Immunomodulation by imiquimod in patients with high-risk primary melanoma.

Imiquimod is a synthetic Toll-like receptor 7 (TLR7) agonist approved for the topical treatment of actinic keratoses, superficial basal cell carcinoma, and genital warts. Imiquimod leads to an 80-100% cure rate of lentigo maligna; however, studies of invasive melanoma are lacking. We conducted a pilot study to characterize the local, regional, and systemic immune responses induced by imiquimod in patients with high-risk melanoma. After treatment of the primary melanoma biopsy site with placebo or imiquimod cream, we measured immune responses in the treated skin, sentinel lymph nodes (SLNs), and peripheral blood. Treatment of primary melanomas with 5% imiquimod cream was associated with an increase in both CD4+ and CD8+ T cells in the skin, and CD4+ T cells in the SLN. Most of the CD8+ T cells in the skin were CD25 negative. We could not detect any increases in CD8+ T cells specifically recognizing HLA-A(*)0201-restricted melanoma epitopes in the peripheral blood. The findings from this small pilot study demonstrate that topical imiquimod treatment results in enhanced local and regional T-cell numbers in both the skin and SLN. Further research into TLR7 immunomodulating pathways as a basis for effective immunotherapy against melanoma in conjunction with surgery is warranted

Intraoperative injection of technetium-99m sulfur colloid is effective in the detection of sentinel lymph nodes in breast cancer

Background Our objective was to determine if intraoperative injection of technetium-99m\u96labeled sulfur colloid is as effective as preoperative injection in the detection of sentinel lymph nodes (SLNs). Methods Two hundred consecutive patients with breast cancer underwent SLN biopsy examination. Radiocolloid was injected in the preoperative area (group A) or immediately after induction of anesthesia in the operating room (group B). Results The SLN detection rate was similar for groups A (96%) and B (100%; P =3D .2). Radioactive SLNs were detected in 95% of patients in group A and in 97% of patients in group B (P =3D .1). The mean number of SLNs harvested was 1.6 and 2.1 for groups A and B, respectively. There was no significant difference in positive SLNs between groups (P =3D .11). Conclusions Intraoperative injection of sulfur colloid is highly effective in the detection of SLNs, avoiding patient discomfort and surgical schedule delays

Correction: Evaluation of the predictive ability of ultrasound-based assessment of breast cancer using BI-RADS natural language reporting against commercial transcriptome-based tests.

[This corrects the article DOI: 10.1371/journal.pone.0226634.]

Correction: Evaluation of the predictive ability of ultrasound-based assessment of breast cancer using BI-RADS natural language reporting against commercial transcriptome-based tests.

[This corrects the article DOI: 10.1371/journal.pone.0226634.]

Correction: Evaluation of the predictive ability of ultrasound-based assessment of breast cancer using BI-RADS natural language reporting against commercial transcriptome-based tests.

[This corrects the article DOI: 10.1371/journal.pone.0226634.]

Evaluation of the predictive ability of ultrasound-based assessment of breast cancer using BI-RADS natural language reporting against commercial transcriptome-based tests.

PURPOSE:The objective of this study was to assess the classification capability of Breast Imaging Reporting and Data System (BI-RADS) ultrasound feature descriptors targeting established commercial transcriptomic gene signatures that guide management of breast cancer. MATERIALS AND METHODS:This retrospective, single-institution analysis of 219 patients involved two cohorts using one of two FDA approved transcriptome-based tests that were performed as part of the clinical care of breast cancer patients at Harbor-UCLA Medical Center between April 2008 and January 2013. BI-RADS descriptive terminology was collected from the corresponding ultrasound reports for each patient in conjunction with transcriptomic test results. Recursive partitioning and regression trees were used to test and validate classification of the two cohorts. RESULTS:The area under the curve (AUC) of the receiver operator curves (ROC) for the regression classifier between the two FDA approved tests and ultrasound features were 0.77 and 0.65, respectively; they employed the 'margins', 'retrotumoral', and 'internal echoes' feature descriptors. Notably, the 'retrotumoral' and mass 'margins' features were used in both classification trees. The identification of sonographic correlates of gene tests provides added value to the ultrasound exam without incurring additional procedures or testing. CONCLUSIONS:The predictive capability using structured language from diagnostic ultrasound reports (BI-RADS) was moderate for the two tests, and provides added value from ultrasound imaging without incurring any additional costs. Incorporation of additional measures, such as ultrasound contrast enhancement, with validation in larger, prospective studies may further substantiate these results and potentially demonstrate even greater predictive utility

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Caudophagie : que penser de la mise en place d’élastique sur la queue de porcs mordus comme solution d’urgence ?

International audienceTail biting is an important animal health and welfare issue. Many risk factors have been identified, and controlling them is the main method of prevention. After a tail-biting outbreak, however, a rubber ring is sometimes put on the injured tail (i) to stop bleeding and thus reduce cannibalism and (ii) to prevent ascending infections. There is currently no scientific data that confirm the utility of this method. A survey of 74 swine veterinarians demonstrated that 49% of them have used it. A trial on commercial pig farms was then performed. Five farms with a tail-biting outbreak were selected by veterinarians in charge of monitoring the health of these farms. On each farm, four pairs of bitten pigs were created, each with one control and one treated animal (i.e. a rubber ring on the edge between the healthy and injured parts of the tail). Pigs were matched by lesion stage, room and pen. Behavioural and clinical observations were performed on days 0, 1, 7 and 28. We observed that the rubber ring causes acute pain, but chronic pain signs were not observed one week later. The rubber ring seems to reduce tail biting and favour wound healing. Further investigations with more animals are necessary to confirm the benefit of this method for pig health and welfare