The backgrounds of informed consent in the history are described with a special reference to human experimentation, clinical trials and physicians' morality and ethical codes. The first informed consent might be one by a Japanese surgeon Hanaoka Seishu (1760-1835), which included information of diagnosis, condition, and immunity to him in case of incidence. During the extensive development in medicine from the nineteenth to twentieth century, a number of inhumane experimentations were carried out in vulnerable subjects. Then, movement against cruel human experiments emerged, and headed toward establishment of human rights. The current concept of informed consent was introduced in 1900 by the Prussian government. In 1931, Reich Minister of the Interior issued the Guidelines for New Therapy and Human Experimentation, which included almost all informed consent rules in a current sense. However, these guidelines could not stop the abuse of people in medical research by doctors. After World War 2, the Nuremberg Code and Helsinki declaration have established the current form of informed consent. However, even this final form of informed consent could not stop the abuse of research subjects by doctors as exemplified by the Taskegee syphilis study, Willowbrook hepatitis trials and the Gelsinger case in the Pennsylvania University. We must remind ourselves the history of informed consent, which tells us that even the finest form of informed consent rule can be jeopardized easily by doctors resulting in the abuse of research subjects.

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A case of multiple gastric cancer arising in a reconstructed stomach roll after a radical operation for esophageal cancer was reported. The patient was a 71-year-old man who had undergone mediastinoscope-assisted transhiatal esophagectomy and posterior mediastinal reconstruction by a stomach roll for superficial esophageal cancer six years before.
At September 2001, a type 0IIc early cancer was discovered in the posterior wall of the stomach. He underwent endoscopic mucosal resection by the strip biopsy method against that lesion, which was finally diagnosted as a mucosal adenocarcinoma histopathologically. Six months after, an another type 0IIc-like lesion was found out again in the side of the greater curvature of the stomach near the antrum. Strip biopsy was conducted against the second lesion and the diagnosis was mucosal adenocarcinoma. The patient is doing well eighteen months after the second strip biopsy.
Cases of gastric cancer in a reconstructed stomach roll may increase with the improvement of the prognosis of esophageal cancer. However, most reported cases were discovered in advanced stages. To avoid such a situation, careful endoscopic pre-operative screening of the stomach and post-operative follow-up of stomach roll, are recommended for the purpose of early detection of recurrent cancer in this organ, leading to better quality of life for the patient.

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A 78-year-old man consulted a nearby clinic because of melena, and was admitted to the hospital. Diagnostic imaging revealed a submucosal tumor with central ulceration in the left wall of the lower rectum. A Miles' operation was performed following the diagnosis and the tumor was 47×40×35mm in size. Histological examination of the resected specimen showed the tumor to be composed of spindle shaped cells with a few mitosis. Tumor cells were positive for c-kit and CD34, negative for α-SMA and S-100 by immunohistochemical examination. We diagnosed this tumor as gastrointestinal stromal tumor (GIST), uncomitted type, malignant. He has been well for 2 years 7 months after operation without evidence of recurrence. GIST of the rectum with immunohistochemically positive for c-kit is rare with only 18 reported cases in the Japanese literature. This immunohistochemical evaluation with c-kit has been essential for the diagnosis of GIST.

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