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We hypothesize that there is a risk of ipsilateral breast tumor recurrence (IBTR) in surgical margin-free invasive ductal carcinoma (IDC) in the presence of ductal carcinoma in situ (DCIS) component affecting surgical margins in early stage. From 1990 to 2014, 343 patients with IDC in which the DCIS component constitute have received radiotherapy (RT) following breast-conserving surgery (BCS). All patients received whole breast irradiation with a prescribed dose of 50 Gy in 20 fractions (four times a week). This one-arm cohort with boost RT (253 patients) was compared for IBTR with a non-cohort group receiving no boost RT because of freedom from positive margins (90 patients). Median observation months were 98 (boost group) vs 119 (no boost group), respectively. The 15-year local recurrence-free survival (LRFS) rates were 98.5% and 85.6% in the boost and no boost groups, respectively (Cox proportional hazards model univariate analysis; p = 0.013, HR 0.13). Similarly, for other background factors, there was a significant difference in the LRFS between age groups. The 15-year LRFS rate was 91.8% in patients aged 45 years or younger and 94.6% in patients older than 46 years (p = 0.031, HR 0.21), respectively. Only these two factors were independently significant in Cox proportional hazards model multivariate analysis. IBTR risk in margin-free IDC with DCIS component was independently decreased by boost RT in the cohort setting. Tumor size, extensive intraductal component (EIC), boost dose, the presence of lymph node (LN) metastasis and hormonal therapy were not IBTR risk factors in this study.

While some studies show improved outcomes in clinical trial participants as compared to non-participants, existence of such a trial effect has not been proved precisely. This was a prospective cohort study to compare the prognoses for participants in the randomized controlled trial (SELECT BC) and non-participants. SELECT BC compared S-1 and taxane as first-line treatment for metastatic breast cancer. Non-participants were all patients who met the eligibility criteria of SELECT BC and who had been requested to participate in that trial by attending doctors and declined. The study aimed to compare the prognoses between participants and non-participants. The primary endpoint was median overall survival. The median OS in participants was significantly superior to that in non-participants with a statistically significant difference (36.8 months vs. 25.2 months. HR 1.48, p = 0.022). A similar result was obtained when only patients who received the same chemotherapy (S-1 or taxane) used in SELECT BC after declining participation were assumed as non-participants (36.8 months vs. 22.0 months. HR 2.03, p = 0.006). This study may suggest the existence of a trial effect, in which, for a given treatment, participation in a clinical trial is associated with a better outcome.

Aromatase inhibitors are superior to tamoxifen as adjuvant therapy in postmenopausal patients with hormone-responsive breast cancer. We report the follow-up efficacy results from the N-SAS BC 03 trial (UMIN CTRID: C000000056) where anastrozole was compared with tamoxifen as adjuvant therapy in postmenopausal Japanese patients with hormone-responsive early breast cancer. The full analysis set contained 696 patients (anastrozole arm, n = 345; tamoxifen arm, n = 351). The log-rank test was used to compare the two groups in terms of disease-free survival (DFS) and relapse-free survival (RFS); Kaplan–Meier estimates were calculated. The treatment effects were estimated by Cox’s proportional hazards model. To examine time-varying effect of hazard ratios, we estimated time-varying hazard ratios at time t [HR(t)] using data from time t up to 12 months. After a median follow-up of 98.5 months, hazard ratios (95 % CIs) were 0.90 (0.65–1.24; log-rank p = 0.526) for DFS and 0.83 (0.56–1.23; log-rank p = 0.344) for RFS. Hazard ratios (95 % CIs) for DFS and RFS up to 36 months were 0.69 (0.40–1.17) and 0.54 (0.27–1.06) and those after 36 months were 1.06 (0.70–1.59) and 1.05 (0.64–1.73), respectively. Time-varying hazard ratios for both DFS and RFS showed that hazard ratios were initially in favor of anastrozole and approached 1.0 at around 36 months. Superior efficacy of anastrozole to tamoxifen suggested by the initial analysis was not confirmed in the present analysis after a long-term follow-up period. Advantage of anastrozole was the greatest immediately after switching from tamoxifen and then decreased thereafter.

Clinical trials conducted in Western countries have shown that aromatase inhibitors are associated with better disease-free survival (DFS) than tamoxifen in postmenopausal early breast cancer. Because pharmacogenetic differences in drug-metabolizing genes may cause ethnic differences, assessment of the efficacy and tolerability of aromatase inhibitors in non-white women is warranted. This open-label, randomized clinical trial included 706 postmenopausal Japanese women with hormone-receptor-positive breast cancer, who had received tamoxifen for 1 to 4 years as adjuvant therapy. This study was closed early after entry of approximately 28% of the initially planned patients. They were randomly assigned to either switch to anastrozole or to continue tamoxifen for total treatment duration of 5 years. Primary endpoints were DFS and adverse events. At a median follow-up of 42 months, the unadjusted hazard ratio was 0.69 (95% confidence interval, 0.42-1.14; P = 0.14) for DFS and 0.54 (95% CI, 0.29-1.02; P = 0.06) for relapse-free survival (RFS), both in favor of anastrozole. The incidence of thromboembolic events in the tamoxifen group and bone fractures in the anastrozole group was not excessively high. Switching from tamoxifen to anastrozole was likely to decrease disease recurrence in postmenopausal Japanese breast cancer patients. Ethnic differences in major adverse events may be attributable to a low baseline risk of these events in Japanese.

To implement cutting-edge services such as high-resolution movie streaming and smart metering on mobile networks cost-effectively, mobile operators must meet various conflicting requirements. For example, they must manage a massive number of devices in smart-meter-type machine-to-machine (M2M) applications for which quality-of-service (QoS) requirements are quite lenient. At the same time, they need to support stringent QoS requirements in the form of a few milliseconds of delay and a high bandwidth guarantee for a smaller number of devices in video and remote surgery applications. As building a dedicated per-service physical network is very costly, network slicing by means of resource virtualization was developed to accommodate such heterogeneous services in a single physical network infrastructure. In network slicing, network resources are isolated to form slices, which then can be used to provide different services. This slicing is helpful in accommodating conflicting, often incompatible services at the cost of losing the multiplexing gain achieved in monolithic composite service networks. The loss in multiplexing gain is not a big problem when the number of slices is relatively low. However, numerous services are provided in cellular networks, and the number is expected to be drastically higher in the 5G era. Creating perservice slices would lead to wastage of resources. In this regard, we aim at balancing the need for isolation to meet conflicting service requirements against resource usage efficiency. We investigated possible means of simultaneously achieving isolation and minimizing the loss of multiplexing gain. Our findings will aid in the development of network management architecture suitable for the 5G era and beyond.

目的:乳腺穿刺細胞診で, 従来法塗抹標本にLiquid-based cytology (LBC) による針洗浄液細胞診標本を追加することの有用性を検討した.方法:塗抹標本とLBC標本を作製した乳腺穿刺細胞診症例を検討した. 標本上の細胞数, 乾燥・挫滅などを基準に適正標本数の変化を検証した. またそれらの細胞診断と病理診断との比較を行い, さらにLBC標本の細胞の特徴を明らかにした.成績:564例中, LBCの実施により126件で細胞数が増加していた. また50件の塗抹標本では細胞数が十分であったが, 乾燥・挫滅がみられた. 総合的には塗抹標本のみでは248件 (44%) が適正検体であったが, LBC標本を追加することにより411件 (73%) と増加した. 塗抹標本とLBC標本の診断内容に大きな差はみられなかったが, LBC標本を追加したことにより正常・良性検体の多くが診断可能となった. LBCの細胞所見にはいくつかの注意すべき点もあった.結論:塗抹標本にLBCによる針洗浄液細胞診を追加することによって明らかに適正標本が増加した. またLBC標本の細胞所見の特徴を把握すれば適切な細胞診断が可能である.

This paper describes a novel scheme which enables scaling of cellular node applications without disrupting session continuity. With this scheme, states of node applications, including User Equipment (UE) states and transport protocol states, are maintained during scaling operations that are possible in a virtualized environment. A prototype of Mobility Management Entity (MME) of Evolved Packet Core (EPC) was designed to show how the proposed scheme together with the Elastic Core Architecture (ECA) can achieve the session continuity by means of empirical evaluations performed in a laboratory test bed. The results show that our proposed scheme can realize virtualization-based scaling of stateful cellular network node applications with negligible session interruption characteristics.

製紙業界では長年の間, 紙の白さ, 不透明性を向上させる目的で炭酸カルシウム, 二酸化チタンなどが填料として広く使用されてきた。しかし, 不透明性を改善するために, 例えば炭酸カルシウムを用いると, 充填量を多くする必要があり, 品質面で表面強度や耐磨耗性の低下を招く。一方, 二酸化チタンは不透明性付与効果は大きいが, 高価であり, また粒子径が小さいためにワイヤーパートでの歩留まりが低く, 白水回収系内での負荷が増加するという問題があると言われている。近年個々の欠点をカバーし, 互いの利点を付与する複合材料の研究開発が行われ, 二酸化チタン-炭酸カルシウム複合粒子において数例の特許が報告されている。今般開発したピグメント「Valkofil」は, 二酸化チタンと水酸化カルシウムの混合水系懸濁液を高剪断領域で炭酸化させることにより, 二酸化チタンをより均一に分散し, さらにその粒子の周りを炭酸カルシウムで被覆させることに成功した。これを内填した手漉き紙の特性は, 優れた不透明性を付与することが見い出されたので, ここに紹介する。

Experience with conserving surgery for lobular carcinoma has grown as more breast conserving surgeries have been performed. We examined the results of breast conserving therapy in lobular carcinoma.We examined the postoperative positive margin rate, presence or absence of additional surgery, presence or absence of local or systemic recurrence and role of breast helical CT in 25 cases of breast conserving surgery performed at this department from 1991 through June 2003.Among the 303 cases of all breast conserving surgeries, there were 63 case with positive margins (20.8%), but there were 15 of 25 positive margin cases (60.0%) among the lobular carcinoma cases. In 8 of the 15 positive margin cases the technique was changed to mastectomy. One case of recurrence in the breast has been observed thus far. Although the positive margin rate and positive margin rate in infiltrating carcinoma cases tended to decline after the introduction of breast helical CT, the rates remained high.Since the positive margin rate was significantly high at the time of breast conserving surgery for lobular carcinoma, careful selection of technique based on imaging studies such as breast helical CT and MRI along with careful follow-up is considered necessary.

We report that single agent therapy with trastuzumab had a significant effect on metastatic breast cancer, which was confirmed to be HER2 positive by Herceptest showing 2+staining, and gene amplification positively detected by FISH analysis. A 48-year-old woman underwent extended radical mastectomy (T2N0M0 stage II). Three years after the operation supraclavicular lymph node metastasis was noted. Bone scintigraphy showed metastases to the left ribs 5 years after operation. She was treated with chemo-endocrine therapy, but nonetheless could not bear the back pain caused by the bone metastases. Another chemotherapy course could not be permitted because of leukopenia. Immunohistochemistry (IHC) analysis with Herceptest showed 2+staining for HER2 and FISH analysis showed gene amplification of HER2. We started single agent therapy with trastuzumab and she subsequently had remarkably improved back pain. Physical examination and ultrasonography showed disappearance of the previous palpable supraclaviclar lymph nodes. Serum tumor markers were also reduced after the first administration of trastuzumab. The patient is currently alive, with no further progression of the lymph node or bone metastases.

乳腺に発生した稀な巨大fibrous tumorの1例を報告する.症例は49歳,女性.約7年前に右乳房腫瘤を自覚,徐々に増大し右乳房全体を占めるほど大きくなってきたことから当科を受診した.穿刺吸引細胞診にて細胞は採取されず, core needle biopsyにて膠原線維の増生を主体とする組織像であった.悪性の所見は得られなかったが,巨大な腫瘍であり正常乳腺が見あたらず,葉状腫瘍の可能性を考慮して単純乳房切除術を施行した.摘出標本肉眼所見では右乳房全体を占める約15×15cm大の白色均一な腫瘍であった.病理組織学的検査で線維芽細胞と周囲に膠原線維の増生を認め,核異型,分裂像などを認めず, fibrous tumorと診断された.

進行再発乳癌20例に対しpaclitaxel 50～80mg/m2,週1回1時間投与を行った. (50mg/m2が6例, 80mg/m2が14例)6投2休を1サイクルとして3サイクルを上限として投与した.投与回数の中央値は10回,奏効率50%, time to progressionの中央値は14.5週で,薬物有害反応としては重篤な急性過敏症は認めず,白血球減少,知覚障害は軽度で,軽度の倦怠感が認められたが外来での投与が十分可能であった. Anthracycline,またはdocetaxel投与歴のある進行再発乳癌に対しても有効率は変わらず,本来QOLを重視する必要がある進行再発乳癌に対して有用であると考えられた.

An 80-year-old man was diagnosed with advanced gastric cancer and underwent distal gastrectomy. Although the pathological Stage of the cancer was III A, he refused adjuvant chemotherapy. One year later, CT revealed multiple liver metastases. Therefore, he was started with S-1 administration and a complete response was obtained at 10 months after starting S-1 administration. He has maintained a complete response for 22 months after S-1 discontinuation.

We propose a database access extension to the Elastic-Core Architecture, a mobile core network virtualization architecture. The proposed improvements, i.e., using a combination of a caching scheme and a peer-to-peer type backend database with a specific read/write mode, reduce the state sharing load, enable more effective network site operation, and further enhance availability. We implement the architecture in virtualized IP Multimedia Subsystem (IMS) servers and compare the proposed caching scheme against the conventional memory synchronization approach. Results show a 12.5% reduction in the CPU usage overhead and network usage is drastically reduced as well. Finally, we prove that the improved Elastic-Core Architecture prevents call loss, achieving 100% service availability for a 20 ms transmission delay among IMS nodes and their state database.

視触診による乳癌検診の効能を検討するため, 北海道対がん協会で見つかった乳癌1,857名を, 検診時無症状であった607名 (検診発見癌) と自覚症状をもって受診し乳癌と診断された1,250名 (検診診断癌) に分け, 比較検討した。平均年齢は変わらず, 検診時期も約1年の違いしかなかったが, 臨床病期1の割合は発見癌でより大きく, 病期HI+IVではより小さかった。T1の割合も発見癌でより大きく, T3+4ではより小さかった。リンパ節転移個数は発見癌で0個の割合が大きく, 5個以上の割合は小さかった。5年生存率は発見癌で有意に高く, 10年生存率はより高い傾向を認めた (p=0.064) 。病院外来発見癌は病期において検診診断癌より進行度が高いと考えられるので, 無症状検診者に視触診検診をすることはある程度有効かもしれない。また, 検診発見癌は診断癌より小さいことから, 視触診検診は乳房温存手術の適応を増やして, 乳癌患者のQOLを増加させるであろう。

The reaction of [Ru(solvent)2(bpy)2]2+ (bpy = 2,2'-bipyridine) with Haet (2-aminoethanethiol) in ethanol/water in the presence of Ag+ gave a thiolato-bridged RuIIAgIRuII trinuclear complex, [Ag{Ru(aet)(bpy)2}2]3+, in which two [RuII(aet)(bpy)2]+ units are linked by an AgI atom. When this complex was treated with HCl in acetonitrile/water, a disulfide-bridged RuIIRuII dinuclear complex, [Ru2(cysta)(bpy)4]4+ (cysta = cystamine), was produced as a result of the removal of an AgI atom and the autoxidation of thiolato groups. It was found that the dinuclear structure in [Ru2(cysta)(bpy)4]4+ is reverted back to [Ag{Ru(aet)(bpy)2}2]3+ by treatment with Ag+ assisted by Zn reduction.

Lanthanoid triisopropoxides are active catalysts for aldol reactions. Aldehydes give the corresponding β-hydroxyaldehydes at low temperatures in good yields, whereas ketones are less reactive, but form condensation products at high temperatures. Exceptionally, γ- or δ-diketones easily undergo condensation to give five- and six-membered unsaturated ketones in high yields. The lanthanoid propoxides, catalyzing the Michael addition of ketones to α,β-unsaturated ketones, which give δ-diketones, are also good catalysts for the Robinson-type annelation. In these reactions, the catalytic activity of the lanthanum propoxide is higher than those of the heavy lanthanoid propoxides, and is almost comparable to that of sodium isopropoxide. Since aluminum triisopropoxide shows poor activity, the lanthanoid propoxides are considerably basic for trivalent metal alkoxides.

2527Background: Whether participation in a randomized-controlled trial provides benefits to patients is controversial. Some studies have showed that participants have longer prognosis than non-part...

The present study examined long‐term efficacy outcomes in a subgroup of postmenopausal, estrogen receptor‐positive Japanese breast cancer patients from the Pre‐Operative “Arimidex” Compared with Tamoxifen trial, following pre‐operative (3 months) and post‐operative (5 years) adjuvant treatment with either anastrozole or tamoxifen. Patients with large, potentially operable, locally‐advanced breast cancer were randomized to receive anastrozole (1 mg/day) plus tamoxifen placebo or tamoxifen (20 mg/day) plus anastrozole placebo pre‐operatively. After surgery at 3 months, patients continued on the same study medication as adjuvant therapy for up to 5 years or until recurrence, intolerable toxicity or withdrawal of patient consent. Recurrence‐free survival and overall survival were measured from the date of randomization to the date of recurrence or death, whichever occurred first. Patients were monitored for adverse events throughout the study period and up to 30 days following administration of the last study medication. During post‐operative adjuvant therapy, 4/48 (8%) anastrozole and 25/49 (51%) tamoxifen patients experienced recurrence. There was a significant difference in recurrence‐free survival between the two groups (hazard ratio 0.14; 95% confidence interval 0.05–0.41; P = 0.0003). There was a significant increase in overall survival with anastrozole (0.21; 0.05–0.96; P = 0.0436) and there were 2/48 (4%) and 10/49 (20%) deaths with anastrozole and tamoxifen, respectively. Most patients responding to pre‐operative therapy remained recurrence‐free. Sequential pre‐operative/post‐operative treatment with anastrozole resulted in lower recurrence and death rates, compared with tamoxifen. (Cancer Sci 2012; 103: 491–496)

A 2 1/2-year-old boy with biliary atresia underwent orthotopic living-related liver transplantation. On the 7th postoperative day, he had an episode of hepatic arterial thrombosis following disseminated intravascular coagulation (DIC) due to severe intraabdominal sepsis. Tissue plasminogen activator was administered regionally and the hepatic arterial flow recovered promptly. On postoperative day 33, portal vein thrombosis occurred and direct tissue plasminogen activator injections into the portal vein improved portal blood flow. However, the patient eventually died of poorly controlled DIC. Throughout the course, color Doppler ultrasonogram and arterial ketone body ratio were good indicators of hepatic arterial and portal blood flow. When hepatic arterial thrombosis and portal vein thrombosis occur, retransplantation is often inevitable. Thus, while the patient is awaiting a suitable donor, it could be possible to maintain blood flow to the graft with this new thrombolytic therapy.

Treatment of a thiolato-bridged Ru(II)Ag(I)Ru(II) trinuclear complex, [Ag{Ru(aet)(bpy)(2)}(2)](3+) (aet = 2-aminoethanthiolate; bpy = 2,2'-bipyridine), with NaI in aqueous ethanol under an aerobic condition afforded a mononuclear ruthenium(II) complex having an S-bonded sulfinato group, [1](+) ([Ru(aesi-N, S)(bpy)(2)](+) (aesi = 2-aminoethanesulfinate)). Similar treatment of optically active isomers of an analogous Ru(II)Ag(I)Ru(II) trinuclear complex, Δ(D)Δ(D)- and Λ(D)Λ(D)-[Ag{Ru(d-Hpen-O,S)(bpy)(2)}(2)](3+) (d-pen = d-penicillaminate), with NaI also produced mononuclear ruthenium(II) isomers with an S-bonded sulfinato group, Δ(D)- and Λ(D)-[2](+) ([Ru(d-Hpsi-O,S)(bpy)(2)](+) (d-psi = d-penicillaminesulfinate)), respectively, retaining the bidentate-O,S coordination mode of a d-Hpen ligand and the absolute configuration (Δ or Λ) about a Ru(II) center. On refluxing in water, the Δ(D) isomer of [2](+) underwent a linkage isomerization to form Δ(D)-[3] (+) ([Ru(d-Hpsi-N,S)(bpy)(2)](+)), in which a d-Hpsi ligand coordinates to a Ru(II) center in a bidentate-N,S mode. Complexes [1](+), Δ(D)- and Λ(D)-[2](+), and Δ(D)-[3](+) were fully characterized by electronic absorption, CD, NMR, and IR spectroscopies, together with single-crystal X-ray crystallography. The electrochemical properties of these complexes, which are highly dependent on the coordination mode of sulfinate ligands, are also described.

The reaction of [Ru(solvent)(2)(bpy)(2)](2+) (bpy = 2,2'-bipyridine) with D-H(2)pen (D-penicillamine) in ethanol/water in the presence of Ag(+) gave a thiolato-bridged Ru(II)Ag(I)Ru(II) trinuclear complex, [Ag{Ru(D-Hpen)(bpy)(2)}(2)](3+) ([1](3+)), in which two octahedral [Ru(II)(D-Hpen)(bpy)(2)](+) units are linked by a linear Ag(I) ion. Of three possible isomers (Delta(D)Delta(D), Delta(D)Lambda(D), and Lambda(D)Lambda(D)), [1](3+) formed the Delta(D)Delta(D) and Lambda(D)Lambda(D) isomers that were separately isolated by fractional crystallization with the use of [Sb(2)(R,R-tartrato)(2)](2-). In [1](3+), each D-Hpen ligand chelates to a Ru(II) center through thiolate and carboxylate groups, while an amine group of D-Hpen is protonated and does not participate in the coordination. On refluxing in ethanol/water, the Delta(D)Delta(D) isomer of [1](3+) was converted to Delta(D)Delta(D)-[2](3+), in which each D-Hpen ligand chelates to a Ru(II) center through thiolate and amine groups with a non-coordinating carboxyl group. On the other hand, a similar thermal linkage isomerization was not noticed for the Lambda(D)Lambda(D) isomer of [1](3+) under the same conditions. The isolated Delta(D)Delta(D)-[1](3+), Lambda(D)Lambda(D)-[1](3+), and Delta(D)Delta(D)-[2](3+) were fully characterized by electronic absorption, CD, and NMR spectroscopies, along with single-crystal X-ray crystallography for Lambda(D)Lambda(D)-[1](3+) and Delta(D)Delta(D)-[2](3+).

In 12 cases of well differentiated thyroid carcinoma infiltrating into the larynx and trachea, one total laryngectomy and 11 partial resections of the thyroid were performed. Anterior cervical tumor was the most common compliant. The half of the cases had symptoms such as dyspnea and hoarseness indicating infiltration into the larynx, trachea and recurrent nerve. CT scan and tracheal endoscopy were useful for cases in which the tumor invaded the tracheal mucosa, but for the other cases it was difficult to diagnose the tracheal invasion before operation. In the one case undergone laryngectomy, 3 circular resection and 8 luminar resection, the tumor was found to invade the mucosa in 3, circular ligamentum in 3, and external ligamentum in 3. Other 3 cases had no pathological invasion. Their prognoses are favorable that all the patients are still alive with no local recurrence. Resection of the thyroid carcinoma with the larynx and the trachea are considered to be useful to control the local area.

胆石症を併存したDubin-Johnson症候群 (以下D-J症候群) の1手術例を報告する.症例は35歳の男性で黄疸, 右季肋部痛を主訴とし, 点滴静注胆嚢・胆管造影法で, 結石の有無は不明であったが, 超音波検査で胆嚢内に音響陰影を伴った結石エコーが描出された.摘出胆嚢内には, コレステロール含量98%以上の327個のコレステロール胆石があった.術後肝機能検査所見は術前とほとんど変わりなく, 術後3日では血清総ビリルビン5D6mg/dl, 直接型ビリルビソ4.0mg/dlと最高値を示したが, 経過は良好で, 術後11日で退院した.1988年までの胆石症を併存したD-J症候群の本邦報告例は本症例を含めて24例であった.D-J症候群を併存しない胆石症手術例の年齢分布と比較して, 報告された24例中では10代, 20代の若年者に胆石の併存が多かった.D-J症候群の患者が腹痛を訴えた時は, 胆石症の併存も考慮して超音波検査を第一に行うことが必要である.

Thirty women (mean age 50.4 years, range 31-63) with primary advanced breast cancer were given EPI 40-60 mg/m(2) and DOC 50-60 mg/m(2) intravenously every three weeks. The efficacy was evaluated after 4 cycle treatments. There were 5 complete responses (CR) and 14 partial responses (PR), giving an overall response rate of 63.3%. There were 2 pathological CR (8%) which showed complete disappearance of cancer cells. The high dose group showed a better response than the low-dose group. The most common grade 3/4 adverse events were neutropenia (26.7%) and general fatigue (6.7%). The simultaneous combination treatment of EPI and DOC is effective for primary chemotherapy and can be performed safely even for outpatients.

Background : At present, it is one of the most important issues for the treatment of breast cancer to develop the standard therapy for patients previously treated with anthracyclines and taxanes. With the objective of determining the usefulness of vinorelbine monotherapy in patients with advanced or recurrent breast cancer after standard therapy, we evaluated the efficacy and safety of vinorelbine in patients previously treated with anthracyclines and taxanes. Methods: Vinorelbine was administered at a dose level of 25 mg/m 2 intravenously on days 1 and 8 of a 3 week cycle. Patients were given three or more cycles in the absence of tumor progression. A maximum of nine cycles were administered. Results: The response rate in 50 evaluable patients was 20.0% (10 out of 50; 95% confidence interval, 10.0-33.7%). Responders plus those who had minor response (MR) or no change (NC) accounted for 58.0% [10 partial responses (PRs) + one MR + 18 NCs out of 50]. The Kaplan-Meier estimate (50% point) of time to progression (TTP) was 115.0 days. The response rate in the visceral organs was 17.3% (nine PRs out of 52). The major toxicity was myelosuppression, which was reversible and did not require discontinuation of treatment. Conclusion: The results of this study show that vinorelbine monotherapy is useful in patients with advanced or recurrent breast cancer previously exposed to both anthracyclines and taxanes.

The reactions of the ΛD or ΔD isomer of [Co(D-Hpen-N,S)(en)2](ClO4)2 (1; D-H2pen = D-penicillamine) with AgNO3 in water, followed by the addition of NaCl and HCl, led to the formation of discrete C...

In the crystal structure of the title compound, ΛLΛL-[AgCo2(C3H5NO2S)2(C2H8N2)4](ClO4)3·5H2O, the AgI atom, which lies on a twofold rotation axis, is linearly coordinated by two thiol­ate S atoms from two ΛL-[Co(C3H5NO2S)(C2H8N2)2]+ octa­hedral units, forming an S-bridged CoIII–AgI–CoIII trinuclear unit. The compound has two uncoordinated carboxyl­ate groups.

The influence of warm ischemia on the metabolism of prostaglandins was investigated using a pig liver transplantation model employing the temporary portal arterialization technique. Eighteen pigs were divided into three groups according to warm ischemia time: 0 min (group I, n = 6), 30 min (group II, n = 6), and 60 min (group III, n = 6). During portal arterialization, the hepatic venous prostaglandin E2 (PGE2) level in group III (3356.0 +/- 1011.8 pg/ml) was significantly higher than that in group I (831.7 +/- 182.1 pg/ml; P = 0.0285). The hepatic venous PGE2 levels were significantly higher than the arterial counterparts in all groups both at the beginning and during portal arterialization. At 60 min after portal revascularization, the arterial PGE2 level in group III (886.7 +/- 268.0 pg/ml) was significantly higher than that in group I (99.0 +/- 18.6 pg/ml; P = 0.0116) and II (204.2 +/- 65.4 pg/ml; P = 0.0282). Neither thromboxane B2 (TXB2) nor 6-keto PGF1 alpha showed any significant differences. In conclusion, the intraoperative changes of PGE2 thus reflected the degree of warm ischemic damage, and PGE2 could also be released from the graft. On the other hand, the increased levels of TXB2 and 6-keto PGF1 alpha were thought to have an extrahepatic origin.

Twelve porcine liver transplantations were performed to investigate whether serum hyaluronic acid (HA) serves as a marker of warm ischemic injury. Group 1 was a control without warm ischemia (n = 7), and pigs in Group 2 were sacrificed by intracardiac KC1 injection 60 min before harvesting (n = 5). All pigs survived more than 4 days in Group 1. In Group 2, all died within 2 days due to graft failure. Arterial and hepatic venous glutamic-oxaloacetic transaminase (GOT) in Group 2 were higher after revascularization. However, there were no differences between the 2 groups in arterial and hepatic venous HA levels. HA clearance by the graft also showed no differences between the groups. Although GOT reflected the degree of warm ischemia, HA and its hepatic clearance were not influenced by warm ischemic damage. In conclusion, HA was not thought to serve as a marker of liver injury when the graft suffered from warm ischemia.

In the crystal of the title compound, [Ru(C(2)H(6)NS)(C(26)H(24)P(2))(2)]PF(6), the Ru(II) atom is in a slightly distorted octa-hedral geometry, coordinated by one 2-amino-ethane-thiol-ate (aet) and two 1,2-bis-(diphenyl-phosphan-yl)ethane (dppe) ligands. The crystal consists of a pair of enanti-omers (Δ and Λ) of the compound. The Δ and Λ isomers have the λ and δ conformations for the aet chelate rings and the δ and λ conformations for the dppe chelate rings. The F atoms of the PF(6) (-) counter-anion are disordered over three positions, with site occupancies of 0.4, 0.3 and 0.3.

This paper discusses operation problems and their causes in mobile communications network, and proposes advanced operation concepts that overcome these problems for a future mobile communications network. Network operation are becoming increasingly difficult as the number of users is increasing rapidly and the variety of services is also increasing. The functional architecture for these advanced operation concepts is described.

Treatment of [Os(bpy)(2)Cl(2)] (bpy = 2,2'-bipyridine) with 2-aminoethanethiolate was accompanied by air oxidation to give [Os(2-aminoethanesulfinato-N,S)(bpy)(2)](+) ([1](+)), which was further oxidized by air to be converted into [Os(2-iminoethanesulfinato-N,S)(bpy)(2)](+) ([2](+)) under photoirradiation. Complex [2](+) was reverted back to [1](+) by treatment with BH(4)(-).