Attentional disturbance following brain damage is usually evaluated by several neuropsychological tests. In a rehabilitation setting, however, the primary concern is not task performance, but rather functional real-world behavior. To address this requirement, a new assessment system for attentional behavior, BAAD (Behavioral Assessment of Attentional Disturbance), has been developed. This assessment is generally completed by the patient's therapist (occupational therapist, OT) during therapy. The aim of this study was to investigate whether BAAD completed by the family at home (BAAD-FM) yields results that are comparable to BAAD completed by an OT during occupational therapy (BAAD-OT). The subjects were 53 patients with brain damage. BAAD consists of six items thought to be associated with attentional behaviors. Each item is rated (0 to 3) based on the frequency with which the problem behaviors appeared during daily living at home and daily sessions of occupational therapy. The intraclass-correlation coefficient of the total score between BAAD-FM and BAAD-OT was 0.89. The mean (SD) values of the total scores were 3.7 (3.7) and 3.7 (3.6), respectively. Similarly, there were no significant differences in any of the item scores between BAAD-FM and BAAD-OT. The coincidence rate between the two BAAD tests on an item-by-item basis was over 64% for all items but one (43%). In conclusion, the total BAAD-FM score seemed comparable to the total BAAD-OT score and valuable for detecting attentional disturbance.

Satisfactory results were obtained when Daiou-kanzui-to was administered to a patient suffering from osteoarthritis with Graves' disease.
The patient was a 61-year-old female, whose chief complaint was bilateral knee joint pain and leg edema. She was admitted to our clinic in May, 1995. She was diagnosed with Graves' disease and thiamazole was administered for six months. After discharge, the knee joint pain and edema worsened and she was readmitted to our clinic **********. Abdominal examination revealed fullness and lenderness of the lower abdomen. After administration. of Daiou-kanzui-to, the knee joint pain and leg edema improved remarkably, and she was discharged on **********. Although hyperthyroidism was discovered during the second admission, it improved without anti-thyroid drugs after five months of treatment with Daiou-kanzui-to.
Despite the fact that Daiou-kanzui-to is a strong purgative, no side effects were observed even with longterm administration. There are only two reports on the use of Daiou-kanzui-to since the Meiji era. The authors investigated old texts concerning abdominal symptoms, such lower abdominal fullness, which characterizes Daiou-kanzui-to, to establish indications for its application.

An exploratory open-label human clinical study was performed in healthy adults with shoulder stiffness to evaluate the efficacy of Astaxanthin by means of measuring blood flow change in the shoulders and subjective questionnaires on physical conditions, including alleviation of stiffness before and after treatment. Two capsules containing 3 mg Astaxanthin each (6 mg in total) were administered once daily (6 mg a day) on days 1 to 28 (4 weeks) to 13 patients (3 men/10 women). All patients were assessed for efficacy and the study demonstrated significant improvements in physical conditions such as shoulder stiffness, physical fatigue, sense of mental irritation, sense of coldness in hands and feet, eye fatigue and eye bleariness. Significant increases of blood flow in shoulders were observed at the end of treatment using laser-doppler graphics. Blood tests conducted to confirm safety before and at the end of treatment showed no clinical differences, and no adverse side effects were reported. In conclusion, Astaxanthin appeared to safely alleviate stiff shoulders and improve other physical conditions during a 4-week open-label study.

Five autopsy cases of poisoning by the weed killer paraquat (Gramoxone) are presented.
Case 1. A 33-year-old female swallowed about 150 ml of Gramoxone. She died after 11 hours of intoxication.
Abnormal post-mortem findings were confined to the lungs, the kidneys and the adrenals. Histologically, the lungs showed congestion and edema; the kidneys showed tubular' degeneration and necrosis; and the adrenals showed cortical degeneration and necrosis.
Case 2. A 74-year-old male swallowed about 20 ml of Gramoxone. He died on the 4th day of ingestion of Gramoxone.
Histologically, the lungs were congestive and there were a moderate degree of hyperplasia of alveolar septa.
Alveolar spaces contained edematous fluid containing fibrin. Some skeletal muscle fibers were variable in size, and showed degenerative changes including vacuolization. The adrenal cortex was atrophic.
Case 3. A 44-year-old female swallowed about 20 ml of Gramoxone. She died on the 8th day of ingestion. The lungs were both congestive and edematous. Alveolar spaces contained edematous fluid with a trace amount of fibrin. The kidneys showed tubular degeneration. The liver showed a moderate degree of fatty changes in the central zones.
Acute oesophagitis and acute ulcerative change in the stomach were noticed.
Case 4. A 45-year-old male swallowed about 90 ml of Gramoxone. He died after 12 hours of intoxication. Histologically, the lungs were remarkably congestive and edematous. There were fatty changes in the central areas of the liver. Acute gastritis were noticed.
Case 5. A 32-year-old female swallowed about 15 ml of Gramoxone. She died on the 28th day of ingestion. At post-mortem examination, the lungs were solid and atelectatic. Histologically, the lungs showed generalized, severe degree of fibrosis together with desquamative changes of alveolar epithelium and PAS-positive hyaline menbrane formations. The liver showed a moderate degree of fatty changes in the central areas. The skeletal muscle fibers were variable in size showing a moderate degree of vacuolar and targetoid changes.
Various amounts of Paraquat were detected in the lungs, the livers, the kidneys and the muscles of case 1 and 4, in the fatty tissues and the brain of case 1 using formalin-fixed specimens.
Degenerative changes of skeletal muscle fibers presented in this report may be ascribed to the effect of Praquat in the light of the literature.

The purpose of this study was to shed light on the prevalence of the metabolic syndrome (MetS) in a rural community and examine whether or not serum adipocytokine levels are associated with the Diagnostic Criteria for MetS and how many MetS components laid down in the standards subjects have. The subjects were 2,858 people (1,744men and 1,114 women, mean age 49.8+/-9.9 yrs) who had participated in our health screening program between April and December, 2005. After obtaining informed consent from them, we measured serum leptin, adiponectin and high-sensitivity C-reactive protein levels, while performing routine blood tests. In the present study, these measurements were used in combination with the number of MetS components applicable to the conditions of our subjects. Two hundred men (11.5%) and 25 women (2.2%) were diagnosed with MetS. The number of MetS women was extremely small. Those women who were above the standard waist circumference of above 90cm accounted for 8.7% of the total. Thus, most women subjects were excluded as MetS candidates here. The leptin levels of the MetS group were higher than those of the non-MetS group in accordance with the number of applicable components in the diagnostic standards for MetS. Especially, the MetS group which met three MetS criteria showed significantly high leptin levels (p/5=0.0081) of 5.26+/-1.86 (ng/ml) compared to 3.31+/-1.44 (ng/ml) of the non-MetS group with waist circumference below 85cm. On the other hand, no significant difference was noted between the groups in adiponectin level. However, in contrast to leptin levels, adiponectin levels were lower in the group having three MetS components than the non-MetS group 4.37+/-1.57 (ng/ml) as against 5.52+/-3.34 (ng/ml). High-sensitivity CRP levels did not show any significant difference between the two groups.As regards the cutoff value of women's waist circumference, further study needs to be done. It was suggested that serum leptin levels might be closely related to the diagnostic criteria for MetS and the number of MetS components applicable.
Human Females ; Leptin ; ng/mL ; seconds ; adiponectin

To develop an osseointegration analyzing system for dental implants, a new analyzing system which can assess the level of osseointegration between an implant and trabecular bone was constructed using digital radiography with morphological filter and node-strut analysis. For assessment of this system, a grayscale test chart that simulates six levels of an osseointegration was created. In addition, digital implant images were made in which the trabecular pattern around the implant was varied over a total of five levels. Implant osseointegration was evaluated on the basis of seven parameters related to the number of nodes (Nd) and terminuses (Tm) of the skeleton bound to the implant (Im) and the skeletal length. The seven parameters were as follows: the number of struts connecting the Im with the Nd and Tm (N.ImNd, N.ImTm), the total number of N.ImNd and N.ImTm (N.Im), the strut length connecting the Im with the Nd and Tm (ImNd, ImTm), and the ratios of the struts connecting the Im with the Nd and Tm (ImNd/TSL, ImTm/TSL), where TSL is the total strut length.Strong correlations (R² = 0.971-1.0) between the theoretical values from the test charts and the measured values were demonstrated. N.ImNd showed the strongest correlation, R² = 0.948, from the digital implant images, followed by N.Im and ImNd, with correlations of R² = 0.86 and R² = 0.84, respectively. This new system for evaluating implant osseointegration by applying morphological processing and node-strut analysis could be useful for computer-assisted diagnosis of digital dental implant images.

A 56-year-old man had aneurysms of the right subclavian artery and cerebral artery in association with congenital absence of the right internal carotid artery. The aneurysm of the subclavian artery was successfully surgically repaired through a partial sternotomy. Congenital absence of the internal carotid artery is rare vascular anomaly. This anomaly contributes to the occurrence of intracranial aneurysms. However, aneurysm of subclavian artery associated with congenital absence of the internal artery is very rare. This is the 3rd case reported in the literature.

The results of our general and medical surveys are summarized as follows:
1) The visitors to this spa are inhabitants of Yamagata prefecture, farmers being the largest in number.
2) Considering the fact that more than half the number of spa visitors come here with therapeutic or convalescing purpose, this spa may be said to be a spa to which visitors come with the sole object of curative treatment.
3) Visitors came for the treatment of common cold, hypertension, neuralgia and diseases of the stomach and intestines respetively from the frequency of diseases. The fact that the visitors with cold were largest in number was probably because of the prevalence of common cold at the time of our survey.
4) Half the number of spa visitors stayed for about 2 weeks, and most of them took bath four to five times a day for curative treatment.
5) 40.1% spa visitors drank hot spring water for curative treatment. Which incidence is higher than that in our previous reports for other Tohoku Area.
6) Only 6.1% of the visitors came to the spa under doctor's direction. Those who noted the bathing reaction: anorexia, feeling of weakness etc., were 23.1%
7) In the tubeless gastric analysis (Gastrotest) scarcely any change was observable for successive drinking of hot spring water.
8) In most cases the oral temperature measured at the time of bathing in this spa never returned to the value before bathing for two hours and the feeling of warmth remained for a long time. This is probably due to the chemical properties of the spring waters and proper treatment after bathing.

Investigations were made into the actual working and living conditions of adults, both men and women, in the families engaged in mixed farming.
The working conditions were analyzed according to the types of crops farmers are growing. The work study was necessary to probe into the causes of farmers' health disturbances.
A questionnaire revealed that farmers are short of sleep during the busiest season. Especially housewives are forced to cut down on their sleeping hours.
It also found that some farmers spray pesticides in quantity and expose themselves to the potentially health injurious chemicals with alarming frequency.
There was evidence to show that some ailments, notably low back pain, had been reduced due to imporovements on farmwork and working environment.
Health checkups showed that the incidences of hypercholesterolemia and obesity remain high. There was imbalance between carolic intake and consumption.

Introduction: We perform our trials in Tsurumi ward, Yokohama city aiming at reducing the number of “cancer refugees” to zero. State: There are many patients who receive cancer therapy outside their hometown. Once their treatment is finished due to progressive disease or deteriorating condition, they are told to leave the hospital and to get palliative care in their district. And they become so-called “cancer refugees”. The beds of palliative care units are limited so the ability to accept patients in case of emergencies is poor. In Tsurumi ward, here are a lot of home care clinics providing palliative care but the place patients want to be or receive palliative care when their condition deteriorates isn't fixed. We organized the “Tsurumi Homecare Network” as the core of medical cooperation, and have worked on improving palliative care and increasing patients who die at home. Specifically, our hospital has played a central role as a special place for palliative care, we send out our original questionnaire to home care clinics to find out how they perform palliative care and introduce patients to the appropriate clinic. Patients who are in need of hospitalization are assured acceptance. On the other hand, we propose the cancer treatment hospitals to follow their patients together with us from their early stage of cancer treatment. Problem: To maintain a good relationship for regional palliative care, improving the management for outpatients, strict and timely backup system, advanced quality of homecare-supporting staff for palliative care and cooperation between home care clinic doctors are necessary.