Objective: The aim of this study was to analyze the clinical and imaging characteristics in patients diagnosed with atypical endometrial hyperplasia based on endometrial biopsy in comparison with the ...final diagnosis from resected uteri; i.e. to determine the rates of underestimation (endometrial cancer), equivalent diagnosis (atypical hyperplasia), and overestimation (hyperplasia without atypia or non-hyperplastic lesion).
Materials and methods: We reviewed 33 patients who were diagnosed with atypical endometrial hyperplasia by endometrial biopsy using a small curette and then underwent total abdominal hysterectomy between September 1992 and May 2002. Clinical parameters obtained from patients’ charts, and imaging analyses using transvaginal ultrasonography (TUS) and magnetic resonance (MR) imaging were retrospectively re-examined.
Results: Among 33 patients who underwent hysterectomy due to a diagnosis of atypical hyperplasia, nine cases (27.2%) were underestimated (cancer), nine cases (27.2%) were equivalent and 15 cases (45.6%) were overestimated as indicated by examination of the endometrium of the resected uterus. There was no difference among these groups in either clinical parameters or diagnostic images obtained by TUS or MR.
Conclusion: Diagnosis of atypical endometrial hyperplasia by endometrial biopsy often resulted in under- or over-estimation, as shown by examination after hysterectomy. As there is neither a reliable clinical parameter nor imaging feature to distinguish between these groups, hysterectomy is still the best treatment for these patients if they are willing to give up their fertility.
The two crystal structures of poly(butylene-2,6-naphthalate) (PBN) have been determined by X-ray diffraction. The space group is P
1
for both forms. The unit cell parameters of the B form are
a = ...4.55
A
̊
, b = 6.43
A
̊
, c
(fibre axis) = 15.31
A
̊
, α = 110.1, β = 121.1 and γ = 100.6. The major difference in crystal structure between the A and B forms lies in the conformation of four methylene group sequences:
SG
TGS for the A form and TST
S
T for the B form.
In order to pursue a possibility of application of radiopaque polymer hydrogels to vascular embolization, studies were made on synthesis of iodine containing copolyanions and properties of their ...hydrogels with polycation via formation of polyion complexes (PIC). Acrylamide derivatives having triiodophenyl groups were synthesized and copolymerized with sodium styrene sulfonate (SS) under several conditions. It was found that
N-(3-carboxy-2,4,6-triiodophenyl)-acrylamide (CIPA) and 2,4,6-triiodophenylacrylamide (TIPA) monomers are effectively copolymerized with SS, while
N-allyl-2,3,5-triiodobenzamide (ATIBA) are hardly copolymerized. Hydrogels were prepared by mixing aqueous solutions of polyanions, i.e. the copolymers (PCIPA and PTIPA) and polyallylamine (PAAn).
13C NMR spectra of PCIPA/PAAn and PTIPA/PAAn hydrogels gave peaks for both polyanion and polycation. This means that there remained free anionic and cationic monomer units, which did not form ion pairs because of spatial hindrance. Time dependence of
1H
T
2 showed quick increment and plateau for PSS/PAAn and gradual increments for PCIPA/PAAn. Therefore, PIC containing the radiopaque copolymer retains the hydrogel state for a long time. Embolization was examined by injection of PCIPA/PAAn hydrogels into the vein of a removed porcine kidney as a preliminary test for transcatheter arterial embolization (TAE). X-ray radiograms of the embolized organ were reasonably explained based on the structure and mobility of hydrogels.
Experimentally observed 14-MeV neutron removal cross sections are presented for 16 materials. At a scattering energy loss of 4 MeV, the effective macroscopic cross section per unit mass (in square ...centimetres per gram) for a nucleus of mass A is given by 0.25A
-1.78
+ 0.10A
-0.47
. Such information provides a simple method for estimating neutron transport in systems driven by thermonuclear neutrons.
A study was made to investigate an optimum condition for ruthenium tetraoxide staining of poly (butylene terephthalate) (PBT) with glass transition temperature as low as ca. 23°C for TEM observation ...of melt‐grown PBT crystals. The morphological study of ultrathin sections prepared based on optimum staining at 25°C for 8 h revealed formation of fringed‐micellar crystal nuclei in the early stage and folded‐chain fringed‐micellar crystals in the later stage of isothermal crystallization at 40°C from melt. The fraction of chain‐folded crystals increased with increasing crystallization temperature from the quantitative analysis of crystal thickness in comparison with the reported morphology using the replica method.
Forty patients underwent coronary revascularization using bilateral internal thoracic artery (ITA) grafts between 1988 and 1992. A total of 111 coronary grafts were performed, or an average of 2.8 ...grafts per patient. Each patient received bilateral ITA grafts, and in 20 patients an additional 29 grafts were constructed with 18 autologous veins and 11 gastroepiploic arteries. The right ITA was grafted as a free graft in 20 patients. The ITA graft patency rate was 96 per cent (67/70) at the time of hospital discharge. The operative morbidity included 3 reoperations for bleeding, 1 perioperative myocardial infarction, 1 renal failure, 2 postcardiotomy shock, and 1 colon perforation. Two hospital deaths occurred; one due to colon perforation and the other due to postcardiotomy cardiogenic shock. One patient died of cerebral infarction 6 month after the operation. Thirty-four patients were in New York Heart Association functional class I, 2 were in class II and 1 was in class III. Cardiac function evaluated by echocardiography and scintigraphy showed significant improvement postoperatively. These data suggest that the use of bilateral ITA grafts is associated with an acceptable mortality and increases the versatility of arterial grafting.
In June 1991, a large outbreak of acute nonbacterial gastroenteritis occurred among students and teachers at 10 primary and 4 junior high schools in Katano City, Osaka, Japan. The outbreak ...affected>4700persons, lasted5days,andwasbelievedto havebeenlinkedtocontaminatedfood from a common supplier. Astrovirus, identified as the etiologic agent, was detected by direct electron microscopy in 10 of 38 fecal samples obtained from patients with diarrhea. Detection was confirmed by solid-phase immune electron microscopy (IEM), EIA, reverse transcriptionpolymerase chain reaction, and virus isolation in CaCo-2 cells. Several patients who had astrovirus in their stool also demonstrated a significant antibody response to a reference strain of astrovirus by IEM and EIA and to their own isolate by IEM. Astrovirus can be an important agent of epidemic acute nonbacterial gastroenteritis in school-aged children and adults in Japan.
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