[A Case of Breast Cancer That Developed Pulmonary Tumor Thrombotic Microangiopathy during Adjuvant Chemotherapy].

A 68-year-old woman underwent neoadjuvant chemotherapy for left breast cancer(triple negative type), cT2N3cM0, cStage ⅢC, and Bt+Ax(Ⅲ). The pathological diagnosis was ypT1aN2aM0, ypStage ⅢA, ER-, PgR-, HER2 score 1+, Ki- 67 25%. Adjuvant radiotherapy(50 Gy/25 Fr)was then administered, followed by capecitabine as adjuvant chemotherapy. Dyspnea occurred during administration of capecitabine, and computed tomography(CT)and blood test results suggested drug-induced interstitial pneumonia and disseminated intravascular coagulation(DIC). The patient was admitted, and steroid pulse therapy, anticoagulant therapy, and antibiotics were administered; however, the treatment was ineffective, and she died 3 days after admission. An autopsy provided a final diagnosis of pulmonary tumor thrombotic microangiopathy(PTTM). There is no established treatment for PTTM, and the prognosis is poor even with anticoagulant therapy and chemotherapy. The definitive diagnosis of PTTM is based on pathological findings; however, during respiratory failure, invasive tests such as lung biopsy are not recommended. Therefore, if a significantly worsening respiratory disorder develops, as in this case, chemotherapy should be considered for suspected PTTM.

[A Case of Triple Negative Breast Cancer with Left Buttock Metastasis].

A female patient in her 50s was diagnosed with triple negative breast cancer in the left breast with a buttock metastasis. After neoadjuvant chemotherapy, the patient underwent surgery on the left breast. As the histopathological findings indicated a residual tumor, she was further treated with capecitabine postoperatively. Twenty months postoperatively, a CT scan revealed a tumor on her left buttock. She was also diagnosed with a relapse of the breast cancer after a core needle biopsy. She was treated with atezolizumab and nab-paclitaxel as first-line therapy for the metastasis and with eriburlin as second- line therapy. As she became uncomfortable sitting owing to the regrowth of the buttock tumor, the left buttock tumor was resected. She has been treated with bevacizumab and paclitaxel for subsequent lung metastases.

Effect of fingernail length on the hand dexterity.

[Purpose] The fingernails allow for increased sensory perception at the finger pulp, and contribute to the accurate picking up of small objects. The purpose of the present study was to clarify the effect of fingernail length on hand dexterity using subjects' own fingernails. [Subjects and Methods] The hand sizes and fingernail configurations of 38 young healthy volunteers (eighteen males and twenty females) were measured. The effect of fingernail length (0 and 2 mm) on hand dexterity also was investigated using the simple test for evaluating hand function. [Results] The hand and finger sizes as well as fingernail widths were significantly larger in males than in females. The time taken for each subtest of the simple test for evaluating hand function was generally shorter at a fingernail length of 2 mm than at 0 mm, and it was significantly shorter for a number of subtests. There was little significant difference in the time taken for the subtests between genders. [Conclusion] It was clear that a fingernail length of 2 mm had an advantageous effect on hand dexterity, with little gender difference observed. These findings suggest that the fingernail lengths of the subjects should be standardized when evaluating changes in their hand dexterity with time.