Granulomatous mastitis (GM) is an uncommon chronic inflammatory disease of the breast that can mimic breast carcinoma or infection. The treatment options include expectant management, complete resection, and corticosteroid therapy, although no standard treatment has been established. Recently, several case reports have suggested that methotrexate is another effective treatment for GM. Here, we describe the first Korean case of recurrent GM successfully treated with low-dose weekly methotrexate and review the relevant literature.
Breast ; Granulomatous Mastitis ; Hydrazines ; Methotrexate

Granulomatous mastitis (GM) is an uncommon chronic inflammatory disease of the breast that can mimic breast carcinoma or infection. The treatment options include expectant management, complete resection, and corticosteroid therapy, although no standard treatment has been established. Recently, several case reports have suggested that methotrexate is another effective treatment for GM. Here, we describe the first Korean case of recurrent GM successfully treated with low-dose weekly methotrexate and review the relevant literature.
Breast ; Granulomatous Mastitis ; Hydrazines ; Methotrexate

OBJECTIVE: DICAM, a dual Ig domain containing adhesion molecule, is involved in cell-cell adhesion through direct interaction with alphavbeta3 integrin. In our previous study showing the inhibitory role of DICAM in osteoclast differentiation, we found that DICAM also has a suppressive role in macrophage, the precursor cell of osteoclast. The role of DICAM in macrophage activation at the inflammatory milieu, however, remains obscure. METHODS: Expression pattern of DICAM by inflammatory cytokines and lipopolysaccharide (LPS) was studied with RAW264.7, a murine macrophage cell line. To study the role of DICAM on macrophage activation, we stably transduced DICAM, or empty vector, into RAW264.7, and then compared the LPS-mediated activation such as spreading and TNF-alpha production. RESULTS: DICAM was abundantly expressed in the synovial tissue of collagen-induced arthritis. When we assessed the expression of DICAM in RAW264.7 cells by mediators of inflammation, inflammatory cytokines, such as TNF-alpha, IL-1beta, and IFN-gamma, and M-CSF increased the expression of DICAM; however, LPS decreased. Functionally, DICAM that stably transduced-RAW264.7 cells showed attenuation of LPS-mediated macrophage activation including spreading and TNF-alpha production. DICAM decreased the phosphorylation of JNK MAP kinase by M-CSF and LPS stimulation, which was corroborated by a decrease in the expression of ITAM-associated receptors including Trem2, Pira1, and Oscar. Finally, a recombinant ectodomain of DICAM suppressed LPS-induced activation of RAW264.7 cells. CONCLUSION: These results indicate that DICAM acts as a negative regulator of LPS-mediated macrophage activation.
Arthritis, Experimental ; Cell Line ; Cytokines ; Inflammation Mediators ; Macrophage Activation ; Macrophage Colony-Stimulating Factor ; Macrophages ; Monocytes ; Osteoclasts ; Phosphorylation ; Phosphotransferases ; Tumor Necrosis Factor-alpha

Background: This study aimed to evaluate the effect of a prefabricated functional appliance (MyobraceⓇ ) on skeletal, dental, and soft tissue components in children with Class II, division 1 malocclusion. Methods: Thirteen patients with Class II, division 1 malocclusion (9 girls and 4 boys; mean age, 8.2±0.9 years at the start and 9.3±1.0 years at the end of the treatment) were treated with MyobraceⓇ for a mean period of 12.9±4.0 months. Patients were instructed to use the appliance daily for 1 hour and overnight while sleeping. A control group of 10 patients with untreated Class II, division 1 malocclusion (3 girls and 7 boys; mean age, 9.0±1.6 years at the start and 10.4±2.1 years at the end of the observation) was included to eliminate possible growth effects. The mean observation period for this group was 17.7±11.2 months. Lateral cephalograms were taken at the start and end of the treatment, and findings from 41 measurements were analyzed using the V-CephTM program. The mean and standard deviation of cephalometric measurements were analyzed using paired and independent sample t-tests. Results: The treatment group showed significant changes in SNB, ANB, maxillary protrusion, ramus height, proclination of upper anterior teeth, interincisal angle, overjet, and upper lip protrusion compared with the control group. However, only decrease in ANB, maxillary protrusion, overjet, upper lip protrusion, and increase in interincisal angle were significantly higher in the treatment group than in the control group. Conclusion The prefabricated functional appliance induced skeletal, dentoalveolar, and soft tissue changes, resulting in a significant reduction in anteroposterior discrepancy.

This retrospective study aimed to compare the clinical features of paramedullary lesions (PLs) and extramedullary lesions (ELs) of plasmacytomas at diagnosis, using positron emission tomography integrated with computed tomography, using glucose labeled with the positron-emitting radionuclide ¹⁸F (¹⁸F-FDG-PET/CT) in newly diagnosed multiple myeloma (NDMM), and to address their prognostic impact. Sixty-four patients with NDMM presenting ELs (n=22) and/or PLs (n=42) were included. Patients with ELs at initial presentation had unfavorable laboratory parameters of calcium and lactate dehydrogenase, a higher percentage of bone marrow plasma cells, and showed a trend toward advanced international staging system (ISS), compared to patients with PLs. Using X-ray imaging, high bone disease (HBD) was observed in 50% and 71% of patients with ELs and PLs, respectively. After a median follow-up of 29.2 months (range, 3.4–76.5 months) in survivors, patients with ELs had a significantly lower overall survival (OS) (p=0.033) than patients with PLs did, whereas the progression-free survival (PFS) did not differ significantly (p=0.818). However, the PFS after 1(st) progression was significantly worse in patients with ELs than in those with PLs (p=0.017). In the multivariate analyses, the negative impact of initial ELs on OS (p=0.033) was sustained. Our results demonstrated the different clinical features and outcomes of ELs and PLs in NDMM. Patients with initial ELs showed a shorter PFS after 1(st) progression, which translated into poor OS, providing insight into the different biological effect of ELs.
Bone Diseases ; Bone Marrow ; Calcium ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Multiple Myeloma* ; Multivariate Analysis ; Plasma Cells ; Plasmacytoma ; Positron-Emission Tomography ; Retrospective Studies ; Survivors