Background
This study evaluated the role and need of a sentinel lymph node biopsy (SLNB) in patients with an initial diagnosis of ductal carcinoma in situ (DCIS) made by stereotactic vacuum-assisted ...biopsy (VAB).
Materials and methods
A retrospective analysis was performed of 1,458 patients who underwent stereotactic VAB between January 1999 and December 2012 at Aichi Cancer Center Hospital. The rates of axillary node metastasis and the underestimation of invasive ductal carcinoma (IDC) were examined.
Results
Of the 1,458 patients who underwent stereotactic VAB, 199 had a preoperative diagnosis of DCIS and underwent surgery. In these patients, 20 % (39/199) were upstaged to IDC or at least microinvasion in final pathology. Axillary lymph node status was investigated in 81 % (161/199) of initially diagnosed DCIS patients, and resulted in finding lymph node metastasis in 0.62 % (1/161) patients. To assess the potential preoperative predictors of invasiveness, the value of DCIS histological grade on biopsy samples, the distribution of calcifications on mammograms, and the combination of these factors were studied. The underestimation rate was higher (30 %) in the combination of high DCIS histological grade and extensive calcification although there was no significant association (
p
= 0.23).
Conclusion
The rate of lymph node metastasis was extremely low (0.62 %), even when invasive carcinoma was identified on excision in patients initially diagnosed with DCIS by stereotactic VAB. Because of the low prevalence of metastatic involvement, the cessation of SLNB is a reasonable consideration in patients initially diagnosed with DCIS by stereotactic VAB.
Background
Five randomized trials of adjuvant trastuzumab have reported significant improvements in recurrence-free survival (RFS) and overall survival. However, patients with node-negative tumors ...1 cm or smaller were excluded from these trials. We assessed the recurrence risk and benefit of adjuvant therapy in such patients with small tumors.
Methods
We identified patients with node-negative breast tumors 1 cm or smaller between April 2003 and December 2007. Patients were categorized according to HER2 status and pathological tumor size (pT <5 mm vs. 5–10 mm), hormone receptor (HR) status and adjuvant chemotherapy. The primary endpoint was RFS.
Results
Of 267 patients included in the analysis, 42 had HER2-positive tumors. The median follow-up was 4.3 years. RFS was worse in patients with HER2-positive tumors than HER2-negative tumors (90.5 vs. 97.7% at 5 years;
P
= 0.031). In the group with HER2-positive tumors, there were no recurrences in patients with pT<5 mm, but 4 recurrences in those with pT 5–10 mm. RFS was worse in patients with pT 5–10 mm than pT <5 mm (79.0 vs. 100%,
P
= 0.025). Furthermore 3 recurrences occurred in patients without adjuvant trastuzumab, and 1 recurrence occurred as soon as adjuvant trastuzumab was finished. Our results appear to establish the efficacy of adjuvant trastuzumab therapy. HR status and use of adjuvant chemotherapy were not significantly associated with RFS.
Conclusions
Patients with HER2-positive, node-negative breast tumors 1 cm or smaller (especially 0.5–1.0 cm) have a significant recurrence risk and the decision to employ adjuvant trastuzumab therapy should be discussed with patients based on our results and those of other studies.
A 54-year-old woman complaing of right upper abdominal pain was referred to the hospital with a diagnosis of a giant hepatocellular carcinoma (HCC) 20cm in size on admission, the HCC occupied the ...entire right and medial lobes of the liver, and contacted with the left hepatic vein. The tumor emboli advanced to the main to left branchs of portal vein (Vp4). A right trisegmentectomy, a caudate lobectomy, a removal of the tumor emboli in the portal vein, a bile duct resection and a hepaticojejunostomy were performed. During the removal of the tumor emboli, a baloon catheter inserted from the umbilical vein was used as a method of hemostasis. The postoperative course was uneventful and she was discharged from the hospital on 24th POD. However, recurrence occurred in the remnant liver two months later. Inspite of additional therapies such as intermittent, intraarterial chemotherapy with reservor and radiation, she died of recurrence ten months after the operation. Pathologically, the mass was moderately differentiated HCC with vp4 and the tumor emboli invaded the wall of the bifurcation of the portal vein. We think that this HCC revealed a rare mode of progression as HCC.
Several reliable QTLs for leaf photosynthesis were detected using reciprocal mapping populations derived from japonica and indica rice varieties with different photosynthetic capacities.
Abstract
...The improvement of leaf net photosynthetic rate (An) is a major challenge in enhancing crop productivity. However, the genetic control of An among natural genetic accessions is still poorly understood. The high-yielding indica cultivar Takanari has the highest An of all rice cultivars, 20–30% higher than that of the high-quality japonica cultivar Koshihikari. By using reciprocal backcross inbred lines and chromosome segment substitution lines derived from a cross between Takanari and Koshihikari, we identified three quantitative trait loci (QTLs) where the Takanari alleles enhanced An in plants with a Koshihikari genetic background and five QTLs where the Koshihikari alleles enhanced An in plants with a Takanari genetic background. Two QTLs were expressed in plants with both backgrounds (type I QTL). The expression of other QTLs depended strongly on genetic background (type II QTL). These beneficial alleles increased stomatal conductance, the initial slope of An versus intercellular CO2 concentration, or An at CO2 saturation. Pyramiding of these alleles consistently increased An. Some alleles positively affected biomass production and grain yield. These alleles associated with photosynthesis and yield can be a valuable tool in rice breeding programs via DNA marker-assisted selection.
In this work, the mechanical and tribological behavior of segment-structured hydrogen-free a-C films deposited on silicon and SUS403 substrates has been studied and compared with those of ...conventional hydrogen-free a-C films. Segment-structured hydrogen-free a-C films were fabricated using metal meshes as masks by filtered cathodic vacuum arc (FCVA) system. It was found that segment-structured hydrogen-free a-C films (220×220μm2 of segment with 30μm of groove width) have approximately 25% less internal stress than a continuous film without changing their mechanical properties. The maximum film thicknesses were 500 and 600nm for silicon and SUS403 substrates, respectively owing to a limitation imposed by high compressive stress. Tribological test results indicate that the segment-structured hydrogen-free a-C films have excellent wear resistance and a lower friction coefficient than conventional hydrogen-free a-C films. The role of grooves in reducing internal stress and trapping the wear debris explains this better performance. Furthermore, a thicker segment-structured hydrogen-free a-C film can suppress the intensive wear of the segment edge. Overall results indicate that the segment-structured hydrogen-free a-C films have the advantages of reduced stress and improved the tribological performance.
•A segment-structured hydrogen-free a-C film was fabricated by the FCVA method.•The internal stress of the hydrogen-free a-C film was reduced by the segmented structure.•A low coefficient of friction and wear rate were obtained for the segment-structured hydrogen-free a-C film.•The wear resistance of the segment-structured hydrogen-free a-C film depends on the film thickness.•The results suggest a possible route for the further tribological improvement of surface coatings.
Chondroitin sulfate E (CS-E) plays a crucial role in diverse processes ranging from viral infection to neuroregeneration. Its regiospecific sulfation pattern, generated by
N
-acetylgalactosamine ...4-sulfate 6-
O
-sulfotransferase (GalNAc4S-6ST), is the main structural determinant of its biological activity. Inhibitors of GalNAc4S-6ST can serve as powerful tools for understanding physiological functions of CS-E and its potential therapeutic leads for human diseases. A family of new 4-acylamino-β-GalNAc derivatives and 4-azido-β-GalNAc derivatives were synthesized for their potential application as inhibitors of GalNAc4S-6ST. The target compounds were evaluated for their inhibitory activities against GalNAc4S-6ST. The results revealed that 4-pivaloylamino- and 4-azido-β-GalNAc derivatives displayed evident activities against GalNAc4S-6ST with IC
50
value ranging from 0.800 to 0.828 mM. They showed higher activities than benzyl D-GalNAc4S that was used as control.
A 38-year-old man was given a diagnosis of as sigmoid colon cancer and underwent sigmoid colectomy. Post-operative pathological staging was stage IIIb. He then underwent adjuvant chemotherapy. One ...year and 4 months after the surgery, CT scans revealed multiple liver and lung metastases. He was given mFOLFOX6+bevacizumab, which was changed later to FOLFIRI+bevacizumab. After these chemotherapies, he was admitted to the hospital due to sudden abdominal pain and high grade fever. Obstructive jaundice was initially diagnosed, but detailed study of initial CT revealed intragastric wall abscess. After the drainage of the abscess, his conditions improved. We speculated that the abscess formation was caused by mucosal damage due to bevacizumab.
We developed a deployable offset-fed reflector antenna with tensioned stainless mesh surface supported by radial ribs for prompt satellite News gathering. For News gathering in emergencies, the ...portability of the antenna system is important as well as the stability to transmit High-quality video signals. In this paper, we describe the electric performance of a prototype deployable offset-fed reflector antenna.
Objective: There is accumulating evidence for the beneficial effects of coffee on the liver. In this study we investigated the effects of coffee on the development of fatty liver and laboratory data ...in a 10-year longitudinal study.Methods: Annual changes in daily coffee intake during the 10-year study period were compared between a fatty liver group and non-fatty liver group in a matched study according to age, BMI and daily exercise level. The effects of changes in daily coffee intake between the 2 groups on the development of fatty liver were investigated after adjustments for related factors. Next, subjects were divided to three groups according to change in coffee intake in 10 years: decreased intake, equal intake, and increased intake group. The rate of developing fatty liver and changes in clinical data were compared among the groups.Results: A significant difference in the changes in daily coffee intake was observed between the fatty liver and non-fatty liver groups, with daily coffee intake decreasing in the former. Moreover, daily coffee intake was negatively correlated with the development of fatty liver after adjustments for related factors. Fatty liver was found less frequently in the increased coffee intake group, compared to the equal or decreased coffee intake group. Furthermore, those with increased coffee intake had better laboratory data regarding lifestyle-related diseases, compared to decreased coffee intake group.Conclusion: These findings suggest a protective effect of coffee against fatty liver, and that coffee may be useful for protecting against lifestyle-related diseases.
PDF
