Pathohistologic studies were carried out for 186 nodules in 171 cases of thyroid cancer treated in the surgical clinic during the last 14 years. No definite relationship was found between the intraglandular dissemination and the size of cancer nodules. In the relationship between the intraglandular dissemination and histologic type of cancer, frequency of the intraglandular dissemination is definitely low in papillary adenocarcinoma. In the relationship between the intraglandular dissemination and the degree of histologic extension, advance in extension is accompanied by the increasing of the frequency of the intraglandular dissemination. In the cases with positive lymph node metastasis, the frequency of the intraglandular dissemination was higher than in the cases with negative metastasis. The intraglandular dissemination was definitely more frequent in the cases with recurrence or multiple occurrence than in the cases with single occurrence without recurrence. Based on these facts, recurrence is probably due to leaving the disseminated lesions in the remaining tissue, and the cases of multiple occurrence develop as die result of the growth of the intraglandular dissemination.

A questionnaire study was conducted in a residential area along trunk roads in Kusatsu, Japan, in order to investigate the association between noise exposure, noise sensitivity, and subjective health. Subjective health of the respondents was measured by the General Health Questionnaire (GHQ-28) which yields the total score as an index of psychiatric disorder and four subscales. Noise sensitivity was measured by the improved version of the Weinstein's noise sensitivity scale named WNS-6B. The original WNS and a single question directly asking respondents' noise sensitivity were also applied to confirm the validity of the WNS-6B for investigating the effects of road traffic noise on subjective health. Respondents were also asked about disturbances of daily life due to noise exposure to find the cause of the health effects. Three hundred and twenty three answers were entered into the analysis. Applying the WNS-6B as the noise sensitivity measurement scale, a significant correlation was found between subjective health and noise exposure in the noise-sensitive group, while no significant correlation was observed in the insensitive group. These results suggest that the adverse health effects may exist especially in the sensitive group. Application of the other two noise sensitivity measurement scales showed no significant relationship either in the sensitive group or in the insensitive group. The WNS-6B would have greater advantage for detecting adverse health effects than the other scales. Furthermore, the primary cause of the adverse health effect was investigated. The results of the analysis indicated that the adverse health effects were mainly caused by the sleep disturbance and were not caused by hearing interference.

Many studies have shown the significant correlation between noise annoyance and noise sensitivity identified by Weinstein's noise sensitivity scale (WNS). However, the validity of the scale has not been sufficiently assessed. This study was designed to investigate the validity of each question in WNS and to develop a more valid noise sensitivity measurement scale. A questionnaire study was conducted in a residential area along trunk roads in Kusatsu, Japan, and 301 responses were collected. In this paper, noise sensitivity was defined as the factor that induced individual variability in reactions caused by noise exposure and that is not affected by the noise exposure. The relationship between noise exposure and answers to each question in WNS was investigated by multiple logistic regression analysis, and the influence of response bias on the score of WNS was examined. The results showed that WNS contained some questions that were inappropriately related to noise exposure level and that the score was affected by response bias. The reported correlation between annoyance and the score of WNS could be confounded by noise exposure and response bias. A noise sensitivity measurement scale named WNS-6B was newly developed, excluding the biased questions from the original WNS and applying binary coding to six-response options in order to reduce the response bias. WNS-6B seemed to be more appropriate to assess noise sensitivity than the original scale.

Background: Orthotopic urinary diversion has become the preferred form of bladder reconstruction after cystectomy. We report on our experience with 66 male patients undergoing this procedure from November 1990 to February 1998. Methods: A neobladder was constructed using an ileal segment with a Hautmann type bladder.Complications were assessed and subdivided into early and late types. Voiding function was evaluated in terms of voiding pattern and continence. Median follow up was 19.5 (range 3.5-87.7) months.Results: There was one (1.5%) perioperative death. The most frequent pouch-related and unrelated early complications were persistent urine leak (7.6%) and prolonged ileus (16.7%), respectively, the majority of cases of which were managed conservatively. Analysis of late complications revealed 6.2% ureteroileal stenosis and 1.5% urethrointestinal stenosis rates, but no case of bladder stone formation. Of the 61 patients in whom voiding function was evaluable, 95.1% achieved excellent daytime continence, while only 67.2% had night-time continence. With regard to posture at voiding, 23 (37.7%) voided in a sitting position. Three of the patients (4.9%) were unable to void and required regular intermittent catheterization. Conclusions: An orthotopic neobladder can be constructed with acceptable morbidity and excellent functional results. We believe that orthotopic urinary diversion offers an attractive alternative to a bladder substitute when cystectomy is required.

Effects of noise on the secretion of salivary chromogranin A (CgA), which is considered to be a substitute measure of catecholamines, were investigated in a laboratory experiment. This study included 20 male subjects with normal hearing; their ages ranged from 21 to 24 years. Prior to the experiment, the subjects were asked to answer a questionnaire containing the 28-item General Health Questionnaire (GHQ-28) and Weinstein's noise sensitivity scale. White noise at 90 dB was presented to the subjects for 15 min with 15-minute-rest periods before and after noise exposure. It was shown that salivary CgA levels increased significantly during noise exposure and decreased immediately after it (Friedman's test, p = 0.001, two tailed). This result suggests that salivary CgA can be used to measure the stress response to noise. Furthermore, individual differences in the change in salivary CgA levels were discussed in relation to the subjective responses of the participants to the questionnaire. Some subjects showed prolonged elevation in the salivary CgA levels and the others showed immediate recovery or no effects. These individual differences correlated with the score on the somatic symptoms in GHQ-28; this implies that the score on the somatic symptoms in GHQ-28 could be a measure of physiological sensitivity to noise.