Skin-Sparing Mastectomy (SSM) is a method of removing a minimum amount of the skin and a mammary gland under the skin and conserving the native skin. Therty-eight patients (39-73 years old) with breast cancer underwent SSM and immediate breast reconstruction by the use of silicon natrium solution bags. Before cancer operation, none of them said they hoped for immediate breast reconstruction by autogenous tissue. Two patients were considering the reconstruction with autogenous tissue after silicon natrium solution bag reconstruction. By the reconstruction of an implant insertion, it was difficult to achieve a good result by one operation. About half of the reconstructed breast was asymmetry. But, nobody hoped for a revision operation or re-implant operation. There patients said they were not afraid of going to a hot spring but two patients said they were hesitant to do so. The Hokushin district is an agricultural area. So, there was no one who wanted to take time off from to undergo a revision operation to preserve a cosmetic appearance. We should advise secondary reconstruction in the Hokushin district.
Solutions ; Neoplasm of uncertain or unknown behavior of skin ; Integumentary system ; Simple mastectomy ; Lower case dee

First and 2nd-year medical students participated as standardized patients in practice for the medical interview. This practice was effective both for students playing doctors for learning medical communication skill and for students playing as a patients for allowing them to understand the patient's situation.

Practice in medical interviewing was held for 5th-and 6th-year medical students during their clinical clerkships. The purpose of the program was to acquire interviewing skills, to communicate with patients by considering the patient's point of view, and to obtain proper medical information. Communication skills and patients' medical problems were discussed after the interview. Students had difficulty obtaining appropriate medical information considering the patients' point of view. They professed an interest in communication skills and relationships between patients and doctors, but their concern after interview practice apparently shifted to collecting medical information and to their lack of knowledge essential for diagnosis. Students were satisfied with this training program and believed it was useful. Practice in medical interviewing in the last years of medical school is effective for teaching communication skills and for obtaining appropriate medical information.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine in August 2021, we conducted a special program focusing on education in Kampo medicine, “Pre-graduate and post-graduate Kampo medicine education for the next generation.” As part of this project, we directed a symposium on the model core curriculum (core curriculum) in medicine, dentistry, pharmacy and nursing. The core curriculum in these fields includes Kampo education. Each institution shall promote education in accordance with the core curriculum, considering the characteristics of the field and the circumstances of the educational institution. We introduced the core curriculum in each field, and summarized and reported the current status of Kampo education in the field, points to note and suggestions for multidisciplinary cooperation, issues related to clinical practice and lack of educators, and future prospects.

BACKGROUND: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, people need to practice social distancing in order to protect themselves from SARS-CoV-2 infection. In such stressful situations, remote cardiac rehabilitation (CR) might be a viable alternative to the outpatient CR program. METHODS: We prospectively investigated patients hospitalized for heart failure (HF) with a left ventricular ejection fraction of < 50%. As for patients who participated in the remote CR program, telephone support was provided by cardiologists and nurses who specialized in HF every 2 weeks after discharge. The emergency readmission rate within 30 days of discharge was compared among the outpatient CR, remote CR, and non-CR groups, and the EQ-5D score was compared between the outpatient CR and remote CR groups. RESULTS: The participation rate of HF patients in our remote CR program elevated during the COVID-19 pandemic. As observed in the outpatient CR group (n = 69), the emergency readmission rate within 30 days of discharge was lower in the remote CR group (n = 30) than in the non-CR group (n = 137) (P = 0.02). The EQ-5D score was higher in the remote CR group than in the outpatient CR group (P = 0.03) 30 days after discharge. CONCLUSIONS Remote CR is as effective as outpatient CR for improving the short-term prognosis of patients hospitalized for heart failure post-discharge. This suggests that the remote CR program can be provided as a good alternative to the outpatient CR program.
Aged ; Betacoronavirus ; Cardiac Rehabilitation ; methods ; Coronavirus Infections ; epidemiology ; Heart Failure ; rehabilitation ; Humans ; Japan ; Middle Aged ; Monitoring, Ambulatory ; Pandemics ; Pneumonia, Viral ; epidemiology ; Prospective Studies ; Self Care ; Telemedicine ; methods ; Telephone