With my retirement as a professor, I would like to review my 47-year history of studying and working at Juntendo University. I was admitted to Juntendo University School of Medicine in 1976, and after graduation I joined the Department of Neurology in 1982, where Professor Hirotaro Narabayashi was the founding chairman. I became particularly interested in movement disorders and neurophysiology. The second chairman, Professor Yoshikuni Mizuno, established an American-style neurology training system. From 1992 to 1994, I studied electrophysiology at the University of Calgary in Canada, and my family and I enjoyed life in Canada very much. In 2000, I moved to Juntendo Izu-Nagaoka Hospital, now renamed Juntendo Shizuoka Hospital. I instructed young neurologists to write case reports in English. Owing to this achievement, the third chairman, Professor Nobutaka Hattori, recommended me to be a recipient of Alumni Scientific Award and to become a professor of neurology in 2009. I also became an executive officer of the Asian and Oceanian Section of the International Parkinson and Movement Disorders Society from 2015 to 2019. In 2017, I was appointed as the dean of the Faculty of Health Science and Nursing. I devoted myself to improving the nursing education and then I received the Best Professor Award twice. The level of the faculty improved, so that all the students were able to pass the National Nursing Examination consistently. In conclusion, I thank all my colleagues, faculty members, and family for letting me have valuable experiences and memories in Juntendo University.

I, the author, expressed gratitude for receiving the 45^th Juntendo Medical School Alumni Association Academic Encouragement Award in May 2023. After completing medical school and surgical training at Juntendo University, I embarked on a new challenge by pursuing a Ph.D. in basic clinical research, with a focus on gastric cancer, the third leading cause of cancer related death in Japan. Collaborating with various experts, I obtained a Ph.D. in cancer research studies in 2014. Subsequently, I pursued further research opportunities in the United States, where I undertook multiple projects focusing on cancer and maternal stress. I would like to present several studies, ERC/mesothelin, fatty acid synthase, and maternal stress in this manuscript.

On returning to clinical practice at Juntendo University Shizuoka Hospital in 2019, I developed an interest in various clinical issues and decided to address these through experiments. In collaborating with several researchers at the Shizuoka Medical Research Center for Disasters, our ongoing research aims to answer several clinical questions.

Furthermore, I aspire to guide junior staff in the future and am grateful for the invaluable connections and opportunities provided by Juntendo University.

Disseminated intravascular coagulation (DIC) is a common and critical complication in various diseases. There are several diagnostic criteria, such as the International Society on Thrombosis and Haemostasis (ISTH) criteria, the Japanese Society on Thrombosis and Hemostasis (JSTH) criteria, and the Japanese Association for Acute Medicine (JAAM) criteria. Due to the strengths and drawbacks inherent in each diagnostic criterion, it has the potential to cause confusion in clinical settings. It is possible to increase the specificity by making a complex criterion but simple and easy-to-use criteria are demanded in practice. To establish pragmatic criteria using readily available biomarkers, the ISTH focused on DIC arising from sepsis and released sepsis-induced coagulopathy criteria (SIC). A similar approach will aid in constructing a practical diagnostic criterion tailored to each specific background.

Background Compared to distal gastrectomy (DG), pylorus-preserving gastrectomy (PPG), a peristaltic function-preserving surgery for early gastric cancer (EGC), is advantageous as it leads to a more improved nutritional status and quality of life (QOL) of patients. In recent years, total laparoscopic PPG (TLPPG), an anastomosis which is performed intracorporeally, has increasingly replaced laparoscopic-assisted PPG (LAPPG) due to its minimal invasiveness.

Aim To evaluate the safety and feasibility of TLPPG in terms of perioperative efficacy.

Patients Three patients underwent TLPPG in the Affiliated Hospital of Changzhi Medical College from September 2021 to March 2022.

Methods Surgical safety analysis: Our three cases (TLPPG group) were compared to data from the CLASS-02 study, which collected data from multiple centers across China for the laparoscopic total gastrectomy (LTG group). The CLASS-02 study provides data from the most invasive type of gastric surgery, providing solid comparative data to our own.Postoperative short-term efficacy analysis: Patient questionnaire responses provided data on postoperative nutritional and QOL status. Results from our three cases were compared to the Japanese multicenter data PGSAS-37 (PGSAS group).

Results There were no complications or deaths occurred during or after operation in our cases. Compared to the PGSAS group, our cases scored lower for abdominal pain, dyspepsia, and weight loss.

Conclusion Although more case information is needed, our findings demonstrate that TLPPG may be a possible and effective treatment for EGC in China, similar to that in Japan.

Objectives This study aimed to determine the effects of high-intensity isokinetic training with blood flow restriction during rest interval between set (rBFR) versus during exercise (eBFR) on muscle hypertrophy and increasing muscle strength and determine whether BFR-induced exercise pain is suppressed by rBFR.

Materials and Methods Fourteen arms (7 participants) were recruited for the study. We conducted the following interventions for each arm: eBFR (n=4), rBFR (n=5), and exercise only (CON, n=5). The participants performed elbow flexion training with a BIODEX device twice weekly for 8 weeks. This study training consisted of total four sets; each was performed until <50% peak torque was achieved twice consecutively. BFR pressure was set at 120 mmHg. Elbow flexor peak torque during concentric contraction (CC), isometric contraction (IM), and muscle cross-sectional area (CSA) were measured before and after the intervention. Numerical rating scale scores used to assess pain during exercise were determined during training.

Results Peak torque at the CC increased in the rBFR (p<0.05) and IM increased in the rBFR and CON (p<0.05), while CSA increased in the rBFR and CON (p<0.001). The pain during exercise was severe in the eBFR and moderate in the rBFR and CON.

Conclusions This study’s showed that high-intensity isokinetic training with rBFR did not have a synergistic effect on increasing muscle strength and muscle size. Additionally, high-intensity isokinetic training with BFR when it may be best not to perform it during exercise, because it was induces severe pain and may inhibit increases in muscle strength.

Objectives Previous studies have demonstrated that adolescents do not tend to actively engage in help-seeking behaviors. Therefore, it is imperative to create an environment where adolescents can seek assistance on their own. However, no concrete method to create such environments has been established.

Design We studied adolescents’ help-seeking behaviors by administering a questionnaire that collected information on who offer help (“helpers”), how help is offered (“methods of help”), and where these interactions occur (“places of help”).

Methods We asked college students to recall their thoughts related to seeking help when they were 10-15 years old.

Results Our results indicated that adolescents require trustworthy helpers who respect and understand them, face-to-face interactions, peer helpers of a similar age, mental health dialog, and safe and secure location outside of school for seeking help.

Conclusions This study suggested a method to provide assistance in the field of child mental health, which is crucial for the development of the adolescents’ ability to seek help and resolve mental health problems on their own.