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Furth, Priscilla A,Cabrera, M Carla,Dí,az-Cruz, Edgar S,Millman, Sarah,Nakles, Rebecca E New York Academy of Sciences 2011 Annals of the New York Academy of Sciences Vol.1229 No.1
<P>Aberrations in estrogen signaling increase breast cancer risk. Molecular mechanisms that impact breast cancer initiation, promotion, and progression can be investigated using genetically engineered mouse models. Increasing estrogen receptor alpha (ER관) expression levels twofold is sufficient to initiate and promote breast cancer progression. Initiation and promotion can be increased by p53 haploinsufficiency and by coexpressing the nuclear coactivators amplified in breast cancer 1 (AIB1) or the splice variant AIB1??3. Progression to invasive cancer is found with coexpression of these nuclear coactivators as well as following a single dose of 7,12-dimethylbenz(a)anthracene. Loss of signal transducer and activator of transcription 5a reduces the prevalence of initiation and promotion but does not protect from invasive cancer development. Cyclin D1 loss completely interrupts mammary epithelial proliferation and survival when ER관 is overexpressed. Loss of breast cancer gene 1 increases estrogen signaling and cooperates with ER관 overexpression in initiation, promotion, and progression of mammary cancer.</P>
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Endoscopic Gallbladder Drainage for Acute Cholecystitis
Jessica Widmer,Paloma Alvarez,Reem Z. Sharaiha,Sonia Gossain,Prashant Kedia,Savreet Sarkaria,Amrita Sethi,Brian G. Turner,Jennifer Millman,Michael Lieberman,Govind Nandakumar,Hiren Umrania,Monica Gaid 대한소화기내시경학회 2015 Clinical Endoscopy Vol.48 No.5
Background/Aims: Surgery is the mainstay of treatment for cholecystitis. However, gallbladder stenting (GBS) has shown promise in debilitated or high-risk patients. Endoscopic transpapillary GBS and endoscopic ultrasound-guided GBS (EUS-GBS) have been proposed as safe and effective modalities for gallbladder drainage. Methods: Data from patients with cholecystitis were prospectively collected from August 2004 to May 2013 from two United States academic university hospitals and analyzed retrospectively. The following treatment algorithm was adopted. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and cystic duct stenting was initially attempted. If deemed feasible by the endoscopist, EUS-GBS was then pursued. Results: During the study period, 139 patients underwent endoscopic gallbladder drainage. Among these, drainage was performed in 94 and 45 cases for benign and malignant indications, respectively. Successful endoscopic gallbladder drainage was defined as decompression of the gallbladder without incidence of cholecystitis, and was achieved with ERCP and cystic duct stenting in 117 of 128 cases (91%). Successful endoscopic gallbladder drainage was also achieved with EUS-guided gallbladder drainage using transmural stent placement in 11 of 11 cases (100%). Complications occurred in 11 cases (8%). Conclusions: Endoscopic gallbladder drainage techniques are safe and efficacious methods for gallbladder decompression in non-surgical patients with comorbidities.
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