In recent years, depression has become diverse, particularly in the younger population. In the field of medical education, it is assumed that a number of educators often experience difficulties in attending to their learners with depression. In this review article, information which contributes to the promotion of mental health for medical residents is provided, considering the knowledge of recent depression in the younger population, including its diversity together with the characteristics of the "generation educated with latitude".

Increased emphasis on community-based education in medicine requires close collaboration with and cooperation from general practitioners. This study examined what motivates community physicians to participate in office-based education, to explore the most appropriate method for recognizing physicians' efforts and keeping them motivated with their precepting role. A large majority of respondents to a questionnaire survey thought that the opportunity to learn from their own teaching was an important reward. When the preceptors were asked what support would be most appropriate, a teaching certification plaque, continuing medical education courses, and a title were ranked highest, while financial reward was listed as the least important. Considered most essential by community preceptors were constructive feedback from students, medical-school instructors' understanding of the importance of community-based medicine, and the instructors' enthusiastic promotion of primary-care education.

A 62-year-old woman was admitted for chest and back pains. She was found to have thrombosed type A aortic dissection by enhanced computed tomography. Since she had no clinical symptoms after her admission, she was discharged. Forty days after the admission, she returned with acute renal failure and ischemia of both lower extremities. Occlusion of the abdominal aorta was diagnosed and emergency axillobifemoral bypass was performed. Her renal function and the ischemia of both lower extremities improved dramatically and she was discharged 30 days after the operation. Axillobifemoral bypass is one of the most effective and least invasive operations in such cases.

Objectives : To determine factors related to peoples' preference for visiting home-doctors when experiencing new health problems.
Method : A questionnaire survey was conducted of people receiving annual health checkups in municipalities in the vicinity of Jichi Medical University Hospital. We surveyed personal characteristics, test equipment, having of a home-doctor, and answers to an assumed scenario (asking about willingness to visit a home-doctor in case of getting certain health problems).
According to the responses to the scenario, we divided the subjects into two groups (a home-doctor group: visiting a home-doctor; and a specialist group: not visiting a home-doctor) and statistically compared the two groups.
Results : In the analytic sample of 1,829, the home-doctor group numbered 1,097 individuals (60%) and the specialist group numbered 732 individuals (40%). The home-doctor group statistically had more home-doctors than the specialist group (adjusted odds ratio, 95% confidence interval: 2.47, 2.00-3.05).
More home-doctors in the home-doctor group had test equipment than home-doctors in the specialist group: Gastrointestinal test equipment (gastroscopy, colonoscopy, or ultrasonography) (adjusted odds ratio, 95% confidence interval: 1.39, 1.06-1.83).
Conclusion : We revealed two factors relating to the preference for visiting home-doctors: First, those people had home-doctors, and, second, the home-doctors had test equipment.

Endoscopic ultrasound (EUS)-guided transgastric drainage has been performed as a less invasive procedure for pancreatic fistulas and intra-abdominal abscesses occurring after surgery in recent years. However, there are no reports of EUS-guided transgastric drainage of intra-abdominal abscesses following gastrectomy. This case report describes 2 patients who developed an intra-abdominal abscess following gastrectomy and underwent EUS-guided transgastric drainage. Both patients underwent laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction for gastric cancer. The intra-abdominal abscesses were caused by postoperative pancreatic fistula that developed following gastrectomy. One patient underwent naso-cystic drainage and the other underwent only a needle puncture of the abscess cavity. EUS-guided drainage was performed safely and effectively, although 1 patient developed gastroduodenal anastomotic leakage related to this procedure. In summary, EUS-guided transgastric drainage is safe and technically feasible even in post-gastrectomy patients. However, it is necessary to be careful if this procedure is performed in the early period following gastrectomy.
Abdominal Abscess ; Abscess ; Anastomotic Leak ; Drainage ; Gastrectomy ; Humans ; Needles ; Pancreatic Fistula ; Punctures ; Stomach Neoplasms ; Ultrasonography