ALS Questionaire !

The whole country questionnaire of ALS, the patient Hitosi Nisio is planned in Japan.
A questionnaire by electronic mail in Japan was made in the cause. In that result, over 80% ALS have the expeareance of the several memory troubles by the traffic accidents, slipping down from the mountain, the shock of medical solution or some fishes etc. So I have to reconfirm the % of it. AND another aspect like the infection of some slow virus or some bacteria from the pets because some spouse get same ALS, or like the influence of strong stress exist?

So that , Ask for family's cooperation though it wants to ask an ALS patient (An age is unknown.) and healthy person (if a comparative object/is made, over 30 years old) for the questionnaire. I am asking you almost about befor getting sick. The item of "I am a healthy person." means to check whether you are a ALS patient or a healthy person, so please check to "no" if you answer it instead of the ALS . Please answer for it and give me your help.

--- reference number XXXXXX ---
reference number is to make the date of birth turn six chained digits.
For example February 26, 1950 becomes 022650.

Reference number < * * * * * * >.
  1. Where is a birthplace? ( ).
  2. Is there an experience of going abroad?
    [Yes,/No.]
  3. Does your spouse have the experience of going abroad?
    [Yes,/No.]
  4. Is there an experience of the traffic accident?
    [Yes,/No.]
  5. Are there a head blow or strong hit, and an experience of the operation brain department?
    [Yes,/No.]
  6. Are there an operation on the spinal cord hernia and a treatment experience?
    [Yes,/No.]
  7. Is there an experience of the memory difficulty?
    [Yes,/No.]
  8. Are an accident, an operation, a blow within 5-year of getting sick?
    [Yes,/No.]
  9. Are an accident, an operation, a blow within 5-10-year of getting sick?
    [Yes,/No.]
  10. Are an accident, an operation, a blow more than the 10-year front of getting sick?
    [Yes,/No.]
  11. Is a blow department etc a former head?
    [Yes,/No.]
    Is it left half the body?
    [Yes,/No.]
  12. Is getting sick from the hand?
    [Yes,/No.]
    Is it from the right hand?
    [Yes,/No.]
  13. Is getting sick from the foot?
    [Yes,/No,]
    and is it from the right foot?
    [Yes,/No.]
  14. Is a getting sick age within 30 years old?
    [Yes,/No.]
  15. Is a getting sick age 31 - 40 years old?
    [Yes,/No.]
  16. Is a getting sick age over 40 years?
    [Yes,/No.]
  17. Is the former occupation which gets sick a salaried worker?
    [Yes,/No.]
  18. Is the former occupation which gets sick agriculture?
    [Yes,/No.]
  19. Is the former occupation which gets sick a self-employed person (except for agriculture)?
    [Yes,/No.]
  20. Is the former occupation which gets sick a driver?
    [Yes,/No.]
  21. Are you a housewife before getting sick?
    [Yes,/No.]
  22. Did you feel stress very much?
    [Yes,/No.]
  23. Were stiff shoulders the cruel ones?
    [Yes,/No.]
  24. Was there an opportunity to touch agricultural chemicals directly?
    [Yes,/No.]
  25. Was there an opportunity to touch agricultural chemicals indirectly and well? (fruit vegetables flower)
    [Yes,/No.]
  26. Did your family, relatives have the person of the special illness?
    [Yes,/No.]
  27. Does your family, relatives have diabetes?
    [Yes,/No.]
  28. Does your family have the person of the virus disease (in such cases as the hepatitis, helpes simplex, the poliomyelitis)?
    [Yes,/No.]
  29. Did you smoke?
    [Yes,/No.]
  30. Did you take folks medicine befor getting sick?
    [Yes,/No.]
  31. Did you take doctor prescription medicine befor getting sick? << anything >>>?
    [Yes,/No.]
  32. Is blood pressure the low one at the time of getting sick?
    [Yes,/No.]
  33. Was frequently your foot cramped?
    [Yes,/No.]
  34. Are you a meat-eater when either is said?
    [Yes,/No.]
  35. Did you tend to get fat at the time of getting sick, and was a movement insufficient?
    [Yes,/No.]
  36. Was it said once that Cholesterol was high?
    [Yes,/No.]
  37. Was it said once that GPT and GOT were high?
    [Yes,/No.]
  38. Was it said once that Ht or the red corpuscle high << it is abundant >>?
    [Yes,/No.]
  39. Are there many opportunities to eat raw food in fishes, eggs, meat and so on?
    [Yes,/No.]
  40. Did you eat vegetables well?
    [Yes,/No.]
  41. Do you think that it was exposed to the electromagnetic wave more than other people?
    [Yes,/No.]
  42. Did momentum decrease very much before getting sick?
    [Yes,/No.]
  43. Is a stain easy to be made of other person with basking in the sunshine?
    [Yes,/No.]
  44. Did you keep a pet such as a dog?
    [Yes,/No.]
  45. Is gardening the favorite one?
    [Yes,/No.]
  46. Did you take treatment for dentistry well?
    [Yes,/No.]
  47. Have you ever caught anesthesia injection?
    [Yes,/No.]
  48. Has a lump ever been made in the lymph node knot?
    [Yes,/No.]
  49. Has a thing like foam ever been prepared in the skin?
    [Yes,/No.]
  50. Have you ever been in the severe headache?
    [Yes,/No.]
  51. Wasn't the thing eaten in a bit of the diarrhea sometimes digested?
    [Yes,/No.]
  52. Is it within 3-year from getting sick?
    [Yes./No.]
  53. Is it within 5-year from getting sick?
    [Yes,/No.]
  54. Is it within 7-year from getting sick?
    [Yes,/No.]
  55. Is it within 10-year from getting sick?
    [Yes,/No.]
  56. Is it within 15-year from getting sick?
    [Yes,/No.]
  57. Is it passing for more than 15 years from getting sick?
    [Yes,/No.]
  58. A respirator is put at present.
    [Yes,/No.]
  59. It sometimes thinks of besides with the getting sick cause.
    [Yes,/No.]
    (Yes, the one that it answered is from the viewpoint of ingredient body.)
  60. I am a healthy person .
    [Yes,/No.]
  61. I am a woman.
    [Yes,/No.]

It was so tired state for a long time. Appreciate cooperation.
Appreciate nurse's and family's cooperation, too.
The same question will be done to ALS, the patient, of the foreign countries as well.

A respirator is put with ALS which national sanatorium Hyogo central hospital east 1 ward in Japan , Nishio is the same as. I got sick in 43 years old, and passed for 6 years.
Attach a respirator, and it is about two years and a half.
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How to send a questionnaire.
E-mail: QYQ05401@スパム対策nifty.ne.jp
FAX : (Japan)81-795-68-3997
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God bless ALL OF THE DISABILITY PERSONS include MND
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