BACKGROUND: Dental caries is a chronic childhood disease and one of the most prevalent public health problems worldwide. Lead is a heavy metal that is taken up by the teeth and bones. However, the association between lead exposure during pregnancy, when the tooth germs are formed, and the prevalence of dental caries in the primary dentition remains unclear. This study aimed to examine the association between maternal blood lead levels and the prevalence of dental caries in the primary dentition of children. METHODS: This cross-sectional study was conducted as an Adjunct Study to the Japan Environment and Children's Study (JECS), which is an ongoing nationwide birth-cohort study. Among children participating in the JECS at the University of Occupational and Environmental Health Sub-Regional Center, those aged 7-8 years underwent oral examination and questionnaire administration. The dft (i.e., sum of the number of decayed and filled primary teeth) was then determined. The dft numerically expresses the dental caries prevalence in the primary dentition (larger value indicates more prevalent dental caries). Poisson regression analyses with robust standard errors were performed to evaluate the association between maternal blood lead levels during pregnancy, measured using frozen samples, and the dft. RESULTS: The study included 139 children, of whom 54.7% were girls, and 89.2% were 7 years old. The median maternal blood lead level was 6.1 ng/g (25-75 percentile, 5.0-7.3). The median dft was 0 (25-75 percentile, 0-4). After adjusting for covariates including age, sex, and oral health status and behavior, maternal blood lead levels were significantly associated with increased dft (prevalence ratio, 1.6; 95% confidence interval, 1.3-1.8; per one standard deviation increase in natural log-transformed maternal blood lead levels). CONCLUSIONS This study found an association between maternal blood lead levels and the prevalence of dental caries in the primary dentition of children aged 7-8 years. Maternal exposure to lead during mid- to late-term pregnancy may affect the caries susceptibility of children after birth.
Humans ; Lead/blood* ; Female ; Dental Caries/epidemiology* ; Prevalence ; Tooth, Deciduous ; Male ; Japan/epidemiology* ; Child ; Cross-Sectional Studies ; Pregnancy ; Adult ; Maternal Exposure/adverse effects* ; Environmental Pollutants/blood* ; Prenatal Exposure Delayed Effects/epidemiology*

We plotted the distribution of long-lived persons derived from the national register of long-lived persons as of fiscal years of 1980 (N=1, 349) and 2000 (N=17, 740) prepared by the Ministry of Health and Welfare to investigate various factors such as medical climatology and geography on healthy aging. The data were plotted on a map of Japan classified into various living environments, such as coastal areas, forests, and mountainous areas. In addition, we investigated universal elements and transforming elements through year-by-year comparisons over a period of 20 years. Japan was divided into nine climatic districts Hokkaido, the Japan Sea area, the Pacific Ocean area, the Sanriku district, the Tokai district, the inland district, the Seto Inland Sea district, the Northern Kyushu district, the Nankai district, and the South-western Islands.
Consequently, we found a common trend that relatively warm climates and climates in coastal areas are favorable for longevity. However, the following trends were also recognized as transforming elements that cannot be ignored: 1. A remarkable improvements in the rate (number of long-lived people per 100, 000 population) in cold climate regions, i.e., the Japan sea area, inland area, and Hokkaido; 2. A remarkable shift of higher rates from coastal areas, which are contaminated by industrial plants, to inland flat areas.
As a result, it has become clear that research on factors of healthy aging, especially in cold climate regions, have to be made in the future.

In 1991, the committee on postgraduate clinical training proposed revised behavioral objectives for basic clinical training in the initial two years. We present here a model for a clinical training program that should enable most residents to attain these objectives within two years.
The program begins with orientation for 1-2 weeks, including a workshop on team care, and nursing practice.
Basic clinical skills for primary care and emergency managements should be learned by experience during rotations through various clinical specialities. All staff members, even senior residents, should participate in teaching beginning residents in hospitals.

Japanese medical graduates are recommended to receive clinical training for more than two years after graduation, because undergraduate clinical training is insuffiicient.
In 1976 the committee of postgraduate clinical training proposed the objectives of basic clinical training after graduation of medical schoool and in 1981 the committee proposed the objectives for the first postgraduate year of training and the methods of clinical skill assessment.
We here present the revised objectives of basic clinical training after graduation of medical school.
It is emphasized that clinical trainees should have basic clinical skills of primary and emergency care during the two year training.
These clinical skills include interviewing techniques, skills in physical examination and interpretation of physical findings, laboratory skills, skills relating to diagnosis and managements, communication skills to other doctors and to other medical co-workers and terminal care.

In search of reasons for regional differences in the death rate from stroke, an extensive factfinding project was carried out in Yamagata Prefecture. Out of the total 44 municipalities in the prefecture, we picked out four townships; two are noted for their high standard mortality rate from cerebrovascular disease and the other two have a low mortality from the disease. In these four townships, a thorough investigation was conducted on the incidence of stroke, along with health examination for cardiovascular disease. The findings are as follows;
1. Despite the fact that Yamagata Prefecture has a high rate of stroke, blood pressure levels stood on a par with, or even lower than, the national average.
2. There were no correlations between the standard mortality rates and blood pressure levels, ECG readings, funduscopic observations, and total serum cholesterol levels.
3. By occupation, white-collar workers showed higher values than blue-collar workers and farmers in diastolic blood pressure, obesity, and cholesterol levels in the blood serum. The occupational difference was observed in each and every one of the four townships.
4. The standard mortality rate and other fatality indices were not correlated with the incidence rate of stroke among the middle-aged and the rate of detection in the health examination for the conditions that might lead to stroke. Interesting to note is the fact that the incidence rate among the middle-aged was parallel with the detection rate. This finding suggests that further study of the incidence rate and the prevalence rate in necessary.