The purpose of this survey is to determine the effect of balneotherapy at the Sukawa hot Spring. The spring provides hot water baths and a special kind of natural steam baths of volcanic origin. The spring water contains alum and green vitriol and shows strong acidity. The steam which blows up from the ground is used for the steam bath. The spring is situated in a alpine plateau, about 1200m. above the sea level, of Kurikoma volcanoes. In summer the climate is mild and the average August temperature is 17.9°C.
Since 1925 studies have been carried out by the staffs of our medical school and Some results were published. In 1935, Miyasaka et al. showed that the most bathers of the spring were the patients with respiratory diseases. It was noted, however, that recently the quality of the bathers seemd to have changed gradually, which led us to reexamine the effect of the balneotherapy on these new population of the bathers.
One hundred and thirty six bathers who stayed more than 2 weeks in the spring and took hot water bath twice daily and stream bath twice daily were used as a material, They were questioned twice by means of the CMI card method, first at the time of their arrival at the spring and the second at the time of departure.
The results are summarized as follows.
In 1935 the patients with respiratory diseases, especially with pulmonary tuberculosis occupied 37 per cent of all the bathers and the patients with gastrointestinal symptomes occupied only 16 per cent. Whereas in 1964 the ratio of the patients with G. I. symptomes increased to 34.7 per cent of all the bathers, most of them with the functional gastrointestinal disorders. The reason of the decrease in the ratio of patients with respiratory diseases may be explained by the fact that during the last 20 years the sanatorium therapy as the treatment of pulmonary tuberculosis has been replaced by the effective chemotherapy and by the increase of patients with functional disorders of the gastrointestinal tract, particularly on psychosomatic bases, which have probably due to “stress” elements spreading into our social life.
The balneotherapy was found to be effective in patients with functional disorders of the G. I. tract including psychosomatic diseases of the G. I. tract, which have characterized by soft stool, diarrhea, constipation, epigastri distress or fullness and abdominal dulla ches. Fifty five per cent of these patients, classified in the 3 rd and 4th area of CMI card or as a neurosis group improved after balneotherapy. Recently such psychosomatic diseases are increasing rapidly. In view of the fact that there is no effective treatment available for such diseases except for psychotherapy, the promissing results in our study suggest that the balneotherapy including sanatorium mood in fine circumstances may be a good indication for such diseases.

In March 1986, an academic program on family care medicine was started at Jikei University School of Medicine upon consultation with Prof. Masakazu Abe, then President of the Jikei University School of Medicine, and Dr. Tomojiro Nagai, founder of the Medical Practitioners' Association of Japan. The program offers two elective seminars on family care medicine in the spring and summer for 4th and 5th year medical students. The objective was to give students opportunities to visit and observe medical care provided by practitioners, to teach them the importance of the function of family physicians, and to offer them options in their future careers.
The total number of participating students from the first through 20th seminars was 121, with a maximum number of participants per seminar of 11 and a minimum of 3 (average of 6). A total of 37 instructors took part in the program by giving from 1 to 18 seminars per instructor (average of 3.3). We found these seminars to be highly educational not only for the students but also for the instructing physicians.

The committee of continuing medical education in Japan Society for Medical Education discussed on PRA of American Medical Association [AMA]. We have first analyzed the brochure of PRA for the members of AMA, and then prepared the questionnaire for AMA. We were able to obtained the answers to the questionnaire which were sent to AMA through courtesy of Japanese Medical Association (JMA). It was realized that AMA emphasizes an importance of PRA for medical practice to the patients; nevertheless acquisition rate of PRA is actually low, and so AMA proceeds with efforts towards completion of PRA.

Two hundred and thirty adipose tissues were collected from inpatients, who had undergone an operation and an autopsy in the Saku Central Hospital from 1980 to 1982. Organochlorine pesticides were extracted from the adipose tissues and determined by gas-liquid chromatography with an electron-capture detector.
The mean value was 1, 429 ppm for total BHC among males, and 1.665 ppm among females, 4.893 ppm and 3.791 ppm for total DDT, 1.082 ppm and 0.782 ppm for PCB, respectively. Regression analysis between the total BHC residue and the ages of patients indicated a positive correlation for both sexs. As for the relation between the rate of obesity and the residues, low rates of obesity (-10%--19%) were most significantly correlated with high values of total BHC, total DDT and PCB.
We also discussed relations between cancerous diseases and the residues.

Surveys on the snail intermediate hosts were undertaken in the paddy fields in Yatomi-cho, Aichi Prefecture, once a year over a 5-year period (1983-1987).
And the cercariae of two different avian schistosomes were detected from snails in paddy fields.
The cercariae from Polyplis haemisphaerula were identified as species beloning to the genus Gigantobilharzia and the cercariae from austropeplea ollula as species belonging to the genus Trichobilharzia.
It was concluded that the paddy field dermatitis occurring in Yatomi-cho was proved to be caused by the invasion of these cercariae.

INTRODUCTIONPulse oximetry (SpO2) measures oxygen saturation but not alveolar ventilation. Its failure to detect alveolar hypoventilation during sedated endoscopy under oxygen supplementation has been reported. The aim of this study was to measure the masking effect of oxygen supplementation in SpO2 when alveolar hypoventilation develops during sedated endoscopy.

METHODSA total of 70 patients undergoing sedated diagnostic colonoscopy were randomly divided into two groups - oxygen supplementation group (n = 35) and room air breathing group (n = 35). SpO2 and end-tidal carbon dioxide (etCO2) were measured by non-intubated capnography during the procedure for all the patients.

RESULTSThe rise of etCO2 caused by alveolar hypoventilation was comparable in the two groups after sedation. SpO2 was significantly higher in the oxygen supplementation group than in the room air breathing group (98.6% ± 1.4% vs. 93.1% ± 2.9%; p < 0.001) at peak etCO2, and oxygen supplementation caused SpO2 to be overestimated by greater than 5% when compared with room air. SpO2 at peak etCO2 was reduced from the baseline before sedation for the oxygen supplementation and room air breathing groups by 0.5% ± 1.1% and 4.1% ± 3.1%, respectively (p < 0.001).

CONCLUSIONSpO2 alone is not adequate for monitoring alveolar ventilation during sedated endoscopy under oxygen supplementation due to possible delays in detecting alveolar hypoventilation in patients. Even if SpO2 decreases by only 1% during the procedure and its level remains near 100%, physicians should consider the onset of severe alveolar hypoventilation, which requires immediate intervention.

Adult ; Aged ; Carbon Dioxide ; analysis ; Colonoscopy ; Conscious Sedation ; Endoscopy ; Female ; Humans ; Hypoventilation ; diagnosis ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Oximetry ; methods ; Oxygen ; administration & dosage ; Respiration, Artificial