Actinomyces israelii May Produce Vulvar Lesions Suspicious for Malignancy

Background. We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. Case. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. Conclusion. Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy

Gas7-Deficient Mouse Reveals Roles in Motor Function and Muscle Fiber Composition during Aging

Background: Growth arrest-specific gene 7 (Gas7) has previously been shown to be involved in neurite outgrowth in vitro; however, its actual role has yet to be determined. To investigate the physiological function of Gas7 in vivo, here we generated a Gas7-deficient mouse strain with a labile Gas7 mutant protein whose functions are similar to wild-type Gas7. Methodology/Principal Findings: Our data show that aged Gas7-deficient mice have motor activity defects due to decreases in the number of spinal motor neurons and in muscle strength, of which the latter may be caused by changes in muscle fiber composition as shown in the soleus. In cross sections of the soleus of Gas7-deficient mice, gross morphological features and levels of myosin heavy chain I (MHC I) and MHC II markers revealed significantly fewer fast fibers. In addition, we found that nerve terminal sprouting, which may be associated with slow and fast muscle fiber composition, was considerably reduced at neuromuscular junctions (NMJ) during aging. Conclusions/Significance: These findings indicate that Gas7 is involved in motor neuron function associated with muscle strength maintenance

Lack of EGF receptor contributes to drug sensitivity of human germline cells

Germline mutations have been associated with generation of various types of tumour. In this study, we investigated genetic alteration of germline tumours that affect the drug sensitivity of cells. Although all germline tumour cells we tested were hypersensitive to DNA-damaging drugs, no significant alteration was observed in their DNA repair activity or the expression of DNA repair proteins. In contrast, germline tumours expressed very low level of epidermal growth factor receptor (EGFR) compared to drug-resistant ovarian cancer cells. An immunohistochemical analysis indicated that most of the primary germline tumours we tested expressed very low level of EGFR. In accordance with this, overexpression of EGFR in germline tumour cells showed an increase in drug resistance, suggesting that a lack of EGFR, at least in part, contributes to the drug sensitivity of germline tumours

Challenging Autologous Breast Reconstruction in Low BMI Patients with Profunda Artery Perforator (PAP) Flap: Impact of Skin Island Design on Complication Rates and Long-Term Aesthetic Outcomes

Background: The Profunda Artery Perforator (PAP) flap is a viable alternative to the Deep Inferior Epigastric Perforator (DIEP) flap, particularly for patients with low BMI and therefore insufficient abdominal tissue. To reduce the high complication rate, especially in our low BMI patient population, we have adapted the use of the vertical skin island design. This study compares complication rates and long-term outcomes of vertical versus horizontal skin island designs in PAP flap breast reconstruction. Methods: This prospective, single-center study included 20 patients who underwent PAP flap breast reconstruction. Quality of life and scar quality were assessed using the BREAST-Q and POSAS questionnaires. Additionally, the cosmetic outcomes were analyzed by four plastic surgeons. Results: Mean BMI in the vertical group was 23.9 kg/m2 and 22.7 kg/m2 in the horizontal group. Mean flap weight was 326 g for the vertical group and 355 g for the horizontal group. Fewer complications were observed at the donor site in the vertical group (Clavien–Dindo Classification 3b at donor site: p = 0.25). The BREAST-Q evaluation revealed significantly better results regarding the psycho-social well-being (p = 0.04) in patients with the horizontalskin island design. Scar evaluation using the POSAS revealed that the scar was perceived as thinner (p = 0.02), less pigmented (p = 0.03), and showed less relief (p = 0.02) in the vertical group. No significant difference was observed in the overall scar assessment by observers (p = 0.46). The aesthetic analysis by plastic surgeons showed significantly better results in the horizontal group. Conclusions: The vertical skin island design in PAP flap breast reconstruction was associated with lower complication rates and better scar quality compared to the horizontal design. Surgeons, however, rated the overall aesthetic outcome of the vertical design less favorably. These findings highlight the importance of balancing donor site morbidity with overall aesthetic results