No outside funding supported this study. The authors have nothing to disclose. All authors contributed to study concept and design, as well data collection and interpretation. Djatche and Goble wrote and revised the manuscript, along with Chun and Varga. Portions of this work have previously been presented at the AMCP Managed Care and Specialty Pharmacy Annual Meeting 2017 in Denver, Colorado, March 27-30, 2017, and at the ISPOR 22nd Annual International Meeting in Boston, Massachusetts, May 20-24, 2017.

There is growing concern in the medical community that silicones, ubiquitous in health care, may exhibit antigenic, immunogenic, and/or adjuvant activity. Sera from women with silicone breast prostheses were assayed by ELISA for humoral immunoreactivity to a variety of common interstitial and cellular components. In decreasing order of frequency, significant IgG avidities were found against silicone surfaces treated with fibronectin-laminin, phospholipids, no treatment, and fibrinogen when compared with sera obtained from healthy, age-matched, nonimplanted women and a population of nonimplanted women with previously diagnosed autoimmune diseases. Moreover, the sera from approximately 15% of the positive responders were found to react to matrix proteins independent of the siloxane polymer. The data show human antibody production to native macromolecules with antibody avidity being related to molecular conformation. Silicone may function as an adjuvant by inducing changes in the conformation of native molecules. 0 1993 John Wiley & Sons, Inc.

In research animals, the immune adjuvant activity of silicone in eliciting antibodies to associated protein antigens is now well established. In humans, the immune adjuvant activity of silicone remains controversial. Clusters of data from various research groups are beginning to define the boundary conditions for future large epidemiological studies. In that spirit, this manuscript reports pilot clinical data from a serological study conducted 3 years ago and reported previously in this journal. Sera from a self-selected symptomatic population of patients with breast implants were assayed for elevated concentrations of antibodies showing binding avidity to silicone surface associated antigens [anti-SSAA(x)]. In that study of 249 patients, two distinct statistically significant subgroups were identified on the basis of the serological assay alone: patients without any elevated anti-SSAA(x) (negative) and patients with elevated anti-SSAA(x) (positive) (p < 0.001). In this study, a clinical survey returned by 226 of those patients was correlated with the previously acquired serological findings. The 11 most common clinical complaints reported by the 199 anti-SSAA(x) negative patients and by the 27 anti-SSAA(x) positive were compared and their frequencies analyzed. The 199 anti-SSAA(x) negative patients, as a group, showed a lower frequency of a variety of signs and symptoms compared to the 27 anti-SSAA(x) positive patients. Statistically significant differences were seen in three of the symptoms: fever, foot pain, and sleep disturbance (p < 0.05). In addition, the syndrome of fever in the absence of local chest pain was a significantly associated with anti-SSAA(x) positivity (p < 0.001).

To explore individual identity narratives of accommodation and resistance in relationship to dominant American social, political and cultural constructs, this paper uses the Listening Guide Method of Qualitative Inquiry (Gilligan et al., 2006) to investigate the intersectionality of race, ethnicity, gender and American identity during and post college among four second-generation, college educated, Korean American women. The analysis, drawing from the emergence of themes across interviews, found that participant women accommodated and/or resisted dominant American social, political, and cultural constructs in service of their individual Korean American identities narratives during and post college.