Preoperative radiographic and histopathologic evaluation of central chondrosarcoma

Distinguishing grade 1 chondrosarcoma from grade 2 chondrosarcoma is critical both for planning the surgical procedure and for predicting the outcome. We aimed to review the preoperative radiographic and histologic findings, and to evaluate the reliability of preoperative grading. We retrospectively reviewed the medical records of 17 patients diagnosed with central chondrosarcoma at our institution between 1996 and 2011. In these cases, we compared the preoperative and postoperative histologic grades, and evaluated the reliability of the preoperative histologic grading. We also assessed the preoperative radiographic findings obtained using plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Preoperative histologic grade was 1 in 12 patients, 2 in 4 patients, and 3 in 1 patient. However, 6 of the 12 cases classified as grade 1 before surgery were re-classified as grade 2 postoperatively. In the radiographic evaluation, grade 1 was suspected by the presence of a ring-and-arc pattern of calcification on plain radiography and CT and entrapped fat and ring-and-arc enhancement on MRI. Grades 2 and 3 were suspected by the absence of calcification and the presence of cortical penetration and endosteal scalloping on plain radiography and CT, as well as soft-tissue mass formation on MRI. Although the combination of radiographic interpretation and histologic findings may improve the accuracy of preoperative grading in chondrosarcoma, the establishment of a standard evaluation system with the histologic and radiographic findings and/or the development of new biologic markers are necessary for preoperative discrimination of low-grade chondrosarcoma from high-grade chondrosarcoma.ArticleARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY. 133(9):1225-1231 (2013)journal articl

Metastatic Carcinoma to Subcutaneous Tissue and Skeletal Muscle: Clinicopathological Features in 11 Cases

Objective: Metastatic carcinoma to subcutaneous tissue or skeletal muscle is relatively rare. The present study aimed to clarify the clinicopathological features for confirming the diagnosis as soft tissue metastasis and determining the primary site. Methods: We reviewed records of 11 patients with soft tissue metastasis who were in our institution from 1996 to 2009. Results: In 9 of 10 patients who underwent magnetic resonance imaging, findings consisted of poorly circumscribed high-intensity lesions around the tumor on T2-weighted images, irregular peritumoral enhancement and poorly enhanced lesions at the center of the tumor on T1-weighted images. Systematic immunohistochemical examination was more valuable for diagnosing as soft tissue metastasis and confirming the primary site. The expression patterns of cytokeratins 7 and 20 and tissue-specific antibodies such as thyroid transcription factor-1, MUC5AC and CDX2 were useful diagnostic markers. The primary site could be determined in five patients with cytokeratin 7/20 immunophenotype and positivity for tissue-specific antibodies. In four cases, determination of the primary site finally became possible by comparison with the histological findings of operative specimens in past carcinoma and/or in consideration of radiological findings and the results of cytokeratin 7/20 phenotyping. Conclusions: Systematic immunohistochemical examination is helpful for confirmation of the primary origin in soft tissue metastasis of carcinoma in addition to clinical information such as the history and condition of past carcinoma, radiological findings and comparison between the histology of biopsy specimens and past carcinoma.ArticleJAPANESE JOURNAL OF CLINICAL ONCOLOGY. 41(3):358-364 (2011)journal articl

Multifocal Periosteal Chondromas in the Ring Finger of an Adolescent Boy: Case Report

We describe an unusual case of a 12-year-old boy who presented with a loss of motion in the ring finger caused by 2 separate periosteal chondromas involving the proximal and middle phalanges. Range of motion improved and recurrence did not occur at the 5-year follow-up after marginal excision of both lesions. (J Hand Surg 2011;36A:101-105.ArticleJOURNAL OF HAND SURGERY-AMERICAN VOLUME. 36A(1):101-105 (2011)journal articl

Application of Nuclear Emulsion to Neutron Emission Profile Diagnostics in the National Spherical Torus Experiment

The technology for OPERA experiments in neutrino physics was applied to neutral-beam-heated deuterium discharges of NSTX in order to measure d-d neutron emission profile. The diagnostic system consisted of nuclear emulsions named OPERA films and the automatic track scanning system S-UTS developed in Nagoya University. A neutron collimator having three channels was temporarily built for this purpose. The nuclear emulsion indicated peaked neutron emission profiles at the plasma center in NSTX as expected

Comparative Genetic Mapping and Discovery of Linkage Disequilibrium Across Linkage Groups in White Clover (Trifolium repens L.)

White clover (Trifolium repens L.) is an allotetraploid species (2n = 4X = 32) that is widely distributed in temperate regions and cultivated as a forage legume. In this study, we developed expressed sequence tag (EST)–derived simple sequence repeat (SSR) markers, constructed linkage maps, and performed comparative mapping with other legume species. A total of 7982 ESTs that could be assembled into 5400 contigs and 2582 singletons were generated. Using the EST sequences that were obtained, 1973 primer pairs to amplify EST-derived SSR markers were designed and used for linkage analysis of 188 F1 progenies, which were generated by a cross between two Japanese plants, ‘273-7’ and ‘T17-349,’ with previously published SSR markers. An integrated linkage map was constructed by combining parental-specific maps, which consisted of 1743 SSR loci on 16 homeologous linkage groups with a total length of 2511 cM. The primer sequences of the developed EST-SSR markers and their map positions are available on http://clovergarden.jp/. Linkage disequilibrium (LD) was observed on 9 of 16 linkage groups of a parental-specific map. The genome structures were compared among white clover, red clover (T. pratense L.), Medicago truncatula, and Lotus japonicus. Macrosynteny was observed across the four legume species. Surprisingly, the comparative genome structure between white clover and M. truncatula had a higher degree of conservation than that of the two clover species

Evaluation of a communication skills seminar for students in a Japanese medical school: a non-randomized controlled study

BACKGROUND: Little data exist for the effectiveness of communication skills teaching for medical students in non-English speaking countries. We conducted a non-randomized controlled study to examine if a short intensive seminar for Japanese medical students had any impact on communication skills with patients. METHODS: Throughout the academic year 2001–2002, a total of 105 fifth-year students (18 groups of 5 to 7 students) participated, one group at a time, in a two-day, small group seminar on medical interviewing. Half way through the year, a five-station objective structured clinical examination (OSCE) was conducted for all fifth-year students. We videotaped all the students' interaction with a standardized patient in one OSCE station that was focused on communication skills. Two independent observers rated the videotapes of 50 students who had attended the seminar and 47 who had not. Sixteen core communication skills were measured. Disagreements between raters were resolved by a third observer's rating. RESULTS: There was a statistically significant difference in proportions of students who were judged as 'acceptable' in one particular skill related to understanding patient's perspectives: asking how the illness or problems affected the patient's life, (53% in the experimental group and 30% in the control group, p = .02). No differences were observed in the other 15 core communication skills, although there was a trend for improvement in the skill for asking the patient's ideas about the illness or problems (60% vs. 40%, p = .054) and one of the relationship building skills; being attentive and empathic nonverbally (87% vs. 72%, p = .064). CONCLUSION: The results of this study suggest that a short, intensive small group seminar for Japanese medical students may have had a short-term impact on specific communication skills, pertaining to understanding patient's perspectives

Multi-Wavelength Observation of Electron Acceleration in the 2006 December 13 Flare

We present a multi-wavelength observation of a solar flare occurring on 2006 December 13 with Hinode, RHESSI, and the Nobeyama Radio Observatory, to study the electron acceleration site and mechanism. The Solar Optical Telescope (SOT) on board Hinode observed elongated flare ribbons, and RHESSI observed double-footpoint hard X-ray (HXR) sources appearing in part of the ribbons. A photospheric vector magnetogram obtained from SOT reveals that the HXR sources are located at the region where horizontal magnetic fields change the direction. The region is interpreted as the footpoint of magnetic separatrix. Microwave images taken with the Nobeyama Radioheliograph show a loop structure connecting the HXR sources. The brighter parts of the microwave intensity are located between the top and footpoints of the loop. We consider these observations as an evidence of the electron acceleration near the magnetic separatrix and injection parallel to the field line.Comment: 20 pages, 7 figures, accepted by Ap