Mental health, mental fatigue and breast cancer screening examination behavior in adult women

　Breast cancer has attracted increasing attention recently, because the number of breast cancer patients has increased, and breast cancer has affected some famous people. In Japan, however, the rate of screening examinations for breast cancer remains low and has shown little increase. Various innovations have been introduced to raise the examination rate, but the existence of some kinds of psychosocial problems in examinees may be one reason for the limited effect of these efforts. Here we report a study on the mental health and mental fatigue level of adult women that could affect their behavior of undergoing examinations. 　Questionnaires on breast cancer screening examination behavior were distributed to 5,321 adult women from March to September 2014, and responses were obtained from 1,752 (32.9%). After excluding women under 40 years old and questionnaires with clearly inadequate responses, the subjects of the investigation were 1,047 women. 　Past experience of undergoing breast cancer screening and levels of mental health and mental fatigue using the WHO subjective well-being inventory (SUBI) were investigated. The SUBI consists of two scales for positive affect and negative affect that make up subjective well-being, with 11 subscales (General Well-Being Positive Affect, Expectation-Achievement Congruence, Confidence in Coping, Transcendence, Family Group Support, Social Support, Primary Group Concern, Inadequate Mental Mastery, Perceived Ill-Health, Deficiency in Social Contacts, and General Well-Being Negative Affect). It is used to assess levels of mental health and mental fatigue. 　802 people (51.6 ± 7.97) had undergone examinations in the past, and 245 (49.3 ± 7.29 years old) had not. The group that had never undergone examinations tended to be significantly younger (P < 0.0001). The score for mental health level was significantly higher in the group that had undergone examinations (P = 0.013), but no significant difference was seen in mental fatigue level (P = 0.847). Subjects with poor mental health (score < 31) were significantly less likely to undergo screening examinations (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.112-2.331, P = 0.012). The results of a multivariate analysis of the 11 subscales showed trends of women being less likely to undergo screening examinations with higher scores for Confidence in Coping (OR 1.175, 95% CI 1.026-1.346, P = 0.019), and more likely to undergo screening examinations with higher scores for Family Group Support (OR 0.872, 95% CI 0.777-0.979, P = 0.020). 　Low mental health level was found to be an impediment to the behavior of undergoing breast cancer screening examinations. Among the mental health items, family support and excessive confidence affected the behavior of undergoing examinations. Thus, approaches that raise mental health with that in mind are thought to be necessary

Analysis of Clinical Outcome of Patients with Poorly Differentiated Thyroid Carcinoma

Background. We retrospectively analyzed whether poor differentiation is the independent prognostic factor for thyroid carcinoma or not. Methods. The subjects were 29 patients with PDTC who were treated between April 1996 and March 2006 to compare with those of well-differentiated papillary carcinoma patients (n = 227). Results. The relapse free (RFS), distant relapse-free survival and cause-specific survival, rates were significantly lower in patients with PDTC (P < .0001, P < .001, and P < .05). After classification into focal (<10%) and diffuse type (over 10%) of PDTC, there were no significant differences in RFS and cause-specific survival due to component type or proportion of poorly differentiated component. On multivariate analysis, poor differentiation (P < .0005, RR = 4.456, 95% CI; 1.953–10.167) and extrathyroidal infiltration (P < .05, RR = 2.898, 95% CI; 1.278–6.572) showed a significant impact on DFS, and poor differentiation (P < .05, RR = 9.343, 1.314–66.453) and age (P < .005, RR = 1.306, 1.103–1.547) significantly impacted cause-specific survival. Conclusion. Poor differentiation was an independent factor for survival. Distant relapse was significantly more common among PDTC patients, and systemic therapy might be warranted

Quantification of Extent of Muscle-skin Shifting by Traversal sEMG Analysis Using High-density sEMG Sensor

Averaging electromyographic activity prior to muscle synergy computation is a common method employed to compensate for the inter-repetition variability usually associated with this kind of physiological recording. Capturing muscle synergies requires the preservation of accurate temporal and spatial information for muscle activity. The natural variation in electromyography data across consecutive repetitions of the same task raises several related challenges that make averaging a non-trivial process. Duration and triggering times of muscle activity generally vary across different repetitions of the same task. Therefore, it is necessary to define a robust methodology to segment and average muscle activity that deals with these issues. Emerging from this need, the present work proposes a standard protocol for segmenting and averaging muscle activations from periodic motions in a way that accurately preserves the temporal and spatial information contained in the original data and enables the isolation of a single averaged motion period. This protocol has been validated with muscle activity data recorded from 15 participants performing elbow flexion/extension motions, a series of actions driven by well-established muscle synergies. Using the averaged data, muscle synergies were computed, permitting their behavior to be compared with previous results related to the evaluated task. The comparison between the method proposed and a widely used methodology based on motion flags, shown the benefits of our system maintaining the consistency of muscle activation timings and synergie

Technetium-99m Methoxyisobutyl Isonitrile Scintigraphy of Bone Metastasis in Three Patients with Differentiated Thyroid Cancer

We studied the usefulness of ^Tc-methoxyisobutyl isonitrile (MIBI) scintigraphy in the detection of bone metastases and in evaluation of therapeutical response to ^I-Na in three patients with differentiated thyroid cancer. On ^Tc-MIBI scintigraphy, increased accumulations were observed in all bone metastatic lesions (14 lesions), whereas on bone scintigraphy using ^Tc-hydroxymethylene diphosphonate (^Tc-HMDP) both increased (eight lesions, 57%) and decreased (six lesions, 43%) accumulations were observed. Within two months after ^I-Na treatment, all 14 lesions were unchanged on bone scintigraphy. However, on ^Tc-MIJBI scintigraphy, disappearance of uptake (six lesions, 43%) and decreased uptake (seven lesions, 50%) were observed in 13/14 lesions (93%). Therefore, ^Tc-MIBI scintigraphy was useful not only in the detection of bone metastatic lesions but also in evaluation of the therapeutical response to ^I-Na in differentiated thyroid cancer

Measurement of Ionized Calcium as Supplementary Marker of Bone Metastasis in Breast Cancer

The serum concentrations of ionized calcium (iCa), corrected automatically for serum pH, were measured in 67 cases with breast cancer (16 positive cases and 51 negative cases for bone metastasis). The serum concentration of iCa in the cases of positive bone metastasis was significantly higher than that in the negative cases (p<0.005). As osteoclastic bone metastasis occurred frequently in breast cancer, the measurements of serum concentrations of iCa might be of help as a supplementary marker of the diagnosis of bone metastasis

Muscle-specific tyrosine kinase-antibody-positive myasthenic crisis with detailed electrophysiologic studies.

A 69-year-old male who presented in a coma due to sudden respiratory arrest was transferred to our hospital. After endotracheal intubation with manual ventilation, he became alert and his neurologic findings were within the normal range, except for palsy of the respiratory muscles. Biochemical analyses of the blood and brain computed tomography failed to indicate the cause of the respiratory arrest. An edrophonium test did not improve the respiratory arrest. An urgent electromyogram at the dorsal interossei, biceps, and sternocleidomastoideus muscle and a repetitive nerve stimulation test at the trapezius and deltoid muscle were also negative on the first hospital day. However, on the 16th day in the hospital, a repetitive nerve stimulation test at the levator labii superioris alaeque nasi showed a waning phenomenon. This result indicated a diagnosis of myasthenia gravis. Anti.muscle-specific tyrosine kinase antibody was found to be positive. After treatment with plasmapheresis and prednisolone, he regained normal respiratory function. Anti.muscle-specific tyrosine kinase (MuSK)-antibodypositive myasthenia gravis (MG) (MuSK-MG) tends to be associated with a lower incidence of a positive edrophonium test, a lower incidence of a positive electrophysiologic study excluding the face, and a higher incidence of respiratory failure in comparison to anti.acetylcholine receptors (AchR)-antibody-positive MG (AchR-MG). Respiratory failure is curable with treatment. Accordingly, in addition to obtaining a precise diagnosis, an emergency physician should recommend an electrophysiologic study including the face to make a differential diagnosis for respiratory arrest when biochemical and radiologic studies fail to indicate the cause of the respiratory arrest