Differential expression of microRNAs during melanoma progression:miR-200c, miR-205 and miR-211 are downregulated in melanoma and act as tumour suppressors

BACKGROUND: The incidence of malignant melanoma is increasing faster than that for any other cancer. Histological examination of skin excision biopsies remains the standard method for melanoma diagnosis and prognosis. Significant morphological overlap between benign and malignant lesions complicates diagnosis, and tumour thickness is not always an accurate predictor of prognosis. METHODS: To identify improved molecular markers to support histological examination, we used microarray analysis of formalin-fixed and paraffin-embedded samples from different stages of melanomagenesis to identify differentially expressed microRNAs (miRNAs). Differential expression was validated by qRT–PCR, and functional studies were carried out after transfection of miRNA precursors or inhibitors into melanoma cells to modulate miRNA expression. RESULTS: In all, 20 miRNAs showed highly significant differential expression between benign naevi and either primary or metastatic melanomas, the majority being downregulated in melanoma, whereas only 2 miRNAs, namely miR-203 and miR-205, were differentially expressed between primary and metastatic melanomas. In functional in vitro assays, overexpression of miR-200c and miR-205 inhibited anchorage-independent colony formation and overexpression of miR-211 inhibited both anchorage-independent colony formation and invasion. CONCLUSION: We have identified a series of differentially expressed miRNAs that could be useful as diagnostic or prognostic markers for melanoma and have shown that three miRNAs (namely miR-200c, miR-205 and miR-211) act as tumour suppressors

The spectrum of medical errors: when patients sue

Barry D Kels,1 Jane M Grant-Kels21Department of Surgery, 2Department of Dermatology, University of Connecticut Health Center, Farmington, CT, USAAbstract: Inarguably medical errors constitute a serious, dangerous, and expensive problem for the twenty-first-century US health care system. This review examines the incidence, nature, and complexity of alleged medical negligence and medical malpractice. The authors hope this will constitute a road map to medical providers so that they can better understand the present climate and hopefully avoid the “Scylla and Charybdis” of medical errors and medical malpractice. Despite some documented success in reducing medical errors, adverse events and medical errors continue to represent an indelible stain upon the practice, reputation, and success of the US health care industry. In that regard, what may be required to successfully attack the unacceptably high severity and volume of medical errors is a locally directed and organized initiative sponsored by individual health care organizations that is coordinated, supported, and guided by state and federal governmental and nongovernmental agencies.Keywords: primum non nocere, medical negligence, medical malpractice, Six Sigm

Confocal Microscopy

Description This issue of Dermatologic Clinics, guest edited by Jane M. Grant-Kels, Giovanni Pellacani, and Caterina Longo, is devoted to Confocal Microscopy. Articles in this timely issue include: Basics of Confocal Microscopy and the Complexity of Diagnosing Skin Tumors: New Imaging Tools in Clinical Practice, Diagnostic Workflows, Cost-estimate and New Trends; Opening a Window Into Living Tissue: Histopathologic Features of Confocal Microscopic Findings in Skin Tumors; Addressing the Issue of Discriminating Nevi from Early Melanomas: Dues and Pitfalls; Melanoma Types and Melanoma Progression: The Different Faces; Lentigo Maligna, Macules of the Face and Lesions on Sun-damaged Skin: Confocal makes the Difference; Glowing in the dark: use of confocal microscopy in dark pigmented lesions; Enlightening the Pink: Use of Confocal Microscopy in Pink Lesions; Shining into the White: The Spectrum of Epithelial Tumors from Actinic Keratosis to SCC; Application of Wide-probe and Handy-probe for Skin Cancer Diagnosis: Pros and Cons; Confocal Microscopy for Special Sites and Special Uses; Confocal Algorithms for Inflammatory Skin Diseases and Hair Diseases; In Vivo and Ex Vivo Confocal Microscopy for Dermatologic and Mohs’ Surgeons; Telediagnosis with Confocal Microscopy: A Reality or a Dream?; “Well-aging": Early Detection of Skin Aging Signs; The Role of Confocal Microscopy in Clinical Trials for Treatment Monitoring; and Fluorescence (multiwave) Confocal Microscopy