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1.
Cancer Res ; 80(5): 964-975, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31900259

RESUMO

Hypoxia induces a vast array of long noncoding RNAs (lncRNA) in breast cancer cells, but their biological functions remain largely unknown. Here, we identified a hitherto uncharacterized hypoxia-induced lncRNA RAB11B-AS1 in breast cancer cells. RAB11B-AS1 is a natural lncRNA upregulated in human breast cancer and its expression is induced by hypoxia-inducible factor 2 (HIF2), but not HIF1, in response to hypoxia. RAB11B-AS1 enhanced the expression of angiogenic factors including VEGFA and ANGPTL4 in hypoxic breast cancer cells by increasing recruitment of RNA polymerase II. In line with increased angiogenic factors, conditioned media from RAB11B-AS1-overexpressing breast cancer cells promoted tube formation of human umbilical vein endothelial cells in vitro. Gain- and loss-of-function studies revealed that RAB11B-AS1 increased breast cancer cell migration and invasion in vitro and promoted tumor angiogenesis and breast cancer distant metastasis without affecting primary tumor growth in mice. Taken together, these findings uncover a fundamental mechanism of hypoxia-induced tumor angiogenesis and breast cancer metastasis. SIGNIFICANCE: This study reveals the molecular mechanism by which the lncRNA RAB11B-AS1 regulates hypoxia-induced angiogenesis and breast cancer metastasis, and provides new insights into the functional interaction between a lncRNA and tumor microenvironment. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/80/5/964/F1.large.jpg.

2.
Breast J ; 26(2): 197-205, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31588665

RESUMO

The incidence of involved intramammary lymph node (intra-MLN) with breast carcinoma (BC) is rare. Its clinical significance and impact on the clinical decision making is unclear. A total of 113 BC cases with at least one positive intra-MLN were collected from 11 academic institutions. The inclusion criteria were subsequent axillary lymph node dissection, and the availability of information on T-stage, size of node metastasis, extranodal extension status, biomarkers status, and clinical follow-up. Stage 4 cases and/or neo-adjuvant treated patients were excluded. AJCC TN-stage was calculated twice, with and without intra-MLN. Five-year overall survival (OS) and relapse (local and/or distant)-free survival (RFS) were calculated and correlated with the clinicopathologic variables. Excluding intra-MLN, TN-stage correlated with OS (P = .016) but not with RFS (P = .19). However, when intra-MLN was included, TN-stage correlated with both OS (P < .001) and RFS (P = .016). In the multivariate analysis, when intra-MLN was excluded, only radiation therapy (RT) correlated with RFS (HR = 0.19, 95% CI: 0.054-0.66, P = .009). However, when intra-MLN was included in the TN-stage both RT (HR = 0.13, 95% CI: 0.04-0.45, P = .001) and TN-stage 3 (HR = 8.92, 95% CI: 1.47-54, P = .017) correlated with RFS. Tumor multifocality was the only variable correlated with OS when the intra-MLN involvement was excluded. When intra-MLN was included, multifocality became insignificant but TN-stage 3 correlated with OS (HR = 8.59, 95% CI: 1.06-69.71, P = .044). Positive intra-MLN is an independent factor in predicting both RFS and OS.

3.
Plant Mol Biol ; 102(1-2): 109-122, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31820285

RESUMO

KEY MESSAGE: Drought tolerance level of 136 soybean genotypes, the correlations among traits were evaluated, and several important drought-tolerant genotypes, traits, SNPs and genes were possibly useful for soybean genetic breeding. Drought is an adverse environmental factor affecting crops growth, development, and yield. Promising genotypes and genes with improved tolerance to drought are probably effective ways to alleviate the situation. In this study, our main task was to determine drought tolerance level of 136 soybean genotypes, the correlations among physiological and agronomic traits under drought, and drought-tolerant single nucleotide polymorphism (SNPs) and genes. In this study, twenty-six varieties were identified as excellent tolerant genotypes to stress among which S14, S93 and S135 with high drought-tolerant index (DTI > 1.3) and yield (Y > 300 kg). Fourteen varieties were identified as drought-sensitive genotypes, such as S25, S45 and S58, with low drought-tolerant index (DTI < 0.5). 422 SNPs and 302 genes correlated with seed number per plant (SNPP), maturity (M), number of seeds per pod (NSPP), node number of main stem (NNMS), Stem diameter (SD) and pull stem (PS) were detected under well-watered and drought conditions by genome-wide association study (GWAS). Among them, we found SNPs (Chr 3:1758920-1958934) between drought-tolerant and sensitive genotypes. 13 genes (Glyma.03G017800, Glyma.03G018000, Glyma.03G018200, Glyma.03G018400, Glyma.03G018500, Glyma.03G018600, Glyma.03G018700, Glyma.03G018800, Glyma.03G018900, Glyma.03G019000, Glyma.03G019100, Glyma.03G019200, Glyma.03G019300) correlated with NNMS were detected. By qRT-PCR, the expression level of Glyma.03G018000 and Glyma.03G018900 in drought-tolerant varieties was significantly increased, but low or no expression in sensitive varieties under drought stress. This study provides important drought-tolerant genotypes, traits, SNPs and potential genes, possibly useful for soybean genetic breeding.


Assuntos
Secas , Genótipo , Fenótipo , Melhoramento Vegetal , Soja/fisiologia , Adaptação Fisiológica/genética , Regulação da Expressão Gênica de Plantas , Genes de Plantas/genética , Genoma de Planta/genética , Estudo de Associação Genômica Ampla , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas , Sementes , Alinhamento de Sequência , Soja/genética
4.
Appl Immunohistochem Mol Morphol ; 27(6): 403-409, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31233398

RESUMO

OBJECTIVES: We compared the performance of two Food and Drug Administration-approved HER2 immunohistochemistry (IHC) tests: HercepTest (Dako) and PATHWAY anti-HER2 (4B5) (Ventana). MATERIALS AND METHODS: In total, 180 invasive breast carcinomas previously tested by both HercepTest and fluorescent in situ hybridization (FISH) were retested with 4B5. Three pathologists scored the HER2 IHC using the 2013 American Society of Clinical Oncology/College of American Pathologists guidelines. The HER2 IHC results were correlated with FISH. RESULTS: Among 135 equivocal cases by HercepTest, 100 (74.1%) were negative by 4B5. Among 45 positive HercepTest cases 9 (20%) were equivocal by 4B5. Among 135 equivocal HercepTest results, 100 (74.1%) were nonamplified, 18 (13.3%) equivocal, and 17 (12.6%) amplified by FISH. Among the 45 positive results with HercepTest, 2 (4.5%) were nonamplified and 1 (2.2%) was equivocal by FISH. All 37 positive and 3 negative by 4B5 cases were amplified by FISH. The absolute interobserver agreement was high for both tests (Fleiss kappa=0.838 for HercepTest and 0.771 for 4B5). CONCLUSIONS: PATHWAY anti-HER2 (4B5) significantly reduced the number of equivocal results that require additional testing. Although HercepTest was positive in a small number of HER2 nonamplified cases, 4B5 failed to detect 3 cases that were interpreted as positive by FISH, all with nonclassic or low levels of amplification.

5.
Breast J ; 25(4): 709-711, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31077474

RESUMO

Primary breast osteosarcoma (PBO) is a rare tumor of the breast, with only case reports and small case series published in the literature. Classic imaging findings of sunburst calcifications, a rim of intermediate density, and intense uptake on bone scintigraphy can help make the correct diagnosis preoperatively, allowing for appropriate surgical and chemotherapeutic management. We present the imaging evaluation, treatment course, and follow-up of a case of PBO diagnosed in a 67-year-old patient.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/terapia , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/terapia , Idoso , Antineoplásicos/uso terapêutico , Biópsia com Agulha de Grande Calibre , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Doxorrubicina/uso terapêutico , Feminino , Humanos , Mamografia , Mastectomia , Osteossarcoma/patologia , Ultrassonografia Mamária
7.
Sci Rep ; 9(1): 5990, 2019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-30979945

RESUMO

As major environment factors, drought or high salinity affect crop growth, development and yield. Transgenic approach is an effective way to improve abiotic stress tolerance of crops. In this study, we comparatively analyzed gene structures, genome location, and the evolution of syntaxin proteins containing late embryogenesis abundant (LEA2) domain. GmSYP24 was identified as a dehydration-responsive gene. Our study showed that the GmSYP24 protein was located on the cell membrane. The overexpression of GmSYP24 (GmSYP24ox) in soybean and heteroexpression of GmSYP24 (GmSYP24hx) in Arabidopsis exhibited insensitivity to osmotic/drought and high salinity. However, wild type soybean, Arabidopsis, and the mutant of GmSYP24 homologous gene of Arabidopsis were sensitive to the stresses. Under the abiotic stresses, transgenic soybean plants had greater water content and higher activities of POD, SOD compared with non-transgenic controls. And the leaf stomatal density and opening were reduced in transgenic Arabidopsis. The sensitivity to ABA was decreased during seed germination of GmSYP24ox and GmSYP24hx. GmSYP24hx induced up-regulation of ABA-responsive genes. GmSYP24ox alters the expression of some aquaporins under osmotic/drought, salt, or ABA treatment. These results demonstrated that GmSYP24 played an important role in osmotic/drought or salt tolerance in ABA signal pathway.

8.
Opt Lett ; 43(23): 5893-5896, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30499968

RESUMO

We propose a grating-based spatial differentiator to process a synthetic three-dimensional optical field, where several conventional two-dimensional optical images are stacked at multiple wavelengths. The device simultaneously enables both spatial differentiation and demultiplexing during light diffraction. We show the spatial differentiation resulting from coupling and interference of spatial modes and derive the theoretical condition for spatial differentiation based on spatial coupled-mode theory. We numerically investigate field transformation during diffraction and demonstrate spatial differentiation with image processing of edge detection for a synthetic three-dimensional optical field, where four images are stored at different wavelengths.

9.
Breast J ; 24(1): 41-50, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28597587

RESUMO

Breast carcinoma with skin ulceration (SU) is considered a locally advanced disease. The purpose of the study is to investigate if SU is an independent adverse factor. Breast carcinoma patients with SU (n=111) were included in the study. A subset (n=38, study cohort) was matched with cases that had no SU (n=38, matched cohort); the survival analyses were compared between these groups. Then, cases (n=80) were staged independent from SU into stage I, II or III. Disease free survival (DFS) and overall survival (OS) were analyzed. Patients with larger tumors tended to present with distant metastases more often than patients with smaller tumors (P=.004). In the matched cases, the 5-year DFS probability was 53% for the study cohort and 58% for the matched cohort; and for OS 75% for the study cohort and 84% for the matched cohort with no statistical significant difference. However, there was a trend towards worse DFS for the patients whose tumors had SU. When the cases were staged based on tumor size and node status (I, II or III), the OS was statistically significant (P=.047) but not the DFS (P=.195). Relatively small tumors with SU had an extent of disease similar to that observed in patients with early stages disease. The survival analysis suggests that SU may not be an adverse factor. However, more cases are needed to further examine this finding.


Assuntos
Neoplasias da Mama/patologia , Úlcera Cutânea/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/complicações , Neoplasias da Mama/mortalidade , Estudos de Casos e Controles , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Úlcera Cutânea/complicações
10.
Opt Lett ; 42(19): 3840-3843, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28957142

RESUMO

We propose a graphene-on-grating nanostructure to enable second-order spatial differentiation computation in the terahertz (THz) region. The differentiation operation is based on the interference between the direct reflected field and the leakage of two excited surface plasmon polaritons counter-propagating along the graphene sheet. With the spatial coupled-mode theory, we derive that the requirement for the second-order spatial differentiation is the critical coupling condition. We numerically demonstrate such an analog computation with Gaussian beams. It shows that the spatial bandwidth of the proposed differentiator is large enough such that even when the waist radius of the Gaussian beam is as narrow as w0=0.68λ (λ is the free-space wavelength), the accuracy of the differentiator is higher than 95%. The proposed differentiator is ultra-compact, with a thickness less than 0.1λ, and useful for real-time imaging applications in THz security detections.

11.
Am J Surg Pathol ; 39(5): 624-31, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25602790

RESUMO

The use of computer-based image analysis for scoring human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) has gained a lot of interest recently. We investigated the performance of the Ventana Image Analysis System (VIAS) in HER2 quantification by IHC and its correlation with fluorescence in situ hybridization (FISH). We specifically compared the 3+ IHC results using the manufacturer's machine score cutoffs versus laboratory-defined cutoffs with the FISH assay. Using the manufacturer's 3+ cutoff (VIAS score; 2.51 to 3.5), 181/536 (33.7%) were scored 3+, and FISH was positive in 147/181 (81.2%), 2 (1.1%) were equivocal, and 32 (17.6%) were FISH (-). Using the laboratory-defined 3+ cutoff (VIAS score 3.5), 52 (28.7%) cases were downgraded to 2+, of which 29 (55.7%) were FISH (-), and 23 (44.2%) were FISH (+). With the revised cutoff, there were improvements in the concordance rate from 89.1% to 97.0% and in the positive predictive value from 82.1% to 97.6%. The false-positive rate for 3+ decreased from 9.0% to 0.8%. Six of 175 (3.4%) IHC (-) cases were FISH (+). Three cases with a VIAS score 3.5 showed polysomy of chromosome 17. In conclusion, the VIAS may be a valuable tool for assisting pathologists in HER2 scoring; however, the positive cutoff defined by the manufacturer is associated with a high false-positive rate. This study highlights the importance of instrument validation/calibration to reduce false-positive results.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias da Mama/genética , Processamento de Imagem Assistida por Computador/instrumentação , Receptor ErbB-2/análise , Calibragem , Feminino , Amplificação de Genes , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Receptor ErbB-2/biossíntese , Receptor ErbB-2/genética , Reprodutibilidade dos Testes
12.
Ann Otol Rhinol Laryngol ; 123(5): 365-73, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24687594

RESUMO

OBJECTIVE: The objective was to report our experience with advanced stage oropharyngeal squamous cell carcinoma treated sequentially with induction chemotherapy followed by concurrent chemoradiotherapy. METHODS: Retrospective chart review identified 49 eligible patients with advanced stage oropharyngeal squamous cell carcinoma treated with induction chemotherapy followed by concurrent chemoradiotherapy. HPV and p16(INK4A) testing was performed on pathology specimens. Follow-up of over 11 months was required unless a death or treatment failure occurred before that time. RESULTS: Treatment with induction chemotherapy followed by concurrent chemoradiotherapy resulted in 44/48 (90%) complete durable response. One death occurred from pulmonary embolism. Toxicity profiles were comparable to other published data. Average follow-up was 3.9 years. Oncologic failure rates among subgroups showed 5.7% failure for HPV+/p16+ cancer, 9.1% failure for HPV-/p16+ cancer, 100% failure for HPV-/p16- cancer, 0% failure for nonsmokers, and 17.9% failure for smokers. CONCLUSIONS: This study showed favorable outcomes in terms of durable oncologic response and acceptable toxicity profiles. It is notable that 36/49 patients were HPV+/p16+ and 11/49 were HPV-/p16+. Only 2 patients were HPV-/p16-, and both died as a result of oncologic failures. This highlights the importance of obtaining HPV and p16 testing in studies evaluating the efficacy of treatments for oropharyngeal squamous cell carcinoma.


Assuntos
Carcinoma de Células Escamosas/terapia , Neoplasias Orofaríngeas/terapia , Adulto , Idoso , Quimiorradioterapia/efeitos adversos , Feminino , Seguimentos , Testes de DNA para Papilomavírus Humano , Papillomavirus Humano 16/isolamento & purificação , Humanos , Imuno-Histoquímica , Hibridização In Situ , Quimioterapia de Indução , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
13.
Hum Pathol ; 45(2): 249-58, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24289969

RESUMO

The use of digital imaging techniques for biomarker assessment has gained recognition as a valid tool for clinical use. In this study, we used image analysis for evaluation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER2), Ki-67 index, and p53 in 172 patients with invasive breast cancer treated with neoadjuvant chemotherapy and compared it with an untreated group (100 cases). We also examined the relationship between biomarker expression and the extent of residual disease using the Web-based MD Anderson residual cancer burden (RCB) calculator. Residual disease was classified as RCB 0/I, II, and III corresponding to complete/near-complete response, moderate, and extensive residual disease, respectively. Overall change in ER, PR, and HER2 status in the treated group was seen in 9.02% (P = .0148), 18.4% (P = .011), and 12.0% (P = .0042), respectively. Change in HER2 status, positive to negative and negative to positive, occurred in 27.2% and 7.0%, respectively. The group with RCB 0/I was frequently younger (P = .0057) and showed higher ER(-) status (P = .0316), lower ER scores (P = .0103), higher Ki-67 index (P = .0008), and p53 (P = .0055) compared with those with RCB II and III. Pathologic tumor stage (P = .0072), lumpectomy versus mastectomy (P = .0048), and p53 expression (P = .0190) were independent predictors of recurrence-free survival. The RCB categories (P = .0003) and tumor grade (P = .0049) were independent predictors of overall survival. This is the first study to conduct a comprehensive analysis of biomarkers in neoadjuvant chemotherapy-treated patients versus an untreated group using the digital image analysis method. We have demonstrated for the first time the relationship between RCB, tumor biomarkers expression, and clinical outcome.


Assuntos
Biomarcadores Tumorais/biossíntese , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasia Residual/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/mortalidade , Neoplasias da Mama/terapia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Estimativa de Kaplan-Meier , Antígeno Ki-67/biossíntese , Pessoa de Meia-Idade , Terapia Neoadjuvante , Neoplasia Residual/patologia , Prognóstico , Receptor ErbB-2/biossíntese , Receptores Estrogênicos/biossíntese , Receptores de Progesterona/biossíntese , Estudos Retrospectivos , Carga Tumoral , Proteína Supressora de Tumor p53/biossíntese
14.
Int Forum Allergy Rhinol ; 3(2): 161-8, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22736440

RESUMO

BACKGROUND: The purpose of this work was to perform a systematic review regarding ossifying fibroma and its multiple variants of the paranasal sinuses, and to identify any clinical differences between the multiple variants. METHODS: A search of the U.S. National Library of Medicine (PubMed) database was performed for the non­Medical Subject Heading (MeSH) search term "ossifying fibroma." The bibliographies of the retrieved manuscripts were searched to identify additional potentially relevant articles. Finally, textbooks of head and neck pathology were searched to identify peer-reviewed literature that addresses the histopathology of ossifying fibroma and its variants. Abstracts were screened by 2 of the authors to identify reports of ossifying fibroma lesions (and its variants) that involved the paranasal sinuses. Extracted data from case reports or case series included the clinical presentation, age, gender, site of involvement, surgical approach, treatment outcome, follow-up period, and recurrence rate. Information derived from cases is summarized in tables, and simple descriptive statistics were applied to the data. RESULTS: A total of 137 distinct patients were identified in 103 reports. Extracted data did not show any appreciable difference in clinical presentation or outcomes. Data on recurrence of these lesions was often limited by a lack of follow-up. CONCLUSION: Although differentiation between the subtypes of ossifying fibroma can be made histologically, and a diverse nomenclature exists, there does not appear to be any overriding clinical significance to the histopathologic differentiation of OF variants.


Assuntos
Neoplasias Ósseas/diagnóstico , Fibroma Ossificante/diagnóstico , Neoplasias Nasais/diagnóstico , Neoplasias Ósseas/classificação , Neoplasias Ósseas/terapia , Fibroma Ossificante/classificação , Fibroma Ossificante/terapia , Humanos , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Neoplasias Nasais/classificação , Neoplasias Nasais/terapia , Neoplasias dos Seios Paranasais/classificação , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Clin Immunol ; 130(2): 186-98, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18955015

RESUMO

Matrix metalloproteinases (MMPs) modulate development, inflammation, and repair in lungs. Tissue inhibitors of MMPs (TIMPs) interact with MMPs, controlling the intensity and nature of the response to injury. Absence of MMP-9, -2, and -8 activities is associated with altered lung inflammation during allergic sensitization. To test the hypothesis that the absence of TIMP-1 enhances allergic lung inflammation, airway hyperreactivity (AHR), and lung remodeling in asthma, we studied TIMP-1 null (TIMP-1 KO) mice and their WT controls using an ovalbumin (OVA) asthma model. TIMP-1 KO mice, compared to WT controls, developed an asthma phenotype characterized by AHR, pronounced cellular lung infiltrates, greater reduction in lung compliance, enhanced Th2 cytokine mRNA and protein expression, and altered collagen lung content associated with enhanced MMP-9 activity. Our findings support the hypothesis that TIMP-1 plays a protective role by preventing AHR and modulating inflammation, remodeling, and cytokine expression in an animal model of asthma.


Assuntos
Asma/imunologia , Citocinas/imunologia , Pneumonia/imunologia , Inibidor Tecidual de Metaloproteinase-1/imunologia , Animais , Asma/induzido quimicamente , Citocinas/biossíntese , Modelos Animais de Doenças , Expressão Gênica , Hidroxiprolina/imunologia , Hidroxiprolina/metabolismo , Imunoglobulina E/sangue , Pulmão/imunologia , Pulmão/patologia , Camundongos , Camundongos Endogâmicos C57BL , Ovalbumina/imunologia , Pneumonia/patologia , RNA Mensageiro/imunologia , RNA Mensageiro/metabolismo , Inibidor Tecidual de Metaloproteinase-1/genética , Inibidor Tecidual de Metaloproteinase-1/metabolismo
19.
Cutis ; 73(5): 327-9, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15186047

RESUMO

Pemphigus vulgaris (PV) is an autoimmune blistering disorder that usually occurs in the fifth and sixth decades of life but may occur at younger ages and during pregnancy. Circulating intercellular antibodies directed at desmosomal proteins may cross the placenta and place children at risk for neonatal pemphigus (NP). We describe the case of a pregnant woman with PV treated successfully with a combination of systemic corticosteroids and plasmapheresis. The possibility of PV should be considered in any pregnant woman with a worsening, widespread, mucocutaneous, blistering disease. Plasmapheresis offers a useful alternative to immunosuppressive therapy in the setting of pregnancy.


Assuntos
Pênfigo/terapia , Plasmaferese , Complicações na Gravidez/terapia , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Pênfigo/congênito , Pênfigo/patologia , Gravidez , Complicações na Gravidez/patologia
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