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The physical function of older patients with heart failure (HF) is likely to decline, and the Short Physical Performance Battery (SPPB) is widely used for its evaluation. No study has analyzed the SPPB by using Rasch model in these patients. The aim of this study was to examine the structural validity and item response of the SPPB in older inpatients with HF.In this multicenter cross-sectional study, we investigated 106 older inpatients with HF. We evaluated the SPPB's rating scale structure, unidimensionality, and measurement accuracy (0 = poor performance to 4 = normal performance).The SPPB rating scale fulfilled the category functioning criteria. All items fit the underlying scale construct. The SPPB demonstrated adequate reliability (person reliability = 0.81) and separated persons into four strata: those with very low, low, moderate, and high physical performance. Item-difficulty measures were -0.59 to 0.96 logits, and regarding the person ability-item difficulty matching for the SPPB, the item was somewhat easy (the mean of person ability = 0.89 logits; mean of item difficulty = 0.00).The SPPB has strong measurement properties and is an appropriate scale for quantitatively evaluating physical function in older patients with HF.For older adults with heart failure (HF), the Short Physical Performance Battery (SPPB) is often used to measure physical performance.Rasch analysis revealed that SPPB had strong measurement properties in older adults with HF.This result may help rehabilitation professionals use the SPPB as a physical performance scale in clinical practice to aid decision-making in intervention planning.

Objective To determine the minimal clinically important difference between the Berg Balance Scale and comfortable walking speed in acute-phase stroke patients. Design Multicenter, prospective, longitudinal study. Setting Inpatient acute stroke rehabilitation. Subjects Seventy-five patients with acute stroke, mean (SD) age 71.7 (12.2) years. Intervention Inpatients with acute stroke were assessed with the Berg Balance Scale and comfortable walking speed before and after rehabilitation. Physiotherapy was conducted to improve balance and gait over a 2-week period: an average of 40 min/day on weekdays and 20 min/day on weekends and holidays. Main measures The patients’ Berg Balance Scale, comfortable walking speed, Global Rating of Change scale (patient-rated and physiotherapist-rated), and motor score of the Functional Independence Measure were obtained. Minimal clinically important differences were estimated using both anchor- (receiver operating characteristic curves and change difference) and distribution-based approaches (minimal detectable change and 0.5× the change score [SD]). Results The baseline scores were 31.2 (18.9) for the Berg Balance Scale and 0.79 (0.35) m/s for comfortable walking speed. The minimal clinically important difference in the Berg Balance Scale was 6.5–12.5 points by the anchor-based approach and 2.3–4.9 points by the distribution-based approach. The minimal clinically important difference in comfortable walking speed was 0.18–0.25 m/s by the anchor-based and 0.13–0.15 m/s by the distribution-based approach. Conclusions A change of 6.5–12.5 points in the Berg Balance Scale and 0.18–0.25 m/s in the comfortable walking speed is required in these measurements’ anchor-based minimal clinically important differences to be beyond measurement error, and to be perceptible by both patients and clinicians.

[Purpose] To clarify the relationship between lower extremity function and activities of daily living and characterize lower extremity function in hospitalized middle-aged and older adults with subacute cardiovascular disease. [Participants and Methods] The Short Physical Performance Battery, 6-minute walk distance, and functional independence measure tests were conducted in 79 inpatients with subacute cardiovascular disease (mean age, 76.7 ± 11.9 years; 34 females). Multiple regression analysis used the functional independence measure score as the dependent variable and the Short Physical Performance Battery and 6-minute walk distance scores as independent variables. Cross-tabulations were performed for each age group, and patients who performed the Short Physical Performance Battery and 6-minute walk distance tests were divided into two groups by their respective cutoff values. [Results] Only the Short Physical Performance Battery (β=0.568) and 6-minute walk distance (β=0.479) scores were adopted as significant independent variables in each multiple regression model. The age75 years group had the most patients with both good lower extremity function and aerobic capacity, whereas the age ≥75 years group had the most patients with both functions impaired. [Conclusion] Although cardiovascular disease is generally associated with decreased aerobic capacity, many older patients with cardiovascular disease in this study had decreased lower extremity function, too.

There is insufficient evidence regarding the minimal clinically important difference (MCID) of the Mini-Balance Evaluation Systems Test (Mini-BESTest).To determine the MCID of the Mini-BESTest in patients with early subacute stroke.In this prospective cohort study, the Mini-BESTest score of 50 patients with stroke was obtained within 1 week of their admission, their Mini-BESTest and Global Rating of Change Scale (GRCS) scores were obtained at discharge. The GRCS scores were reported by both the patients and their physical therapists. We evaluated the correlation between the Mini-BESTest change scores and the GRCS by determining Spearman's rank correlation coefficient. The MCID was calculated using 0.5× standard deviation (SD) for the distribution method and the change difference and receiver operating curve (ROC) for the anchor method.The mean (SD) number of days between evaluations was 15.4 (4.8), and the Mini-BESTest score at admission was 17.7 (5.2) and 23.1 (3.5) at discharge. The correlation between the GRCS and the change in the Mini-BESTest score was 0.28 (p = .04) for the patients and 0.54 (p .001) for the therapists. The MCID based on the distribution method was 3 points for 0.5× SD. The MCID values based on the anchor method were 2.3 for the change difference and 0.5 for the ROC in the patient-rated GRCS, and 4.2 for the change difference and 4.5 for the ROC in the physical therapist-rated GRCS.The MCID based on the anchor method was 4.2-4.5 points, and the MCID based on the distribution method was 2.3 points.

A 45-year-old woman underwent primary systemic therapy for left breast cancer(cT1N1M0, cStage ⅡA, Luminal B [HER2-positive]). She received EC therapy(epirubicin 90mg/m2, and cyclophosphamide 900mg/m2). On the 4th and 5th day of the third EC cycle, she developed sore throat and a fever of over 38℃, and was not able to consume anything orally. She visited our hospital and underwent a laryngeal endoscopy on the 8th day of the third EC cycle, which revealed severe inflammation of her pharynx and larynx. Viral pharyngolaryngitis was suspected and hence, she was admitted to our hospital. She developed laryngeal edema after hospitalization, for which hydrocortisone was administered. She was discharged from the hospital when her symptoms improved.

Purpose To compare the reader performance of artificial intelligence computer-aided detection synthesized mammograms (AI CAD SM) with that of digital mammograms (DM) when used alone or in combination with digital breast tomosynthesis (DBT) images. Materials and methods This retrospective multireader (n = 4) study compared the reader performances in 388 cases (84 cancer, 83 benign, and 221 normal or benign cases). The overall accuracy of the breast-based assessment was determined by four radiologists using two sequential reading modes: DM followed by DM + DBT; and AI CAD SM followed by AI CAD SM + DBT. Each breast was rated by each reader using five-category ratings, where 3 or higher was considered positive. The area under the receiver-operating characteristic curve (AUC) and reading time were evaluated. Results The mean AUC values for DM, AI CAD SM, DM + DBT, and AI CAD SM + DBT were 0.863, 0.895, 0.886, and 0.902, respectively. The mean AUC of AI CAD SM was significantly higher (P P = 0.094). A significant reduction in the reading time was observed after using AI CAD SM + DBT when compared with that after using DM + DBT (P Conclusion AI CAD SM + DBT might prove more effective than DM + DBT in a screening setting because of its lower radiation dose, noninferiority, and shorter reading time compared to DM + DBT.

Background It remains unclear whether original full-field digital mammograms (DMs) can be replaced with synthesized mammograms in both screening and diagnostic settings. To compare reader performance of artificial intelligence computer-aided detection synthesized mammograms (AI CAD SMs) with that of DM alone or in combination with digital breast tomosynthesis (DBT) images in an experimental setting. Methods We compared the performance of multireader (n = 4) and reading multicase (n = 388), in 84 cancers, 83 biopsy-proven benign lesions, and 221 normal or benign cases with negative results after 1-year follow-up. Each reading was independently interpreted with four reading modes: DM, AI CAD SM, DM + DBT, and AI CAD SM + DBT. The accuracy of probability of malignancy (POM) and five-category ratings were evaluated using areas under the receiver operating characteristic curve (AUC) in the random-reader analysis. Results The mean AUC values based on POM for DM, AI CAD SM, DM + DBT, and AI CAD SM + DBT were 0.871, 0.902, 0.895, and 0.909, respectively. The mean AUC of AI CAD SM was significantly higher (P = 0.002) than that of DM. For calcification lesions, the sensitivity of SM and DM did not differ significantly (P = 0.204). The mean AUC for AI CAD SM + DBT was higher than that of DM + DBT (P = 0.082). ROC curves based on the five-category ratings showed similar proximity of the overall performance levels. Conclusions AI CAD SM alone was superior to DM alone. Also, AI CAD SM + DBT was superior to DM + DBT but not statistically significant.

BACKGROUND: The Brief-Balance Evaluation Systems Test (Brief-BESTest) has the potential to be used effectively for interventions on specific balance components. However, it has not been utilized for acute stroke cases. OBJECTIVE: This study determined the characteristics of the distribution of the Brief-BESTest scores of patients who suffered acute stroke and examined its relationship with physical function and activities of daily living ability. METHODS: The Brief-BESTest, sub-items of Stroke Impairment Assessment Set (SIAS), and Functional Independence Measure (FIM) were conducted among 41 hospitalized acute stroke patients (71.3±9.5 years, 32 males). The skewness of the Brief-BESTest and Spearman’s rank correlation (ρ) between Brief-BESTest, SIAS, and FIM were analyzed. RESULTS: The skewness of the total score of the Brief-BESTest was -0.038. There were no ceiling or floor effects. The total score of the Brief-BESTest had a weak positive correlation with the SIAS lower extremity motor function (ρ= 0.457) and muscle tone (ρ= 0.374), and the total score on FIM (ρ= 0.365). Each sub-item of the Brief-BESTest was associated with different physical functions. CONCLUSIONS: The Brief-BESTest was unaffected by floor and ceiling functions among hospitalized acute stroke patients, and different physical functions were associated with each balance component.

Objective: This study aimed to elucidate the therapeutic effects of intra-articular administration of ultra-purified low endotoxin alginate (UPLE-alginate) on osteoarthritis (OA) using a canine anterior cruciate ligament transection (ACLT) model. Design: We used 20 beagle dogs. ACLT was performed on the left knee of each dog and a sham operation was performed on the right knee as a control. All animals were randomly divided into the control (saline) and therapeutic (UPLE-alginate) groups. Animals in the control and therapeutic groups received weekly injections with 0.7 mL normal saline or 0.7 mL 0.5% UPLE-alginate, respectively, from 0 to 3 weeks after ACLT or sham operation. At 9 weeks after ACLT, the knee joints of all animals were observed using arthroscopy. All animals were euthanized at 14 weeks after ACLT and evaluated using morphologic assessment, histologic assessment, and biomechanical testing. Results: Arthroscopic findings showed intact cartilage surface in both groups. Morphologic findings in the therapeutic group showed milder degeneration compared with those of the control group, but there were no significant differences between groups. Histologic scores of the medial femoral condyle (MFC) and lateral femoral condyle (LFC) were better in the therapeutic group than the control group (MFC: p = 0.009, LFC: p = 0.009). Joint lubrication did not differ significantly between groups. Conclusion: Intra-articular administration of UPLE-alginate in the early stage of OA slowed disease progression in canines. UPLE-alginate may have potential as a therapeutic agent for OA patients and reduce the number of patients who need to undergo total joint arthroplasty. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 3441–3448, 2015.

Aneurysm or pseudoaneurysm formation in the aortic patch containing the intercostal or visceral arteries is an unusual late complication after thoracoabdominal aortic surgery. We report the case of a 58-year-old woman who had previously undergone thoracoabdominal aortic replacement (Crawford extent II) for dissecting aneurysm. About 12 months after the operation repeated pseudoaneurysmal degenerations occurred at the intercostal or visceral artery reattachment site. They were repaired with open surgery or endovascular stent-graft. The patient recovered without major complications, and computed tomographic scans showed no recurrence of aneurysm or pseudoaneurysm at the sites of repair 1 year after the procedure.

The objective of this study was to determine whether the local administration of stromal cell-derived factor-1 (SDF-1) using ultrapurified alginate gel (UPAL gel) could improve reparative tissues of osteochondral defects compared with those without treatment. For the investigation, a full-thickness osteochondral defect 4.5 mm in diameter and 3 mm in depth was created in the patella groove of the distal femur in rabbits. Local expression of SDF-1 protein was temporarily upregulated at 1 week after creating the osteochondral defect. The local administration of SDF-1 enhanced the migration of host cells, mainly bone marrow stromal cells (BMSCs), to the site of the osteochondral defect. In vitro cell migration assay supported this result. In the SDF-1 (UPAL gel containing SDF-1) treatment group, the histological scores and the compressive modulus of reparative tissues were significantly improved compared with the no-treatment and vehicle (UPAL gel without SDF-1) groups. On the other hand, SDF-1 did not influence the cellular proliferation and chondrogenesis of BMSCs. Based on the results obtained here, we speculate that SDF-1 enhances the reparative process of osteochondral injuries not through direct effects on the behavior of host cells, but through increased migration of host cells to the injured site. UPAL gel, as a vehicle material, may play an important role in chondrogenesis of recruited cells, mainly BMSCs. The cell-free approach with local administration of SDF-1 may be an effective strategy for developing a minimally invasive technique for cartilage tissue regeneration.

We developed an ultra-purified in situ forming gel as an injectable delivery vehicle of bone marrow stromal cells (BMSCs). Our objective was to assess reparative tissues treated with autologous BMSCs implanted using the injectable implantation system into osteochondral defects in a canine model. Forty-eight osteochondral defects in the patella groove of the knee joint were created in 12 adult beagle dogs (two defects in each knee). The defects were divided into a defect group (n = 16), an acellular novel material implantation (material) group (n = 16), and a BMSCs implantation using the current vehicle system (material with BMSCs) group (n = 16). The reparative tissues at 16 weeks postoperatively were assessed through gross, histological, and mechanical analyses. The reparative tissues of the material with BMSCs group were substituted with firm and smooth hyaline-like cartilage tissue that was perfectly integrated into the host tissues. This treatment group obviously enhanced the subchondral bone reconstruction. The compressive modulus of the reparative tissues was significantly higher in the material with BMSCs group than the other groups. This study demonstrated that the implantation of BMSCs using our novel in situ forming material induced a mature hyaline-like cartilage repair of osteochondral defects in a canine model.

Objective: We have developed an ultrapurified low endotoxin alginate (UPLE alginate), which can drastically reduce endotoxin levels. Our purposes were to examine the effects of UPLE alginate administration on osteoarthritis (OA) progression and to determine the adequate molecular weight of the UPLE alginate for therapeutic effects. Design: To induce knee OA, 35 Japanese White rabbits underwent anterior cruciate ligament transection. Intra-articular injections of 0.3 mL solution of each material were started at 4 weeks postoperatively for a total of 5 weekly injections. Seventy knees were divided into the following groups: AL430 (430 kDa molecular weight UPLE alginate), AL1000 (1,000 kDa), AL1700 (1,700 kDa), HA (hyaluronan), and NS (normal saline). At 9 weeks postoperatively, all knees were assessed macroscopically, histologically, and mechanically. Results: Macroscopically, the UPLE alginate groups exhibited milder cartilage degradation compared to that of the NS and HA groups. Histological findings of the UPLE alginate groups showed an obvious reduction in the severity of OA. The histological scores of Kikuchi et al. were superior in the alginate treatment groups compared to the NS group. The friction coefficient of the AL1000 group was significantly lower than that of the NS and HA groups. Conclusion: This study indicates that our UPLE alginates, especially AL1000, have promising potential as an effective agent in preventing OA progression.

An ideal scaffold material is one that closely mimics the natural environment in the tissue-specific extracellular matrix (ECM). Therefore, we have applied hyaluronic acid (HA), which is a main component of the cartilage ECM, to chitosan as a fundamental material for cartilage regeneration. To mimic the structural environment of cartilage ECM, the fundamental structure of a scaffold should be a three-dimensional (3D) system with adequate mechanical strength. We structurally developed novel polymer chitosan-based HA hybrid fibers as a biomaterial to easily fabricate 3D scaffolds. This review presents the potential of a 3D fabricated scaffold based on these novel hybrid polymer fibers for cartilage tissue engineering.

74歳女性，両側性乳腺アポクリン癌の症例を経験した．右C領域に1.8cmの腫瘤を認め，穿刺吸引細胞診にて悪性であったため，右乳房円状部分切除術+センチネルリンパ節生検を施行した．病理所見は非浸潤性アポクリン癌で，リンパ節転移なし，ER(－)PgR(－)，HER2:3+であった．右乳癌手術1年後の超音波検査にて左CA領域に低エコー腫瘤影を認め，針生検にてアポクリン癌と推定した．MRIにて乳管内進展像をみとめ，左単純乳房切除術+センチネルリンパ節生検を施行した．病理結果はアポクリン癌，リンパ節転移なし，ER(－)PgR(－)，HER2:1+であった．術後9カ月経過するが再発は認めていない．乳腺アポクリン癌は比較的まれな疾患であるが，われわれの調べる限り両側性の報告は本症例が2例目であり，きわめて稀少なものと思われた．

In this study, we successfully developed two types of volume-reduced three-dimensional scaffolds, including cushion- and cylinder-shape scaffolds, fabricated from chitosan-based hyaluronic acid hybrid polymer fibers. Using these scaffolds combined with a bioreactor system, we regenerated histologically and mechanically mature cartilage constructs. The final goal of this study was to clarify the ability of this engineered cartilage construct to induce cartilage repair in osteochondral defects. The mature cartilage constructs regenerated with two types of scaffolds were implanted into 5-mm diameter osteochondral defects in the patellar groove of rabbits. At 12 weeks after implantation, the reparative tissues consisted of hyaline-like cartilage with evidence of stable fusion to adjacent native cartilage and normal reconstitution of subchondral bone. The histological score of these tissues significantly outranked the value of untreated tissue. Biomechanically, compression modulus of reparative tissue at 12 weeks postoperatively was comparative to that of normal articular cartilage. Our results indicate that the implantation of constructs with mature cartilage have potential as a better approach for joint resurfacing.

This study aimed to elucidate the therapeutic effects of intra-articular administration of ultra-purified low endotoxin alginate (UPLE-alginate) on osteoarthritis (OA) using a canine anterior cruciate ligament transection (ACLT) model.We used 20 beagle dogs. ACLT was performed on the left knee of each dog and a sham operation was performed on the right knee as a control. All animals were randomly divided into the control (saline) and therapeutic (UPLE-alginate) groups. Animals in the control and therapeutic groups received weekly injections with 0.7 mL normal saline or 0.7 mL 0.5% UPLE-alginate, respectively, from 0 to 3 weeks after ACLT or sham operation. At 9 weeks after ACLT, the knee joints of all animals were observed using arthroscopy. All animals were euthanized at 14 weeks after ACLT and evaluated using morphologic assessment, histologic assessment, and biomechanical testing.Arthroscopic findings showed intact cartilage surface in both groups. Morphologic findings in the therapeutic group showed milder degeneration compared with those of the control group, but there were no significant differences between groups. Histologic scores of the medial femoral condyle (MFC) and lateral femoral condyle (LFC) were better in the therapeutic group than the control group (MFC: p = 0.009, LFC: p = 0.009). Joint lubrication did not differ significantly between groups.Intra-articular administration of UPLE-alginate in the early stage of OA slowed disease progression in canines. UPLE-alginate may have potential as a therapeutic agent for OA patients and reduce the number of patients who need to undergo total joint arthroplasty.

Purpose: To investigate the feasibility of 3-dimensional rotational digital subtraction angiography (3D DSA) and the creation of virtual angioscopic images from its data before and after endovascular treatment. Technique: Data sets from 3D DSA studies were used to create intraluminal images simulating angioscopy for 36 patients with arterial stenosis, aneurysm, or endoleak after stent-graft deployment. A biplanar DSA unit was used to acquire rotational angiography data, which was then processed with a surface-rendering technique to create maximum intensity projections, shaded surface displays, multiplanar reconstructions, and virtual angioscopy. 3D reconstructions were created in 2 minutes after angiography and provided realistic views adequate for vessel measurement, morphology assessment, and endoleak evaluation. Conclusions: 3D DSA and virtual angioscopy are novel techniques that have been successful in recreating images of blood vessels immediately after angiography. These techniques could be useful as additional imaging modalities to complement computed tomography or magnetic resonance imaging in the evaluation of vascular diseases after endovascular therapy.

We report herein a 5-year survivor after the resection of peritoneal metastases from pedunculated hepatocellular carcinoma (HCC). A 42-year-old man underwent lateral segmentectomy of the liver, with a diagnosis of pedunculated HCC, on October 10, 1994. The lesion was associated with intratumoral hemorrhage and was covered by the greater omentum, but there were no peritoneal metastases. The patient was readmitted to our hospital 4 months later with right upper quadrant pain. His serum alpha-fetoprotein level was 3ng/dl. Hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (HCV-Ab) were both negative. Abdominal computed tomography (CT) revealed two nodular lesions in the right upper abdominal cavity. He was diagnosed with peritoneal metastases from HCC. Because there were no other distant metastases, laparotomy was performed to resect these tumors. We found two other tumors, located in the mesentery of the appendix and ileum. All four tumors were resected by partial transverse colectomy and appendectomy. The histopathology of the tumors showed poorly differentiated HCC (Edmondson-Steiner's grade III). The patient has been doing well without recurrent disease for more than 5 years after the second operation. The prognosis of patients with pedunculated HCC is poor. Furthermore, resection for peritoneal metastases from HCC is rare because of the presence of multiple seeding in the abdominal cavity and distant organ metastases. To our knowledge, our patient is the longest survivor after resection of peritoneal metastases from pedunculated HCC.

OBJECTIVE To evaluate the estrogenic effect of tamoxifen (TAM) therapy in postmenopausal women. STUDY DESIGN The subjects were 26 postmenopausal women. The maturation index (MI), maturation value (MV) and karyopyknotic index (KPI) were evaluated based on hormonal cytology. Endometrial cytologic examinations and transvaginal ultrasonography were also performed. RESULTS Of the 26 patients, 16 had low estrogenic activity from the viewpoint of hormonal cytology before TAM administration. During administration, their mean MV rose significantly, from 25.8 +/- 17.7 to 68.8 +/- 13.2, (mean +/- SD) and their mean KPI rose from 9.0 +/- 8.3 to 47.1 +/- 23.1. In contrast, among the 10 patients with high estrogenic activity, mean MV and KPI decreased from 62.9 +/- 8.4 and 27.2 +/- 16.9 to 58.4 +/- 7.7 and 17.7 +/- 16.1, respectively, with TAM administration. Mean endometrial thickness increased more significantly with TAM administration in the low estrogenic activity group than in the high estrogenic activity group. CONCLUSION TAM had a reciprocal effect; no additional estrogenic effect was seen in patients with high estrogenic activity. Conversely, an estrogenic effect was seen in those with low estrogenic activity. An individualized gynecologic evaluation based on hormonal cytology is useful in selecting patients who will be more susceptible to TAM-induced endometrial abnormality.

The E Z - selectivities in the [2,3]-Wittig rearrangements of secondary β-(methyl or silyl)allylic ethers are shown to depend critically on the nature of groups on the carbanion terminus, thereby permitting elucidation of the structural requirements for attaining high Z-selectivity.

Breath-hold 2D phase-contrast (PC) cine MR angiography with a phased-array coil and 2D time-of-flight (TOF) MR angiography were performed in the renal arteries and their findings were compared. Breath-hold 2D thin slice PC and TOF MR angiography were performed in 10 normal volunteers for renal arteries. A PC technique with k-space segmentation was utilized with the phased-array coil. A PC technique provided visualization of the renal artery more distally than a TOF technique (4.8 +/- 0.5 cm vs. 3.7 +/- 0.8 cm). With cardiac triggering, distal renal arteries were well demonstrated in PC MR angiography. On PC images, up- or downward movements of the mid to distal renal arteries with aortic pulsatility were recognized. The quality of the images was better with the PC than with the TOF technique (3.4 vs. 2.7). The mid to distal portions of the renal arteries translationally move with aortic pulsatility. To consistently visualize and evaluate them on MR angiography, cardiac triggering might be required to reduce the effects of pulsatile motions of the renal artery in the use of a phased-array coil.

1984～1993年の10年間に香川医科大学附属病院で治療された子宮体癌68例中, 術中腹膜細胞診施行例は47例であり, うち5例 (10.6%) が陽性であった. これを臨床進行期1期のみについてみると, 腹膜細胞診陽性例は41例中4例 (9.8%) であった. ただし, この中には手術進行期分類IIIの1例が含まれていた. 腹膜細胞診陽性例は, 腺扁平上皮癌, 未分化腺癌や推計学的有意差はなかったものの子宮筋層浸潤の深いものとの関連が示唆された. 腹膜細胞診陽性5例中1例は, 細胞形態学的に悪性細胞と判別できたものの子宮体癌由来と診断することは難しい細胞像を呈していた.術前に子宮鏡診を施行した46例中, わずか4例のみが腹膜細胞診陽性であった.

The purpose of this article is to determine the effectiveness of MRI for visualizing spiculated breast cancer lesions that were previously identified using mammography and to compare the diagnostic quality of 3- and 1.5-T dynamic MRI by assessing the visualization of spiculation in such lesions.One hundred twenty MRI studies of breast cancers clearly identified as spiculated masses using mammography (71 MRI studies at 3 T that included both bilateral axial and unilateral sagittal images and 49 MRI studies at 1.5 T that included bilateral axial images only) were independently reviewed by three radiologists. The three different radiologists scored the visualization of the spiculation with respect to 3-T sagittal, 3-T axial, or 1.5-T axial images.The diagnostic quality of sagittal 3-T dynamic MRI studies, as determined by assessing the visualization of spiculation, was significantly better than that of axial 3-T (p = 0.009) and 1.5-T (p = 0.004) studies. For small (1 cm) lesions, the diagnostic quality of sagittal 3-T studies determined by assessing the visualization of spiculation was significantly better than that of axial 1.5-T studies (p = 0.029).Unilateral sagittal in-plane and through-plane high-spatial-resolution 3-T images can offer particularly higher spatial resolution for improved assessment of spiculation than do axial in-plane high-spatial-resolution images obtained at 1.5 and 3 T.

The TiCl4-promoted reaction of (4S, 6S)-(4,6-dimethyl-1,3-dioxan-2-yl)tributylstannane with Grignard reagents is shown to afford, after oxidation followed by base treatment, the (S)-α-hydroxystannanes in >95∼20% ee.

The [1,2]-Wittig rearrangements of enantio-defined α-benzyloxypropyllithium and its (R)-α-methylbenzyloxy analogs, generated from the enantio-enriched stannanes via Sn / Li exchange, are shown to proceed predominantly with inversion of configuration at the Li-bearing terminus and retention of configuration at the migrating center, and exhibit a significant level of mutual enantiomer recognition in the radical recombination process.

Ytterbium (Yb) doped glass is expected as next generation high-performance solid laser material. However, the laser glasses have a problem that the ions-doping-concentration is much lower than crystals. In this study, we make highly-doped Ytterbium-ions glasses (YbF 3 -BaF 2 -AlF 3 -GeO 2 , YbBAG), and succeeded laser oscillations of 20 mol.% Ytterbium-ions glass. The highly-doped Ytterbium-ions glasses are much suitable for short-fiber or waveguide lasers.

The [1,2]-Wittig rearrangements of enantio-defined α-benzyloxypropyllithium and its (R)-α-methylbenzyloxy analogs, generated from the enantio-enriched stannanes via Sn / Li exchange, are shown to proceed predominantly with inversion of configuration at the Li-bearing terminus and retention of configuration at the migrating center, and exhibit a significant level of mutual enantiomer recognition in the radical recombination process.