In this review article, the essence of the research results is introduced while reflecting on the existing situation at the time of the research. The author concludes the review by expressing gratitude to all colleagues for supporting the research in the author's laboratory.The difficult experience of treating scabies in an elderly hospital reaffirmed my determination and responsibilities as a pharmacist. In 2000, there was no effective treatment for scabies in Japan. With the Japan Pharmaceutical Association as well as the Japanese Dermatological Association, the indication of ivermectin which is the intestinal fecal nematode was expanded for scabies. Since it was found that the administration of ivermectin through a tube to patients who could not take it orally had a dose loss of 50% depending on the injection method, an appropriate administration method was proposed. However, the oral administration of ivermectin has side effects including systemic liver damage, and external preparations require labor for systemic application, and recurrence from unapplied areas is also a problem. Therefore, we devised a whole-body bathing, in which patients are immersed in a fluid that contains ivermectin. The repeated ivermectin bathing three times a week cured scabies and has no problematic side effects in the clinical trial, suggesting that this method is a safer treatment. Next, in Okinawa, phenothrin-resistant head lice infestation was prevalent, and no medical drug for this infestation is available in Japan yet. Hence, to address this situation, we conducted a clinical trial to investigate the efficacy and safety of a combination regimen of 5% topical phenothrin and the unapproved 0.5% topical ivermectin. https://www.selleckchem.com/products/Cyclopamine.html Consequently, 92% and 100% effectiveness were obtained in Okinawa and Tsukuba, respectively. As a result, we were able to conduct research aimed to maximize the safety and effectiveness of ivermectin in Japan. The management of open abdomen with enteroatmospheric fistula is a real nightmare for surgeons; negative pressure with fluid instillation is affordable and effective. After improvement of general conditions, a good strategy for promoting tissue granulation around the fistula could be the application of a matrix wound dressing. A 45-year-old man was admitted to our Emergency Department for abdominal compartment syndrome following a previous intervention for bowel occlusion; at exploration we found a frozen abdomen that was managed by negative pressure wound therapy with fluid instillation (AbThera  device, VAC Instill , 3M+KCI). The condition was complicated by an enteroatmospheric fistula that we managed by negative pressure and fistula diversion according to "Baby Bottle Nipple VAC technique". After improvement of general and local conditions, in order to obtain a faster reepithalization around the stoma, we decided to apply a dermal substitute (Integra  Bilayer Wound Matrix, LifeSciences Corporation). We obtained a good reeepithalization and five months after admittance the patient was dismissed in a good health with a stoma bag applied on the fistula. Six month lather bowel continuity was restored. The role of negative pressure with instillation in the management of open abdomen is defined; it allows to preserve healthy bowel integrity and to improve septic environment control. If an enteroatmospheric fistula is present, the application of a dermal substitute can be a good strategy for promoting tissue granulation around the fistula, thus allowing the application of a stoma bag and a faster regain of the upright position. Dermal Substitute, Enteroatmospheric fistula, Negative pressure Wound therapy, Open abdomen. Dermal Substitute, Enteroatmospheric fistula, Negative pressure Wound therapy, Open abdomen. To define the change in Emergency Surgical Unit (ESU) workload during the COVID-19 pandemic. Patient data for a three-week period was prospectively collected for ESU patients during lockdown period and compared to the ESU workload for the same time period prior to lockdown. Surgical emergencies admissions reduced by 2.5 times during our study period (p value = 0.001). In this changed paradigm, the overall number of surgical emergencies were reduced. A high mortality (n = 4, 5.7%) was noted during lockdown period as compared to pre-lockdown period (n = 1, 0.58%, p value = 0.025). Almost half of surgical admissions were tested for COVID-19 based on their symptoms and more than third (n=14, 38.9%) of them were positive. Gastrointestinal symptoms were common in COVID-19 positive group (85.7%) and only a third (36%) of COVID-19 positive patients needed surgical attention. Chest x-ray findings were comparable to PCR testing in terms of sensitivity and specificity but CT chest was more sensitive. It remains unclear how COVID-19 reduced surgical emergencies. A significant proportion of COVID-19 presented with gastrointestinal symptoms. In a new outbreak all General Surgical patients should be tested with CRP and WCC used as a triage adjunct. Coronavirus, COVID-19, Emergency Surgery Pandemic, General Surgery. Coronavirus, COVID-19, Emergency Surgery Pandemic, General Surgery. The aim of this study is to determine the incidence of intraoperative hyperlactatemia and its risk factors in patients undergoing laparoscopic colorectal surgery. We retrospectively enrolled 75 patients who underwent laparoscopic resection for colorectal cancer. Initial lactate levels were determined from blood gas analysis before the incision. The end lactate values were recorded after the termination of the pneumoperitoneum. Hyperlactatemia defined as lactate levels between 2 mmol/L and 5 mmol/L without evidence of acidosis. The patients were divided into two groups as normolactatemia and hyperlactatemia according to lactate values at the end of the surgery. Of the 75 patients, 45 (60.0%) had higher lactate levels than normal at the end of the surgery. The median age of the study population was 62 (24-84) years. Forty (53.3%) of the patients were male. Most of the patients in the study had colon cancer origin [56 cases (74.7%)]. Univariate logistic regression analysis for a possible independent risk factor in terms of hyperlactatemia showed that Charlson comorbidity index (CCI) ≥ 3, body mass index (BMI) ≥ 30 kg/m2, the operative time, and the tumor size were significant (p < 0.