It has been recognized in several studies that physical stressors such as noise and/or vibration have an influence on hypothalamo-hypophysial-adrenal system and autonomic nervous system in human as well as in rat.
Since the enforcement of Equal Employment Opportunity Law and the revision of Labor Standards Law, working fields are being expanded for women and the number of women with prolonged working hours is increasing. Working women also do housework and they need to be compatible with child and elder care. Therefore, special health care for the working women becomes necessary. As an elongation of a conventional study, labor circumstances and health of women was investigated. In particular, it was found using electromyography, electrocardiography and questionnarire for fatigue investigation that working women engaged in farming were affected by word/stress load. In additon, the results of a study on effects of night word on urinary excretion of hormone suggested that the night work of the pregnant shift workers should be much more relieved.
Demand-control-support model in work in order to prevent sickness outbreak by various occupational stress factors is seemed to be necessary.

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Many authors have reported on the effect of muscle strengthening training for elders. However, there are few prospective studies comparing the effectiveness of intervention against controls.
This study was to determine whether an intervention with training was effective to strengthen muscles and improve physical performance.
A total of 25 women, 80.3 ± 3.4 years of age (mean ± SD) were recruited. They lived in the same community and received day services at the same facility. They were divided into 2 groups using a crossover design. Each of the groups carried out the training 5 times in 3 months alternately. The training consisted of 10 exercises for grasping and lower extremities. Subjects were encouraged to carry out the exercise program at home. The researchers also recorded which subjects carried out the exercises at home between training sessions.
There were no significant changes between variable ratio of the intervention period and non-intervention period, except back strength (p=0.032). There were also no significant changes between the home program group and the subjects who did not carry out the exercises at home.
Further study is indicated to determine effective means of increasing muscle strength and physical performance to maintain independence.

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A patent ductus arteriosus (PDA) causes signs and symptoms of poor tissue perfusion and heart failure in premature infants. To evaluate the outcome of surgical closure of a PDA, we retrospectively examined 26 premature infants who underwent this procedure, after treatment with a Prostaglandin inhibitor had either failed or its use was contraindicated. The overall mortality was 27% (7/26) and the surgery-related mortality was 0% (0/26). There were no remarkable differences in mean gestational age and weight at birth, or mean age and weight at the time of surgery, between the survivors and non-survivors. The deaths were caused by serious complications such as necrotizing enterocolitis, acute renal failure, intraventricular hemorrhage, and severe twin-to-twin transfusion syndrome. We conclude that surgical closure of PDA is effective and relatively safe in premature infants.

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Prognosis of multiple trauma patients with severe pelvic fracture has been extremely poor. There are some indices to evaluate the severity and the outcome, such as injury severity score (ISS), revision of trauma score, lactate, and acute physiology and chronic health evaluation, but many of them are not good enough in emergency rooms.
In the present study, ISS based on anatomical injury score, arterial lactate based on pathophysiochemical score on admission and “ISS × lactate” index was evaluated in 31 multiple trauma patients with severe pelvic fracture, who were admitted to Yamaguchi university hospital. ISS and arterial lactate were good indices to evaluate their mortality. Moreover, “ISS × lactate” was an excellent index, because the sensitivity was 88% and the specificity was 93%, if the index was fixed at 60 points mmol/L.
It is concluded that “ISS × lactate” is an excellent index to evaluate the severity and the mortality of the multiple trauma patients with severe pelvic fracture and to decide the priority of their treatments, including transcatheter arterial embolization.

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Purpose We evaluated the status of vascular disease in our Medical Emergency and Critical Care center over 4 years from the time of its establishment.
Materials and Methods Between January 1, 2000 and December 31, 2003, 113 patients with severe vascular disease were treated in our Emergency and Critical Care Center by the same group of cardiovascular surgeons.
Results Severe vascular emergencies accounted for 4.4% of all cases. The number of vascular emergencies increased every year. Ninty six patients were transferred to our center from another hospital and 17 were brought in by ambulance. By disorder, acute Stanford type A aortic dissection was treated surgically in 28 patients and conservatively in 6, with resuscitation attempts in 6; acute Stanford type B aortic dissection was treated surgically in 4, and conservatively in 23; ruptured thoracic and thoraco-abdominal aortic aneurysm was treated surgically in 5 patients and conservatively in 4, with resuscitation attempts in 3; ruptured abdominal aortic aneurysm was treated surgically in 17 and conservatively in 3, with resuscitation attempts in 3; the remaining disorders were treated surgically. Ninty three patients survived and 20 died. Among acute aortic Stanford type A dissection, 33 survived and 7 died; among acute aortic Stanford type B dissection, 24 survived and 3 died; among ruptured thoracic and thoraco-abdominal aortic aneurysm, 9 survived and 3 died; among ruptured abdominal aortic aneurysm, 17 survived and 6 died; and among acute arterial occlusion of the extremity, 8 survived and 1 died. The two other patients survived.
Conclusion The number of patients with severe vascular diseases seen in our Emergency and Critical Care Center was limited in our geographical region. However, the good results were largely attributable to the cooperation of the cardio-vascular surgeons and the paramedics.

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Retrospective analysis was performed to determine the incidence and risk factors for sudden death after surgery for congenital heart disease (CHD). The records of 7,444 procedures, including 1,660 palliative surgery and 5,784 radical surgery procedures, in 5,806 patients with CHD admitted in National Cardiovascular Center from 1977 to 2001, were examined. Forty-two patients died suddenly after palliative surgery. Thirty-nine of these (92.9%) died within three years of palliative surgery and 35 patients (83.3%) were less than 5 years of age. The main cause of sudden death after palliative surgery was hypoxia. Thirty-five patients (83.3%) had previous systemic-to-pulmonary shunt operations. Fifty-eight patients died suddenly after radical surgery. Age at sudden death varied from two months to the 20's. Sudden death after radical surgery occurred in 3 patients (5.1%) with myocardial infarction, 14 (24.1%) with arrhythmia, 4 (6.9%) with heart failure, and 15 (25.9%) with pulmonary hypertension. While all patients complicated with myocardial infarction or arrhythmia died suddenly within 5 years of radical surgery, some patients with heart failure and pulmonary hypertension died suddenly more than 5 years after radical surgery. Sudden deaths occurred with high frequency after atrial switch operations or the Fontan operation. The risk factors for sudden death after surgery of CHD patients were as follows: hypoxia after palliative surgery, previous systemic-to-pulmonary shunt operations, atrial switch operations and the Fontan operation.

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We experienced a case of intra-abdominal abscess due to fish bone penetration. A 38-year-old man was admitted to our hospital because of a lower abdominal pain. He had an abdominal mass and abdominal CT and magnetic resonance imaging revealed an intra-abdominal abscess with a fish bone. The laparotomy was carried out. Operative findings were an intra-abdominal abscess with a fish bone surrounded by the omentum. The sigmoid colon appeared to be a penetrated site. An about 2.5 cm fish bone was removed and partial omentectomy and peritoneal drainage was performed. Postoperative course was uneventful and the patient was discharged on the 21st postoperative day.
Intra-abdominal abscess due to fish bone penetration is a relatively rare entity. It has been believed that the preoperative diagnosis is difficult, but that CT examination is effective in preoperative diagnosis.

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