Introduction: The diagnosis of cancer-related neuropathic pain is often difficult for non-pain medicine specialists. We examined whether a Japanese version of a neuropathic pain screening questionnaire (Japan-Q), which was developed for chronic pain, is appropriate for screening cancer-related neuropathic pain. Methods: Our palliative care team screened 104 patients from May 2014 to December 2015 and compared total points of the Japan-Q with diagnosis of the type of cancer pain by specialized pain clinicians. Validity was evaluated using a receiver operating characteristic (ROC) curve. Results: The area under the ROC curve in terms of the total score, sensitivity, and specificity for the Japan Q was 0.82, which indicated a moderate level of diagnostic accuracy. A cut-off value of 3 points was shown to be best (sensitivity: 79%, specificity: 82%). When a cut-off value of 9 points was used as the diagnostic criterion for neuropathic pain, there was greatly reduced sensitivity (sensitivity: 40%, specificity: 97%). Conclusion: Although the Japan-Q shows moderate diagnostic accuracy related to cancer pain, the cut-off value for this tool is lower than that for chronic pain. Cancer-related neuropathic pain should be suspected with a total score of 3 or more in the Japan-Q.

Objective: Combination therapy with glecaprevir and pibrentasvir (G/P) has been shown to provide a sustained virologic response (SVR) rate of >97% in patients with chronic hepatitis C virus (HCV) infection in the first published real-world Japanese data. However, a recently published study showed that the treatment was often discontinued in patients ≥75 years old, resulting in low SVR in intention-to-treat (ITT) analysis. Thus, our aim was to evaluate real-world data for G/P therapy in patients ≥75 years of age, the population density of which is high in “rural” regions.Patients and Methods: We conducted a multicenter study to assess the efficacy and safety of G/P therapy for chronic HCV infection, in the North Kanto area in Japan.Results: Of the 308 patients enrolled, 294 (95.5%) completed the treatment according to the protocol. In ITT and per-protocol analyses, the overall SVR12 rate was 97.1% and 99.7%, respectively. The old-aged patients group consisted of 59 participants, 56 of whom (94.9%) completed the scheduled protocol. Although old-aged patients tended to have non-SVR factors such as liver cirrhosis, history of HCC, and prior DAA therapies, the SVR12 rates in old-aged patients were 98.3% and 100% in the ITT and PP analyses, respectively. Of 308 patients enrolled, adverse events were observed in 74 patients (24.0%), with grade ≥3 events in 8 patients (2.6%). There was no significant difference in any grade and grade ≥3 adverse events between the old-aged group and the rest of the study participants. Only one patient discontinued the treatment because of adverse events.Conclusion: G/P therapy is effective and safe for old-aged patients.

A study was conducted to examine activity patterns of surface electromyograms (EMGs) in the triceps surae muscles (medial gastrocnemius, MG ; lateral gastrocnemius, LG ; soleus, SOL) during isometric contraction in plantar flexion (60% MVC, 20% MVC) after immersion in water at three different temperatures. Seven healthy male subjects were immersed in water at 2-3°C (ICE), 19-21°C (MID), and 40-42°C (HOT) . The results of the study are summarized as follows :
1) In the MG and LG, there was a slight increase in the rate of integrated electromyograms (IEMGs) in the MG (the main agonist muscle) . However, the rate of increase in the LG, which is the synergistic muscle, was much greater than that in the MG when contraction was sustained at 60% MVC. Therefore, the activity pattern suggests that muscle activity in the LG compensates for that in the MG.
2) The IEMGs of the SQL with sustained contraction, increased significantly after immersion in HOT and MID, but the IEMGs decreased after immersion in ICE. These results suggest that the recruitment threshold in slow-type motor units should increase during sustained isometric contrac-tion in ICE.
As illustrated above, the activity of the LG increased to compensate for that of MG. In the SQL, muscle activity with sustained contraction decreased in ICE. These results suggest that control mechanisms of the central nervous system might play an important role in the associated movement of the triceps surae muscles.

Effects of various tetanic stimulation frequencies (50 Hz, 100 Hz and 200 Hz) on the time course of twitch potentiation were examined in the adduction of human pollicis. Isometric twitch tension curve and surface electromyogram were recorded immediately after (1 sec) the 10 sec-tetanus and at intervals of lOsec (up to 300sec) . The stimulating methods were by nerve and direct stimulations in order to examine the role of nerve on the post-tetanic potentiation. The results were summarized as follows :
1) The greatest potentiation was observed immediately after the tetanus. The potentiation decreased rapidly in the period of 60 sec after the tetanus. Then, the potentiation continued to decrease at the low frequency (50 Hz) ; however, it tended to level off at the high frequencies (100 Hz and 200 Hz) .
2) The time course of twitch potentiation by the nerve stimulation was larger than that by the direct stimulation. This result suggests that nerve has a factor which enhances potentiation. The duration of the potentiation varied according to the stimulation frequencies by the nerve stimulation. It seems that this phenomenon was strongly influenced by the nerve.
3) The degree of increase in twitch tension tended to depend greatly on the peak rate of force development. This result suggests that the increase in twitch tension was closely related to the intensity of the active state.
4) Time course of time to peak tension relatively corresponded to the half relaxation time. It seems possible for the duration of the active state to be related to calcium uptake at the sarcoplasmic reticulum.
5) The coupling efficiency by the direct stimulation tended to be smaller than that by the nerve stimulation after 10 sec. This result suggests that the stimulating nerve possesses a factor which prolongs the period of potentiation.

In order to examine muscle activities, surface electromyo-grams (EMGs) were recorded from the triceps surae muscles (lateral gastrocnemius: LG, medial gastrocnemius: MG, soleus: SOL) during prolonged isometric contractions at 20°of ankle joint angle under constant load (10% MVC) . The results were summarized as follows;
1) EMG recordings were obtained which showed complementary activity in each muscle in the time course. Changes in activity was found between whole muscles in the synergist of triceps surae muscles.
2) Muscle activity most frequently took the form of MG+SOL, followed by MG acting alone and SOL acting alone. Ta/Ts value (the ratio of total activity period and total silent period on EMG activity) showed 4.0 in MG and SOL. In contrast, it showed 0.3 in the LG.
3) In the latter half of all exercise times, frequent changes in activity were shown, and Ta/Ts value increased in the gastrocnemius muscle and decreased in the soleus muscle. These results indicate that frequent changes in activity in the latter half were caused by the reduc tion in Ts in the gastrocnemius muscle, and the reduction in Ta in the soleus muscle.
4) Mean integrated EMGs increased significantly in the middle and latter phases in each burst activity, but those in the latter phase did not increase compared to those in the middle phase. These results suggest that the rotation of activity between muscles may have occured before the remarkable increase of EMG activity with fatigue.

Surface electromyograms (EMGs) were recorded from the triceps surae muscles in order to examine muscle activities during concentric and eccentric ankle joint movements at various angular velocities under constant load (5 and 10%MVC) . The results were summarized as follows ;
1) At slow angular velocity (6 deg/s) of ankle joint movement, EMG amplitude tended to increase at a larger ankle joint angle in the gastrocnemius muscle, and at a smaller angle in the soleus muscle.
2) Following an increase in angular velocities (6→30→60 deg/s), peak values of integrated EMGs were significantly increased (7-15%) in the medial gastrocnemius muscle. However, these peak values were significantly decreased in the soleus muscle (22-49%) . These results suggest selective recruitment of motor units depending on angular velocity.
3) Ankle joint angle at the peak integrated EMGs was significantly increased following an increase in angular velocity (6→30→60 deg/s) in the soleus muscle. This suggests that the angle at the recruitment of motor units may be dependent on angular velocity in the soleus muscle.

To examine personal space perception, a method of identifying joint position was determined by having the subject equally bisect the joint angle, by producing a minimum increment in change of position and by selecting a threshold for two-point discrimination using the metacarpophalangeal joint of digits 2-5.
Eight healthy adults (6 males and 2 females) were used as subjects. The subjects' eyes were covered at all times to prevent any visual feedback.
Each metacarpophalangeal joint of digits 2-5 was extended, flexed and pointed to the bisection position in 6 sec (about 2 sec in each position) . The difference in the bisection position selected using the index finger with the shoulder, elbow and hand in variety of positions was determined. The deviation from the mid-bisection point and the standard deviation were less when the hand was positioned most comfortably and near the face (“natural and near”) than when the hand was positioned in the more uncomfortable position and further from the face (“unnatural and further”) .
In a second test, the index finger was moved from full extension to the full flexion in increments as small as possible at a rate of one change in position per second. Again, the effect of arm position was determined.
In case of“the natural and near”position, each increment in joint position was smaller than in“the unnatural and further”position.
In“the natural and near”position, the two point threshold was smallest of all. It was measured at the thumb side of right palm in the proximo-distal direction.
These results suggest that personal space perception of metacarpophalangeal joint is affected by the position of adjoining limb segments.

To examine personal space perception, a method of identifying joint position was determined by having the subject equally bisect the joint angle, by producing a minimum increment in change of position and by selecting a threshold for two-point discrimination using the metacarpophalangeal joint of digits 2-5.
Eight healthy adults (6 males and 2 females) were used as subjects. The subjects' eyes were covered at all times to prevent any visual feedback.
Each metacarpophalangeal joint of digits 2-5 was extended, flexed and pointed to the bisection position in 6 sec (about 2 sec in each position) . The difference in the bisection position selected using the index finger with the shoulder, elbow and hand in variety of positions was determined. The deviation from the mid-bisection point and the standard deviation were less when the hand was positioned most comfortably and near the face (“natural and near”) than when the hand was positioned in the more uncomfortable position and further from the face (“unnatural and further”) .
In a second test, the index finger was moved from full extension to the full flexion in increments as small as possible at a rate of one change in position per second. Again, the effect of arm position was determined.
In case of“the natural and near”position, each increment in joint position was smaller than in“the unnatural and further”position.
In“the natural and near”position, the two point threshold was smallest of all. It was measured at the thumb side of right palm in the proximo-distal direction.
These results suggest that personal space perception of metacarpophalangeal joint is affected by the position of adjoining limb segments.

The series of ECG examination were performed to study the influence of different kinds of exercise on heart of two untrained middle aged healthy male volunteers.
One of them was assigned to run 10 kilometers or so, as fast as he could, once a day for 17 days. The other was assigned to run on a treadmill of three degree gradient for 20 minutes with a speed of 150 meters per minute once a day for 10 years. This volume of exercise was designed at a workload requiring 2/3 of his VO₂max value.
In the former case, frequent supraventricular premature beats with ventricular aberrant conduction occurred on the 21 st day from the beginning of the study. These changes on ECG were complicated with sinus arrhythmia and complete AV block on the 23 rd day. Sinus bradycardia and supraventricular bigeminy with ventricular aberrant conduction were noted on the 44 th day. Supraventricular bigeminies still persisted on the 213 th day, however they disappeared after that.
The latter developed interpolated ventricular premature beats at rest for the first time in the 5 th year from the beginning of the study. These premature beats disappeared during exercise and recurred at rest. In the 8 th year ventricular premature beats became to show bigeminies.
These results suggest that the severe exercise could cause various types of arrhythmia for a long period of time after the cessation of exercise even if the term of exercise would be short. On the other hand, the moderate load of exercise could not cause clinically significant arrhythmias inspite of continuous performance for a long term.

To examine the variation in the knee extension force and the integrated electromyogram from rectus femoris, medial vastus and lateral vastus muscles with the knee joint angle in growing children, measurements were conducted in 61 school boys aged from 7 to 12 years old. Anthropometric measurements were also done on the body height, the lower limb length, and so on. Results obtained were as follows.
1) Ratio of the lower limb length comparing with the body height increased with the grade.
2) Maximal force at each joint angle in each grade was shifted peak from 70°to 90°with the grade.
3) The pattern of the integrated surface electromyogram from rectus femoris, medial vastus or lateral vastus muscle at each joint angle was the same in all of the grade. The integrated electromyogram at the maximal voluntary contraction was maximal at 45°of the knee joint angle in the rectus femoris muscle, at 110°in the medial vastus and at 90°in the lateral vastus muscle.