Additional lesions seen in magnetic resonance imaging of breast cancer patients: the role of second-look ultrasound and imaging-guided interventions

Purpose The purpose of this study was to investigate the final outcomes of magnetic resonance imaging (MRI)-identified additional lesions (MRALs) in breast cancer patients and the role of second-look ultrasound (SLUS) and imaging-guided interventions. Methods We analyzed breast cancer patients with MRALs on preoperative MRI between January and June 2012. MRALs were defined as additional lesions suspected on MRI but not suspected on mammograms or ultrasound. The malignancy rate of MRALs, MRI-based Breast Imaging Reporting and Database System (BI-RADS) category, positional relationship with the index cancer, MRI-concordant lesion visibility on SLUS, performance of imaging-guided interventions, and total mastectomy (TM) rates were evaluated for the confirmed lesions. Results Among the 119 confirmed lesions, SLUS and imaging-guided interventions were performed in 94 (79.0%) and 82 cases (68.9%), respectively. The malignancy rate was 68.1% (81 of 119), and was significantly higher in BI-RADS 4C-5 lesions than in 4A-4B lesions (94.6% vs. 56.1%, P<0.01) and in ipsilateral same-quadrant lesions than in contralateral lesions (84.2% vs. 33.3%, P<0.01). The lesion visibility rate on SLUS was 90.4%. The malignancy rate was not significantly different according to lesion visibility on SLUS. The TM rate in the 98 cases with ipsilateral MRALs was 37.8%, while it was significantly lower in patients who underwent an imaging-guided intervention than in those who did not (27.9% vs. 54.1%, P=0.017). Conclusion MRALs show a high probability of malignancy, especially if they are ipsilateral. SLUS and imaging-guided interventions can eliminate many unnecessary TMs

Biogenic CaCO3 and Opal Depositions and Their Latitudinal Comparison During the Past 600 ka in the Central Equatorial Pacific

The orbital-scale variations in biogenic CaCO3 and opal abundance in two piston cores collected in the central equatorial Pacific (core PC5101 from a southern site at _ and core PC5103 from a northern site at _ were compared to assess latitudinal differences. The correlation between the oxygen isotope stratigraphy of planktonic foraminifera (Globigerinoides sacculifer) of PC5103 with the LR04 stacks provides the age of PC5103 to be approximately 950 ka. The age of PC5103 was further refined by correlating the CaCO3 content with the well-dated core RC11-210. The age of PC5101 was also constrained by the same CaCO3 chronostratigraphic correlation with RC11-210, resulting in an age of approximately 650 ka. Distinct orbital-scale series of CaCO3 and opal variations appear to be parallel between the two cores during the past 600 ka, which are controlled mainly by eccentricity with an approximate periodicity of 100 ka. It is worth noting that the biogenic CaCO3 and opal deposition patterns in the two cores differ between interglacial and glacial periods. During interglacial periods the biogenic opal content is higher in the southern core than in the northern core, which corresponds with the present-day condition. In contrast the CaCO3 content is higher in the northern core, which is contradictory to the present-day northward decreasing CaCO3 deposition pattern from the Equator. The collection site of PC5101 is approximately 350 m deeper than that of PC5103, which significantly promotes CaCO3 dissolution and causes unexpectedly high CaCO3 content at the northern site in contrast to the biogenic opal content

Reorganization of Photoreceptor Layer on Optical Coherence Tomography Concurrent with Visual Improvement after Macular Hole Surgery

To report three cases in which reorganization of the photoreceptor layer on optical coherence tomography (OCT) was concurrent with long-term visual recovery after macular hole surgery. Serial OCT scans of three eyes in which visual acuity continued to improve for 1 or more years after successful macular hole surgery were reviewed. Case 1. At postoperative four weeks, visual acuity was 20/100 with disorganized photoreceptor layer on OCT. The photoreceptor layer had been reorganized and visual acuity had improved to 20/25 by 1 year. Case 2. Two weeks after the operation, visual acuity was 20/125 and disorganization of the photoreceptor layer was noted. Visual acuity improved to 20/50 by four months. The photoreceptor layer had been partly reorganized and had appearance of a broken line. Visual acuity had improved to 20/40 and the photoreceptor layer had been reorganized further with a residual defect on OCT by 15 months. Case 3. Visual acuity at two weeks was 20/100. OCT revealed disorganization of the photoreceptor layer. Six months after the operation, the partly reorganized photoreceptor layer appeared as a broken line and visual acuity had reached 20/80. Visual acuity had improved further to 20/40 by 1 year, concurrent with improved organization of the photoreceptor layer. The reorganization of the photoreceptor layer plays a part in long-term improvement of visual acuity after macular hole surgery

Papillary Thyroid Carcinoma of a Diffuse Sclerosing Variant: Ultrasonographic Monitoring from a Normal Thyroid Gland to Mass Formation

A diffuse sclerosing variant of papillary thyroid carcinoma is uncommon and has a tendency for rapid growth and a higher incidence of cervical lymph node metastases. We experienced a case of a diffuse sclerosing variant of papillary thyroid carcinoma in a 48-year-old man. This case showed benign features on initial ultrasonography and positron emission tomography (PET) scan. A new nodule was detected on follow-up ultrasonography that showed rapid enlargement. This case was confirmed by surgical excision. We herein describe the initial and follow-up ultrasonographic findings of a diffuse sclerosing variant of papillary thyroid carcinoma

MPC Based Energy Management System for Hosting Capacity of PVs and Customer Load with EV in Stand-Alone Microgrids

This paper presents the improvements of the hosting capacity of photovoltaics (PVs) and electric vehicles (EVs) in a stand-alone microgrid (MG) with an energy storage system (ESS) by consider-ing a model predictive control (MPC) based energy management system. The system is configured as an MG, including PVs, an ESS, a diesel generator (DG), and several loads with EVs. The DG is controlled to operate at rated power and the MPC algorithm is used in a stand-alone MG, which supplies the energy demanded for several loads with EVs. The hosting capacity of the load in-cluding the EV and PVs can be expanded through the ESS to the terminal node of the microgrid. In this case, the PVs and the load can be connected in excess of the capacity of the diesel genera-tor, and each bus in the feeder complies with the voltage range required by the grid. The effec-tiveness of the proposed algorithm to resolve the hosting capacity is demonstrated by numerical simulations

Metastatic Thymoma of the Breast

Breast metastasis from nonmammary malignant neoplasms is uncommon, and it accounts for approximately 2% of all breast tumors. Distant metastasis of thymoma is very rare, and especially to extrathorcic areas. We report a female who had a metastatic thymoma in her breast 20 years after undergoing resection for a non-invasive thymoma. She presented with a palpable mass in her left breast. Mammography and ultrasonogram showed a lobular mass at the anterior glandular portion. Histological examination after surgical excision revealed a metastatic thymoma