Purpose: As breast-conserving surgery (BCS) has become the most common type of breast surgery, oncoplastic BCS has developed in response to improve cosmetic outcomes. Acellular dermal matrix (ADM) has been used as an adjunct to enhance cosmetic outcomes in partial breast reconstruction. This study aimed to evaluate postoperative complications, cosmetic satisfaction, and oncologic safety over a short-term follow-up period. Methods: This retrospective study included 26 patients who underwent BCS at Myongji Hospital between April 2019 and April 2021. All procedures were performed by three surgeons. We reviewed demographic data, histologic grades, tumor-node-metastasis stages, treatment modalities, and survival data based on patient medical records. Results: Of the 26 total patients, 5 developed seromas, which was the most common complication, and one patient experienced red breast syndrome. The incidence of complications per surgeon was less than 25%. The mean satisfaction score for the cosmetic outcome on a 10-point scale was 7.6 ( ± 2.1) as scored by patients and 8.8 ( ± 0.9) as scored by surgeons. Responses regarding cosmetic satisfaction revealed no significant differences among surgeons (<i>p</i>= 0.444). Of the 26 patients, four were lost to follow-up, and the mean follow-up period was 35.2 months. Two patients experienced recurrence, both of whom had regional recurrence with no local recurrence. Conclusion: ADM replacement is a favorable alternative to oncoplastic BCS, in terms of the ease of surgical procedures, minimal complications, and low rates of local recurrence.
ABSTRACT A localized form of lymphomatoid papulosis (LyP) has been described very rarely. A 38‐year‐old Korean man presented with a single bean‐sized, non‐tender, erythematous nodule confined to periorbital areas with three recurrences over a 2‐year duration. With findings of biopsy, immunohistochemical staining and T‐cell receptor gene rearrangement, LyP was diagnosed. We report a case of CD30 (Ki‐1)‐positive LyP which developed recurrently and was confined to the periorbital areas.
Abstract Many polysaccharides isolated from mushroom are considered to be biological response modifiers and have been shown to enhance various immune responses. Paecilomyces cicadae have been reported to have immunomodulatory properties. In this study, we investigated the membrane receptor and intracellular signaling responsible for the activation of macrophage by polysaccharide (PCP) isolated from P. cicadae. PCP induced the production of nitric oxide (NO) and the mRNA expression of IL-1β, IL-6, and TNF-α in RAW 264.7 cells. To investigate the membrane receptor involved in the activation of NO production, we examined the effect of PCP on primary macrophages isolated from C3H/HeN mice having normal-TLR4 and C3H/HeJ mice having mutant-TLR4. PCP induced NO production and cytokine gene expression in macrophages from C3H/HeN, but not from tlr4-mutated C3H/HeJ mice, which suggests that TLR4 is the membrane receptor for PCP. As a mechanism of action, PCP induced the phosphorylation of ERK, JNK, and p38, and the nuclear translocation of NF-κB p50/p65, which are the main signaling molecules down-stream from TLR4. In addition, p38 and NF-κB inhibitor attenuated PCP-mediated induction of NO production by macrophages. These results indicate that PCP activates macrophages through the TLR4 signaling pathway
548 Background: In early estrogen receptor (ER)+HER2- breast cancer, a 21-gene expression assay-guided decision-making for adjuvant treatments has been widely utilized as a standard-of-care. The GenesWell BCT is a multigene assay that is designed to predict the risk of distant recurrence (DR) in patients with ER+HER2- breast cancer. This assay consists of nine genes, which are used to generate a risk score that can help guide treatment decisions. We addressed an additional value of the GenesWell Breast Cancer Test (BCT) score using the cohort of ER+HER2- breast cancer patients receiving a 21-gene assay-guided adjuvant treatments, focusing the chemotherapy untreated subset with low 21-gene recurrence score (RS). Methods: This multicentre, observational follow-up study was done in 4 academic institutions in South Korea. Patients with ER+HER2- breast cancer who received RS-guided adjuvant treatments were enrolled. A total of 705 patients were included. Of these, the rate of women with node-positive disease was 21.6% (152/705), and the rate of women with younger than 50 years old was 61.4% (433/705). The BCT score was obtained using the specimens which were previously analyzed for RS. The primary endpoint was recurrence-free survival (RFS), and the secondary endpoint was distant recurrence-free survival (DRFS). Results: Among the 705 patients, the RS assigned 110 (15.6%) as high risk (≥26), whereas the BCT score assigned 239 (33.9%) as high risk (≥4). The agreement between two tests was noted in 494 (70.1%); concordances were made in 69 for high and in 425 for low, respectively. At a median follow up of 85 months, 80 had tumor recurrences, 38 had distant recurrences, and the 7-year RFS was 90.0% (95% CI, 87.6%-92.5%). In the 595 patients with low RS, 556 (93.4%) did not receive adjuvant chemotherapy. Within the 556 chemotherapy-untreated patients with low RS, the RFS differed significantly according to the BCT score ( p= .014); the 7-year RFS was 92.9% in the BCT-low, while it was 85.7% in the BCT-high. Within the group, the BCT score was demonstrated as an independent prognostic factor for both RFS and DRFS adjustment of tumor size, nodal stage, and histologic grade. In addition, the RFS of the low-BCT score group was superior to that of the high-BCT group in either women younger than 50 years of age with an RS of 21 to 25 or all women with an RS of 21 to 25. Conclusions: We found that the BCT score was useful in stratifying the risk of relapse in chemotherapy-untreated patients with a low recurrence score (RS). This indicates that the BCT score could provide additional clinical value in identifying patients with a long-term risk of relapse, particularly in young women with an RS of 21 to 25.
Lipoplysacchride (LPS) signals to downstream effectors such as nuclear factor-kappaB (NF-kB) and mitogen-activated protein kinases (MAPK) by using toll-like receptor 4 (TLR4). However, their specific roles in survival and maturation of NF-kB (TPCK), ERK (PD98059), p38 (SB203658) and Jun kinase (SP600125) differentially affect DC survival and maturation. Immature DCs were generated from bone marrow precursors by using 2 ng/ml of GM-CSF. On day 8 of culture, non-adherent and loosely adherent cells, i.e., immature DCs, were harvested from cultures and further activated with LPS for 1 day. TPCK impaired DC maturation without affecting their survival. On the other hand, SB203658 and PD98059 decreased survival, but not maturation, of DCs. Neither maturation nor survival was affected by SP600125. These results implicate that TLR4 signaling induces DC maturation through ERK and p38 activation, while NF-kB activation is required to maintain DC survival.
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