Objectives: ：This study intends to assess the associations among perceived stigma at the time of infection, coping strategies adopted 12 months later and depressive and posttraumatic symptoms 24 months later in Middle Eastern Respiratory Syndrome (MERS) survivors. Methods: ：A nationwide cohort study was conducted on 63 survivors of 2015 MERS outbreak. Demographic data, illness severity of MERS, depression and posttraumatic stress symptoms, coping strategies and MERS-related stigma were collected 12 and 24 months after the MERS outbreak, respectively. Results: ：Higher levels of perceived stigma at the time of outbreak were associated with higher levels of dysfunctional coping strategies after 12 months (p=0.003) and more severe depressive (p=0.058) and posttraumatic stress symptoms (p=0.011) after 24 months. Moreover, higher levels of dysfunctional coping strategies after 12 months were significantly associated with more severe depressive (p=0.002) and posttraumatic stress symptoms (p<0.001) after 24 months. Conclusions ：Social stigma against people who have contracted an emerging infectious disease can leave a negative impact on the mental health of the survivors in the long term. In case of novel pandemics in the future, promptrectification of stigma and promotion of adaptive coping strategies in survivors are needed.

Basal-type breast cancers are among the most aggressive and deadly breast cancer subtypes, displaying a high metastatic ability associated with mesenchymal features. However, the molecular mechanisms underlying the maintenance of mesenchymal phenotypes of basal-type breast cancer cells remain obscure. Here, we report that KRAS is a critical regulator for the maintenance of mesenchymal features in basal-type breast cancer cells. KRAS is preferentially activated in basal-type breast cancer cells as compared with luminal type. By loss and gain of KRAS, we found that KRAS is necessary and sufficient for the maintenance of mesenchymal phenotypes and metastatic ability through SLUG expression. Taken together, this study demonstrates that KRAS is a critical regulator for the metastatic behavior associated with mesenchymal features of breast cancer cells, implicating a novel therapeutic target for basal-type breast cancer.
Animals ; Breast Neoplasms/*genetics/metabolism/pathology ; Cell Line, Tumor ; Cell Transformation, Neoplastic/genetics/metabolism ; Disease Models, Animal ; Epithelial-Mesenchymal Transition/*genetics ; Female ; Gene Expression Regulation, Neoplastic ; Gene Knockdown Techniques ; Heterografts ; Humans ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Phenotype ; Proto-Oncogene Proteins/*genetics/metabolism ; *Transcriptional Activation ; ras Proteins/*genetics/metabolism

PURPOSE: Laparoscopic distal pancreatectomy (LDP) has been widely performed for solid pseudopapillary neoplasm (SPN) involving the body or tail of the pancreas. However, it has not been established whether spleen preservation in LDP is oncologically safe for the treatment of SPN with malignant potential. In this study, we compared the short- and long-term outcomes between patients with SPN who underwent laparoscopic spleen-preserving distal pancreatectomy (LSPDP) vs laparoscopic distal pancreatectomy with splenectomy (LDPS). METHODS: We retrospectively reviewed the medical records of 46 patients with SPN who underwent LDP between January 2005 and November 2016. Patients were divided into 2 groups according to spleen preservation: the LSPDP group (n=32) and the LDPS group (n=14). Clinicopathologic characteristics and perioperative outcomes were compared between groups. RESULTS: There were no significant differences in pathologic variables, including tumor size, tumor location, node status, angiolymphatic invasion, or perineural invasion between groups. Median operating time was significantly longer in the LSPDP group vs the LDPS group (243 vs 172 minutes; p=0.006). Estimated intraoperative blood loss was also significantly greater in the LSPDP group (310 vs 167 ml; p=0.063). There were no significant differences in incidence of postoperative complications (≥ Clavien-Dindo class IIIa) or pancreatic fistula between groups. After a median follow-up of 35 months (range, 3S153 months), there was no recurrence or disease-specific mortality in either group. CONCLUSION: The results show that LSPDP is an oncologically safe procedure for SPN involving the body or tail of the pancreas.
Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Fistula ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Spleen ; Splenectomy ; Tail