Evaluation of safety, efficacy, and risk factors of different breast reconstruction strategies following polyacrylamide hydrogel removal: A 20-year retrospective cohort study of 436 cases.

BACKGROUND: Globally implemented for breast augmentation, polyacrylamide hydrogel (PAAG) always leads to breast deformity upon its removal. Despite a pressing need for breast reconstruction following PAAG removal to address aesthetic issues, the optimal timing remains controversial. METHODS: A retrospective cohort study analyzed patients who underwent PAAG removal between 2003 and 2023. They were categorized into three cohorts: immediate (IBR), delayed (DBR), or no breast reconstruction (NBR) post-PAAG removal. Complication rates, re-operation frequencies, risk factors, and BREAST-Q scores were assessed. RESULTS: A total of 436 breasts were identified and divided into IBR (n = 126), DBR (n = 48), and NBR (n = 262). Complication rates were 50.0 % (IBR), 31.3 % (DBR), and 26.7 % (NBR) (P < 0.001); reoperation rates were 26.2 % (IBR), 18.8 % (DBR), and 13.0 % (NBR) (P = 0.006). IBR showed significantly shorter complication-free survival than NBR (113.38 ± 8.34 vs. 178.21 ± 6.82 months; log-rank P < 0.001). Cox regression identified injection period, aspiration history, Baker grade II/III/IV, glandular infiltration, and IBR as independent predictors of higher postoperative complications. As for the Breast-Q scores, physical well-being was similar across groups. However, NBR scored significantly lower for postoperative sexual well-being (P < 0.001), psychosocial well-being (P < 0.001), and satisfaction with breasts (P = 0.001) compared to both IBR and DBR. CONCLUSIONS: DBR is a safe and effective solution for secondary breast deformities after PAAG removal. Notably, patients with prolonged injection histories, previous aspiration history, Baker Grade II/III/IV, and MRI evidence of gel infiltration into glandular tissues are at a higher risk for postoperative complications. These findings may be beneficial for optimizing strategies to manage patients with PAAG injections in clinical practice.

AURKA Activates FOXO3a to Form a Positive Feedback Loop in the Proliferation and Migration of Keloid Fibroblasts.

Objective: Keloids are benign fibroproliferative disorders with invasive growth exceeding the wound boundary. Aurora kinase A (AURKA) is a serine/threonine kinase highly expressed in various tumors, facilitating tumor growth and invasion. Currently, the role of AURKA in keloid remains unclear. Approach: Fibroblasts were isolated from keloid and normal skin samples. AURKA was evaluated by qPCR, Western blot, and immunohistochemistry. Transcriptome sequencing and dual-luciferase reporter assays were applied to figure out targets of AURKA. Following expression alteration and MLN8237 (an AURKA kinase inhibitor, AKI) treatment, phenotypical experiments were conducted to clarify biological functions of AURKA along with its target, and to probe into the clinical potential of AURKA inhibition. Results: AURKA was upregulated in keloid tissues and fibroblasts. Forkhead box O 3a (FOXO3a) was verified as a downstream of AURKA. Further experiments demonstrated that AURKA transactivated FOXO3a by binding to FOXO3a, while FOXO3a directly transactivated AURKA. Functionally, AURKA and FOXO3a cooperated in enhancing the proliferation and migration of keloid fibroblasts via protein kinase B (AKT) phosphorylation. Although MLN8237 weakened the proliferation and migration in keloid fibroblasts, the transactivation of AURKA on FOXO3a was independent of kinase activity. Innovation: This study reveals that AURKA and FOXO3a compose a transactivation loop in enhancing the proliferative and migrative properties of keloid fibroblasts, and proposes AURKA as a promising target. Conclusion: AURKA/FOXO3a loop promotes the proliferation and migration of keloid fibroblasts via AKT signaling. Despite the anti-keloid effects of AKIs, AURKA acts as a transcription factor independently of kinase activity, deepening our understanding on AKI insensitivity.

miR-656-3p inhibits melanomas in vitro and in vivo by inducing senescence via inhibiting LMNB2.

BACKGROUND: Ultra-Violet Radiation (UVR) is the most significant exogenous contributor to skin aging. UVB causes the senescence of melanocytes, which results in a permanent arrest in the proliferative process. Senescence is also regarded as a physiological tumor-suppressing mechanism of normal cells. However, the mechanism of the relationship between melanocyte senescence and melanoma was not sufficiently clarified. METHODS: Melanocytes and melanoma cells were irradiated with UVB for the indicated time. The miRNA expression profile of melanocytes were obtained by miRNA sequencing and confirmed by real-time PCR. Cell count kit-8 assays, cell cycle assays were also employed to explore the effect of miR-656-3p and LMNB2 on senescence. Dual-luciferase reporter assays were applied to determine the miRNA targets. Finally, a xenograft model and a photoaging model of mice were conducted to verified the function of miR-656-3p in vivo. RESULTS: Melanoma cells did not alter into a senescence stage and the expressions of miR-656-3p had no significant changes under the same intensity of UVB radiation. miR-656-3p appeared to be upregulated in melanocytes rather than melanoma cells after UVB radiation. miR-656-3p could promote the photoaging of human primary melanocytes by targeting LMNB2. Finally, overexpression of miR-656-3p significantly induced senescence and inhibited the growth of melanomas in vitro and in vivo. CONCLUSION: Our work not only demonstrated the mechanism by which miR-656-3p induced the senescence of melanocytes but also proposed a treatment strategy for melanomas by using miR-656-3p to induce senescence.

"Red Spitz Tumor" on the Ear: Case Report and Review of the Literature.

Spitz nevus (SN) is a benign melanocytic lesion with cytologic and architectural atypia. It is sometimes difficult to distinguish SNs from atypical Spitz tumor (AST), Spitz melanoma, or conventional melanoma. SNs frequently develop in Caucasians and appear on the skin of the head and lower extremities. Lesions on the ear in Asian populations are rare. Here, we report a "red Spitz tumor" on the ear of a Chinese 18-year-old boy. Dermoscopic examination revealed possibly malignant features presented as polymorphous vessels along with central white area, pseudo-network depigmentation and atypical peripheral globular pattern. The results of histopathological examination strongly suggested that the neoplasm was a compound SN and no recurrences or metastases occurred during 1-year follow-up post-surgery. Further, we review the literature on 4 previously reported cases of SN on the ear and summarize the main points of SN diagnosis and differential diagnosis with atypical Spitz tumors and melanoma.