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To evaluate the accuracy of preoperative endometrial biopsy and magnetic resonance imaging (MRI) of endometrial cancer compared with that of intraoperative frozen section.This retrospective study included 264 patients who underwent surgery with intraoperative frozen section for endometrial cancer at our institution between 2014 and 2018. Diagnosis was determined by histologic type, grade, and myometrial invasion. Concordance rate, sensitivity, and specificity of preoperative diagnosis and intraoperative frozen diagnosis were calculated, in comparison to the final pathologic diagnosis.Preoperative and intraoperative diagnoses showed no statistically significant difference in determining histologic type and grade (P = 0.152). Intraoperative diagnosis showed higher sensitivity for endometrioid carcinoma grade 3 and other types, and higher specificity for grade 1. For myometrial invasion, intraoperative diagnosis showed significantly higher concordance rate than preoperative MRI findings (P 0.01). Intraoperative diagnosis showed higher sensitivity and specificity in patients with and without myometrial invasion, respectively.Higher agreement between intraoperative and final diagnoses, especially in myometrial invasion, suggests that intraoperative frozen section is a good indicator for appropriate surgical procedure decision making.

Introduction: The significance of endometrial cytology in determining the therapeutic efficacy of medroxyprogesterone acetate (MPA) therapy is unclear. This study aimed to evaluate the clinical usefulness of endometrial cytology during MPA therapy. Methods: Overall, 77 patients who underwent dilatation and curettage (D&C) to evaluate the therapeutic efficacy of MPA therapy at our hospital between January 2018 and December 2019 were retrospectively analyzed. The results of D&C, cytological evaluation, and other clinicopathological factors were analyzed based on the patients’ medical records. Results: The sensitivity and specificity of cytology were 61% and 92%, respectively, with D&C being the gold standard for diagnosis in 142 D&C/cytological examinations. Among patients with no residual disease on D&C, 5 (4%) had suspicious or positive cytology. Although MPA therapy was terminated in 3 of these patients, only 1 patient had early recurrence, and the frequency of recurrence was similar to that of patients who showed negative results in both D&C and cytology. Discussion/Conclusion: The sensitivity of endometrial cytology in determining the therapeutic effect of MPA therapy is low, and we confirmed that the omission of D&C is unacceptable. Our findings also suggested that the addition of cytological evaluation to D&C during MPA therapy had a low clinical significance.

Aim Tamoxifen (TAM) is widely used in adjuvant endocrine therapy for invasive breast cancer as a selective estrogen modulator, but this treatment has a risk of developing endometrial malignancy. However, hysteroscopic findings during or after TAM treatment are unclear. The aim of this study is to examine the association between hysteroscopic patterns and malignant histological findings during or after treatment with TAM. Methods The subjects were patients who received TAM after surgery for breast cancer and underwent hysteroscopy at our institution from January 2016 to December 2019. Clinicopathological factors and hysteroscopic findings were collected from medical records and investigated retrospectively. Histologically, atypical endometrial hyperplasia, endometrial cancer, and carcinosarcoma were classified as malignant diseases. Results A total of 26 patients were eligible for the study. Hysteroscopic findings included an irregular surface of the endometrium (n = 3, 11.5%), atypical vessels (n = 10, 38.5%), papillary structure (n = 3, 11.5%), and polypoid structure (n = 18, 69.2%). Histological examination revealed malignancy in six patients (23.0%). The percentage of atypical vessels in patients with malignancies was significantly higher than that in patients with a normal endometrium or benign lesion (100% vs. 20%, p = 0.0009). The sensitivity and specificity of atypical vessels in hysteroscopy for diagnosis of malignant diseases were 100% and 80%, respectively. Conclusions Hysteroscopic findings of atypical vessels may be useful for prediction of malignant diseases in patients treated with TAM.

There has been a rapid advance in germline multigene panel testing by next-generation sequencing, and it is being widely used in clinical settings. A 56-year-old woman suspected of having Lynch syndrome was identified as a BRCA2 pathogenic variant carrier by multigene panel testing. The patient was diagnosed with endometrial cancer at the age of 39 years, and total laparoscopic hysterectomy and bilateral salpingectomy were performed at the age of 49 years; however, bilateral oophorectomy was not performed at that time. As she had a family history of colorectal cancer and a history of endometrial cancer, Lynch syndrome was suspected. However, germline multigene panel testing revealed a pathogenic BRCA2 variant rather than pathogenic variants in mismatch repair genes. In this case, with conventional genetic risk assessment, we were unable to determine whether the patient had a high risk of hereditary breast and ovarian cancer; thus, germline multigene panel testing may provide valuable information to improve disease management strategies for patients in clinical settings. Particularly, germline multigene panel testing may be useful for detecting hereditary tumor syndromes if a patient does not present with a typical family history of cancer.

The aim of this study was to establish criteria that would indicate whether fertility preservation therapy would likely be safe for patients aged 40 years or less with endometrioid endometrial cancer based on their DNA methylation profile.Forty-nine fresh-frozen tissue samples from patients with endometrial cancer from an initial cohort and 31 formalin-fixed paraffin-embedded tissue samples from a second cohort were subjected to genome-wide DNA methylation analysis using the Infinium MethylationEPIC BeadChip.Epigenomic clustering of early-onset endometrial cancer was correlated with the widely used recurrence risk classification. Genes showing differences in DNA methylation levels between the low-recurrence-risk category and intermediate- and high-risk categories were accumulated in pathways related to fibroblast growth factor and nuclear factor-κB signaling. DNA hypomethylation and overexpression ofDNA methylation diagnostics criteria using up to 6 of 8 CpG sites for

To assess the impact of COVID-19 on cervical cancer screening.The Japanese Society of Gynecologic Oncology launched COVID-19 Task Force surveyed the municipalities in urban areas of Japan. Questionnaires were sent to 20 ordinance-designated cities and 23 wards of Tokyo metropolitan area in Japan via telephone and mail in January 2021. An additional survey was conducted in March and April 2021, counted the monthly checkups in 2020 and, as a control data, the number of monthly checkups in 2019. "The State of Emergency" between April 7 and May 25, 2020, included 13 prefectures. The data collected in this research involved the number of screenings only. The chi-square test was performed for statistical analysis.The number of cancer screenings from March to August, with May being the month with the lowest number of screenings, was less than 50% of that in the previous year. In particular, the drop in the number of cancer screenings in the "Prefectures operating under special safety precautions" was remarkable and significantly lower than that in other Prefectures. However, after August, the number recovered to the usual level, despite the second wave of the pandemic occurring nationwide. The initial "the State of Emergency" caused a significant decrease in the number of people receiving population-based screenings, but the recovery has been remarkable, and the total number is expected to be the same as in previous years.The initial "the State of Emergency" caused a significant decrease in the number of people receiving population-based screenings.

Objective As coronavirus disease 2019 (COVID-19) rages on, it is a challenging task to balance resources for treatment of COVID-19 and malignancy-based treatment. For the development of optimal strategies, assessing the conditions and constrains in treatment during the COVID-19 pandemic is pertinent. This study reported about a nationwide survey conducted by the Japan Society of Gynecologic Oncology. Methods We interviewed 265 designated training facilities about the state of their clinical practice from the time period between March and December 2020. We asked the facility doctors in charge to fill a web-based questionnaire. Results A total of 232 facilities (87.5%) responded. A decrease in the number of outpatient visits was reported, and the major reason attributed was reluctance of patients to visit hospitals rather than facility restrictions. The actual number of surgeries decreased by 3.9%, compared to 2019. There was a significant difference when the variable of “Prefectures operating under special safety precautions” or not was introduced. There was no increase in the rate of advanced stages in the three cancer types studied. However, 34.1% participants perceived COVID-19 affected management and prognosis. Conclusion Refraining from visiting hospitals based on the patient's judgment may be expected to be an issue in the future. No significant decrease in surgeries was observed, and it would seem that there were few forced changes in treatment plans, but “the State of Emergency” had an impact. There was no increase in the rate of advanced cancers, but this will need to be monitored., Synopsis Japan Society of Gynecologic Oncology conducted a nationwide survey about gynecologic malignancy in Japan under coronavirus disease 2019 pandemic. Patients refrained from visiting hospitals which led to reduced outpatient. “The State of Emergency” impacted healthcare but major decrease in surgery was not observed. Patients did not report advanced cancer states, but careful observation is required.

[Objective] Lynch syndrome (LS) is an autosomal dominant inherited disorder caused by a germline pathogenic variant in DNA mismatch repair (MMR) genes. Endometrial cancer frequently precedes another LS-associated tumor. This study aimed to clarify the incidence and features of LS in young Japanese endometrial cancer patients. [Methods] Sixty-five patients aged 40 years or younger, who were diagnosed with endometrial cancer, were enrolled in this study. Targeted sequencing of a hereditary colorectal cancer-related gene panel including the MMR genes MLH1, MSH2, MSH6, and PMS2 was conducted on DNA samples extracted from blood cells. [Results] Overall, 6 missense variants (2 in MSH2, 2 in MSH6, and 2 in PMS2), 1 inframe deletion variant in MSH2, 1 splice variant in MSH2, and 1 two-base substitution in the 3’ untranslated region in MLH1 were detected in 9 (13.8%) patients. Among these, the splice variant c.1276G > T (p.Ile411_Gly426del16) in MSH2 was annotated as pathogenic, while other variants were of uncertain significance. The patient with the pathogenic variant had a family history of endometrial and colorectal cancer and was diagnosed with endometrial cancer at age 35. [Conclusion] The incidence of LS among Japanese endometrial cancer patients of reproductive age (≤ 40 years) in this study was at least 1.5%; however, 12.3% of patients had variants of uncertain significance in MMR genes.

ObjectiveSentinel nodes (SNs) have been observed in several reports from Japan and overseas in cases with endometrial cancer; however, no consensus has been reached regarding the types of tracers or the method of their injection. A combination of the radioisotope (RI) and dye method is considered to be desirable. We assessed SN mapping using either dye or near-infrared fluorescence imaging to clarify a suitable method in cases of endometrial cancer.MethodsPatients were enrolled from 92 patients diagnosed with endometrial cancer and having no extrauterine metastasis by the preoperative imaging between 2009 and 2014 at our institution. To identify the SNs, we performed 3 methods using either dye or fluorescence solutions in conjunction with a RI method. In the dye method, we injected indocyanine green in the uterine subserosa, visually identifying SNs as stained green. In the fluorescence method, a dilute indocyanine green solution (0.5 mg, fluorescence A or 0.25 mg, fluorescence B, each per 10 mL of solvent) was injected and the SN identified by the HyperEye Medical System.ResultsThe SN detection rates were 100%, 100%, and 96% using dye and fluorescence A or B solution, respectively. Pelvic SNs were detected by the 3 methods in 98%, 100%, and 96% of cases and para-aortic SNs in 65%, 88%, and 74%, respectively. Fluorescence A solution was somewhat better than dye in detecting para-aortic SNs, although not significantly so (P = 0.07). The sensitivity and negative predictive values for detecting SNs with metastases with the dye method were 92% and 98% compared with 100% and 100%, respectively, for both fluorescence solutions.ConclusionsAlthough both dye and fluorescence methods performed well, no method perfectly identified para-aortic SNs. The concomitant use of the RI method is required to detect para-aortic SNs.

Introduction/Background Hysterectomy,bilateral salpingectomy, and retroperitoneal lymphadenectomy are often performed as standard surgical procedures for endometrial cancer. However, lymph edema and lymphocele, which are adverse effects of lymphadenectomy, degrade a woman’s quality of life. The therapeutic significance of lymphadenectomy has not been established. This study aimed to clarify the impact of lymphadenectomy on the therapeutic outcome. Methodology The cancer database of Japan Society of Obstetrics and Gynecology provided data on 43,779 patients who started treatment between 2004 and 2011. Among these patients, we retrospectively analyzed the difference in overall survival with and without lymphadenectomy in 36,813 patients who underwent initial surgery and had well registered clinicopathological factors and prognoses. In this study FIGO 1988 staging was used. Results The median age was 58 years, and the median follow-up period was 1610 days. Stage I, II, III and IV were 24,296 (66%), 3,313 (9%), 7,362 (20%) and 1,840 (5%) patients respectively. In terms of histologic type, there were 18,406 (50%), 8,098 (22%), 3,681 (10%), and 5,153 (14%) patients with G1, G2, or G3 endometrioid adenocarcinoma, and non-endometrioid adenocarcinoma, respectively. Seventy-three percent of patients underwent lymphadenectomy. Analysis of each histological type showed that prognosis was significantly better in the lymphadenectomy group than in the non-lymphadenectomy group for each histological type. Analysis at each stage showed that prognosis was significantly better in the lymphadenectomy group than in the non-lymphadenectomy group for each stage, except stage Ia. In the low recurrence-risk group (stage Ia-b, G1-2), there was no significant difference in stage Ia, but in stage Ib. A multivariate analysis revealed that the presence or absence of lymphadenectomy was an independent prognostic factor considering age, stage, histological type, and adjuvant therapy. Conclusion Although there is a limitation that various biases cannot be eliminated because of retrospective study, lymphadenectomy for endometrial cancer may have a prognostic improvement effect. Disclosure Nothing to disclose.

To date, the results of the clinical trial of sentinel node navigation surgery (SNNS) for endometrial cancer are not reported, and SNNS should be not yet performed as a clinical practice. SNNS is thought to be performed as a clinical trial in the institutions with enough experiences of SN mapping. Regarding the methods of the tracer injection and tracer detection, the diagnostic accuracy of metastasis, the clinical significance of ITC, or micrometastasis, the oncologic significance of solitary metastasis-positive sentinel lymph node (SN) in para-aortic basin, the usefulness of SN biopsy using surgical robots with fluorescence imaging system for detecting ICG, accumulations of clinical trials, and the data analysis in many facilities are needed so that SNNS comes to be safely performed as a clinical practice. Furthermore, the standardization of the diagnosing method for the pathological search for SN and the establishment of the molecular biologic laboratory procedure are necessary, too. However, we think SNNS will emerge as a promising, elegant solution to the ongoing discussion regarding lymphadenectomy in the initial surgical management of endometrial cancer in order to prevent many patients from receiving oversurgery, in order to properly select patients who need to receive lymphadenectomy, and in order to definitely evaluate the risk of recurrence by using ultra-staging or biological diagnosing method in the near future.

This study investigated the image quality using controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) to shorten the imaging time in dynamic abdominal examinations. Comparisons with the conventional generalized autocalibrating partially parallel acquisitions (GRAPPA) method were made by changing the sampling shift in CAIPIRINHA using a 3.0 T MRI. The measurements included the visual evaluation of five stages, the signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in phantom experiments. The visual evaluation (five stages) and SNR were determined using a nickel sulfate bottle phantom attached to the MRI device. Each evaluation was performed on the middle slice of the 3D image. The SNR was compared with the mean region of interest value calculated from five locations within the phantom. The CNR was determined using custommade phantoms that mimic the T1 and T2 values of the liver and spleen. In the results, at reduction factor (Rf) = 6 and 8, the SNR per unit imaging time was reduced with GRAPPA, while there was no decrease in SNR and CNR with CAIPIRINHA. By performing imaging using an appropriate sampling shift, it is possible to acquire an equivalent GRAPPA in a short period of time using CAIPIRINHA.

The present study was performed to clarify the significance of DNA methylation alterations during endometrial carcinogenesis. Genome-wide DNA methylation analysis and targeted sequencing of tumor-related genes were performed using the Infinium MethylationEPIC BeadChip and the Ion AmpliSeq Cancer Hotspot Panel v2, respectively, for 31 samples of normal control endometrial tissue from patients without endometrial cancer and 81 samples of endometrial cancer tissue. Principal component analysis revealed that tumor samples had a DNA methylation profile distinct from that of control samples. Gene Ontology enrichment analysis revealed significant differences of DNA methylation at 1034 CpG sites between early-onset endometrioid endometrial cancer (EE) tissue (patients aged ≤40 years) and late-onset endometrioid endometrial cancer (LE) tissue, which were accumulated among ‘transcriptional factors’. Mutations of the CTNNB1 gene or DNA methylation alterations of genes participating in Wnt signaling were frequent in EEs, whereas genetic and epigenetic alterations of fibroblast growth factor signaling genes were observed in LEs. Unsupervised hierarchical clustering grouped EE samples in Cluster EA (n = 22) and samples in Cluster EB (n = 12). Clinicopathologically less aggressive tumors tended to be accumulated in Cluster EB, and DNA methylation levels of 18 genes including HOXA9, HOXD10 and SOX11 were associated with differences in such aggressiveness between the two clusters. We identified 11 marker CpG sites that discriminated EB samples from EA samples with 100% sensitivity and specificity. These data indicate that genetically and epigenetically different pathways may participate in the development of EEs and LEs, and that DNA methylation profiling may help predict tumors that are less aggressive and amenable to fertility preservation treatment., Genome-wide analysis using 112 samples of endometrial tissue has revealed that genetically and epigenetically different pathways may participate in early- and late-onset endometrial carcinogenesis. DNA methylation profiling may predict tumors that are less aggressive and amenable to fertility preservation treatment.

Objective: Reports on the repeated administration of medroxyprogesterone acetate (MPA) for intrauterine recurrence after fertility-preserving therapy for atypical endometrial hyperplasia (AEH) and early grade 1 endometrioid carcinoma (G1) are lacking. We aimed to clarify the outcomes of repeated MPA therapy in cases of intrauterine recurrence after fertility-preserving therapy with MPA against AEH/early G1. Methods: Patients with AEH or stage IA well-differentiated endometrioid carcinoma without myometrial invasion who underwent first-line MPA therapy for primary lesions or intrauterine recurrence were divided into initial treatment and repeated treatment groups (162 and 82 patients, respectively). Oral MPA administration (400-600 mg/day) was continued until pathological tumor disappearance. Data regarding clinicopathological factors, adverse events, and outcomes following the initial and repeated hormonal treatments were extracted from medical records and analyzed. Results: Complete response rates in the initial and repeated treatment groups were 98.5% and 96.4%, respectively, among patients with AEH, and were 90.7% and 98.1%, respectively, among patients with G1. In the initial treatment group, 5-year recurrence-free survival (RFS) rates were 53.7% and 33.2% among patients with AEH and G1, respectively. In the repeated treatment group, RFS rates were 14.0% and 11.2% among patients with AEH and G1, respectively. Among patients with AEH, the pregnancy rate tended to be lower in the repeated treatment group than in the initial treatment group (11.1% vs. 29.2%; p=0.107), while no significant group difference was observed among patients with G1 (20.8% vs. 22.7%). Conclusion: Repeated treatment is sufficiently effective for intrauterine recurrence after hormonal therapy for AEH/early G1.

Objective Interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) is currently one of the preferred treatment options for advanced ovarian, fallopian tube or peritoneal cancer. This study was conducted to evaluate the clinical efficacy and safety of dose-dense paclitaxel plus carboplatin therapy (ddTC therapy) as NAC for these cancers. Patients and methods A retrospective study was conducted in 25 patients with Stage III/IV ovarian, fallopian tube or peritoneal cancer who received ddTC therapy as NAC. For ddTC therapy, paclitaxel (80 mg/m2) was administered intravenously on Days 1, 8 and 15 and carboplatin (AUC 6.0 mg/ml × min) was administered intravenously on Day 1 every 3 weeks. IDS was performed after three cycles of ddTC therapy, and ddTC therapy was also continued after surgery. Results With ddTC therapy as NAC, the response rate was 92% and disease progression did not occur in any patient. Grade 4 hematologic toxicity and ≥Grade 3 non-hematologic toxicity both occurred in 8% of the patients, but no patient discontinued NAC because of adverse events. When IDS was performed, the complete surgery rate was 64% and the optimal surgery rate was 96%. ≥Grade 3 perioperative complications occurred in 16% of the patients, but there were no perioperative deaths. Median overall survival was 35.7 months and median progression-free survival was 17.7 months. Conclusion This study showed that ddTC therapy was considerably effective and tolerable as NAC. The complete surgery rate was high with IDS, and perioperative complications were acceptable.

We previously reported an association between dyslipidemia and endometrial cancers. Osteoporosis is also reported to relate with some cancers. A common etiologic event has been proposed between dyslipidemia and osteoporosis. However, the pattern of interrelationships among dyslipidemia, osteoporosis and endometrial cancer is not well understood. To improve the quality of life of endometrial cancer survivors, these relationships should be determined. This study included 179 Japanese menopausal women who underwent bilateral salpingo-oophorectomy, including 114 women with incident endometrial cancer and 65 without endometrial cancer. The women were categorized according to dyslipidemia status. Bone mineral density was measured and compared between groups. Osteoporosis was statistically more frequent in women with hypertriglyceridemia who did not have endometrial cancer. In contrast, osteoporosis was statistically less frequent in women with hypertriglyceridemia who had endometrial cancer. In this cross-sectional study in a Japanese population, osteoporosis was associated with hypertriglyceridemia in post-menopausal women without endometrial cancer, but was less frequent in endometrial cancer survivors with hypertriglyceridemia.

The purpose of this study was to optimize scan parameters for evaluation of carotid plaque characteristics by k-space trajectory (radial scan method), using a custom-made carotid plaque phantom. The phantom was composed of simulated sternocleidomastoid muscle and four types of carotid plaque. The effect of chemical shift artifact was compared using T1 weighted images (T1WI) of the phantom obtained with and without fat suppression, and using two types of k-space trajectory (the radial scan method and the Cartesian method). The ratio of signal intensity of simulated sternocleidomastoid muscle to the signal intensity of hematoma, blood (including heparin), lard, and mayonnaise was compared among various repetition times (TR) using T1WI and T2 weighted imaging (T2WI). In terms of chemical shift artifacts, image quality was improved using fat suppression for both the radial scan and Cartesian methods. In terms of signal ratio, the highest values were obtained for the radial scan method with TR of 500 ms for T1WI, and TR of 3000 ms for T2WI. For evaluation of carotid plaque characteristics using the radial scan method, chemical shift artifacts were reduced with fat suppression. Signal ratio was improved by optimizing the TR settings for T1WI and T2WI. These results suggest the potential for using magnetic resonance imaging for detailed evaluation of carotid plaque.

There is poor evidence regarding effective treatment for recurrent endometrial cancer. We treated patients with recurrent endometrial cancer with docetaxel-cisplatin (DP) therapy as second-line or third-line chemotherapy. We aimed to evaluate the feasibility and efficacy of DP therapy for patients with recurrent endometrial cancer.We included 26 patients diagnosed with recurrent endometrial cancer, who underwent DP chemotherapy at our Institution. Docetaxel at 70 mg/m(2)and cisplatin at 60 mg/m(2)were administered by intravenous injection every 3 weeks. We retrospectively analyzed the clinicopathological factors associated with the response rate (RR) and prognosis. We also analyzed the adverse effects of DP therapy.Median follow-up was 33.8 months and the median number of therapy cycles was six. Grade 3 or 4 adverse effects included leukopenia (66%), neutropenia (81%), anemia (9%), diarrhea (12%), general fatigue (12%), liver dysfunction (4%), peripheral neuropathy (4%), and hyponatremia (4%). RR was 58% and the median progression-free survival (PFS) was 7.5 months. The group with a treatment-free interval of 6 months or more tended to have better PFS than that with less than 6 months (p=0.01). The group with a platinum-free interval of 6 months or more had significantly better PFS than that with less than 6 months (p=0.09). Although the history of taxane usage was not relevant to prognosis, a taxane-free interval of 12 months or more was associated with a tendency for better PFS (p=0.06).DP therapy was fully feasible and demonstrated efficacy for patients with recurrent endometrial cancer.

Introduction : Bilateral salpingo-oophorectomy (BSO) is a risk factor for osteoporosis. Previous studies have reported an association between genetic polymorphisms and the risk of developing osteoporosis. However, the relationship between osteoporosis and genetic polymorphisms in Japanese women treated with BSO is not well understood. To improve the quality of life for post-BSO patients, it is important to determine the genetic factors that influence their risk for osteoporosis. The aim of this study was to investigate the association between gene variations of estrogen metabolism-related genes and osteoporosis in surgically menopausal patients, which may improve the quality of life for surgically menopausal patients. Material and methods : This study included 203 menopausal women treated with BSO because of gynecologic disorders. One hundred and twenty-six women with artificial (surgical) menopause, who had undergone BSO in the premenopausal period, were compared with 77 women with natural menopause, who had undergone BSO in the postmenopausal period. The women were tested for bone mineral density to diagnose osteoporosis. Polymorphisms of estrogen receptor 1 ( ESR1 ) and UDP-glucuronosyl transferase (UGT) genes UGT2B17 and UGT1A1 were analyzed, and their association with bone mass and osteoporosis was statistically evaluated. Results : No significant association was found between osteoporosis and polymorphisms in ESR1 , UGT2B17 , or UGT1A1 in both groups, suggesting that BSO might be a more significant physiological factor in influencing bone mass density compared to genetic variations. Conclusions : These results suggest that the ESR1 , UGT2B17 , and UGT1A1 polymorphisms are not genetic factors affecting osteoporosis in postmenopausal Japanese women.

The VIBE method has been developed imaging also holds its breath in an abdomen, and to do three-dimensional T1WI in possible time in gradient echo sequence, and applied to dynamic study mainly and planning for time reduction using an interpolation and partial fourier. We considered the condition for imaging to do whole brain as high resolution image using VIBE. Even if base matrix was maintained when an interpolation and partial fourier were used too much excessively by Phantom experiment, the resolution of MPR image fell. There was a limit of the interpolation therefore to maintain the resolution as voxel. SNR fell by FA increase by the applicability to the head, and peak existed in about 15 degrees in CNR of white matter and gray matter. Therefore by it's clinical and optimizing the imaging condition of VIBE, whole brain, it was imaging possible in about 3 minutes as high resolution image.

Dot-like low intensity spots (a dot-like hemosiderin spot: dotHS) on T2*-weighted MR images (T2*WI), which is regarded as a sensitive method for hemosiderin detection, have been histologically diagnosed as old microbleeds associated with microangiopathies. The clinical significance of the dotHS, however, is still under debate. Therefore, we investigated the factors associated with dotHS.We investigated 209 healthy volunteers in our hospital (sex: 106 males, 103 females; age: 38 to 78 years old, mean age: 56.4 +/- 8.3 years old) using "Brain Dock", a formalized screening system for asymptomatic brain diseases. The Odds ratio (OR) was estimated from multiple logistic regression analyses using the dotHS and variables.T2*WI demonstrated dotHS in 7.7% of volunteers, and the mean number of dotHS was 0.16 +/- 0.78. The hemosiderin was preferentially deposited in the basal ganglia and thalamus. Ageor = 65 years old (OR: 5.9; 95% confidence interval [CI]: 1.4-25.9; p = 0.02), hypertension (OR: 7.0; 95% CI: 1.4-34.7; p = 0.02), and headache (OR: 5.8; 95% CI: 1.4-24.6; p = 0.02) were all found to be independently associated with dotHS.The dotHS was significantly associated with several factors, including age, hypertension and headache.

Cerebral fat embolism (CFE) is serious complication of a long-bone fracture. We reported magnetic resonance (MR) diffusion-weighted (DWI) and fluid attenuated inversion recovery (FLAIR) images in a patient suffered with CFE. A 26-year-old man with a right femoral bone fracture lapsed into a semicoma eight hours later. Eighteen hours after the depressed consciousness, DWI and FLAIR images on MR imaging showed multiple high-intensity spots in corona radiata, basal ganglia, thalamus, corpus callosum, brain stem and cerebellum. Thereby, he was diagnosed as CFE. These multiple lesions were more detectable on FLAIR images than DWI, particularly in posterior fossa. Eight days after the onset, follow-up DWI, FLAIR, and T 2-weighted MR image (T 2 WI) showed most of the lesions disappeared or shrunk. The resolution of the lesions suggests that most of the lesions were brain edema as a result of the unique pathophysiological condition of CFE. The remained lesions were diagnosed as cerebral infarctions. The consciousness of the patient improved alert. Three months later, follow-up MRI showed almost complete resolution of the abnormal intensities. Follow up DWI and FLAIR images observed in the patient indicated that many small lesions occurs throughout the whole brain without a preferential region, and many of the lesions can subside or attenuate in CFE.