Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata university

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 I am Shuji Terai. Since January 1, 2015, as a successor of the first Professor Emeritus Fumihiro Ichida, the second Professor Emeritus Hitoshi Asakura, and the third Professor Emeritus Yutaka Aoyagi, I have been appointed to the post of Professor of the Division of Gastroenterology and Hepatology (formerly the Third Department of Internal Medicine), Graduate School of Medical and Dental Sciences, Niigata University. With the efforts made by the successive professors and the seniors, the Division of Gastroenterology and Hepatology, Niigata University, has left a major mark on the field of Gastroenterology & Hepatology in Japan. I will inherit the tradition and would like to develop it further for our promising department.

 With the development of minimally invasive treatment techniques due to the advancement of endoscopic technology, the field of Gastroenterology & Hepatology has now entered a new age, in which viral hepatitis or hepatitis C virus and Helicobacter pylori, which are the main causes of hepatic carcinoma and gastric carcinoma, can be completely controlled. It is expected that there will be an increase in the incidence of cancer related to metabolic syndrome (e.g., Barrett’s adenocarcinoma, colorectal cancer, pancreatic cancer, liver cancer), as well as inflammatory bowel disease. Hence, going forward, it will be necessary to develop and apply new medical technology for these diseases, including regenerative medicine using novel materials and liver cirrhosis, inflammatory bowel syndrome and esophageal obstruction post ESD treatment. and novel anticancer drugs and therapies. Including various efforts to allow for cancer patients to enjoy meals for as long as possible (via preventive measures against sarcopenia), we should manage and study advanced cancer therapy by getting back to the basics of digestion, absorption, and metabolism. Our research theme is “the development of diagnosis methods and therapy for intractable progressive digestive system diseases,” and the development for diagnosis and treatment methods for currently "undiagnosed diseases" using genomics and cell biology. Therefore, the fundamental research team is divided into subgroups: the fatty change analysis team; the fibrosis/regeneration team; the canceration analysis team; the immune team; and the minimally invasive instruments development team. The clinical study team is also divided into subgroups: a gastrointestinal group (with an upper gastrointestinal tract team and lower gastrointestinal tract team); and a hepato-biliary-pancreas group (with a liver sub-team and liver and pancreas sub-team). As cross-sectional clinical study analysis teams, the following teams have been newly established: a portal hypertension analysis team; a urinary proteomics analysis team; a visceral fat, skeletal muscle, and ascitic analysis team; a microbiota, enteral sensor analysis team; a digestive organ hemodynamics analysis team; a POEM (movement of digestive organs) analysis team; a metabolism study team and an interventional gastroenterology analysis team (in Uonuma Kikan Hospital). Together, all of these teams will unite and promote the development of next-generation diagnosis and therapies beyond specific fields.

 We have created a new logo for our department, the "Sun Ship,” which indicates our vision that all digestive organs should be examined and managed as a orchestra, and that the organ network should be focused on in the future. In the logo, Hermes orange is placed on the center, which contrasts with green, our school color. By the contrasting effects, the logo looks like a yacht (ship) with III on the base, which means the former Third Department of Internal Medicine. This design also implies that we are supported by the seniors belonging to the society “Domonkai,” and will sail out to sea in the world from the Sea of Japan. The sun of the Sun Ship suggests "the sun" as well as “san," which means "III" of "Third Department of Internal Medicine" in Japanese. We believe that the seniors and members in our department will continue to contribute to and be recognized in the field as this logo spreads throughout Japan and the world.

 I was a practitioner of judo in my undergraduate days (now black belt). In my opinion, “Shu-Ha-Ri," (which is a concept in Japanese that implies three stages of performance ability: following the fundamentals; breaking and improving them; and advancing them to a new stage independently), is important in acquiring skills of medical care as a physician, in the same way as in the acquisition of martial arts. As you know, of "Shu-Ha-Ri"; "Shu" is to acquire the fundamentals while sticking to them (follow the fundamentals); "Ha" is to apply the acquired fundamentals to something and acquire one’s own style (break the fundamentals); and "Ri" is to create a novel style away from "Shu" and "Ha" (dissociate oneself from the fundamentals). Based on this concept, I provide an explanation to the members of our department as follows: "Shu" is to acquire the essential basics required of "General Gastroenterologist" (who create a form to see and manage all digestive system diseases); "Ha" is to develop next-generation treatment from Niigata University by collecting the wisdom (secure high specialty and develop new diagnosis and treatment methods(Clinician-Scientist)); and "Ri" is to be a leader who will work actively in Japan and who will make a mark on the world stage from our department. In addition, we believe that future leaders need to acquire extensive knowledge and high expertise, flexible thoughts, and an ability of implementation. Thus, it is necessary to foster the idea of the “Clinician-Scientist," in other words. There are many members of our department who have great potential. There are many seniors with rich experience and affection belonging to the society “Domonkai”. In such an advantaged environment, I am going to present various opportunities to run the department in order to collect "Mon-Si-Shu" (which is a concept in Japanese that implies listening, thinking, and practicing), with the cooperation of all the members. Also, I am planning to make it so that many talents gather at Niigata University to learn from both Japan and abroad in the future. In closing, I invite young doctors, residents, and students who want to become a Clinician-Scientist, as a General Gastroenterologist who can give medical care supported by rich experience, to our new "Sun Ship.” Let's set sail towards the exploration of new areas of gastroenterology!

Shuji Terai, M.D.,Ph.D.
Professor and Chairman
Division of Gastroenterology and Hepatology,
Graduate School of Medical and Dental Sciences,
Niigata university.