Related Articles

Expression of Yes-associated protein in non-small cell lung cancer and its relationship with clinical pathological factors.

Chin Med J (Engl). 2012 Nov;125(22):4003-8

Authors: Su LL, Ma WX, Yuan JF, Shao Y, Xiao W, Jiang SJ

Abstract
BACKGROUND: Yes-associated protein (YAP) plays an important role in signal transduction and gene transcription regulation in normal cells, with elevated and over-expressed YAP levels observed in various malignant tumors. The aim of this study was to investigate the expression of YAP in non-small cell lung cancer (NSCLC), and to study the possible relationship of YAP expression with the occurrence and development of NSCLC.
METHODS: YAP expression was assessed in 40 cases of NSCLC tumor tissues by immunohistochemistry, and their protein and mRNA levels were evaluated through Western blotting and reverse transcription-polymerase chain reaction (PCR), respectively. Normal lung tissues obtained from the same patient were used as control. Statistical analysis was performed to correlate the YAP expression to clinical pathological factors, such as tumor type, stage and grade.
RESULTS: YAP-positive expression was found in 28 (70%) of the 40 cases of NSCLC, which included 10 cases of squamous cell carcinoma (25%), 17 cases of adenocarcinoma (42.5%) and 1 case of squamous adenocarcinoma (2.5%). In the 28 YAP-positive cases, 19 cases showed lymph node metastasis and were classified in TNM stage II + III (47.5%); the other nine cases showed no lymph node metastasis (22.5%) and were classified in the TNM stage I. There was no relationship between YAP expression and patients' age, gender or tumor histological grades. However, YAP showed significant over expression in late period of T stage (P = 0.012), TNM stage (P = 0.039), and lymph node metastasis (P = 0.013), respectively. Notably, YAP-positive expression was significantly higher in adenocarcinoma than that in squamous cell carcinoma (P = 0.041).
CONCLUSIONS: Over-expression of YAP was associated with NSCLC, especially lung adenocarcinoma. The high YAP expression in late period of tumor stage and lymph node metastasis may indicate that YAP expression could be an early marker for NSCLC tumorigenesis.

PMID: 23158133 [PubMed - in process]

Related Articles

Home noninvasive ventilation: what does the anesthesiologist need to know?

Anesthesiology. 2012 Sep;117(3):657-68

Authors: Brown KA, Bertolizio G, Leone M, Dain SL

Abstract
Treatment of chronic respiratory failure with noninvasive ventilation (NIV) is standard pediatric practice, and NIV systems are commonly used in the home setting. Although practice guidelines on the perioperative management of children supported with home NIV systems have yet to be published, increasingly these patients are referred for consultation regarding perioperative management. Just as knowledge of pharmacology underlies the safe prescription of medication, so too knowledge of biomedical design is necessary for the safe prescription of NIV therapy. The medical device design requirements developed by the Organization for International Standardization provide a framework to rationalize the safe prescription of NIV for hospitalized patients supported at home with NIV systems. This review article provides an overview of the indications for home NIV therapy, an overview of the medical devices currently available to deliver it, and a specific discussion of the management conundrums confronting anesthesiologists.

PMID: 22797282 [PubMed - indexed for MEDLINE]

Related Articles

Non-invasive ventilation for weaning, avoiding reintubation after extubation and in the postoperative period: a meta-analysis.

Br J Anaesth. 2012 Sep;109(3):305-14

Authors: Glossop AJ, Shepherd N, Bryden DC, Mills GH

Abstract
Non-invasive ventilation (NIV) is a supportive therapy that improves mortality in acute respiratory failure (RF). It may also be used in patients recently extubated in intensive care units (ICUs), after operation, and to aid weaning from mechanical ventilation (MV) by reducing the morbidity and mortality associated with further MV. A meta-analysis of the available evidence was performed on the use of NIV in three areas: weaning, reduction in reintubation rates post-extubation on ICU, and reduction in RF after major surgery. Sixteen relevant randomized controlled trials were identified by three reviewers after a detailed search of identified medical databases. A meta-analysis of summary statistics relating to predetermined endpoints (ICU and hospital length of stay, ICU and hospital mortality, reintubation, pneumonia) was performed. NIV reduced the ICU length of stay when used for weaning (5.12 days) and post-surgery (0.44 days). NIV reduced reintubation rates post-surgery [odds ratio (OR) 0.24, 95% confidence interval (CI) 0.12-0.50] and the incidence of pneumonia in weaning (OR 0.12, 95% CI 0.05-0.31) and post-surgery (OR 0.27, 95% CI 0.09-0.77). There was insufficient evidence to suggest that NIV improves ICU survival, but an increased hospital survival in weaning (OR 0.55, 95% CI 0.31-0.98) and post-surgery (OR 4.54, 0.95% CI 1.35-15.31) was seen. A meta analysis of NIV use in selected subgroups of recently extubated patients suggests that the judicious NIV use may reduce ICU and hospital length of stay, pneumonia, and reintubation rates and hospital survival.

PMID: 22879654 [PubMed - indexed for MEDLINE]

Extended Utilization of Non-Invasive Positive Pressure Ventilation for Acute Respiratory Failure and Its Clinical Outcomes.

Respir Care. 2012 Oct 8;

Authors: Gupta P, Pendurthi MK, Modrykamien A

Abstract
BACKGROUND: Non-invasive positive pressure ventilation (NIV) has increasingly been used for the treatment of acute respiratory failure. Despite recommendations supporting its utilization in a limited group of patients, NIV is frequently relied as a first line treatment. We conducted a retrospective study to assess whether the extended use of NIV is associated with worse clinical outcomes. METHODS: This is a retrospective review of a dataset consisting of patients admitted with respiratory failure and treated with NIV. Based on guidelines, we assessed whether patients had indications and/or contraindications for NIV. Subjects were grouped in: 1- NIV indicated and non-contraindicated; 2- indicated and contraindicated; 3- non-indicated and non-contraindicated; and 4: non-indicated and contraindicated. The need of endotracheal intubation, hospital mortality, and length of stay were compared between these 4 groups. RESULTS: Demographic data was not significantly different between groups. Within the group of subjects with no contraindication for NIV, those with indication and no-indication had a rate of intubation of 28% and 17%, respectively (p= 0.39). Among the group of patients with indication for NIV, the rate of intubation was 28% for those with no contraindication and 56% in those with it (p = 0.13). In the group of patients with no indication for NIV, the presence of contraindications was associated with higher rate of intubation, compared with those without them (70% vs. 17%, p = 0.002). CONCLUSIONS: This study supports the extended utilization of NIV for patients without contraindication, and for patients with indication despite the presence or absence of contraindications.

PMID: 23050563 [PubMed - as supplied by publisher]