Nerve conduction velocity (NCV) testing for the median nerve is the gold standard for diagnosing carpal tunnel syndrome (CTS), which affects about 6% of the general population. However, NCV equipment is relatively expensive and not always available at outpatient clinics. This study investigated the effects of different sampling rates and electrode placements on the NCV values of the median nerve to establish the practical significance of those specifications. The NCV of the median nerve at the wrist was measured in 30 healthy subjects with sampling rates of 2 kHz or 10 kHz and wide or narrow spacing of the electrode; Paired t-tests were used to compare the NCV values acquired by the different testing protocols. We found that the sampling rate had a statistically significant effect on the NCV values (P<0.01), while the electrode placements did not significantly affect the NCV values (P>0.05). The findings of this study have implications for improving the cost-effectiveness and technical applicability of NCV instruments.

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Erythema annulare centrifugum (EAC) presents as erythematous or urticarial papules, each with an annular shape, that exhibit peripheral extension. Internal malignancies are occasionally associated with EAC, and infectious diseases, including fungal, bacterial or viral infections, have also been regarded as possible causes of EAC. A 35-year old man had a 1-week history of a painful vesicular eruption over the trunk corresponding to dermatomes Th8-10.Concomitantly, he developed several annular eruptions over the trunk. We diagnosed the former lesions as herpes zoster and the latter as EAC associated with herpes zoster. Although DNA was extracted from the EAC region, no varicella-zoster virus DNA was detected. We consider that this is Wolfʼs isotopic response, which is caused by an alteration of the local immunity due to viral infection. An etiologic relationship between EAC and herpes zoster is strongly suggested by the present case and by our review.

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Although otosclerosis is essentially a middle ear disease, patients with this disease often exhibit mixed hearing loss. This discrepancy is thought to be explained by the following mechanism: the resonance of the ossicular chain is disturbed by the fixation of stapes, leading to the attenuation of inertial bone conduction. The bone-conduction hearing level usually recovers after stapes surgery. We herein studied the change in air- and bone-conduction hearing after stapes surgery in patients with otosclerosis. Six consecutive patients with otosclerosis who underwent stapes surgery in our department were enrolled. They were 2 men and 4 women, ranging in age from 16 to 74 with an average of 57.2 years. Stapedotomy was performed in 5 patients, and the other patient underwent partial stapedectomy. Their pure tone hearing levels of air and bone conduction were measured before and after surgery. In the air conduction, the hearing levels at 125, 250, 500, 1000, 2000, and 4000 Hz significantly improved after surgery, but showed no significant change at 8000 Hz. On the other hand, in the bone conduction, the hearing levels at 500 and 1000 Hz significantly improved after surgery, whereas those at 250, 2000, and 4000 Hz showed no significant change. The recovery of the bone conduction hearing at 500 and 1000 Hz is explained by the resonance of the ossicular chain. However, the unimproved bone conduction hearing at 2000 Hz is unexplainable, and remains to be further investigated in future studies.

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Japan, USA and other foreign space agencies have plans for the construction of a lunar base and long-term stay of astronauts on the moon. The surface of the moon is covered by a thick layer of soil that includes fine particles called "lunar regolith", which is formed by meteorite impact and space weathering. Risk assessment of particulate matter on the moon is important for astronauts working in microgravity on the moon. However, there are few investigations about the biological influences of lunar regolith. Especially, there is no investigation about allergic activity to lunar regolith. The main chemical components of lunar regolith are SiO₂, Al₂O₃, CaO, FeO, etc. Of particular interest, approximately 50% of lunar regolith consists of SiO₂. There is a report that the astronauts felt hay fever-like symptoms from the inhalation of the lunar regolith. Yellow sand, whose chemical components are similar to lunar regolith, enhances allergenic reactions, suggesting the possibility that lunar regolith has an adjuvant-like activity. Although intraperitoneal administration of lunar regolith with ovalbumin to mouse did not show enhancement of allergenic reactions, further evaluation of lunar regolithʼs potential to exacerbate the effects of allergies is essential for development of the moon.

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Research on cognitive function related to temporal lobe epilepsy has thus far focused on memory, language, and general intelligence. Recently, however, the concept of social cognitive function has been proposed in the field of neuropsychology. Social cognitive function refers collectively to the higher cognitive functions that are essential in our social lives, and its representative aspects are facial expression recognition and decision-making. Emotional processing centered around the amygdala is thought to play a key role in the neural mechanism of this function. We conducted a study on the social cognitive function (decisionmaking) of patients with temporal lobe epilepsy, and found that this function is reduced in these patients, and that the right amygdalo-hippocampal complexes play an important role. In order to ensure the best possible treatment for epilepsy patients, it is necessary not only to make an accurate diagnosis and provide appropriate treatment, but also to provide support for enabling a smoother social life from the perspective of social cognitive function. Future research developments in this field are expected to contribute to total management in medical care for epilepsy patients.

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Accidental hypothermia is the state in which body temperature falls due for exposure to a chilly environment. In accidental hypothermia, the mortality rate is higher the lower the body temperature. We report a case of a consciousness disorder and severe hypothermia, with a body temperature below 28°C, in which it later became clear that a cervical spinal cord injury had been caused by a small external force. A 70-year old woman was transported to our hospital in an ambulance for consciousness disturbance and severe hypothermia. At the time of arrival, her rectal temperature was 26.2°C. We promptly performed rewarming. Her consciousness level became clear, but paralysis and diminished sensation were observed below the C5 domain. We suspected cervical spinal cord injury and performed cervical magnetic resonance imaging. She was diagnosed as having C5 cervical spinal cord injury. When there is a consciousness disorder due to accidental hypothermia, it might not be possible to evaluate the neurological value of the cervical spinal cord injury correctly. The presence of cervical spinal cord injury should be considered when patients have a decreased consciousness level due to hypothermia.

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This is a case report of a 65-year-old female with malakoplakia in the urinary bladder. An ultrasound scan showed many tumor-like polyp lesions, where a transurethral resection was performed. Since the lesions revealed gross papillary neoplasms, malignancy was suspected. However, histpathological examination showed an aggregation of many infiltrating histiocytes containing characteristic Michaelis-Gutmann bodies positively reactive with von Kossa staining, indicating a typical case of malakoplakia of the urinary bladder. Immunohistochemical study demonstrated that the cytoplasms of the histiocytes were focally positive for an anti-Escherichia coli antibody. One of the etiologies of malakoplakia is infection by Escherichia coli, which is supported by our data.

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Forensic nursing scientifically obtains and preserves the criminal damage from victims of domestic violence, child abuse, elder abuse, sexual violence and other related forms of violence. This was developed in North America in the 1980s, and has carried out appropriate nursing care while protecting the human rights of victims. Serious crime in Japan has been increasing, and it would seem that forensic nursing opportunities should expand as well. However, in Japan, there hasnʼt been much discussion about forensic nursing. Theorizing that support for clinical forensic nursing should be recognized and relevant, we carried out a survey of 581 clinical nurses to investigate the development of forensic nursing in Japan. 93 clinical nurses (16.0%) had a low level of familiarity with forensic nursing; however, 324 nurses (56.3%) had encountered patients who had suffered violence. 264 nurses (45.4%) had a feeling of wanting to be involved in forensic nursing, but were not confident with the knowledge and technology, while 144 nurses (24.8%) were concerned about the larger responsibility they would have. 400 nurses (68.8%) hoped to receive specialized knowledge and technical education. It is necessary to establish an education system for forensic nursing in accordance with the educational status-quo while considering the present state of forensic nursing education.

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