Tapentadaol reportedly induce hyperactive delirium via its noradrenaline reuptake inhibitory action. This case suggests that switching tapenatadol to other opioid could be an effective option for opioid induced delirium.

This paper discussed the introductory medical training system and medical team care problems at University Hospital of Tsukuba.
The characteristics of this training system are that the duration of training is the fourth year medical students at the University of Tsukuba and to exercise the roles of nursing service at University Hospital.
In this practice, medical students are expected to comprehend about the significance of team work in medical care, to practice in the work of nurses and c-medical workers for learning their roles. We introduce our purpose and practice of this medical team care. Problems of this trial are discussed in this paper. But we have confirmed that this experimental. Trial is useful experience to all medical students and the items of this practical exercise are one of the most effective training method for them.

For the purpose of learning the comprehensive medical team care. we tried for the fourth year medical students at University of Tsukuba to exercise the nursing service and the team care system in the Hospital of University of Tsukuba.
These practice were already undergone during past twelve years.
In this practice, students are expected to comprehend about the significance of team work in medical care, to understand the meaning of medical care, to learn especially the roles of nursing and rehabilitation medicine (in total medical care system), to practice in the work of nurses and co-medical workers for understanding their roles, to study the basic science and contribution in medical team care of rehabilitation medicine, to comprehend about the outline of the health, medical care system, and medical economics.
As the items of this practical exercise, all students must work as follows:
1. collection of venous blood and check of vital signs.
2. practical work of nursing service.
day time service: 8:00 a.m.-11:30 a.m.(fourtimes)
1:00 p.m.-4:30 p.m.(once)
early night service: 5:00 p.m.-0:00 a.m.(once)
midnight service: 0:00 a.m.-8:30 a.m.(once)
Moreover 15 corelative lectures are prepared.
For these twelve years, we researched motivating effects and impression of this exercise about both medical students and nurses by method of using questionnaire. We hope to grow kindly doctors having the mind of humanity.

Premenstrual syndrome (PMS) that occur during late luteal phase is a problem for many female athletes. Many studies reported that subjective condition is affected by PMS in female athletes. Moreover, female athletes with PMS have higher stress and/or anxiety levels during luteal phase compared with non-PMS athletes. However, the relationship between PMS and physical performance in female athletes are not clarified yet. The purpose of this study was to investigate the relationship between premenstrual syndrome (PMS) and jump performance in female track and field athletes. Sixteen participants who has natural basal body temperature pattern with the menstrual cycle (observed low-temperature and high-temperature phase), were participated in this study. PMS was assessed by ACOG’s premenstrual syndrome questionnaire. As physical performance, counter movement jump (CMJ) and rebound jump (RJ) were evaluated in low-temperature phase and high-temperature phase. The result of this study, no significant differences were observed in body composition and physical performance between low-temperature phase and high-temperature phase. However, compared with participants who had non-symptom, participants who had a breast tenderness of PMS showed larger decreases in jump height of CMJ (p = 0.038) and RJ index (p = 0.015) in high-temperature phase. Therefore, PMS may have a negative effect on physical performance during high-temperature phase in female athletes.

Utilizing data presented in the article by Miyashita et al., we illustrate the importance of testing data when assessing surveillance data. Accounting for the number of tests (denominator) and positivity (proportion of tests positive for a specific pathogen(s)) improves data interpretation in ways not possible from numerator case data alone.