A case of minimal uterine serous carcinoma with distant lymph node metastasis without peritoneal dissemination

A 61-year old woman underwent total abdominal hysterectomy and pelvic lymph node dissection under the diagnosis of endometrial cancer. Although pelvic lymph nodes were positive for adenocarcinoma with psamomma bodies, no other lesion that was a primary lesion was verified. A postoperative study revealed the existence of para-aortic lymph node and supraclavicular lymph node metastases. Therefore, the endometrial biopsy specimen was reviewed. With the findings of p53 positivity by immunohistochemistry in the papillary part, the final histopathological diagnosis was changed to endometrial serous adenocarcinoma. Postoperative chemotherapy followed by radiotherapy for supraclavicular lymph node metastasis achieved complete response. This type of tumor must be considered in a differential diagnosis when metastatic papillary serous carcinoma is detected, but the primary site remains unknown

Muscle Shear Moduli Changes and Frequency of Alternate Muscle Activity of Plantar Flexor Synergists Induced by Prolonged Low-Level Contraction

During prolonged low-level contractions, synergist muscles are activated in an alternating pattern of activity and silence called as alternate muscle activity. Resting muscle stiffness is considered to increase due to muscle fatigue. Thus, we investigated whether the difference in the extent of fatigue of each plantar flexor synergist corresponded to the difference in the frequency of alternate muscle activity between the synergists using muscle shear modulus as an index of muscle stiffness. Nineteen young men voluntarily participated in this study. The shear moduli of the resting medial and lateral gastrocnemius muscles (MG and LG) and soleus muscle (SOL) were measured using shear wave ultrasound elastography before and after a 1-h sustained contraction at 10% peak torque during maximal voluntary contraction of isometric plantar flexion. One subject did not accomplish the task and the alternate muscle activity for MG was not found in 2 subjects; therefore, data for 16 subjects were used for further analyses. The magnitude of muscle activation during the fatiguing task was similar in MG and SOL. The percent change in shear modulus before and after the fatiguing task (MG: 16.7 ± 12.0%, SOL: −4.1 ± 13.9%; mean ± standard deviation) and the alternate muscle activity during the fatiguing task (MG: 33 [20–51] times, SOL: 30 [17–36] times; median [25th–75th percentile]) were significantly higher in MG than in SOL. The contraction-induced change in shear modulus (7.4 ± 20.3%) and the alternate muscle activity (37 [20–45] times) of LG with the lowest magnitude of muscle activation during the fatiguing task among the plantar flexors were not significantly different from those of the other muscles. These results suggest that the degree of increase in muscle shear modulus induced by prolonged contraction corresponds to the frequency of alternate muscle activity between MG and SOL during prolonged contraction. Thus, it is likely that, compared with SOL, the alternate muscle activity of MG occurs more frequently during prolonged contraction due to the greater increase in fatigue of MG induced by the progression of a fatiguing task

Evidence for Spin–Orbit Alignment in the TRAPPIST-1 System

In an effort to measure the Rossiter–McLaughlin effect for the TRAPPIST-1 system, we performed high-resolution spectroscopy during transits of planets e, f, and b. The spectra were obtained with the InfraRed Doppler spectrograph on the Subaru 8.2 m telescope, and were supplemented with simultaneous photometry obtained with a 1 m telescope of the Las Cumbres Observatory Global Telescope. By analyzing the anomalous radial velocities, we found the projected stellar obliquity to be λ = 1 ± 28° under the assumption that the three planets have coplanar orbits, although we caution that the radial-velocity data show correlated noise of unknown origin. We also sought evidence for the expected deformations of the stellar absorption lines, and thereby detected the "Doppler shadow" of planet b with a false-alarm probability of 1.7%. The joint analysis of the observed residual cross-correlation map including the three transits gave λ = 19_(-15)^(+13)°. These results indicate that the the TRAPPIST-1 star is not strongly misaligned with the common orbital plane of the planets, although further observations are encouraged to verify this conclusion

The association between the reduction of body weight and new-onset type 2 diabetes remission in middle-aged Japanese men: Population-based Panasonic cohort study 8

AimThis study aimed to investigate the association between change in body weight (BW) and type 2 diabetes remission in Japanese men with new-onset type 2 diabetes.MethodsThis study enrolled 1,903 patients with new-onset type 2 diabetes between 2008 and 2013 from a medical health checkup program conducted by the Panasonic Corporation, Osaka, Japan. The baseline was defined as the year of new-onset diabetes. We assessed the type 2 diabetes remission five years after baseline and the association between the change in BW and type 2 diabetes remission using logistic regression analyses. To evaluate the predictive performance of the change in BW, we employed the receiver operating characteristic curves and the area under the receiver operating characteristic (ROC) curve (AUC).ResultsThe BW loss was associated with type 2 diabetes remission in the participants with a BMI ≥25 kg/m2 but not in the participants with a BMI <25 kg/m2. The odds ratios were 1.96 (95% CI: 1.19–3.29) and 3.72 (95% CI: 2.14–6.59) in the participants with a loss of 5–9.9% and loss of ≥10% for five years, respectively, in the participants with a BMI ≥25 kg/m2 (reference; stable group [0.9% gain to 0.9% loss]). The AUC and cut-off values for the rate of change in BW for type 2 diabetes remission were 0.59 and 5.0%.DiscussionBody weight loss of ≥5% effectively achieved diabetes remission in Japanese men with a BMI ≥25 kg/m2 and new-onset type 2 diabetes

The discovery and follow-up of four transiting short-period sub-Neptunes orbiting M dwarfs

Sub-Neptunes with radii of 2–3 R⊕ are intermediate in size between rocky planets and Neptune-sized planets. The orbital properties and bulk compositions of transiting sub-Neptunes provide clues to the formation and evolution of close-in small planets. In this paper, we present the discovery and follow-up of four sub-Neptunes orbiting M dwarfs (TOI-782, TOI-1448, TOI-2120, and TOI-2406), three of which were newly validated by ground-based follow-up observations and statistical analyses. TOI-782 b, TOI-1448 b, TOI-2120 b, and TOI-2406 b have radii of Rp = 2.740 +0.082-0.079 R⊕, 2.769+0.073-0.068 R⊕, 2.120 ± 0.067 R⊕, and 2.830+0.068-0.066 R⊕ and orbital periods of P = 8.02, 8.11, 5.80, and 3.08 days, respectively. Doppler monitoring with the Subaru/InfraRed Doppler instrument led to 2σ upper limits on the masses of <19.1 M⊕, <19.5 M⊕, <6.8 M⊕, and <15.6 M⊕ for TOI-782 b, TOI-1448 b, TOI-2120 b, and TOI-2406 b, respectively. The mass–radius relationship of these four sub-Neptunes testifies to the existence of volatile material in their interiors. These four sub-Neptunes, which are located above the so-called "radius valley," are likely to retain a significant atmosphere and/or an icy mantle on the core, such as a water world. We find that at least three of the four sub-Neptunes (TOI-782 b, TOI-2120 b, and TOI-2406 b), orbiting M dwarfs older than 1 Gyr, are likely to have eccentricities of e ∼ 0.2–0.3. The fact that tidal circularization of their orbits is not achieved over 1 Gyr suggests inefficient tidal dissipation in their interiors.Peer reviewe