This study aimed to develop a new method of increasing water content in the cutaneous stratum corneum under a dry skin condition. For this purpose, the experiments were performed using 10 healthy women (age: 20 ± 5 years, height: 158 ± 4 cm, weight: 50 ± 6 kg) in winter to ensure the dry condition. The subjects immersed the right hand into a 42˚C bath for 10 min. Skin surface temperature and water content in the stratum corneum of the left forearm were simultaneously measured during and for 1 h after the hand warming. The skin surface temperature began to increase (P<0.05) 15 min after the hand warming and thereafter remained increased for 1 h. Similarly, the water content in the stratum corneum began to increase immediately after the hand warming and remained increased throughout the experiment. The present results suggest that warming of one hand is effective in enhancing skin moisture in the other forearm and thereby maintaining barrier function of the skin.

Objective: To clarify administrators' awareness of outpatient cancer nursing clinics.Methods: We conducted semi-structured interviews of six administrators overseeing outpatient cancer nursing clinics and performed a qualitative, inductive analysis.Results and discussion: In this study, interviews with the administrators led to the identification of ten categories for outpatient cancer nursing clinics such as [the nurses' role in easing the concerns and worries of patients with cancer and their families], [challenges in training and securing outpatient cancer nursing clinic personnel], and [the influence of the passion and confidence of nurses on practice in outpatient cancer nursing clinics]. These interviews revealed that, in practice, outpatient cancer nursing is a useful skill for elucidating the real needs of patients and supporting their decision-making. Coordinated efforts and collaboration among human resources/disciplines may affect day-to-day outpatient cancer nursing clinics.Conclusion: This study revealed that the development of assessment indices to substantiate the accomplishment of outpatient cancer nursing clinics and the training of personnel with a high level of practical skills are two challenges for the expansion of outpatient cancer nursing clinics.

The aim of this study was to investigate the relationship between heart rate variability (HRV) during exercise and ventilatory threshold (VT), using the MemCalc system which is superior in spectral analysis. Nine healthy male subjects with no cardiopulmonary disease performed an exercise test to exhaustion to determine VT on a bicycle ergometer. Low frequency (LF : 0.04-0.15 Hz), high frequency (HF : 0.15-0.40Hz) and LF/HF ratio power spectra were calculated by maximum entropy method (MEM) spectral analysis, using the MemCalc system. In each case, when the subject started exercise, the HF component declined rapidly during the first 30 seconds ; and compared to the resting value, it declined to approximately 5 % at VT. The possibility of using this phenomenon as a criterion for setting intensity of exercise is tinder consideration. The LF/HF ratio showed different patterns of variation among the subjects. A significant linear relationship was seen between the declining rate of the HF component and VT (r=0.93, p<0.001), suggesting a corres pondence between the heart's capability of adjusting to maintained exercise and high endurance capacity.

Severe burn injuries often result in significant long-term physical complications with scarring and contractures, but cancers associated with chronic burn scars are relatively rare. We report a case of a 58-year-old man with skin cancer arising from a healed burn scar. He initially suffered from an extensive fire burn on both lower limbs as a child. The burn scars extended from his upper thighs to his toes bilaterally and caused severe contractures which immobilized the ankles in plantar flexion. Two years ago, he noticed a small ulcerated lesion on the right heel and self-treated it with topical ointments. However, the ulcer increased in size and became malodorous. He presented to a clinic with a large, ulcerated, tumorous lesion, and histology proved it to be squamous cell carcinoma. He subsequently underwent a right below-the-knee amputation, and the previous scars presented on the stump. Thus the patient received a total surface bearing prosthesis with an Icelandic roll-on silicone socket system, which is ideal for patients with extensive scarring at the stump because it may reduce prosthesis-induced stump injuries by evenly distributing the patient's weight in the socket. After he left the hospital, he walked so far with the prosthesis every day that small ulcers often developed at the right popliteal fossa. However, he did not take care to treat these lesions properly, so we had to educate him on how to treat them. Patients such as these will often require education for self-management, family involvement and regular follow-up to monitor scar ulceration and watch out for any malignant transformation.

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. sent questionaire about their present curricula and future plans for teaching English to the deans of all 49 public and 31 private medical schools from January 9 to March 9, 1995, and collected the responses from 30 (61.2%) public, 24 (77.4%) private, in total 54 (67.5%) medical schools. The teaching of useful English includes English conversation in 37 (68.5%), medical English in 34 (63.0%), and structures of medical papers in 9 (16.7%) schools. Medical English is also taught as extracurricular and other activities in 40 (74.1%) schools. These figures have increased as compared with the ques-tionaire conducted two years previously. English conversation can be taught to junior (1st & 2nd yrs) students, for whom medical English can only be taught on general medical topics such as the medical care delivery system, bioethics, roles of physicians, and primay care. Therefore medical English is more and more taught to middle-class (3rd & 4th yrs) and senior (5th & 6th yrs) students. It seems necessary to annually conduct a workshop for medical English teachers to improve their strategies of teaching.

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. here proposes a model curriculum for teaching useful English in medical schools at three levels. The major objectives are listening, speaking, rapid reading, and sentence structuring including paragraphing for junior (1st & 2nd yrs) students, reading medical papers and charts in English, structures of medical scientific papers, and listening to medical English for middleclass (3rd & 4th yrs) students, and writing and orally presenting papers in English on given medical subjects are for senior (5th & 6th yrs) students.

The Working Group for the Improvement of Foreign Language Education in Medical Schools in Japan, organized in 1994 and chaired by Prof. K. Uemura, M.D. lists here English teaching materials for medical purposes. More than half of the materials listed are those that one of the group members, T. Ohki, has used or wants to use in his classes. The list has been enlarged due to the responses to the questionnare sent to those who participated in the first workshop held in 1995. The list is divided into 12 categories: listening & reading, writing, medical terminology, pronunciation, textbooks for training the four skills, essays on medicine, fictional stories about medicine & medical doctors, medical ethics and terminal care, handbooks for medical students and doctors, writing medical charts, self-teaching materials. and video materials.
It is hoped that the materials listed here will supplement a model curriculum for teaching ‘useful’ English in medical schools, as proposed by the working group.

BACKGROUND: For an effective bone graft for reconstruction of the maxillofacial region, an adequate vascular network will be required to supply blood, osteoprogenitor cells, and growth factors. We previously reported that the secretomes of bone marrow-derived mesenchymal stem cells (MSC-CM) contain numerous growth factors such as insulin-like growth factor (IGF)-1, transforming growth factor (TGF)-β1, and vascular endothelial growth factor (VEGF), which can affect the cellular characteristics and behavior of regenerating bone cells. We hypothesized that angiogenesis is an important step for bone regeneration, and VEGF is one of the crucial factors in MSC-CM that would enhance its osteogenic potential. In the present study, we focused on VEGF in MSC-CM and evaluated the angiogenic and osteogenic potentials of MSC-CM for bone regeneration. METHODS: Cytokines in MSC-CM were measured by enzyme-linked immunosorbent assay (ELISA). Human umbilical vein endothelial cells (HUVECs) were cultured with MSC-CM or MSC-CM with anti-VEGF antibody (MSC-CM + anti-VEGF) for neutralization, and tube formation was evaluated. For the evaluation of bone and blood vessel formation with micro-computed tomography (micro-CT) and for the histological and immunohistochemical analyses, a rat calvarial bone defect model was used. RESULTS: The concentrations of IGF-1, VEGF, and TGF-β1 in MSC-CM were 1515.6 ± 211.8 pg/mL, 465.8 ± 108.8 pg/mL, and 339.8 ± 14.4 pg/mL, respectively. Tube formation of HUVECs, bone formation, and blood vessel formation were increased in the MSC-CM group but decreased in the MSC-CM + anti-VEGF group. Histological findings suggested that new bone formation in the entire defect was observed in the MSC-CM group although it was decreased in the MSC-CM + anti-VEGF group. Immunohistochemistry indicated that angiogenesis and migration of endogenous stem cells were much more abundant in the MSC-CM group than in the MSC-CM + anti-VEGF group. CONCLUSIONS: VEGF is considered a crucial factor in MSC-CM, and MSC-CM is proposed to be an adequate therapeutic agent for bone regeneration with angiogenesis.
Animals ; Blood Vessels ; Bone Regeneration ; Culture Media, Conditioned ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Human Umbilical Vein Endothelial Cells ; Humans* ; Immunohistochemistry ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Mesenchymal Stromal Cells* ; Osteogenesis ; Rats ; Stem Cells ; Transforming Growth Factors ; Transplants ; Vascular Endothelial Growth Factor A

To understand the regulation of Helicobacter pylori (H. pylori)-associated gastric carcinogenesis, we examined the effect of B-cell translocation gene 2 (BTG2) expression on the biological activity of Tipα, an oncoprotein secreted from H. pylori. BTG2, the human ortholog of mouse TIS21 (BTG2(/TIS21)), has been reported to be a primary response gene that is transiently expressed in response to various stimulations. Here, we report that BTG2 is constitutively expressed in the mucous epithelium and parietal cells of the gastric gland in the stomach. Expression was increased in the mucous epithelium following H. pylori infection in contrast to its loss in human gastric adenocarcinoma. Indeed, adenoviral transduction of BTG2(/TIS21) significantly inhibited Tipα activity in MKN-1 and MGT-40, human and mouse gastric cancer cells, respectively, thereby downregulating tumor necrosis factor-α (TNFα) expression and Erk1/2 phosphorylation by reducing expression of nucleolin, a Tipα receptor. Chromatin immunoprecipitation proved that BTG2(/TIS21) inhibited Sp1 expression and its binding to the promoter of the nucleolin gene. In addition, BTG2(/TIS21) expression significantly reduced membrane-localized nucleolin expression in cancer cells, and the loss of BTG2(/TIS21) expression induced cytoplasmic nucleolin availability in gastric cancer tissues, as evidenced by immunoblotting and immunohistochemistry. Higher expression of BTG2 and lower expression of nucleolin were accompanied with better overall survival of poorly differentiated gastric cancer patients. This is the first report showing that BTG2(/TIS21) inhibits nucleolin expression via Sp1 binding, which might be associated with the inhibition of H. pylori-induced carcinogenesis. We suggest that BTG2(/TIS21) is a potential inhibitor of nucleolin in the cytoplasm, leading to inhibition of carcinogenesis after H. pylori infection.

Rehabilitation therapy is important for patients with cancer, especially for those with terminal stage cancer who have physical malfunction and psychological distress. By setting goals according to patients' wishes, rehabilitation therapy may positively affect physical activity. In this study, we reported the implementation of rehabilitation training outside the hospital as a rehabilitation treatment. A 64-year-old man was diagnosed as having multiple brain metastases from lung cancer. The patient was admitted to the palliative care ward without active treatment according to his wish and was referred to the rehabilitation department. The patient had mild right hemiplegia at the time of initial examination and therefore required assistance for walking and eating. On the 51st day of the intervention, he requested to visit the ramen restaurant of his friend, which recently opened. Going out independently to the restaurant served as his practical training for improving his quality of life (QOL). This outing further expanded his activities of daily living, which made him motivated to treat his cancer. On the 71st day of intervention, he was discharged from the hospital and underwent outpatient examination. Therefore, the role of treatment in palliative care is to achieve the highest possible QOL. In this case, providing options according to the patients' wishes, such as outing, is believed to be effective in cancer treatment