To clarify the neural basis of distorted thinking, such as hallucination and delusion, recent functional neuroimaging studies demonstrated the abnormality of linguistic and emotional brain functions in psychiatric disorders. In this article, we aimed to discuss the practicability of functional neuroimaging as a clinical application in neuropsychiatry. First, we explained the fundamental principle of functional MRI. Next, we summarized our recent findings from the application of functional MRI in relation to auditory linguistic brain function and voice-specific brain function. Some of our previous clinical functional neuroimaging studies demonstrated 1) a reduction of left-hemispheric linguistic brain function in schizophrenia, 2) right-lateralized hypoactivation of voice-specific brain response at the superior temporal gyrus in schizophrenia, 3) functional abnormality of social brain regions while subjects were judging auditory attractiveness, 4) a reduction of left lateral frontal function in depressive state, as well as loss of interest and pleasure. These previous findings have pointed out the significance of investigating linguistic and emotional brain functions during the clinical assessment of neuropsychiatry patients, such as those with schizophrenia and depression. In the recognition of non-verbal auditory affective contents, our previous findings revealed cross-cultural differences, thereby suggesting the importance of considering the influence of cross-cultural differences in the clinical evaluation of the affective state. Further, our recent findings also demonstrated the importance of functional neuroimaging for evaluating the pharmacological effect on emotional brain regions by psychotropic drugs, such as by modafinil and bupropion. In addition, our results also alluded to the importance of evaluating linguistic brain function by functional MRI to examine the effect of transcranial direct-current stimulation.

This is a report about Saiseigakusha, the predecessor of Nippon Medical School, which advocated "Saisei-Kyumin", a philosophy that obliged Saiseigakusha to extend social and frontline medical support to ordinary people during the Meiji Era. Founded in 1876, Saiseigakusha was one of the most prominent private medical schools of the time, and it produced a large number of caring and skilled doctors to carry out the tenets of Saisei-Kyumin. The mission of Saiseigakusha's founder, Tai Hasegawa, was to foster excellent doctors who practice medicine with "selfless devotion to patients and society", and this also became the mission of his school. It was Hasegawa's conviction that medicine must engage deeply with society and people's lives, and he dedicated great effort to public health administration so that priority could be given to saving people in financial difficulty, which is the core principle of "socialized medicine". This paper examines the teachings and wise words of such medical professionals who studied at Saiseigakusha as Chuta Oguchi, Kenzo Suto, Hideyo Noguchi, Norihiko Asakawa and Tetsuzo Sugano, whose wisdom still shines now as it did then, and explores their personalities and encounters with outstanding medical visionaries. The history of Saiseigakusha and its contributions to medicine will continue for generations to come to be studied and to guide the medical education given at this school and the future of medicine and health care.

During their clinical clerkships (CCs) in surgery, medical students are generally introduced to such areas as surgical indications, surgical techniques, and perioperative management through rounds and practical skills training on wards and in operating rooms. Given the technological advances made in virtual reality (VR) over recent years and its increasing use in education and corporate training, we decided to try using VR for the benefit of students on surgical CCs. To this end, we developed what we termed a "VR surgery tour" in the field of gastrointestinal surgery, which involved students using VR goggles to view edited 3D images. We then asked 26 fifth- and sixth-year medical students at Nippon Medical School assigned to CCs in gastrointestinal surgery between November 2020 and September 2021 to evaluate the VR surgery tour via a questionnaire survey. The questionnaire included questions using a five-point Likert scale and space for free comments. Our results showed that all respondents felt satisfied with the VR surgery tour, with 96% of them indicating it was a viable alternative to clinical training; moreover, about 90% of the students found it useful as a teaching aid for pre-learning and requested that VR teaching materials be made available in other fields as well. We concluded that our VR surgery tour is a valuable supplement to practical training in gastrointestinal surgery and that it increases medical students' motivation to learn. We believe VR is an effective teaching aid and that there will be increasing demand for its use in various education and training programs.

A 70-year-old man was admitted to our hospital with sudden hematochezia and an elastic, soft, reddish tumor measuring 40 mm in diameter prolapsed through the anus. The prolapsed tumor was manually repositioned, and subsequent computed colonography revealed it to be a villous tumor located in the sigmoid colon; it was diagnosed as a tubulovillous adenoma on biopsy. After the patient underwent bowel rest, elective laparoscopic resection was performed. The postoperative course was uneventful, and the patient was discharged 12 days after surgery. In this patient, the manual repositioning of the prolapsed tumor enabled effective bowel rest, which in turn meant that minimally invasive surgery could be performed. If it had not been possible to reposition the tumor, emergency surgery would have been unavoidable.

When resection of a malignant facial lesion is followed by reconstruction, the functional aspects and appearance of the face must be carefully considered. Reconstruction of facial aesthetic units requires a negative oncological margin. Herein, on the basis of our experience of reconstruction after resecting a skin tumor in the upper lip, we describe the optimal range of resection for a malignant facial tumor and optimization of reconstruction. A 68-year-old man with an elevated lesion on the upper right lip and nasal cavity consulted a dermatologist at our hospital. A biopsy revealed malignant fibrous histiocytoma, and the patient was referred to our department for radical treatment. After excising the tumor to ensure a macroscopic negative margin, we reconstructed the upper lip and nasal wing by using an Abbe's flap and nasolabial orbicularis oris myocutaneous flap, respectively. The recommended method for excising a soft tissue sarcoma on the face requires removal of many free rims or tissues that are difficult to replace, which can result in extremely low postoperative quality of life for the patient. As an alternative to definite wide-margin excision, we recommend that radical treatment by marginal excision and adjuvant therapy should be considered when indicated. In addition, when excising tumors in areas of aesthetic importance, wide-margin excision may not always be necessary. Reconstruction of each aesthetic unit after individual excision may help achieve a satisfactory aesthetic result.