Based upon the 8 years' experience in vertical banded gastroplasty (VBG) for the treatment of morbid obesity in our department, we analysed the clinical results after operation. As a result, the weight-reducing effect and safety of VBG were found favourvable, but some of complications developed in a few, causing serious conditions. Therefore, a modification of VBG was tried in order to utilize the characteristics of VBG and to lessen the factors of complications development as much as possible. Its essential points are to utilize the His-angle by making an oblique staple line instead of a vertical one, and to block the stomach with GIA90 and EEA28 and embed the staple line by suturing the serous membrane. Because the stomach is formed into a K-shape, it has been named k-gastroplasty. Its operative mode is discussed.

Introduction : To promote influenza prevention activities, we investigated the current status of prevention strategies for influenza among college students.
Methods : We handed out a questionnaire regarding prevention strategies for influenza to all students who visited at Oita University's Health Science Center for a medical checkup.
Results : Of the 2,752 students surveyed, 2,579 (93.7%) responded. Valid responses were obtained from 2,489 students (response rate 96.5%). Analysis of the questionnaire data revealed that the percentage of the students who received influenza vaccine was 21.0%. The proportion of the male students who received vaccine was significantly lower than that of female students (19.1% vs 23.7%). Regarding to the daily prevention habits, 71.7% of the students were able to carry out hand-washing, while less than half of the students carried out gargling, wearing a facemask and avoiding crowds. The proportion of the students who carried out daily prevention habits was significantly lower in non-vaccinated students than in vaccinated groups.
Conclusion : These results suggest that promotion of educational activities about prevention strategies for influenza at university is needed. Among them, promotion of vaccination for male students and daily prevention habits for non-vaccinated students are important.

The patient was a 63-years-old female with early gastric cancer in her upper stomach. Widely spreading on the mucous membrane, the cancer was too big to remove by endoscopical mucosal resection, although she wanted minimal invasive treatment. Therefore, we adopted total gastrectomy with hand-assisted laparoscopic surgery (HALS) after obtaining “informed consent” from her. Five small skin-incisions were necessary to perform it-one 7cm' for hand-port and four 1.2cm' for trocars.
The dissection was started from greater omentum and proceeded counterclockwise to remove primary lymphnodes. The abdominal esophagus and the duodenum were devided with a single or double application of Endo GIA stapler (linear stapler). All these steps were accomplished safely and securely with the effective support of the left hand of the operator. After extraction of the whole stomach through the 7cm-incision, Roux-en Y reconstruction was performed laparoscopically (esophago-jejunostomy) followed by hand sewing through the 7cm-incision (jejuno-jejunostomy). The anvil of 21mm circular stapler (EEA) was inserted orally in order to anastomose the esophagus to the jejunum. The patient had acceptable results intra-operatively as well as postoperatively by HALS total gastrectomy, which had been considered to be very hard to perform up to present time.