Diffusion kurtosis imaging as a biomarker of breast cancer

Diffusion kurtosis imaging (DKI) is a diffusion-weighted imaging method that describes non-Gaussian signal behavior using a relatively simple mathematical model. A parameter, kurtosis K, describes the deviation of the diffusion signal decay from a Gaussian pattern. The deviation reflects the complexity of the tissue microstructure affecting water diffusion. Several studies have investigated the diagnostic performance of DKI in distinguishing malignant from benign breast lesions. DKI has been reported to correlate with subtypes and with several molecular and other factors related to the treatment and prognosis of breast cancer. Some technical considerations remain to be resolved for the clinical application of DKI in the breast

Analysis of plasmin generation and clot lysis of plasma fibrinogen purified from a heterozygous dysfibrinogenemia, B beta Gly15Cys (Hamamatsu II)

This is a non-final version of an article published in final form in Blood Coagulation & Fibrinolysis. 20(8):726-732, December 2009.We found a heterozygous dysfibrinogenemia caused by the substitution of B beta Gly15Cys and designated it fibrinogen Hamamatsu II (H-II). Although the propositus suffered an infarction of the medulla oblongata, other thrombotic risk factors, paradoxical cerebral infarction, and arterial dissection were not found. To determine whether the delayed lysis of fibrin clots or not in the context of the B beta Gly15Cys substitution, we examined the clot lysis and plasmin generation of propositus' fibrinogen. Fibrinogen was purified from the propositus' and normal control plasma by immunoaffinity chromatography and was used for the following experiments: sodium dodecyl sulfate-polyacrylamide gel electrophoresis, fibrin polymerization, scanning electron microscopic observation of fibrin clot and fibers, clot lysis, and tissue-type plasminogen activator-mediated plasminogen activation. The H-II plasma fibrinogen showed the presence of albumin-binding variant forms, a dimeric molecule of variant fibrinogen, and impairment of lateral aggregation during fibrin polymerization. The H-II fibrin clot showed lower density of bundles and thinner diameters of fibers than in the normal fibrin clot. In the clot lysis experiments with overlaid plasmin, H-II fibrin showed a similar lysis period and lysis rate to the normal control. Moreover, plasmin generation from a mixture of thrombin, tissue-type plasminogen activator, plasminogen, and H-II fibrinogen also showed a similar rate to normal fibrinogen. Although the propositus suffered an infarction, the present study did not observe delayed clot lysis, that is, the clot was not resistant to plasmin degradation. Therefore, we did not clarify an association between the B beta Gly15Cys dysfibrinogenemia and arterial thrombosis.ArticleBLOOD COAGULATION & FIBRINOLYSIS. 20(8):726-732 (2009)journal articl

Joint Symptoms, Aromatase Inhibitor-Related Adverse Reactions, Are Indirectly Associated with Decreased Serum Estradiol

Background. Joint symptoms (JSs) are problematic adverse drug reactions (ADRs) of aromatase inhibitors (AIs). Involvement of decreased serum estradiol (SE) has been suggested. Patients and Methods. 104 postmenopausal breast cancer patients administered an AI were prospectively investigated regarding various clinical parameters, JS and hot flashes as ADRs, and the SE level. Results. JS manifested in 31.7% of patients and hot flashes in 18.3%. Chi-square testing showed a significantly higher incidence of JS in several patient strata: <55 years old, decreased SE, and elevated total cholesterol (TC). In univariate analysis, JS correlated significantly with a pre-AI % YAM of ≥80%, decreased SE, and elevated TC. Eight (7.7%) patients maintained SE at ≥5 pg/mL for >6 consecutive months, with no JS. In chi-square testing, hot flashes showed a significantly higher incidence in patients <55 years old. Conclusion. AI-ADRs occurred more readily in younger patients. Decreased SE may be indirectly involved in JS

アイスランドの労働移動 : EU第5次拡大と金融危機がもたらした影響を中心として

Iceland applied for EU membership in 2009 and commenced negotiations the following year. The possibility for Iceland to gain EU membership has become much more promising. Even before its application for membership, the country had established special relations with the EU concerning the migration of its citizens. Having entered the European Economic Area (EEA) agreement, Icelanders, like other citizens of the member countries, are free to move and settle anywhere within the EEA. When EU was enlarged in 2004 with the addition of the Central and Eastern European countries (CEE), the legal framework for free movement was extended to the people of CEE. This paper presents the facts on migration in and out of Iceland between 1994 and 2010. It will examine the causes for these facts, showing how they influence the institutional development of Iceland\u27s labour migration

EU における経済的自由と社会民主的権利の衝突 : ヴァイキング事件,ECJ 先決裁定,モンティ規則を巡って

In two previous articles, I presented two case studies on conflicts between trade unions and employers in EU member countries: one in Sweden and the other in the U.K. Both case studies indicate these conflicts originate in the EU\u27s two important but partly conflicting aims, namely, ensuring complete economic freedom within the EU, and guaranteeing full social democratic rights which have been long established in EU member countries. Conflicts over these issues have become more intense since the fifth enlargement of the EU. To establish an appropriate balance between economic freedoms and social democratic rights is an urgent and challenging task for the EU. Presented here is a third case study to complete this series of studies. It introduces the conflict between the Finnish shipping company "Viking" and the Finnish trade union, and examines public debate after the preliminary ruling of the ECJ concerning the Viking Case. I argue that it is vital for the EU to find a fair balance between the abovementioned two aims

EUにおける国外派遣労働者 : イギリスで生じた労働争議に関する一考察

The European Union is attempting to create a single market where goods, capital, services and people move freely as if they were in a domestic market. Both goods and capital markets of the EU have been integrated to a great degree, respectively. However, European labour markets are not yet well integrated, nor are markets of services which include movement of natural persons. Due to the lack of sufficient coordination in national labour market policies, EU law concerning posted workers has caused conflicts in several EU member countries. In a previous article, I performed a case study on the conflict between a Latvian company and the Swedish Trade Union and analyzed reasons why a single European labour market can not be smoothly realized. This article presents another case study on the conflict between an Italian company and the British Trade Union in order to reinforce the evidence provided in the previous article

EU 拡大と労働移動 : 第5次拡大におけるスウェーデンとラトビアのケース

Ten countries in 2004 and two countries in 2007 have newly become members of the European Union. Those twelve countries are much poorer than old member states and Latvia is the third poorest of the twelve. Economic theory of international migration tells us that labour will move from a country with low income to a country with high income, if barriers between the two countries are eliminated, so that the wage rate of both countries will converge to the same level, but the theory does not describe what will happen in the process of such a convergence. This article is a case study on the conflict between a Latvian Company "Laval"and Swedish Trade Unions in order to provide an example of what conflict would be like when a poor country has become a member in the EU enlargement process, and to consider what it implies regarding EU integration

Dental Implant Treatment for a Patient with Bilateral Cleft Lip and Palate

Dental reconstruction in the cleft space is difficult in some patients with cleft lip and palate because of oronasal fistulas. Most of these patients receive a particle cancellous bone marrow (PCBM) graft to close the alveolar cleft, and secondary bone grafting is also required. Treatment options for the alveolar cleft including fixed or removable prostheses require the preparation of healthy teeth and are associated with functional or social difficulties. Recently, the effectiveness of dental implant treatment for cleft lip and palate patients has been reported. However, there have been few reports on the use of this treatment in bilateral cleft lip and palate patients. We report the case of a patient who had bilateral cleft lip and palate and was missing both lateral incisors. She received dental implant treatment after a PCBM graft and ramus bone onlay grafting (RBOG). A 34-month postoperative course was uneventful.</p

Biomarkers Predictive of Distant Disease-free Survival Derived from Diffusion-weighted Imaging of Breast Cancer

Purpose: To investigate whether intravoxel incoherent motion (IVIM) and/or non-Gaussian diffusion parameters are associated with distant disease-free survival (DDFS) in patients with invasive breast cancer. Methods: From May 2013 to March 2015, 101 patients (mean age 60.0, range 28-88) with invasive breast cancer were evaluated prospectively. IVIM parameters (flowing blood volume fraction [ɪᴠɪᴍ] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion parameters (theoretical apparent diffusion coefficient [ADC] at a b value of 0 s/mm² [ADC₀] and kurtosis [K]) were estimated using a diffusion-weighted imaging series of 16 b values up to 2500 s/mm². Shifted ADC values (sADC₂₀₀-₁₅₀₀) and standard ADC values (ADC₀-₈₀₀) were also calculated. The Kaplan-Meier method was used to generate survival analyses for DDFS, which were compared using the log-rank test. Univariable Cox proportional hazards models were used to assess any associations between each parameter and distant metastasis-free survival. Results: The median observation period was 80 months (range, 35-92 months). Among the 101 patients, 12 (11.9%) developed distant metastasis, with a median time to metastasis of 79 months (range, 10-92 months). Kaplan-Meier analysis showed that DDFS was significantly shorter in patients with K > 0.98 than in those with K ≤ 0.98 ( = 0.04). Cox regression analysis showed a marginal statistical association between K and distant metastasis-free survival ( = 0.05). Conclusion: Non-Gaussian diffusion may be associated with prognosis in invasive breast cancer. A higher K may be a marker to help identify patients at an elevated risk of distant metastasis, which could guide subsequent treatment