These tumors are best managed in multidisciplinary clinics, and the mainstay of treatment is wide local excision and planned postoperative adjuvant radiotherapy.
We underestimated tumour extent at only 4% of margins. Tissue shrinkage was the most important factor affecting eventual histological margin. Our novel technique allowed us to demonstrate that this shrinkage is not uniform across the specimen, but is disproportionately high in the tumour-free margin. This suggests that previous estimates of margin shrinkage, based on whole-specimen contraction measurements, may have been erroneously low.
The use of Slow Mohs formalin-fixed tissue and H&E section staining, even with comparator biopsies, does not provide sufficient discrimination to identify residual disease confidently.
The introduction of a standard proforma led to a significant improvement in the completeness of breast cancer histopathology reports in this centre, but continued vigilance is needed to ensure that standards continue to improve.
Aim: To study collagen-induced arthritis in human leucocyte antigen (HLA)-DR1 transgenic mice lacking endogenous major histocompatibility complex class II molecules (MHC-II) and to determine T cell specificity against the arthritogenic CII 259-273 epitope of type II collagen either unmodified or post-translationally glycosylated at Lys 264 . Methods: Arthritis was induced by immunisation with human type II collagen in complete Freund's adjuvant and measured by footpad swelling, clinical score and histology. T cell responses were assessed by proliferation of spleen and lymph node cells and in antigen presentation assays, using T cell hybridomas specific for the glycosylated and non-glycosylated CII 259-273 epitope. Results: The incidence of arthritis was 50% in DR1-transgenic mice lacking endogenous MHC-II molecules. Recall T cell responses in draining lymph nodes and spleen were consistently greater against the nonglycosylated epitope than to the glycosylated CII [259][260][261][262][263][264][265][266][267][268][269][270][271][272][273] . Most of the T cell hybridomas generated from CIIimmunised mice recognised the non-glycosylated CII epitope and this form of the epitope was also presented with 100-fold higher efficiency and 1 h faster kinetics by both macrophages and dendritic cells. Conclusion: This study shows that T cell responses to the non-glycosylated epitope of heterologous (human) CII are dominant in HLA-DR1 transgenic mice lacking MHC-II, which could contribute to the pathogenicity of autoimmune arthritis.
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