Malpractice or masterful practice?Navigating vicarious liability in healthcare

In the intricate landscape of healthcare,vicarious liability looms large,shaping the responsibilities and actions of healthcare practitioners and administrators alike.Illustrated by a poignant scenario of a medication error,this article navigates the complexities of vicarious liability in healthcare.It explains the legal basis and ramifications of this theory,emphasizing its importance in fostering responsibility,protecting patient welfare,and easing access to justice.The paper explores the practical effects of vicarious responsibility on day-to-day operations,leadership practices,and decision-making processes via the eyes of senior consultants,junior doctors,and hospital administrators.Through comprehensive insights and real-world examples,it underscores the imperative of fostering a culture of accountability,communication,and quality care to navigate the intricate web of liabilities inherent in modern healthcare.

Determination of Liability for Violation of “Sexual Autonomy” and Compensation for Mental Damages

At the legislative level in China,there has been insufficient theoretical preparation to explicitly include“sexual autonomy”within the scope of general personality rights.In handling the increasing number of disputes related to violations of“sexual autonomy,”judicial biases have emerged during the trial process when courts determine the attribute of the right to“sexual autonomy.”This situation necessitates a clear legal analysis of the concept and attributes of“sexual autonomy”to establish its essential attribute as a personality right,and,from the perspective of legal doctrine,enable the justification of the right to“sexual autonomy”as either a general personality right or other personality interests,thereby providing theoretical support for courts to“adjudicate according to law.”By delineating and categorizing instances of violations of“sexual autonomy,”the constitutive elements and fundamental characteristics of such violations can be clarified.By examining the legal norms governing civil litigation and civil litigation associated with criminal cases concerning violations of“sexual autonomy,”the responsibility determination,remedies,and existing regulatory loopholes regarding violations of“sexual autonomy,”especially in cases involving both criminal and civil matters,can be defined.Based on this foundation,the legal basis,determination mechanism,and compensation standards for claiming compensation for mental damages resulting from violations of“sexual autonomy”can be elucidated.

Risk Assessment of an Environmental Liability in the Commercialization of Hydrocarbons-A Secondary Publication

The risk analysis evaluates the probability of occurrence with the impact of said risks.In the hydrocarbon sector,an environmental liability is an improperly abandoned facility,soil contaminated by spills or others.The objective of this work is to define a risk management plan.The characterization of the residue and the area was carried out.Hazardous events were identified:overflow spill,soil contamination by infiltration,as well as radiant heat and suffocating and toxic fumes from a fire.The matrix method was applied considering the probability of occurrence against vulnerability.The danger of infiltration implied a high level of risk.The risk management plan was drawn up,its main action being the liquidation of the pool and the sanitation of the area.

FibroScan-aspartate transaminase:A superior non-invasive model for diagnosing high-risk metabolic dysfunction-associated steatohepatitis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4.

Efficacy of mycophenolate mofetil combined with topical 0.05%tacrolimus in high-risk keratoplasty:1-year cohort study

AIM:To investigate the efficacy of systemic mycophenolate mofetil(MMF)as an adjunct in combination with topical tacrolimus(FK506)and corticosteroid eyedrops for preventing corneal graft rejection after high-risk keratoplasty(HRK).METHODS:In this cohort study,55 consecutive patients(55 eyes)from an eye center who met the criteria of HRK were included.The definition for HRK includes large grafts of no less than 9 mm diameter,vascularized cornea of two or more quadrants,regrafting,or eccentric grafts.After penetrating keratoplasty,25 patients treated with systemic MMF in combination with 0.05%FK506 and tapering corticosteroid eyedrops were enrolled in Group 1 from October 2019.Thirty patients receiving postoperative treatment with 0.05%FK506 and tapering corticosteroid eyedrops alone were enrolled in Group 2 from January 2018 to September 2019.All participants were closely monitored after surgery,and episodes of graft rejection and relevant clinical data were collected and assessed over a one-year follow-up period.RESULTS:After a follow-up of 9.6±3.2mo,graft rejection episodes occurred in 4 cases(16%)in Group 1 and 18 cases(60%)in Group 2.One reversible and 3 irreversible graft rejections occurred in Group 1,while 3 reversible and 15 irreversible rejections occurred in Group 2.Kaplan-Meier analysis revealed that 82.5%of grafts in Group 1 and 37.1%in Group 2 did not experience corneal graft rejection(P<0.01,log-rank test).The clear graft survival rate was 83.6%in Group 1 and 36.7%in Group 2(P<0.01,log-rank test)within one year of follow-up.No severe systemic side effects were observed in either group during the follow-up period.CONCLUSION:The triple treatment regimen consisting of MMF,topical FK506,and corticosteroid eyedrops represents a promising strategy for effectively preventing graft rejection and improving graft survival in patients with HRK.

Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.

Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon

Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Experimental models of high-risk bowel anastomosis in rats:A systematic review

BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.

Application Value of NLR,PLR,LMR,HEART score,and POCT in Early Warning and Accurate Graded Diagnosis of High-Risk Chest Pain in Emergency Medicine

Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and point-of- care testing (POCT) in the early warning and precise diagnosis of high-risk chest pain in emergency medicine. Methods: A total of 157 patients with acute chest pain who were admitted to the emergency department and chest pain treatment unit of our hospital between August 2022 and September 2023 were selected. Rapid testing of bedside myocardial markers (ultrasensitive troponin (hs-cTnI), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), D-dimer (D-Dimer), and N-terminal B-type natriuretic peptide precursor (NT-proBNP)) was performed on the patients using a POCT device (ThermoKing BioMQ60proB). A HEART score was used to classify the patients into low (n = 53), intermediate (n = 59), and high-risk (n = 45) groups, and the NLR, PLR, and LMR were calculated. The NLR, PLR, and LMR values were compared among the three groups of patients, and the optimal cutoff values as well as sensitivity and specificity were determined based on receiver operating characteristic (ROC) analysis. Results: The HEART scores of patients in the low-risk, intermediate-risk, and high-risk groups were (2.72 ± 0.24), (4.75 ± 0.56), and (5.32 ± 0.73) respectively, and the differences were statistically significant (P < 0.05). Compared with the low-risk group, the intermediate-risk group and high-risk group had a significantly higher NLR and PLR, and a significantly lower LMR;the high-risk group had higher NLR and PLR and lower values of LMR as compared to the other two groups, and the difference was statistically significant (P < 0.05). The ROC curves suggested that the area under the curve, sensitivity, and specificity of the combined diagnosis of NLR, PLR, LMR, HEART score, and POCT were greater than those of LR, PLR, and LMR with HEART score and POCT alone. Conclusion: The combined application of NLR, PLR, LMR, HEART score, and POCT has significant application value in the early warning and precise diagnosis of emergency high-risk chest pain. It provides a more simple, easy-to-access, and efficient assessment index for the clinical prediction and treatment of emergency high- risk chest pain.

Spontaneous combustion liability of coal and coal-shale: a review of prediction methods

This study presents a review of the various methods to predict the spontaneous combustion liability of coal and coal-shale. The relative propensity of coal to undergo self-heating can be established by different methods. These methods are well established in their usage, but the fact that no particular test method has become a standard to predict the spontaneous combustion liability indicates that doubt still exists as to the validity of all of them. The underlying principle of all the tests is that the more readily the coal undergoes exothermic oxidation, the more liable it is to self-heat. Comprehensive studies that centres on the international position on research being conducted by academics, different research institutes and industries on spontaneous combustion of coal and coal mine fires were evaluated. Relationships between the geochemical analysis (proximate and ultimate analysis, forms of sulphur, petrographic properties, X-ray diffraction and X-ray fluorescence) and spontaneous combustion testing methods (numerical and experimental approaches) used to predict the spontaneous combustion liability of coal were reviewed. The combination of these tests provides a better understanding of the mechanism that controls the spontaneous combustion phenomena. However, irrespective of the extensive studies that have been conducted over time, spontaneous combustion is still a major problem in the coal value chain.

Replenishment policy and inventory optimization for supply-hub with liability period consideration

A replenishment decision-making model for supply-hub is firstly established from the angle of supplier, and optimal replenishment decision of the supplier is analyzed. Then, inventory optimization model for supply-hub is formulated from the angle of the manufacturer, and the optimization algorithm for obtaining optimal inventory levels is given. The result shows that liability period decides the share of the inventory cost between two sides in supply chain. With the increase of liability period, the service level has been quickly reduced even though the manufacturer's cost has been cut down by transferring the inventory cost to the supplier. As to the safety inventory, if the lower bound of components safety inventory increases, the supplier's cost will rise up more slowly than the liability period does, while the service levels increases as the safety inventory's lower bound is raised.

Proposing a novel comprehensive evaluation model for the coal burst liability in underground coal mines considering uncertainty factors

Coal burst is a severe hazard that can result in fatalities and damage of facilities in underground coal mines.To address this issue,a robust unascertained combination model is proposed to study the coal burst hazard based on an updated database.Four assessment indexes are used in the model,which are the dynamic failure duration(DT),elastic energy index(WET),impact energy index(KE)and uniaxial compressive strength(RC).Four membership functions,including linear(L),parabolic(P),S and Weibull(W)functions,are proposed to measure the uncertainty level of individual index.The corresponding weights are determined through information entropy(EN),analysis hierarchy process(AHP)and synthetic weights(CW).Simultaneously,the classification criteria,including unascertained cluster(UC)and credible identification principle(CIP),are analyzed.The combination algorithm,consisting of P function,CW and CIP(P-CW-CIP),is selected as the optimal classification model in function of theory analysis and to train the samples.Ultimately,the established ensemble model is further validated through test samples with 100%accuracy.The results reveal that the hybrid model has a great potential in the coal burst hazard evaluation in underground coal mines.

Analysis of spontaneous combustion liability indices and coal recording standards/basis

The characterization of the physical and chemical properties of coal on a standard provides an understanding of its characteristics towards spontaneous combustion.The trend of linear relationships between coal recording standards(%air-dried(ad),%dry(db)and%dry ash free(daf)basis)of 30 selected coal samples from the Witbank coalfields and spontaneous combustion liability indices were evaluated.The spontaneous combustion liability indices of these samples were evaluated by crossing point temperature(XPT),Stage II Slope,FCC(Feng,Chakravorty,Cochrane)and the Wits-Ehac tests,while the coal properties were determined from the proximate and ultimate analyses.The results obtained from these coal properties were related to different liability indices to develop trends of linear relationships using regression analysis.The ad basis indicated higher correlation coefficients than the db and daf basis for the XPT and FCC index,while the daf showed higher correlation coefficients than the ad and db basis for the Wits-Ehac index.It was found that the trend of linear relationships of these coal properties differs from one liability index to the next.The XPTs showed a better trend followed by the Stage II Slope on the coal properties among the spontaneous combustion liability indices evaluated.

Reliability of a Tissue Microarray in Detecting Thyroid Transcription Factor-1 Protein in Lung Carcinomas

OBJECTIVE To compare the expression of the thyroid transcription factor-1 （TTF-1） in human normal adult type Ⅱ alveolar epithelial cells, embryonic pneumocytes and cancer cells of lung carcinoma and metastatic lymph nodes using a tissue microarray （TMA） along with paired conventional full sections, and to investigate the reliability of tissue microarrays in detecting protein expression in lung carcinoma. METHODS A lung carcinoma TMA including 765 cores was constructed. TTF-1 protein expression in both TMA and paired conventional full sections were detected by the immunohistochemical SP method using a monoclonal antibody to TTF-1. A PU （Positive Unit） of TTF-1 protein was assessed quantitatively by the Leica Q500MC image analysis system with results from the paired conventional full sections as controls. RESULTS There was no significance between TMA and paired conventional full sections in TTF-1 expression in different nuclei of the lung tissue. CONCLUSION TTF-1 protein expression in lung carcinoma detected by TMA was highly concordant with that of paired full sections. TMA is a reliable method in detecting protein expression.

Trends in the International Regime of Liability and Compensation for Oil Pollution Damage

Since the entry into force of the International Convention on liability and compensation for oil spill damage, there have been many discussions on the improvement of this regime. Based on the existing tworegimes, the writer tried to analysis the advantages of the new regimes and foresee the trends of the international regime of liability and compensation for oil pollution damage.

The Emerging Importance of Professional Liability Insurance Coverage for Pharmacists

As the responsibilities for clinical pharmacists have increased in recent years, the pharmacy practitioner finds the need for professional liability insurance. This report describes the practice changes under way and describes the malpractice insurance options available to current pharmacy practitioners.

A Liability Division Method for Harmonic Pollution Based on Line-Transferred Power Components

The existing liability division methods for harmonic pollution are either inexplicit or incomplete in physical meaning. To compensate these defects, two new methods are proposed based on line-transferred power components in this paper. At first, all harmonic sources are represented by ideal equivalent current source, line current components and bus voltage components of a source are determined by stimulation of this source with all other sources disabled. Then, the line-trans- ferred power component owing to a source under all sources action together is determined by the theory of line-transferred power components, and called source’s line-transferred power component. At last, the liability of a source for line-end harmonic pollution is divided by two methods: the ration of the source’s line-transferred active power component to the total line-transferred power, and the ration of projection of the source’s line-transferred complex power component to absolute value of the total line-transferred complex power. These two methods are taken into account not only harmonic voltage but also harmonic current in the liability division. Simulation results show that the proposed liability division method based on active power component is the most effective and ideal one.

Two-step strategy—conjunctival flap covering surgery combined with secondary deep anterior lamellar keratoplasty for the treatment of high-risk fungal keratitis

AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were included.Reported outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant complications.RESULTS:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 mm.The mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μm.The mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μm.Hypopyon and endothelial plaques were presented in all patients.The period between the two steps was 3.65±0.9(ranging from 3 to 5)mo.The graft diameter was 7.75±0.39 mm.At the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of BCVA.One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal.CONCLUSION:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK.It is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.

Rapid genetic screening of Charcot-Marie-Tooth disease type 1A and hereditary neuropathy with liability to pressure palsies patients

We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 （PMP22） to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Tooth disease type 1 and one family with hereditary neuropathy with liability to pressure palsies. The proband and one subclinical family member from the Charcot-Marie-Tooth disease type 1 family had a PMP22 gene duplication; one patient from the hereditary neuropathy with liability to pressure palsies family had a PMP22 gene deletion. Electron microscopic analysis of ultrathin sections of the superficial peroneal nerve from the two probands demonstrated demyelination and myelin sheath hyperplasia, as well as an ＇onion-like＇ structure in the Charcot-Marie-Tooth disease type 1A patient. We observed an irregular thickened myelin sheath and ＇mouse-nibbled＇-Iike changes in the patient with hereditary neuropathy with liability to pressure palsies. In the Charcot-Marie-Tooth disease type 1A patient, nerve electrophysiological examination revealed moderate-to-severe reductions in the motor and sensory conduction velocities of the bilateral median nerve, ulnar nerve, tibial nerve, and sural nerve. Moreover, the compound muscle action potential amplitude was decreased. In the patient with hereditary neuropathy with liability to pressure palsies, the nerve conduction velocity of the bilateral tibial nerve and sural nerve was moderately reduced, and the nerve conduction velocity of the median nerve and ulnar nerve of both upper extremities was slightly reduced.