We studied in acne vulgaris of Korean adolescence by inspections and questionaires. We examined 4,766 of male and 4,178 of female, aged 10 to 21. Maximal prevalence rate was observed in the group of 20 years old male (84.4%) and 18 years old female (50.4%). Generally, prevalence rate and severity in male were higher than fema1e. Female, however, had higher prevalence rate than male before 14 years of age. The mean age of onset was 15.9 + l.4 in male and 14.9 + 1.5 in female. The earliest age with acne eruption was 11 in male and 10 in female. The extensive acne was observed to be more comon in male than in female. The highest prevalerice of more severe forrn tha Grade 2 (clinical acne) was observed in male of 16 years old group (67.9%) and in female of 14 (16.1%). The course of acne vulgaris was 1-2 year earlier in fcmale than in male. Acne vulgaris in Korean was milder, lesser common, and had later development than in Caucasoid.
Acne Vulgaris* ; Adolescent* ; Age of Onset ; Female ; Humans ; Male ; Prevalence ; Young Adult

No abstract available.
Respiration* ; Sleep Wake Disorders*

An epidemiological study of clonorchiasis and paragonimiasis westermani prevailed among the people of a rural county. The author studied the infection rates of clonorchiasis sinensis and paragonimiasis westermani in the ingabitants of Chungsong Gun, Kyungbuk Province, Korea. The examinations were carried out from March 1965 to November 1965 fowards 1.303 inhabitants whose ages were ranging from three months to over sixty years. All the inhabitants were tested intradermally with clonorchis and paragonimus antigen and then confirmed the eggs by M.G.L. technique and sputum test. The results of the examination were summarized as follows : 1. Out of the persons tested, 15.8% were infected with clonorchiasis sinensis. 2. Out of the persons tested with paragonimus antigen, 20.9% were infected with Paragonimus westermani. 3. The infection rate of paragonimiasis was higher than that of clonorchasis, 4. The infection rate of clonorchiasis in male was 20.8%(147 out of 706), while that in female was 7.1%(58 out of 597). The infection rate of paragonimiasis in male was 21.2%(150 out of 706), while that in female was 20.1%(120 out of 597). 5. The maximum infection rates of clonorchiasis and paragonimiasis were observed among the 45-49 age group(65.2% and 43.5%) respectively, however it was gradually decreased in the senile group. 6. By occupation, the maximum infection rate of clonorchisasis was observed in policemen(45.7%) and the maximum carrier of eggs(by sputum test) was observed in unemployed(paragonimiasis). 7. By education, the maximum infection rate of clonorchiasis was observed in the unemployed(28.9%) and the maximum carrier of eggs(by sputum test) was observed in the unemployed(paragnomiasis).
Clonorchiasis* ; Education ; Eggs ; Epidemiologic Studies* ; Female ; Humans ; Korea ; Male ; Occupations ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Sputum

Diseases of the digestive system have been the most frequently occurring malady in Japan. Foremost among them is stomach cancer in terms of the frequency of incidence and poor prognosis. In recent years however the incidence of colorectal cancer, a well-known malignancy of plaguing. Western countries, has been increasing also in Japan apparently as a result of the change in eating habit, and is expected to become the highest of all the rates of malignancies affecting the Japanese population in due course of time.
Under such circumstances, it is worthwhile to grasp the current exact status of occurrence of cancer of the digestive system in farming areas of Japan and to know the actual status of mass screening which is known to be effective in early detection of cancer, if it is to improve therapeutic results and thereby to establish ways and means of further effective cancer therapy.
The recent improvement in therapeutic results of gastric cancer is due largely to energetic mass screening and/or complete medical checkup activities of participating institutions and a marked increase in early detection rate of disease.Positive performance of an extended radical operation, such as total gastrectomy or extra-gastric organ resection, facilitated or aided by the improved anesthetic technique and postoperative management as well as by advances in surgical technique for advanced gastric cancer certainly is also a contributing factor. In fact, therapeutic results obtained by some of the participating institutinons were not at all inferior to those achieved by national institutions as far as gastric cancer is concerned.
Since mass screening for colorectal cancer is a formidable task apparently beyond each private institution's capacity and since, because of the anatomical position of a lesion, it may occasionally be difficult to have examinees cooperate, the mass colorectal survey system generally was less well organized and working as compared with the mass gastric survey system.
However, the availability of immunologic testing for occult blood in stools, enema fluoroscopy and colonoscopy has made it possible to raise detection rates of early-stage cancer. As in the case with gastric cancer, extended radical operation has been performed positively andtherapeutic results improved markedly thanks to recent progress in diagnostic and operative techniques.

I graduated from the Tokyo Medical and Dental Professional School in 1948. After I completed a 1-year internship, I joined the hospital attached to the alma mater as a member of the First Department of Surgery headed by Prof. Kenkichi Kawashima in April 1949 and worked at the hospital and school for 24 years and 9 months.
Professor Kawashima was a master surgeon having the highest surgical skill, as well as a true educator with exemplary character.
During this period, I received a basic training and instruction in surgical techniques as a surgeon from him, while I conducted research on liver, gallbladder, and pancreas diseases.
Subseqently, on October 1, 1973, I succeeded Prof. emeritus Kawashima in his position as the head director of Tsuchiura Kyodo General Hospital and have since there for 21 years. What I always kept in mind was not to damage Prof. Kawashima's reputation, to treat patients with sympathy, which Prof. Kawashima taught, and to manage the hospital soundly while training our juniors.
As such, my 45-year life as a physician can be divided into the school period and the hospital period.
[I The school period]
Majoring in abdoninal and thoracic surgery, I particularly threw myself into the studies of liver, gallbladder and pancreas diseases, and contributed to (1) the development of a cholangioscope, (2) advances in the treatment of malignant diseases in the liver, gallbladder and pancreas, and (3) clarification of pathogenesis of cholelithiasis, in particular strawberry-like gallbladder.
[II The Tsuchiura Kyodo General Hospital period]
In this period, I put emphasis on the providing of medical care to regional farmers and residents. For that purpose, I strove to restructure the hospital as a full-scale complete medical care facility, namely, a congregation of differently specialized centers.
The subjects that I concentrated on included (1) enlargement and improvement of the facilities in the Rural Health Care Center, (2) establishmeht of a perinatal center, (3) construction of a new Emergency Life-saving Center, (4) approval as a Local Cancer Center of Ibaraki Prefecture, (5) cooperation with Santenu Senile Care House, and (6) AIDS.
When I look back on my 45-year career as a physician, my respected professors who taught us in the school and the juniors with whom studies were conducted together were recalled.
I express my sincere gratitude to the chairman of Ibaraki Prefectural Koseiren and the officers who entrusted me with all the responsibillities of the hospital management, and the entire medical staff who were devoted to developing the hospital together with me.
These are friends with whom I have openly consulted for all problems which I faced since I entered the Japanese Association of Rural Medicine. I will share that joy by living together with friends.
Finally, what I would like to say is that I wish to continue to work for activating the association and medicine in which foresight and creative opinions of vigorous young people are respected and encouraged.

1) Japan made a remarkable recovery from ashes in the aftermath of World War II due to the people's effort to rebuild their lives and policy markers strong leadership. Moreover, great progress in medicine improved the quality of life.
2) A sweeping change in the living environment brought about a salient change in “disease structure.” There is no major difference between diseases endemic in the rural area and those in urban area.
3) Services provided by hospitals affiliated Koseiren (the Agricultural Cooperation for Health and Welfare) include internal medicine, pediatrics, surgery, orthopedics and obstetrics and gynecology. Medical services are provided by expert doctors in each department, and their mission is to improve the quality of rural medicine.
4) Apart from department-wise treatment, there is an interdisciplinary system making it easier for clinicians in different departments to cooperate. More attention should therefore be given to medical practices by these clinicians. Clinical medicine needs not be considered a particular type of practice in a rural setting. Rural medicine should be included in the category of general medicine.
5) Unlike teaching hospitals affiliated with a university, Koseiren hospitals have an extensive range of services including treatment of common diseases (eg, common cold or diarrhea, etc.), primary care, prevention of the three most common causes of death, treatment of lifestyle-related diseases, emergency treatment, a routine health checkup, home-visit nursing care services and home care. Given the present status surrounding a rural hospital which offers extensive services, young clinicians should no longer be equally encouraged to embrace the traditional idea of rural medicine. They should rather make better use of their expertise in the management of community-based medical services.
6) Studies on clinical medicine have gradually outnumberd those on rural medicine in the collection of lectures given at the general meeting of the Japanese Association of Rural Medicine (JARM) since its establishment indicating a change in the trend of rural medicine.
7) A course in rural medicine is not offered by the faculty of medicine in Japanese universities, which indicates that Japanese Ministry of Education, Culture, Sports, Science and Technology underestimates the importance of rural medicine.
8) Rural medicine dedicated to maintaining and improving the health of the rural populace is not related to the declining tendency of agriculture and rural population as a result of irresponsible Japanese agricultural administration. Rural clinicians are not responsible for that.
9) There is no point in discussing a definition of rural medicine usually influeneced by the thought, career and religious idea of those who govern. From my standpoint as a director of a community general hospital, I think clinical medicine should cover a broad range of areas.
10) Last but not least, my strongest hope is that an increasing number of young researchers will be interested in rural medicine besides pursuing their interests im their own area of expertise, and will be enrolled a members of the JARM. With a reduced number of members, the society's idea will die. I will follow the way that the JARM changes over time hoping for its further develpoment.

　To survive in a changing social environment of medical care in Japan, medical students should learn viewpoints and methods of social sciences. In recent years in Japan, the importance of primary and community care is increasing due to the change of the disease structure in an aging society. Future talented doctors should be competent mediators between hospital medical and community care. In community care, it is necessary to understand clients in socio-cultural contexts. Social sciences can provide viewpoints and methods to understand people in such contexts. Social sciences can also provide a macroscopic understanding of the influence of the social structure on the medical system.

　Case studies and PBL may be suitable to learn viewpoints and methods of social sciences in medical education. So, the accumulation of cases which sufficiently provide problems to be analyzed by the methods of social sciences is necessary. The collaboration of medical practitioners and social scientists is also necessary to develop these teaching materials and education methods.