Introduction: Based on findings of previous follow-up studies, extremely low birthweight (ELBW) or birthweight under 1,000 g adults have more mental health problems than do normal controls.

Materials and Methods: A qualitative analysis of the mothers' interviews was conducted to clarify the relationship between the mother's role and the developmental trajectory of ELBW adults from birth to adulthood. The participants were 18 near and dear mothers whose sons or daughters were born with ELBW. All ELBW adults had been under medical care in Maternal and Perinatal Center, Tokyo Women's Medical University Hospital.

Results: Semi-structural individual interviews were conducted by the first author as the interviewer. All speech records of the 18 interviews were converted into text and consisted of meaningful segments, containing one sentence or a few sentences, that consolidated 342 codes. Based on these codes, the authors were able to extract 14 categories, which were then summarized into three major categories: (1) an early and immature birth, a sudden and unexpected event; (2) childcare with tension and anxiety; and (3) a time in which the mothers felt "It's all right!" and the child graduated from being an ELBW infant.

Conclusion: Mothers have a significant influence on the mental health of their ELBW children; however, clinicians should pay more attention to friends or senior colleagues who exert positive impacts to the life of ELBW adults.

Introduction: Based on previous follow-up studies, extremely low birthweight (ELBW) or birthweight under 1,000 g adults have more mental health problems than do normal controls.

Materials and Methods: A mail-in survey was conducted to clarify the life style and health status of 132 adults, who had been under medical care in Maternal and Perinatal Center, Tokyo Women's Medical University Hospital. The questionnaires consisted of open-questions for the ELBW adults' mothers (Survey 1) and, the original life style and health status questionnaire and World Health Organization Subjective Well-Being Inventory, (WHO SUBI) for the ELBW adults (Survey 2).

Results: Survey 1 revealed the recent status of 63 ELBW adults, based on 55 mail responses by the mothers. In Survey 2, 28 (38%) responses from 77 mail questionnaires were received. Survey 1 revealed that 5 (8%) of 63 ELBW adults had the so-called school refusal experience. Based on Survey 2, 28 ELBW adults were doing the same days as average young adults and showed higher self-esteem than that of young adults.

Conclusion: The authors clarified that the life style and health status of ELBW adults has no major sequalae. There is no denying that this group who responded to the questionnaire represent only successful examples rather than ordinary ELBW adults.

In current medical education, there are a few university medical schools that systematically provide education on "home medical care" and "end-of-life care"; however, their methods have not yet been established. It is an important issue for medical education instructors to examine whether students can deepen their understanding and learning about home medical care characteristics and its target patients and their families through home medical care practice.

To this end, this study analyzed medical students' free-text reports using text mining. Text mining is a method of cutting text data word by word, analyzing it in a quantitative way, and visualizing the results. In this study, 69 fifth-year medical students and 11 sixth-year medical students participated from 2015 to 2019, and submitted free-text reports for analysis. The total number of extracted words was 76,976, and the top five most frequently extracted words were "patient" (1,044 times), "think" (436 times), "medical care" (431 times), "home medical care" (362 times), and "hospital" (335 times). In the co-occurrence network, fifth-year medical students were strongly associated with words such as "surprise" and "know," and sixth-year medical students with words such as "cooperation" and "background." In the correspondence analysis, fifth-year medical students in 2017 were strongly associated with such terms as "death" and "end-of-life care." By using text mining, we were able to easily obtain a holistic overview of the reports of 80 students and capture their characteristics. Although this method requires attention to data processing and interpretation, it is expected to be a useful tool for analyzing medical students' reports.

Rotavirus infection occurs in almost all children by the age of 5 years, with a peak between 6 months and 2 years. Most cases resolve spontaneously in about a week, but some children develop severe disease. A rotavirus vaccine became available in Japan in 2011 and was added to the routine vaccination schedule in October 2020. Here we report a fatal pediatric case of dehydration due to rotavirus gastroenteritis. An otherwise healthy 1-year-old boy who had not received the rotavirus vaccine began vomiting and having frequent watery diarrhea accompanied by decreased oral intake for 2 days. During the morning on the third day of illness, an emergency call was made because of irregular respiration. When the emergency medical team arrived, he was in cardiopulmonary arrest. He was transported to our hospital with resuscitation but died. He had no suspected metabolic diseases, and dehydration due to rotavirus gastroenteritis was diagnosed as the cause of death. It is important to provide education and guidance to parents of children with rotavirus gastroenteritis regarding oral rehydration in the early stages of the disease, symptoms to watch for, and when to seek medical attention.

Muscular dystrophy is often present as an underlying disease in patients with dilated cardiomyopathy. When skeletal muscle symptoms such as muscle weakness are not conspicuous, muscular dystrophy might be overlooked, leading to misdiagnosis. When muscular dystrophy is given a diagnosis of the form, the prediction of the symptom is enabled and can connect the burden to muscular strength and heart with whole body controls such as the reduction, and the like. Also, in the event of secondary cardiomyopathy due to muscular dystrophy, the cardiomyopathy can be appropriately managed by treating the primary disease. Heart transplantation may even be indicated. Therefore, an accurate diagnosis, obtained by thoroughly evaluating the muscular dystrophy including a genetic examination, has become an essential aspect of managing dilated cardiomyopathy.

A woman in her 60s underwent upper gastrointestinal endoscopy to investigate the cause of epigastric pain. Upper gastrointestinal endoscopy showed extensive swelling of the corpus and partially depressed lesions in the body of the stomach. A biopsy yielded a diagnosis of poorly differentiated adenocarcinoma. Abdominal computed tomography showed extensive swelling of the regional lymph nodes and no multi-organ metastasis. She was diagnosed with scirrhous gastric cancer with multiple lymph node metastasis. She underwent total gastrectomy, D2 dissection (Roux-en-Y reconstruction) and splenectomy. The pathological findings revealed numerous non-necrotic epithelioid granulomas in the proper mucosal layer of the stomach and the dissected lymph nodes. Two of the 74 dissected lymph nodes showed cancer metastasis.

Even in cancer patients who do not suffer from sarcoidosis, non-necrotic epithelioid granulomas may be found in the regional lymph nodes, however, this is rare for malignant tumors such as gastric cancer. This phenomenon is called a sarcoid reaction. Therefore, many non-metastatic lymph nodes can become swollen, which may cause a divergence in the preoperative staging. Further detailed examinations are required when deciding the surgical procedure, however, there are very few detailed reports on lymphadenopathy peculiar to sarcoid reactions, and there remain many unclear points at present. We herein report a case of advanced gastric cancer with sarcoid reaction-induced gastric wall thickening and lymphadenopathy, with a review of the relevant literature.