This paper examines the effects of shift work on the mental state of factory workers. As an indicator of the workers' mental condition, the authors used a scoring system (referred to below as the ‘ depression tendency score') based on the SRQ-D investigative report. The depression tendency score of the men was higher among the shift worker group than among the regular day worker group (p<0.01). The depression tendency score of the male back-to-back shift workers was higher than that of the male regular day workers among skilled workers (p<0.05). Among the women, no notable difference in depression tendency score was observed between the regular day worker group and the shift worker group. However, the depression tendency score of the female two-shift workers was higher than that of the female regular day workers among skilled workers (p<0.05). We conclude that the mental health of men is easily affected by back-to-back shift work and that of women is affected by two-shift work because of the difference in modern societal/home role between man and woman.

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It has been reported that a low signal peripheral line (black line) around the lumbar herniated nucleus pulposus (HNP) on magnetic resonance imaging (MRI) can be used for the evaluation of the interruption of the posterior longitudinal ligament (PLL). However, the previous reports have showed that different rates of agreement between MRI and surgical findings. In order to clarify this matter, the black line on MRI was assessed by a combined anatomic and clinical investigation. Three cadavers were used for the anatomic part of the study. For the clinical study, 11 patients with the diagnosis as HNP and 5 healthy volunteers were subjected to MRI to compare with the results from the anatomic study. The lumbo-sacral spine was dissected en bloc from the cadavers. The first imaging on MRI of the specimens was performed with the dural sac; the second imaging was performed after the dural sac and the nerve roots have been removed but with the PLL left; the third imaging was performed after the PLL was completely removed. After completion of imaging, the specimens were cut in sagittal and horizontal planes for histological evaluation. In the cadavers after removing the PLL histologically, the black lines were still shown on MRI. Finally, after changing encoding, the black lines were interrupted at some disc levels in the cadaver specimen, the patients with HNP, and healthy volunteers. Therefore the black lines could be interpreted as a chemical shift artifact. These results indicate that the continuity or the discontinuity of the black line is not appropriate sign to diagnose whether disruption of the PLL has occurred or not.

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A 56-year-old man suffered from muscle weakness with elevated serum creatine kinase. Under diagnosis of polymyositis, the patient was treated with corticosteroid, methotrexate and cyclosporin A. Eleven months after the first signs of muscle weakness, the patient suffered an abrupt onset of anuria and underwent hemodialysis. The patient died of respiratory insufficiency 14 months after the first signs of muscle weakness.
Autopsy findings revealed associated urinary bladder cancer with histological indications of adenosquamous cell carcinoma, liver metastasis and cancerous lymphangitis of the lung.

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A 64-year-old man was presented to another hospital with bleeding from the upper jaw with a platelet count of 0.1×10⁴/μl one year ago, and idiopathic thrombocytopenic purpura complicated with aortic stenosis and regurgitation was diagnosed. Corticosteroid administration was initiated and the patient was admitted to our hospital for surgery two months after confirmation of symptoms associat ed with cerebral ischemia. Corticosteroid was administered for one year until the day of surgery, and aortic valve replacement was performed with a platelet count of 8.4×10⁴/μl. During surgery, bleeding tendency with decreased platelets was confirmed, which was corrected with intraoperative platelet transfusion, postoperative γ-globulin administration, and postoperative oral corticosteroid administration. Caution must be exercised against perioperative bleeding tendency in open heart surgery, even when platelet count is maintained using small amounts of preoperative corticosteroid.

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