Sportology, a field pioneered by Professor Hideoki Ogawa, CEO of Juntendo University in Tokyo, integrates neuroscience, philosophy, and sociology to examine the links between playing or watching sports and health benefits.

What is written in genome? According to proposition since Watson - Crick Model was proposed for DNA structure: nucleotide sequence is the code source of the genome. However, we still do not understand what the real meaning of genome sequence consisting of four bases is, and what molecular mechanism beyond the development of individual organism from a fertilized egg is. Various sorts of proteins in our body are the final products of genome sequence in terms of classical central dogma, but protein is just a sort of the so-many products derived from the genome information. To understand “what is written in genome” , one need to analyze not only genome and proteome, but also all of other “omes” .

In this paper, we describe the history of the international Functional Annotation of the Mammalian Genome (FANTOM) consortium led by RIKEN for the past quarter century, to clarify the transcriptome, promotome, network and enhancerome. We argue that the FANTOM activity is a model of the from-now research style in life sciences.

Next generation sequencing-based cancer genome analysis has been widely performed in basic research as well as clinical trials. Datasets with comprehensive genome data with limited retrospective clinical information have been provided by national and international consortia and contributed to exploring cancer-related genome information. RET-fusion in non-small cell lung cancer is one of the most successful stories of identifying druggable targets. To maximize the benefit of these results, it is necessary to prove the clinical usefulness by appropriate clinical trials. Recruitment of the patients stratified with genome biomarkers often becomes a barrier to design and implement the proper trials. Nation-wide prospective screening programs have been launched in Japan and other countries. SCRUM-Japan, one of the largest cancer genome screening programs, was established in 2015. We have accumulated genome and clinical information of more than 4,800 cases of lung and gastrointestinal cancers. SCRUM-Japan prioritizes several criteria; validation and short turn-around time of the genomic test, validation of clinical information, secure and immediate data-sharing among academic and industrial collaborators. Appropriately controlled clinico-genome data are useful for guiding the patients to clinical trials. In addition, clinical data of the patients who had target genome alteration but did not enter the clinical trial are also useful to obtain the “natural historical control data”. SCRUM-Japan is designated as a model disease registry system by AMED and is establishing a new database system producing more reliable and good for regulatory-use datasets.

Along with the recent progress in medical science, expert individuals and research groups need to collaborate, and thus training personnel for international translational research is urgently needed. The Academy of Cancer Expert (ACE) is a program that developed through the cooperative efforts of three sister institutes, University of Texas MD Anderson Cancer Center (UTMDACC), Keio University School of Medicine, and St. Luke’s International University to train the next generation of cancer care experts in Japan. Juntendo University has become a sister institute of the UTMDACC, together with Keio University and St. Luke's International University. The annual career development seminar hosted by ACE is an open session for Japanese physicians, nurses, pharmacists, and scientists involved in oncology. In this seminar, we learned how to create a constructive team that is essential in the clinical and translational research field. Also, participants shared successful or difficult experiences to build a high-performing team. Strategies for career advancements while being part of a team were also discussed by facilitators. My experience in ACE helped direct my career path. 　Herein, I detail ACE workshop and review the research that I participated in at UTMDACC.

Academy of Cancer Experts (ACE) program was developed to foster the next generation of cancer care experts in Japan. It started through the cooperative efforts of three sister institutions, The University of Texas MD Anderson Cancer Center, Keio University School of Medicine, and St. Luke’s International Hospital. The goal of ACE is to build the premier international collaborative program to help health care professionals and researchers develop and implement multidisciplinary care for cancer patients and conduct cancer research.

ACE Oncology Leadership School is the core component of ACE, and offers educational training and research programs to develop the leadership skills of health care providers and researchers in Japan, and to establish and promote multidisciplinary clinical and translational research in Japan. Multidisciplinary Clinical and Translational Research Workshop is the core offering of the ACE Oncology Leadership School. It is an innovative workshop that helps participants develop the leadership skills that are necessary for individual career development in academic oncology. The Workshop incorporates the concepts of core values, mission and vision, and mentorship and teaches team alignment skills, interpersonal communication skills, and conflict management skills.

To date, five workshops have been held, with 62 participants from various professions and medical specialties. It has evolved to adjust its contents to meet the specific and unique needs of participants in Japan and neighboring Asian countries. From this experience, the members of the ACE Oncology Leadership School have started an educational series called the Career Development Seminar to more widely distribute the concepts taught in the Workshop. Five seminars have been offered and more than 300 participants have joined the seminar.

This article summarize the activities of ACE in Japan over the last nine years and its achievements through my personal experience as a member and one of the co-leaders of the program.

Objective: Werner syndrome (WS) is a rare autosomal recessive disorder characterized by the premature onset of several aging-associated diseases. WS is caused by mutations in WRN, encoding a RecQ DNA helicase that plays a role in the maintenance of genomic stability. To elucidate the mechanisms underlying WS-associated aging, it is important to establish a WS experimental model. The objective of this study was to generate induced pluripotent stem cells (iPSCs) from cells derived from a patient with WS and to obtain differentiated cells from those iPSCs to study the mechanisms underlying WS-associated aging.

Methods: Peripheral blood was sampled from a patient with WS, and the T lymphocytes isolated from those samples were activated by IL-2 and anti-CD3 antibody. Next, the cells were transduced with reprogramming factors (OCT4, SOX2, KLF4, and MYC ) using Sendai virus, and WS-specific iPSCs (WS-iPSCs) were generated.

Results: The expression analysis and the teratoma formation assay revealed that the WS-iPSCs expressed pluripotency markers and differentiated into all tissues derived from all three germ layers. Importantly, WS-iPSCs showed normal karyotypes, with proliferation rates similar to that of control iPSCs. WS-iPSCs were culturable for over two years, maintaining their pluripotent status, and they differentiated into endothelial cells (ECs) and smooth muscle cells (SMCs) in vitro.

Conclusion: We generated WS-iPSCs with normal karyotypes, and these cells differentiated to ECs and SMCs, which could be studied to elucidate the mechanisms underlying premature aging in WS.

Objective: We aimed to investigate how primary care physicians (PCPs) in Japan use antipsychotics for treating the behavioural and psychological symptoms of dementia (BPSD).

Materials and Methods: A nationwide cross-sectional online survey was conducted of PCPs who annually treated patients aged over 65 years with dementia. Responses from 509 PCPs were analysed by binominal logistic regression analysis.

Results: Approximately one-third of the PCPs had treated excitatory BPSD (delusion, hallucination, agitation and violence), with half of them prescribing antipsychotics for this. Some PCPs still prescribed antipsychotics for non-excitatory BPSD, such as wandering. More than half of the PCPs had opportunities to learn about the appropriate use of antipsychotics and understood the increased mortality risk in elderly people with dementia. Referring to the Japanese Government’s BPSD guideline for PCPs was negatively associated with antipsychotic dosage (odds ratio=0.491, 95% confidence intervals 0.32-0.75, p-value=0.001) and positively associated with a greater awareness of increased mortality with antipsychotics (odds ratio=2.149, 95% confidence intervals 1.41-3.27, p-value=0.0004).

Conclusion: PCPs continue to prescribe antipsychotics for excitatory BPSD in clinical practice despite official information about mortality risks. Educational material about the appropriate use of the antipsychotics should include specific mention of the risks of using antipsychotics for dementia.

As part of an out-of-hospital practice program conducted by the Department of Coloproctological Surgery, we investigated the facilities for ostomates together with Malaysian medical students from British colleges. We visited Asakusa and Kamakura to search for ostomate-compatible toilets. We had paid little attention to the ostomate symbol. Actually, there were not only ostomate-compatible toilets in hospitals, but also in many public places. An ostomate-compatible toilet was equipped with a large and deep sink at waist height, which allows the ostomate to dispose of feces from the stoma pouch. Some ostomate-compatible toilets also had a hand shower for cleaning the skin around the stoma. Since there has been an increase of ostomates, it is an urgent necessity to also increase the number of ostomate-compatible toilets and raise public awareness. However, there is a larger number of ostomate-compatible toilets in Japan, compared with other countries. This tour provided our first experience with ostomate-compatible toilets. We were able to identify a larger than expected number of ostomate-compatible toilets during out-of-hospital practice.

Chronic kidney disease (CKD) is a major cause of end-stage kidney disease (ESKD). The growing body of evidences has demonstrated that even minor renal dysfunction and/or albuminuria are associated with increased risks for cardiovascular events, and therefore the concept ‘cardio-renal syndrome’ is well recognized. Recently, over 300,000 Japanese patients had maintenance dialysis therapy. The diabetic kidney disease, IgA nephropathy, nephrotic syndrome and hypertension are major factors driving the progression of CKD to ESKD. The last decade has seen an evolution and ongoing refinement of a disease-oriented approach to CKD that offered an advantage of aligning patient’s comorbidities. In this review, we summarize and discuss the evolution of disease-oriented approach for CKD and the underlying mechanisms for cardio-renal syndrome, focused on prevention, early diagnosis, and treatment of individual disease.