miRNA sequencing revealed novel miRNA candidates that need to be further confirmed in functional Dicer knockout studies. Clinically, on the basis of our surgical experience described here, neoadjuvant vismodegib therapy in BCC appears to impede histopathologic evaluations with effects on surgical therapy. Thus, larger studies are necessary, but are not preferable at this time if other options are available.
Abstract. The use of mammography screening, followed by needle core biopsy (NCB), is associated with an increasing amount of invasive procedures. A considerable amount of specimens must be classified as lesions with uncertain malignant potential (B3-lesion). In these cases, an open biopsy is indicated for further diagnosis. We evaluated patients with B3-lesions to determine the risk of malignancy corresponding to the histopathological NCB results and the type of radiological lesion identified. A total of 95 patients participating in the German mammography screening program with a B3-lesion following NCB (104 B3-lesions in total) were included in our analysis. We analyzed the correlation between the initial histopathological findings from the NCB specimen and cancer risk. We further analyzed the correlations of malignant results with the type of mammographic lesion. In 23 cases (22%), histopathological examination following excision revealed a malignant lesion, including invasive and in situ carcinoma. The positive predictive value of the subgroups of B3-lesions ranged between 0.11 and 0.31; the B3-lesion associated with the highest cancer risk was the atypical ductal hyperplasia; however, no significant difference was observed between the B3-lesion subgroups (P=0.309) regarding the risk of malignancy. Comparing the different types of mammographic findings, such as radiological mass or microcalcifications, there was no significant difference in the risk for malignancy (P=0.379). The different types of B3-lesions did not exhibit differences in the risk for malignancy, and the morphological type of mammographic lesion does not appear to be correlated with cancer risk; therefore, our results underline the need for open biopsy in patients with B3-lesions following NCB.
High-frequency oscillatory ventilation is not superior to conventional mechanical ventilation in surfactant-treated rabbits with lung injury. D. Gommer, A. Hartog, R. Schnabel, A. De Jaegere, B. Lachmann. #ERS Journals Ltd 1999. ABSTRACT: The aim of this study was to compare high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV) with and without surfactant in the treatment of surfactant-deficient rabbits. A previously described saline lung lavage model of lung injury in adult rabbits was used. The efficacy of each therapy was assessed by evaluating gas exchange, lung deflation stability and lung histopathology.Arterial oxygenation did not improve in the CMV group without surfactant but increased rapidly to prelavage values in the other three study groups. During deflation stability, arterial oxygenation decreased to postlavage values in the group that received HFOV alone, but not in both surfactant-treated groups (HFOV and CMV). The HFOV group without surfactant showed more cellular infiltration and epithelial damage compared with both surfactant-treated groups. There was no difference in gas exchange, lung deflation stability and lung injury between HFOV and CMV after surfactant therapy.It is concluded that the use of surfactant therapy in combination with highfrequency oscillatory ventilation is not superior to conventional mechanical ventilation in improving gas exchange, lung deflation stability and in the prevention of lung injury, if lungs are kept expanded. In the first reported high-frequency oscillatory ventilation (HFOV) trial, a low distending airway pressure was used in order to minimize the risk of barotrauma [1]. However, experimental studies have shown that alveoli should be actively opened and that a relatively high airway pressure has to be used to stay above the closing pressure to avoid hypoxaemia and lung injury [2,3]. Results of recent pilot studies in neonates with respiratory distress syndrome (RDS) applying this high-lung volume strategy are encouraging [4±6].To date, very few studies have been published on the combined use of surfactant and HFOVin animals or humans [4, 6±9]. Those studies demonstrated that after surfactant therapy HFOV was superior to conventional mechanical ventilation (CMV) in improving pulmonary function and reducing lung injury [4, 6±9]. However, in those studies, HFOV was used in combination with the high-lung volume strategy whereas CMV was not. Recently, FROESE et al.[8] compared HFOV to CMV after surfactant therapy at low-and high-lung volume and confirmed that HFOV at high-lung volume was superior to the alternatives in improving gas exchange and lung mechanics in lunglavaged rabbits. Surprisingly, these authors were not able to maintain oxygenation above 46.7 kPa (350 mmHg), despite the high-lung volume strategy, after surfactant therapy with the use of CMV [8]. This finding is in contrast to earlier results of CMV with surfactant therapy in lung-lavaged rabbits in which oxygenation increased rapidly to prelavage values aft...
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