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Objective: This study aims to analyze that specific prognostic factors such as Ki-67 value, histologic grade, pathology type, and cancer stage can affect controlled ovarian stimulation outcomes(COS) for fertility preservation in women with breast cancer. Methods: This retrospective cohort study included 92 patients with breast cancer aged 21-44 who underwent COS from August 2012 to April 2020, excluding patients with previous gonadotoxic therapy history. All COS cycles were conducted letrozole-combined random start GnRH antagonist protocol. COS outcomes were compared according to prognostic factors;Ki-67 (< 30% vs. ≥ 30%), histologic grade (low vs. high), and pathologic type (intraductal carcinoma(IDC) vs. triple-negative breast cancer(TNBC)), and cancer stage (early (I, II) vs. advanced (III, IV)). Multivariate analysis was also conducted to find any parameter that can impact over 10 mature oocytes acquisition. Results: Among the 92 patients, 42 were Ki-67≥30% compared to 49 of Ki-67<30%. The number of oocytes, and initial mature oocytes were comparable between Ki-67<30% and ≥30 group. The maturation rate was significantly higher in Ki-67≥30% group than Ki-67<30% group (57.4±36.8% vs. 44.8±28.3%, p=0.041). The same results were drawn when divided according to IDC or TNBC. The maturation rate was significantly higher in TNBC than the IDC group (73.0±17.6% vs. 47.0±28.1% p=0.001). However, the histologic grade or stage did not show any difference in COS outcomes between high and low grade or early and advanced stages. With multivariate analysis, age and AMH are parameters associated with the acquisition of over 10 mature oocytes (OR 0.863, 95% CI [0.755-0.987], OR 1.408, 95% CI [1.145-1.732], respectively). Conclusion: Either Ki-67 or pathologic type can be a potential reliable marker for predicting COS outcome, especially maturation rate. Further study with larger sample size with specific conditions is necessary to clarify the correlation between breast cancer prognostic factors and COS outcomes.
Delicious Foods by James Hannaham tells the story of a mother and son, Darlene and Eddie Hardison, who become involved in a debt slavery scam that preys upon drug-addicts, immigrants, and African-Americans. More importantly, it sheds light on racist institutions and the failure of representative democracy that lead them to a life of contemporary slavery. In the novel, many of the tragedies that happen arise as a result of the characters' love for each other. Love in the novel is represented in the grief that Darlene feels for her husband Nat and the need that Eddie has for Darlene to be a proper mother. Their emotional attachment to each other's bodies and the control of their affective responses by racist institutions cause the tragedy of this novel. This paper will employ the concepts of vulnerability, affect, and bio-power as defined by Judith Butler in Precarious Life to examine how love operates in the context of “the social vulnerability” of bodies. While the novel does not disprove Butler's argument, I argue that Delicious Foods illustrates what happens when a person's vulnerability and existence under the law is unacknowledged.
Tumor necrosis factor (TNF)-α targeted therapies has been widely used in the treatment of rheumatic and autoimmune diseases. The monoclonal antibodies that inhibit TNF-α include infliximab, etanercept and adalimumab. They have good clinical efficacy and tolerance but cutaneous adverse events have been encountered. We report a case of a 53-year old male with akylosing spondylitis who developed cutaneous vasculitis after TNF-α antagonist treatment. After 10 days of his second adalimumab administration, he developed purpuric eruption on his both legs. Histological examination revealed features consistent with a leukocytoclastic vasculitis. Investigative work-up revealed no infective or allergic cause for this eruption. Adalimumab was discontinued, and skin lesion slowly regressed without any additional treatment. The most likely triggering factor for this vasculitis is cutaneous adverse effect probably due to adalimumab.The incidence of a cutaneous adverse effect of adalimumab is rare compared to infliximab and etanercept. Considering the increasing use of TNF-α antagonist therapy, doctors should be aware of and monitor for this potential complication. Early recognition and appropriate management adverse cutaneous reation in patients receiving TNF-α antagonist is critical to a successful patient outcome.
Nichole Dennis-Benn's Here Comes the Sun provides insight into what life is like for a homosexual woman in Jamaica. Although there have been studies on homosexuality in Jamaica, they were mostly concerned with male homosexuality. Such studies, like that of Noel M. Cowell, concentrate on male homosexuality because they believe that Jamaica is more lenient towards female homosexuality. However, Dennis-Benn strongly disproves this point through her novel. Verdene, a rare middle-class woman living by herself in the poor, homophobic community of River Bank, is a lucky woman despite the fact that she is constantly harassed and has to live like a hermit. Other lesbian women, like her ex-lover Akua, are either dead or victims of “corrective” rape. The usual justification for such atrocities is Christianity. Dennis-Benn unravels the hypocrisy behind such reasoning by illustrating the differences in the characters' attitude towards sex work and homosexuality, both traditionally condemned by conservative Christians. This paper analyzes the economic and social background of the characters, and their views on homosexuality. It argues that perverse masculinity stemming from poverty and patriarchy are what Dennis-Benn depicts as the root cause of rampant homophobia and the subjugation of female sexuality.
Polyphenol oxidases (PPO) are copper-containing enzymes responsible for tissue browning in fruits and vegetables including potato, apple and pears. Although these enzymes have been studied for many years, their physiological roles in plants are not yet clear. Therefore, these enzymes need to be purified to characterize further from potato tubers. The classical methods used for the purification of PPO involve several steps. So in this study, we developed a one-step chromatography process for the potato tuber PPO purification. After removal of salts from dissolved ammonium sulfate precipitates of potato tuber extracts using Sephadex-G50 gel filtration, affinity chromatography was carried out on NHS-activated Sepharose 4B using p-aminobenzoic acid as a ligand. The purified enzyme was confirmed by silver staining and a zymogram. The optimum temperature and pH for the purified potato tuber PPO were 15℃ and pH 6.0, respectively. The results obtained in the present study will aid to evaluate PPO from various fruits and vegetables.
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The purpose of this study was to investigate the relationship between information quality, Online Travel Agency (OTA) trust, and continuous usage intention provided by OTA through the application of the SOR(Stimulus-Organism-Response) model. To achieve the purpose of the study, 234 responses were used for analysis, and the hypotheses were tested through the SPSS v.21 program and AMOS v.21 programs. The research results can be classified into the following three categories. First, it was determined that accuracy, timeliness, and usefulness among the factors for information quality had a significant positive effect on OTA trust and continuous usage intention. Second, it was determined that OTA trust was found to have a significant positive effect on continuous usage intention. Third, it was determined that OTA trust had an indirect effect on the relationship between accuracy, timeliness, usefulness, and continuous usage intention among the factors for information quality. This study looked at the lower dimension of information quality, which was insufficient in the field of OTA. This study can be used as basic data to, in practice, build a user-centered informational provision environment by identifying the factors that promote the continuous usage intention of consumers, which is linked to the revenue of online travel agencies.
Herein, we report a case of successful mature oocyte retrieval during laparotomy after random-start controlled ovarian stimulation (COS) in a 21-year-old nulliparous woman with suspected recurrent ovarian immature teratoma. The patient had been diagnosed with stage IIIC immature teratoma two years earlier following a staging operation, including right oophorectomy and left ovarian cystectomy. And she had subsequently undergone four rounds of postoperative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. Approximately two years after the initial surgery, she was strongly suspected of having recurrent ovarian immature teratoma on radiologic followup. We performed random-start COS and in vivo oocyte retrieval during laparotomic debulking surgery including left oophorectomy. Eight mature oocytes were successfully retrieved and vitrified for fertility preservation. The final pathologic diagnosis was mature cystic teratoma of the ovary and peritoneal implants consistent with gliomatosis peritonei. This is the first case report in which random-start COS and in vivo oocyte retrieval were performed.
The objective of this study was to evaluate single-port laparoscopic myomectomy (SPLM) for the surgical treatment of fibroids and to compare surgical outcomes and postoperative pain to conventional laparoscopic myomectomy (CLM). A total of 118 patients who underwent SPLM or CLM were included in the study (59 in SPLM group and 59 in CLM group). A single experienced surgeon performed both procedures. We analyzed and compared basal characteristics such as age, body mass index, number of myomas, size and type of the largest myoma and surgical outcomes between the two groups. There were no statistically significant differences in basal characteristics between the two groups. The surgical outcomes such as operative time, estimated blood loss, postoperative hemoglobin drop, postoperative hospital stay, and postoperative pain scores were not different between two groups. No patient experienced major intraoperative complications including bowel, ureter, or bladder injuries and transfusion. Postoperative complication was occurred in 3 cases (2 in SPLM and 1 in CLM groups) and all of them were wound infections. Our study demonstrated that SPLM is feasible and offers comparable surgical outcomes to CLM.