Aims: The purpose of this study was to verify the morphological characteristics of the alopecic scalp.

Method: Texture analysis of alopecic scalps caused by anti-cancer drug treatment and scalps with hair of healthy subjects was performed using the gray level co-occurrence matrix (GLCM). Two-hundred seventy images taken from alopecic scalps and 342 images taken from scalps with hair, set to 50 pixels, were used in the analysis.

Result: In comparison, the angular second moment (ASM) and inverse difference moment (IDM) values were significantly higher in alopecic scalps, while contrast (CON), correlation (COR), and entropy (ENT) values were significantly lower than in scalps with hair.

Discussion: The results of analysis and the visual inspection of the images revealed that sulci cutis and cristae cutis of alopecic scalps were indistinct, suggesting that the scalp texture changes may have occurred.

Conclusion: The findings suggest the possibility of verifying morphological features of scalps based on the presence or absence of hair loss by image analysis.

Purpose: We examined the effects of concerns regarding urinary, bowel, and sexual function on the overall satisfaction of patients who underwent robot-assisted radical prostatectomy. Next, we investigated postoperative sexual dysfunction.

Methods: We investigated 204 patients who underwent robot-assisted radical prostatectomy from June 2014 to December 2018 at Gunma University Hospital. The Expanded Prostate Cancer Index Composite (EPIC) was used to assess overall satisfaction, and urinary, bowel, and sexual function.

Results: (1) Overall satisfaction was affected by concerns of urinary function in the first year, and concerns of sexual function in the second and third years after surgery. (2) 40 to 50％ of the patients had no sexual intercourse or had erectile dysfunction before surgery. (3) Although nerve-sparing procedures were a favorable factor, postoperative sexual function decreased overall except for some patients and recovery was poor. There was a positive correlation between preoperative and postoperative sexual function. (4) Patients with good preoperative sexual function had greater postoperative sexual function concerns.

Conclusion: Sexual function concerns after radical prostatectomy become apparent after urinary function concerns are relieved, and become a burden to the patient. Before surgical therapy, we should ask carefully about the patient’s current sexual function and sufficiently explain postoperative sexual dysfunction.

Purpose: Approximately 30-70％ of patients with cancer reportedly experience insomnia-induced pain. Progressive muscle relaxation (PMR) is a widely used relaxation technique to help people experiencing insomnia. However, PMR involves an added burden for patients with cancer as their disease progresses. Therefore, the authors created a simple PMR. This study assessed improvement in sleep quality associated with simple PMR for patients with cancer.

Methods: Patients with cancer hospitalized for treatment underwent one day of intervention with PMR and one control day. The measurement indicators were the Japanese version of the Pittsburgh Sleep Quality Index, the Oguri-Shirakawa-Azumi Sleep Inventory MA Version (OSA), and interviews.

Results: The analysis included ten participants with a mean age of 58 years. Scores for OSA sleepiness on rising (P＝0.003) and sleep initiation/maintenance (P＝0.012) differed significantly between the PMR and control days. A content analysis of the interview recordings extracted four major classifications, such as “my sleep quality improved” and “my sleep quantity improved.”

Conclusions: The results suggest that even a single session of simple PMR may improve sleep in patients with cancer, such as with falling asleep and maintaining sleep.

Objective: To elucidate support over time by visiting nurses for older adults and caregivers in the transition period to home-care.

Methods: We conducted semi-structured interviews of seven visiting nurses, and qualitatively analyzed the responses by an inductive approach.

Results: Before discharge, visiting nurses “coordinated multidisciplinary care to accommodate　the patient’s and caregiver’s intents” and “shared information with ward nurses regarding guidance for the patient and caregiver pertaining to homecare life;” from immediately after discharge to two weeks thereafter, visiting nurses “assessed the care environment and shared it with multidisciplinary staff,” “educated the patient and caregiver to become competent in self-health management,” “established a system for caregiver emergency responses,” and “provided assistance to improve the caregiver’s and patient’s care ability;” and from three weeks to one month after discharge, visiting nurses “cooperated with other professions to help the patient continue health management,” “encouraged patients and caregivers to acquire new care methods,” and “provided ongoing intervention for patients and caregivers to achieve their wishes and intentions in convalescence.”

Conclusion: Repeated support by visiting nurses for older adults and caregivers according to the timing of the home-care transition period is recommended.

The number of cases of bacterial meningitis has decreased compared to previous years due to vacccination, but the mortality and sequelae rate are still high even with appropriate treatment. The incidence of the disease is low after school age. We report a rare case of bacterial meningitis caused by acute isolated sphenoid sinusitis in a child. The patient was a 13-years-old girl. One week prior to her visit to our hospital, she developed headache, which did not improve, so she visited her home doctor on the day of her visit. She had worsening headache, paralysis of the extraocular muscles on right side, and leukocytosis and elevated CRP in blood tests. Cerebrospinal fluid (CSF) examination revealed increased cell count with decreased CSF glucose. Head MRI scan showed T2WI high signal in the bilateral sphenoid sinuses, and she was transferred to our hospital for endoscopic sinus surgery. The patient’s symptoms improved with antibiotic therapy, and she was discharged without sequelae on the 21st day after a total of 19 days of intravenous antibiotic therapy. Spinal fluid culture identified Streptococcus intermedius. Clinicians must be aware of intracranial complications such as meningitis by sinusitis.