We studied the extent of BRCA1/2 genetic testing to help select the surgical approach for patients with breast cancer in Japan remains unclear. The study subjects were female patients with primary unilateral invasive breast cancer considered as candidates for breast-conserving surgery who underwent preoperative BRCA1/2 genetic testing. click here A retrospective analysis was performed on the results of BRCA1/2 genetic testing and surgical method selection using national registration data from the Japanese Hereditary Breast and Ovarian Cancer Syndrome Consortium. Our study included 318 female patients. Among these patients, 23.7% of patients with BRCA1/2 mutations and 61.8% of patients without these variants underwent breast-conserving surgery (P< .01). Among the patients with BRCA1/2 mutations, those who chose breast-conserving surgery tended not to undergo risk-reducing salpingo-oophorectomy (P< .05). Among the patients with BRCA1/2 mutations who underwent mastectomy for the affected side, 31.8% received contralateral risk-reducing mastectomy. Patients diagnosed with breast cancer under the age of 50 years were more likely to have contralateral risk-reducing mastectomy than patients over the age 50 years (P< .05). Patients with BRCA1/2 mutations tend to choose mastectomy. However, it is speculated that the final surgical method selection is made in consideration of not only the test results but also with careful consideration of the patient, taking into account other factors including individual values for risk-reducing surgeries and the age of breast cancer onset.Patients with BRCA1/2 mutations tend to choose mastectomy. However, it is speculated that the final surgical method selection is made in consideration of not only the test results but also with careful consideration of the patient, taking into account other factors including individual values for risk-reducing surgeries and the age of breast cancer onset. The plasma acylcarnitine profile is frequently used as a biochemical assessment for follow-up in diagnosed patients with fatty acid oxidation disorders (FAODs). Disease specific acylcarnitine species are elevated during metabolic decompensation but there is clinical and biochemical heterogeneity among patients and limited data on the utility of an acylcarnitine profile for routine clinical monitoring. We evaluated plasma acylcarnitine profiles from 30 diagnosed patients with long-chain FAODs (carnitine palmitoyltransferase-2 (CPT2), very long-chain acyl-CoA dehydrogenase (VLCAD), and long-chain 3-hydroxy acyl-CoA dehydrogenase or mitochondrial trifunctional protein (LCHAD/TFP) deficiencies) collected after an overnight fast, after feeding a controlled low-fat diet, and before and after moderate exercise. Our purpose was to describe the variability in this biomarker and how various physiologic states effect the acylcarnitine concentrations in circulation. Disease specific acylcarnitine species were highebut the response to exercise was highly variable across subjects and diagnoses. The clinical utility of routine plasma acylcarnitine analysis for outpatient treatment monitoring remains questionable; however, if acylcarnitine profiles are measured in the clinical setting, standardized procedures are required for sample collection to be of value. Myxofibrosarcoma (MFS) is a common soft tissue sarcoma in the elderly patients with both clinical and magnetic resonance imaging (MRI) peculiar features very high recurrence rate, relatively low risk of distant metastases. On MRI it shows an infiltrative pattern ("tail sign") and high myxoid matrix content with water-like appearance on fluid-sensitive sequences. Due to these unusual characteristics, we propose a specific MRI grading system to stratify the risk of local recurrence (LR) and offer other prognostic information. Two expert radiologists retrospectively and blindly reviewed preoperative MRI of 150 patients affected by MFS of the extremities treated at a single Institution. Myxoid matrix component and contrast enhancement of the tumor were evaluated and graded with a semiquantitative method. The presence of an infiltrative pattern, the depth of the tumor (deep and/or superficial) and tumor sizes were also recorded. MRI features were analyzed separately and correlated to LR risk, sarcoma specific atify the risk of LR in MFS of the extremities. The system is applicable to all the standard MRI studies protocols, might help in surgical planning, and may offer prognostic information.This is the largest series evaluating MRI features as prognostic factors for MFS. The MRI grading system proposed is significantly able to stratify the risk of LR in MFS of the extremities. The system is applicable to all the standard MRI studies protocols, might help in surgical planning, and may offer prognostic information. In February 2020, administrators for the US medical licensing examination (USMLE) announced that Step 1 reporting would change to pass/fail in hopes of reducing the overemphasis of USMLE performance on the residency selection system and improving medical student well-being. Our objective was to determine the perspectives of diagnostic radiology (DR), interventional radiology (IR), and nuclear medicine (NM) program directors (PDs) regarding pass/fail USMLE Step 1 scoring. A survey composed of thirteen questions on a three-point Likert scale, five demographic questions, and a free-text question was distributed to 179 DR, 84 IR, and 34 NM PDs from ACGME-accredited residency programs. In total, 140 unique responses were obtained (response rate = 47.1%). The PD respondents had a male predominance of 79.1%, average age of 46 ± 7.2 years, and average tenure of 5.9 ± 5.2 years. A majority of PDs (69.6%) disagreed that the change is a good idea, and a minority (21.6%) believe the change will improve medical student well-being. Further, 90.7% of PDs believe a pass/fail format will make it more difficult to objectively compare applicants and most will place more emphasis on USMLE Step 2 scores and medical school reputation (89.3% and 72.7%, respectively). The lasting impact of pass/fail Step 1 scoring are uncertain and many radiology PDs do not support this change. While the central motivations to reduce the overemphasis on USMLE Step 1 performance and improve medical student well-being are admirable, it remains to be seen if pass/fail scoring will accomplish these goals.The lasting impact of pass/fail Step 1 scoring are uncertain and many radiology PDs do not support this change. While the central motivations to reduce the overemphasis on USMLE Step 1 performance and improve medical student well-being are admirable, it remains to be seen if pass/fail scoring will accomplish these goals.