ABSTRACT
Breast cancer is one of the leading causes of cancer globally. Radiotherapy following breast-conserving surgery is the standard treatment of breast cancer. Recently, hypofractionated irradiation comprising 42.56 Gy in 16 fractions was selected as a viable radiation therapeutic option. Radiation-induced sarcoma is the most prevalent secondary malignancy in patients undergoing radiotherapy after breast cancer surgery. Angiosarcomas are the predominant type of radiation-induced sarcomas, whereas liposarcomas have rarely been reported. The present report details an uncommon instance of radiation-induced pleomorphic liposarcoma that occurred 8 years after breast-conserving surgery and hypofractionated radiotherapy. The patient visited the hospital due to hardening of the tissue beneath the skin of the right breast. Ultrasonography revealed a hypoechoic mass in the lower part of the right breast containing internal blood flow. An excisional biopsy revealed that the tumor contained infiltrating spindle-shaped cells without a capsule containing pleomorphic cells. Lipoblasts were also observed and tended to differentiate into adipose tissue, leading to a diagnosis of pleomorphic liposarcoma. Immunostaining revealed negativity for cytokeratin AE1/AE3, ERG, MDM2 and S-100 protein; the Ki-67 index was ~20%. An enlargement resection involving a postoperative bed was performed because of close tumor margins. 18F-fluorodeoxyglucose positron emission tomography/computed tomography revealed pale accumulation of 18F-fluorodeoxyglucose in the right chest wall, which was interpreted as a postoperative change owing to the resection biopsy. The tumor was observed in the irradiated field with no distant metastases. Following extensive resection, the patient maintained a recurrence-free survival period of 3 years and 2 months, during which no adjuvant therapy was administered. Therefore, follow-up is necessary in patients with breast cancer treated with radiotherapy.
ABSTRACT
East China Sea (ECS) is considered one of the largest dissolved oxygen (DO) depleted areas in the world's oceans. To assess the relative importance of water sources and biological processes to modulate low DO water over the ECS shelf, we conducted 7 cruises in the summers between 2004 and 2015. To cover a broad study area, observations were taken by both Chinese and Japanese research vessels in 2013, the consistent DO values were obtained in the intercalibration station from China and Japan. The subsurface/bottom water DO depletion was observed over both the inner and mid-outer shelves. In 2009 and 2013, the low DO (3-4.2 mg L-1) area covered ca. 4 × 104 km2 on the mid-outer shelf, comparable with the reported area of summer hypoxia off the Changjiang estuary. On the basis of a seven endmember mixing model using heavy rare earth elements, temperature and salinity data collected in 2013 and 2015, we determined that on the southern shelf the low DO water mainly originated from Kuroshio Subsurface Water (28-72%). Both the DO level in the dominant source water and organic matter (OM) remineralization modulated the formation and expansion of low DO waters. Oxygen-depleted bottom waters featured with high nutrients were both transported from the water's source regions and produced by OM remineralization on the mid-outer shelf. The estimated regenerated nutrient fluxes derived from OM respiration in the bottom water of the mid-outer shelf were equivalent to 18-37% of the nitrate and nitrite, and 2 to 5-fold the phosphorus, delivered from the Changjiang River in summer. The large quantity of regenerated nutrients from oxygen-depleted bottom waters on the mid-outer shelf could be utilized and support primary production in the adjacent oceans. Our findings provide valuable observation for simulation models of nutrient cycles and budgets in the ECS and adjacent oceans.
Subject(s)
Estuaries , Oxygen , China , Nutrients , Oxygen/analysis , Rivers , WaterABSTRACT
Some skin adnexal tumors display both epithelial and myoepithelial cell populations and can be broadly categorized as biphasic tumors. These include apocrine hidrocystoma, mixed tumor, adenomyoepithelioma (AME), and adenoid cystic carcinoma (ACC). Myoepithelioma is the myoepithelial cell-predominant type in this category. Cutaneous AME is exceedingly rare and usually has a benign prognosis, but it is considered to have the potential for local recurrence and metastasis. We report the case of a 57-year-old man with a 1-year history of an ulcerated nodule on his scalp. Microscopically, it was a defined cutaneous nodule with a focal lobulated architecture, composed of epithelial cells forming ducts and myoepithelial cells distributed around the ducts. In addition to these findings of typical AME, the present case focally revealed atypical features, such as increased mitotic activity (7/10 high power fields), invasive growth, and necrosis. However, cytological atypia was not significant. We conclusively diagnosed cutaneous AME with atypical features, suggesting malignant potential. Moreover, areas showing appearances similar to apocrine hidrocystoma, mixed tumor, myoepithelioma, and ACC were focally observed. We present a unique case of cutaneous AME exhibiting histopathological heterogeneity. The recognition of morphological variation could be helpful in appropriately diagnosing and treating AME of the skin.
Subject(s)
Adenomyoepithelioma/pathology , Head and Neck Neoplasms/pathology , Scalp/pathology , Skin Neoplasms/pathology , Adenomyoepithelioma/diagnosis , Head and Neck Neoplasms/diagnosis , Humans , Male , Middle Aged , Skin Neoplasms/diagnosisABSTRACT
Steep oceanic ridges and tidal currents in the Luzon Strait generate some of the world's strongest turbulent mixing. To evaluate the impacts of the turbulence intensity on the marine ecosystem, we carried out measurements of microstructure turbulence and biogeochemical hydrography along 21°N in the Luzon Strait during the R/V Hakuho Maru cruise, KH-17-5-2, in November 2017. We found a turbulent kinetic energy dissipation rate exceeding O(10-7) W kg-1 and vertical eddy diffusivity exceeding O(10-3) m2 s-1, two orders of magnitude larger than those in the open ocean, above a shallow sub-ridge on the eastern ridge of the Luzon Strait. In addition, a clear chlorophyll a bloom was identified in the surface layer above the sub-ridge from in situ measurements and satellite observations. High values of nitrate (4.7 mmol N m-2 d-1) and phosphate (0.33 mmol P m-2 d-1) fluxes estimated near the base of the surface chlorophyll a bloom strongly suggest that enhanced turbulent mixing promotes nutrient supply to the euphotic zone and generates new production within the surface layer, contributing to the formation of a quasi-permanent local chlorophyll a bloom north of Itbayat Island on the eastern ridge.
ABSTRACT
Mitral cells are the major projection neurons of the olfactory bulb. They receive olfactory inputs, regulate information, and project their axons to the olfactory cortex. To understand output regulation of mitral cells better, we established a method to visualize individual projection neurons and quantitatively examined their synaptic distribution. Individual mitral cells were labeled by viral injection, reconstructed three dimensionally with light microscopy, and serial sectioned for electron microscopy. Synaptic distributions were analyzed in electron microscopically reconstructed cell bodies, two regions of secondary dendrites (near the somata and â¼200 µm from the somata), and primary dendrites. The ratio of presynaptic sites (60%) and reciprocal synapses (60% presynaptic and 80% postsynaptic sites) were similar in each region. Characteristically, primary dendrite synapses were distributed mainly within the inner half of the external plexiform layer (EPL). For comparison, tufted cells were also examined, and the synaptic distribution in two secondary dendrite regions, which corresponded with mitral cells, was analyzed. The results showed that the ratio of reciprocal synapses (80% presynaptic and 90% postsynaptic sites) was greater than in mitral cells. The distribution of symmetrical synapses was also analyzed with synaptic and neuronal markers, such as parvalbumin, vesicular gamma-aminobutyric acid transporter, and gephyrin. Parvalbumin-expressing neurons tended to form synapses on secondary dendrites near the somata and were more uniformly distributed on primary dendrites of mitral cells. These results indicate that local mitral cell synaptic circuits are formed in accordance with their functional roles and restricted to the inner half of the EPL. J. Comp. Neurol. 525:1633-1648, 2017. © 2016 Wiley Periodicals, Inc.
Subject(s)
Olfactory Bulb/ultrastructure , Olfactory Nerve/ultrastructure , Synapses/ultrastructure , Animals , Female , Imaging, Three-Dimensional , Immunohistochemistry , Male , Mice , Mice, Inbred C57BL , Microscopy, Confocal , Microscopy, Electron, TransmissionABSTRACT
The "Cancer Chemotherapy and its Management" subcommittee at the Ehime Cancer Care Network Priority Hospitals (Ehime Cancer Kyoten Hospitals)with a focus on medical expenses associated with chemotherapy, surveyed awareness among 98 clinicians regarding certifications of eligibility for Limited Health Insurance Payments during cancer treatment. This committee also lists social and clinical problems encountered at the Ehime Cancer Care Network Priority Hospitals. In our survey, 78% of clinicians were consulted about medical expenses associated with chemotherapy and were actively involved in resolving medical expense problems and resulting correspondences. However, only 38% of clinicians could explain the details of the Japanese guideline on the catastrophic cap and the certifications of eligibility for Limited Health Insurance Payments. This knowledge deficit was more pronounced in younger residents. From our analyses of the awareness about medical expenses among clinicians, we recommend the establishment of the following systems for the management of cancer patients. First, establish a reporting system and early consultation on the catastrophic cap and the certifications of eligibility before initiating cancer treatment. Second, education regarding medical expenses should be mandatory for clinicians, especially for young residents. Third, patients with cancer suffering in the interval of the medical expense and the social system should be relieved with new systems.
Subject(s)
Antineoplastic Agents/economics , Health Knowledge, Attitudes, Practice , Insurance, Health , Neoplasms/economics , Antineoplastic Agents/therapeutic use , Cancer Care Facilities , Humans , Japan , Neoplasms/drug therapy , Surveys and QuestionnairesABSTRACT
Ehime Priority Hospitals of Cancer Care Network(Ehime Cancer Kyoten Hospitals)regularly have meetings to discus the current problems in cancer care in Ehime Prefecture. We established three subcommittees:"Registration of Cancer Incident," "Critical Paths for the Management of Patients with Cancer,"and"Palliative Care for Patients with Advanced Cancer"to exchange our opinions. We recently set up a new subcommittee related to the physical and spiritual care of patients undergoing chemotherapy treatment,"A Subcommittee dealing with Cancer Chemotherapy and its Management"."This subcommittee has tried to identify current problems with chemotherapy for outpatients in each institution through questionnaire and analysis. As a result of this survey, it was found that Ehime Priority Hospitals have total of seventy-three beds for outpatients undergoing chemotherapy, and that they performed chemotherapy 19, 671 times in 2008. A total of eight oncology physicians and sixteen oncology nurses were engaged in performing chemotherapy in this system. The questions patients most frequently asked during chemotherapy concerned the management of therapy-related complications, dealing with problems at night and during holidays after chemotherapy, and financial problems related to the costs of treatment. In this study we found three issues that need to be managed in Ehime Priority Hospitals. First, for the nursing of outpatients undergoing chemotherapy, more staff engaged in different types of care is required. Second, a new system to deal with emergencies at night and during holidays after chemotherapy is necessary, because Ehime Priority Hospitals use the same system to deal with chemotherapy patients as for other patients. Third, cooperation between pharmacies and out-clinics is important for patient compliance during chemotherapy, especially for the administration of oral anti-tumor agents. Ehime Priority Hospitals of Cancer Care Network is trying to improve each institution while dealing with these problems.