Purpose: Surgical resection of remnant gastric cancer (RGC) is technically challenging and difficult. Minimally invasive surgery (MIS) has been adopted for various procedures, but reports of MIS for RGC remain limited. Herein, we report the surgical techniques and short-term outcomes of MIS for RGC. Methods: We conducted a retrospective cohort study involving 61 consecutive RGC patients who underwent open or minimally invasive (laparoscopic or robotic) total gastrectomy for potentially curable RGC at our institution (January 1999–August 2025). A propensity scorematched cohort was used for an exploratory evaluation of the safety and efficacy of MIS for RGC, focusing on feasibility rather than superiority over open surgery. Results: Of these 61 patients, 53 underwent open surgery and eight underwent MIS gastrectomy for RGC. The median age was 70 years. The cohort comprised 53 men and eight women. The initial procedure was open surgery in 58 patients and MIS in three patients.Propensity score matching showed significantly reduced intraoperative blood loss in the MIS group compared with the open surgery group (39 mL vs. 576 mL, p < 0.05), and significantly longer operation time in the MIS group (352 minutes vs. 297 minutes, p < 0.05). Postoperative hospital stay was significantly shorter in the MIS group (12 days vs. 17 days, p < 0.05). The incidence of postoperative pancreatic fistula was lower in the MIS group, although not significantly different (0% vs. 16.7%). Conclusion MIS, including robotic gastrectomy, is feasible and safe for RGC, with potential perioperative benefits requiring multicenter validation.

The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.

The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.

1) In 2004, Shinshu University School of Medicine started a program for third-year medical students to experience nursing services during both the day and night shifts. The program included lectures on nursing sciences before practice and debriefing sessions after practice.2) Most students viewed this program favorably and felt that the night-shift training was particular meaningful. They also had favorable opinions about the nurses who taught them.3) Some practical issues remain to be solved, such as security during the night shift and the possible excessive burden upon nurses.

The importance of cooperation among the staffs of various medical specialties has been recognized.However, medical students have little chance to study with students of other specialties.We planned and held an interdisciplinary freshman seminar based on problem-based group learning for health science students.
1) All freshmen entering the Shinshu University School of Medicine were divided into 20 groups and participated in a group-learning program.
2) Students watched video material focusing on medical communication and were asked to investigate and discuss this issue in greater detail to deepen their understanding.
3) Questionnaires filled out by students after the course revealed that most students were satisfied with the program because they could deepen their partnership with students of other specialties but were unsatisfied with the program's tight schedule and the inefficiency of discussions.
4) Many instructors felt that the number of students in each group (12 or 13) was too large for effective group discussion.
5) This program helped students understand the importance of communication in medicine but did not encourage students to study for themselves.

Choto-san was administered to 6-week-old spontaneously hypertensive rats (SHR) at the usual dose used for humans and at a 10-times higher dose, and its effects on blood pressure and the autonomic nervous system were examined. Significant blood pressure elevation was noted in the SHRs administered with the 10-fold dose, but no such changes were observed in the SHRs that were administered the usual human dose. Since the urinary levels of adrenaline and noradrenaline and the granulocyte count significantly increased in the 10-fold dose group, the elevation in blood pressure in this group appears to be attributable to stimulation of the sympathetic nervous system. Accelerated sympathetic nervous activity is noted in SHRs during the growing stage, and the excessively high dose of Choto-san probably further stimulated the sympathetic nervous activity.