Approximately 40% of protein-coding genes in the nematode Caenorhabditis elegans (C. elegans) are orthologous to human protein-coding genes, making this animal a useful model organism. The characteristics of this model organism include its simple structure, detailed basic biological description, and ease of culturing and freezing. In older years, researchers have used forward genetics to isolate mutants, examine their phenotypes, and clone the causal gene, revealing gene functions. By the end of the 20th century, researchers began to use various experimental techniques developed in the C. elegans community, including transgenic analyses by green fluorescent protein (GFP) expression and RNA interference, and this facilitated gene function analyses. These techniques are now used regularly in mammalian experiments. The C. elegans genome was sequenced for the first time as a multicellular organism, and the technologies used were then transferred to human genome sequencing.

We used C. elegans genome sequences and developed efficient techniques to isolate deletion mutants in a genome-wide manner using reverse genetics. We introduced deletions in the C. elegans genome by treating the animals with trimethylpsoralen (TMP) and ultraviolet light, and then screened for mutants using PCR. Next-generation sequencing was used to isolate the deletion mutants more efficiently. Current research has revealed that our laboratory has achieved a higher number and quality of deletion mutants than that of other laboratories worldwide. Furthermore, only our laboratory has effectively isolated deletion mutants for approximately half of the total genes. Through the National Bioresource Project funded by MEXT (Ministry of Education, Culture, Sports, Science and Technology), Japan, we have been distributing these deletion mutants to laboratories worldwide. Thus, in the past 20 years, gene function analyses of C. elegans have progressed notably. This information is useful for understanding the functions of human disease-causing genes. We hope that the knowledge gained from these activities will benefit research on the treatment of human diseases.

Diabetic ketoacidosis (DKA) can cause hypertriglyceridemia and, rarely, acute pancreatitis. Propofol, which is used as a sedative for mechanical ventilation management, is a lipid preparation and may cause hypertriglyceridemia and pancreatitis; however, there are few reports in the literature. We describe a case of propofol-induced acute pancreatitis during DKA treatment. A 43-year-old woman, known with type 1 diabetes and hypertriglyceridemia, presented with a chief complaint of abdominal pain. Acute pancreatitis was diagnosed after a detailed examination. At presentation, she had no evidence of pancreatitis. She required intubation and mechanical ventilation, and 5 hours after starting propofol, she developed elevated pancreatic enzymes. Based on computed tomography (CT) imaging findings acute pancreatitis was diagnosed. The propofol was discontinued, and the administration of large volume fluid replacement, continuous administration of insulin, and administration of gabexate mesilate improved the DKA and acute pancreatitis. DKA can cause acute pancreatitis, and administration of propofol when mechanical ventilation is required may cause hypertriglyceridemia, further increasing the risk of developing pancreatitis. Therefore, triglycerides (TG) monitoring is recommended when using propofol as a continuous sedative in patients with DKA.

The Hospital Disaster Prevention and Mitigation Support Office, established at the Tokyo Women's Medical University Hospital in 2014, has planned and implemented the following: (1) information communication drills; (2) preparation and distribution of stockpiles; (3) awareness-raising activities; and (4) ward evacuation. The focus is primarily on comprehensive disaster drills, which are implemented throughout the year, aiming to raise awareness and the response capacity of staff regarding disaster prevention. Before the COVID-19 pandemic, the number of participants and the scale of the training were expansive; however, the pandemic made it impossible to conduct most group-based drills and training from 2020 onward. Training resumed in 2021 with changes in the content, format, approaches, and methods, particularly focusing on recent technological advancements in the telecommunications environment and introducing staff to systems with full remote functionality.

In the future, to respond to the ever-changing external environment in a timely and accurate manner, we will collaborate with educational institutions and use the Google Forms cloud system to improve the efficacy and accuracy of information collection. We believe that effective utilization of the limited human resources is the cornerstone of medical institutions that can efficiently respond to disasters. At the Hospital Disaster Prevention and Mitigation Support Office, we will continue to develop and strengthen our systems.

Our hospital has been appointed as the core site among the local disaster base hospitals in the north-eastern ward of Tokyo. Our hospital moved from the risk 5 area regarding the earthquake to the risk 2 area in January 2022. However, regarding the inundation danger area caused by the Arakawa flooding, we practice various preparation measures in a new hospital to play a role as the core facilities. We established four elevators (EV) of the earthquake-resistant performance S14 class. Regarding flood measures, we surrounded a hospital ridge with a waterproofing retaining wall of 2.4 m and laid earth up to 2.0 m off the ground and prevented the inundation. We placed the important section above the second floor. The ambulances reach the second-floor deck on a slope. EV is situated on the second floor or above and can drive continuously even if flooded in the EV pit. As a conveyance method when the neighborhood was surrounded with water, it comprised an amphibious vehicle. We developed and deployed the NBC (nuclear, biological, and chemical) ambulance which mobile operations and emergency procedures to be performed in the car. We carry out the natural disaster and CBRNE (chemical, biological, radiological, nuclear, and explosive) training of the hospital once a year.

We successfully managed the effects of the Great East Japan Earthquake on March 11, 2011, through the rapid organization of an emergency operation headquarters and implementation of emergency plans. The incident thus allowed us to review and address prospective problems in our medical institute's emergency and disaster response. Notably, the aged and vulnerable infrastructure of our facilities impelled us to rebuild the grand design and upgrade its seismic shock resistance. We also devised a medical care plan based on disaster prevention and business continuity plan (BCP) plans at each facility. Furthermore, strategic communication and information-sharing within our institution was another issue addressed during our disaster-response training in FY2021.

Taking these observations into consideration, we aim to continuously monitor and adjust our disaster-response plan according to rapidly changing socio-environmental conditions. As disaster resilience must be built within the institution as a whole, we will continue our efforts to improve our disaster-response plans and information distribution within our community.

In recent years, both earthquake and flood disasters are frequent occurrences and are thus regarded as an increasingly important issue. The Tokyo Medical Association (TMA) has actively dispatched Japan Medical Association Teams (JMAT), not only to disasters within Tokyo, but also to those that have occurred nationwide. The TMA has also responded to terrorism disasters at large-scale events as well as to mass casualty incidents (MCI). As part of our advance preparation training, we have undertaken the following: produced a "Large-Scale Event Medical Relief Guidebook"; held a TMA/JMAT training workshop; coordinated a municipal disaster medical coordination exercise, and held a disaster simulation exercise for Tokyo. In addition, in association with Tokyo Municipality, the TMA has provided comprehensive disaster prevention training.