There are fateful encounters that may be turning points in your life. I regard my retirement as a professor to be an excellent opportunity to look back on my life. I have been blessed with encounters that would never come again, for instance, when I decided to become a physician, then a hematologist, when I was appointed a professor, and when I selected a new path after a mandatory retirement age. Although my life was chosen by myself, it is true that it went in a completely different direction I had vaguely imagined or expected in the past. However, I have no regrets at all. Looking back on my life, it is totally attributed to wonderful encounters with many people, inspiration from them, and their support in various places. Now that I have completed my 16-year-plus responsibility as a professor and reached the retirement age with no troubles, I am just grateful to all the people who supported me. There are many things I experienced as a professor, but what struck me most is "people are the treasure." I cite here a famous word of a great commander Shingen Takeda, "The people are your castle, your stone walls, your moat. We show compassion for our allies, and vengeance for our enemies," which shows us "the importance of people." The word "Jin," the motto of Juntendo University, can help us to take the first step ("Jin" means "I live surrounded by other people" and "thoughtful consideration to others, affection for others.")

Various episodes of interest and achievements centered of our department from the time I was appointed at Juntendo University as Professor and Chairman 17 years and 5 months ago are summarized as follows: i) basic and clinical research in the three pillar fields of otology, rhinology, and head and neck oncology; ii) a bold policy of 3M (Money, Management, Manpower) for department management; iii) acquisition of competitive funds of 150 proposals totaling to about 760 million yen; iv) publication of 206 English articles (total impact factor: 344); v) interview by a magazine called “University with High Research Ability;” vi) a press release of research activities; vii) amount of clinical income of medical care; viii) creation of a home page and communication of information through the SNS website; ix) publication of the Alumni Association magazine; x) education of medical student and freshmen ENT doctors; xi) establishment of a solid system of departmental operation with professors in each of the Juntendo University branch hospitals.

The clinicopathological examinations for the colorectal adenomas with Paneth cell and the colorectal Paneth cell metaplasia were described, from, mainly, our studies about those, in the current review. And the histogenesis of the colorectal carcinoma was discussed and the relashioship between the development of the colorectal carcinoma, and the continous intake of high-fat foods could be pointed out from the investigations using human cells and organs, for the first time.

In the spring of 1986, the director of the medical office asked me if I would like to go to Izunagaoka Hospital from June. I agreed to go there. The annual number of operations managed by anesthesiologists gradually increased from less than 1,000 in 1986 to more than 3,000 in 2000. The numbers of total operations and operations managed by anesthesiologists reached about 8,500 and 4,500, respectively, in 2020.

A pain clinic was established in 1990, and the annual number of patients reached about 2,000 in 1993.

In 2004 and later, we started seminars for the standardization of emergency resuscitation (ICLS), and first launched the in-hospital emergency resuscitation system “J-STAT Call”.

I have presided over the anesthesiology department of this hospital, believing that there can be no hospital with a strong surgical system without strenuous efforts of anesthesiologists. However, I was constantly about to be overwhelmed by too busy works in the operating room.

Unfortunately, the working environment might be unattractive for many doctors in the anesthesiology department, and regrettably, the department stood on the verge of collapse several years ago.

However, I deeply thank the medical staff, including many doctors, for helping me to overcome difficulties and for enabling me to work continuously as an anesthesiologist at Juntendo University Shizuoka Hospital until my retirement age.

In 1961, the Berlin Wall was built by East Germany all around West Berlin. East Berlin was governed by the Soviet Union, and West Berlin was governed by France, Great Britain, and the United States. West Berlin and West Germany were connected by autobahns, railroads and planes, and West Berlin developed with West Germany. On November 9, 1989, the Berlin Wall suddenly collapsed. Many people were destroying the Berlin Wall with a hammer, as if they vented their anger for years. The work to remove the Berlin Wall began the next day, and East and West Germany were unified on October 3, the following year.

I tried two studies on liver transplantation in West Germany. One was an experimental study on the effects of the donor’s fasting and graft viability after liver transplantation, and the other was a study on the role of Kupffer cells in the induction of tolerance after liver transplantation. It has been suggested that poor nutritional status of donors promotes preservation injury and contributes to a decrease in the viability of the transplanted liver, and hepatic Kupffer cells are involved in the establishment of induction of specific immunological tolerance in donor specific blood transfusion.

The gap between clinical and basic medicine has long been discussed, and much effort has been made to fill it in various terms, such as “translational medicine,” “bench to bedside,” or “bedside to bench.” It is no doubt that physician-scientists play an essential role as the bridge between clinicians and basic scientists. In the United States, however, physician-scientists have been ironically called an “endangered species” for 40 years. Since the social and medical backgrounds are different between the countries, it doesn't seem easy to apply the term physician-scientist to Japanese medicine directly. Although the objective of the present article is not to discuss the future of physician-scientists, it is concerned that the number of an MD who is going to obtain PhD also declines in Japan. With the rapid progress of biomedical science, it is impossible for physicians to fully understand cutting-edge basic science. At the same time, it is becoming hard to provide medical care without understanding basic medicine. Not all physicians need to aim for physician-scientist, but for physicians, the bridge between clinical and basic science will be more crucial than ever.

I have been involved in clinical practice and the research of dementia, focusing on Alzheimer’s disease. Alzheimer’s disease is the most common form of dementia in Japan and Dementia with Lewy Bodies is the second most common form. It was as a psychiatrist at Juntendo Koshigaya Hospital during the early stages of my career that I established the foundation of my interest in dementia. Here, I would like to describe the two autopsy cases of dementia that I experienced there. Although both of the patients were clinically diagnosed as having Alzheimer’s disease, the autopsies revealed a different definitive diagnosis. This discrepancy became the cornerstone of my clinical practice in dementia.

The story of this clinical study began with a patient I encountered as a post-graduate student on night duty at Juntendo University Hospital in 1989. The patient was diagnosed as idiopathic ventricular fibrillation (IVF) with incomplete right bundle branch block and a bizarrely shaped ST segment elevation in V_1-3. He had a history of sick sinus syndrome (SSS) one year earlier. Three years after that encounter, the Brugada brothers reported eight patients with IVF whose ECG findings were very similar to those of my patient, and this syndrome was later named Brugada syndrome (BrS). It is now known that there are many individuals with BrS in Japan and across Asia, and regrettably the first patient’s report was not released in Japan. With the later progress in genomic research it has become apparent that a single gene mutation could be a cause of both BrS and SSS. We have begun a clinical study of the association between BrS and SSS and have published several papers about this issue. My first patient with BrS and SSS has been doing well without syncope for over 30 years.

Parkinson's disease (PD) is a neurodegenerative disorder with the degeneration of midbrain dopaminergic neurons. However, few disease-modifying drugs for patients with PD have been identified. Familial Parkinson's diseases are numbered in the order in which the causative genes are identified, and one of them, PARK9, is caused by autophagy dysfunction and has mutation in the ATP13A2 gene which encodes a lysosomal type 5 P-type ATPase. To elucidate the pathogenesis and to screen effective drugs for PARK9, we generated iPSCs from the T cells from a PARK9 patient. Three independent clones were used for the analysis after quality verification. First, we confirmed reduced autophagy function in dopaminergic neurons derived from PARK9 iPSCs by examining the accumulation of LC3B, an autophagosome marker, due to impaired lysosomal functions. Then, we successfully quantified LC3B accumulation in the cell bodies of PARK9 dopaminergic neurons using IN Cell Analyzer 2200. Using these methods, we screened a compound library containing 320 chemical compounds using reduced LC3B accumulation in PARK9 dopaminergic neurons as an indicator. The first screening narrowed the list of candidate compounds to 70, followed by the second screening to exclude the compounds that reduce LC3B production. This two-step and 96 well-based high-throughput screening resulted in the identification of five novel disease modifying drug candidates that ameliorate impaired lysosomal dysfunction in PARK9-dopaminergic neurons.

Objective Upper blepharoplasty surgery includes both esthetic and functional considerations. Double eyelid surgery is one of the most commonly performed facial plastic and esthetic surgical procedures in Asia. Although correctly performed procedures are esthetically pleasing for patients, there are many potential complications and complaints that need to be avoided. Myanmar is a country where there are many ethnic groups and people of different cultures, appearance, and preferences. The purpose of this study is to evaluate the surgical techniques and the outcome in a limited medical environment in Myanmar.

Methods Three hundred and four patients (37 men, 267 women) who underwent double eyelid surgery were enrolled in the study. The double eyelid fold was created by placing and attaching three points between the dermis and levator aponeurosis. The directions of eyelash lines were then adjusted to be inverted approximately 100° upwards on both sides. Satisfactory outcomes were assessed by contacting and surveying the patients’ feedback via telephone whereas functional outcomes were assessed by measuring marginal reflex distance (MRD1) who could visit back to the clinic.

Results The incisional technique healed very rapidly and looked natural within 1 month in young patients but only looked natural after 2 to 6 months in the elders. The MRD1 was increased on postoperative measurement of all patients (p<0.05). Nearly all the patients were aesthetically satisfied with the result by 6 months postoperatively.

Conclusions The outcomes were esthetically satisfying with functional improvement. This is the first retrospective clinical outcome study of double eyelid surgery in Myanmar.

Juntendo University has the longest history as a medical education institution in Japan. Juntendo started out in the Edo period (1603-1868) as an institution for medical treatment and education, especially in the field of surgery, and has survived and continued to develop through the period of change from the early modern era to the modern era. The purpose of this research paper is to examine the activity of Juntendo in its early times focusing on the first two directors of Juntendo, Taizen Sato and Takanaka Sato. This literature analysis shows that Juntendo continued to practice Western medicine at the highest level in Japan at the time, and was committed to increasing access to health care for the masses. During the Edo period, when traditional Chinese medicine was the mainstream, Taizen practiced the treatments described in Dutch medical books and trained physicians who understood the Dutch language and could implement advanced treatments. Takanaka was involved in the administration of medical care and medical education at the national level during the early Meiji period, when Western medicine was becoming mainstream, and laid the groundwork for Western medicine to take root. He also realized that public medical institutions alone could not provide sufficient opportunities for medical services and decided to create private medical institutions. Inheriting the will of both directors, Juntendo has continued to grow to the present day.