51 Thai doctors and nurses visited Juntendo University Hospital on March 30^th 2015. Dr. Teruhiko Hisaoka, professor of Department of General Medicine, gave a lecture about the history of Juntendo University Hospital and the Japanese medical system. The Thai visitors listened attentively to his lecture and had a rush of questions afterwards. The discussion focused on differences between the Japanese and Thai medical systems. We were able to have a highly meaningful and thoughtful discussion.
After the lecture, the visitors were divided into 4 groups to visit a hospital ward, the rehabilitation center, general reception desk and the primary care center in Juntendo University Hospital. We believe that found their visit educational and rewarding.

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Juntendo University held the 1^st Juntendo University - Peking University International Academic Joint Symposium on February 26, 2010 on the 17^th floor of Juntendo University Century Tower.
This joint symposium was sponsored by the Juntendo University International Center (JUIC) according to the MOU between both universities, aiming for further development of collaborative research through international academic exchange. In this symposium, a simultaneous interpretation service was offered.
The MOU was signed on December 6, 2007, and the signing ceremony was held at the Office of International Relations, Peking University Health Science Center (PUHSC). The CEO (and also President of JUIC), Professor Hideoki Ogawa, signed on behalf of Juntendo University, and Peking University Executive Vice President Professor Ke Yang signed on behalf of Peking University. Although the exchange based on the MOU started three years ago, the relationship between the two universities has had a much longer history; the beginning of Juntendo’s strong connection with Peking University can be found in 1982. When belonging to the Department of Dermatology, Professor Ogawa visited various places in China, including Peking University, as the Secretary-General of the Japanese Dermatology Association delegation. Since then, Juntendo’s quality of medical education, research works, and number of Chinese students have been highly regarded by people from Peking University, leading to lively collaborative works with many other Chinese universities, and encouraging more Chinese students to study at Juntendo.
Professor Ke expressed her great respect and gratitude to Professor Ogawa, who was also an executive committee chairperson of this symposium, by accepting his invitation and arranging a special delegation of members for the discussions.
The symposium’s theme was: “Practice of basic and clinical research and treatment of digestive tract cancer in Japan and China”, and took place with the following program: (The rest is omitted)

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The Second International Academic Joint Symposium was held at Juntendo University on August 25^th, 2011. The aim of this symposium was to exchange ideas and share experiences between Peking University and Juntendo University in the field of medical science and clinical treatment.
After the great success of the first symposium, the second symposium was held with the theme, “Recent Advances in Gastrointestinal Cancer Research, from Bench to Bedside, in Japan and China”, focusing on three topics: 1) surgery for gastrointestinal tract cancer, 2) recent advances in cancer research and treatment in the field of gastroenterology, and 3) surgery for hepatobiliary and pancreatic lesions.
Organizers of the second symposium were Professor Hideoki Ogawa, CEO, Juntendo University, and Professor Ke Yang, Executive Vice President, Peking University. The detailed program is described below. (The rest of omitted)

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The first and second Juntendo University and Peking University International Academic Joint Symposia were held at Juntendo University Hongo Campus in Tokyo Japan, in 2010 and 2011. The third joint symposium was held at Peking University Cancer Hospital in Peking China on 6th September 2012, and was organized by Juntendo University, Peking University, and Cardiff University (UK). The title of this symposium was “2012 International Joint Symposium of Clinical and Translational Studies of Gastrointestinal Malignancies” (Figure-1). In the first and second symposia, the presenters had been professors from only Juntendo University and Peking University. However, the third symposium included two professors from the National Cancer Center in Japan and five professors from Cardiff University in the UK as presenters, in addition to those from Juntendo and Peking University. The agenda is shown in Figure-2. The delegates from Japan were as follows (Figure-3). (The rest is omitted)

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In recent years, treatment of rheumatoid arthritis(RA)with biological agents, also called biological disease-modifying antirheumatic drugs(bDMARDs), has become standard. bDMARDs are generally used for patients with an inadequate response to methotrexate and/or other conventional DMARDs. Thus far, tumor necrosis factor(TNF)inhibitors, an interleukin 6 inhibitor and a T cell-selective regulatory bDMARD have been approved for RA in Japan. The strategy of RA management has also changed. Clinical remission is recommended as a primary goal of treatment because this may prevent subsequent articular destruction and impairment of joint functions. TNF inhibitors are also prescribed to patients with other inflammatory rheumatic diseases, such as ankylosing spondylitis, psoriatic arthritis and Behcet’s disease, whose conditions have not adequately responded to conventional therapy. Furthermore, B cell depletion therapy with an anti-CD20 monoclonal antibody is an important option in the treatment of refractory anti-neutrophil cytoplasmic antibody-associated vasculitis, especially in granulomatosis with polyangiitis. In addition, biological agents have also been used for off-label indications. However, these agents are costly and may cause serious infections. This article reviews the current use of biological agents in adult rheumatic diseases.

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Among neuroimmunological disorders, the most common disease is multiple sclerosis (MS). MS is an intractable disease particularly affecting young adults and is increasing all over the world, including Japan. The main goal of treatment is to decrease the frequency of relapses, manage symptoms, improve function, and delay disease progression for good quality of life. To prevent relapses, interferon beta 1b, an injectable disease-modifying therapy (DMT), has been used; however, it has been only available in Japan since 2000, about seven years behind world usage, because of the drug lag caused by healthcare system barriers. At present, second-line DMTs, such as fingolimod and natalizumab, are available; both are more effective compared to first-line injectable interferons and glatiramer acetate (approved on September 28, 2015). However, it is still difficult to block the neurodegenerative process of axonal damage, and that is why there is no cure for MS. In this article, we summarize current immunotherapy in Japan and discuss the pros and cons of the newer DMTs, which might modulate disease course. We also discuss the future prospects of DMTs. Even if DMT treatment is initiated immediately after the completion of diagnosis, patients need to remain on therapy for a long period of time. Adhering patients to treatment is another important aspect. In this regard, a treatment algorithm for escalation therapy or early aggressive induction therapy is not a final decision, and we need to reconsider other better options with low risk of drug adverse effect, and exclude pregnancy-related risks in females.

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In recent years, landmark progress has been made in the treatment of patients with inflammatory bowel diseases (IBD). The anti-tumour necrosis factor (TNF) -α antibody era has shown that mucosal healing is a key therapeutic goal, and may predict the sustainability of remission or resection-free survival in IBD patients. Further, the anti-TNF-α antibody infliximab (IFX) became an alternative medication for refractory UC in 2010 under the Japan national health reimbursement scheme. However, to induce remission in steroid-refractory UC, currently several therapeutic options are available in Japan including cytapheresis, tacrolimus, and anti-TNF-α biologics, but as yet, there are no guidelines for the sequence and timing of these therapeutic interventions. Additionally, there are many patients who do not respond, or are intolerant, to anti-TNF-α biologics. Recently, new strategies like faecal microbiota transplantation and anti-leucocyte infiltration have been tested for induction and maintenance of remission in IBD patients. This paper provides an overview of the latest treatment options and future perspectives in IBD therapy.

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Allergen immunotherapy(AIT)has been used to treat allergic diseases, such as asthma, rhinitis, and venom-induced anaphylaxis, for more than 100 years. AIT aims to suppress immune responses established in patients sensitized to allergens, which are mediated by allergen-specific IgE and memory T cells, through the controlled administration of allergens over prolonged periods. AIT in appropriately selected patients effectively reduces the symptoms of allergic diseases. The mechanisms underlying AIT have been suggested to include the very early desensitization of mast cells and basophils; generation of regulatory T/B cell responses; regulation of IgE and IgG4; and regulation of mast cells, basophils, and eosinophils. Two types of AIT, subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT), are currently used in clinical practice. The main side effect of SCIT is unwanted IgE-mediated reactions. SLIT is safer than SCIT, allowing for home administration. Advances in AIT, such as alternative routes of administration, allergen standardization, modification of allergens, use of adjuvants, and combination with the anti-IgE monoclonal antibody omalizumab, have improved the safety and efficacy of AIT. Other biologics such as those targeting Th2-related pathways have been tested. This review provides a brief overview of advances and future prospects in AIT and biologics to treat allergies.

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Monoclonal antibodies (mAbs) for cancer therapy can be broadly divided into three classes. First are those that target biological features expressed by the tumor cell itself, second are those that target factors produced by the tumor cell or as a host response to the tumor, and third are those that target the immune regulatory networks responsible for inhibiting antitumor immune responses. Of these, tumor-specific therapeutic mAbs are particularly unique because they partially and passively reconstitute the humoral arm of the tumor antigen-specific immune response, as well as provide critical support in establishing the antigen-specific adaptive immune response through cross-priming. This review focuses on these categories and will discuss ongoing clinical trials.

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For identification of three species categorized in Streptococcus anginosus group (SAG), genotyping employing multiplex PCR for detection of species-specific genes has been widely used. We wondered whether possession of the specific genes correlated to differentiation of housekeeping genes, with an attempt to obtain more information on genetic background of clinical isolates of SAG strains and to evaluate reliability of the multiplex PCR. We therefore determined nucleotide sequences of some housekeeping genes of 52 SAG isolates from healthy volunteer to investigate whether the sequences phylogenetically corresponded to the identification by the multiplex PCR. The phylogenetic trees drawn with all of the sequences of 16S rRNA, sodA, groEL and rpoB were found to clearly correlate to species identified by the multiplex PCR. Interestingly, phylogenetic tree drawn only with single housekeeping gene often did not match with the species identified by the multiplex PCR. Our analysis implies even housekeeping genes can have their sequence varieties as independent manner from presence of species-specific genes in SAG strains, and the choice of housekeeping genes for the phylogenetic analyses may result in failure of the species identification.

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A 73-year-old woman visited our clinic for right abdominal fullness and dull pain. She had been treated rheumatoid arthritis and CT scan had shown hydronephrosis with a renal stone in the right kidney of horseshoe kidney 2 and a half years ago, although no treatment had been sought because of the lack of symptoms. Although retrograde pyelography showed no filling defect in the upper urinary tract, urine cytology was positive. Subsequent ureteroscopy of the right renal pelvis showed multiple papillary tumors. Right nephroureterectomy and isthmusectomy were performed. The pathological diagnoses were urothelial carcinoma in the renal pelvis and squamous cell carcinoma, accompanied by urothelial carcinoma in the ureter. The present report describes the 35th case of renal pelvic carcinoma occurred in a horseshoe kidney in Japan.

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