The pathological (histological and cytological) diagnosis of mucinous ovarian tumors presents the following problems: 1) conflicting definitions of borderline tumors, intraepithelial carcinoma and microinvasive carcinoma, 2) mural nodules within mucinous cystic tumors, 3) differential diagnosis in primary vs. metastatic mucinous tumors, and 4) difficulties in the intraoperative rapid diagnosis of mucinous ovarian tumors. Mucinous adenocarcinomas may include benign and/or borderline tumor components in other areas of the tumor. Therefore for pathological diagnosis, the sampling of these tumors must include up to one histological section per 1 to 2cm of tumor diameter as well as sampling of any suspicious lesions (multilocular and solid areas including mural nodules). The most important differential diagnosis for mucinous ovarian carcinoma is metastatic mucinous carcinoma. Histological findings from metastatic mucinous carcinoma from the appendix, large intestine, stomach, pancreas, and cervix are similar. In general, immunohistological staining, such as cytokeratin 7 (CK7) and CK20, is necessary to determine the origin of the cancer. False-negative diagnoses from frozen sections can occur due to limited sampling, as only a few frozen sections (1 or 2 in our hospital) can be taken from each tumor. Cytological specimens (scrape or imprint smears) which are sampled from any suspicious lesions or from almost all cut surfaces of the tumors can facilitate intraoperative rapid diagnosis of mucinous ovarian tumor.

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Triple-negative breast cancer (TNBC), lacking estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor (HER2) expression, is resistant to conventional therapies. Recent studies have focused on microRNAs (miRNAs) as novel molecular targets for treating TNBC because they modulate gene expression and tumor progression. In the current study, we analyzed the expression of selected miRNAs (miR-145 and miR-182) and tumor promoting factors such as Fascin and poly (ADP-ribose) polymerase (PARP) in human TNBC tissues and “Luminal A” breast cancer tissues, which express ER and PgR, but not HER2, as well as breast cancer cell lines including the triple-negative MDA-MB-231 and Luminal A MCF-7. The results showed that miR-145 and miR-182 were expressed in Luminal A breast cancer tissues and MCF-7 cells, but not in TNBC tissues and MDA-MB-231 cells. In contrast, Fascin and PARP proteins were highly expressed in TNBC and MDA-MB-231, but poorly expressed in Luminal A tissues and MCF-7 cells, indicating a negative correlation between expression of these miRNAs and that of the tumor promoting factors Fascin and PARP. The current study therefore suggests that miR-145 and miR-182 could be potential novel therapeutic targets for TNBC therapy.

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Silencing of gene expression by RNA interference (RNAi) has become a widely used tool for assessing gene function in a fast and easy manner. An important advance in the RNAi field was the discovery that plasmid-based short hairpin RNA transcription can substitute for synthetic small interference RNAs both in vitro and in vivo. The constitutive knockdown of gene expression by RNAi can limit the scope of experiments, especially if the inhibition of genes leads to cell lethality, which prevents in vivo functional analysis. We have generated double-conditional short hairpin RNA from a single vector that can regulate its own transcription by a combination of tetracycline-inducible and Cre-loxP systems. This vector will be useful for the control of short hairpin RNA expression in a spatially-regulated manner by Cre recombinase as well as a temporally-regulated manner by tetracycline induction. These control features provide for the specific silencing of genes to facilitate functional genetic analysis in mammals in vivo.

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This study aimed to determine the expression of c-kit, human epidermal growth factor receptor type 2 (HER2), insulin-like growth factor receptor (IGFR), estrogen receptor (ER), progesterone receptor (PgR), vascular endothelial growth factor (VEGF), c-MET, and survivin in adenoid cystic carcinomas (ACC), carcinomas ex pleomorphic adenomas (CXPA), and mucoepidermoid carcinomas (MEC) of the salivary glands. These expression levels and locations were compared to estimate the availability of molecular and hormonal targets for therapy in salivary gland carcinomas. Forty patients with a salivary gland carcinoma, diagnosed and treated at our hospital, were studied. On the basis of histopathology, 13, 12, and 15 patients were diagnosed with ACC, CXPA, and MEC, respectively. Associations between histological types were evaluated by Fisher's exact test, with a significance level of P < 0.05. Compared with the other two histological types, ACC samples demonstrated significantly higher c-kit (85%), IGFR (77%), and ER (38%) expression, while CXPA demonstrated significant HER2 (75%) staining, and MEC demonstrated significant IGFR (77%) staining. The differences in expression of the tested markers among the histological types in our study suggested that c-kit- and IGFR-targeted therapy and anti-estrogen treatment could be effective in ACC, HER2-targeted therapy could be effective in CXPA, and that IGFR-target therapy could be effective in MEC of the salivary glands.

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In the case of orbital floor fractures, enophthalmos occurs if the volume of orbital tissue incarcerated into the maxillary sinus increases. However, during severe eyelid swelling, enophthalmos measurement is inaccurate. We aimed to investigate the correlation between the incarcerated tissue volume and ocular deviation. Patients with isolated orbital floor fracture were included. Orbital and incarcerated tissue volumes were measured using coronal computed tomography images. The ratio of incarcerated tissue volume to orbital volume (V) was calculated. Ocular deviation was measured using the Showa exophthalmometer. Ocular deviations in anterior-posterior and superior-inferior planes were defined as E1 and E2, respectively. Correlations between V and E1, V and E2, and E1 and E2 were statistically analyzed. Correlation coefficients between V and E1, V and E2, and E1 and E2 were 0.765, 0.279, and 0.237, respectively, and regression lines were E1 = 0.13 × V + 0.18, E2 = 0.05 × V-0.16, E2 = 0.24 × E1 + 0.07, respectively. Only the correlation between V and E1 was statistically significant. When enophthalmos cannot be measured after an isolated orbital floor fracture, if the tissue incarcerated volume can be measured using CT images, enophthalmos can be diagnosed.

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Organ-based tube-current modulation has been used to reduce radiation exposure to specific organs. However, there are no reports yet published on reducing radiation exposure in clinical cases. In this study, we assessed the reduction in radiation exposure to the mammary glands during thoracic computed tomography (CT) using X-CARE. In a phantom experiment, the use of X-CARE reduced radiation exposure at the midline of the precordial region by a maximum of 45.1%. In our corresponding clinical study, CT was performed using X-CARE in 15 patients, and without X-CARE in another 15. Compared to the non-X-CARE group, radiation exposure was reduced in the X-CARE group at the midline of the precordial region by 22.3% (P < 0.05) and at the medial sides of the right and left breasts by 16.8% and 14.2%, respectively (P < 0.05 for each). Analysis of the visual quality of CT images as well as CT values for the muscles of the chest walls showed no difference in either assessment between the X-CARE and non-X-care groups (P > 0.05). X-CARE thus reduced radiation exposure at the midline of the precordial region and allowed us to obtain consistent CT values without increasing noise. However, this study revealed increases in radiation exposure at the lateral sides of the breasts. It is conceivable that patients' breasts were laterally displaced by gravity under the standard thoracic imaging conditions. Further studies that consider factors such as body size and adjustment of imaging conditions may be needed in the future.

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Touch therapy is important in many clinical settings to reduce patient stress and anxiety. However, few studies have examined the effects of touch therapies, particularly those that use specific techniques to ease psychological and physiological distress, on the emotional state of patients. Respiratory rate is correlated with emotional changes. Thus, the aim of the present study was to elucidate the effects of touching and rubbing methods on various respiratory parameters as indices of the emotional state in 11 normal, healthy subjects. Subjects were divided into high and low anxiety groups based on their State-Trait Anxiety Inventory (STAI) score before the experiment. After the application of specific touching and rubbing stimuli, the subjects were asked to evaluate their comfort level on a visual analog scale. The respiratory rate in subjects with high anxiety increased significantly more during rubbing than touching; in contrast, the respiratory rate in subjects with low anxiety did not differ between the two methods. As a whole, the data suggest that touch rather than rub therapy may be more suitable for subjects with high anxiety, and that the therapeutic technique to be used should be chosen with care for subjects with high anxiety.

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Well-differentiated papillary mesothelioma of the pleura (WDPM-P) is an extremely rare type of mesothelial tumor that is thought to be of low malignant potential. Herein, we report on a case of WDPM-P. A 74-year-old woman was admitted for evaluation of shortness of breath. Pleural effusion was observed in the right thorax. Computed tomography after chest drainage did not reveal any lung or pleural tumors. Abnormally high levels of hyaluronic acid were detected in the pleural effusion. Cytological examination of the effusion revealed Class V findings; however, it was difficult to distinguish mesothelioma from adenocarcinoma. Because immunological evaluation may have provided more information, video-assisted thoracic surgical pleural biopsy (VATS-PB) was performed. Biopsied frozen specimens were revealed to be mesothelioma, and so localized pleurectomy and partial resection of the diaphragm were performed. Pathological examination established a diagnosis of WDPM-P. Six years postoperatively, the patient is doing well. As demonstrated in the present case, combined VATS-PB and pathological studies are useful for the diagnosis of and determination of surgical indications for pleural malignancies.

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