The number of patients with human immunodeficiency virus infection (HIV) is gradually increasing in Japan. Mycobacterium tuberculosis is a virulent pathogen and can cause a disease in any stage of HIV infection. As Japanese people have the high prevalence and incidence of tuberculous infection among the developed countries, the risk of active tuberculosis will be elevated for HIV-seropositive patients. Some patients were first diagnosed as HIV-seropositive when active tuberculosis developed. Disseminated infection due to the Mycobacterium avium complex (MAC) is the most common systemic bacterial disease among patients with AIDS. Treatment of MAC infections is difficult, and response to therapy is often fleeting. Therefore, the prompt diagnosis and treatment of disseminated MAC infection are important. I described the review of mycobacterial disease in patients with HIV infection

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Congenital fascial dystrophy is a unique congenital disease involving only the fascia systemati-cally, first proposed by Jablonska and her co-workers in 1984. In their original paper, they in-sisted that the first patients Esterly and McKusick named stiff skin syndrome in 1971 belonged to this condition. To date, 6 cases have been confirmed at least; four from Poland and two from Japan. Congenital fascial dystrophy is characterized by symptoms caused by the diseased fascia, such as limitations of joint motility, specific posture and difficult walking; respiratory symptoms in some cases. These symptoms remain essentially unchanged throughout life, although symptoms may appear progressive in childhood. Prognosis of this syndrome as to life appears good. No specific treatment exists, but symptomatic relief and spiritual encouragement are important

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To investigate the mother-to-infant transmission of hepatitis B virus (HBV), we tried to detect HBs antigen, HBV-DNA and HBV polymerase in cord sera and in breast milk of HBV carrier mothers.
In a group of HBe antigen-positive mothers, HBs antigen in breast milk was detected in 33.3%, HBe antigen in 77.8%, and HBc antibody in 62.5%. Among HBe antigen-negative mothers, HBs antigen in breast mirk was detected in 11.1%, HBc antibody in 66.7%. HBe antibody in breast milk was detected in 37.5% among HBe antibody-positive mothers.
HBV-DNA in serum was detected in 6 cases (66.7%) out of 9 HBe-antigen-positive mothers, it was detected in one case (7.7%) out of 13 in cord sera, and just traces of HBV-DNA were found in 2 cases (20%) out of 10 in breast milk. HBV polymerase was detected in 6 cases (75%) out of 8 in the mothers' sera, in one case (7.7%) out of 13 in cord sera, in two cases (20%) out of 10 in breast milk.
By the infants' follow-up study for more than two years, one infant failed to respond to vac-cination and developed a chronic HBV carrier state. Another case had transient hepatitis with high ALT levels but did not develop into a chronic HBV carrier state

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We surveyed all cases who visited psychiatric facilities and were considered as emergent by phy-sicians in Saga prefecture, to clarify the need for comprehensive psychiatric emergency system.
The study period was from 29 Jan. to 28 Feb. 1996. Four hundred and eighty four cases were reported as emergent. Twenty eight cases were required admission for both psychiatric and physical reasons. We investigated these cases in terms of service delivery and difficulties perceived by those who were concerned with the cases. Patients, their family members, police officer, and ambulance service personnel felt difficulty in transferring patients. Psychiatric facilities find it difficult to treat physical complication and refer those cases to other hospitals. Some hospitals refused either consultation or admission of patients with physical illness because of mental illness. Psychiatric hospitals could not help but treat physical complication with limited resources.
We concluded that the administrative organ should make efforts for building comprehensive psychiatric emergency system in Saga prefecture, and that all of health care workers should have basic skills to triage psychiatric emergency cases. We proposed simple diagram to classify psychiatric emergency cases to enhance those skills

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We report a case of xanthogranulomatous pyelonephritis with a clinical course of a Bechet's disease. A 56-year-old woman was presented continuous fever and anorexia. She was diagnosed as Bechet's disease about 19 years ago, and treated with prednisone. When she was admitted our hospital she showed slight parapresis and hyperactive deep tendon reflexes. With a pulse therapy of methylprednisone, the fever temporarily subsided and rose again. To find out the cause, the abdominal computed tomography, an enhanced CT scan of the masses and Gascintigraphy took places. Each showed abnormal masses in the posterior facies, a rimenhancement figure and hyperaccumulation in the right kidney. Those data suggested that the mass of the right kidney was a perirenal abscess. Surgical drainage was performed but there was no abscess. The enlarged right kidney was sur-rounded with severe adhesive and thickened perirenal tissue. The right nephrectomy was carried out. The fever disappeared immediately after the operation. Histopathological examination of the kidney showed xanthogranulomatous pyelonephritis. In regard to this case, suppression of host defence due to long steroid therapy for Bechet's disease seemed to be an important factor for inducing xanthogranulomatous pyelonephritis

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A case of 41-year-old woman with malignant phyllodes tumor of the left breast is reported. This phyllodes tumor invaded to major pectoral muscle and then a standard radical mastectomy was performed. Lymph node metastasis was not found. Since one year later, local recurrences occurred five times and tumoral resection and partial resection of ribs were performed. Eight years after the first operation, a distant subcutaneous metastasis of right waist and a pleomorphic adenoma of mandible part were resected. Metastasis to lung, vertebral canal and second recurrence of waist subcutaneous occurred. Rapid growth of the subcutaneous tumor made large ulcers of the skin. She became anemia and low proteinemia, then she died ten yesrs after first operatin

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The effect of high protein and low calorie diet, Hiprokie^® (cookie and two tastes of risotto; creamy or curry taste), in weight loss program was studied in 9 obese patients (1 male and 8 females). Five patients comleted the program, in which Hiprokie was served as a combination of cookie and risotto at every meal for 14 days. In addition, vegitables and water were allowed to take freely. Four of the nine patients could not complete the program. Two of them stopped tee dieting thn days later and the other two patients took additional 200-300 kcal per day. small but significant weight loss was obtained in these patients. No serious side effects were observed. Plasma cholesterol levels were lowered in four patients who completed the program. Failure to continue the diet with Hiprokie seemed to be from the reason that two kinds of meal (cookie and risotto) were not enough to satisfy their tastes. These results suggested the usefulness of Hiprokie in diet program, as well as the difficulty of the diet with Hiprokie alone for a relatively long period. Hiprokie may be useful in the initial step of a diet program, or as an alternative food to conventional low calorie diet for a short period

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