Objectives:To assess the sonographic visibility and feasibility of biopsy under ultrasound guidance of mammographically suspicious microcalcification-only lesions. Methods: A retrospective review was performed of mammographically detected suspicious microcalcificationonly lesions in patients who underwent ultrasound-guided or surgical biopsy between March 2009 and February 2012. The identified microcalcifications were not associated with a mass, architectural distortion or asymmetry on mammography; or a mass, dilated duct, hypoechoic area or microcyst on ultrasound. Microcalcifications were divided into two groups of visible and invisible based on their sonographic visibility. An ultrasound-guided biopsy was performed for the visible group, and mammography-guided localisation and excisional biopsy were conducted for the invisible group. To confirm microcalcification retrieval, radiographs were obtained for all patients. The histological outcomes of the two groups were assessed. Results: Of the 45 lesions in 44 patients, 22 (48.9%) were in the visible group. Calcifications were retrieved from 21 (95.5%) of the visible group lesions. The malignancy rate was 50.0% (11 of 22; p = 0.029) in the visible group and 17.4% (4 of 23) in the invisible group. Among the 10 sonographically visible and one invisible lesion that underwent surgical excision after biopsy, three (30.0%) in the visible group were upgraded pathologically. Conclusion: The sonographic visibility and retrieval rates of microcalcification-only lesions were 48.9% and 95.5%, respectively. Among the suspicious microcalcification-only lesions, sonographically visible microcalcifications were more likely to be malignant than sonographically invisible microcalcifications.
To avoid the systemic adverse effects that might occur after oral administration, transdermal delivery of ambroxol was studied as a method for maintaining proper blood levels for an extended period. Release of ambroxol according to concentration and temperature was determined, and permeation of drug through rat skin was studied using two chamber-diffusion cells. The solubility according to PEG 400 volume fraction was highest at 40% PEG 400. The rate of drug release from the EVA matrix increased with increased temperature and drug loading doses. A linear relationship existed between the release rate and the square root of loading rate. The activation energy (Ea) was measured from the slope of the plot of log P versus 1000/T and was found to be 10.71, 10.39, 10.33 and 9.87 kcal/mol for 2, 3, 4 and 5% loading dose from the EVA matrix, respectively. To increase the permeation rate of ambroxol across rat skin from the EVA matrix, various penetration enhancers such as fatty acids (saturated, unsaturated), propylene glycols, glycerides, pyrrolidones, and non-ionic surfactants were used. The enhancing effects of the incorporated enhancers on the skin permeation of ambroxol were evaluated using Franz diffusion cells fitted with intact excised rat skin at 37° using 40% PEG 400 solution as a receptor medium. Among the enhancers used, polyoxyethylene-2-oleyl ether increased the permeation rate by 4.25-fold. In conclusion, EVA matrix containing plasticizer and permeation enhancer could be developed for enhanced transdermal delivery of ambroxol.
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