Lifestyle-related diseases have been considered to be caused by genetic factors and lifestyle. In recent years, it has been reported that there is a third factor, based on the developmental origin of health and disease (DOHaD), which involves environmental factors during fetal life and development that are related to health in adulthood and the risk of developing lifestyle-related diseases. In Japan, the percentage of low birth weight (LBW) infants born below 2,500 g has been increasing since around 1980, which seems to correlate with the increase in thinness (body mass index <18.5 kg/m²) of women in their 20s and 30s, inadequate caloric intake during pregnancy, and increasing age at first birth. It is interpreted that infants who acquire a thrifty constitution through this process become relatively overnourished as the nutritional environment improves after birth, leading to an increased risk of developing lifestyle-related diseases. Since it is difficult to correct the acquired frugality after birth, pediatricians need to be aware of the future development of obesity and insulin resistance when monitoring adolescents and young adults born as LBW infants. Physicians caring for adults also need to pay attention to the patient’s birth history, when the patient has a lifestyle-related disease.

Society 5.0, a visionary human-centered societal model, fuels economic development and resolves long-standing social problems. The model establishes a technological foundation and social contract to integrate cyberspace into the physical (real) space fully. The medical infrastructure outlined by the model envisions a healthcare paradigm that revolves around preventative, lifelong patient- and population- centered care that functions seamlessly within one's daily life.

In satisfying this goal, cross-hierarchical integrative data-driven biological research has received attention due to medical big data and artificial intelligence (AI) technologies, capable of highly accurate and rapid data analysis. However, the collection of big data has been a bottleneck, and the capability of AI analysis is not being utilized to its full potential. In solving this obstacle, we explore mobile health (mHealth) and multi-omics as two rich sources of medical big data. Additionally, we discuss the implications of cross-hierarchical integrative analysis that encompasses all levels of cellular function, from intracellular molecular dynamics to end-phenotypes. This is to understand ocular disease pathology and implement the pillars of P4 (predictive, personalized, preventative, participatory) medicine toward human-centered healthcare.

Here, we discuss notable studies in utilizing mHealth to stratify subjective symptoms, presentations of dry eye disease, and employing multi-omics machine learning targeted at elucidating immunologic mechanisms of corneal allograft rejection and ocular inflammation. We also discuss the role of cross-hierarchical integrative data-driven research in promoting future-oriented healthcare envisioned by the Society 5.0 plan.

Parkinson’s disease is a neurodegenerative disorder that manifests with motor dysfunction, such as bradykinesia, tremor, and rigidity. Furthermore, patients experience many non-motor problems, including dementia, psychosis, pain, sleep disturbances, and autonomic dysfunction, which impact their quality of life. Thus, disease-modifying therapies for Parkinson’s disease are needed. The pathological hallmark of this disease is dopaminergic neuronal loss with intraneuronal aggregations, known as Lewy bodies, which contain proteins and lipids. Recently, it was revealed that several membranous organelles, such as mitochondria, lysosomes, autophagosomes, and synaptic vesicles, are involved in Lewy bodies. Moreover, the main protein component of Lewy body, α-synuclein, binds to lipid membranes via two α-helices at the N-terminus. Interestingly, disrupted associations between lipid membranes and α-synuclein might trigger the formation of Lewy body. Accordingly, α-synuclein aggregation and lipid-synuclein interactions are important for the pathomechanisms of Parkinson’s disease. In this review, I will focus on (1) the role of lipid metabolism in Parkinson’s disease, and (2) α-synuclein aggregation and propagation in Parkinson’s disease.

Objective The safety and feasibility of robotic-assisted radical prostatectomy (RARP) compared with retropubic radical prostatectomy(RRP) is debated. As a result it is becoming the most common approach for prostate cancer surgery in the world. We examined whether the surgical results would be improved compared to RRP at a single facility where RARP is newly performed.

Patients The subjects were 81 patients who underwent radical prostatectomy for localized prostate cancer at Juntendo University Nerima Hospital from March 2017 to December 2020.

Methods Perioperative factors analyzed in this study included the total operative time, estimated blood loss(EBL), complication and hospitalization. The recovery of urinary continence (UC) was either safety-pad only or pad-free. Oncological outcomes were assessed by surgical margin status.

Results Patients underwent RARP have the higher level of initial-PSA. But there was no significant difference on age, BMI and prostate volume between the RARP and RRP group. Perioperative EBL was less and the operative time and the length of hospital stay was shorter in the RARP group. Our study evaluating RARP and RRP reported positive surgical margins (PSM) rates. The results showed a significant difference with higher PSM rates in RRP group. Mean time to recovery of UC was no significantly difference among the two groups; 8 months in RRP group, 7 months in RARP group.

Conclusions The newly introduced RARP confirmed shorter operative time, lower EBL, shorter length of hospital stay, and fewer complications, demonstrating that RARP is less invasive than RRP.

Objective The present study aimed to report on the activity of a medical relief team from Juntendo Shizuoka Hospital that was dispatched to the Atami debris flow in 2021.

Design Narrative report.

Results A debris flow in Atami city resulted in the destruction of 131 houses and 26 deaths, with 1 people remaining missing. Twenty-seven of the 28 victims rescued after the collapse of their houses were asymptomatic or had minor injuries. The lifeline in Atami city and the faculty of a level II acute critical care hospital were preserved; thus, the demand for emergency medical intervention did not dramatically increase. The medical relief team from Juntendo Shizuoka Hospital contributed to the management of the headquarters of the Disaster Medical Assistance Teams in the public health center in Atami city, in coordination with members of various medical occupations or organizations to provide appropriate life support to refugees rather than urgent medical intervention.

Conclusions The main activity of the medical relief team from Juntendo Shizuoka Hospital was to provide appropriate life support for evacuated refugees in order to prevent disaster-related death among the refugees.

There are two main applications of genomic medicine with respect to CNS tumors: awareness and prevention of hereditary and/or familial tumors, and personalized medicine for sporadic tumors in individuals. We need to understand the difference between these two medicinal approaches and the status of genomic medicine in this lecture note.

Firstly, this lecture will show the status of hereditary and familial tumors. The lecture will also explain what medicine has to offer for these tumors and the dangers of taking genetic tests blindly. Next, we will discuss personalized medicine. Recent advances in molecular biology have significantly impacted clinical practice. Molecular biological analysis methods are necessary for the classification of tumors, especially for central nervous system (CNS) tumors. The classification of a tumor indicates its prognosis and grade. The fact that this technology is being used suggests that the clues to treatment will depend on molecular biological properties. However, the treatment of CNS tumors has not progressed compared to changes in diagnostic technique. There are some issues that need to be overcome to develop new therapeutics for CNS tumors, such as the blood-brain barrier and the rarity of epidemiology for CNS tumors. Finally, we will discuss how we are working to overcome this challenge.