Mucinous cystadenocarcinoma of the breast: A case report and review of the literature

We report a case of mucinous cystadenocarcinoma (MCA) of the breast in a 96-year-old woman. This is an extremely rare variant of primary breast carcinoma that bears a striking resemblance to MCAs of the ovary and pancreas. The macroscopic appearance and secretion pattern (cytologic findings) resembled cystic hypersecretory carcinoma. However, microscopically, the epithelial cells were quite different from those of cystic hypersecretory carcinoma. In the present study as well as in the literature, MCAs tend to occur more frequently in elderly women. Immunohistochemical findings suggest that they may develop independently of estrogenic stimulation. Although MCAs show high proliferative activity, the prognosis was favorable in the present case as well as in the reported cases. Because MCAs appear to have a distinct pathogenesis and biologic behavior, they should be distinguished from ordinary mucinous carcinomas, cystic hypersecretory carcinomas, and carcinomas of other histologic subtypes

Carbon-Assisted Bioleaching of Chalcopyrite and Three Chalcopyrite/Enargite-Bearing Complex Concentrates

Overcoming the slow-leaching kinetics of refractory primary copper sulfides is crucial to secure future copper sources. Here, the effect of carbon was investigated as a catalyst for a bioleaching reaction. First, the mechanism of carbon-assisted bioleaching was elucidated using the model chalcopyrite mineral, under specified low-redox potentials, by considering the concept of Enormal. The carbon catalyst effectively controlled the Eh level in bioleaching liquors, which would otherwise exceed its optimal range (0 ≤ Enormal ≤ 1) due to active regeneration of Fe3+ by microbes. Additionally, Enormal of ~0.3 was shown to maximize the carbon-assisted bioleaching of the model chalcopyrite mineral. Secondly, carbon-assisted bioleaching was tested for three types of chalcopyrite/enargite-bearing complex concentrates. A trend was found that the optimal Eh level for a maximum Cu solubilization increases in response to the decreasing chalcopyrite/enargite ratio in the concentrate: When chalcopyrite dominates over enargite, the optimal Eh was found to satisfy 0 ≤ Enormal ≤ 1. As enargite becomes more abundant than chalcopyrite, the optimal Eh for the greatest Cu dissolution was shifted to higher values. Overall, modifying the Eh level by adjusting AC doses to maximize Cu solubilization from the concentrate of complex mineralogy was shown to be useful

Carbon-Assisted Bioleaching of Chalcopyrite and Three Chalcopyrite/Enargite-Bearing Complex Concentrates

Overcoming the slow-leaching kinetics of refractory primary copper sulfides is crucial to secure future copper sources. Here, the effect of carbon was investigated as a catalyst for a bioleaching reaction. First, the mechanism of carbon-assisted bioleaching was elucidated using the model chalcopyrite mineral, under specified low-redox potentials, by considering the concept of E_normal. The carbon catalyst effectively controlled the Eh level in bioleaching liquors, which would otherwise exceed its optimal range (0 ≤ E_normal ≤ 1) due to active regeneration of Fe^3+ by microbes. Additionally, E_normal of ~0.3 was shown to maximize the carbon-assisted bioleaching of the model chalcopyrite mineral. Secondly, carbon-assisted bioleaching was tested for three types of chalcopyrite/enargite-bearing complex concentrates. A trend was found that the optimal E_h level for a maximum Cu solubilization increases in response to the decreasing chalcopyrite/enargite ratio in the concentrate: When chalcopyrite dominates over enargite, the optimal E_h was found to satisfy 0 ≤ E_normal ≤ 1. As enargite becomes more abundant than chalcopyrite, the optimal E_h for the greatest Cu dissolution was shifted to higher values. Overall, modifying the E_h level by adjusting AC doses to maximize Cu solubilization from the concentrate of complex mineralogy was shown to be useful

National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study

Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era