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Immunological dysfunction has been suggested to play a major role in the pathogenesis of idiopathic granulomatous mastitis (IGM). We recently showed that ozone therapy was effective in patients with steroid‐resistant IGM. This study assessed alterations in intracellular cytokine expression patterns in different T‐lymphocyte subsets after ozone therapy in refractory IGM. Peripheral blood T lymphocyte subsets (CD8+, CD4+, CD4+CD25+CD127−) were analyzed via flow‐cytometry for intracellular cytokine expressions IFN‐γ, TNF‐α, IL‐10, and TGF‐β before and after completion of 4‐month systemic ozone therapy. Ozone therapy significantly increased the CD4+IFN‐γ+ (p = 0.032), CD4+TNF‐α+ (p = 0.028), and the CD8+TNF‐α+ (p = 0.012) T cells. In contrast, significant decreases in CD4+ IL‐10+ (p = 0.047) and CD8+IL‐10+ T cells (p = 0.022) and CD4+CD25+CD127−//low Treg cells secreting TGF‐β (p = 0.005) were found after ozone therapy. When patients were analyzed according to the response to ozone therapy, patients with a complete remission were more likely to have increased CD3−CD16+CD56+ natural killer cells (p = 0.0027) and decreased CD19+ B lymphocytes (p = 0.046) following ozone therapy. Our results suggest that ozone therapy stimulated a T‐helper‐1 response associated with IFN‐γ production and downregulation of TGF‐β expression in CD4+CD25+CD127− Treg cells. These alterations in the immune system following ozone therapy can improve wound healing and restore immune dysfunction in patients with refractory IGM. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions The omission of axillary lymph node dissection (ALND) remains controversial for patients with residual axillary disease after neoadjuvant chemotherapy (NAC), regardless of the residual burden. This study evaluated the oncologic safety and factors associated with outcomes in patients with residual axillary disease. These patients were treated solely with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD), without ALND, after NAC.A joint analysis of two different multicenter cohorts—the retrospective cohort registry MF18‐02 and the prospective observational cohort registry MF18‐03 (NCT04250129)—was conducted between January 2004 and August 2022. All patients received regional nodal irradiation.Five hundred and one patients with cT1‐4, N1‐3M0 disease who achieved a complete clinical response to NAC underwent either SLNB alone (n = 353) or TAD alone (n = 148). At a median follow‐up of 42 months, axillary and locoregional recurrence rates were 0.4% (n = 2) and 0.8% (n = 4). No significant difference was found in disease‐free survival (DFS) and disease‐specific survival (DSS) rates between patients undergoing TAD alone versus SLNB alone, those with breast positive versus negative pathologic complete response, SLN methodology, total metastatic LN of one versus ≥2, or metastasis types as isolated tumor cells with micrometastases versus macrometastases. In the multivariate analysis, patients with nonluminal pathology were more likely to have a worse DFS and DSS, respectively, without an increased axillary recurrence.The omission of ALND can be safely considered for patients who achieve a complete clinical response after NAC, even if residual disease is detected by pathologic examination. Provided that adjuvant radiotherapy is administered, neither the SLNB method nor the number of excised LNs significantly affects oncologic outcomes. [ABSTRACT FROM AUTHOR]

Objective: For locally advanced breast cancer (LABC) patients, neoadjuvant hormonal therapy (NHT) can be administered as primary treatment or simultaneously with neoadjuvant chemotherapy (NCT). Various publications emphasized that this approach may increase pathologic complete response (pCR) rates. We aim to assess the pCR rates of our patients that NHT was administered. Materials and Methods: Between May 2017 and May 2019, 32 patients with hormone receptor positive LABC patients who received NHT±NCT were assessed. Patients' demographics, surgical and histopathologic data were analysed for pCR rates. A p-value of <0.05 was considered as significant. Results: Median age of patients were 50 (28-74) and 15 (47%) were >50. Clinically 10 (31%) patients were stage IIB and 22 (69%) were stage III (A,B,C). All of the patients were clinically node positive. Six (19%) patients were luminal-A, 26 (81%) were luminal-B and 5 of them were also HER2+. Four (12.5%) patients received only NHT and 28 (87.5%) received NHT+NCT. Of the 32 patients, 9 (28%) had breast conserving surgery and 16 (72%) had mastectomy. Eight (25%) patients had pCR in the breast, 11 (34%) had pCR in the axilla, and 7 (22%) had both in the breast and axilla. There were no statistically significant difference for patients with pCR and without pCR in means of demographics, neoadjuvant treatment options, and histopathological data. Although pCR rate was higher for luminal-B group (luminal-B 27% vs. luminal-A 17%), there were not enough cases to have a significant difference at this point of the study. Conclusion: NHT can be used solely or simultaneously with NCT for hormone positive patients. Specifically for HER2(-) luminal-B patients, pCR rates were slightly higher than published data when compared with patients that received only NCT. To assess the effect of NHT on survival rates and local recurrences, prospective randomised studies with long term follow-up is needed. [ABSTRACT FROM AUTHOR]

Background: Mesenteric vein thrombosis occurs rarely and is responsible for approximately 5-15% of all cases of acute mesenteric ischemia. The aim of this report was to discuss the management of mesenteric vein thrombosis based on our experience with 34 patients., Methods: In the present study, 34 patients who were admitted to our emergency surgery department between January 2007 and January 2010 with a diagnosis of acute mesenteric vein thrombosis were assessed retrospectively. Patients with peritoneal signs first underwent diagnostic laparoscopy to rule out perforation or bowel gangrene. We performed a second-look laparoscopy within 72 hours of the first operation. All patients were administered 100 mg/kg of the anticoagulant enoxaparin twice daily. In the 6th and 12th months of follow up, CT angiography was performed to evaluate recanalization of the veins., Results: CT angiography revealed superior mesenteric vein thrombosis in 25 (73%) patients, portal vein thrombosis in 24 (70%) patients, and splenic vein thrombosis in 12 (35%) patients. Eleven patients with peritoneal signs underwent diagnostic laparoscopy; eight of the patients underwent small bowel resection, anastomosis, and trocar insertion. During second-look laparoscopy, small bowel ischemia was found in two patients and re-resection was performed., Conclusion: Early diagnosis with CT angiography, surgical and non-surgical blood flow restoration, proper anticoagulation, and supportive intensive care are the cornerstones of successful treatment of mesenteric vein thrombosis.