In breasts with cancer, ductal lavage appears to have low sensitivity and high specificity for cancer detection, possibly because cancer-containing ducts fail to yield fluid or have benign or mildly atypical cytology.

Early detection of breast lesions continues to be an important goal in the management of breast cancer. At present, mammographic imaging in addition to physical examination is the main screening method for the detection of cancer. Fiberoptic ductoscopy and duct lavage are being recently used to evaluate patients at risk for breast cancer. Both techniques examine the nipple and central duct area to identify intraductal lesions. In this study, we examined the frequency of involvement of these structures in mastectomy specimens as a surrogate marker to estimate the utility of these methods in breast Breast cancer is the most frequent type of cancer in women and will affect 1 in 12 women during their lifetime (1). Physical examination and mammographic imaging are the currently used methods for screening for breast cancer. Although larger cancers are easily detected by these methods, smaller tumors can be missed, especially if they arise in densely fibrotic breast tissue. The combination of these screening methods with targeted biopsies ultimately has resulted in earlier detection and treatment of breast cancers. This not only improves patient survival but also decreases the morbidity associated with the disease. Unfortunately, we are still unable to detect a significant number of earlystage cancers. It is for this reason that there is an immense interest in developing new methods for breast cancer screening that would permit detection of carcinoma at an earlier stage, as well as precancerous lesions. Duct lavage and the fiberoptic ductoscopy system are two such methods being evaluated for early detection of breast disease. Duct lavage and fiberoptic ductoscopy involve evaluation of the ductal system of the breast for detection of intraductal carcinomas and precursor lesions such as atypical ductal hyperplasia. At present, breast cancer is believed to originate within the terminal duct lobular units (2, 3) through a succession of events involving and ductal carcinoma in situ (4, 5). Therefore, visual and/or cytological examination of these structures would permit identification of abnormal lesions before the development of invasive disease.Ductal lavage is accomplished with nipple aspiration using a 20-mL syringe (6). If fluid is obtained, the fluid-yielding duct is identified and cannulated.

No abstract

Recent studies have identified the Drosophila brain circuits involved in the sleep/wake switch and have pointed to the modulation of neuronal excitability as one of the underlying mechanisms triggering sleep need. In this study we aimed to explore the link between the homeostatic regulation of neuronal excitability and sleep behavior in the circadian circuit. For this purpose, we selected Pumilio (Pum), whose main function is to repress protein translation and has been linked to modulation of neuronal excitability during chronic patterns of altered neuronal activity. Here we explore the effects of Pum on sleep homeostasis in Drosophila melanogaster, which shares most of the major features of mammalian sleep homeostasis. Our evidence indicates that Pum is necessary for sleep rebound and that its effect is more pronounced during chronic sleep deprivation (84 h) than acute deprivation (12 h). Knockdown of pum, results in a reduction of sleep rebound during acute sleep deprivation and the complete abolishment of sleep rebound during chronic sleep deprivation. Based on these findings, we propose that Pum is a critical regulator of sleep homeostasis through neural adaptations triggered during sleep deprivation.

AbstractRecent studies have identified the Drosophila brain circuits involved in the sleep/wake switch and have pointed to the modulation of neuronal excitability as one of the underlying mechanisms triggering sleep need. In this study we aimed to explore the link between the homeostatic regulation of neuronal excitability and sleep behavior in the circadian circuit. For this purpose, we selected the neuronal homeostasis protein Pumilio (Pum), whose main function is to repress protein translation and has been linked to modulation of neuronal excitability during chronic patterns of altered neuronal activity. Here we explore the effects of Pum on sleep homeostasis in Drosophila melanogaster, which shares most of the major features of mammalian sleep homeostasis. Our evidence indicates that Pum is necessary for sleep rebound and that its effect is more pronounced during chronic sleep deprivation (84 hours) than acute deprivation (12 hours). Knockdown of pum, results in a reduction of sleep rebound during acute sleep deprivation and the complete abolishment of sleep rebound during chronic sleep deprivation. These behavioral changes were associated with accompanying changes in the expression of genes involved in the regulation of neuronal excitability. Interestingly, pum knockdown also increased baseline daytime sleep, suggesting that Pum differentially regulates rebound and normal sleep. Based on these findings, we propose that Pum is a critical regulator of sleep homeostasis through neural adaptations triggered during sleep deprivation and induces rebound sleep by altering neuronal excitability.