A 43-year-old man was admitted to our hospital for rehabilitation of higher brain dysfunction caused by traumatic brain injury. He had undergone an emergency operation for acute epidural hematoma after a fall. He had impaired cognitive function with regard to memory, attention, and executive function. However, he also exhibited facial features such as frontal baldness and hatched face. Neurological examination showed mild distal muscle weakness in the extremities, gait disturbance, and grip and percussion myotonia. Needle electromyography showed myotonic discharges. Brain magnetic resonance imaging did not show any intra-axial abnormalities. Myotonic dystrophy (DM) was therefore diagnosed. Rehabilitation resulted in improved gait stability, but the patient's cognitive function did not improve. Severity of illness in DM patients varies from a floppy infant to a lack of awareness of the disease throughout one's lifetime. Therefore, DM patients might not be properly diagnosed because of the mildness of their clinical symptoms. It is important for non-neurologists to be aware of the possible occurrence of this disease.

Objective：To investigate the efficacy of micturition induction therapy (MIT) for recovery of urinary continence in stroke patients without uresiesthesia.
Methods：We retrospectively examined the efficacy of MIT for recovery of continence in stroke patients without uresiesthesia and assessed improvement in the Functional Independence Measure (FIM) score in 201 stroke patients admitted to our rehabilitation hospital.
Results：Of the 201 patients, 160 had uresiesthesia. The 41 patients without uresiesthesia were significantly older and had lower FIM scores on admission than those with uresiesthesia. Of 41 patients without uresiesthesia, 15 received MIT. There was no difference between the groups in terms of age or FIM scores on admission. Nine of 15 (60％) patients who received MIT recovered continence, whereas only 7 of 26 (26.7％) who did not receive MIT recovered continence. MIT was significantly effective for recovery of continence in patients without uresiesthesia (p ＜0.05). The gain in FIM scores was significantly higher in patients who recovered continence than in those who did not recover continence, irrespective of whether MIT was provided (p 0.05).
Conclusion：MIT was effective for recovery of uresiesthesia and continence in patients without uresiesthesia after stroke.

Objective: The standard dose for pegylated liposomal doxorubicin (PLD) is 50 mg/m2 every 4 weeks. While 40 mg/m2 has recently been used in clinical practice, evidence supporting this use remains lacking. Methods: This phase III randomized, non-inferiority study compared progressionfree survival (PFS) for patients with platinum-resistant ovarian carcinoma between an experimental arm (40 mg/m2 PLD) and a standard arm (50 mg/m2 PLD) until 10 courses, disease progression or unacceptable toxicity. Eligible patients had received ≤2 prior lines.Stratification was by performance status and PFS of prior chemotherapy (<3 months versus ≥3 months). The primary endpoint was PFS and secondary endpoints were overall survival (OS), toxicity profile, clinical response and tolerability. The total number of patients was 470. Results: The trial was prematurely closed due to slow recruitment, with 272 patients randomized to the experimental arm (n=137) and standard arm (n=135). Final analysis was performed with 234 deaths and 269 events for PFS. In the experimental arm vs. standard arm, median PFS was 4.0 months vs. 4.0 months (hazard ratio [HR]=1.065; 95% confidence interval [CI]=0.830–1.366) and median OS was 14.0 months vs. 14.0 months (HR=1.078; 95% CI=0.831–1.397). Hematologic toxicity and oral cavity mucositis (≥grade 2) were more frequent in the standard arm than in the experimental arm, but no difference was seen in ≥grade 2 hand-foot skin reaction. Conclusion Non-inferiority of 2 PLD dosing schedule was not confirmed because the trial was closed prematurely. However, recommendation of dose reduction of PLD should be based both on efficacy and safety.