Detecting and treating dementia at an early stage are important. Although the Revised Hasegawa Dementia Scale (HDS-R) is commonly used to detect dementia, it takes about 10 min to complete. In contrast, the 1-min animal test (OMAT) takes only 1 min to complete and may be a helpful screening test for general practitioners in deciding whether to proceed with administering further diagnostic tests such as the HDS-R. We sought to examine the relationship between the OMAT and HDS-R scores, and determine the cut-off OMAT score that balanced the sensitivity and specificity in identifying HDS-R-positive patients.

SaijoTaeniasis in humans is a parasitic infection caused by 3 tapeworm species, such as Taenia asiatica, Taenia saginata, and Taenia solium (1).T. asiatica infection is caused by eating raw or undercooked pig liver containing the larvae (2) and is conventionally uncommon in Japan.However, between 2010 and 2011, several human cases of T. asiatica infections were reported in the Kanto area (3), while another case was recently confirmed in the Chiba Prefecture, Japan (4).However, studies on imported T. asiatica infections in Japan remain limited (5).Herein, we report the case of a 47-year-old Filipina who presented with an imported T. asiatica infection in Japan.The patient was referred to our hospital with a 10-day history of excreting proglottids through the anus.She complained of some discomfort in her lower abdomen but had no particular medical history or known allergies and did not take any medications or use illicit drugs.She had lived in Japan for 26 years with a Japanese partner and worked as a housekeeper.The partner did not show similar symptoms.Approximately 10 months previously, she returned to the Philippines for a month and had eaten raw pig liver during her visit.She brought a proglottid to our hospital (Fig. 1A).No palpable abdominal tumor or abdominal tenderness was observed.Her physical examination was normal.Blood tests revealed a white blood cell count of 5,000/μL, eosinophil count of 150/μL, hemoglobin level of 13.2 g/dL, platelet count of 294,000/μL, C-reactive protein level of 0.13 mg/dL, and albumin level of 4.0 g/dL.Other test results were also within normal limits.The proglottid was thick and opaque; the uteri stemmed out from the center forming ＞ 20 branches, and the scolex did not have any hooks (Fig. 1B).Based on these findings, clinical data, and her dietary history, T. saginata or T. asiatica infection was suspected.Prazi-

We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.

目的：情報通信技術を活用した事前授業とシミュレータ演習を合体したブレンド型授業を導入した．

A 42‐year‐old man with schizophrenia was referred to our hospital after 2 weeks of worsening fatigue. His hemoglobin level was 2.8 g/dL owing to folic acid deficiency stemming from alcohol abuse and consumption of unbalanced meals. We induced behavioral changes in the patient by motivational interviewing. We had direct methodical conversations with medical staff involved with the patient as well as his family, and established new social support for him as well as public assistance. These have resulted in the patient maintaining a favorable lifestyle ever since.

Background: Most cases of disseminated carcinomatosis of the bone marrow (DCBM) arise from gastric cancer. DCBM from pancreatic cancer is very rare. We herein present a case of DCBM from pancreatic cancer.Case presentation: A 57-year-old man was referred to our hospital for severe lumbago. Laboratory data indicated that he suffered from disseminated intravascular coagulation (DIC). Non-contrast abdominal computed tomography (CT) revealed multiple bone masses but no other abnormal findings. Left iliac bone marrow biopsy revealed poorly differentiated adenocarcinoma cells. Positron emission tomography (PET)-CT showed diffuse abnormal uptake in the bones and tail of the pancreas. Contrast whole-body CT showed a tumor measuring approximately 28 mm in diameter with poor enhancement in the tail of the pancreas. The patient's final diagnosis was pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC. His DCBM was thus believed to originate from the pancreatic cancer. He succumbed to the disease approximately 2 months after admission to our hospital.Conclusion: We herein describe a case of pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC, which, in our case, was DCBM. Therefore, in cases of DCBM with an unknown primary tumor, pancreatic cancer should be considered during differential diagnosis.

A majority of menstruating women experience a cyclic recurrence of a constellation of various symptoms in the premenstrual phase. The etiopathogenesis of the phenomenon, however, remains unknown. The present study was designed to evaluate whether the activity of the autonomic nervous system (ANS), which modulates a human's internal environment, is altered during the menstrual cycle of women with premenstrual symptomatology. Thirty healthy young women participated in this study. All subjects were investigated during the follicular and late luteal phases. The ANS activity was assessed by means of heart rate variability power spectral analysis during supine rest. The ANS activity significantly changed in the symptomatic late luteal phase from the non-symptomatic follicular phase only in women who experienced substantial increase (>20%) in diverse symptoms premenstrually. In addition, the women of this group possessed higher sympathetic nerve activity and lower parasympathetic nerve activity in the late luteal phase compared with the women who experienced less premenstrual symptomatology. The ANS activity in the follicular phase did not differ among the subjects regardless of their premenstrual symptoms. The present study suggests that the altered functioning of ANS in the late luteal phase could be associated with diverse psychosomatic or behavioral symptoms appearing premenstrually.

Cervical cancer can be classified into two histological types: squamous cell carcinoma (SCA) and adenocarcinoma (ACA). Reportedly ACA has poorer prognoses, metastasizes more easily to lymph nodes, and is more resistant to radiotherapy than SCA. To clarify the cause of characteristic differences between these histological types, we examined the expressions of apoptosis inhibiting and tumor-invasion related factors in both histological types. We reviewed the 34 cases of cervical cancer (17 ACA, 17 SCA) that had surgery as their initial treatment at Osaka City University Medical School Hospital between 1996 and 2001. The differences of survivin, and matrix metalloproteinase (MMP-2, and MMP-7) expressions between both histological types were immunohistochemically assayed, and the correlation between the expression of each protein and clinicopathological characteristics was analyzed. Survivin was expressed significantly stronger in ACA cases (p=0.035). The number of patients who expressed MMP-2 and MMP-7 simultaneously was significantly higher in SCA cases (p=0.039). MMP-2 and MMP-7 had tendencies to be expressed stronger in SCA (p=0.057 and p=0.084, respectively). These results suggest that the differences of the expression of survivin (an apoptosis inhibiting factor), MMP-2, and MMP-7 (tumor-invasion related factors) between ACA and SCA were causes of the characteristic differences between the two histological types.

The purpose of this study was to investigate the clinical application of a microwave tissue coagulator at 2.45 GHz with a needle electrode specifically customized for endometrial ablation. Endometrial ablation was performed under intravenous thiopental anesthesia on three women suffering from hypermenorrhea caused by aplastic anemia (two), von Willebrand's disease (one) using a microwave tissue coagulator at 2.45 GHz. All patients were amenorrheic after endometrial ablation. No notable complications were observed during or after endometrial ablation. Endometrial ablation using a microwave tissue coagulator at 2.45 GHz is a simple and efficacious method for the treatment of hypermenorrhea.

In order to investigate an evidence for genetic disorders in endometriotic patients, eutopic endometrial stromal cells were cultured in vitro for more than 4 months and their antigenecities were characterized by flowcytometry. Eutopic stromal cells from 3 endometriotic patients showed lower expressions of the seven antigens (4 cytokine receptors and 3 leukocyte antigens) than the stromal cells from 5 non-endometriotic women. The preliminary results suggest a possibility that endometriotic patients have certain irreversible genetic abnormalities in the stromal cells, and suggest that endometriosis does not occur as a result in vitro unknown transient stimulation.