When participating in international disaster relief operations (IDR), medical staff must work under limited human resources and medical equipment. The actual role of a nurse in IDR has not yet been clarified, while the role of a doctor is relatively clear.
In this study, we have examined the actual role of nurses in IDR through a survey by questionnaire to 61 medical staff who have worked in past IDR. Full usable responses were received from 50 (82%) of them. These 50 were consisted of 24 doctors, 17 nurses, and 9 medical coordinators. The questionnaire was distributed from September 1 to December 31 in 2005. We investigated 17 activities reported variously in the literature;-setting up temporary medical facilities, inside arrangements, health care of the medical staff, coordination within the team, keeping medical records, performing triage, wound irrigation, debridement, performing incisions, removing stitches, suturing, reception of patients, medical interview of patients, assisting a doctor performing medical examination and treatment, management of commodities, management of medical waste, management of medical records, and conventional nursing care. The questionnaire asked the respondent to indicate a level of appropriate for a nurse to perform each of the activities in IDR.
Provided that the nurse had a basic national licence in nursing and IDR education and training, then triage and wound irrigation were each considered appropriate during IDR with a doctor supervising, beyond the conventional nursing role. But suturing, performing incisions, removing stitches, and debridement were each considered to be problematic for nurses.

Objective: The water-soluble extract of Ganoderma lucidum mycelia (WER), which is used as a health food, reduced hyperglycemia and enhanced glucose transporter 4 (GLUT4) translocation to the plasma membrane in skeletal muscle and adipose tissue in KK-A^y mice, a type 2 diabetic animal model with obesity.In order to elucidate the reduction of hyperglycemia by WER, we investigated the translocation of glucose transporter 4, glucose uptake and associating signal transduction in rat skeletal muscle (L6) cells. Method: The glucose uptake was analyzed with radioactive 2-deoxy-D-glucose.The localization of GLUT4 in L6 cells treated with various concentrations of WER was analyzed with immunohistochemical staining and Western blot technique.As a positive control, insulin or troglitazone was used in these experiments.Furthermore, the activation of intracellular signaling pathways by Western blot analysis and the influence of glucose uptake using four kinds of inhibitors (LY294002 as potent PI3K inhibitor, rapamycin as mTOR inhibitor, Gö6983 as broad PKC inhibitor, compound C as AMPK inhibitor) was evaluated. Results: GLUT4 protein content in the plasma membrane was induced in a dose-dependent manner of WER without increasing the gene expression and amount of total protein in the L6 cells and the glucose uptake was augmented with increasing the amount of GLUT4 translocated on the plasma membrane.The phosphorylation of phosphatidylinositol-3 kinase (PI3K), Akt and acetyl CoA carboxylase (ACC) were induced in a concentration dependent manner and inhibited by the above inhibitors except rapamycin. Conclusion: These results indicate that the hypoglycemic effect of some material(s) in WER may be due to the enhancement of glucose uptake through GLUT4 translocation on the plasma membrane by activating the PI3K/Akt pathway through improving insulin resistance.

Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year-old man with a 17-year history of UC began receiving surveillance colonoscopy at the age of 37 years; 2 years later, dysplasia was detected in the sigmoid colon, and he underwent colonoscopy every 3 to 6 months. Approximately 1.5 years thereafter, a flat adenocarcinoma lesion occurred in the rectum. Flat lesions with high-grade dysplasia were found in the sigmoid colon and surrounding area. The patient underwent laparoscopic total proctocolectomy and ileal pouch-anal anastomosis with ileostomy. Adenocarcinoma was diagnosed in the sigmoid colon and NEC in the rectum. One year postoperation, recurrence or metastasis was not evident. Regular surveillance colonoscopy is important in patients with long-term UC. A histological examination of UCAC might demonstrate NEC.