Risk Factors for Eribulin-induced Severe Neutropenia in Patients With Recurrent Breast Cancer.

BACKGROUND/AIM: Eribulin is an effective chemotherapeutic agent for advanced and metastatic breast cancer. However, severe neutropenia occurs in 30-40% of patients and interferes with the recommended treatment schedule. Neutropenia is a major cause of treatment interruptions, delays, or even relative dose reductions. This study aimed to examine the risk factors for severe neutropenia after eribulin treatment. PATIENTS AND METHODS: We retrospectively evaluated 263 patients with metastatic breast cancer who had received eribulin therapy. Risk factors for severe neutropenia in the first cycle were evaluated. RESULTS: Severe neutropenia in cycle 1 occurred in 50% of the patients. Multivariate analysis suggested six risk factors for severe neutropenia: low baseline neutrophil count and body mass index, high aspartate aminotransferase and bilirubin levels, creatinine clearance (CrCl) less than 50 ml/min, and eribulin dose of 1.4 mg/m2 Conclusion: This is one of the few studies to simultaneously examine both hepatic and renal functions in relation to severe neutropenia induced by eribulin. We have provided important information to support the close monitoring of patients with these risk factors and subsequent dosage adjustments, if necessary.

Nanostructure Control in Zinc Oxide Films and Microfibers through Bioinspired Synthesis of Liquid-Crystalline Zinc Hydroxide Carbonate; Formation of Free-Standing Materials in Centimeter-Level Lengths.

Free-standing zinc oxide in the forms of films and fibrous materials are expected to be used as functional devices such as piezoelectric devices and catalyst filters without being limited by the growth substrate. Herein, a synthetic morphology-control method for 2D and 1D free-standing ZnO materials with ordered and nanoporous structures by conversion of liquid-crystalline (LC) zinc hydroxide carbonate (ZHC) nanoplates is reported. As a new colloidal liquid crystal, the LC ZHC nanoplate precursors are obtained by a biomineralization-inspired method. The approach is to control the morphology and crystallographic orientation of ZHC crystals by using acidic macromolecules. Their nano-scale and oriented structures are examined. The LC oriented ZHC nanoplates have led to the synthesis of free-standing films and microfibers of ZHC in centimeter-level lengths, with the successful thermal conversion into free-standing films and microfibers of ZnO. The resultant ZnO films and ZnO microfibers have nanoporous structures and preferential crystallographic orientations that preserve the alignment of ZHC nanoplates before conversion.

Experimental probing of dynamic self-organized columnar assemblies in colloidal liquid crystals.

Self-organized supramolecular assemblies are widespread in nature and technology in the form of liquid crystals, colloids, and gels. The reversible nature of non-covalent bonding leads to dynamic functions such as stimuli-responsive switching and self-healing, which are unachievable from an isolated molecule. However, multiple intermolecular interactions generate diverse conformational and configurational molecular motions over various time scales in their self-assembled states, and their specific dynamics remains unclear. In the present study, we have experimentally unveiled the static structures and dynamical behaviors in columnar colloidal liquid crystals by a coherent X-ray scattering technique using refined model samples. We have found that controlling the size distribution of the colloidal nanoplates dramatically changed their static and dynamic properties. Furthermore, the resulting dynamical behaviors obtained by X-ray photon correlation spectroscopy have been successfully decomposed into multiple distinct modes, allowing us to explore the dynamical origin in the colloidal liquid-crystalline state. The present approaches using a columnar liquid crystal may contribute to a better understanding of the dynamic nature of molecular assemblies and dense colloidal systems and bring valuable insights into rational design of functional properties of self-assembled materials such as stimuli-responsive liquid crystals, self-healing gels, and colloidal crystals. For these materials, the motion of constituent particles and molecules in the self-assembled state is a key factor for structural formation and dynamically responsive performance.

Will preoperative atrophy and Fatty degeneration of the shoulder muscles improve after rotator cuff repair in patients with massive rotator cuff tears?

Recently, retear rate after repair for massive cuff tear have been improved through devised suture techniques. However, reported retear rate is relevant to preoperative atrophy and fatty degeneration. The purpose of this study was to investigate whether preoperative atrophy and fatty degeneration of rotator cuff muscles improve by successful repair. Twenty-four patients with massive rotator cuff tear were evaluated on the recovery of atrophy and fatty degeneration of supraspinatus and infraspinatus muscle after surgery. Atrophy was classified by the occupation ratio and fatty degeneration by modified Goutallier's classification. Both were assessed on magnetic resonance imaging (MRI) before and after the operation. When the cuff was well repaired, improvement of the atrophy and fatty degeneration were observed in a half and a one-fourth of the cases, respectively. In retear cases, however, atrophy and fatty degeneration became worse. Improvement of atrophy and fatty degeneration of the rotator cuff muscles may be expected in the cases with successful achievement of rotator cuff repair for large and massive tear.

Open repair for massive rotator cuff tear with a modified transosseous-equivalent procedure: preliminary results at short-term follow-up.

BACKGROUND: Many surgical procedures have been reported for rotator cuff tears. We adopted the modified transosseous-equivalent procedure, also termed "surface-holding repair with transosseous sutures," and demonstrated that this procedure has a biomechanical advantage regarding the concentration of stress on the tendon stump. This study aimed to evaluate the clinical and structural outcomes of this technique, which has been demonstrated by postoperative magnetic resonance imaging (MRI) to produce high intact rates. METHODS: Twenty-nine massive rotator cuff tears involving at least two tendons were treated by open repair using this procedure. Twenty-four patients were evaluated at an average of 43.2 months (range 24-71) postoperatively (the follow-up rate was 83.8%). The pre- and postoperative clinical outcomes were examined using the scoring system of the Japanese Orthopedic Association (JOA score). In an A-P radiograph, the presence of osteoarthritis (OA) of the glenohumeral joint and upward migration of the humeral head were compared pre- and postoperatively. The repair integrity of the cuff tendon was evaluated by applying Sugaya's classification to the postoperative MRIs. RESULTS: The JOA score improved from 42.8 points preoperatively to 89.3 points at final follow-up. Radiographic examination showed that OA progressed in 16.7% and upward migration of the humeral head progressed in 20.8%. Postoperative MRI scans revealed 14 shoulders with type 1 repair based on Sugaya's classification, 4 shoulders with type 2, 4 shoulders with type 3, 2 shoulders with type 4, and no shoulders with a type 5 repair. CONCLUSIONS: Although osteoarthritis of the glenohumeral joint and upward migration of the humeral head had both progressed postoperatively in some cases, postoperative MRI scans revealed that 91.7% of the repairs resulted in a continuous rotator cuff. Therefore, this technique produces a high healing rate.

A procedure to determine the optimum imaging parameters for atomic/molecular resolution frequency modulation atomic force microscopy.

We propose a general procedure to determine the optimum imaging parameters (spring constant and oscillation amplitude) to obtain the optimum resolution in frequency modulation atomic force microscopy. We calculated the effective signal-to-noise ratio for various spring constants and oscillation amplitudes, based on the measurement of frequency shift and energy dissipation versus tip-sample distance curves, to find the optimum. We applied this procedure for imaging a lead phthalocyanine (PbPc) thin film on a MoS(2)(0001) substrate, and found that the optimum parameters were about 5 N/m and 20 nm, respectively. An improved signal-to-noise ratio was attained in a preliminary experiment using parameters which were close to the calculated optimum.