Lymph node (LN) macrophages play critical roles in anti‐tumor immunity, which develops via the activation of cytotoxic T cells (CTL) and NK cells. The present study aims to determine the prognostic significance of CD169+ LN macrophages in patients with endometrial carcinoma (EC). The number of CD169+ cells or the CD169+‐to‐CD68+ macrophage ratio in regional LN (RLN), and the number of CD8+ CTL or CD57+ NK cells in tumor tissues were investigated by immunohistochemistry in paraffin‐embedded tissue samples from 79 patients with EC. A high density of CD169+ cells in the RLN of patients with EC was correlated with an early clinical stage or no LN metastasis. A high number of CD169+ cells and a high CD169+‐to‐CD68+ macrophage ratio were significantly associated with longer overall survival in EC. We also found that the density of CD169+ macrophages was positively correlated with the number of CD8+ CTL and CD57+ NK cells that infiltrated into tumor tissues. A high density of CD57+ cells in EC tissues was associated with a better prognosis, while a high density of CD8+ cells was not linked to an altered prognosis. The present study showed that the density of CD169+ macrophages in RLN was associated with an improved prognosis in EC patients. CD169+ macrophages in RLN might represent a useful marker for assessing clinical prognoses and monitoring anti‐tumor immunity in patients with EC.

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Letrozole as well as progestins could be the first choice of treatment for patients with recurrent or residual LGESS, which is difficult to resect surgically because of its efficacy and minimal adverse effects.

AimPolycystic ovary syndrome (PCOS) is a significant risk factor for premenopausal endometrial cancer (EC) and/or atypical endometrial hyperplasia (AEH). The aim was to elucidate the clinical background and detailed menstrual history of EC and/or AEH in young women with PCOS.MethodsFrom January 2001 to December 2013, women under 35 years of age who had been diagnosed with EC and/or AEH and who had been treated at Kumamoto University Hospital, Japan, were recruited. The patients’ clinical characteristics, clinical stages of EC and/or AEH, medication and operation methods, endocrine profiles, and menstrual history were assessed retrospectively.ResultsOf all the cases of EC and/or AEH, 25 (4.6%) were under 35 years of age. The mean age was 29.0 years and all the patients were nulligravida. The clinical stages of EC and/or AEH that were identified included: AEH (five cases), stage IA (18 cases), IB (one case), and IIIA (one case). Fourteen (56%) cases met the criteria for PCOS. Both the Body Mass Index and Homeostatic Model Assessment–insulin resistance were significantly higher in the patients with PCOS than in the patients without PCOS. Medroxyprogesterone acetate therapy was not effective for the patients with PCOS and they underwent a hysterectomy more often than the patients without PCOS. All the patients with PCOS exhibited irregular menstruation or amenorrhea, the mean duration of which was 13.1 years before PCOS and EC and/or AEH were diagnosed.ConclusionAlthough both the patients with and without PCOS had irregular menstruation, the patients with PCOS were less likely to have fertility‐sparing surgery than the patients without PCOS because they had more advanced disease or failed to respond to medroxyprogesterone acetate therapy.

Assessment of the annoyance of combined noise environments has been the subject of much research and debate. Currently, most countries use some form of the A-weighted equivalent level (ALEQ) to assess the annoyance of most noises. It provides a constant filter that is independent of sound level. Schomer [Acust. Acta Acust. 86(1), 49-61 (2000)] suggested the use of the equal loudness-level contours (ISO 226, 1987) as a dynamic filter that changes with both sound level and frequency. He showed that loudness-level-weighted sound-exposure level (LLSEL) and loudness-level-weighted equivalent level (LL-LEQ) can be used to assess the annoyance of environmental noise. Compared with A-weighting, loudness-level weighting better orders and assesses transportation noise sources, sounds with strong low-frequency content and, with the addition of a 12-dB adjustment, it better orders and assesses highly impulsive sounds vis-a-vis transportation sounds. This paper compares the LLSEL method with two methods based on loudness calculations using ISO 532b (1975). It shows that in terms of correlation with subjective judgments of annoyance-not loudness-the LLSEL formulation performs much better than do the loudness calculations. This result is true across a range of sources that includes aircraft, helicopters, motor vehicles, trains, and impulsive sources. It also is true within several of the sources separately.