OBJECTIVE: Anxiety is prevalent in patients with mild cognitive impairment (MCI) and are considered to be a risk factor for conversion to dementia. The purpose of this study was to evaluate whether Anxiety symptoms in MCI promote disease progression in a manner related to amyloid status, and to determine the relationship between anxiety symptoms and longitudinal cerebral structural changes. METHODS: Baseline data for 230 patients with amyloid-positive MCI (52 with anxiety and 178 without) from the Alzheimer's Disease Neuroimaging Initiative study were analyzed. All participants underwent comprehensive cognitive testing, volumetric MRI, and [18F]AV45 positron emission tomography amyloid imaging. Anxiety symptoms were measured using the Neuropsychiatric Inventory Questionnaire. A voxel-based morphometric analysis using volumetric brain MRI data was used to compare longitudinal structural changes related to anxiety symptoms. RESULTS: The conversion rate to dementia was different between patients with and without anxiety in amyloid-positive MCI (37.7% vs. 16.1%, respectively ; p=0.001). Anxiety in amyloid-positive MCI was associated with longitudinal cortical atrophy in the left superior temporal gyrus, left Heschl's gyrus, left parahippocampal gyrus, left anterior cingulum, bilateral anterior cingulum and right superior orbital gyrus. CONCLUSION: Our study indicates that the presence of anxiety in patients with amyloid-positive MCI is associated with higher conversion to dementia and longitudinal cortical atrophy.
Alzheimer Disease ; Amyloid ; Anxiety* ; Atrophy ; Brain ; Dementia* ; Disease Progression ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment* ; Neuroimaging ; Parahippocampal Gyrus ; Positron-Emission Tomography ; Prefrontal Cortex ; Risk Factors ; Temporal Lobe

Thermodynamically immiscible poly(lactic acid) (PLA) and poly(ε-caprolactone) (PCL) were blended and solution-cast by adding the 3% compatibilizer (tributyl citrate, TBC) of the PCL weight. In the PLA/PCL composition range of 99/1–95/5 wt%, mechanical properties of the PLA/PCL films with TBC were always superior to those of the films without TBC. The tensile strength of 42.9 ± 3.5 MPa and the elongation at break of 10.3 ± 2.7% were observed for the 93/7 PLA/PCL films without TBC, indicating that PCL addition is effective for strength and ductility. However, the tensile strength of 54.1 ± 3.4 MPa and the elongation at break of 8.8 ± 1.8% were found for the 95/5 PLA/PCL with TBC, indicating that the effect of co-addition of PCL and TBC on mechanical properties of the films is more pronounced. No cytotoxicity was observed for the PLA/PCL films regardless of TBC addition.
Cell Proliferation ; Citric Acid ; Tensile Strength

The aim of this trial was to investigate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of heavily pretreated recurrent or persistent epithelial ovarian cancer (EOC). Patients with recurrent or persistent EOC who had measurable disease and at least two prior chemotherapy participating in this phase II trial were to receive etoposide at a dose of 100 mg/m2/day intravenously (IV) on days 1 to 3 in combination with ifosfamide 1 g/m2/day IV on days 1 to 5, every 21 days. Thirty-seven patients were treated; about 78% had previously received more than two separate regimens. The response rate (RR) was 18.9% and median duration of response was 7 months (range, 1-15). Treatment free interval prior to ETI (TFI) has significant correlation with RR rate (P=0.034). Patients (n=6) with TFI > or =6 months had 50% of RR, while patients (n=31) with TFI <6 months had 12.9%. Median survival was 9 months at a median follow-up of 9.2 months. Grade 3 or 4 toxicities included neutropenia in 20.1% of the 139 cycles of ETI, anemia in 7.2% and thrombocytopenia in 8.6%. The ETI produces relatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC. This is significant in patients with TFI > or =6 months.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Etoposide/administration & dosage/*therapeutic use ; Female ; Humans ; Ifosfamide/administration & dosage/*therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local/*drug therapy ; Ovarian Neoplasms/*drug therapy/mortality ; Survival Rate ; Treatment Outcome

PURPOSE: The purpose of this study was to evaluate the factors that are associated with the accuracy of magnetic resonance (MR) imaging for predicting myometrial invasion and lymph node metastasis in women with endometrial carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the medical records and preoperative MR imaging reports of 128 women who had pathologically proven endometrial carcinoma. We compared the MR imaging and the histopathology findings. RESULTS: The sensitivity, specificity and accuracy for identifing any myometrial invasion (superficial or deep) were 0.81, 0.61 and 0.74, respectively; these values for deep myometrial invasion were 0.60, 0.94 and 0.86, respectively. The sensitivity, specificity and accuracy of MR imaging for detecting lymph node metastasis were 50.0%, 96.6% and 93.0%, respectively. The patients who were older, had more deliveries and a larger tumor size more frequently had incorrect prediction of deep myometrial invasion (p=0.034, p=0.044, p=0.061, respectively). A higher tumor grade, a histology other than the endometrioid type, myometrial invasion on MR findings and a larger tumor size were associated with a more frequent false-negative prediction of lymph node metastasis (p=0.018, p=0.017, p=0.002, p=0.047, respectively). A larger tumor size was also associated with more frequent false-positive results (p=0.009). CONCLUSIONS: There are several factors that make accurate assessment of myometrial invasion or lymph node metastasis difficult with using MRI; therefore, the patients with these factors should have their MR findings cautiously interpreted.
Endometrial Neoplasms* ; Female ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Medical Records ; Neoplasm Metastasis* ; Retrospective Studies ; Sensitivity and Specificity