The authors examined the appropriateness of an IIP, which was modified to fit the Japanese population, who were usually less obese and less insulin-resistant. This IIP maintained blood glucose levels within the target range in patients who underwent open-heart surgery as equally well as the previous empirical therapy. These findings confirm the efficiency and safety of our IIP with less burden in blood glucose management of Japanese patients.

Authors report a young girl with an HNF1β mutation, who had a history of neonatal cholestasis, persistent liver dysfunction, and developed insulin-dependent diabetes without renal involvement. Further, authors review the literature related to the hepatic involvement associated with HNF1β mutations.

Authors report a case of lower extremity lymphedema treated by LVA that preoperatively mapped not only lymphatic vessels by PDE, but also veins and venules using Veinsite™ .

Authors report a new perspective on the case of a 22-year-old female with no significant medical history who posed a diagnostic and therapeutic challenge; a giant cystic mass of the abdominal cavity.

Authors present a case of combined proximal median and ulnar nerves extensive injury that was successfully managed using a novel safe strategy implemented.

Authors present two cases of dilatory Eustachian tube dysfunction caused by localized nasopharyngeal amyloidosis.

Combining intraoperative ICG lymphography with NIR vein visualization can aid supermicrosurgeons in identifying lymphatic vessels and superficial venules to guide LVA incision placement. This guided approach significantly improves successful creation of LVAs when compared to the blind (anatomic) approach. In addition, the absence of linear ICG lymphographic patterns does not prevent formation of successful LVAs.

The authors present a novel synthetic vascular model for microanastomosis training. This model is suitable for trainees with intermediate level of microsurgical skills, and useful as a bridging model between simple suturing exercise and in vivo rat vessel anastomosis during pre-clinical training. It is an easy model to construct, using widely available materials. It simulates arterial anastomosis well, and enables direct observation and feedback of the anastomosis quality. This model is non-commercialized, cost effective, and is readily accessible. This model allows the trainee to grow their microsurgical skills ethically, systematically and confidently.

Diabetes control in the studied population could be too strict, and consequently, hypoglycemia in these patients could play a role in the major decline of cognitive function. Therefore, avoiding treatments that could lead to hypoglycemia in these patients could be very important. The aim of the treatment of diabetes in elderly patients is focused on stabilization, prevention of acute complications, and improving the quality of life.

HbA1c levels decreased with increasing Hb levels, independent of age, sex, BMI, FPG, and smoking and alcohol habits in Japanese men and women without diabetes or anemia. There was an interaction between sex and hemoglobin in the effects on HbA1c. The interpretation of HbA1c values should be cautious in the screening of glucose intolerance.