The role of academic journals evolves with the times. Academic publishing is diversifying, shifting from traditional paper-based formats to broader dissemination through open access. In response to these developments-and to contribute to ongoing progress in medical education-Medical Education (Japan) has undertaken a comprehensive revision of its submission guidelines. As of January 17, 2025, all submissions, peer reviews, and editorial processes are being conducted in accordance with the updated guidelines.　The Editorial Board convened a round-table discussion to explore recent developments, beginning with the revision of the submission guidelines. This discussion elaborates on the journal's role and its relevance to the academic community, including society members, authors, and readers. It features statements from participating editorial committee members and highlights the key issues discussed, including the criteria each member uses to evaluate manuscripts. The aim is to offer insight into the journal's editorial stance and decision-making process.

Background: Cell blocks (CBs) from pleural fluid are frequently used in the practice of respiratory medicine, but there have been few reports on the use of CBs from forceps and brush washing fluid in bronchoscopy for pathological diagnosis. We retrospectively analyzed the usefulness of CBs from forceps and brush washing fluid. 　Patients and Methods: Patients who underwent bronchoscopy and had CBs made from forceps and brush washing fluid in bronchoscopy at our institution between June 2016 and May 2021 were included. Cases in which additional information was obtained from CBs were reviewed in detail. 　Results: In total, 138 patients had CBs made from forceps and brush washing fluid in bronchoscopy during the study period. EBUS-GS (endobronchial ultrasound-guide sheath) was used for 102 of these patients. The final diagnosis was lung cancer in 114 cases, infection disease in 10 cases, metastatic lung tumor in 8 cases, lymphoproliferative disease in 2 cases, sarcoidosis in 1 case, and organizing pneumonia in 1 case. There were 13 cases with additional information obtained from CBs, all of which were cases of malignant tumors. 　Conclusions: CBs from forceps and brush washing fluid in bronchoscopy were useful for pathological diagnosis in some cases.

Although saikanto has often been an effective Kampo medicine for chest pain accompanied by coughing or deep breathing, there are few reports on its usefulness in recent years. Here we report 3 cases of outpatients who visited the respiratory department of our hospital with the symptom of chest pain accompanied by coughing or deep breathing. They were successfully treated with saikanto. Case 1 was a 17-year-old woman who was diagnosed with pleuritis. Case 2 was a 57-year-old man who was suspiciously diagnosed with pleuritis. Case 3 was a 45-year-old woman who was diagnosed with upper respiratory tract inflammation. In Kampo medical examination before the treatment with saikanto, 3 patients had kyokyokuman (fullness and discomfort in chest and hypochondrium) and 2 patients had shinkahiko (epigastric stuffiness and resistance). All of the patients recovered from the chest pain early without analgesic drugs. This suggests that Kampo medicine of saikanto is effective for the early recovery without using analgesic drugs from chest pain caused by pleuritis or a severe cough, and that kyokyokuman and shinkahiko are useful indications for its effectiveness.

There are cases of intractable eye pain, which can be difficult to treat. The late Shogo Yamamoto treated un­explained eye pain with various Chinese herbal prescriptions. Among them, there were clinical trials of heating agents including orengedokuto and hangeshashinto, but no trials of orento are mentioned. Further, no trials of cases of eye pain treated with orento were found in several other collections of clinical trials ;however, here we report on two cases of intractable eye pain of unknown origin that showed significant effects when admin­istered orento. In case 1, unexplained eye pain appeared after cataract surgery and after various treatments were found to be ineffective, acupuncture treatment in our hospital showed a positive effect. In case 2, unex­plained eye pain developed without any obvious cause, and the pain was increased by acupuncture treatment at our hospital. A common finding in both cases was objective cooling of the upper abdomen. The eye pain was considered to be upper heat and the abdominal pain to be middle cold, thus a diagnosis of upper heat and mid­dle cold was made and orento administration begun. We therefore consider that orento could be listed as a treatment for unexplained eye pain.

In Kampo medicine, abdominal palpation is essential procedure to make the diagnosis of Sho. We experienced two cases of abdominal aortic aneurysm which are diagnosed by means of abdominal palpation. The coexistence of aneurysm and the sign of abdominal palpitation is extremely rare, but every clinician should pay attention to this fact.

Nasolacrimal duct stenosis, which causes epiphora and eye mucus, is generally treated with probing and irrigation of the nasolacrimal duct. A 57-year-old woman was treated with probing and irrigation of the nasolacrimal duct three times, however, her symptoms of refractory nasolacrimal duct stenosis did not improve. Following 3 days administration of saisoin, her epiphora ameliorated. Based on this experience, we treated 11 adult patients with nasolacrimal duct stenosis using saisoin, and 10 (90.9%) achieved remission within a week. All the adult patients had received treatment by probing and irrigation of the nasolacrimal duct at an ophthalmological clinic, and their symptoms had not improved. Two such cases in infants, moreover, were cured with saisoin in a week. This is the first report on the efficacy of saisoin for the treatment of nasolacrimal duct stenosis in Japan.

Since late 2013 through March 2014, Japan experienced a rapid rise in measles cases. Here, we briefly report on the ongoing situation and share preliminarily findings, concerns and challenges and the public health actions needed over the coming months and years.

Measles is a notifiable disease in Japan based on nationwide case-based surveillance legally requiring physicians to report all clinically diagnosed and laboratory-confirmed cases within seven days, but preferably within 24 hours. After a large outbreak in 2007–2008 (more than 11 000 cases reported in 2008 alone) and a goal of elimination by April 2015, a catch-up programme using the bivalent measles-rubella (MR) vaccine was offered for grades seven and 12 (ages 12–13 and 17–18 years) from April 2008 through March 2013. During this period, there was an estimated 97% decline in measles notifications, and the cumulative number of reported cases has been steadily declining over the last five years (732 cases in 2009, 447 cases in 2010, 439 cases in 2011, 293 cases in 2012 and 232 cases in 2013). However, since late 2013 through March 2014, the country experienced a resurgence only a year after a large rubella outbreak.

This case involved an 86-year-old woman. She had suffered from vomiting, abdominal pain, distension and constipation, 3 times in 3 years.
Her constipation episodes were not complicated by ileus. There were no obstructive lesions on two colonoscopies.
She again suffered from same symptoms in March 2012. Abdominal radiography and CT scans showed significant gasses in her intestine along with a large volume of stool. The previous treatments had not been effective. So we switched to hachimigan with her. This Kampo medicine was very effective. Eight days after hachimigan administration start, all symptoms were relieved. Moreover, no constipation was observed in a 1 year course of hachimigan treatment. We thus conclude that hachimigan was very effective for this patient's constipation.