Background: HER2 expression in the primary tumor and its lymph node metastases vary in gastric cancer, reflecting intratumoral heterogeneity. This finding also suggests that proliferation of a different clone in metastatic nodes is possible. In the current study, we aimed to determine the cause of discordance in HER-2 expression in the primary tumor and lymph node metastases for patients with gastric cancer. Materials and Methods: Eighty-one patients with gastric cancer who had undergone radical gastrectomy and were found to have lymph node metastasis upon pathological examination were included. Histopathological samples were obtained from biopsies obtained during patient gastrectomies and lymph node dissection. HER2 status was evaluated by both immunohistochemistry (IHC) and silver in situ hybridization (SISH). Results: Sixty-four (79%) patients were SISH (-), while 17 (21%) were SISH (+) in the primary tumor. However, in metastatic lymph nodes, HER2 status was SISH positive in 5 (28.3%) of the 64 SISH (-) primary tumor specimens. One of the 17 SISH (+) primary tumors was SISH (-) in the metastatic lymph nodes. Thus, SISH results for HER2 in both primary tumors and lymph node metastases were comparable, showing a concordance of 92.5%. In total, six patients demonstrated discordance between the primary tumor and lymph node metastases. The prevalence of HER2 discordance was significantly higher for patients in the pN2 and N3 stages (p=0.007). Although discordant patients had worse survival rates than concordant patients, the differences were not significant (p>0.05).Conclusions: Our study indicates that the frequency of concordance in HER2 status, as determined by IHC or SISH, is high in primary tumors and their corresponding lymph node metastases for patients with gastric cancer. If there is a discrepancy in HER2 status, its evaluation by both IHC and SISH may be useful for detecting patients who would benefit from trastuzumab, and it would therefore help guide decision-making processes in administering treatment.
The Greek sculptor, Pygmalion, created a sculpture which was perfect in shape and fell in love with it. He prayed the goddess of love, Venus to transform it into a real woman. She answered his asking, and he finally got married to her. In Bernard Shaw's movie, , the linguist, Dr. Higgins, brought a street girl, Eliza Doolittle to his home and educated her standard London dialect and upper-class manners. Unlike the Greek sculptor, Higgins changed not only her appearance but also her inner identity, then she became 'a new woman' of the age. Abby in seems to live a successful life of thorough planning and pursuing knowledge, but there is no place for her to express natural instinct and human emotion. On the other hand, Mike is a totally different type of a person from her. Like a Greek sculptor, he changes her into a woman who can truly understand other people from her heart and listen to what her inner-self says to her. The Greek myth metaphorically suggests the way to build true relationships between people of all times.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.4
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pp.242-249
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2019
This study examined the wounds and healing of the character as a woman in Samuel Beckett's play, Happy Days, through a microscopic approach by focusing on her inner I, and to study how she tries to heal her wounds. Winnie in Happy Days spends hard times not recognizing her internal wounds and pains. By facing her wounds and pains, however, she starts the process of self-healing, mainly through communicating and sharing her sorrows with her past inner child. Winnie's positive and optimistic character appears to change Willie's behaviors, which may be a positive sign that her wounds and pains will possibly be healed. In conclusion, Winnie has a chance to face her inner wounds and pains while interacting and communicating with her husband Willie, and she is slowly heading for healing her wounded inner I.
Jeongun(丁芸) Lee, Young-do (李永道), who is deemed a representative female poet of Korea, began her literary career in May, 1946 when she published in a publication called "Bamboo Sprout, (죽순)". Her Korean identity, which was formed through her Confucius upbringing as well as traditional value system of her family, had a strong presence in her work, and she remained a quintessential figure in Korea's female sijo poet circle for 30 years until her passing in 1976. Despite the highly acclaimed talent and her noble aspirations, it is undeniable that her works did not receive fair assessment due to her private life. Against this backdrop, it is necessary to deeply inquire the literary values and beauty of Young-do Lee's sijo. As mentioned, Young-do Lee is a solidly established figure in Korea's modern poetry. The following illustrates the spirit and the world of her poetry. First, Young-do Lee lived through turbulent times and it was her country that served as the source of her sijo work. Assessing the multitude of dramatic historical events such as Japanese colonization, 8.15 Liberation of Korea, division of the nation, 6.25 Korean war, 4.19 Revolution, 5.16 military coup, it is natural that patriotism was strongly present in her work who was one of the intellectuals at the time. Second, Young-do Lee is a poet who had experienced more pain than others in terms of the turbulence of the time. Her Korean identity, which was formed through her Confucius upbringing as well as traditional value system of her family, had a strong presence in her work. Third, Jeongun Lee, Young-do is a poet of longing. The abundance and richness of her emotions were fortified through the relationship with another poet, Chihwan Yu. Fourth, Young-do Lee is a poet opened up new horizons for the modennization. The transparency of image reflected in her work and the elaborate nature of her language are outstanding. In summary, Young-do Lee was a true artist, who has a strong presence in Korea's modern poetry society, and who was a poet of patriotism, poet who suffered the turbulence of the times, and a poet of longing.
Background: Neoadjuvant systemic chemotherapy is the accepted approach for women with locally advanced breast cancer. Anthracycline- and taxane-based regimens have been extensively studied in clinical trials and consequently are widely used. In this study aimed to research the complete response (pCR) rates in different regimens for neoadjuvant setting and determine associated clinical and biological factors. Methods: This study included 63 patients diagnosed with breast carcinoma among 95 patients that had been treated with neoadjuvant chemotherapy between 2007 and 2010. TNM staging system was used for staging. The histologic response to neoadjuvant chemotherapy was characterized as a pCR when there was no evidence of residual invasive tumor in the breast or axillary lymph nodes. Biologic subclassification using estrogen receptor (ER), progesterone receptor (PR), HER2 were performed. Luminal A was defined as ER+, PR+, HER2-; Luminal B tumor was defined as ER+, PR-, HER2-; ER+, PR-, HER2+; ER-, PR+, HER2-; ER+, PR+, HER2+; HER2 like tumor ER-, PR+, HER2+; and triple negative tumor ER, PR, HER2 negative. Results: Patients median age was 54.14 (min-max: 30-75). Thirty-two patients (50.8%) were premenapousal and 31 (49.2%) were postmenapousal. Staging was performed postoperatively based on the pathology report and appropriated imaging modalities The TNM (tumor, lymph node, metastasis) system was used for clinical and pathological staging. Fifty-seven (90.5%) were invasive ductal carcinomas, 6 (9.5%) were other subtypes. Thirty nine (61.9%) were grade II and 24 (38.1%) were grade III. Seven (11.1%) patients were stage II and 56 (88.9) patients were stage III. The patients were classified for ER, PR receptor and HER2 positivity. Seventeen patients had complete response to chemotherapy. Forty patients (63.5%) were treated with dose dense regimen (cyclophosphamide 600 mg/m2 and doxorubicine 60 mg/m every two weeks than paclitaxel 175 mg/m2 every two weeks with filgrastim support) 40 patients (48%) were treated anthracycline and taxane containing regimens. Thirteen patients (76%) from 17 patients with pCR were treated with the dose dense regimen but without statistical significance (p=0.06). pCR was higher in HER2(-), ER(-), grade III, premenopausal patients. Conclusion: pCR rate was higher in the group that treated with dose dense regimen, which should thus be the selected regimen in neoadjuvant setting. Some other factors can predict pCR in Turkish patients, like grade, menopausal status, triple negativity, percentage of ER positivity, and HER2 expression.
Varun, Chopra;Dineshkumar, Thayalan;Jayant, VS;Rameshkumar, Annasamy;Rajkumar, Krishnan;Rajashree, Padmanaban;Mathew, Jacob;Arunvignesh, Rajendran K
Asian Pacific Journal of Cancer Prevention
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v.16
no.14
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pp.5773-5777
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2015
Background: Oral squamous cell carcinoma (OSCC) is thought to develop from precancerous dysplastic lesions through multistep processes of carcinogenesis involving activation of oncogenes and loss of tumor suppressor genes. The human epidermal growth factor receptor 2 (Her-2/neu [erbB-2]), a cell membrane glycoprotein, is a growth factor receptor that has receptor tyrosine kinase activity. Her2/neu activation plays a central role in cell proliferation and survival. It has been shown that overexpression of Her2/neu increases the rate of cell division and growth, leading to precancerous changes. The aim of the present study was to compare the serum and salivary Her2/neu levels between cases with premalignant and malignant oral lesions. Materials and Methods: Fasting blood samples and unstimulated saliva by passive drooling were collected from three groups of healthy control (n=20), premalignant disorder (PMD) (n=20) and OSCC (n=25) subjects. The HER2 extracellular domain (HER2 ECD) levels were measured using ELISA. Results: The levels of serum Her2/neu showed no significant differences between any of the groups but on the other hand salivary Her2/neu levels were found to be significantly (p<0.05) higher when compared between control (median 68.7 pg/ml, range: 21.5 - 75.8) and OSCC (median 145.6 pg/ml, range: 45.1-191.1). A similar trend was observed when comparing between PMD (median 43.3, range: 22.1 -94.7) and OSCC with a statistical significance of p<0.05. Conclusions: Our study provided evidence of increased salivary Her2/neu in OSCC when compared to PMD and control which was not the case for serum levels. This suggests that probably Her2/neu is not highly amplified as in breast cancer so as to be reflected in serum. Since saliva is in local vicinity of the OSCC, even a mild increase might be mirrored. On the whole, this study proposes Her2/neu as marker for distinguishing premalignant and malignant conditions.
Human epidermal growth factor receptor 2 (HER2) inhibitors, such as trastuzumab and lapatinib are used to treat HER2-positive breast and gastric cancers. However, as with other targeted therapies, intrinsic or acquired resistance to HER2 inhibitors presents unresolved therapeutic problems for HER2-positive gastric cancer. The present study describes investigations with AUY922, a heat shock protein 90 (HSP90) inhibitor, in primary lapatinib-resistant (ESO26 and OE33) and lapatinib-sensitive gastric cancer cells (OE19, N87, and SNU-216) harboring HER2 amplification/over-expression. In order to investigate whether AUY922 could overcome intrinsic and acquired resistance to HER2 inhibitors in HER2-positive gastric cancer, we generated lapatinib-resistant gastric cancer cell lines (OE19/LR and N87/LR) by continuous exposure to lapatinib in vitro. We found that activation of HER2 and protein kinase B (AKT) were key factors in inducing intrinsic and acquired lapatinib-resistant gastric cancer cell lines, and that AUY922 effectively suppressed activation of both HER2 and AKT in acquired lapatinib-resistant gastric cancer cell lines. In conclusion, AUY922 showed a synergistic anti-cancer effect with lapatinib and sensitized gastric cancer cells with intrinsic resistance to lapatinib. Dual inhibition of the HSP90 and HER2 signaling pathways could represent a potent therapeutic strategy to treat HER2-positive gastric cancer with intrinsic and acquired resistance to lapatinib.
This study explored a sandplay therapy case of a woman maturing through conflicts with an adolescent son. The goal of the therapy was to relieve her from conflicts with going through individuation process under a free and protected space in sandplay therapy. Forty-six therapy sessions were held. The client exhibited that she needed a conversation with her feminity and maternity in the initial phase of therapy (1-5, regression). In the intermediate phase of therapy (6-43, struggle), she displayed the scenes of meeting of opposites, shadow, death, nurturing and integration of opposites. In the final phase of therapy (44-46, transformation), she showed the acception of her life with leaving her situations to God. Through sandplay therapy in the free and protected space, this study showed the effectiveness of sandplay therapy since the client achieved individuation by showing the acceptance of her life and could control her enraged feelings.
The purpose of this research is to understand the gender identity expressed in Madonna music video texts and performances. Madonna has reconstructed the fluid identities through the variations of body, images, costumes, and attitudes . The results are as fellows; ① Her punky sexuality is to be seen the flash trash look, kitsch fashion, which reconstructs a good/bad taste, modesty/immodesty, the relations of under/outer wear using bawdy sexuality through her early Virgin tour. ② Her Heterosexuality is to be seen the glamourous look, traditional images of women, which represents the passive feminity of patriarch. ③ Her sadomasochism sexuality is to be seen the bondage look of dominatrix image, which deconstructs sexual taboos; represents sexual power. ④ Her bisexuality is to be seen androgynous look, the 3rd species look using masculinity/feminity signifier, which deconstructs the stereotypes of gender roles. ⑤ Her homosexuality is to be seen the fetish fashion by drag and lesbian, which deconstructs the dichotomy of normality/perversion; opens a possibility of women subjectivity of sexual desires.
For the purpose of estimation of navigational method and ability about fishing raft, we have practical navigation of her from Chujado on Oct, 7 to Maryang-ri , Kangjin-kun, Jeonranman-do on Oct.10. The results obtained are as follow : 1. Ancient navigation of her is thought to over to an isolated island in the vicinity with a good informations and experiences. 2. Speed of her in outward voyage is 1.34 knots, but is varied with structure and shape of her and ability of fishing raftman. 3. The lee way(U) of her with sail of hight 2.5m and breadth about 1.2m according to windspeed(W) is U=$0.038{\times}W$ 4. We could estimate to take only three days to go over from Chujado to Maryang-ri, Kangjin-kun. Jeonranam-do by her with sail, and make a voyage total 55 miles for thirty-four hours and ten minutes i, e, mean speed is 1.6knots resulty.
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