Background: The potassium voltage-gated channel subfamily Q member 1 (KCNQ1) gene has recently received much attention as a candidate susceptibility gene for type 2 diabetes mellitus, especially in Asian populations. We previously reported that Kcnq1 mutant mice exhibit reduced insulin secretion and hyperglycemia due to a decrease in pancreatic β-cell mass. Through in vivo and in vitro analyses, we ascertained that this mechanism is the result of the downregulation of the non-coding RNA ‘Kcnq1ot1,’ which is expressed in the paternal allele of the Kcnq1 gene region, causing an increase in the expression of the cell cycle inhibitor cyclin dependent kinase inhibitor 1C (Cdkn1c). It was found that decreased Kcnq1ot1 expression resulted in pancreatic β-cell failure; however, the degree of pancreatic β-cell volume reduction was not severe. Methods: We induced obesity in Kcnq1ot1 truncation mice by feeding them a high-fat diet and evaluated pancreatic β-cell mass. Results: In the present study, we reveal that CCAAT/enhancer binding protein beta (C/EBPβ), which is expressed at higher levels in pancreatic β-cells in obese individuals, further increases the expression of Cdkn1c, which is upregulated by the Kcnq1 gene mutation. We found that simultaneous Cdkn1c hypomethylation and C/EBPβ overexpression in pancreatic β-cells causes a synergistic decrease in pancreatic β-cell mass. Conclusion This finding suggests that the synergistic effect of genetic factors such as Kcnq1 gene mutations and environmental factors such as obesity and overeating, which lead to increased expression of C/EBPβ, contribute to the regulation of pancreatic β-cell mass. This study is the first to show that the Kcnq1 gene is related to pancreatic β-cell mass through genetic-environment interactions.

Purpose: To visually impress upon school students that medicine should be taken with a full glass of cool or lukewarm water as part of medical education on pharmaceuticals, we conducted an experiment in which pharmaceutical drugs were added to juice and the foaming behavior was observed.　However, the degree of foaming differed depending on the type of juice and medicine, and consistent experimental results could not be obtained. Therefore, a basic study was conducted to elucidate the selection criteria for juices and medicines suitable for this experiment. Method: 3.0 grams of reagent-grade sodium bicarbonate (NaHCO3) was added to about 100 mL of various types of juice, and the height of the foam was measured promptly with a ruler for comparison. In addition, we added one packet of different medicines containing NaHCO3 to grapefruit juice (GFJ), and measured the foam height for comparison. Furthermore, we conducted experiments to test 3.0-5.0 grams of food-grade NaHCO3. We also examined their convenience, cost, and portability. Results and Discussion: The study suggested that 100% GFJ may lead to significant foaming, and this foaming volume seems to be influenced by the number of moles of acidic groups in the juice neutralized by NaOH. Higher NaHCO3 in one packet content produced a greater amount of foam. A large amount of food-grade NaHCO3 also increased the amount of foaming. These results led to the creation of our experiment protocol. We believe that it is possible to implement effective medical education utilizing this protocol.

Purpose: Patients with end－stage cancer are prone to various problems in their oral mouth. Survey of nurses’ attitudes regarding oral care in our cancer base hospital was conducted and discussed. Method: 197 nurses working with terminally ill cancer patients in the hospital were involved in the questionnaire survey. Results: 159 nurses completed the questionnaire (81%). 153 nurses responded that oral care was necessary for end－of－life stage (96%) but only 29 nurses responded that adequate oral care was provided (18%). Conclusion: The results showed that the nurses acknowledged of importance of oral care at end－of－life stage but didn’t provide the adequate oral care. The survey found that requesting oral care and relief of symptoms as supportive care are lacking of cooperation with the Dentists. How to share information and work with out－of－hospital dentists will be a challenge in the future.

An abdominal advancement flap (AAF) is a flap that pulls the elevated abdominal skin up and creates the shape of the inferior portion of the breast by making a neo-inframammary fold. Seven patients underwent remodeling using an AAF or a method combining an AAF with other volume displacement techniques after partial mastectomy. The excision volume ranged from 15% to 35%. AAF with only mobilization of the gland flaps was performed in two cases, with lateral mammoplasty in one case, with the round block technique (RBT) in one case, with a modified RBT in one case, and with medial mammoplasty in two cases. Although one patient treated with a RBT had a partial blood-flow insufficiency of the nipple-areola complex, it improved with conservative treatment. The cosmetic results were found to be excellent in three cases, good in three, and fair in one case.
Breast ; Cosmetics ; Displacement (Psychology) ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Skin ; Surgical Procedures, Operative

We introduce a method combining two oncoplastic techniques for breast-conserving reconstruction. The procedure is as follows: first, an extended glandular flap is made by undermining the breast from both the skin and the pectoralis fascia to the upper edge of the breast at the subclavicular area. After modeling the breast mound with the extended glandular flap, an inframammary adipofascial flap is made. The flap is reflected back to the breast area remodeled using the extended glandular flap. After reshaping the breast, the inframammary line is then re-shaped. This method is indicated for patients with breast cancer in the outer portion of the breast, who have small dense breasts, and have undergone a large excision of about 40% of their breast volume. We treated four patients, all of whom had either excellent or good cosmetic results with no fat necrosis.
Breast ; Breast Neoplasms ; Cosmetics ; Fascia ; Fat Necrosis ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Skin