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Background: The prevalence of sleep disordered breathing is high in patients with end-stage renal disease. Salt intake is related to the severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism. We investigated the relationship between salt intake and sleep disordered breathing in patients on maintenance hemodialysis., Patients and Methods: We studied 128 dialysis outpatients (mean age 63 ± 11 years) who were followed at Kokura Daiichi Hospital. We estimated each patient's salt intake using an InBody S10 body composition analyzer and measured the 3% oxygen desaturation index (ODI) during sleep using a Pulsewatch: PMP-200 GplusX., Results: The average estimated salt intake was 8.0 ± 2.6 g/day, and the median value of that was 7.5 g/day. Blood pressure (BP) before and after dialysis were 140 ± 18/78 ± 11 and 127 ± 13/72 ± 8 mmHg, respectively. The geometric average number of 3% ODI was 7.1, and sleep disordered breathing was detected in 30% of all subjects. The patients with ≥ 7.5 g/day salt intake were younger and more frequently male and had higher body mass index (BMI) and BP before dialysis compared to those with salt intakes < 7.5 g/day. Patients with ≥ 7.5 g/day salt intake had a significantly higher geometric average number of 3% ODI; however, this relationship became weaker after adjusting for BMI. The same relationship was obtained for the prevalence of sleep disordered breathing., Conclusion: The prevalence of sleep disordered breathing in patients on maintenance hemodialysis was high, and the sleep disordered breathing was associated with salt intake and BMI., (© 2021. Japanese Society of Nephrology.)

The effects of various sample parameters for solid-state dye sensitized solar cells were studied with carrier dynamics measurements and electrochemical measurements. Although many parameters and processes have been decided based on the experience of researchers, the chemical and physical reasons for the selections have not been clarified. We studied the effect of the generally utilized materials and processing such as the blocking layer, titanium oxide thickness, surface treatment, and the selection of dyes and hole transfer materials. Based on our findings, we were able to rationally optimize the structure of the solid-state dye sensitized solar cells in terms of cell performance or the lifetime of charge carriers.

Metaplastic breast cancers (MBCs) [spindle cell carcinoma (SpCC), squamous cell carcinoma (SCC), and matrix-producing carcinoma (MPC)] and invasive carcinomas with central acellular zones (CACs) were analyzed with respect to biological potential by immunohistochemical analyses. Specimens from 40 patients [20 with MBCs (7 with SCC, 6 with SpCC, 5 with MPC, and 2 with mixed type)] and 20 with CACs were analyzed using antibodies to cytokeratin (CK) 8, 5/6, 14, AE1/AE3, 34αE12, involucrin, c-kit, vimentin (VIM), alpha-smooth muscle actin, p63, epidermal growth factor receptor, epithelial cell adhesion molecule, and estrogen receptor (ER)/progesterone receptor (PR)/HER2. Expression of CK5/6, 34βE12, VIM, nuclear p63, and cytoplasmic p63 was significantly higher with MBCs than CACs (38%/13%, 70%/43%, 85%/33%, 68%/40%, and 48%/18%, respectively). Other markers were expressed at various levels in these tumors, but the difference between them was not significant. Eighteen MBC and 8 CAC cases were triple (ER/PR/HER2) negative; 17 MBCs and 7 CACs were basal-like tumors. Several differences were seen in MBCs and CACs, but they were heterogeneous, differentiating multipotentially into mesenchymal, myoepithelial, basal-like phenotypes with "stem cell-like" features. Thus, CACs are related to MBCs by immunohistochemical analyses as well as according to morphological findings.

Purpose: The aim of this study was to perform the phantom experiment and demonstrate the clinical usefulness of tissue quantification using a linear array transducer and acoustic radiation force impulse (ARFI) technology., Materials and Methods: For the phantom study, the commercially available Elasticity QA Phantom Model 049 was used. First, we measured the shear wave velocity (m/s) for the four spheres and the background of the phantom. Then, the shear wave velocity at nine sites was measured, with the region of interest being moved gradually from a shallow region (3 mm) to a deeper region (38 mm). For the clinical study, the shear wave velocities of 15 solid breast mass lesions were measured., Results: The phantom study confirmed the feasibility of quantitative determination of the degree of tissue hardness. Dispersion of the measured values tended to be somewhat increased for the depths of 3 mm and 38 mm. The mean shear wave velocity was 2.07-2.93 m/s for five benign lesions, whereas higher shear wave velocities (n = 2) (7.15, 7.44 m/s) or "X.XX" (unmeasurable state) (n = 7) were found for malignant lesions other than mucinous carcinoma (2.44 m/s)., Conclusion: ARFI tissue quantification is a potentially promising ultrasonographic technique for diagnosing breast lesions.

High-grade carcinoma with a large central acellular zone (central acellular carcinoma, CAC) and matrixproducing carcinoma (MPC) are aggressive tumors that both have a central myxomatous acellular zone. Their characteristic morphology may be useful in diagnostic imaging. Ultrasonographic findings based on the Breast Imaging Recording and Data System (BI-RADS) and detailed histological features were evaluated in 11 cases of CAC and 2 cases of MPC to characterize their features. Safranin-O staining was undertaken for the evaluation of central acellular zones in these tumors. Overall, ultrasonography demonstrated heterogeneous hyperechoic lesions in the center of the hypoechoic mass. Posterior echo enhancement was observed in all but 1 case. One case was classified as malignant and the others as "borderline." Histologically, cancer tissue was located in the periphery of the tumor with a ring-like structure and fewer cellular central areas comprising hyaline cartilage myxoid material such as those stained by safranin-O. The present study showed that the pathological findings of CACs and MPCs accurately reflect the ultrasonographic findings. Tumors that showed hyperechoic areas in the center of the hypoechoic mass, with posterior echo enhancement indicating acellular zones composed by myxochondroid material, and that were also relatively round on ultrasonography may be benign, but evaluation is required to exclude CAC and MPC.

Purpose: The aim of this study was to investigate the clinical usefulness of acoustic radiation force impulse (ARFI) imaging for the differential diagnosis of breast lesions., Materials and Methods: We studied 40 solid mass lesions from a total of 40 patients (age range 29-67 years, mean 50 years). There were 18 benign lesions and 22 malignant tumors. ARFI imaging was performed using Virtual Touch tissue imaging. We examined the possibility of lesions seen on B-mode images being visually confirmed on ARFI images. When the lesion was visually confirmed, the lesions that were bright or dark inside were classified into patterns 1 and patterns 3, respectively. The lesions that failed to be visually confirmed were classified as pattern 2., Results: There were 3 pattern 1 lesions and 7 pattern 2 lesions; all of these lesions were benign. The remaining 8 benign lesions and 22 malignant lesions were determined to be pattern 3. The negative predictive value was 100%., Conclusion: ARFI imaging is a potentially promising ultrasonographic technique for the differential diagnosis of breast lesions, particularly complicated cysts without a cystic component on B-mode images.

Purpose: The aims of this study were to investigate the visualization rate for the mammary gland under the nipple with automated breast ultrasonography (US) and to compare the detectability of breast lesions under the nipple with automated breast imaging and handheld US imaging., Materials and Methods: A total of 60 patients underwent automated breast US (ABVS; Siemens Medical Solutions, Mountain View, CA, USA) and handheld US. The scans of the four segments of the breast included sequential scans in the upper-outer (C), lower-outer (D), lower-inner (B), and upper-inner (A) regions., Results: The visualization rates for the mammary gland under the nipple were 72% (86/120 breasts) in A-scanning, 84% (101/120) in B-scanning, 78% (93/120) in C-scanning, and 80% (96/120) in D-scanning. Interscanning mode differences were statistically significant only for A-scanning and B-scanning (P = 0.02). Eventually, 98% (117/120 breasts) of the breasts examined were rated as "visualized." In 14 of the 15 patients with breast lesions under the nipple, the lesions were detectable with handheld US and the ABVS. In the other patient, the lesion was not detectable on handheld US but was detected on ABVS imaging., Conclusion: ABVS imaging is by no means inferior to handheld US for detecting breast lesions under the nipple.

Purpose: The aim of this study was to assess the scanning technique for covering the whole breast using a commercially available automated breast ultrasonography (US) system., Materials and Methods: A total of 40 patients in the supine position underwent automated breast US (ABVS: Siemens Medical Solutions, Mountain View, CA, USA) and hand-held US. The scanning included sequential scans in the upper-outer, lower-outer, lower-inner, and upper-inner regions. After scanning all four segments of each breast using ABVS, hand-held US was performed in all the patients. The detectability of the lesions using the ABVS technique compared with that using the handheld US was evaluated. The average scanning time was compared between any two of the three examiners with various lengths of experience in breast US., Results: In all, 61 lesions were detected by hand-held US. The average size of the lesions was 7.7 mm (range 2.5-26.0 mm). The number of detected lesions by ABVS was consistent with those found by hand-held US in each patient. The average total scanning time for each examiner using ABVS was 10.9, 11.1, and 11.5 min, respectively. No significant difference was found in the total scanning time between any two of the three examiners., Conclusion: The four-scans technique for the major segments of the breast is thought to be an operator-independent, feasible method for performing automated breast US.

We report a 17-year-old woman with refractory high-grade breast cancer who died early after surgery, with reference to the histogenesis of the cancer. Macroscopically, the tumor was cystic, composed of a mixture of solid and myxomatous areas. Histologically, the tumor exhibited ductal structures and areas with squamoid features. Cancer cells were markedly atypical and polymorphic, and included a mixture of bizarre and eosinophilic cells with rhabdoid feature-like free cells. Immunohistochemically, cytokeratin (CK) 8, CK 18, 34 beta E12, CD10, involucrin, CK14, and vimentin were partially positive, whereas estrogen and progesterone receptors and HER-2 were negative. These findings suggest an undifferentiated cancer whose cells have multilineage potential to differentiate into mesenchymal, basal, and squamoid cells, and it was diagnosed as pleomorphic carcinoma, which is a histological type hitherto unreported in young girls. The cancer was refractory to treatment, and the patient died 1 year and 5 months after surgery despite chemotherapy and radiotherapy.

A rare case of neuroendocrine small cell carcinoma (SmCC) of the breast is reported. A 51-year-old postmenopausal woman noticed a nodule approximately 3 cm in diameter in her right upper breast. Histologically, the tumor consisted of small ovoid to pleomorphic cells with hyperchromatic nuclei, and a large central area was occupied by acellular amorphous tissue. Extensive lymphatic permeation was seen around the tumor. Invasive and in situ ductal carcinoma foci were not observed in and surrounding the tumor. Immunohistochemically, estrogen and progesterone receptors and HER2/neu were all negative in the tumor cells. Synaptophysin and chromogranin A were diffusely positive in the tumor cells. Cytokeratin 8 was only positive in a few tumor cells. The labeling indices of Ki-67 and p53 were high in the tumor. Postoperatively, systemic studies including positron emission tomography were performed but failed to reveal any other possible primary sites, including lung. Based on these findings, the tumor was diagnosed as neuroendocrine primary SmCC of the breast. Postoperatively, the patient received a course of weekly paclitaxel. However, pelvic bone metastasis was identified on a bone scintigram 1 year after surgery. Mammary SmCC showing high Ki-67 and p53 index should be treated carefully because of their aggressive clinical behavior.

Thrombopoietin (TPO) is a hematopoietic cytokine that regulates megakaryocytosis and thrombocytosis by binding to its receptor (c-Mpl). The signaling pathways downstream of c-Mpl include the Ras/Raf/MAP kinase and JAK/STAT pathway and are transduced into the regulation of immediate early-, early- and delayed-response genes. How these genes couple c-Mpl activation to the biochemical machinery of cell growth and cell cycle progression in hematopoietic cells is still unclear. UT-7/TPO is a recently characterized TPO-dependent cell line. Using RNA fingerprinting with arbitrarily primed PCR (RAP-PCR) to identify the TPO-regulated genes in this cell line, we found that the mRNA expression of nucleolin was upregulated in the UT-7/TPO cells in response to TPO. Concomitantly, the TPO-stimulated cells expressed an increased amount of full length nucleolin as determined by immunoblot analysis. The TPO-induced upregulation of nucleolin mRNA was not inhibited by the MEK1/2 inhibitor PD98059, suggesting that ERK/MAPK activation is not necessary for elevation of nucleolin gene expression in response to TPO in UT-7/TPO. Nucleolin is a multifunctional nucleolar protein thought to be involved in many cellular processes, including ribosome biogenesis, the processing of ribosomal RNA (rRNA), mRNA stability, transcriptional regulation, and cell proliferation. Thus, these results indicate that the upregulation of nucleolin mRNA and protein may be important for the TPO-induced effects of hematopoietic cells.