Transrectal ultrasound in male urethritis.

OpenAIRE

Ghaly, A F; Taylor, P M; Goorney, B P; Haye, K R

1994-01-01

OBJECTIVE--To assess the prevalence of prostatic abnormalities in men with gonococcal and non-gonococcal urethritis using trans-rectal ultrasonic markers. DESIGN--A case control study of patients attending a department of genitourinary medicine with symptoms of urethritis. SETTING--Department of Genitourinary Medicine and Department of Radiology in Manchester Royal Infirmary. RESULTS--A total of 42 patients were recruited to the study: 26 with urethritis and 16 controls. Of the 26 study patie...

Color/power Doppler transrectal US in prostate cancer: Correlation with Gleason score

International Nuclear Information System (INIS)

Kim, Hyo Cheol; Kim, Seung Hyup; Moon, Min Hoan; Park, Byung Kwan; Kim, Keon Ha; Choi, Hyuck Jae; Yoon, Chang Jin

2002-01-01

To evaluate the relationship between hypervascularity on color/power Doppler transrectal ultrasonography and the Gleason score of corresponding biopsied specimen in patients with prostatic cancer. From July 1998 to March 2002, one hundred fifty seven patients with pathologically proven prostate cancer at this institution were included, and all of them underwent transrectal ultrasonographic examination. Initially, ultrasonographic findings and pathologic data of 129 patients were retrospectively reviewed and excluded 28 patients whose sonographic images were either unavailable or inconclusive. The presence of hypoechoic lesion on transrectal sonography and hypervascularity on color/power Doppler sonography in the peripheral zone of the prostate was first evaluated, and these sonographic findings and Gleason score of the corresponding biopsied specimen were then compared. Statistical analysis was done by Student t-test using SPSS package. Among one hundred twenty nine patients, ninety four patients had a hypoechoic lesion on gray scale sonography while sixty one showed a hypervascular lesion on color/power Doppler sonography. Fifty seven of 61 patients (93.4%) had hypoechoic lesion on gray scale sonography. The mean Gleason score of patients with hypervascular lesion was 7.9 ± 0.98 whereas that of the patients without hypervascular lesion, 6.9 ± 1.22, showing a statistically significant difference (p<0.01). Prostate cancer with hypervascularity on transrectal sonography appears to have a higher Gleason score on pathologic examination than that without hypervascularity.

Transperineal seed-implantation guided by biplanar transrectal ultrasound

DEFF Research Database (Denmark)

Holm, Hans Henrik; Torp-Pedersen, S; Myschetzky, P

1990-01-01

A new method for precise transperineal placement of therapeutic sources in prostatic cancer is described. The method is a modification of the technique described in 1983 by Holm and coworkers. Insertion of needles is monitored by transverse as well as longitudinal transrectal ultrasound....

Transperineal seed-implantation guided by biplanar transrectal ultrasound

International Nuclear Information System (INIS)

Holm, H.H.; Torp-Pedersen, S.; Myschetzky, P.

1990-01-01

A new method for precise transperineal placement of therapeutic sources in prostatic cancer is described. The method is a modification of the technique described in 1983 by Holm and coworkers. Insertion of needles is monitored by transverse as well as longitudinal transrectal ultrasound

Transrectal contrast-enhanced ultrasonography, transrectal ultrasonography and retrograde cystography for the detection of vesicourethral anastomosis leakage after radical retropubic prostatectomy: a prospective comparative evaluation.

Science.gov (United States)

Cantiello, Francesco; Cicione, Antonio; Autorino, Riccardo; De Nunzio, Cosimo; Tubaro, Andrea; Damiano, Rocco

2013-01-01

To evaluate the diagnostic accuracy of cystography (CG), transrectal ultrasonography (TRUS) and transrectal contrast-enhanced ultrasonography (CEUS) for the detection of vesicourethral extravasation (VE) after radical retropubic prostatectomy (RRP). In 80 consecutive patients who underwent RRP, the strength of the vesicourethral anastomosis (VUA) was assessed by CG, TRUS and transrectal CEUS. The investigation started with a conventional CG evaluated by an experienced uroradiologist. Following this, patients underwent TRUS which was performed by an experienced urologist who was blinded to the CG findings. The examination started with a conventional B-scan and, subsequently, a CEUS was performed by emptying and refilling the bladder with 90 ml of NaCl 0.9% + 10 ml suspension of 1:10 SonoVue and NaCl 0.9%. 26 patients (32.5%) presented urinary VE and 54 (67.5%) a watertight VUA. In 16 patients (61%) we observed a small leakage, 9 patients (35%) presented a moderate VE, and a large VE was detected in 1 patient (4%). No statistically significant difference in detection of VE was found among the three tests (p = 0.472). TRUS and CEUS are able to provide information about the integrity of the VUA that is comparable with that of CG. Copyright © 2013 S. Karger AG, Basel.

Reproducibility of contrast-enhanced transrectal ultrasound of the prostate

NARCIS (Netherlands)

Sedelaar, J. P.; Goossen, T. E.; Wijkstra, H.; de la Rosette, J. J.

2001-01-01

Transrectal three-dimensional (3-D) contrast-enhanced power Doppler ultrasound (US) is a novel technique for studying possible prostate malignancy. Before studies can be performed to investigate the clinical validity of the technique, reproducibility of the contrast US studies must be proven.

Reverse Transrectal Stapling Technique Using the EEA Stapler: An ...

African Journals Online (AJOL)

Reverse Transrectal Stapling Technique Using the EEA Stapler: An Alternative Approach in Difficult Reversal of Hartmann's Procedure. SK Zachariah. Abstract. The introduction of circular end-to-end stapling devices (CEEA OR EEA stapler) into colorectal surgery have revolutionised anastomotic techniques. The EEA ...

La biopsia intraoperatoria en patología oncológica urológica

OpenAIRE

Algaba, F.; Arce, Y.; Santaularia, J.Mª; Villavicencio Mavrich, H.

2007-01-01

Las indicaciones de la biopsia intraoperatoria (BI) en las cirugías por neoplasias urológicas son muy concretas, esto explica que sólo representen un 7´3% de las BI en los hospitales generales y motiva que se conozca de una forma precisa su utilidad, siendo éste el motivo la revisión que presentamos. En términos generales no está justificada la BI para identificar la naturaleza de una masa tumoral, a excepción de: 1) Las masas renales con dudas sobre el origen parenquimatoso o en vías urinari...

The initial experience of trans-rectal ultrasound and biopsy in ...

African Journals Online (AJOL)

The initial experience of trans-rectal ultrasound and biopsy in diagnosis of carcinoma prostate in Gezira Hospital for Renal Disease and Surgery (GHRDS). Walaa Eldin Ibraheem, Sami Mahjoub Taha, Mustafa Omran Mansour, Mohammed El Imam Mohamed Ahmed ...

The contribution of periapical nerve block in transrectal ultrasound ...

African Journals Online (AJOL)

Objective: Periprostatic nerve block has been shown to be the most effective method to reduce pain during transrectal ultrasound (TRUS) guided prostate biopsy, but the ideal technique remains controversial. The aim of this studywas to compare pain control between bilateral basal block (BBB) alone and BBB combined ...

Analysis of costs of transrectal prostate biopsy.

Science.gov (United States)

Fandella, Andrea

2011-01-01

Literature reports mortality and morbidity data from prostatic carcinoma which permit a better use of some routine diagnostic tools such as transrectal ultrasound-guided biopsy. The aim of this work is to quantify the overall cost of transrectal ultrasound biopsy of the prostate (TRUSB) and to assess the economic impact of current procedures for diagnosing prostatic carcinoma. The total cost of TRUSB was calculated with reference to 247 procedures performed in 2008. The following cost factors were evaluated: personnel, materials, maintenance/depreciation of the equipment, energy consumption, and hospital overheads. A literature review was also carried out to check if our extrapolated costs corresponded to those of other authors worldwide, and to consider them in the wider framework of the economic effectiveness of strategies for early diagnosis of cancer of the prostate. The overall cost of TRUSB (8 samples) was EUR 249,000, obtained by adding together the costs of: personnel (EUR 160,000); materials (EUR 59,000); equipment maintenance and depreciation (EUR 12,400); energy consumption (EUR0,1); hospital overheads (EUR 17,500). With extended or saturation biopsies the cost increases for the more time needed by pathologists and can be calculated as EUR 300,000. The literature review points out TRUSB as an invasive tool for diagnosing prostatic carcinoma, clinically and economically controversial. Post-mortem data report the presence of cancer cells in the prostate of 50% of 70-year-old men, while extrapolations calculate a morbidity rate from prostatic carcinoma in 9.5% of 50-year-old men. It is therefore obvious that randomized prostatic biopsies, methods apart, have a good probability of being positive. This probability varies with the patient's age, the level of prostate specific antigen (PSA), the density of PSA/cm3 of prostate volume (PSAD), and the detection by digital exploration and/or positive transrectal ultrasound. CONCLUSIONS. Despite the severe

A review of transrectal ultrasound guided prostate biopsies: Is there ...

African Journals Online (AJOL)

Objective: We compared our institution's initial experience with transrectal ultrasound-guided (TRUS) prostate biopsies in a single arm prospective study to a historical cohort of finger guided (FG) biopsies. The primary outcome measure was prostate cancer detection. We documented our findings on TRUS including the ...

Biopsias colorectales para el estudio del paciente pediátrico con estreñimiento: experiencia acumulada en los últimos cinco años en un hospital pediátrico Colombiano

OpenAIRE

López Takegami, Juan Carlos Hiromi

2011-01-01

El estreñimiento crónico es un problema de alta prevalencia mundial. Afecta aproximadamente al 8% de los niños. El estreñimiento crónico en aquellos de origen orgánico y los de origen funcional. Del total de pacientes con estreñimiento crónico menos del 10% se deben a causas identificables; de este porcentaje las disganglionosis intestinales o neuropatías entéricas son patologías susceptibles a de ser identificadas en las biopsias colorectales. Se revisaron y clasificaron las biopsias colorec...

Biopsia en enfermedad intersticial pulmonar Lung biopsy for the diagnosis of interstitial lung disease

Directory of Open Access Journals (Sweden)

Silvia Quadrelli

2007-12-01

Full Text Available El objetivo del presente estudio fue determinar el rédito diagnóstico y los factores asociados a mayor morbimortalidad en la biopsia quirúrgica de pulmón en pacientes con enfermedad intersticial difusa. Se analizaron en forma retrospectiva los registros clínicos de 71 pacientes. Se registraron complicaciones en 16 pacientes (22.5%. La mortalidad operatoria fue 11.2%. Los pacientes en quienes la biopsia se realizó por videotoracoscopia (n = 52 y por toracotomía (n = 17 tuvieron la misma duración de estadía en terapia intensiva y de estadía hospitalaria. La tasa de complicaciones (22.2% vs. 21.0%, p = 1.0000 y la mortalidad (9.2 vs. 15.7%, p = 0.2738 no fueron diferentes. Ocho pacientes murieron dentro de los 30 días. La prevalencia de inmunosupresión (4/8 vs. 9/63, p = 0.0325 fue significativamente superior en el grupo de pacientes fallecidos. Estos pacientes tuvieron valores preoperatorios más elevados de urea (50 ± 20.1 mg/dl vs. 31.2 ± 10.3 mg/ dl, p = 0.0013 y menores valores de saturación de O2: 82.7 ± 14.8% vs. 92.8 ± 3.4%, p = 0.0009. En los 11 pacientes con iniciación aguda la mortalidad fue significativamente más elevada (36.3% vs. 7.1%, p = 0.0223. La biopsia aportó un diagnóstico específico en 100% de los pacientes y cambió la estrategia terapéutica en 66.7%. En conclusión, la biopsia de pulmón por vía toracoscópica es un procedimiento útil y seguro en los pacientes con enfermedad intersticial difusa del pulmón. Sin embargo, en el grupo de pacientes inmunocomprometidos, con cuadros de presentación aguda y con insuficiencia respiratoria preoperatoria, la mortalidad es elevada y deben balancearse muy críticamente los riesgos contra los beneficios en ese grupo de enfermos.The objective of this study was to determine the morbidity, mortality and diagnostic yield of video assisted thoracoscopy (VATS and thoracotomy lung biopsy in interstitial lung disease (ILD. Clinical records of 71 patients were

Laparoscopic subtotal colectomy with transrectal extraction of the colon and ileorectal anastomosis.

Science.gov (United States)

Awad, Ziad T

2012-03-01

Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Five trocars (one 12 mm and four 5 mm) were used. The video describes the technique of performing laparoscopic subtotal colectomy, laparoscopic cholecystectomy, transrectal removal of the gallbladder and the entire colon, and intracorporeal stapled ileorectal anastomosis in a 27-year-old female with colonic inertia and biliary dyskinesia. There were no intraoperative complications. The operating time was 180 min. Blood loss was 10 cc. The patient was discharged home on postoperative day 4. Laparoscopic subtotal colectomy with transrectal removal of the colon is a safe and effective procedure that can be added to the armamentarium of surgeons performing laparoscopic colon surgery. This technique may provide both an attractive way to reduce abdominal wall morbidity and a bridge to NOTES colon surgery.

Automated analysis and interpretation of transrectal ultrasonography images in patients with prostatitis

NARCIS (Netherlands)

de la Rosette, J. J.; Giesen, R. J.; Huynen, A. L.; Aarnink, R. G.; van Iersel, M. P.; Debruyne, F. M.; Wijkstra, H.

1995-01-01

Transrectal ultrasound (TRUS) offers a valuable complement to digital rectal examination (DRE) in diagnosing prostate diseases. However, in case of prostatitis syndromes, contradictions are found with regard to characteristic ultrasound features in these patients. Therefore we sought for better

Diagnose of the prostate cancer: Utility of the antigen specifies of prostate, transrectal echography and aspired by fine needle; Diagnostico del cancer de prostata: utilidad del antigeno especifico de prostata, ecografia transrectal y aspirado por aguja fina

Energy Technology Data Exchange (ETDEWEB)

De Nubbila, Eduardo; Rosillo, Marco; Fals, Orlando

1993-04-01

We describe three improved methods of detecting prostate cancer while it is still confined to the gland: Prostrate specific antigen (PSA), trans-rectal ultrasound (TRUS) and trans-rectal ultrasound-directed prostatic fine needle aspirate (TRFNA). Of a total of 60 studied cases, 23 cytological procedures were done, and half of these were found to have prostate cancer. We compare traditional methods like digital rectal examination and prostatic phosphatase acid with PSA and TRFNA. We conclude that these methods increase the sensibility and specificity of early prostate cancer detection.

Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

Directory of Open Access Journals (Sweden)

Kohei Kobatake

2015-04-01

Full Text Available Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy. Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants and to the non-insertion group (group B: 130 participants. In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy. Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0% vs. 11 (8.5%, P=0.029. The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis. Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

Sensibilidad de la biopsia gástrica en la detección de Helicobacter pylori en pacientes en tratamiento con inhibidores de la bomba de protones.

Directory of Open Access Journals (Sweden)

Daisy Azaña

2012-03-01

Full Text Available Objetivo: Comparar la sensibilidad de la biopsia gástrica en la detección de Helicobacter pylori (Hp en pacientes que recibieron inhibidores de la bomba de protones (IBP entre 7 y 14 días previos a la endoscopía digestiva alta y los que recibieron medicación diferente a IBP o no usaron medicación. Material y métodos: Estudio tipo serie de casos comparativo. Se incluyeron pacientes con dispepsia sometidos a endoscopía digestiva alta y biopsia gástrica en el Servicio de Gastroenterología del Hospital Nacional Cayetano Heredia entre noviembre 2008 y enero 2009, que habían recibido IBP entre 7 y 14 días. Se excluyeron pacientes con cáncer gástrico, cirugía previa, que se encontraban en terapia antibiótica o con salicilato de bismuto en las 4 semanas previas. Se tomaron dos biopsias en cuerpo y dos en antro. Se utilizó el programa STATA 10 para el análisis. Resultados: Se estudiaron 80 pacientes; 38 (47,5% recibieron IBP. El 64,29% (27/42 de los que no tomaron IBP fueron Hp (+ y el 65,79% (23/38 de los que tomaron IBP (p=0,90. Conclusiones: La proporción de resultados positivos para Hp fue similar en los pacientes que tomaron IBP entre 7 y 14 días y los que no recibieron IBP.

Biopsia de médula ósea: Patrones morfológicos de las hemopatías y tumores sólidos en pediatría

Directory of Open Access Journals (Sweden)

Alma Torres Gómez de Cádiz Silva

1996-12-01

Full Text Available Se presentan los resultados del estudio de 165 biopsias de médula ósea realizadas a pacientes ingresados en el Hospital Pediátrico Docente "Juan Manuel Márquez". Las distintas afecciones que motivaron las biopsias fueron: enfermedades hematológicas no malignas, 56 casos; leucemia linfoblástica aguda, 9 casos; leucemia mieloide crónica juvenil, 2 casos; histiocitosis maligna, 1 caso; linfoma no Hodgkin, 25 casos; enfermedad de Hodgkin, 31 casos; neuroblastoma, 13 casos; sarcoma de partes blandas, 11 casos; neuroblastoma, 13 casos; evaluación del órgano posquimioterapia, 17 casos. Se describen las características morfológicas de la médula ósea en diferentes hemopatías y los patrones de infiltración de las leucemias y los tumores sólidos más frecuentes en el niño.The results of the study of 165 bone marrow biopsias performed to patients admitted in the "Juan Manuel Márquez" Pediatric Teaching Hospital, are presented. The different affections leading to biopsies were: non-malignant hematologic diseases, 56 cases; acute lymphoblastic leukemia, 9 cases; juvenile chronic myeloid leukemia, 2 cases; malignant histiocytosis, 1 case; non-Hodgking lymphoma, 25 cases; Hodgkin's disease, 31 cases, neuroblastoma, 13 cases; soft tissues sarcomas, 11 cases; and, postchemiotherapy organ evaluation, 17 cases. The morphological characteristics of the bone marrow in different hemopathies, as well as the infiltration patterns of leukemias and of the most common solid tumours in children, are described.

Clinically low-risk prostate cancer: evaluation with transrectal doppler ultrasound and functional magnetic resonance imaging

Directory of Open Access Journals (Sweden)

Maria Inês Novis

2011-01-01

Full Text Available OBJECTIVES: To evaluate transrectal ultrasound, amplitude Doppler ultrasound, conventional T2-weighted magnetic resonance imaging, spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in localizing and locally staging low-risk prostate cancer. INTRODUCTION: Prostate cancer has been diagnosed at earlier stages and the most accepted classification for low-risk prostate cancer is based on clinical stage T1c or T2a, Gleason score <6, and prostate-specific antigen (PSA <10 ng/ml. METHODS: From 2005 to 2006, magnetic resonance imaging was performed in 42 patients, and transrectal ultrasound in 26 of these patients. Seven patients were excluded from the study. Mean patient age was 64.94 years and mean serum PSA was 6.05 ng/ml. The examinations were analyzed for tumor identification and location in prostate sextants, detection of extracapsular extension, and seminal vesicle invasion, using surgical pathology findings as the gold standard. RESULTS: Sixteen patients (45.7% had pathologically proven organ-confined disease, 11 (31.4% had positive surgical margin, 8 (28.9% had extracapsular extension, and 3 (8.6% presented with extracapsular extension and seminal vesicle invasion. Sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV and accuracy values for localizing low-risk prostate cancer were 53.1%, 48.3%, 63.4%, 37.8% and 51.3% for transrectal ultrasound; 70.4%, 36.2%, 65.1%, 42.0% and 57.7% for amplitude Doppler ultrasound; 71.5%, 58.9%, 76.6%, 52.4% and 67.1% for magnetic resonance imaging; 70.4%, 58.7%, 78.4%, 48.2% and 66.7% for magnetic resonance spectroscopy; 67.2%, 65.7%, 79.3%, 50.6% and 66.7% for dynamic contrast-enhanced magnetic resonance imaging, respectively. Sensitivity, specificity, PPV, NPV and accuracy values for detecting extracapsular extension were 33.3%, 92%, 14.3%, 97.2% and 89.7% for transrectal ultrasound and 50.0%, 77.6%, 13.7%, 95.6% and 75.7% for magnetic resonance imaging

Assessment and clinical factors associated with pain in patients undergoing transrectal prostate biopsy.

Science.gov (United States)

Gómez-Gómez, E; Ramírez, M; Gómez-Ferrer, A; Rubio-Briones, J; Iborra, I; J Carrasco-Valiente; Campos, J P; Ruiz-García, J; Requena-Tapia, M J; Solsona, E

2015-09-01

To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain. Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain. A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P<.01), age (RR, .63; 95% CI .47-.85; P<.01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P<.01) were factors independently associated with greater pain during the procedure. Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Repeat biopsy in patients with initial diagnosis of PIN; La biopsia ripetuta nei pazienti con diagnosi iniziale di PIN

Energy Technology Data Exchange (ETDEWEB)

De Matteis, Massimo [Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Bologna (Italy). UO Radiologia Albertoni; Poggi, Cristina; De Martino, Antonietta; Pavlica, Pietro [Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Bologna (Italy). UO Radiologia Palagi, Dipartimento area radiologica; Corti, Barbara [Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Bologna (Italy). UO Anatomia ed istologia patologica, Dipartimento oncologico ed ematologico; Barozzi, Libero [Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Bologna (Italy). UO Radiologia d' urgenza, Dipartimento emergenze ed accettazione

2005-09-15

indirizzare i pazienti alla biopsia ripetuta. Materiale e metodi. Abbiamo valutato i risultati di 72 biopsie ripetute in pazienti con una diagnosi di PIN ad una prima agobiopsia prostatica ecoguidata. A tutti e stato effettuato un numero minimo di 6 prelievi. Tutti avevano un PSA>4 ng/ml. Risultati. Sono stati rilevati alla biopsia ripetuta 15 adenocarcinomi su 50 pazienti (30%) con diagnosi iniziale di PIN a basso grado e 10 carcinomi su 22 (45,4%) con PIN ad alto grado. Sono stati diagnosticati 7 carcinomi in 18 pazienti (39%) nei quali il PSA era diminuito durante l'intervallo di osservazione, in 16 su 46 (35%) nei quali il PSA in aumento e 2 su 8 casi (25%) con PSA stabile. Conclusioni. I risultati sembrano confermare che il PIN puo essere considerato un precursore dell'adenocarcinoma prostatico o un'alterazione istologica frequentemente associata ad esso. I pazienti con diagnosi iniziale di PIN a basso grado e soprattutto quelli con PIN ad alto grado dovrebbero sistematicamente essere sottoposti a biopsia ripetuta a breve distanza per l'elevata frequenza di diagnosi finale di carcinoma. Non esistono ancora indicazioni condivise sull'intervallo temporale tra le due biopsie. Le variazioni del PSA che si possono riscontrare durante il periodo di osservazione non rappresentano un parametro statisticamente significativo per proporre o meno al paziente la ripetizione della biopsia prostatica.

Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature

Institute of Scientific and Technical Information of China (English)

Klaus Gottlieb; Paul H Lin; David M Liu; Karl Anders

2008-01-01

Chordomas are rare tumors which originate from the remnants of the notochord.These tumors are locally aggressive and have a predilection for the ends of the axial skeleton.An important prerequisite for optimal management of these tumors is a correct preoperative diagnosis.The present case is the first report of the use of endoscopic ultrasound to obtain transrectal fine needle aspiration biopsy of a presacral chordoma.A review of the prior computer tomography (CT) scans allowed us to calculate the tumor volume doubling time (18.3 mo).Transrectal biopsy of chordomas is controversial,however we believe that such concerns are not justified.

Diagnose of the prostate cancer: Utility of the antigen specifies of prostate, transrectal echography and aspired by fine needle

International Nuclear Information System (INIS)

De Nubbila, Eduardo; Rosillo, Marco; Fals, Orlando

1993-01-01

We describe three improved methods of detecting prostate cancer while it is still confined to the gland: Prostrate specific antigen (PSA), trans-rectal ultrasound (TRUS) and trans-rectal ultrasound-directed prostatic fine needle aspirate (TRFNA). Of a total of 60 studied cases, 23 cytological procedures were done, and half of these were found to have prostate cancer. We compare traditional methods like digital rectal examination and prostatic phosphatase acid with PSA and TRFNA. We conclude that these methods increase the sensibility and specificity of early prostate cancer detection

Fused-data transrectal EIT for prostate cancer imaging.

Science.gov (United States)

Murphy, Ethan K; Wu, Xiaotian; Halter, Ryan J

2018-05-25

Prostate cancer is a significant problem affecting 1 in 7 men. Unfortunately, the diagnostic gold-standard of ultrasound-guided biopsy misses 10%-30% of all cancers. The objective of this study was to develop an electrical impedance tomography (EIT) approach that has the potential to image the entire prostate using multiple impedance measurements recorded between electrodes integrated onto an end-fired transrectal ultrasound (TRUS) device and a biopsy probe (BP). Simulations and sensitivity analyses were used to investigate the best combination of electrodes, and measured tank experiments were used to evaluate a fused-data transrectal EIT (fd-TREIT) and BP approach. Simulations and sensitivity analysis revealed that (1) TREIT measurements are not sufficiently sensitive to image the whole prostate, (2) the combination of TREIT  +  BP measurements increases the sensitive region of TREIT-only measurements by 12×, and (3) the fusion of multiple TREIT  +  BP measurements collected during a routine or customized 12-core biopsy procedure can cover up to 76.1% or 94.1% of a nominal 50 cm 3 prostate, respectively. Three measured tank experiments of the fd-TREIT  +  BP approach successfully and accurately recovered the positions of 2-3 metal or plastic inclusions. The measured tank experiments represent important steps in the development of an algorithm that can combine EIT from multiple locations and from multiple probes-data that could be collected during a routine TRUS-guided 12-core biopsy. Overall, this result is a step towards a clinically deployable impedance imaging approach to scanning the entire prostate, which could significantly help to improve prostate cancer diagnosis.

The results of transrectal prostate biopsy in patients with low levels of prostate specific antigen

Directory of Open Access Journals (Sweden)

Ahmet Ali Sancaktutar

2012-06-01

Full Text Available Objectives: The aim of this study is to evaluate the resultsof prostate biopsy of patients who had the prostatespecificantigen (PSA levels below 4 ng/ml.Material and methods: The medical records of 63 patientswho underwent transrectal prostate biopsy, betweenJanuary 2005 and December 2011, due to suspicionof prostate cancer with the PSA levels under 4 ng/mlwere retrospectively reviewed.Results: Transrectal Prostate biopsy was performed to63 patients. Prostate cancer was detected in 12 (19%patients. The mean value of PSA was 2.5 ng/ml. TheGleason score of Prostate cancer patients was 6,8 (5-7and the number of positive cores were 3.Conclusions: The rate of prostate cancer was found as19% in patients with levels of PSA under 4 ng/ml and thisratio is compatible with the results of previous reports.

Association between placentome size, measured using transrectal ultrasonography, and gestational age in cattle.

Science.gov (United States)

Adeyinka, F D; Laven, R A; Lawrence, K E; van Den Bosch, M; Blankenvoorde, G; Parkinson, T J

2014-03-01

The aim of this study was to estimate whether fetal age could be accurately estimated using placentome size. Fifty-eight cows with confirmed conception dates in two herds were used for the study. The length of the long axis and cross-sectional area of placentomes close to the cervix were measured once every 10 days between approximately 60-130 days of gestation and once every 15 days between 130-160 days of gestation. Four to six placentomes were measured using transrectal ultrasonography in each uterine horn. A linear mixed model was used to establish the factors that were significantly associated with log mean placentome length and to create an equation to predict gestational age from mean placentome length. Limits of agreement analysis was then used to evaluate whether the predictions were sufficiently accurate for mean placentome length to be used, in practice, as a method of determining gestational age. Only age of gestation (puterine horn (p=0.048) were found to have a significant effect on log mean placentome length. From the three models used to predict gestational age the one that used log mean placentome length of all placentomes, adjusting for the effect of horn, had the smallest 95% limits of agreement; ±33 days. That is, predicted gestational age had a 95% chance of being between 33 days greater and 33.7 days less than actual age. This is approximately twice that reported in studies using measurement of fetal size. Measurement of placentomes near to the cervix using transrectal ultrasonography was easily achieved. There was a significant association between placentome size and gestational age, but between-cow variation in placentome size and growth resulted in poor agreement between placentome size and gestational age. Although placentomes can be easily visualised during diagnosis of pregnancy using transrectal ultrasonography, mean placentome size should not be used to estimate gestational age.

Usefulness of jejunal biopsy in the study of intestinal malabsorption in the elderly Utilidad de la biopsia yeyunal en el estudio de la malabsorción intestinal en el anciano

Directory of Open Access Journals (Sweden)

B. Lobo

2004-04-01

clave en el estudio de la malabsorción intestinal es la biopsia yeyunal, cuya utilidad, eficacia o complicaciones, son poco conocidas en el grupo de población de edad avanzada. Objetivo: determinar la utilidad de la biopsia yeyunal con la cápsula de Watson en el anciano. Pacientes: pacientes de edad superior a los 65 años, remitidos para biopsia yeyunal desde 1996 a 2001 por sospecha de malabsorción intestinal. Resultados: se han incluido 47 pacientes. La biopsia obtuvo muestra útil para estudio histológico en 42 casos, obteniendo muestra en un segundo intento en 3 de los 5 fracasos iniciales. La histología demostró atrofia vellositaria parcial en 10 casos (22,2%, atrofia vellositaria completa en 5 (11,1%, linfocitosis intraepitelial en 5 (11,1%, y casos aislados de linfangiectasia intestinal, amiloidosis, yeyunitis inespecífica y enfermedad de Whipple. La histología fue normal en 19 casos (42%. El diagnóstico definitivo fue enfermedad celíaca en 14 pacientes, sobrecrecimiento bacteriano en 3, yeyunitis en 3, enfermedad de Whipple en 1, linfangiectasia en 1, gastritis atrófica en 3, amiloidosis en 1 (asociada a sobrecrecimiento bacteriano, y colitis isquémica en 1. La biopsia yeyunal fue esencial para el diagnóstico en 20 pacientes. No se registró perforación o hemorragia en ningún paciente. Conclusión: en el estudio de la malabsorción intestinal del anciano, la biopsia yeyunal es un método diagnóstico útil y seguro para identificar la causa de la malabsorción.

Malakoplakia of the prostate diagnosed by elevated PSA level and transrectal prostate biopsy

Directory of Open Access Journals (Sweden)

Sacit Nuri Görgel

2011-04-01

Full Text Available Malakoplakia is an inflammation which is thought to develop secondary to chronic Escherichia coli infections. Although often seen in the genitourinary tract, it can also be seen in colon, stomach, lung, liver, bone, uterus, and skin. In this case report, we present prostatic malakoplakia diagnosed by elevated prostate-specific antigen level and transrectal prostate biopsy.

[Cost analysis of ultrasound-guided transrectal needle biopsy in prostatic carcinoma].

Science.gov (United States)

Bissoli, E; Fandella, A; La Torre, E; Faggiano, L; Anselmo, G; Frasson, F

1998-04-01

The literature mortality and morbidity rates from prostatic carcinoma prompt to the better use of some routine diagnostic tools such as transrectal ultrasound-guided biopsy. We evaluated the overall cost of transrectal ultrasound biopsy (TRUSB) of the prostate and investigated the economic impact of the procedures currently used to diagnose prostatic carcinoma. The total cost of TRUSB was calculated with reference to 247 procedures performed in 1996. The following cost factors were evaluated: personnel, materials, maintenance-equipment depreciation, energy consumption and hospital overheads. A literature review was also carried out to check if our extrapolated costs corresponded to those of other authors worldwide and to consider them in the wider framework of the cost effectiveness of the strategies for the early diagnosis of prostatic cancer. The overall cost of TRUSB was Itl. 249,000, obtained by adding together the costs of: personnel (Itl. 160,000); materials (Itl. 59,000); equipment maintenance and depreciation (Itl. 12,400); energy consumption (Itl. 100); hospital overheads (Itl. 17,500). The literature review points out TRUSB as a clinically invasive tool for diagnosing prostatic carcinoma whose cost-effectiveness is debated. Cadaver studies report the presence of cancer cells in the prostate of 50% of 70-year-old men, while extrapolations calculate a morbidity from prostatic carcinoma in 9.5% of 50-year-old men. It is therefore obvious that randomized prostatic biopsies, methods apart, are very likely to be positive. This probability varies with the patient's age, the level of prostate specific antigen (PSA), the density of PSA/cm3 of prostate volume (PSAD), and the positivity of exploration and/or transrectal ultrasound findings. Despite the strict application of all these criteria and the critical assessment of the patient's general conditions, TRUSB is indicated for 16% of the male population over 50, with obvious implications. It has been recently

Antibiotic prophylaxis for transrectal ultrasound biopsy of the prostate in Ireland.

LENUS (Irish Health Repository)

Smyth, L G

2012-03-01

Prostate cancer is the most common solid cancer affecting men in Ireland. Transrectal ultrasound (TRUS) biopsies of the prostate are routinely performed to diagnose prostate cancer. They are, in general, a safe procedure but are associated with a significant risk of infective complications ranging from fever, urinary tract infection to severe urosepsis. At present, there are no recommended national guidelines on the use of antibiotic prophylaxis to minimise the risk of infective complications post-TRUS biopsy.

Targeted histology sampling from atypical small acinar proliferation area detected by repeat transrectal prostate biopsy

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A. V. Karman

2017-01-01

Full Text Available Оbjective: to define the approach to the management of patients with the detected ASAP area.Materials and methods. In the time period from 2012 through 2015, 494 patients with previously negative biopsy and remaining suspicion of prostate cancer (PCa were examined. The patients underwent repeat 24-core multifocal prostate biopsy with taking additional tissue samples from suspicious areas detected by multiparametric magnetic resonance imaging and transrectal ultrasound. An isolated ASAP area was found in 127 (25. 7 % of the 494 examined men. All of them were offered to perform repeat target transrectal biopsy of this area. Targeted transrectal ultrasound guided biopsy of the ASAP area was performed in 56 (44.1 % of the 127 patients, 53 of them being included in the final analysis.Results. PCa was diagnosed in 14 (26.4 % of the 53 patients, their mean age being 64.4 ± 6.9 years. The average level of prostate-specific antigen (PSA in PCa patients was 6.8 ± 3.0 ng/ml, in those with benign lesions – 9.3 ± 6.5 ng/ml; the percentage ratio of free/total PSA with PCa was 16.2 ± 7,8 %, with benign lesions – 23.3 ± 7.7 %; PSA density in PCa patients was 0.14 ± 0.07 ng/ml/cm3, in those with benign lesions – 0.15 ± 0.12 ng/ml/cm3. Therefore, with ASAP area being detected in repeat prostate biopsy samples, it is advisable that targeted extended biopsy of this area be performed. 

Biopsia del ganglio centinela en el melanoma: camino a la desaparición Sentinel lymph node biopsy for melanoma: bound to disappear

OpenAIRE

RE Achenbach; S Monroy

2011-01-01

La biopsia del ganglio centinela continúa siendo utilizada para la terapéutica del melanoma, sin fundamento científico comprobado. Los estudios prospectivos-randomizados han fracasado en demostrar beneficio alguno en el punto clave de los mismos, conocer si aumenta la sobrevida global del paciente con melanoma invasor. Se revisan algunos trabajos que demuestran que el punto de vista contrario a su uso rutinario, es el correcto con el fin de ofrecer al dermatólogo, amplitud de criterio en el m...

Use of dynamic 3-dimensional transvaginal and transrectal ultrasonography to assess posterior pelvic floor dysfunction related to obstructed defecation.

Science.gov (United States)

Murad-Regadas, Sthela M; Regadas Filho, Francisco Sergio Pinheiro; Regadas, Francisco Sergio Pinheiro; Rodrigues, Lusmar Veras; de J R Pereira, Jacyara; da S Fernandes, Graziela Olivia; Dealcanfreitas, Iris Daiana; Mendonca Filho, Jose Jader

2014-02-01

New ultrasound techniques may complement current diagnostic tools, and combined techniques may help to overcome the limitations of individual techniques for the diagnosis of anorectal dysfunction. A high degree of agreement has been demonstrated between echodefecography (dynamic 3-dimensional anorectal ultrasonography) and conventional defecography. Our aim was to evaluate the ability of a combined approach consisting of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a 3-dimensional biplane endoprobe to assess posterior pelvic floor dysfunctions related to obstructed defecation syndrome in comparison with echodefecography. This was a prospective, observational cohort study conducted at a tertiary-care hospital. Consecutive female patients with symptoms of obstructed defecation were eligible. Each patient underwent assessment of posterior pelvic floor dysfunctions with a combination of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a biplane transducer and with echodefecography. Kappa (κ) was calculated as an index of agreement between the techniques. Diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of the combined technique in detection of posterior dysfunctions was assessed with echodefecography as the standard for comparison. A total of 33 women were evaluated. Substantial agreement was observed regarding normal relaxation and anismus. In detecting the absence or presence of rectocele, the 2 methods agreed in all cases. Near-perfect agreement was found for rectocele grade I, grade II, and grade III. Perfect agreement was found for entero/sigmoidocele, with near-perfect agreement for rectal intussusception. Using echodefecography as the standard for comparison, we found high diagnostic accuracy of transvaginal and transrectal ultrasonography in the detection of posterior dysfunctions. This combined technique should be compared with other dynamic techniques and

Prostate cancer prediction using the random forest algorithm that takes into account transrectal ultrasound findings, age, and serum levels of prostate-specific antigen

Directory of Open Access Journals (Sweden)

Li-Hong Xiao

2017-01-01

Full Text Available The aim of this study is to evaluate the ability of the random forest algorithm that combines data on transrectal ultrasound findings, age, and serum levels of prostate-specific antigen to predict prostate carcinoma. Clinico-demographic data were analyzed for 941 patients with prostate diseases treated at our hospital, including age, serum prostate-specific antigen levels, transrectal ultrasound findings, and pathology diagnosis based on ultrasound-guided needle biopsy of the prostate. These data were compared between patients with and without prostate cancer using the Chi-square test, and then entered into the random forest model to predict diagnosis. Patients with and without prostate cancer differed significantly in age and serum prostate-specific antigen levels (P < 0.001, as well as in all transrectal ultrasound characteristics (P < 0.05 except uneven echo (P = 0.609. The random forest model based on age, prostate-specific antigen and ultrasound predicted prostate cancer with an accuracy of 83.10%, sensitivity of 65.64%, and specificity of 93.83%. Positive predictive value was 86.72%, and negative predictive value was 81.64%. By integrating age, prostate-specific antigen levels and transrectal ultrasound findings, the random forest algorithm shows better diagnostic performance for prostate cancer than either diagnostic indicator on its own. This algorithm may help improve diagnosis of the disease by identifying patients at high risk for biopsy.

Assessment of the feasibility of using transrectal ultrasound for postimplant dosimetry in low-dose-rate prostate brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Davies, Rhian Siân, E-mail: rhian.s.davies@wales.nhs.uk; Perrett, Teresa; Powell, Jane; Barber, Jim; Tanguay, Jacob; Button, Michael; Cochlin, Dennis; Smith, Christian; Lester, Jason Francis

2016-01-01

A study was performed to establish whether transrectal ultrasound (TRUS)-based postimplant dosimetry (PID) is both practically feasible and comparable to computed tomography (CT)-based PID, recommended in current published guidelines. In total, 22 patients treated consecutively at a single cancer center with low-dose-rate (LDR) brachytherapy for early-stage prostate cancer had a transrectal ultrasound performed immediately after implant (d0-TRUS) and computed tomography scan 30 days after implant (d30-CT). Postimplant dosimetry planning was performed on both image sets and the results were compared. The interobserver reproducibility of the transrectal ultrasound postimplant dosimetry planning technique was also assessed. It was noticed that there was no significant difference in mean prostate D{sub 90} (136.5 Gy and 144.4 Gy, p = 0.2197), V{sub 100} (86.4% and 89.1%, p = 0.1480) and V{sub 150} (52.0% and 47.8%, p = 0.1657) for d30-CT and d0-TRUS, respectively. Rectal doses were significantly higher for d0-TRUS than d30-CT. Urethral doses were available with d0-TRUS only. We have shown that d0-TRUS PID is a useful tool for assessing the quality of an implant after low-dose-rate prostate brachytherapy and is comparable to d30-CT PID. There are clear advantages to its use in terms of resource and time efficiency both for the clinical team and the patient.

Baja frecuencia de positividad serológica en pacientes con biopsias histológicamente compatibles con enfermedad celiaca en Perú Low serological positivy in patients with histology compatible with celiac disease in Perú

Directory of Open Access Journals (Sweden)

F. Arévalo

2010-06-01

Full Text Available Objetivo: estudiar la frecuencia de positividad de las pruebas serológicas en pacientes con biopsias compatible con enfermedad celiaca. Material y métodos: estudio transversal. Se incluyeron pacientes con biopsia duodenal histológicamente compatible con enfermedad celiaca y determinación de anticuerpos antigliadina, antiendomisio y antitransglutaminasa IgA. Definimos como caso de enfermedad celiaca a quienes tuvieran biopsia positiva y anticuerpos antiendomisio y/o antitransglutaminasa positivos. Resultados: 31 pacientes fueron incluidos de los cuales 6 fueron antiendomisio positivo, 5 fueron antitransglutaminasa positivo y antigliadina fue positivo en 14. Por lo tanto de 31 pacientes con cambios histológicos compatibles con enfermedad celiaca sólo 10 tuvieron serología diagnóstica. Sólo uno de los pacientes tuvo positividad tanto para antitransglutaminasa como para antiendomisio. Conclusiones: a encontramos que la mayoría de biopsias de duodeno con un cuadro histológico sugerente de enfermedad celiaca no se corresponden con serología diagnóstica de esta enfermedad; b encontramos baja coincidencia en la positividad serológica entre antiendomisio y antitransglutaminasa.Objective: to study the frequency of positive serology for celiac disease (CD in patients with duodenal biopsies suggestive of this disease. Material and methods: cross sectional study. We included patients with duodenal biopsies histologically compatible with CD and antigliadin, antiendomysial and IgA antitransglutaminase antibodies. We defined a "case" of CD if there was a positive biopsy and either antiendomisial or antitransglutaminase positive antibodies. Results: thirty one patients were included in our study. Six were antiendomysial positive and 5 antitransglutaminase positive while the antigliadin was positive in 14 cases. Therefore, out of 31 patients only 10 had a serology compatible with CD and only one had positive both antibodies, antiendomysial and

Colour Doppler and microbubble contrast agent ultrasonography do not improve cancer detection rate in transrectal systematic prostate biopsy sampling.

Science.gov (United States)

Taverna, Gianluigi; Morandi, Giovanni; Seveso, Mauro; Giusti, Guido; Benetti, Alessio; Colombo, Piergiuseppe; Minuti, Francesco; Grizzi, Fabio; Graziotti, Pierpaolo

2011-12-01

What's known on the subject? and What does the study add? Transrectal gray-scale ultrasonography guided prostate biopsy sampling is the method for diagnosing prostate cancer (PC) in patients with an increased prostate specific antigen level and/or abnormal digital rectal examination. Several imaging strategies have been proposed to optimize the diagnostic value of biopsy sampling, although at the first biopsy nearly 10-30% of PC still remains undiagnosed. This study compares the PC detection rate when employing Colour Doppler ultransongraphy with or without the injection of SonoVue™ microbubble contrast agent, versus the transrectal ultrasongraphy-guided systematic biopsy sampling. The limited accuracy, sensitivity, specificity and the additional cost of using the contrast agent do not justify its routine application in PC detection. • To compare prostate cancer (PC) detection rate employing colour Doppler ultrasonography with or without SonoVue™ contrast agent with transrectal ultrasonography-guided systematic biopsy sampling. • A total of 300 patients with negative digital rectal examination and transrectal grey-scale ultrasonography, with PSA values ranging between 2.5 and 9.9 ng/mL, were randomized into three groups: 100 patients (group A) underwent transrectal ultrasonography-guided systematic bioptic sampling; 100 patients (group B) underwent colour Doppler ultrasonography, and 100 patients (group C) underwent colour Doppler ultrasonography before and during the injection of SonoVue™. • Contrast-enhanced targeted biopsies were sampled into hypervascularized areas of peripheral, transitional, apical or anterior prostate zones. • All the patients included in Groups B and C underwent a further 13 systematic prostate biopsies. The cancer detection rate was calculated for each group. • In 88 (29.3%) patients a histological diagnosis of PC was made, whereas 22 (7.4%) patients were diagnosed with high-grade prostatic intraepithelial

Digital rectal examination and transrectal ultrasonography in staging of rectal cancer

DEFF Research Database (Denmark)

Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

1994-01-01

Staging of rectal carcinoma before surgical treatment was performed in a prospective blind study, comparing digital rectal exploration and transrectal linear ultrasonography (TRUS) with the resulting pathological examination. TRUS underestimated depth of penetration in 3 of 33 patients...... and overestimation resulted in 9 of 74. The figures for digital examination were 5 of 18 and 20 of 76, respectively. Penetration of the rectal wall was correctly identified in 56 of 61 patients by digital examination and in 59 of 61 by TRUS. Specimens without penetration of the rectal wall were identified in 26...

Serial transrectal ultrasonography for monitoring the reproductive activity of the Asiatic black bear (Ursus thibetanus ussuricus).

Science.gov (United States)

Kang, H G; Jeong, D H; Yang, J J; Lee, B K; Kong, J K; Lee, J W; Kim, I H

2015-02-01

This study evaluated the structural changes in the reproductive tract of Asiatic black bears using serial transrectal ultrasonography. In addition, the ultrasonographic observations were compared with the results of vaginal cytology and hormonal analyses. The collection of blood for hormonal analysis, vaginal cytology and transrectal ultrasonography was performed in two bears (Bears 1 and 2) from June 2011 to August 2013 without mating and in a third bear (Bear 3) from April to December 2012, allowing natural mating. Serial ultrasonographic observations showed cyclic changes in ovarian structures (e.g. emergence of small follicles, growth and ovulation of dominant follicles and corpus luteum (CL) formation) during the reproductive cycles of the three bears. The diameter of the uterine horns remained similar throughout the reproductive cycle in Bears 1 and 2, and it remained similar from April until October, but an enlargement containing foetuses was observed in Bear 3 in December. The ultrasonographic observations were consistent with the data obtained through vaginal cytology and progesterone analysis during the reproductive cycle. An average of 4.0 (±0.4) dominant follicles was observed during the oestrous stage (May-August), during which the superficial cells accounted for >90% of the total vaginal cells. In addition, the detection of an average of 2.6 (±0.2) CL was associated with increased plasma progesterone concentrations (3.0 ± 0.4 ng/ml) between June and December (near hibernation). In conclusion, serial transrectal ultrasonography demonstrated yearly oestrous (ovulation) cycles via follicular dynamics and CL formation on ovaries, accordingly with vaginal cytology and hormonal level in the Asiatic black bear. © 2014 Blackwell Verlag GmbH.

Biopsia por congelación para diagnóstico de infección en revisión de reemplazo total de cadera

OpenAIRE

Correcha Urazán, Johan; Franco Torres, Hernando; Rincón Hoyos, Jairo; Manrique, Jorge

2007-01-01

En estados unidos se realizaron 200.000 reemplazos de cadera en el 2001, de los cuales 36.000 fueron cirugías de revisión. La incidencia de infección en primarios es del 1% mientras que en revisión es 4% . Es determinante detectar la presencia o no de infección, sin embargo no existe una prueba 100% sensible ni 100% especifica. El cultivo intraoperatorio es el patrón de oro, pero inoportuno para tomar decisiones intraoperatorias. La biopsia por congelación es un estudio histopatológico que ay...

Estimation of sensitivity and specificity of pregnancy diagnosis using transrectal ultrasonography and ELISA for pregnancy-associated glycoprotein in dairy cows using a Bayesian latent class model.

Science.gov (United States)

Shephard, R W; Morton, J M

2018-01-01

To determine the sensitivity (Se) and specificity (Sp) of pregnancy diagnosis using transrectal ultrasonography and an ELISA for pregnancy-associated glycoprotein (PAG) in milk, in lactating dairy cows in seasonally calving herds approximately 85-100 days after the start of the herd's breeding period. Paired results were used from pregnancy diagnosis using transrectal ultrasonography and ELISA for PAG in milk carried out approximately 85 and 100 days after the start of the breeding period, respectively, from 879 cows from four herds in Victoria, Australia. A Bayesian latent class model was used to estimate the proportion of cows pregnant, the Se and Sp of each test, and covariances between test results in pregnant and non-pregnant cows. Prior probability estimates were defined using beta distributions for the expected proportion of cows pregnant, Se and Sp for each test, and covariances between tests. Markov Chain Monte Carlo iterations identified posterior distributions for each of the unknown variables. Posterior distributions for each parameter were described using medians and 95% probability (i.e. credible) intervals (PrI). The posterior median estimates for Se and Sp for each test were used to estimate positive predictive and negative predictive values across a range of pregnancy proportions. The estimate for proportion pregnant was 0.524 (95% PrI = 0.485-0.562). For pregnancy diagnosis using transrectal ultrasonography, Se and Sp were 0.939 (95% PrI = 0.890-0.974) and 0.943 (95% PrI = 0.885-0.984), respectively; for ELISA, Se and Sp were 0.963 (95% PrI = 0.919-0.990) and 0.870 (95% PrI = 0.806-0.931), respectively. The estimated covariance between test results was 0.033 (95% PrI = 0.008-0.046) and 0.035 (95% PrI = 0.018-0.078) for pregnant and non-pregnant cows, respectively. Pregnancy diagnosis results using transrectal ultrasonography had a higher positive predictive value but lower negative predictive value than results from the

Diagnóstico molecular de Mycobacterium tuberculosis en biopsias pleurales embebidas en parafina

Directory of Open Access Journals (Sweden)

Helí Barrón

2006-03-01

Full Text Available Objetivo: Determinar la sensibilidad de la prueba de reacción en cadena de la polimerasa (TB-PCR frente a la tinción de fluorocromo auramina (AFB-auramina en muestras histológicas de biopsias pleurales embebidas en parafina, en el diagnóstico de tuberculosis pleural. Materiales y Métodos: Se usó 48 bloques de parafina obtenidos de los archivos de Patología del Hospital San José del Callao y del Instituto Nacional de Enfermedades Neoplásicas, 30 de los cuales tenían diagnóstico clínico de tuberculosis y 18 presentaron diagnóstico diferente de tuberculosis. Resultados: De los 30 casos con diagnóstico clínico de tuberculosis, 29 resultaron ser TB-PCR positivos. Los 18 casos negativos para tuberculosis resultaron también negativos para TB-PCR. La sensibilidad y el valor predictivo negativo para TB-PCR fueron 96,7% y 94,7%. La sensibilidad y el valor predictivo negativo para AFB-auramina fueron 58,6% y 56,7%. En ambos casos, el valor predictivo positivo fue de 100%. Conclusión: TB-PCR ha resultado ser un método muy sensible en el diagnóstico de tuberculosis en muestras histológicas embebidas en parafina.

Prevalence of fluoroquinolone-resistant rectal flora in patients undergoing transrectal ultrasound-guided prostate needle biopsy: A prospective multicenter study.

Science.gov (United States)

Chung, Ho Seok; Hwang, Eu Chang; Yu, Ho Song; Jung, Seung Il; Lee, Sun Ju; Lim, Dong Hoon; Cho, Won Jin; Choe, Hyun Sop; Lee, Seung-Ju; Park, Sung Woon

2018-03-01

To estimate the prevalence of fluoroquinolone-resistant rectal flora in patients undergoing transrectal ultrasound-guided prostate needle biopsy and to identify the high-risk groups. From January 2015 to March 2016, rectal swabs of 557 men who underwent transrectal ultrasound-guided prostate needle biopsy were obtained from five institutions. Clinical variables, including demographics, rectal swab culture results and infectious complications, were evaluated. Univariable and multivariable analyses were used to identify the risk factors for fluoroquinolone resistance of rectal flora and infectious complications. The incidence of fluoroquinolone-resistant and extended-spectrum beta-lactamase production was 48.1 and 11.8%, respectively. The most common fluoroquinolone-resistant bacteria was Escherichia coli (81% of total fluoroquinolone-resistant bacteria, 39% of total rectal flora), and 16 (2.9%) patients had infectious complications. Univariable and multivariable analysis of clinical parameters affecting fluoroquinolone resistance showed no factor associated with fluoroquinolone resistance of rectal flora. The clinical parameter related to infectious complications after prostate biopsy was a history of operation within 6 months (relative risk 6.60; 95% confidence interval 1.99-21.8, P = 0.002). These findings suggest that a risk-based approach by history taking cannot predict antibiotic resistance of rectal flora, and physicians should consider targeted antibiotic prophylaxis or extended antibiotic prophylaxis for Korean patients undergoing transrectal ultrasound-guided prostate biopsy because of high antibiotic resistance of rectal flora. © 2017 The Japanese Urological Association.

Does imprint cytology improve the accuracy of transrectal prostate needle biopsy?

Science.gov (United States)

Sayar, Hamide; Bulut, Burak Besir; Bahar, Abdulkadir Yasir; Bahar, Mustafa Remzi; Seringec, Nurten; Resim, Sefa; Çıralık, Harun

2015-02-01

To evaluate the accuracy of imprint cytology of core needle biopsy specimens in the diagnosis of prostate cancer. Between December 24, 2011 and May 9, 2013, patients with an abnormal DRE and/or serum PSA level of >2.5 ng/mL underwent transrectal prostate needle biopsy. Samples with positive imprint cytology but negative initial histologic exam underwent repeat sectioning and histological examination. 1,262 transrectal prostate needle biopsy specimens were evaluated from 100 patients. Malignant imprint cytology was found in 236 specimens (18.7%), 197 (15.6%) of which were confirmed by histologic examination, giving an initial 3.1% (n = 39) rate of discrepant results by imprint cytology. Upon repeat sectioning and histologic examination of these 39 biopsy samples, 14 (1.1% of the original specimens) were then diagnosed as malignant, 3 (0.2%) as atypical small acinar proliferation (ASAP), and 5 (0.4%) as high-grade prostatic intraepithelial neoplasia (HGPIN). Overall, 964 (76.4%) specimens were negative for malignancy by imprint cytology. Seven (0.6%) specimens were benign by cytology but malignant cells were found on histological evaluation. On imprint cytology examination, nonmalignant but abnormal findings were seen in 62 specimens (4.9%). These were all due to benign processes. After reexamination, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate of imprint preparations were 98.1, 96.9, 98.4, 92.8, 99.3, 1.6, 3.1%, respectively. Imprint cytology is valuable tool for evaluating TRUS-guided core needle biopsy specimens from the prostate. Use of imprint cytology in combination with histopathology increases diagnostic accuracy when compared with histopathologic assessment alone. © 2014 Wiley Periodicals, Inc.

Prostate cancer prediction using the random forest algorithm that takes into account transrectal ultrasound findings, age, and serum levels of prostate-specific antigen.

Science.gov (United States)

Xiao, Li-Hong; Chen, Pei-Ran; Gou, Zhong-Ping; Li, Yong-Zhong; Li, Mei; Xiang, Liang-Cheng; Feng, Ping

2017-01-01

The aim of this study is to evaluate the ability of the random forest algorithm that combines data on transrectal ultrasound findings, age, and serum levels of prostate-specific antigen to predict prostate carcinoma. Clinico-demographic data were analyzed for 941 patients with prostate diseases treated at our hospital, including age, serum prostate-specific antigen levels, transrectal ultrasound findings, and pathology diagnosis based on ultrasound-guided needle biopsy of the prostate. These data were compared between patients with and without prostate cancer using the Chi-square test, and then entered into the random forest model to predict diagnosis. Patients with and without prostate cancer differed significantly in age and serum prostate-specific antigen levels (P prostate-specific antigen and ultrasound predicted prostate cancer with an accuracy of 83.10%, sensitivity of 65.64%, and specificity of 93.83%. Positive predictive value was 86.72%, and negative predictive value was 81.64%. By integrating age, prostate-specific antigen levels and transrectal ultrasound findings, the random forest algorithm shows better diagnostic performance for prostate cancer than either diagnostic indicator on its own. This algorithm may help improve diagnosis of the disease by identifying patients at high risk for biopsy.

Automated Real-Time Needle-Guide Tracking for Fast 3-T MR-guided Transrectal Prostate Biopsy: A Feasibility Study

NARCIS (Netherlands)

Zamecnik, P.; Schouten, M.G.; Krafft, A.J.; Maier, F.; Schlemmer, H.-P.; Barentsz, J.O.; Bock, M. de; Futterer, J.J.

2014-01-01

Purpose To assess the feasibility of automatic needle-guide tracking by using a real-time phase-only cross correlation (POCC) algorithm-based sequence for transrectal 3-T in-bore magnetic resonance (MR)-guided prostate biopsies. Materials and Methods This study was approved by the ethics review

Transrectal ultrasonography of anorectal disease: advantages and disadvantages

Energy Technology Data Exchange (ETDEWEB)

Kim, Min Ju [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

2015-01-15

Transrectal ultrasonography (TRUS) has been widely accepted as a popular imaging modality for Epub ahead of print evaluating the lower rectum, anal sphincters, and pelvic floor in patients with various anorectal diseases. It provides excellent visualization of the layers of the rectal wall and of the anatomy of the anal canal. TRUS is an accurate tool for the staging of primary rectal cancer, especially for early stages. Although magnetic resonance imaging is a modality complementary to TRUS with advantages for evaluating the mesorectum, external sphincter, and deep pelvic inflammation, three-dimensional ultrasonography improves the detection and characterization of perianal fistulas and therefore plays a crucial role in optimal treatment planning. The operator should be familiar with the anatomy of the rectum and pelvic structures relevant to the preoperative evaluation of rectal cancer and other anal canal diseases, and should have technical proficiency in the use of TRUS combined with an awareness of its limitations compared to magnetic resonance imaging.

Transrectal ultrasound evaluation in tropical dairy goats: an indispensable tool for the diagnosis of reproductive disorders.

Science.gov (United States)

Maia, A L R S; Brandão, F Z; Souza-Fabjan, J M G; Veiga, M O; Balaro, M F A; Facó, O; Fonseca, J F

2018-04-01

In Brazil, great milk productivity was achieved after the implementation of a genetic improvement program. However, reproductive efficiency is still far from optimal, possibly due to the high number of undiagnosed disorders that may affect fertility. The aim of this study was to evaluate occurrences of the main reproductive disorders in dairy goats in southeastern Brazil. Data were collected between January 2015 and May 2017 from 23 commercial herds of different breeds, with goats ranging from 8 months to 12 years of age. Transrectal ultrasound exams were performed in 2680 goats. A total of 14.8% of the does showed a disorder in the reproductive tract: hydrometra (10.0%), ovarian follicular cysts (2.3%), gestational loss (1.5%), and hydrosalpinx (1.1%). This was the first study evaluating reproductive disorders in live animals that used a high number of Brazilian dairy goats. Considering that all these diseases affect fertility to different degrees, the performance of transrectal ultrasonography exams twice a year is strongly suggested, in order to guide precocious treatment or discard the animal as soon as possible, thus reducing economic losses in dairy goat farming.

Cost-Effectiveness Comparison of Imaging-Guided Prostate Biopsy Techniques: Systematic Transrectal Ultrasound, Direct In-Bore MRI, and Image Fusion

NARCIS (Netherlands)

Venderink, W.; Govers, T.M.; Rooij, M. de; Futterer, J.J.; Sedelaar, J.P.M.

2017-01-01

OBJECTIVE: Three commonly used prostate biopsy approaches are systematic transrectal ultrasound guided, direct in-bore MRI guided, and image fusion guided. The aim of this study was to calculate which strategy is most cost-effective. MATERIALS AND METHODS: A decision tree and Markov model were

Feasibility of a 2"n"d generation MR-compatible manipulator for transrectal prostate biopsy guidance

International Nuclear Information System (INIS)

Bomers, J.G.R.; Yakar, D.; Bosboom, D.G.H.; Tigelaar, G.H.; Sabisch, J.; Fuetterer, J.J.

2017-01-01

To assess the feasibility of a 2"n"d generation MR-compatible, remote-controlled manipulator (RCM) as an aid to perform MR-guided transrectal prostate biopsy in males with suspicion of prostate cancer (PCa). This prospective phase I study was approved by the local ethical committee and written informed consent was obtained from each patient. Twenty patients with ≥1 cancer suspicious region (CSR) with a PI-RADS score of ≥3 detected on the diagnostic multi-parametric MRI and no prior prostate treatment underwent MR-guided biopsy with the aid of the RCM. Complications were classified according to the modified Clavien system for reporting surgical complications. For evaluation of the workflow, procedure- and manipulation times were recorded. All CSR's (n=20) were reachable with the MR-compatible RCM and the cancer detection rate was 70 %. The median procedure time was 36:44 minutes (range, 23 - 61 minutes) and the median manipulation time for needle guide movement was 5:48 minutes (range, 1:15 - 18:35 minutes). Two Clavien grade 1 complications were reported. It is feasible and safe to perform transrectal MR-guided prostate biopsy using a MR-compatible RCM as an aid. It is a fast and efficient way to biopsy suspicious prostate lesions with a minimum number of biopsies per patient. (orig.)

In-bore transrectal MRI-guided prostate biopsies: Are there risk factors for complications?

Energy Technology Data Exchange (ETDEWEB)

Meier-Schroers, Michael, E-mail: michael.meier@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Homsi, Rami, E-mail: rami.homsi@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Kukuk, Guido, E-mail: guido.kukuk@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Wolter, Karsten, E-mail: karsten.wolter@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Decker, Georges, E-mail: georges.decker@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Fischer, Stefan, E-mail: stefan.fischer@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Marx, Christian, E-mail: christian.marx@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Schmeel, Frederic Carsten, E-mail: carsten.schmeel@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Block, Wolfgang, E-mail: wolfgang.block@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Sprinkart, Alois Martin, E-mail: sprinkart@uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Traeber, Frank, E-mail: frank.traeber@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Willinek, Winfried, E-mail: w.willinek@bk-trier.de [Department of Radiology, Neuroradiology, Sonography and Nuclear Medicine, Hospital of the Barmherzige Brüder Trier, Nordallee 1, 54292 Trier (Germany)

2016-12-15

Purpose: To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB). Materials and methods: 90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e.g. hemorrhages or signs of prostatitis). Differences between patients with and without complications were analyzed regarding possible risk factors: age, prostate volume, number of taken samples, biopsy duration, biopsy of more than one lesion, diabetes, arterial hypertension, hemorrhoids, benign prostate hyperplasia, carcinoma or prostatitis (according to histopathological analysis), and lesion localization. Complications were classified according to the Clavien-Dindo classification. Results: We observed 15 grade I complications in 90 biopsies (16.7%) with slight hematuria in 9 cases (10%), minor vasovagal reactions in 4 cases (4.4%), and urinary retention and positioning-related facial dysesthesia in 1 case each (1.1%). One patient showed acute prostatitis requiring antibiotics as the only grade II complication (1.1%). There were no adverse events that occurred later than one week. Complications grade III or higher such as pelvic abscesses, urosepsis or severe hemorrhages were not seen. There were no significant associations between the assessed risk factors and biopsy-related complications. Conclusion: In-bore transrectal MRI-guided prostate biopsies can be considered safe procedures in the diagnosis of prostate cancer with very low complication rates. There seem to be no risk factors for complications.

In-bore transrectal MRI-guided prostate biopsies: Are there risk factors for complications?

International Nuclear Information System (INIS)

Meier-Schroers, Michael; Homsi, Rami; Kukuk, Guido; Wolter, Karsten; Decker, Georges; Fischer, Stefan; Marx, Christian; Schmeel, Frederic Carsten; Block, Wolfgang; Sprinkart, Alois Martin; Traeber, Frank; Schild, Hans Heinz; Willinek, Winfried

2016-01-01

Purpose: To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB). Materials and methods: 90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e.g. hemorrhages or signs of prostatitis). Differences between patients with and without complications were analyzed regarding possible risk factors: age, prostate volume, number of taken samples, biopsy duration, biopsy of more than one lesion, diabetes, arterial hypertension, hemorrhoids, benign prostate hyperplasia, carcinoma or prostatitis (according to histopathological analysis), and lesion localization. Complications were classified according to the Clavien-Dindo classification. Results: We observed 15 grade I complications in 90 biopsies (16.7%) with slight hematuria in 9 cases (10%), minor vasovagal reactions in 4 cases (4.4%), and urinary retention and positioning-related facial dysesthesia in 1 case each (1.1%). One patient showed acute prostatitis requiring antibiotics as the only grade II complication (1.1%). There were no adverse events that occurred later than one week. Complications grade III or higher such as pelvic abscesses, urosepsis or severe hemorrhages were not seen. There were no significant associations between the assessed risk factors and biopsy-related complications. Conclusion: In-bore transrectal MRI-guided prostate biopsies can be considered safe procedures in the diagnosis of prostate cancer with very low complication rates. There seem to be no risk factors for complications.

Feasibility of a 2{sup nd} generation MR-compatible manipulator for transrectal prostate biopsy guidance

Energy Technology Data Exchange (ETDEWEB)

Bomers, J.G.R.; Yakar, D. [Radboud University Nijmegen Medical Center, Department of Radiology, route 766, P.O Box 9101, Nijmegen (Netherlands); Bosboom, D.G.H. [Radboud University Nijmegen Medical Center, Department of Radiology, route 766, P.O Box 9101, Nijmegen (Netherlands); Soteria Medical, Arnhem (Netherlands); Tigelaar, G.H.; Sabisch, J. [Soteria Medical, Arnhem (Netherlands); Fuetterer, J.J. [Radboud University Nijmegen Medical Center, Department of Radiology, route 766, P.O Box 9101, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Enschede (Netherlands)

2017-04-15

To assess the feasibility of a 2{sup nd} generation MR-compatible, remote-controlled manipulator (RCM) as an aid to perform MR-guided transrectal prostate biopsy in males with suspicion of prostate cancer (PCa). This prospective phase I study was approved by the local ethical committee and written informed consent was obtained from each patient. Twenty patients with ≥1 cancer suspicious region (CSR) with a PI-RADS score of ≥3 detected on the diagnostic multi-parametric MRI and no prior prostate treatment underwent MR-guided biopsy with the aid of the RCM. Complications were classified according to the modified Clavien system for reporting surgical complications. For evaluation of the workflow, procedure- and manipulation times were recorded. All CSR's (n=20) were reachable with the MR-compatible RCM and the cancer detection rate was 70 %. The median procedure time was 36:44 minutes (range, 23 - 61 minutes) and the median manipulation time for needle guide movement was 5:48 minutes (range, 1:15 - 18:35 minutes). Two Clavien grade 1 complications were reported. It is feasible and safe to perform transrectal MR-guided prostate biopsy using a MR-compatible RCM as an aid. It is a fast and efficient way to biopsy suspicious prostate lesions with a minimum number of biopsies per patient. (orig.)

The effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety.

Science.gov (United States)

Hızlı, Fatih; Özcan, Osman; Selvi, İsmail; Eraslan, Pınar; Köşüş, Aydın; Baş, Okan; Yıkılmaz, Taha Numan; Güven, Oğuz; Başar, Halil

2015-11-01

Several studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 ± 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 ± 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.

Enhancement characteristics of benign and malignant focal peripheral nodules in the peripheral zone of the prostate gland studied using contrast-enhanced transrectal ultrasound

International Nuclear Information System (INIS)

Tang, J.; Yang, J.-C.; Luo, Y.; Li, J.; Li, Y.; Shi, H.

2008-01-01

Aim: To assess the value of contrast-enhanced grey-scale transrectal ultrasound (CETRUS) in predicting the nature of peripheral zone hypoechoic lesions of the prostate. Materials and Methods: Ninety-one patients with peripheral zone hypoechoic lesions on ultrasound were evaluated with CETRUS followed by lesion-specific and sextant transrectal ultrasound-guided biopsies. The enhancement patterns of the lesions were observed and graded subjectively using adjacent peripheral zone tissue as the reference. Time to enhancement (AT), time to peak intensity (TTP) and peak intensity (PI) were quantified within each nodule. Ultrasound findings were correlated with biopsy findings. Results: Transrectal ultrasound-guided biopsy of the hypoechoic lesions revealed prostate cancer in 44 patients and benign prostatic diseases in 47. The intensity of enhancement within the lesions were graded as no enhancement, increased, equal, or decreased compared with adjacent peripheral zone tissue in two, 30, five and seven in the prostate cancer group and 14, 15, four and 14 in the benign group, respectively. The difference was statistically significant (p < 0.05). The peak enhancement intensity was found to be the most optimal discriminatory parameter (area under curve AUC 0.70; 95% CI: 0.58, 0.82). Conclusion: Malignant hypoechoic nodules in the peripheral zone of the prostate are more likely to enhance early and more intensely on CETRUS. A non-enhanced hypoechoic peripheral zone lesion was more likely to be benign

Patología de las glándulas salivales. Utilidad diagnóstica de la biopsia por punción-aspiración con aguja fina

OpenAIRE

Lorenzo Martínez, R.; Chimenos Küstner, Eduardo

1996-01-01

La biopsia por punción aspiración con aguja fina es una técnica diagnóstica que, originada en los Estados Unidos, se ha venido desarrollando en Europa durante las últimas décadas. Se han descrito patrones citológicos característicos en la mayoría de los procesos patológicos, tanto tumorales como no tumorales, que acontecen en las glándulas salivales. En este trabajo se revisa la epidemiología de las lesiones que asientan en las glándulas salivales y se incide en los criterios citológicos de l...

Prolonged antibiotic therapy increases risk of infection after transrectal prostate biopsy: A case report after pancreasectomy and review of the literature

Directory of Open Access Journals (Sweden)

Guevar Maselli

2014-12-01

Full Text Available Infection due to prostate biopsy afflicted more than 5% of patients and is the most common reason for hospitalization. A large series from US SEER-Medicare reported that men undergoing biopsy were 2.26 times more likely to be hospitalized for infectious complications within 30 days compared with randomly selected controls. The factors predicting a higher susceptibility to infection remain largely unknown but some authors have higlighted in the etiopathogenesis the importance of the augmented prevalence of ciprofloxacin resistant variant of bacteria in the rectum flora. We present one case of sepsis after transrectal prostate biopsy in a patient with history of pancreatic surgery. Based on our experience patients candidated to prostate biopsy with transrectal technique with history of recent major surgery represent an high risk category for infective complication. Also major pancreatic surgery should be consider an high risk category for infection. A transperineal approach and preventive measures (such as rectal swab should be adopted to reduce biopsy driven infection.

Interstitially implanted I125 for prostate cancer using transrectal ultrasound

International Nuclear Information System (INIS)

Greenburg, S.; Petersen, J.; Hansen-Peters, I.; Baylinson, W.

1990-01-01

Prostate cancer is the third leading cause of death from cancer among men in the United States. Traditional treatments for prostate cancer are prostatectomy, external beam irradiation, and interstitial implantation of Iodine125 (I125) via laparotomy. These treatments are associated with significant morbidity and limitations. Based on experience with I125 interstitial implantation by transrectal ultrasound guidance for early-stage prostate cancer, it seems that this newer method of treatment has greater accuracy of placement and distribution of the isotope and has had few reported complications. The need for a surgical incision has been eliminated. Hospitalization time also has been decreased, creating the need for ambulatory and inpatient nurses to understand the importance of their respective roles in providing coordinated quality care for these patients. Nurses in these departments must have knowledge of the procedure, radiation safety, and common side effects related to the implant

The diagnostic value of transrectal ultrasonography combined with prostate specific antigen density in prostate cancer

International Nuclear Information System (INIS)

Shen Weidong; Zha Yueqin; Wang Ajun; Hou Jianquan; Ouyang Jun

2008-01-01

Objective: To discuss the value of transrectal ultrasound (TRUS) and prostate specific antigen density (PSAD) and prostate specific antigen density of transition zone (PSATZ) for diagnosing prostate cancer. Methods: Chose cases of prostate cancer(PCa) and benign prostate hyperplasia(BPH), each was 19, all the eases were authenticated by pathology. Then compared the characteristic of prostate cancer with prostate specific antigen (PSA) and homologous PSAD, PSATZ. Results: Fourteen cases were discovered by ultrasound among the 19 PCa, the others were only diagnosed as BPH.Among the 14 cases, diffuse pathological changing was found in 1 patient, nodular changing in 13 patients (16 nodules were found). Among the 16 nodules, there were 13 hypoechoic nodules (75%) and 3 hyper echoic or compound echoic nodules (25%), and there were 13 nodules in outer zone and 3 nodules in transition zone.The PSA of PCa and BPH was 8.61-98.65 ng/ml [(48.79±25.34)ng/ml] and 0.58-28.36 ng/ml [(9.73±8.19)ng/ml]. There were no significant differences between the volume of prostate and prostate transition zone (P>0.05), but there were significant differences between the PSAD and PSATZ (P<0.01). That the PCa group was higher than that in the BPH group. Conclusion: It is higher sensitive but bess specific in diagonosis PCa by means of transrectal ultrasound. If it is combined with PSAD and PSATZ, the diagnostic rate of PCa is highly raised. (authors)

Acute bacterial prostatitis after transrectal ultrasound-guided prostate biopsy: epidemiological, bacteria and treatment patterns from a 4-year prospective study.

Science.gov (United States)

Campeggi, Alexandre; Ouzaid, Idir; Xylinas, Evanguelos; Lesprit, Philippe; Hoznek, Andras; Vordos, Dimitri; Abbou, Claude-Clément; Salomon, Laurent; de la Taille, Alexandre

2014-02-01

To evaluate the incidence, and clinical and bacterial features of iatrogenic prostatitis within 1 month after transrectal ultrasound-guided biopsy for detection of prostate cancer. From January 2006 to December 2009, 3000 patients underwent a 21-core transrectal ultrasound-guided prostate biopsy at Henri Mondor Hospital (Créteil, France) and were prospectively followed. All patients had a fluoroquinolone antimicrobial prophylaxis for 7 days. The primary study end-point was to evaluate the incidence of iatrogenic acute prostatitis within 1 month after the biopsy. The secondary end-point was to analyze the clinical and the bacterial features of the prostatitis. Overall, 20 patients of the entire study population (0.67%) had an acute bacterial prostatitis within 2.90 ± 1.77 days (range 1-7 days) after the transrectal ultrasound-guided biopsy. The groups of patients with (n = 20) and without (n = 2980) infection were similar in terms of age, prostate-specific antigen level and prostate volume. Escherichia coli was the only isolated bacteria. The subsequent tests for antibiotic susceptibility showed a 95% resistance for fluroquinolone and amoxicillin. Resistance to amoxiclav, trimethoprim-sulfamethoxazole, third generation cephalosporin and amikacin was 70%, 70%, 25% and 5% respectively. No resistance to imipenem was reported. They were all admitted for treatment without the need of intensive care unit referral. Complete recovery was achieved after 21.4 ± 7 days of antibiotic treatment. A fluroquinolone-based regimen still represents an appropriate prophylaxis protocol to minimize the risk of acute prostatitis secondary to prostate biopsy. Patients should be provided the appropriate care soon after the onset of the symptoms. An intravenous third generation cephalosporin or imipenem-based therapy seem to provide satisfying results. © 2013 The Japanese Urological Association.

Experimental and clinical trial of measuring urinary velocity with the pitot tube and a transrectal ultrasound guided video urodynamic system.

Science.gov (United States)

Tsujimoto, Yukio; Nose, Yorihito; Ohba, Kenkichi

2003-01-01

The pitot tube is a common device to measure flow velocity. If the pitot tube is used as an urodynamic catheter, urinary velocity and urethral pressure may be measured simultaneously. However, to our knowledge, urodynamic studies with the pitot tube have not been reported. We experimentally and clinically evaluated the feasibility of the pitot tube to measure urinary velocity with a transrectal ultrasound guided video urodynamic system. We carried out a basal experiment measuring flow velocity in model urethras of 4.5-8.0 mm in inner diameter with a 12-Fr pitot tube. In a clinical trial, 79 patients underwent transrectal ultrasound guided video urodynamic studies with the 12-Fr pitot tube. Urinary velocity was calculated from dynamic pressure (Pd) with the pitot tube formula and the correcting equation according to the results of the basal experiment. Velocity measured by the pitot tube was proportional to the average velocity in model urethras and the coefficients were determined by diameters of model urethras. We obtained a formula to calculate urinary velocity from the basal experiment. The urinary velocity could be obtained in 32 of 79 patients. Qmax was 8.1 +/- 4.3 mL/s (mean +/- SD; range, 18.4-1.3 mL/s), urethral diameter was 7.3 +/- 3.0 mm (mean +/- SD; range, 18.7-4.3 mm) and urinary velocity was 69.4 +/- 43.6 (mean +/- SD; range, 181.3-0 cm/s) at maximum flow rate. The correlation coefficient of Qmax measured by a flowmeter versus Qdv flow rate calculated with urethral diameter and velocity was 0.41 without significant difference. The use of the pitot tube as an urodynamic catheter to a transrectal ultrasound-guided video urodynamic system can measure urethral pressure, diameter and urinary velocity simultaneously. However, a thinner pitot tube and further clinical trials are needed to obtain more accurate results.

Transrectal ultrasound of the prostate bed after collagen injection

Energy Technology Data Exchange (ETDEWEB)

Salomon, C.G.; Dudiak, C.M.; Pyle, J.M.; Wheeler, J.S.; Waters, W.B.; Flanigan, R.C. [Loyola Univ. Medical Center, Maywood, IL (United States)

1996-03-01

Transurethral injection of collagen (TCI) may be used to treat urinary incontinence following radical prostatectomy for prostate cancer. The transrectal ultrasound (TRUS) findings after TCI are described in this report. TRUS exams of four postprostatectomy patients who had undergone TCI were reviewed. Findings were correlated with pathologic specimens obtained at TRUS-guided core biopsy. These histologic specimens were compared with others from postprostatectomy patients who had not undergone TCI. Well defined bladder apex masses of uniform echogenicity, hypoechoic to adjacent fat and muscle, were identified sonographically in all TCI patients. Masses from which positive biopsies were obtained were similar in appearance to those with no malignant. Hypocellular fibrous tissue and foci of acellular loose connective tissue were identified in the biopsies of those patients who had undergone TCI No acellular areas were identified in specimens from patients who had not had TCI. Sequelae of to should be included in the differential diagnosis of perianastomotic masses in postprostatectomy patients. However, the need for biopsy is not obviated as residual or recurrent prostate carcinoma may coexist. 14 refs., 4 figs.

Comparison of two techniques of transrectal ultrasonography for the assessment of local extent of polypoid tumours of the rectum

DEFF Research Database (Denmark)

Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

1996-01-01

The capability of transrectal ultrasonography (TRUS) to differentiate between benign and malignant rectal polyps was evaluated. Digital palpation and sigmoidoscopy were followed by TRUS with a 7.5-MHz linear-array transducer, in a blinded design. In the second part of the study the procedure...... indicated 20 of 49 adenomas to be carcinomas, compared with 4 out of 49 by digital examination (P benign and malignant...

Utilidad de la biopsia transbronquial en el diagnostico de enfermedades pulmonares en pacientes VIH/SIDA

Directory of Open Access Journals (Sweden)

Carmen Elena Fuenmayor

2014-04-01

Full Text Available La biopsia transbronquial es una herramienta útil en el diagnóstico de un grupo heterogéneo de enfermedades pulmonares. El objetivo del presente estudio fue determinar la etiología de los procesos pulmonares más frecuentes en el grupo de pacientes VIH/SIDA controlados en el Instituto Autónomo Hospital Universitario de los Andes durante el periodo febrero a septiembre del 2009. Se realizó un estudio observacional, analítico y descriptivo con enfoque epidemiológico, clínico y anatomopatológico en un grupo de 39 pacientes portadores de virus de Inmunodeficiencia Humana. De estos solamente 36 cumplieron los criterios de inclusión para esta investigación. Se hicieron análisis sanguíneo, perfil inmunológico, estudios imagenológicos, lavado bronco-alveolar, cepillado bronquial y biopsia transbronquial. Los cortes histológicos mostraron respuesta inflamatoria en diferentes fases de evolución, daño alveolar difuso y edema intraalveolar. Se realizó el diagnóstico de un grupo de enfermedades oportunistas tales como: neumocistosis, Histoplasmosis, Candidiasis y lesiones probablemente debidas a virus Herpes y Citomegalovirus. Se destaca la participación de más de un germen. Además hubo vasculitis, trombos, áreas de infarto, fibrosis intersticial y hallazgos sugestivos de Hipertensión Pulmonar. Uno de los pacientes presento neoplasia maligna epitelial indiferenciada. El empleo de esta técnica permitió evaluar la presencia de infecciones oportunistas y neoplasias infrecuentes, así como los hallazgos sugestivos de Hipertensión pulmonar. Se avala su utilización ante la necesidad de realizar un diagnóstico etiológico de certeza y establecer así la terapéutica adecuada. Utility transbronchial biopsy in the diagnosis ofpulmonary disease in patients HIV/AIDS Abstract Transbronchial biopsy is a useful tool in the diagnosis of a heterogeneous group of lung diseases. The aim of this study was to determine the etiology of pulmonary

Postprostatectomy ultrasound-guided transrectal implantation of gold markers for external beam radiotherapy. Technique and complications rate

Energy Technology Data Exchange (ETDEWEB)

Langenhuijsen, J.F.; Kiemeney, L.A.L.M.; Witjes, J.A. [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Urology; Donker, R. [Medical Center Alkmaar (Netherlands). Dept. of Radiation Oncology; McColl, G.M.; Lin, E.N.J.T. van [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Radiation Oncology

2013-06-15

Background and purpose: Postprostatectomy radiotherapy (RT) improves survival in adjuvant and salvage settings. The implantation technique and complications rate of gold markers in the prostate bed for high-precision RT were analyzed. Patients and methods: Patients undergoing postprostatectomy RT for prostate-specific antigen (PSA) relapse or high-risk disease were enrolled in the study. Under transrectal ultrasound guidance, three fine gold markers were implanted in the prostate bed and the technical difficulties of insertion were documented. Patients received our self-designed questionnaires concerning complications and pain. The influence of anticoagulants and coumarins on bleeding was analyzed, as was the effect of potential risk factors on pain. Results: In 77 consecutive patients, failure of marker implantation or marker migration was seen in six cases. Rectal bleeding was reported by 10 patients and 1 had voiding complaints. No macroscopic hematuria persisting for more than 3 days was observed. Other complications included rectal discomfort (n = 2), nausea (n = 1), abdominal discomfort (n = 1), and pain requiring analgesics (n = 4). No major complications were reported. On a 0-10 visual analogue scale (VAS), the mean pain score was 3.7. No clinically significant risk factors for complications were identified. Conclusion: Transrectal implantation of gold markers in the prostate bed is feasible and safe. Alternatives like cone beam computed tomography (CBCT) should be considered, but the advantages of gold marker implantation for high-precision postprostatectomy RT would seem to outweigh the minor risks involved. (orig.)

Contribución al estudio de la función pulmonar en pacientes intervenidos de cirugía cardíaca extracorpórea : biopsia pulmonar y lavado broncoalveolar

OpenAIRE

Abad Vázquez, Cipriano Carlos

1988-01-01

[spa] En la presente tesis se hace una introducción histórica, clasificación y se relatan las complicaciones de la circulación extracorpórea. Seguidamente se hace una revisión bibliografica y se justifica la realización de la tesis. Para el estudio se toman 31 enfermos que se intervienen de cirugia cardiaca extracorpórea y se les realiza un protocolo clínico de estudio que incluye la realización de una biopsia pulmonar (microscopia óptica y electrónica) y lavado bronco alveolar; antes y desp...

Contribución al estudio de la función pulmonar en pacientes intervenidos de cirugía cardíaca extracorpórea : biopsia pulmonar y lavado broncoalveolar

OpenAIRE

Abad Vázquez, Cipriano Carlos

1988-01-01

En la presente tesis se hace una introducción histórica, clasificación y se relatan las complicaciones de la circulación extracorpórea. Seguidamente se hace una revisión bibliografica y se justifica la realización de la tesis. Para el estudio se toman 31 enfermos que se intervienen de cirugia cardiaca extracorpórea y se les realiza un protocolo clínico de estudio que incluye la realización de una biopsia pulmonar (microscopia óptica y electrónica) y lavado bronco alveolar; antes y después de ...

Effectiveness of stress management in patients undergoing transrectal ultrasound-guided biopsy of the prostate

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Chiu LP

2016-02-01

Full Text Available Li-Pin Chiu,1,2 Heng-Hsin Tung,3 Kuan-Chia Lin,3 Yu-Wei Lai,1,4 Yi-Chun Chiu,1,4 Saint Shiou-Sheng Chen,1,4 Allen W Chiu1,4 1Division of Urology, Taipei City Hospital, 2University of Taipei, General Education Center, 3School of Nursing, Department of Care Management, National Taipei University of Nursing and Health Science, 4Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Background: To assess the utilization of stress management in relieving anxiety and pain among patients who undergo transrectal ultrasound (TRUS-guided biopsy of the prostate.  Methods: Eighty-two patients admitted to a community hospital for a TRUS biopsy of the prostate participated in this case-controlled study. They were divided into an experimental group that was provided with stress management and a control group that received only routine nursing care. Stress management included music therapy and one-on-one simulation education. Before and after the TRUS biopsy, the patients’ state-anxiety inventory score, pain visual analogue scale (VAS, respiratory rate, heart rate, and blood pressure were obtained.  Results: There were no differences in baseline and disease characteristics between the two groups. The VAS in both groups increased after the TRUS biopsy, but the difference in pre- and postbiopsy VAS scores was significantly lower in the experimental group (P=0.03. Patients in both groups experienced mild anxiety before and after the biopsy, but those in the experimental group displayed a significantly greater decrease in postbiopsy state-anxiety inventory score compared to the control group (P=0.02.Conclusion: Stress management can alleviate anxiety and pain in patients who received a TRUS biopsy of the prostate under local anesthesia. Keywords: anxiety, pain, stress management, transrectal ultrasound-guided biopsy of the prostate

Dedicated mobile high resolution prostate PET imager with an insertable transrectal probe

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Majewski, Stanislaw; Proffitt, James

2010-12-28

A dedicated mobile PET imaging system to image the prostate and surrounding organs. The imaging system includes an outside high resolution PET imager placed close to the patient's torso and an insertable and compact transrectal probe that is placed in close proximity to the prostate and operates in conjunction with the outside imager. The two detector systems are spatially co-registered to each other. The outside imager is mounted on an open rotating gantry to provide torso-wide 3D images of the prostate and surrounding tissue and organs. The insertable probe provides closer imaging, high sensitivity, and very high resolution predominately 2D view of the prostate and immediate surroundings. The probe is operated in conjunction with the outside imager and a fast data acquisition system to provide very high resolution reconstruction of the prostate and surrounding tissue and organs.

The Accuracy of Prostate Cancer Localization Diagnosed on Transrectal Ultrasound-Guided Biopsy Compared to 3-Dimensional Transperineal Approach

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Kevin Krughoff

2013-01-01

Full Text Available Background. Prostate cancer is often understaged following 12-core transrectal ultrasound- (TRUS- guided biopsies. Our goal is to understand where cancers are typically missed by this method. Methods. Transperineal 3-dimensional mapping biopsy (3DMB provides a more accurate depiction of disease status than transrectal ultrasound- (TRUS- guided biopsy. We compared 3DMB findings in men with prior TRUS-guided biopsies to determine grade and location of missed cancer. Results were evaluated for 161 men with low-risk organ confined prostate cancer. Results. The number of cancer-positive biopsy zones per patient with TRUS was 1.38 ± 1.21 compared to 3.33 ± 4.06 with 3DMB, with most newly discovered cancers originating from the middle lobe and apex. Approximately half of all newly discovered cancerous zones resulted from anterior 3DMB sampling. Gleason upgrade was recognized in 56 patients using 3DMB. When both biopsy methods found positive cores in a given zone, Gleason upgrades occurred most frequently in the middle left and right zones. TRUS cancer-positive zones not confirmed by 3DMB were most often the basal zones. Conclusion. Most cancer upgrades and cancers missed from TRUS biopsy originated in the middle left zone of the prostate, specifically in anterior regions. Anterior sampling may lead to more accurate diagnosis and appropriate followup.

Identifying the variables associated with pain during transrectal ultrasonography of the prostate

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Hou CP

2015-08-01

Full Text Available Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Meng-Chiao Hsieh,3 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ying-Chen Huang,2 Ke-Hung Tsui1,21Department of Urology, Chang Gung Memorial Hospital at Linkou, 2School of Medicine, Chang Gung University, 3Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan Objective: The purpose of this study was to prospectively investigate the degree of pain experienced by the patients receiving transrectal ultrasonography (TRUS of the prostate by applying a visual analog scale. We also identified the clinical parameters influencing pain during the TRUS examination.Materials and methods: Records were obtained from a prospective database for male patients who received TRUS of prostate in the outpatient department of Chang Gung Memorial Hospital, Taiwan, from January 2014 to June 2014. The patients underwent a detailed physical examination and medical history review. Immediately after the TRUS examination, the patients completed questionnaires based on a ten-point visual analog pain scale. The variables of interest were age, body mass index, prostate volume, prostate sagittal length, prostate-specific antigen, previous TRUS experience, external hemorrhoids, anal surgical history, prostate calcification, and image artifact caused by stool in the rectum. All variables were correlated to the visual analog scale by applying multivariate regression analysis.Results: By using linear regression analysis, we identified the independent factors that affected the pain score during the TRUS examination. The patients who received the examination for the first time or had longer prostate sagittal lengths, external hemorrhoids, anal surgical history, or stool stored in the rectum experienced more pain during the TRUS examination. Furthermore, the pain was reduced when we provided the patients with a detailed explanation before the procedure and

Biopsia de la arteria temporal: revisión de indicaciones y técnica quirúrgica para cirujanos plásticos Temporal artery biopsy: review of indications and surgical technique for plastic surgeons

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A. Rodríguez Lorenzo

2007-06-01

Full Text Available La arteritis de células gigantes (ACG es una vasculitis que presenta complicaciones graves si no es diagnosticada y tratada precozmente con corticoides a altas dosis. La biopsia de la arteria temporal (BAT es la técnica diagnóstica estandarizada utilizada para confirmar la enfermedad. Se trata de una técnica sencilla y con poca morbilidad. No obstante, en la actualidad existe una controversia sobre su indicación en pacientes con sospecha clínica de arteritis sin síntomas craneales debido a la baja tasa de positividad de la biopsia. Presentamos en este trabajo una serie de 28 pacientes en los que se realizaron 30 BAT con el objetivo de revisar las indicaciones y describir la técnica quirúrgica utilizada.Giant cell arteritis is a vasculitis that presents serious complications if it is not diagnosed and treated prematurely with corticosteroids to high dose. The temporal artery biopsy is the gold estandar technique of diagnosis used to confirm the disease. It is a simple technique with little morbidity. Nevertheless, currently there is a controversy on its indication in patients with clinical suspicion of arteritis without craneal symptoms because of the downward rate of positiveness of the biopsy. We present in this work a serie of 28 patients in which 30 biopsies were carried out with the objective to review the indications and to describe the surgical technique utilized.

The value and limitations of contrast-enhanced transrectal ultrasonography for the detection of prostate cancer

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Zhao, Han-Xue, E-mail: zhaohx861@163.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Xia, Chun-Xia, E-mail: star9901482@163.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Yin, Hong-Xia, E-mail: hongxia_yin79@yahoo.com.cn [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Guo, Ning, E-mail: ningguo99@sina.com.cn [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Zhu, Qiang, E-mail: qzhutrhos@gmail.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China)

2013-11-01

Objectives: To evaluate the role of contrast-enhanced transrectal ultrasonography (CE-TRUS) for detecting prostate carcinoma. Methods: Sixty-five patients with elevated serum prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE) were assessed using transrectal ultrasound (TRUS) and CE-TRUS. In all the patients, CE-TRUS was performed with intravenous injection of contrast agent (SonoVue, 2.4 ml) before biopsy. The cancer detection rates of the two techniques were compared. False-positive and false-negative findings related to CE-TRUS were analyzed in comparison to the pathological results of biopsy or radical prostatectomy. The targeted biopsy to abnormal CE-TRUS areas was also compared to systematic biopsy. Results: Prostate cancer was detected in 29 of the 65 patients. CE-TRUS showed rapid focal enhancement or asymmetric vessels of peripheral zones in 28 patients; 23 of them had prostate cancer. CE-TRUS had 79.3% sensitivity, compared to 65.5% of TRUS (P < 0.05). There were five false-positive and six false-negative findings from CE-TRUS. Benign prostate hyperplasia, and acute and chronic prostatitis were important causes related to the false-positive results of CE-TRUS. Prostate cancer originating from the transition zone or peripheral zone with lower PSA levels, small-size foci, and moderately or well-differentiated tumor was missed by CE-TRUS. The cancer detection rate of targeted biopsy (75%, 33/44 cores) was significantly higher than one of systematic biopsy (48.2%, 162/336) in those 28 cases (P < 0.05). In addition, no significant correlation was found between the cancer detection rate with CE-TRUS and serum PSA levels. Conclusion: CE-TRUS may improve the detection rate of prostate cancer through targeted biopsy of contrast-enhanced abnormalities. Our findings indicate that systematic biopsies should not be eliminated on the basis of false-positive and false-negative findings related to CE-TRUS.

No Effect of Music on Anxiety and Pain During Transrectal Prostate Biopsies: A Randomized Trial.

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Packiam, Vignesh T; Nottingham, Charles U; Cohen, Andrew J; Eggener, Scott E; Gerber, Glenn S

2018-07-01

To investigate the effect of ambient music on anxiety and pain in men undergoing prostate biopsies. Between September 2015 and June 2016, men undergoing office transrectal prostate biopsy at our institution were randomly assigned to music (n = 85) or control (n = 97) groups. We examined clinical characteristics, pathologic variables, and baseline anxiety using the Trait Instrument of State-Trait Anxiety Inventory. Primary outcomes included anxiety assessed by State Instrument of STAI (STAI-S) and pain using a visual analog scale. There were no significant differences in baseline characteristics between the music and control groups, including median age, prostate-specific antigen, use of magnetic resonance imaging-guided biopsies, or Trait Instrument of State-Trait Anxiety Inventory. The majority (93%) of patients indicated they desired music in their prebiopsy survey. There were no significant differences in STAI-S (33.7 ± 8.9 vs 34.4 ± 9.9, P = .6), pain score (2.3 ± 2.1 vs 2.0 ± 2.1, P = .3), or vital signs between the music and control groups, respectively. There were also no differences in STAI-S, visual analog scale, or vital signs between groups when stratified by age, prostate-specific antigen, or number of previous biopsies. Men who received music were more likely to request music for future prostate biopsy, compared to men who did not (93% vs 83%, P = .07, respectively). This randomized study showed no difference in anxiety or pain scores for patients who had ambient music during transrectal prostate biopsy. Future studies are needed to discern the influence of details including method of music delivery, music type, and utilization of adjunct relaxation tools. Copyright © 2018 Elsevier Inc. All rights reserved.

Transrectal ultrasonographic evaluation of combined utero-placental thickness during the last half of pregnancy in Martina Franca donkeys.

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Carluccio, A; Noto, F; Parrillo, S; Contri, A; De Amicis, I; Gloria, A; Robbe, D; Veronesi, M C

2016-12-01

In the recent years, the donkey population decreased dramatically so that many breeds are presently considered as endangered. In comparison to the horse, the donkey placenta still remains not completely studied. In the horse, one of the diagnostic tools useful to identify pregnant mares at risk of abortion or premature delivery, include the transrectal ultrasound examination of the uterus and its contents; and especially of the combined thickness of the uterus and of the placenta (CUPT). Since the CUPT was never investigated in donkeys, the present study was aimed to define the transrectal CUPT values during the last half of pregnancy in 20 Martina Franca jennies. Foalings times, foals characteristics and placental gross appearance, and measurements were also evaluated and values resulted always within normality. Differently to the mare, a continuous significant CUPT increase between the sixth to the 12 months of pregnancy, and a substantial increase from the ninth to the 12th month of pregnancy, was found. Although statistically not evaluable, the CUPT values recorded from three jennies with pregnancy loss did not show evidence of CUPT increases. In conclusion, normal CUPT values from the sixth to the 12th month of pregnancy in Martina Franca donkeys are provided, but further investigations are needed to define possible breed or body-size CUPT specific differences, as well as the CUPT values during pregnancy disturbances or placental abnormalities. Copyright © 2016 Elsevier Inc. All rights reserved.

Granulomatous Prostatitis: Gray-scale Transrectal Ultrasonography and Color Doppler Ultrasonography Findings

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Kim, Hyoung Jung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae; Kim, Eui Jong [Kyung Hee University Medical Center, Seoul (Korea, Republic of)

2007-12-15

We report here three cases of granulomatous prostatitis. All cases were confirmed by a transrectal ultrasonography (TRUS)-guided core biopsy of the prostate. Two cases received intravesical BCG therapy for a bladder tumor, and one case had no known predisposing condition. Gray-scale TRUS showed low echoic nodules in the outer gland in all cases. Color Doppler ultrasonography (CDUS) showed several dot-like blood flows within the low echoic nodules in two cases and several dot-like blood flows and short linear blood flows within the low echoic nodules in one case. Gray-scale TRUS findings of granulomatous prostatitis are similar to findings of prostate cancer. On CDUS, several dot-like blood flows or short linear blood flows were noted within the low echoic nodules in patients with granulomatous prostatitis. If low echoic nodules with dot-like or short linear blood flows are noted in patients with genitourinary tract tuberculosis or previous BCG therapy, granulomatous prostatitis should be included in the differential diagnosis. However, a prostatic biopsy is required for a final diagnosis

Transrectal real-time tissue elastography targeted biopsy coupled with peak strain index improves the detection of clinically important prostate cancer.

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Ma, Qi; Yang, Dong-Rong; Xue, Bo-Xin; Wang, Cheng; Chen, Han-Bin; Dong, Yun; Wang, Cai-Shan; Shan, Yu-Xi

2017-07-01

The focus of the present study was to evaluate transrectal real-time tissue elastography (RTE)-targeted two-core biopsy coupled with peak strain index for the detection of prostate cancer (PCa) and to compare this method with 10-core systematic biopsy. A total of 141 patients were enrolled for evaluation. The diagnostic value of peak strain index was assessed using a receiver operating characteristic curve. The cancer detection rates of the two approaches and corresponding positive cores and Gleason score were compared. The cancer detection rate per core in the RTE-targeted biopsy (44%) was higher compared with that in systematic biopsy (30%). The peak strain index value of PCa was higher compared with that of the benign lesion. PCa was detected with the highest sensitivity (87.5%) and specificity (85.5%) using the threshold value of a peak strain index of ≥5.97 with an area under the curve value of 0.95. When the Gleason score was ≥7, RTE-targeted biopsy coupled with peak strain index detected 95.6% of PCa cases, but 84.4% were detected using systematic biopsy. Peak strain index as a quantitative parameter may improve the differentiation of PCa from benign lesions in the prostate peripheral zone. Transrectal RTE-targeted biopsy coupled with peak strain index may enhance the detection of clinically significant PCa, particularly when combined with systematic biopsy.

Prospective randomized controlled trial comparing three different ways of anesthesia in transrectal ultrasound-guided prostate biopsy

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M. Tobias-Machado

2006-04-01

Full Text Available PURPOSE: To make an objective controlled comparison of pain tolerance in transrectal ultrasound-guided prostatic biopsy using intrarectal topic anesthesia, injectable periprostatic anesthesia, or low-dose intravenous sedation. MATERIALS AND METHODS: One hundred and sixty patients were randomized into 4 groups: group I, intrarectal application of 2% lidocaine gel; group II, periprostatic anesthesia; group III, intravenous injection of midazolam and meperidine; and group IV, control, patients to whom no sedation or analgesic was given. Pain was evaluated using an analogue pain scale graded from 0 to 5. Acceptance of a repetition biopsy, the side effects of the drugs and complications were also evaluated. RESULTS: 18/20 (90% and 6/20 (30% patients reported strong or unbearable pain in the group submitted to conventional biopsy and topical anesthesia (p = 0.23, chi-square = 1.41; whereas those submitted to periprostatic blockade and sedation, severe pain occurred in only 2/60 (3% patients (p < 0.001, chi-square = 40.19 and 3/60 (5% patients (p < 0.001, chi-square = 33.34. Acceptance of repetition of the biopsy was present in only 45% of the patients submitted to conventional biopsy, 60% of those that were given topical anesthesia (p = 0.52, chi-square = 0.4, compared to 100% of those submitted to periprostatic anesthesia (p < 0.01, chi-square = 15.17, and 95% of those who were sedated (p < 0.001, chi-square = 25.97%. CONCLUSIONS: Transrectal ultrasound-guided prostatic biopsy is an uncomfortable experience; however application of periprostatic blockade and intravenous analgesia are associated to higher tolerance of the exam and patient comfort. Low dose sedation by association of intravenous meperidine and midazolam is an emerging and safe outpatient option.

Evaluation of clinical efficacy of transrectal sonography and computed tomography for prostatic diseases

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Watanabe, Hiroki; Ohe, Hiroshi; Tanahashi, Toshikatsu and others

1988-07-01

Receiver operating characteristics (ROC) analysis was performed to evaluate the clinical efficacy of transrectal sonography (US) and computed tomography (CT) for prostatic diseases. One hundred US and CT images of prostatic diseases collected from 10 medical institutions, including 33 cases of prostatic cancer, 29 of benign prostatic hypertrophy, 7 of prostatitis, 2 of prostatic stone and 29 of normal finding, were read by 21 urologists. As the results, US was found to be more useful than CT for both the detection of prostatic diseases and the differentiation between prostatic cancer and benign prostatic hypertrophy. The sensitivity of US for the diagnosis of prostatic cancer was 64.2 % on average of all the urologists. However, the sensitivity was 80.0 % on average of 5 urologists who have read more than 3,000 US images and 59.5 % on average of 16 doctors who have read within 3,000 US images.

Biopsia del ganglio centinela en el melanoma: camino a la desaparición Sentinel lymph node biopsy for melanoma: bound to disappear

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RE Achenbach

2011-03-01

Full Text Available La biopsia del ganglio centinela continúa siendo utilizada para la terapéutica del melanoma, sin fundamento científico comprobado. Los estudios prospectivos-randomizados han fracasado en demostrar beneficio alguno en el punto clave de los mismos, conocer si aumenta la sobrevida global del paciente con melanoma invasor. Se revisan algunos trabajos que demuestran que el punto de vista contrario a su uso rutinario, es el correcto con el fin de ofrecer al dermatólogo, amplitud de criterio en el momento de discutir con el paciente dicho estudio.Sentinel node biopsy and selective lymph node dissection are still a frequent tool for therapeutic management of melanoma without scientific support. Prospective-randomized trials have failed to show overall survival - the main goal in such trials in invasive melanoma. Some articles proving that the opposite point of view to its standard use is correct have been reviewed, in order to offer to the dermatologist the different alternatives so as to discuss such procedures with amplitude of criteria at the time of discussing such procedure with the potential patient.

Inmunohistoquímica de la proteína p16INK4a en biopsias y extendidos cervicovaginales y su relación con HPV por PCR Immunohistochemistry of p16INK4a in biopsies and cervicovaginal smears, and its correlation with HPV detected by PCR

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Alejandro García

2008-12-01

Full Text Available Estudios recientes sugieren que la sobreexpresión de p16, determinada por inmunohistoquímica, sería un marcador específico de células escamosas displásicas y neoplásicas con alta asociación con HPV de alto riesgo. Nuestro objetivo fue correlacionar los hallazgos cito/histológicos con la expresión de p16 y el subtipo de HPV por PCR. Seleccionamos 95 biopsias de cuello uterino y 4 legrados endocervicales de 99 individuos, y 30 extendidos cervicovaginales de otros 30 individuos, que se dividieron según el diagnóstico morfológico. Inmunomarcamos cortes del material incluido en parafina y los extendidos con el kit CINtecT p16INK4a (DAKO. Evaluamos HPV por PCR utilizando 25/99 biopsias con lesión intraepitelial escamosa de bajo grado. Observamos marcación positiva para p16 en 1/35 biopsias (2.9% y 1/11 extendidos (9% en los grupos sin HPV ni displasia; 16/25 biopsias (64% y 6/10 extendidos (60% en aquellos con lesión de bajo grado y 38/39 biopsias (97.4% y 8/9 extendidos (89% en los grupos con lesión de alto grado y carcinoma escamoso. Todas las muestras con HPV-6/11 fueron negativas o positivas focales para p16, en tanto que aquellas con HPV-18 u otros subtipos fueron mayoritariamente positivas de tipo difuso. Concluimos que la expresión de p16 presenta alta correlación con el diagnóstico cito/histológico y alta asociación entre la marcación difusa y la presencia de HPV de alto riesgo, aportando mayor objetividad en casos dudosos y ayudando a seleccionar grupos de individuos con riesgo de progresión de enfermedad, con un costo aceptable para estudiar grandes grupos.Recent studies suggest that p16 overexpression determined by immunohistochemistry would be a specific marker for neoplastic and dysplastic squamous cells associated with high-risk HPV. The purpose of this study was to assess the correlation between cyto-histological findings, p16 expression and HPV subtype. A total of 99 biopsies were selected, 4 endocervical

SU-E-J-93: Parametrisation of Dose to the Mucosa of the Anterior Rectal Wall in Transrectal Ultrasound Guided High-Dose-Rate Brachytherapy of the Prostate

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Aitkenhead, A; Hamlett, L; Wood, D; Choudhury, A [The Christie Hospital NHS Foundation Trust, Manchester, Greater Manchester (United Kingdom)

2014-06-01

Purpose: In high-dose-rate (HDR) brachytherapy of the prostate, radiation is delivered from a number of radioactive sources which are inserted via catheter into the target volume. The rectal mucosa also receives dose during the treatment, which may lead to late toxicity effects. To allow possible links between rectal dose and toxicity to be investigated, suitable methods of parametrising the rectal dose are needed. Methods: During treatment of a series of 95 patients, anatomy and catheter locations were monitored by transrectal ultrasound, and target volume positions were contoured on the ultrasound scan by the therapist. The anterior rectal mucosal wall was identified by contouring the transrectal ultrasound balloon within the ultrasound scan. Source positions and dwell times, along with the dose delivered to the patient were computed using the Oncentra Prostate treatment planning system (TPS). Data for the series of patients were exported from the TPS in Dicom format, and a series of parametrisation methods were developed in a Matlab environment to assess the rectal dose. Results: Contours of the anterior rectal mucosa were voxelised within Matlab to allow the dose to the rectal mucosa to be analysed directly from the 3D dose grid. Dose parametrisations based on dose-surface (DSH) and dose-line (DLH) histograms were obtained. Both lateral and longitudinal extents of the mucosal dose were parametrised using dose-line histograms in the relevant directions. Conclusion: We have developed a series of dose parametrisations for quantifying the dose to the rectal mucosa during HDR prostate brachytherapy which are suitable for future studies investigating potential associations between mucosal dose and late toxicity effects. The geometry of the transrectal probe standardises the rectal anatomy, making this treatment technique particularly suited to studies of this nature.

SU-E-J-93: Parametrisation of Dose to the Mucosa of the Anterior Rectal Wall in Transrectal Ultrasound Guided High-Dose-Rate Brachytherapy of the Prostate

International Nuclear Information System (INIS)

Aitkenhead, A; Hamlett, L; Wood, D; Choudhury, A

2014-01-01

Purpose: In high-dose-rate (HDR) brachytherapy of the prostate, radiation is delivered from a number of radioactive sources which are inserted via catheter into the target volume. The rectal mucosa also receives dose during the treatment, which may lead to late toxicity effects. To allow possible links between rectal dose and toxicity to be investigated, suitable methods of parametrising the rectal dose are needed. Methods: During treatment of a series of 95 patients, anatomy and catheter locations were monitored by transrectal ultrasound, and target volume positions were contoured on the ultrasound scan by the therapist. The anterior rectal mucosal wall was identified by contouring the transrectal ultrasound balloon within the ultrasound scan. Source positions and dwell times, along with the dose delivered to the patient were computed using the Oncentra Prostate treatment planning system (TPS). Data for the series of patients were exported from the TPS in Dicom format, and a series of parametrisation methods were developed in a Matlab environment to assess the rectal dose. Results: Contours of the anterior rectal mucosa were voxelised within Matlab to allow the dose to the rectal mucosa to be analysed directly from the 3D dose grid. Dose parametrisations based on dose-surface (DSH) and dose-line (DLH) histograms were obtained. Both lateral and longitudinal extents of the mucosal dose were parametrised using dose-line histograms in the relevant directions. Conclusion: We have developed a series of dose parametrisations for quantifying the dose to the rectal mucosa during HDR prostate brachytherapy which are suitable for future studies investigating potential associations between mucosal dose and late toxicity effects. The geometry of the transrectal probe standardises the rectal anatomy, making this treatment technique particularly suited to studies of this nature

Distal ureteral calculi: the usefulness of transrectal ultrasound and comparison with intravenous urography

International Nuclear Information System (INIS)

Choi, Moon Hae; Yoon, Dae Young; Shim, Joo Eun; Kim, Ho Chul; Yi, Jeong Geun; Choi, Chul Sun; Bae, Sang Hoon; Kim, Ha Young

1996-01-01

To determine the usefulness of transrectal ultrasound (TRUS) and to compare TRUS with intravenous urography (IVU) in the evaluation of distal ureteral calculi. TRUS and IVU were performed in 24 patients with distal ureteral calculi. Using TRUS, we evaluated the presence and size of calculus, type of ureteral jet at the affected site and diameter of ureter proximal to calculus, and using IVU evaluated the presence and size of calculus, degree of ureteral obstruction, and degree of hydroureter. TRUS and IVU findings, were compared. In each patient, TRUS detected calculus of the distal ureter;in only 18 cases (75%), were the calculi demonstrated with IVU. In 18 cases where calculi were detected by both modalities, average calculus size was 4.5x3.0mm (longest and shortest dimensions) by IVU, and 6.1x3.7mm by TRUS. Between TRUS and IVU(p 0.05). TRUS appears to be a useful adjunctive method for the evaluation of distal ureteral calculus

Morbidade da biópsia da próstata transretal guiada por ultrassonografia Morbidity of transrectal ultrasound guided prostate biopsy

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Raphael Sandes Solha

2013-04-01

Full Text Available OBJETIVO: Avaliar a incidência de complicações pós-procedimento nos pacientes submetidos a biópsia prostática transretal guiada por ultrassom no setor de intervenção do Departamento de Diagnóstico por Imagem da Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIAIS E MÉTODOS: Foram avaliados, via contato telefônico, 132 pacientes submetidos a biópsia de próstata transretal guiada por ultrassom no período de abril/2011 a junho/2011, seguindo o protocolo padrão do nosso setor. RESULTADOS: As complicações pós-biópsia foram categorizadas em maiores e menores de acordo com a necessidade de avaliação médica adicional. Cinquenta e nove pacientes (61,8% apresentaram complicações, e desses, grande parte (86,4% apresentou sintomas leves e autolimitados, considerados menores. Oito pacientes (8,2% apresentaram complicações maiores, sendo que apenas um deles necessitou de tratamento sob regime de internação hospitalar. A retenção urinária foi a complicação maior mais incidente no nosso estudo. CONCLUSÃO: Corroborando outros estudos da literatura, nosso trabalho demonstrou baixa prevalência de complicações maiores após a biópsia prostática transretal.OBJECTIVE: To evaluate the incidence of postprocedural complications in patients submitted to transrectal ultrasound-guided prostate biopsy at the Unit of Intervention, Department of Imaging Diagnosis of Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIALS AND METHODS: Telephone interviews were conducted with 132 patients who had undergone transrectal ultrasound-guided prostate biopsy in the period from April 2011 to June 2011, according to the institution's protocol. RESULTS: Post-biopsy complications were categorized into two groups - minor and major complications, according to their need for further clinical evaluation. Complications were reported by 59 patients (61.8%, most of them (86.4% with mild and self-limited symptoms

A Rectourethral Fistula due to Transrectal High-Intensity Focused Ultrasound Treatment: Diagnosis and Management

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Valeria Fiaschetti

2012-01-01

Full Text Available Colovesical fistula (CVF is an abnormal connection between the enteric and the urinary systems. The rectourethral fistula (RUF is a possible but extremely rare complication of treatment of prostate cancer with “transrectal High-Intensity Focused Ultrasound (HIFU treatment.” We present a case of CVF due to HIFU treatment of recurrent prostate cancer. The case was assessed with cystography completed with a pelvic CT scan—with MPR, MIP, and VR reconstruction—before emptying the bladder. Since the CT scan confirmed that the fistula involved solely the urethra and excluded even a minimal involvement of the bladder, it was possible to employ a conservative treatment by positioning a Foley catheter of monthly duration, in order to allow the urethra to rest. Still today, after 6 months, the patient is in a good clinical condition and has not shown yet signs of a recurrence of the fistula.

Ablative efficiency of lithium triborate laser vaporization and conventional transurethral resection of the prostate: a comparison using transrectal three-dimensional ultrasound volumetry

Science.gov (United States)

Gross, Oliver; Sulser, Tullio; Hefermehl, Lukas J.; Strebel, Daniel D.; Largo, Remo; Mortezavi, Ashkan; Poyet, Cédric; Eberli, Daniel; Zimmermann, Matthias; Müller, Alexander; Michel, Maurice S.; Müntener, Michael; Seifert, Hans-Helge; Hermanns, Thomas

2011-03-01

Introduction and objectives: It is unknown if tissue ablation following 120W lithium triborate (LBO) laser vaporization (LV) of the prostate is comparable to that following transurethral resection of the prostate (TURP). Therefore, transrectal 3D-ultrasound volumetry of the prostate was performed to compare the efficiency of tissue ablation between LBO-LV and TURP. Methods: Between 03/2008 and 03/2010 110 patients underwent routine LBO-LV (n=61) or TURP (n=49). Transrectal 3D-ultrasound with planimetric volumetry of the prostate was performed pre-operatively, after catheter removal, 6 weeks and 6 months. Results: Median prostate volume was 52.5ml in the LV group and 46.9ml in the TURP group. After catheter removal, median absolute volume reduction (LV: 7.05ml, TURP: 15.8ml) and relative volume reduction (15.9% vs. 34.2%) were significantly lower in the LV group (p<0.001). After 6 weeks/ 6 months, the relative volume reduction but not the absolute remained significantly lower in the LV group. Conclusions: LBO-LV is an efficient procedure evidenced by an absolute tissue ablation not significantly different to that after TURP. However, TURP seems to be superior due to a higher relative tissue ablation. The differences in tissue ablation had no impact on the early clinical outcome. Delayed volume reduction indicates that prostatic swelling occurs early after LV and then decreases subsequently.

A Pitfall in Transrectal Prostate Biopsy: Malakoplakia Evaluation of Two Cases Based on the Literature Review

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Solakoglu Kahraman, Dudu; Sayhan, Sevil; Diniz, Gulden; Ayaz, Duygu; Karadeniz, Tugba; Can, Ertan

2014-01-01

Malakoplakia is a rarely seen inflammatory condition that is considered to develop secondary to a chronic Escherichia coli infection. Although malakoplakia usually affects the genitourinary tract, it may also be observed in the colon, stomach, lungs, liver, bones, uterus, and skin. Malakoplakia of the genitourinary system usually involves the bladder, whereas it may also affect the prostate along with the bladder. Malakoplakia of the prostate is very rare, and it may be clinically mistaken for prostatic malignancies. Definitive diagnosis is only possible through histopathological examination. This study elaborates on two patients who presented to our hospital in 2013 with high PSA levels. The primary clinical consideration was prostate carcinoma. However, these two cases were diagnosed as malakoplakia based on the results of histopathological analysis of the transrectal prostate biopsy specimen. PMID:24868476

Elastic Versus Rigid Image Registration in Magnetic Resonance Imaging-transrectal Ultrasound Fusion Prostate Biopsy: A Systematic Review and Meta-analysis.

Science.gov (United States)

Venderink, Wulphert; de Rooij, Maarten; Sedelaar, J P Michiel; Huisman, Henkjan J; Fütterer, Jurgen J

2016-07-29

The main difference between the available magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion platforms for prostate biopsy is the method of image registration being either rigid or elastic. As elastic registration compensates for possible deformation caused by the introduction of an ultrasound probe for example, it is expected that it would perform better than rigid registration. The aim of this meta-analysis is to compare rigid with elastic registration by calculating the detection odds ratio (OR) for both subgroups. The detection OR is defined as the ratio of the odds of detecting clinically significant prostate cancer (csPCa) by MRI-TRUS fusion biopsy compared with systematic TRUS biopsy. Secondary objectives were the OR for any PCa and the OR after pooling both registration techniques. The electronic databases PubMed, Embase, and Cochrane were systematically searched for relevant studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis Statement. Studies comparing MRI-TRUS fusion and systematic TRUS-guided biopsies in the same patient were included. The quality assessment of included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies version 2. Eleven papers describing elastic and 10 describing rigid registration were included. Meta-analysis showed an OR of csPCa for elastic and rigid registration of 1.45 (95% confidence interval [CI]: 1.21-1.73, pimaging-transrectal ultrasound fusion systems which vary in their method of compensating for prostate deformation. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Comparing Three Different Techniques for Magnetic Resonance Imaging-targeted Prostate Biopsies : A Systematic Review of In-bore versus Magnetic Resonance Imaging-transrectal Ultrasound fusion versus Cognitive Registration. Is There a Preferred Technique?

NARCIS (Netherlands)

Wegelin, Olivier; Melick, H.H.E.; Hooft, Lotty; Bosch, J L H Ruud; Reitsma, Hans B; Barentsz, Jelle O; Somford, Diederik M

CONTEXT: The introduction of magnetic resonance imaging-guided biopsies (MRI-GB) has changed the paradigm concerning prostate biopsies. Three techniques of MRI-GB are available: (1) in-bore MRI target biopsy (MRI-TB), (2) MRI-transrectal ultrasound fusion (FUS-TB), and (3) cognitive registration

Fast 3-T MR-guided transrectal prostate biopsy using an in-room tablet device for needle guide alignment: a feasibility study.

Science.gov (United States)

Overduin, Christiaan G; Heidkamp, Jan; Rothgang, Eva; Barentsz, Jelle O; de Lange, Frank; Fütterer, Jurgen J

2018-05-22

To assess the feasibility of adding a tablet device inside the scanner room to assist needle-guide alignment during magnetic resonance (MR)-guided transrectal prostate biopsy. Twenty patients with one cancer-suspicious region (CSR) with PI-RADS score ≥ 4 on diagnostic multiparametric MRI were prospectively enrolled. Two orthogonal scan planes of an MR fluoroscopy sequence (~3 images/s) were aligned to the CSR and needle-guide pivoting point. Targeting was achieved by manipulating the needle-guide under MR fluoroscopy feedback on the in-room tablet device. Technical feasibility and targeting success were assessed. Complications and biopsy procedure times were also recorded. Needle-guide alignment with the in-room tablet device was technically successful in all patients and allowed sampling after a single alignment step in 19/20 (95%) CSRs (median size 14 mm, range: 4-45). Biopsy cores contained cancer in 18/20 patients. There were no per-procedural or post-biopsy complications. Using the tablet device, the mean time to first biopsy was 5.8 ± 1.0 min and the mean total procedure time was 23.7 ± 4.1 min. Use of an in-room tablet device to assist needle-guide alignment was feasible and safe during MR-guided transrectal prostate biopsy. Initial experience indicates potential for procedure time reduction. • Performing MR-guided prostate biopsy using an in-room tablet device is feasible. • CSRs could be sampled after a single alignment step in 19/20 patients. • The mean procedure time for biopsy with the tablet device was 23.7 min.

Complications and risk factors in transrectal ultrasound-guided prostate biopsies

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Carlos Márcio Nóbrega de Jesus

Full Text Available CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE or levels higher than 4 ng/ml in prostate-specific antigen (PSA tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%, while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%. Urinary tract infection (UTI occurred in 16 patients (9.2%. Sepsis was observed in three patients (1.7%. The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05. Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05. The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

La biopsia estereotáctica en el diagnóstico de las lesiones cerebrales focales en sida Stereotactic brain biopsy in the diagnosis of focal brain lesions in AIDS

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Marcelo Corti

2008-08-01

Full Text Available Las lesiones cerebrales focales constituyen una complicación frecuente en los pacientes con infección por el virus de la inmunodeficiencia humana (HIV y síndrome de inmunodeficiencia adquirida (sida. Durante el período comprendido entre enero de 1999 y mayo de 2007 se realizaron un total de 83 biopsias en pacientes con sida y lesiones cerebrales. Se incluyeron aquellos pacientes que no hubiesen respondido al algoritmo habitual de enfoque diagnóstico-terapéutico de estas lesiones. Todas las muestras obtenidas fueron sometidas a evaluación intraoperatoria para asegurar la obtención de material patológico y posterior análisis histopatológico y exámenes microbiológicos. De los 41 pacientes con lesiones cerebrales múltiples, 62 tenían localización supratentorial, en 4 eran infratentoriales y 17 mostraron ambas localizaciones. Cincuenta y un lesiones seleccionadas como blanco estereotáctico tuvieron refuerzo periférico del contraste. Se obtuvo material histopatológico en el 100% de los procedimientos. El diagnóstico más frecuente fue el de leucoencefalopatía multifocal progresiva (LEMP con 24 casos (29%, seguido del linfoma primario del sistema nervioso central (LPSNC con 19 diagnósticos (23% y de toxoplasmosis en 13 pacientes (15.7%. Se comprobó una relación significativa entre los diagnósticos histopatológicos y la localización de las lesiones y entre los diagnósticos histopatológicos y el comportamiento de las imágenes luego de la administración de la sustancia de contraste. El rédito diagnóstico alcanzó el 90.3% (75 biopsias. La morbiletalidad en esta serie fue de 2.4%. La biopsia cerebral estereotáctica permitió alcanzar el diagnóstico etiológico y adecuar el enfoque terapéutico en la mayoría de los pacientes de esta serie.Focal brain lesions are frequent complications among HIV/AIDS patients. Between January 1999 and May 2007, 83 procedures of stereotactic brain biopsies in HIV/AIDS patients with focal

Contrast-enhanced versus systematic transrectal ultrasound-guided prostate cancer detection: An overview of techniques and a systematic review

International Nuclear Information System (INIS)

Heijmink, Stijn W.T.P.J.; Barentsz, Jelle O.

2007-01-01

An overview is given of the current conventional and contrast-specific transrectal ultrasound (TRUS) techniques for prostate imaging that may be used for guiding biopsy. Subsequently, a systematic literature search resulted in inclusion of four studies that directly compared systematic and contrast-enhanced-targeted TRUS-guided biopsy of the prostate. All four studies revealed that contrast-enhanced-targeted TRUS-guided biopsy significantly improved the positive biopsy core rate. In the largest study, the mean Gleason score of the contrast-enhanced-targeted TRUS-guided biopsies was significantly higher than that of the systematic biopsies. Future randomized clinical trials, preferably in a non-academic multi-institutional set-up, will have to be performed to confirm the value of contrast-enhanced-targeted TRUS-guided biopsy in regular clinical practice

Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

International Nuclear Information System (INIS)

Halliwell, O.T.; Yadegafar, G.; Lane, C.; Dewbury, K.C.

2008-01-01

Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications

Portosystemic shunting in portal hypertension: evaluation with portal scintigraphy with transrectally administered I-123 IMP

International Nuclear Information System (INIS)

Kashiwagi, T.; Azuma, M.; Ikawa, T.; Takehara, T.; Matsuda, H.; Yoshioka, H.; Mitsutani, N.; Koizumi, T.; Kimura, K.

1988-01-01

Portosystemic shunting was evaluated with rectal administration of iodine-123 iodoamphetamine (IMP) in seven patients without liver disease and 53 patients with liver cirrhosis. IMP (2-3 mCi [74-111 MBq]) was administered to the rectum through a catheter. Images of the chest and abdomen were obtained for up to 60 minutes with a scintillation camera interfaced with a computer. In all patients, images of the liver and/or lungs were observed within 5-10 minutes and became clear with time. In patients without liver disease, only liver images could be obtained, whereas the lung was visualized with or without the liver in all patients with liver cirrhosis. The portosystemic shunt index was calculated by dividing counts of lungs by counts of liver and lung. These values were significantly higher in liver cirrhosis, especially in the decompensated stage. Transrectal portal scintigraphy with IMP appears to be a useful method for noninvasive and quantitative evaluation of portosystemic shunting in portal hypertension

Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

Energy Technology Data Exchange (ETDEWEB)

Halliwell, O.T. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)], E-mail: hallo99@doctors.org.uk; Yadegafar, G. [Public Health Sciences and Medical Statistics Division, School of Medicine, Southampton General Hospital, Southampton University, Southampton (United Kingdom); Lane, C.; Dewbury, K.C. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)

2008-05-15

Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications.

Evaluación de dos métodos de extracción de ADN a partir de biopsias fijadas en formalina y embebidas en parafina en condiciones no optimas

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Javier Andres Bustamante

2011-05-01

Full Text Available Los tejidos de archivo son un material de incalculable valor para estudios retrospectivos que requieran la aplicación de análisis moleculares. Existen múltiples métodos de extracción de ADN a partir de este tipo de muestras. No obstante, la mayoría de métodos toman mucho tiempo y los reactivos empleados contribuyen a la fragmentación del ADN. Con el objetivo de optimizar dos métodos de extracción de ADN a partir de tejidos embebidos en parafina en condiciones no optimas. Se seleccionaron 47 bloques en parafina que contenían biopsias de pleura, pulmón y pericardio correspondientes a 24 pacientes (66,66%hombres mayores de 18 años, con inflamación granulomatosa crónica, remitidos al Departamento de Patología del Hospital Universitario del Valle entre 2002-2007. A cada muestra se le realizaron 10 cortes y se sometieron a dos métodos de extracción de ADN: 1.Convencional y 2.QIAamp-DNA mini kit®. La eficiencia del ADN fue valorada por espectrofotometría y amplificación del gen GAPDH. La concentración de ADN de las muestras extraídas por el método convencional fue de 65.52ng/µl ±11.47 (promedio±EE y la relación 260/280 vario entre 0.52 y 2.30. De las muestras extraídas por el método comercial, la concentración media de ADN fue 60.89ng/µl±6.02, con una absorbancia que oscilo entre 0 y 2.64. El ADN obtenido fue sometido a PCR, de 47 muestras extraídas por ambos métodos, 25 y 23 respectivamente amplificarón exitosamente el gen GAPDH. Los métodos usados para la obtención de ADN presentaron un desempeño similar, revelando así su potencial utilidad en estudios retrospectivos a partir de biopsias embebidas en parafina en condiciones inadecuadas.

Concordancia entre los hallazgos citológicos de ASC-US en atrofia y metaplasia con la biopsia en el laboratorio de Patología de Clínica Colsanitas S.A. durante los años 2009 a 2012

OpenAIRE

Posada Restrepo, Alejandro

2015-01-01

Introducción: La categoría atipia de células escamosas de significado indeterminado (ASC-US) en la terminología Bethesda plantea un reto para el citólogo(a)/patólogo(a), necesitándose una estrecha correlación con otras herramientas diagnósticas para lograr un diagnóstico preciso y un tratamiento adecuado. Se puede observar ASC-US en extendidos con atrofia y metaplasia que dificultan la interpretación, haciéndose necesario otros métodos como la biopsia cervical para acercarnos al diagnóstico p...

Transrectal rigid-hybrid NOTES cholecystectomy can be performed without peritoneal contamination: a controlled porcine survival study.

Science.gov (United States)

Müller, Philip C; Senft, Jonas D; Gath, Philip; Steinemann, Daniel C; Nickel, Felix; Billeter, Adrian T; Müller-Stich, Beat P; Linke, Georg R

2018-01-01

The risk of infectious complications due to peritoneal contamination is a major concern and inhibits the widespread use of transrectal NOTES. A standardized rectal washout with a reversible colon occlusion device in situ has previously shown potential in reducing peritoneal contamination. The aim of this study was to compare the peritoneal contamination rate and inflammatory reaction for transrectal cholecystectomy after ideal rectal preparation (trCCE) and standard laparoscopic cholecystectomy (lapCCE) in a porcine survival experiment. Twenty pigs were randomized to trCCE (n = 10) or lapCCE (n = 10). Before trCCE, rectal washout was performed with saline solution. A colon occlusion device was then inserted and a second washout with povidone-iodine was performed. The perioperative course and the inflammatory reaction (leukocytes, C-reactive protein) were compared. At necropsy, 14 days after surgery the abdominal cavity was screened for infectious complications and peritoneal swabs were obtained for comparison of peritoneal contamination. Peritoneal contamination was lower after trCCE than after lapCCE (0/10 vs. 6/10; p = 0.003). No infectious complications were found at necropsy in either group and postoperative complications did not differ (p = 1.0). Immediately after the procedure, leukocytes were higher after lapCCE (17.0 ± 2.7 vs. 14.6 ± 2.3; p = 0.047). Leukocytes and C-reactive protein showed no difference in the further postoperative course. Intraoperative complications and total operation time (trCCE 114 ± 32 vs. 111 ± 27 min; p = 0.921) did not differ, but wound closure took longer for trCCE (31.5 ± 19 vs. 13 ± 5 min; p = 0.002). After standardized rectal washout with a colon occlusion device in situ, trCCE was associated without peritoneal contamination and without access-related infectious complications. Based on the findings of this study, a randomized controlled clinical study comparing clinical outcomes of trCCE with

Usefulness of transrectal ultrasound-guided 12 core biopsy method in patients with clinically suspected prostate cancer

International Nuclear Information System (INIS)

Kwon, Se Hwan; Lim, Joo Won; Park, Seong Jin; Ko, Young Tae; Kim, Yoon Wha

2000-01-01

To evaluate the improvement of prostate cancer detection provided by transrectal ultrasound (TRUS)-guided 12 core biopsy method compared with sextant biopsy method. Between June 1997 and February 1999, 29 patients with pathologically proven prostate cancer in 124 patients who underwent TRUS-guided 12 core biopsy method were evaluated. They had abnormal findings in prostate specific antigen (PSA), digital rectal examination (DRE) or TRUS findings. The prostate was diffusely enlarged in all patients on DRE findings and in 15 cases (15/29, 52%), hard nodule was palpated. The average of PSA and prostate specific antigen density (PSAD) is 229.33 ng/ml (1-2280) and 9.14 ng/ml/cm 3 (0.048-142.5), respectively, 12 transrectal biopsy, including 2 transition zones, was performed in both lobe, 6 biopsies were located in both base, middle and apex. Then 2 biopsies were inserted between 3 biopsies in both peripheral zone and 2 biopsies were performed in both transition zone. Each specimen was pathologically examined. The results of pathology were compared with method 1 and 2, respectively. We defined the method 1 and 2 as different sextant biopsy method. The method 1 is that cores are taken from both base, middle and apex and method 2 is that cores are taken from both base, apex and transition zone. TRUS findings were analyzed by two radiologists. Of the 29 patients with prostate cancer, 3 (10%) had carcinomas only in the additional regions as compared with method. When compared with method 2,2 (7.0%) had carcinomas only in the additional regions. 2 patients were same in both cases. TRUS findings were abnormal in 21 cases in all patients whose 12 biopsy method was not helpful. 12 biopsy method was helpful in 2/8 (25%) whose TRUS findings were non-specific and 1/21 (4.8%) whose TRUS findings were abnormal. Small low echoic lesion was seen in one patients whose 12 biopsy method was helpful, but cancer was found in other area. TRUS-guided 12 core biopsy method may be superior to

Prostate cancer multi-feature analysis using trans-rectal ultrasound images

International Nuclear Information System (INIS)

Mohamed, S S; Salama, M M A; Kamel, M; El-Saadany, E F; Rizkalla, K; Chin, J

2005-01-01

This note focuses on extracting and analysing prostate texture features from trans-rectal ultrasound (TRUS) images for tissue characterization. One of the principal contributions of this investigation is the use of the information of the images' frequency domain features and spatial domain features to attain a more accurate diagnosis. Each image is divided into regions of interest (ROIs) by the Gabor multi-resolution analysis, a crucial stage, in which segmentation is achieved according to the frequency response of the image pixels. The pixels with a similar response to the same filter are grouped to form one ROI. Next, from each ROI two different statistical feature sets are constructed; the first set includes four grey level dependence matrix (GLDM) features and the second set consists of five grey level difference vector (GLDV) features. These constructed feature sets are then ranked by the mutual information feature selection (MIFS) algorithm. Here, the features that provide the maximum mutual information of each feature and class (cancerous and non-cancerous) and the minimum mutual information of the selected features are chosen, yeilding a reduced feature subset. The two constructed feature sets, GLDM and GLDV, as well as the reduced feature subset, are examined in terms of three different classifiers: the condensed k-nearest neighbour (CNN), the decision tree (DT) and the support vector machine (SVM). The accuracy classification results range from 87.5% to 93.75%, where the performance of the SVM and that of the DT are significantly better than the performance of the CNN. (note)

The future perspectives in transrectal prostate ultrasound guided biopsy

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Sung Il Hwang

2014-12-01

Full Text Available Prostate cancer is one of the most common neoplasms in men. Transrectal ultrasound (TRUS-guided systematic biopsy has a crucial role in the diagnosis of prostate cancer. However, it shows limited value with gray-scale ultrasound alone because only a small number of malignancies are visible on TRUS. Recently, new emerging technologies in TRUS-guided prostate biopsy were introduced and showed high potential in the diagnosis of prostate cancer. High echogenicity of ultrasound contrast agent reflect the increased status of angiogenesis in tumor. Molecular imaging for targeting specific biomarker can be also used using ultrasound contrast agent for detecting angiogenesis or surface biomarker of prostate cancer. The combination of TRUS-guided prostate biopsy and ultrasound contrast agents can increase the accuracy of prostate cancer diagnosis. Elastography is an emerging ultrasound technique that can provide the information regarding tissue elasticity and stiffness. Tumors are usually stiffer than the surrounding soft tissue. In two types of elastography techniques, shearwave elastography has many potential in that it can provide quantitative information on tissue elasticity. Multiparametric magnetic resonance imaging (MRI from high resolution morphologic and functional magnetic resonance (MR technique enables to detect more prostate cancers. The combination of functional techniques including apparent diffusion coefficient map from diffusion weighted imaging, dynamic contrast enhanced MR and MR spectroscopy are helpful in the localization of the prostate cancer. MR-ultrasound (US fusion image can enhance the advantages of both two modalities. With MR-US fusion image, targeted biopsy of suspicious areas on MRI is possible and fusion image guided biopsy can provide improved detection rate. In conclusion, with recent advances in multiparametric-MRI, and introduction of new US techniques such as contrast-enhanced US and elastography, TRUS-guided biopsy

[Transrectal magnetotherapy of the prostate from Intramag device in prophylaxis of postoperative complications of transurethral resection of prostatic adenoma].

Science.gov (United States)

Neĭmark, A I; Snegirev, I V; Neĭmark, B A

2006-01-01

The authors analyse preoperative preparation of 91 patients with benign prostatic hyperplasia (BPH). Two groups of patients received conventional preparation (group 1) and magnetotherapy (group 2) before TUR of the prostate. The examination covered immune system, bacteriological indices of urine and prostatic tissue. Infection of the urinary tract is a main risk factor of complications after TUR. Conventional preoperative preparation fails to correct immunity, to change bacterial urine flora, to improve hemodynamics in the prostate. Transrectal magnetotherapy with running magnetic field eliminates deficiency of T- and B-cell immunity, raises functional activity of B-lymphocytes and phagocytic ability of neutrophils, reduces endogenic intoxication, tissue edema, bacterial contamination, number of thrombohemorrhagic complications. This leads to a decrease in the number of postoperative complications.

Biopsia por aspiración y supresión con hormonas tiroideas en el diagnóstico de cáncer tiroideo: comparación con la cirugía en 77 nódulos hipocaptantes Fine-Needle aspiration biopsy and suppression with thyroid hormone in the diagnosis of thyroid carcinoma

Directory of Open Access Journals (Sweden)

Humberto Aristizábal

1992-01-01

Full Text Available Se estudiaron 77 pacientes con nódulos tiroideos hipocaptantes, demostrados por gamagrafía, por medio de biopsia tiroidea por aspiración y terapia supresiva con hormonas tiroideas durante 6 meses o más. Se realizó estudio ecográfico del nódulo antes de iniciar la terapia y seis meses después de estarla administrando. Todos fueron intervenidos porque en ninguno desapareció el nódulo con la terapia, a pesar de que se obtuvo supresión de la tirotrofina en plasma. La biopsia tiroidea por aspiración (BT A fue Interpretada en todos los pacientes como bocio coloide o nodular o neoplasia folicular. En contraste, en el estudio de la pieza quirúrgica 52 pacientes presentaron bocio nodular, multinodular o coloide; 16 tenían carcinomas (12 papilares y 4 foliculares y 9 tiroiditis de Hashimoto. Contrariamente a lo esperado se observó que 5 de loS carcinomas (31.3% disminuyeron de volumen durante el tratamiento hormonal; de acuerdo a la ecografía la disminución promedio fue 0.41 cm3. En cambio 4 de los 52 nódulos benignos (7.7% aumentaron de volumen, en promedio 3.7 cm3. Estos hallazgos sugieren que la prueba de supresión con hormonas tiroideas no es confiable para definir si una lesión es benigna o maligna. En el estudio quirúrgico se demostró que 20.8% (16/77 de los nódulos eran carcinomas. A la luz de estos datos la biopsia por aspiración no estableció por lo general el diagnóstico de carcinoma; por ello se debe recurrir a la cirugía aunque la biopsia sea negativa.

Seventy-seven patients with cold thyroid nodules were studied with flne-needle aspiration biopsy and suppression with thyroid hormone. The volume of the nodule was calculated ultrasonographycally at the beginning of the study and after six months of oral therapy with thyroglobulin, at doses sufficient to maintain TSH at the low limits of the normal

Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy

DEFF Research Database (Denmark)

Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta

2015-01-01

OBJECTIVES: The purpose of this study was to investigate the detection rate of prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsies (mp-MRI-bx) in patients with prior negative transrectal ultrasound biopsy (TRUS-bx) sessions without previous experience of this......-RADS) and Likert classification. All underwent repeated TRUS-bx (10 cores) and mp-MRI-bx under visual TRUS guidance of any mp-MRI-suspicious lesion not targeted by systematic TRUS-bx. RESULTS: PCa was found in 39 out of 83 patients (47%) and mp-MRI identified at least one lesion with some degree of suspicion...

Multi-atlas-based automatic 3D segmentation for prostate brachytherapy in transrectal ultrasound images

Science.gov (United States)

Nouranian, Saman; Mahdavi, S. Sara; Spadinger, Ingrid; Morris, William J.; Salcudean, S. E.; Abolmaesumi, P.

2013-03-01

One of the commonly used treatment methods for early-stage prostate cancer is brachytherapy. The standard of care for planning this procedure is segmentation of contours from transrectal ultrasound (TRUS) images, which closely follow the prostate boundary. This process is currently performed either manually or using semi-automatic techniques. This paper introduces a fully automatic segmentation algorithm which uses a priori knowledge of contours in a reference data set of TRUS volumes. A non-parametric deformable registration method is employed to transform the atlas prostate contours to a target image coordinates. All atlas images are sorted based on their registration results and the highest ranked registration results are selected for decision fusion. A Simultaneous Truth and Performance Level Estimation algorithm is utilized to fuse labels from registered atlases and produce a segmented target volume. In this experiment, 50 patient TRUS volumes are obtained and a leave-one-out study on TRUS volumes is reported. We also compare our results with a state-of-the-art semi-automatic prostate segmentation method that has been clinically used for planning prostate brachytherapy procedures and we show comparable accuracy and precision within clinically acceptable runtime.

Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

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Baek, Song Ee; Oh, Young Taik [Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jang Hwan; Rha, Koon Ho; Hong, Sung Joon; Yang, Seung Choul [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2010-09-15

To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4{+-}1.78: group 2, 2.8{+-}1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

International Nuclear Information System (INIS)

Baek, Song Ee; Oh, Young Taik; Kim, Jang Hwan; Rha, Koon Ho; Hong, Sung Joon; Yang, Seung Choul

2010-01-01

To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4±1.78: group 2, 2.8±1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

Energy Technology Data Exchange (ETDEWEB)

Baek, Song Ee; Oh, Young Taik [Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jang Hwan; Rha, Koon Ho; Hong, Sung Joon; Yang, Seung Choul [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2010-09-15

To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4{+-}1.78: group 2, 2.8{+-}1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

THE PROGNOSTIC AND DIAGNOSTIC VALUE OF REPEATED TRANSRECTAL PROSTATE SATURATION BIOPSY

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M. A. Kurdzhiev

2014-08-01

Full Text Available Objective: to determine the rate of prostate cancer (PC development after repeated transrectal saturation prostate biopsy (RTRSPB, to study the characteristics of diagnosed tumors, and to estimate their clinical significance from the data of radical retropubic prostatectomy (RRP.Materials and methods. The results of RTRSPB were analyzed in 226 patients with a later evaluation of a tumor from the results of RRP. All the patients underwent at least 2 prostate biopsies (mean 2.4. The average number of biopsy cores was 26.7 (range 24—30. The average value of total prostate-specific antigen before saturation biopsy was 7.5 (range 7.5 to 28.6 ng/ml. The mean age of patients was 62 years (range 53 to 70.  Results. PC was diagnosed in 14.6% of cases (33/226. An isolated lesion of the prostatic transition zone was in 12.1% of cases. If this zone had been excluded from the biopsy scheme, the detection rate of PC during saturation biopsy should be reduced by 13.8%. Better PC detectability during repeated saturation biopsy generally occurred due to the localized forms of the disease (93.3%. The agreement of Gleason tumor grading in the biopsy and prostatectomy specimens was noted in 66.7% of cases.Conclusion. Saturation biopsy allows prediction of a pathological stage of PC, Gleason grade of a tumor and its site localization with a greater probability. Most tumors detectable by saturation biopsy were clinically significant, which makes it possible to recommend RTRSPB to some cohort of high PC-risk patients 

Hypothalamic-pituitary-adrenal and cardiac autonomic responses to transrectal examination differ with behavioral reactivity in dairy cows.

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Kovács, L; Kézér, F L; Kulcsár-Huszenicza, M; Ruff, F; Szenci, O; Jurkovich, V

2016-09-01

Behavior, hypothalamic-pituitary-adrenal axis, and cardiac autonomic nervous system (ANS) activity were evaluated in response to transrectal examination in nonlactating Holstein-Friesian cows with different behavioral reactivity. According to behavioral reactions shown to the procedure of fixing the heart rate (HR) monitors, the 20 cows with the highest and the 20 cows with the lowest behavioral reactivity were involved in the study (high responder, n=20; and low responder, n=20, respectively). Activity of the ANS was assessed by HR and HR variability parameters. Blood and saliva were collected at 5 min before (baseline) and 0, 5 10, 15, 20, 30, 40, 60, and 120 min after the examination to determine cortisol concentrations. The examination lasted for 5 min. Cardiac parameters included HR, the root mean square of successive differences between the consecutive interbeat intervals, the high frequency (HF) component of heart rate variability, and the ratio between the low frequency (LF) and HF parameter (LF/HF). Following the examination, peak plasma and saliva cortisol levels and the amplitude of the plasma and saliva cortisol response were higher in high responder cows than in low responders. Areas under the plasma and saliva cortisol response curves were greater in high responder cows. Plasma and salivary cortisol levels correlated significantly at baseline (r=0.91), right after examination (r=0.98), and at peak levels (r=0.96). Area under the HR response curve was higher in low responder cows; however, maximum HR and the amplitude of the HR response showed no differences between groups. Minimum values of both parameters calculated for the examination were higher in high responders. Following the examination, response parameters of root mean square of successive differences and HF did not differ between groups. The maximum and the amplitude of LF/HF response and area under the LF/HF response curve were lower in low responder cows, suggesting a lower sympathetic

Oncogenes E6-E7 de los Papilomavirus Humanos de alto riesgo detectados por PCR en Biopsias de pene incluidas en parafina

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I Guerrero

1999-01-01

Full Text Available La alta prevalencia del papilomavirus humano (PVH, referida a nivel mundial, en lesiones genitales de ambos sexos, el rol del varón como reservorio pasivo del virus, y el incremento de la mortalidad por cáncer genital en la mujer en nuestro país, motiva la detección y correlación de los oncogenes de los PVH de alto riesgo con la neoplasia de pene. Informamos de diez casos de biopsias de carcinoma escamoso de pene, incluidos en parafina, los cuales fueron investigados para la presencia de los oncogenes E6-E7 de PVH de alto riesgo, utilizando cebadores tipo específico para los PVH -16 y 18, mediante la reacción en cadena de la polimerasa (PCR. El 40% de los casos mostró un producto de amplificación ADN E6-E7 de los PVH estudiados, correspondiendo el 75% de ellos a detección simple por PVH-18 y el 25% presentó detección mixta ADN E6 - E7 del PVH-16 y 18 simultáneamente. El producto de amplificación fue sometido a comprobación por análisis de restricción específico. La prevalencia obtenida de los oncogenes E6-E7 de los PVH de alto riesgo, usando un método tan sensible como la PCR, apoya el rol de estos virus en el proceso de carcinogénesis de la neoplasia de pene.

UTILIDAD DE LA BIOPSIA RECTAL EN EL DIAGNÓSTICO DEL PACIENTE PEDIÁTRICO CON ESTREÑIMIENTO. EXPERIENCIA DE CINCO AÑOS EN UN CENTRO COLOMBIANO DE REFERENCIA The usefulness of rectal biopsy when diagnosing paediatric patients suffering from straining. Five year-experience in a Colombian reference centre (public hospital)

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Juan Carlos-Hiromi López T; Lina E Jaramillo B

2011-01-01

Antecedentes. El estreñimiento en la edad pediátrica es un problema de alta prevalencia que afecta aproximadamente al 8% de los niños. La mayoría de los pacientes no tienen una patología estructural de base y sólo en un pequeño porcentaje se encuentra una causa orgánica como las disganglionosis intestinales también llamadas neuropatías entéricas; es en estos casos donde la biopsia rectal juega un papel primordial para el diagnóstico. Objetivos. Determinar la incidencia de las neuropatías enté...

Fisher criteria vs. thyroid aspiration citology in the diagnosis of hashimoto's thyroiditis Valor de cuatro de los criterios de Fischer comarados con la biopsia tiroidea por aspiración en el diagnóstico de la tiroiditis de Hashimoto

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Constanza Díaz González

1991-02-01

Full Text Available

One hundred and forty one patients with diffuse goiter were studied In order to evaluate four of Fisher's criteria for the diagnosis of Hashimoto's thyroiditis and to compare them with the result of thyroid aspiration biopsy. The following criteria were Included in the analysis: a physical characteristics of the gland; b appearance of the radioisotope scan; c plasma TSH concentration; d serum tilters of antithyroid antibodies. It was found that neither criteria was satisfactory in terms of sensitivity or specificity when compared with the result of the aspiration cytology. Ac. cordingly, we favor the use of the latter provided that adequate material is obtained and that an expert reading is performed.

Se hicieron estudios clínico y de laboratorio y biopsia tiroidea por aspiración a 133 mujeres y 8 hombres con bocio difuso, de la Consulta Externa del Instituto de Seguros Sociales de Medellín, con el fin de comparar el valor diagnóstico de cuatro de los cinco criterios de Fisher con el de dicha biopsia, en la tiroiditis de Hashimoto. El diagnóstico citológico fue bocio simple (nodular, multinodular O coloide en 130 casos (92.2% y tiroiditis de Hashimoto en 11 (7.8%. Se aplicó la prueba tamiz a los criterios de Fisher, aisladamente O en grupos, con resultados deficientes en cuanto a sensibilidad y especificidad. Los criterios analizados fueron: a glándula moderadamente crecida, difusa y firme; b captación tiroidea Irregular; c TSH plasmática elevada; y d anticuerpos antitiroideos positivos a muy altas diluciones (≥:1 :25.000. La captación tiroidea Irregular tuvo la mayor sensibilidad (90% pero su especificidad fue sólo 11 %. En contraste, la sensibilidad y la especificidad de los títulos altos de anticuerpos antimicrosomales fueron 78% 71 %, respectivamente.

Early effect of external beam radiation therapy on the anal sphincter: A study using anal manometry and transrectal ultrasound

International Nuclear Information System (INIS)

Birnbaum, E.H.; Dreznik, Z.; Myerson, R.J.; Lacey, D.L.; Fry, R.D.; Kodner, I.J.; Fleshman, J.W.

1992-01-01

The early of pelvic irradiation on the anal sphincter has not been previously investigated. This study prospectively evaluated the acute effect of preoperative radiation on anal function. Twenty patients with rectal carcinoma received 4,500 cGy of preoperative external beam radiation. The field of radiation included the sphincter in 10 patients and was delivered above the anorectal ring in 10 patients. Anal manometry and transrectal ultrasound were performed before and four weeks after radiotherapy. No significant difference in mean maximal squeeze or resting pressure was found after radiation therapy. An increase in mean minimal sensory threshold was significant. Histologic examination revealed minimal radiation changes at the distal margin in 8 of 10 patients who underwent low anterior resection and in 1 of 3 patients who underwent abdominoperineal resection. The authors conclude that preoperative radiation therapy has minimal immediate effect on the anal sphincter and is not a major contributing factor to postoperative incontinence in patients after sphincter-saving operations for rectal cancer

Clinical and microbiological characteristics of spontaneous acute prostatitis and transrectal prostate biopsy-related acute prostatitis: Is transrectal prostate biopsy-related acute prostatitis a distinct acute prostatitis category?

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Kim, Jong Wook; Oh, Mi Mi; Bae, Jae Hyun; Kang, Seok Ho; Park, Hong Seok; Moon, Du Geon

2015-06-01

This study aimed to compare the clinical and microbiological characteristics between acute bacterial prostatitis and transrectal biopsy-related acute prostatitis. We retrospectively reviewed the records of 135 patients hospitalized for acute prostatitis in three urological centers between 2004 and 2013. Acute bacterial prostatitis was diagnosed according to typical symptoms, findings of physical examination, and laboratory test results. Clinical variables, laboratory test results, and anti-microbial susceptibility results were reviewed. Patients were classified into the spontaneous acute prostatitis group (S-ABP) or biopsy-related acute prostatitis (Bx-ABP) for comparison of their clinical, laboratory, and microbiological findings. The mean age of all patients was 61.7 ± 12.9 years. Compared with S-ABP patients, Bx-ABP patients were significantly older, had larger prostate volumes, higher PSA values, higher peak fever temperatures, and higher incidence of septicemia and antibiotic-resistant bacteria. Overall, of the 135 patients, 57.8% had positive bacterial urine and/or blood cultures. Bx-ABP patients had a higher incidence of bacterial (urine and/or blood) positive cultures compared to S-ABP patients (66.7% versus 55.6%). Escherichia coli was the predominant organism in both groups, but it was more common in Bx-ABP (88.9%) than in S-ABP (66.7%). Extended spectrum beta-lactamase -producing bacteria accounted for 64.7% of culture-positive patients in the Bx-ABP group compared to 13.3% in the S-ABP group. Bx-ABP patients showed a higher incidence of septicemia and antibiotic-resistant bacteria than S-ABP patients. These results have important implications for the management and antimicrobial treatment of Bx-ABP, which may well deserve to be considered a distinct prostatitis category. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Vasculites e eosinófilos em biópsia endomiocárdica, como preditores de rejeição em transplante cardíaco Vasculitis y eosinófilos en biopsia endomiocárdica, como predictores de rechazo en transplante cardíaco Vasculitides and eosinophils in emdomyocardial biopsies as rejection predictors in heart transplantation

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Reginaldo Cipullo

2011-08-01

Full Text Available FUNDAMENTO: O significado clínico de vasculites, lesões isquêmicas, efeito Quilty e da presença de eosinófilos em biópsias endomiocárdicas de receptores de transplante cardíaco com rejeições leves não foi ainda estabelecido. OBJETIVO: Verificar se esses achados histológicos encontrados nas biópsias endomiocárdicas (eosinófilos, vasculites, efeito Quilty e lesões isquêmicas são capazes de predizer rejeição aguda do enxerto. MÉTODOS: Foram reavaliadas 1.012 biópsias endomiocárdicas consecutivas; dessas, 939 foram classificadas como OR ou 1R pela Nomenclatura da Sociedade Internacional de Transplante de Coração e Pulmão de 2005, e divididas em dois grupos: (1 Biópsias preditoras: aquelas que precederam rejeição aguda; e (2 Biópsias não preditoras: aquelas que não precederam rejeição aguda. Comparamos a ocorrência dos seguintes achados histológicos: vasculites, lesões isquêmicas, efeito Quilty e eosinófilos por análise uni e multivariada entre os grupos. RESULTADOS: Após análise estatística verificou-se a presença de vasculite intensa e de eosinófilos como maiores preditores para rejeição aguda futura, apresentando respectivamente as seguintes razões de chance: 10,60 (IC95%: 3,62 - 31,06. p FUNDAMENTO: El significado clínico de vasculitis, lesiones isquémicas, efecto Quilty y de la presencia de eosinófilos en biopsias endomiocárdicas de receptores de transplante cardíaco con rechazos leves no fue aun establecido. OBJETIVO: Verificar si esos hallazgos histológicos encontrados en las biopsias endomiocárdicas (eosinófilos, vasculitis, efecto Quilty y lesiones isquémicas son capaces de predecir rechazo agudo del injerto. MÉTODOS: Fueron reevaluadas 1.012 biopsias endomiocárdicas consecutivas; de esas, 939 fueron clasificadas como OR o 1R por la Nomenclatura de la Sociedad Internacional de Transplante de Corazón y Pulmón de 2005, y divididas en dos grupos: (1 Biopsias predictoras: aquellas que

Transrectal ultrasound-guided biopsy sepsis and the rise in carbapenem antibiotic use.

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Leahy, Olivia R; O'Reilly, Mary; Dyer, David R; Phillips, David; Grummet, Jeremy P

2015-12-01

This study sought to determine the number of hospital admissions for sepsis following transrectal ultrasound-guided (TRUS) biopsy, and the rate of both prophylactic and therapeutic use of carbapenem antibiotics for TRUS biopsy, at a single institution. A retrospective review of prospectively collected data from the medical records electronic database of Cabrini Health, a private metropolitan hospital, was queried for coding of admissions under any admitting urologist for sepsis and prostate-related infections from 2009 to 2012. Records were examined for whether a TRUS biopsy had been performed within 14 days prior and if a therapeutic carbapenem was required. The database also queried the use of carbapenems as prophylaxis in patients undergoing TRUS biopsy. Of the 63 admissions for TRUS biopsy sepsis, multi-drug-resistant organisms were isolated from 26 (41%). Twenty-three admissions were from the 1937 patients who underwent a TRUS biopsy at Cabrini (a sepsis rate of 1.2%) and 40 were following TRUS biopsies at other centres. Thirty-seven (58.7%) patients received therapeutic carbapenems either empirically, or after culture results. Of the 1937 Cabrini TRUS biopsy patients, 154 (8%) were given a carbapenem as prophylaxis, with a rapid increase in prophylactic use over the 4 years studied from 0.25% to 13%. This study did not show evidence of an increasing rate of hospital admissions for TRUS biopsy sepsis at this institution. However, there was a dramatic uptake in prophylactic administration of carbapenems. Increasing carbapenem use may contribute to development of carbapenem-resistant bacteria. Alternative methods of prostate biopsy that avoid sepsis should be considered. © 2014 Royal Australasian College of Surgeons.

Tissue ablation after 120W greenlight laser vaporization and bipolar plasma vaporization of the prostate: a comparison using transrectal three-dimensional ultrasound volumetry

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Kranzbühler, Benedikt; Gross, Oliver; Fankhauser, Christian D.; Hefermehl, Lukas J.; Poyet, Cédric; Largo, Remo; Müntener, Michael; Seifert, Hans-Helge; Zimmermann, Matthias; Sulser, Tullio; Müller, Alexander; Hermanns, Thomas

2012-02-01

Introduction and objectives: Greenlight laser vaporization (LV) of the prostate is characterized by simultaneous vaporization and coagulation of prostatic tissue resulting in tissue ablation together with excellent hemostasis during the procedure. It has been reported that bipolar plasma vaporization (BPV) of the prostate might be an alternative for LV. So far, it has not been shown that BPV is as effective as LV in terms of tissue ablation or hemostasis. We performed transrectal three-dimensional ultrasound investigations to compare the efficiency of tissue ablation between LV and BPV. Methods: Between 11.2009 and 5.2011, 50 patients underwent pure BPV in our institution. These patients were matched with regard to the pre-operative prostate volume to 50 LV patients from our existing 3D-volumetry-database. Transrectal 3D ultrasound and planimetric volumetry of the prostate were performed pre-operatively, after catheter removal, 6 weeks and 6 months. Results: Median pre-operative prostate volume was not significantly different between the two groups (45.3ml vs. 45.4ml; p=1.0). After catheter removal, median absolute volume reduction (BPV 12.4ml, LV 6.55ml) as well as relative volume reduction (27.8% vs. 16.4%) were significantly higher in the BPV group (p<0.001). After six weeks (42.9% vs. 33.3%) and six months (47.2% vs. 39.7%), relative volume reduction remained significantly higher in the BPV group (p<0.001). Absolute volume reduction was non-significantly higher in the BPV group after six weeks (18.4ml, 13.8ml; p=0.051) and six months (20.8ml, 18ml; p=0.3). Clinical outcome parameters improved significantly in both groups without relevant differences between the groups. Conclusions: Both vaporization techniques result in efficient tissue ablation with initial prostatic swelling. BPV seems to be superior due to a higher relative volume reduction. This difference had no clinical impact after a follow-up of 6M.

Transrectal ultrasound in detecting prostate cancer compared with serum total prostate-specific antigen levels

International Nuclear Information System (INIS)

Tamsel, S.; Killi, R.; Demirpolat, G.; Hekimgil, M.; Soydan, S.; Altay, B.

2008-01-01

We carried out a retrospective study to review the efficiency of grey-scale transrectal ultrasonography (TRUS) in detecting prostate cancer compared with the data in recent published work, including alternative imaging methods of the prostate gland. Our study group consisted of 830 patients who underwent TRUS-guided biopsy of the prostate between May 2000 and June 2004. The relation between abnormal TRUS findings and serum total prostate-specific antigen (tPSA) levels was evaluated in patients with prostate cancer who were divided into three different groups according to serum tPSA levels. Group I included patients with tPSA levels of 4-9.9 ng/mL, group II included tPSA levels of 10-19.9 ng/mL and group III included patients with tPSA levels of 20 ng/mL or more. In general, TRUS detected 185 (64%) of 291 cancers with a specificity of 89%, a PPV of 76% and an accuracy of 80%. TRUS findings enabled the correct identification of 22 (56%) of the 39 cancers in group I, 28 (30%) of the 93 cancers in group II and 135 (85%) of the 159 cancers in group III. In conclusion, TRUS alone has a limited potential to identify prostate cancer, especially in patients with tPSA levels lower than 20 ng/mL. Therefore, increased numbers of systematically placed biopsy cores must be taken or alternative imaging methods are required to direct TRUS-guided biopsy for improving prostate cancer detection.

Ultrasound to video registration using a bi-plane transrectal probe with photoacoustic markers

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Cheng, Alexis; Kang, Hyun Jae; Zhang, Haichong K.; Taylor, Russell H.; Boctor, Emad M.

2016-03-01

Modern surgical scenarios typically provide surgeons with additional information through fusion of video and other imaging modalities. To provide this information, the tools and devices used in surgery must be registered together with interventional guidance equipment and surgical navigation systems. In this work, we focus explicitly on registering ultrasound with a stereo camera system using photoacoustic markers. Previous work has shown that photoacoustic markers can be used in this registration task to achieve target registration errors lower than the current available systems. Photoacoustic markers are defined as a set of non-collinear laser spots projected onto some surface. They can be simultaneously visualized by a stereo camera system and an ultrasound transducer because of the photoacoustic effect. In more recent work, the three-dimensional ultrasound volume was replaced by images from a single ultrasound image pose from a convex array transducer. The feasibility of this approach was demonstrated, but the accuracy was lacking due to the physical limitations of the convex array transducer. In this work, we propose the use of a bi-plane transrectal ultrasound transducer. The main advantage of using this type of transducer is that the ultrasound elements are no longer restricted to a single plane. While this development would be limited to prostate applications, liver and kidney applications are also feasible if a suitable transducer is built. This work is demonstrated in two experiments, one without photoacoustic sources and one with. The resulting target registration error for these experiments were 1.07mm±0.35mm and 1.27mm+/-0.47mm respectively, both of which are better than current available navigation systems.

The usefulness of the transrectal ultrasonography in the diagnosis of the prostate cancer : comparison with systemic sextant biopsy

International Nuclear Information System (INIS)

Moon, Min Hoan; Seong, Chang Kyu; Jeong, Jun Yong; Choi, Huck Jae; Sim, Jung Suk; Kim, Seung Hyup

2001-01-01

To retrospectively compared the usefulness of the transrectal ultrasonography LEAVE A SPACE(TRUS) and systemic sextant biopsy in the diagnosis of prostate cancer. A total of 84 patients with clinical and laboratory findings suggestive of prostate cancer underwent TRUS and systemic sextant biopsy. Nine patients with diffuse prostatic lesion had been excluded from the list. Following sonographic evaluation, additional targeted biopsy for the focal lesion was performed in 14 patients. A total of 464 biopsy specimens were obtained and retrospectively compared with the sonographic findings. For cancer, the sensitivity, specificity and false-positive rate of TRUS were 48%, 97% and 53%, respectively. The hypoechoic nodules seen in prostate cancer were more commonly located in the outer half of the peripheral zone of the prostate, while most BPH lesions were located in the inner half of this zone. Between prostate cancer and BPH there was statistically significant difference in the location of hypoechoic nodules revealed by TRUS (p=0.01). The location of the hypoechoic nodules provides useful information for differentiating between BPH nodules and malignant prostatic nodules and may reduce the false-positive rate of TRUS in the diagnosis of prostate cancer

Dinámica del virus de la hepatitis C con carga viral y ALT y monitoreo del daño hepático libre de biopsias Dinámica del virus de la hepatitis C con carga viral y ALT y monitoreo del daño hepático libre de biopsias

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Justino Alavez Domínguez

2006-12-01

Full Text Available Se compara el modelo estándar reducido de tres poblaciones (hepatocitos sanos y enfermos, y carga viral para el estudio de la dinámica del virus de la hepatitis C (VHC, con el modelo de la dinámica viral con alanina aminotransferasa (ALT. En términos del parámetro umbral que es el mismo para ambos modelos, se determina la existencia y estabilidad del estado de equilibrio endémico, así como la estabilidad global del estado de equilibrio del individuo sano. Por otro lado, se presenta un estudio experimental que muestra que es posible monitorear el daño hepático sin biopsias, mediante la estimación numérica de los parámetros de los modelos, considerando solamente mediciones de la carga viral, de los niveles de ALT y una valoración razonable del daño hepático pretratamiento.aThe standard model of three populations (healthy and unhealthy hepatocytes, and viral load for the study of the dynamics of hepatitis C virus (HCV, is compared with viral dynamic model with alanine aminotransferase (ALT. In terms of the threshold parameter that it’s the same for both models, the existence and local asymptotic stability of the endemically infected equilibrium steady state, and the global stability of the healthy individual equilibrium steady state are established. Furthermore, an experimental study is presented showing that it’s possible to carry out the monitoring of hepatic damage biopsies free by numerical parameter estimation, considering only viral load and ALT levels measurements and a reasonable assessment of pretreatment hepatic damage.

A new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction.

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Faller, Emilie; Albornoz, Jaime; Messori, Pietro; Leroy, Joël; Wattiez, Arnaud

2013-01-01

To show a new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction, a technique particularly suited for treatment of bowel endometriosis. Step-by-step explanation of the technique using videos and pictures (educative video). Endometriosis may affect the bowel in 3% to 37% of all endometriosis cases. Bowel endometriosis affects young women, without any co-morbidities and in particular without any vascular disorders. In addition, affected patients often express a desire for childbearing. Radical excision is sometimes required because of the impossibility of conservative treatment such as shaving, mucosal skinning, or discoid resection. Bowel endometriosis should not be considered a cancer, and consequently maximal resection is not the objective. Rather, the goal would be to achieve functional benefit. As a result, resection must be as economic and cosmetic as possible. The laparoscopic approach has proved its superiority over the open technique, although mini-laparotomy is generally performed to prepare for the anastomosis. Total laparoscopic approach in patients with partial bowel stenosis, using the vagina for specimen extraction. This technique of intracorporeal anastomosis with transvaginal specimen extraction enables a smaller resection and avoidance of abdominal incision enlargement that may cause hernia, infection, or pain. When stenosis is partial, this technique seems particularly suited for treatment of bowel endometriosis requiring resection. If stenosis is complete, the anvil can be inserted above the lesion transvaginally. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

Organ-confined prostate cancer: effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging

International Nuclear Information System (INIS)

Qayyum, Aliya; Coakley, F.V.; Lu, Y.; Olpin, J.D.; Wu, L.; Yeh, B.M.; Carroll, P.R.; Kurhanewicz, J.

2004-01-01

Objective: Our aim was to determine the effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging findings in patients with organ-confined prostate cancer. Materials and Methods: Endorectal MRI and MR spectroscopic imaging were performed in 43 patients with biopsy-proven prostate cancer before radical prostatectomy confirming organ-confined disease. For each sextant, two independent reviewers scored the degree of hemorrhage on a scale from 1 to 5 and recorded the presence or absence of capsular irregularity. A spectroscopist recorded the number of spectrally degraded voxels in the peripheral zone. The outcome variables of capsular irregularity and spectral degradation were correlated with the predictor variables of time from biopsy and degree of hemorrhage after biopsy. Results: Capsular irregularity was unrelated to time from biopsy or to degree of hemorrhage. Spectral degradation was inversely related to time from biopsy (p < 0.01); the mean percentage of degraded peripheral zone voxels was 18.5% within 8 weeks of biopsy compared with 7% after 8 weeks. Spectral degradation was unrelated to the degree of hemorrhage. Conclusion: In organ-confined prostate cancer, capsular irregularity can be seen at any time after biopsy and is independent of the degree of hemorrhage, whereas spectral degradation is seen predominantly in the first 8 weeks after biopsy. MRI staging criteria and guidelines for scheduling studies after biopsy may require appropriate modification. (author)

Sedation as an alternative method to lessen patient discomfort due to transrectal ultrasonography-guided prostate biopsy

International Nuclear Information System (INIS)

Turgut, A.T.; Ergun, E.; Kosar, U.; Kosar, P.; Ozcan, A.

2006-01-01

Background: Despite being highly efficient for the relief of patient discomfort due to transrectal ultrasound (TRUS) guided prostate biopsy, periprostatic anesthesia is occasionally reported to be of limited use. We aimed to evaluate the efficacy of conscious sedation, an accepted method for lessening patient discomfort due to interventional radiological procedures and compare it with periprostatic anesthesia. Methods: 93 candidates for biopsy were randomised to three groups: group 1 (n = 31) received intravenous midazolam, group 2 (n = 31) received periprostatic lidocaine injection, whereas group 3 (n = 31) received no anesthetic before the procedure. After the biopsy patients were asked to express discomfort by visual anologue scale (VAS). Results: The mean scores for groups 1 and 2 were significantly lower than that of group 3 (1.4 ± 1.1 and 2.0 ± 1.5 versus 4.7 ± 1.6, respectively; p < 0.05 for both). For patients with VAS scores exceeding 4 (moderate to severe discomfort), a significant difference was calculated between groups 1 and 2 (3% versus 29%, p < 0.05) and between each and group 3 (3% and 29% versus 80%, respectively; p < 0.05 for each). Conclusions: Sedation is an alternative for increasing patient comfort during TRUS-guided prostate biopsy, especially in clinical situations like patient anxiety, young age, repeat biopsies or inflammatory anal diseases

Safety of transrectal ultrasound-guided prostate biopsy in patients affected by Crohn’s disease

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Lucio Dell'Atti

2017-06-01

Full Text Available Purpose: Crohn’s disease (CD is a chronic inflammatory condition of the gastrointestinal tract. It is usually considered a contraindication to transrectal ultrasound-guided prostate biopsy (TRUSBx. The aim of this study was to investigate the safety of TRUSBx in a small cohort of patients with CD. Methods: We queried our institutional database clinical data of patients with a diagnosis of CD undergoing TRUSBx, and a retrospective prospective study of 5 patients was planned. All patients enrolled were in the remission phase of CD and asymptomatic. They received the same antibiotic prophylaxis and a povidone-iodine aqueous solution enema before the procedure. A standardized reproducible technique was used with using a ultrasound machine equipped with a 5-9 MHz multifrequency convex probe “end-fire”. The patients were treated under local anaesthesia, and a 14-core biopsy scheme was performed in each patient as first intention. After the procedure each patient was given a verbal numeric pain scale to evaluate tolerability of TRUSBx. Results: TRUSBx was successfully completed in all patients. The number of biopsy cores was 14 (12-16. Of the 5 biopsy procedures performed 40% revealed prostatic carcinoma (PCa with a Gleason score 6 (3+3. No patients required catheterization or admission to the hospital for adverse events after the procedure. The most frequent adverse event was hematospermia (60%, while hematuria was present in 20% of patients and a minimal rectal bleeding in 20% of the patients. No patients reported severe or unbearable pain (score ≥ 8. Conclusions: This study suggests that CD may not be an absolute contraindication to TRUSBx for prostate cancer detection, but still requires a careful patients selection.

Biopsia por aspiración con aguja fina en el síndrome adénico cervical crónico

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Nélido González Fernández

1997-08-01

Full Text Available Con el objetivo de determinar en nuestro medio el valor de la citología aspirativa con aguja fina, al evaluar una linfadenopatía cervical asintomática, como procedimiento diagnóstico preliminar, se realizó un estudio de 40 pacientes que acudieron a la consulta de otorrinolaringología del Hospital Clinicoquirúrgico Docente "Joaquín Albarrán", durante el año 1994, en los cuales se practicó primero biopsia aspirativa con aguja fina y posteriormente la extirpación quirúrgica de los ganglios afectados para evaluar los diagnósticos citopatológicos realizados. El 72,5 % de los pacientes tenían más de 50 años y el 62,5 % era del sexo masculino. Se diagnosticaron lesiones metastásicas en el 45 %, tumores primarios en el 20 %, adenitis aguda en 7,5 %. En la correlación se encontraron 2 falsos positivos (5 % e igual número de falsos negativos. La eficacia del método fue de 90 %, sensibilidad de 92,3 % y especialidad de 85,75 %. Los índices predictivos positivos y negativos fueron 92,3 y 85,7 %Forty patients who were attended at the Otorrhinolaryngology Service of "Joaquín Albarrán" Teaching Clinical and Surgical Hospital during 1994 were studied with the aim of determine in our environment the value of fine needle aspiration cytology when evaluating an asymptomatic cervical lymphoadenopathy. First, patients underwent a fine needle aspiration biopsy and afterwards they were submitted to a surgical removal of the affected ganglia to assess the cytopathologic diagnoses performed. 72.5 % of patients were over 50 years of age and 62.5 % were male. Metastatic lesions were diagnosed in 45 %, primary tumors in 20 %, and acute adenitis in 7.5 %. In the correlation, 2 false positive results were found (5 % and an equal number of false negative results. The effectiveness of the method was found to be of 90 %, sensitivity was 92.3 %, and specificity was of 85.75 %. Positive and negative predictive indexes were 92.3 and 85.7 %

Intramuscular diclofenac vs periprostatic lidocaine injection for controlling pain undergoing transrectal ultrasound guided prostatic biopsy

International Nuclear Information System (INIS)

Alam, S.I.

2017-01-01

Background: Transrectal ultrasound (TRUS) technique for getting prostatic tissue for histopathology is now the standard procedure for malignant lesions of the prostate and imperative diagnostic investigation of patients with clinical specks of prostatic neoplasia. During TRUS guided biopsy, pain control has been important issue therefore, highly potent analgesia before this procedure should be considered on high priority according to current census. Therefore, we compared intramuscular diclofenac injection with sensory blockade of injection lidocaine to abolish pain undergoing prostatic biopsy with TRUS technique. Methods: Total 200 patients were selected for this study having raised PSA values and suspicious nodule on Digital Rectal Examination. These patients were segregated into two groups by randomization. Group Ar eceived intramuscular diclofenac and group Bw ere infiltrated with lidocaine injection for sensory blockade. Results: Patients in group A was having mean age of 64.5±5.8 years while for group B patients was 65.6±4.9 years (p=0.16). Both groups have statistically insignificant difference in their mean PSA values (p=0.24) and mean prostatic volume (p=0.22). The mean pain scores on visual analogue scale in groups A was 3.5±0.8 and in group B it was 2.4±0.8 (p<0.001). 60% group A patients reported with mild or no pain compared to 90% in group B. (p<0.001). Conclusion: Local blockade with lidocaine injection has better pain control as compared to patients experienced pain with intramuscular diclofenac used for prostatic biopsy through TRUS technique.

The effect of rectal Foley catheterization on rectal bleeding rates after transrectal ultrasound-guided prostate biopsy.

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Kilciler, Mete; Erdemir, Fikret; Demir, Erkan; Güven, Oğuz; Avci, Ali

2008-09-01

To assess whether Foley catheterization of the rectum after transrectal ultrasound (TRUS)-guided prostate biopsy decreases complication rates. Between June 2000 and September 2006, 275 consecutive patients were evaluated after undergoing TRUS-guided prostate biopsy. All procedures were performed on an outpatient basis. Patients were divided into two groups. In the first group (n = 134), a Foley catheter was inserted into the rectum and inflated to 50 cm(3) after TRUS-guided biopsy. In the second group (n = 141), catheterization was performed without balloon placement. Rectal bleeding, hematuria, hematospermia, infection, and acute urinary retention rates were compared between groups. The mean ages of the patients were 63.3 years +/- 5.6 and 62.1 years +/- 7.2 years in the Foley catheter group and control group, respectively (P = .112). Hematuria, hematospermia, infection, and rectal bleeding occurred in 31 (23.1%), 30 (22.4), nine (6.7%), and two patients (1.5%), respectively, in the Foley catheter group; and in 36 (25.5%), 36 (25.5%), 11 (7.8%), and 25 patients (17.7%), respectively, in the control group. The incidences of infection, hematuria, and hematospermia were not significantly different between groups (P > .05). In contrast, the rectal bleeding rate was significantly lower in the Foley catheter group (1.5%) than in the control group (17.7%; P = .001). Although it has no effect on other complications, TRUS-guided prostate biopsy with rectal Foley catheterization is a useful, practical method to decrease or prevent rectal bleeding.

Prostate specific antigen, digital rectal examination, transrectal ultrasound: how accurate are they in determining prostate carcinoma?

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Gomez, John Anthony M.; Pagdanganan, Ernest Jerome A.; Caedo, Florencio Gerardo O.; Magsino, Benjamin C.; Rivera, Eduardo Ll.; Songco, Jaime S.D.

1998-01-01

Prostate cancer is an increasing problem. It is the most frequent malignancy in men past the age of 65 years. In the Philippines, 10-20% of males operated for prostatic obstruction had prostate cancer. The potential for cure is optimized by early detection and treatment of organ confined disease. Digital rectal examination, serum prostatic specific antigen and transrectal ultrasound of the prostate have been advocated individually and collectively to determine prostatic cancer. Our study involved forty-nine males who underwent all three screening modalities. Results of the study showed a statistically significant association between the presence of a nodule and occurrence of prostate cancer, a statistically significant association between hardness in consistency and cancer, a statistically significant difference in mean weight between those with Ca and BPH; a statistically significant difference in mean PSA levels between those with Ca and with BPH; statistically significant association between abnormal PSA levels and Ca; and a statistically significant association between a composite positive result and cancer. On the other hand, there was no statistically significant difference in mean age between those with cancer and those with BPH; there is no statistically significant association between the presence of prostatism and whether the patient has Ca or BPH; and there is no statistically significant difference in the mean duration between those with cancer and those with BPH. The study advocates the use of DRE, serum PSA in determining prostatic Ca as well as TRUS for determining occult carcinoma. (Author)

Stereotactic biopsy for intracranial lesions: clinical-pathological compatibility in 60 patients Biopsia estereotáctica para lesões intracranianas: compatibilidade clínico patológica em 60 casos

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Eduardo Urbano da Silva

2009-12-01

Full Text Available OBJECTIVE: Image guided stereotactic biopsy (SB provides cerebral tissue samples for histological analysis from minimal lesions or those that are located in deep regions, being crucial in the elaboration of therapeutic strategies, as well as the prevention of unnecessary neurosurgical interventions. METHOD: Sixty patients with central nervous lesions underwent SB from November 1999 to March 2008. They were followed up to 65 months. Preoperative diagnosis was based on clinical presentation and neuro-radiological features, pathologic diagnosis, clinical outcome. The compatibility of these findings with the pathologic diagnosis was analyzed. RESULTS: Considering diagnosis confirmation when inflammatory hypothesis were made, our accuracy was of 76%, with 94% of those cases having clinic-pathological correspondence after an average of 65.2 months of follow up. Considering diagnosis confirmation with the preoperative hypothesis of neoplasm, our accuracy was of 69% with 90% of these cases having clinic-pathological correspondence after an average of 47.3 months of follow-up. Morbidity rate was of 5% and mortality was zero. The diagnosis rate was 95%. CONCLUSION: Stereotactic biopsy represents a safe and precise method for diagnosis. Anatomic and histopathological analyses have high compatibility with long-term clinical outcome.OBJETIVO: A biopsia estereotáctica (BE guiada por imagem propicia amostras de tecido cerebral para análises histológicas, sendo decisiva na estratégia terapêutica e prevenção de intervenções neurocirúrgicas desnecessárias. MÉTODO: 60 pacientes com lesões do sistema nervoso central foram submetidos à biópsia estereotáctica no período de novembro de 1999 a março de 2008. Foram analisados a acurácia do método, a capacidade de confirmar o diagnóstico clínico pré-operatório e o comportamento evolutivo com sua compatibilidade com o diagnóstico patológico. RESULTADOS: As três lesões mais freqüentes foram

Automatic localization of the da Vinci surgical instrument tips in 3-D transrectal ultrasound.

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Mohareri, Omid; Ramezani, Mahdi; Adebar, Troy K; Abolmaesumi, Purang; Salcudean, Septimiu E

2013-09-01

Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical system is the current state-of-the-art treatment option for clinically confined prostate cancer. Given the limited field of view of the surgical site in RALRP, several groups have proposed the integration of transrectal ultrasound (TRUS) imaging in the surgical workflow to assist with accurate resection of the prostate and the sparing of the neurovascular bundles (NVBs). We previously introduced a robotic TRUS manipulator and a method for automatically tracking da Vinci surgical instruments with the TRUS imaging plane, in order to facilitate the integration of intraoperative TRUS in RALRP. Rapid and automatic registration of the kinematic frames of the da Vinci surgical system and the robotic TRUS probe manipulator is a critical component of the instrument tracking system. In this paper, we propose a fully automatic registration technique based on automatic 3-D TRUS localization of robot instrument tips pressed against the air-tissue boundary anterior to the prostate. The detection approach uses a multiscale filtering technique to identify and localize surgical instrument tips in the TRUS volume, and could also be used to detect other surface fiducials in 3-D ultrasound. Experiments have been performed using a tissue phantom and two ex vivo tissue samples to show the feasibility of the proposed methods. Also, an initial in vivo evaluation of the system has been carried out on a live anaesthetized dog with a da Vinci Si surgical system and a target registration error (defined as the root mean square distance of corresponding points after registration) of 2.68 mm has been achieved. Results show this method's accuracy and consistency for automatic registration of TRUS images to the da Vinci surgical system.

Correlación ecográfico-anatómica de la medición del volumen prostático total y de la zona transicional mediante ecografía transrectal: correlation with surgical specimen

OpenAIRE

Cabello Benavente, R.; Jara Rascón, J.; Monzó, J.I.; López Díez, I.; Subirá Ríos, D.; Lledó García, E.; Herranz Amo, F.; Hernández Fernández, C.

2006-01-01

Objetivo: Determinar la fiabilidad de la ecografía transrectal (ECOTR) en la medición del volumen prostático total y de la zona transicional (ZT) y buscar coeficientes de correlación capaces de mejorar la equiparación entre ambas medidas y el peso real prostático. Material y Métodos: Comparamos los volúmenes estimados mediante ECOTR con el peso de la pieza quirúrgica en pacientes con cáncer prostático localizado (grupo A, n=33) o HBP (grupo B, n= 37) sometidos a cirugía. El volumen se calculó...

Towards 3D ultrasound image based soft tissue tracking: a transrectal ultrasound prostate image alignment system.

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Baumann, Michael; Mozer, Pierre; Daanen, Vincent; Troccaz, Jocelyne

2007-01-01

The emergence of real-time 3D ultrasound (US) makes it possible to consider image-based tracking of subcutaneous soft tissue targets for computer guided diagnosis and therapy. We propose a 3D transrectal US based tracking system for precise prostate biopsy sample localisation. The aim is to improve sample distribution, to enable targeting of unsampled regions for repeated biopsies, and to make post-interventional quality controls possible. Since the patient is not immobilized, since the prostate is mobile and due to the fact that probe movements are only constrained by the rectum during biopsy acquisition, the tracking system must be able to estimate rigid transformations that are beyond the capture range of common image similarity measures. We propose a fast and robust multi-resolution attribute-vector registration approach that combines global and local optimization methods to solve this problem. Global optimization is performed on a probe movement model that reduces the dimensionality of the search space and thus renders optimization efficient. The method was tested on 237 prostate volumes acquired from 14 different patients for 3D to 3D and 3D to orthogonal 2D slices registration. The 3D-3D version of the algorithm converged correctly in 96.7% of all cases in 6.5s with an accuracy of 1.41mm (r.m.s.) and 3.84mm (max). The 3D to slices method yielded a success rate of 88.9% in 2.3s with an accuracy of 1.37mm (r.m.s.) and 4.3mm (max).

Transrectal microwave thermotherapy causing a short-time influence on sperm quality in Chinese chronic nonbacterial prostatitis patients.

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Jin, Jia-Xin; Wang, Han-Zhang; Zhai, Zheng-Xing; Ma, Bao-Liang; Li, Qin-Fang; Xiao, Nan; Wang, Zhi-Ping; Rodriguez, Ronald

2017-01-01

Chronic prostatitis can affect the sperm's quality. Previous studies have shown that transrectal microwave thermotherapy (TRMT) results in symptomatic relief in patients with chronic prostatitis, but the effects on sperm have not been carefully investigated. This study evaluates the impact of TRMT on the relief or decrease of symptoms and quality of sperm when used to treat patients with chronic nonbacterial prostatitis. Sixty patients were enrolled in the study. TRMT treatment was administered over 5 days, 1 h per day. Semen examination was carried out pretreatment and immediately at the conclusion of the 5-day treatment. Also, it was repeated 1 month, 3 months, and 6 months later. The treatment's symptom relief efficacy was evaluated using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). After the treatment, the overall NIH-CPSI scores were lower compared to those of pretreatment. In addition, the white blood cells and lecithin in expressed prostatic secretion were normal after the treatment. The sperm count was decreased by 23.8% 3 months after the treatment, sperm motility was reduced by 10.3% immediately after treatment, and sperm deformity was increased by 17.2%. The sperm volume and PH were not affected. However, the sperm quality recovered after treatment and the malformation rate was also lower at 6 months after treatment. TRMT is a favorable and safe treatment option for patients with nonbacterial chronic prostatitis. It could relieve the patient's symptoms and impact on sperm quality in the short-term.

Cost-Effectiveness of Antibiotic Prophylaxis Strategies for Transrectal Prostate Biopsy in an Era of Increasing Antimicrobial Resistance.

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Lee, Kyueun; Drekonja, Dimitri M; Enns, Eva A

2018-03-01

To determine the optimal antibiotic prophylaxis strategy for transrectal prostate biopsy (TRPB) as a function of the local antibiotic resistance profile. We developed a decision-analytic model to assess the cost-effectiveness of four antibiotic prophylaxis strategies: ciprofloxacin alone, ceftriaxone alone, ciprofloxacin and ceftriaxone in combination, and directed prophylaxis selection based on susceptibility testing. We used a payer's perspective and estimated the health care costs and quality-adjusted life-years (QALYs) associated with each strategy for a cohort of 66-year-old men undergoing TRPB. Costs and benefits were discounted at 3% annually. Base-case resistance prevalence was 29% to ciprofloxacin and 7% to ceftriaxone, reflecting susceptibility patterns observed at the Minneapolis Veterans Affairs Health Care System. Resistance levels were varied in sensitivity analysis. In the base case, single-agent prophylaxis strategies were dominated. Directed prophylaxis strategy was the optimal strategy at a willingness-to-pay threshold of $50,000/QALY gained. Relative to the directed prophylaxis strategy, the incremental cost-effectiveness ratio of the combination strategy was $123,333/QALY gained over the lifetime time horizon. In sensitivity analysis, single-agent prophylaxis strategies were preferred only at extreme levels of resistance. Directed or combination prophylaxis strategies were optimal for a wide range of resistance levels. Facilities using single-agent antibiotic prophylaxis strategies before TRPB should re-evaluate their strategies unless extremely low levels of antimicrobial resistance are documented. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Transrectal ultrasound: Diagnosis of prostate cancer by a new biplane US-guided biopsy technique. Comparison of thin-needle cytology and histology with large-core biopsy

International Nuclear Information System (INIS)

Lee, F.; Littrup, P.; McLeary, R.; Kumasaka, G.; Borlaza, G.; McHugh, T.; Soiderer, M.; Roi, L.

1986-01-01

A new transperineal biopsy technique was developed that uses biplane transrectal US guidance for needle placement into anechoic-hypoechoic lesions thought to indicate prostate cancer (n = 83). The results of histologic studies on biopsy material obtained with a 22-gauge needle and of aspiration histologic studies on biopsy material obtained with a 19-gauge needle were compared with results of histologic studies on material obtained with a 14-gauge needle. When sufficient tissue was obtained, the positive biopsy yield was 61% by cytology and 58% by histology; the combined yield was 61%. A limited study ( n = 21) of histologic findings in biopsy material obtained with 19-gauge and 14-gauge needles showed equivalent diagnostic results. Sixty-seven percent of the biopsies were of lesions less than 1.5 cm in diameter, and 57% (13 of 23) of the biopsy-proved cancers in this group were either nonpalpable or only mildly suspicious on digital rectal examination

Rectal culture-directed antibiotic prophylaxis before transrectal prostate biopsy: Reduced infectious complications and healthcare costs.

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Baldissera-Aradas, J V; Rodríguez-Villamil, L; Blanco-Fernández, R; Pérez-García, C; Viejo de la Guerra, G; González-Rodríguez, I; Mosquera-Madera, J

2018-01-10

Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (P<.005). The estimated total cost, including the management of the ICs, was €57,076 with EP versus €4802.33 with GP. The average cost per patient with EP was €368.23 versus €33.11 with GP. GP achieved an estimated total savings of €52,273.67. Six patients had to undergo GP to prevent an IC. GP is associated with a marked decrease in the incidence of ICs caused by CRB and reduced healthcare costs. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI.

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Turkbey, Baris; Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Shah, Vijay; Bernardo, Marcelino; Baccala, Angelo; Rastinehad, Ardeshir; Benjamin, Compton; Merino, Maria J; Wood, Bradford J; Choyke, Peter L; Pinto, Peter A

2011-03-29

During transrectal ultrasound (TRUS)-guided prostate biopsies, the actual location of the biopsy site is rarely documented. Here, we demonstrate the capability of TRUS-magnetic resonance imaging (MRI) image fusion to document the biopsy site and correlate biopsy results with multi-parametric MRI findings. Fifty consecutive patients (median age 61 years) with a median prostate-specific antigen (PSA) level of 5.8 ng/ml underwent 12-core TRUS-guided biopsy of the prostate. Pre-procedural T2-weighted magnetic resonance images were fused to TRUS. A disposable needle guide with miniature tracking sensors was attached to the TRUS probe to enable fusion with MRI. Real-time TRUS images during biopsy and the corresponding tracking information were recorded. Each biopsy site was superimposed onto the MRI. Each biopsy site was classified as positive or negative for cancer based on the results of each MRI sequence. Sensitivity, specificity, and receiver operating curve (ROC) area under the curve (AUC) values were calculated for multi-parametric MRI. Gleason scores for each multi-parametric MRI pattern were also evaluated. Six hundred and 5 systemic biopsy cores were analyzed in 50 patients, of whom 20 patients had 56 positive cores. MRI identified 34 of 56 positive cores. Overall, sensitivity, specificity, and ROC area values for multi-parametric MRI were 0.607, 0.727, 0.667, respectively. TRUS-MRI fusion after biopsy can be used to document the location of each biopsy site, which can then be correlated with MRI findings. Based on correlation with tracked biopsies, T2-weighted MRI and apparent diffusion coefficient maps derived from diffusion-weighted MRI are the most sensitive sequences, whereas the addition of delayed contrast enhancement MRI and three-dimensional magnetic resonance spectroscopy demonstrated higher specificity consistent with results obtained using radical prostatectomy specimens.

Contrast-enhanced transrectal ultrasound for prediction of prostate cancer aggressiveness: The role of normal peripheral zone time-intensity curves.

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Huang, Hui; Zhu, Zheng-Qiu; Zhou, Zheng-Guo; Chen, Ling-Shan; Zhao, Ming; Zhang, Yang; Li, Hong-Bo; Yin, Li-Ping

2016-12-08

To assess the role of time-intensity curves (TICs) of the normal peripheral zone (PZ) in the identification of biopsy-proven prostate nodules using contrast-enhanced transrectal ultrasound (CETRUS). This study included 132 patients with 134 prostate PZ nodules. Arrival time (AT), peak intensity (PI), mean transit time (MTT), area under the curve (AUC), time from peak to one half (TPH), wash in slope (WIS) and time to peak (TTP) were analyzed using multivariate linear logistic regression and receiver operating characteristic (ROC) curves to assess whether combining nodule TICs with normal PZ TICs improved the prediction of prostate cancer (PCa) aggressiveness. The PI, AUC (p < 0.001 for both), MTT and TPH (p = 0.011 and 0.040 respectively) values of the malignant nodules were significantly higher than those of the benign nodules. Incorporating the PI and AUC values (both, p < 0.001) of the normal PZ TIC, but not the MTT and TPH values (p = 0.076 and 0.159 respectively), significantly improved the AUC for prediction of malignancy (PI: 0.784-0.923; AUC: 0.758-0.891) and assessment of cancer aggressiveness (p < 0.001). Thus, all these findings indicate that incorporating normal PZ TICs with nodule TICs in CETRUS readings can improve the diagnostic accuracy for PCa and cancer aggressiveness assessment.

Inflamación Granulomatosa Crónica: Métodos de detección de bacilos ácido alcohol resistentes en biopsias embebidas en parafina

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Javier Andres Bustamante Rengifo

2010-05-01

Full Text Available La detección de bacilos ácido alcohol resistentes (BAAR en frotis resulta un aporte significativo al diagnóstico y tratamiento de individuos con inflamación granulomatosa crónica (IGC. Con el objetivo de evaluar la presencia de BAAR en diferentes tejidos de pacientes con IGC demostrada y comparar la frecuencia de los extendidos positivos para BAAR con el grado de formación de granulomas y necrosis, se diseño un estudio retrospectivo, en el que se seleccionaron 57 bloques embebidos en parafina que contenían biopsias de pleura, pulmón, pericardio, ganglio linfático y lóbulo cerebral, correspondientes a 30 pacientes (63.3% hombres, mayores de 18 años, con IGC demostrada y remitidos al departamento de patología del Hospital Universitario del Valle entre el 2002-2008, a cada muestra se le realizaron 3 cortes y se sometieron a tinciones de H/E, Zielh Neelsen y Auramina. La detección de BAAR en frotis fue similar para ambas tinciones especiales en pacientes con IGC necrotizante, reflejando una excelente concordancia en el diagnostico (kappa=0.89, IC95%[0.68-1.0]. Sin embargo, la tinción con Auramina fue superior a la tinción Ziehl Neelsen para la detección de BAAR en pacientes con IGC no necrotizante (kappa=0.65, IC95%[0.23-1.0]. No se encontraron diferencias significativas entre la presencia de BAAR y el tipo de inflamacion, sexo y localización anatómica comprometida. En general, fue buena la concordancia entre los métodos histológicos empleados. Además, se hizo evidente la importancia de implementar el uso de técnicas moleculares mínimamente afectadas por el escaso número de bacilos presentes en las muestras, que finalmente ayudan en el reconocimiento del microorganismo.

The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

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Alper Otunctemur

2013-06-01

Full Text Available Aim: Transrectal ultrasound (TRUS guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001. In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

Contrast-enhanced transrectal ultrasonography for the detection of diffuse prostate cancer

International Nuclear Information System (INIS)

Gao, Y.; Liao, X.H.; Lu, L.; Wang, L.; Ma, Y.; Qin, H.Z.; Yan, X.; Guo, P.

2016-01-01

Aim: To evaluate the diagnostic accuracy of contrast-enhanced transrectal ultrasonography (CE-TRUS) versus baseline TRUS (combination of grey-scale and colour Doppler imaging) for diffuse prostate cancer. Materials and methods: Forty-six patients without an obvious focal mass on baseline TRUS (grey-scale and colour Doppler), underwent additional CE-TRUS and TRUS-guided biopsy due to elevated levels of prostate-specific antigen (PSA ≥4 ng/ml) and/or abnormal digital rectal examination (DRE). In all patients, CE-TRUS was performed with intravenous injection of a contrast agent (sulphur hexafluoride microbubble; SonoVue, 2.4 ml) before biopsy. TRUS-guided biopsy targeted suspicious areas detected on CE-TRUS imaging or sampled the outer gland of the normal prostate. The final diagnosis was based on results of the TRUS-guided biopsy. The diagnostic accuracy of baseline TRUS and CE-TRUS for diffuse prostatic lesions was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Diffuse prostate cancer was present in 32 (69.5%) patients and absent in 14 (30.5%) patients. Nineteen patients had diffuse prostate cancer that was not detected by baseline TRUS, whereas 15 cases were identified using CE-TRUS. Conversely, five patients had benign prostatic hypertrophy (BPH) that was diagnosed as cancer by CE-TRUS, and two of these patients were diagnosed with BPH by baseline TRUS. The combined sensitivity, specificity, and accuracy were 87.5%, 64.2%, and 80.4%, respectively, for CE-TRUS, and 40.6%, 78.5%, and 52.1%, respectively, for baseline TRUS. The area under the ROC curve (AUC) values for the diagnostic accuracy of baseline CE-TRUS versus TRUS for diffuse prostate cancer differed significantly at 0.904 and 0.667, respectively (Z=4.098, p<0.0001). Conclusion: CE-TRUS exhibited greater diagnostic accuracy for diffuse prostate cancer than baseline TRUS. CE-TRUS may improve cancer detection over baseline TRUS imaging for the diagnosis of diffuse

Limiting overdiagnosis of low-risk prostate cancer through an evaluation of the predictive value of transrectal and power Doppler ultrasonography.

Science.gov (United States)

Sauvain, Jean Luc; Sauvain, Elise; Papavero, Roger; Louis, Didier; Rohmer, Paul

2016-12-01

Overdiagnosis induced by prostate cancer screening makes necessary a better selection of candidate patients for prostate biopsy. The objective of our study is to assess the probability of having a high- or low-risk lesion that could require active surveillance (AS) after biopsies and a normal or abnormal examination, including transrectal and power Doppler ultrasonography (TRUS-PDS). Four hundred and twenty-nine consecutive patients with a PSA level risk of a biological recurrence and Dall'Era's criteria to assess possible AS. The TRUS-PDS was considered positive if one biopsy was positive in the same sextant as the suspect image. One hundred and seventy-seven out of 429 (41 %) T1c cancers were diagnosed; 131 out of 177 (74 %) could be qualified as low risk, and 119 out of 177 (67 %) could require AS. The TRUS-PDS was normal in 285 of 429 patients (66 %). With a normal TRUS-PDS, the probability of not having cancer with a high or intermediate risk was 96 % (negative predictive value). With an abnormal TRUS-PDS, the probability of having a positive biopsy was 59 %, and the probability of having a significant cancer was 30 %, according to the Dall'Era criteria. When TRUS-PDS was normal, these probabilities significantly decreased to 32 and 5 %, respectively ( p  risk of high- or intermediate-risk cancer.

[Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied].

Science.gov (United States)

Tamarelle, B; Perrin, P; Devonec, M; Paparel, P; Ruffion, A

To identify hospitalizations directly related to a complication occurring within 30 days following a transrectal prostate biopsy (PBP). Overall hospitalization rates, mortality rates, potential predisposing factors for complications. Single-center study including all patients who underwent PBP between January 2005 and January 2012. Any hospitalization occurring within 30 days of the PBP for urgent motive was considered potentially attributable to biopsy. We identified the reason for hospitalization with direct complications (urinary infection or fever, rectal bleeding, bladder caillotage, retention) and indirect (underlying comorbidities decompensation) of the biopsy. The contributing factors were anticoagulant or antiplatelet treatment well as waning immunity factors (corticosteroid therapy, HIV, chemotherapy or immunodulateur). Among 2715 men who underwent PBP, there were 120 (4.4%) hospitalizations including 28 (1.03%) caused by the biopsy. Twenty-five (0.92%) were related to a direct complication of biopsy: 14 (56%) for urinary tract infection or fever including 1 hospitalization in intensive care, 5 (20%) for rectal bleeding which required several transfusions 1, 10 (40%) urinary retention and 3 (0.11%) for an indirect complication (2 coronary syndromes and 1 respiratory failure). Several direct complications were associated in 3 cases. Only two hospitalizations associated with rectal bleeding were taking an antiplatelet or anticoagulant. There was no association between hospitalization for urinary tract infections and a decreased immune status. The first death observed in our study occurred at D31 of pulmonary embolism (advanced metastatic patient with bladder cancer). Twenty (60.6%) patients urgently hospitalized did not have prostate cancer. Within this large sample of patients the overall rate of hospitalization due to the realization of a PBP was 1%. It has not been found predictive of complications leading to hospitalization. 4. Copyright © 2016

Decrease in Infection Rate Following Use of Povidone-Iodine During Transrectal Ultrasound Guided Biopsy of the Prostate: A Double Blind Randomized Clinical Trial

International Nuclear Information System (INIS)

Ghafoori, Mahyar; Shakiba, Madjid; Seifmanesh, Hamidreza; Hoseini, Kamal

2012-01-01

Infection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication can not completely eliminate infection after biopsy. We performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection. Totally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria. The mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1). Simple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate

Poster — Thur Eve — 77: Implanted Brachythearpy Seed Movement due to Transrectal Ultrasound Probe-Induced Prostate Deformation

International Nuclear Information System (INIS)

Liu, D; Usmani, N; Sloboda, R; Meyer, T; Husain, S; Angyalfi, S; Kay, I

2014-01-01

The study investigated the movement of implanted brachytherapy seeds upon transrectal US probe removal, providing insight into the underlying prostate deformation and an estimate of the impact on prostate dosimetry. Implanted seed distributions, one obtained with the prostate under probe compression and another with the probe removed, were reconstructed using C-arm fluoroscopy imaging. The prostate, delineated on ultrasound images, was registered to the fluoroscopy images using seeds and needle tracks identified on ultrasound. A deformation tensor and shearing model was developed to correlate probe-induced seed movement with position. Changes in prostate TG-43 dosimetry were calculated. The model was used to infer the underlying prostate deformation and to estimate the location of the prostate surface in the absence of probe compression. Seed movement patterns upon probe removal reflected elastic decompression, lateral shearing, and rectal bending. Elastic decompression was characterized by expansion in the anterior-posterior direction and contraction in the superior-inferior and lateral directions. Lateral shearing resulted in large anterior movement for extra-prostatic seeds in the lateral peripheral region. Whole prostate D90 increased up to 8 Gy, mainly due to the small but systematic seed movement associated with elastic decompression. For selected patients, lateral shearing movement increased prostate D90 by 4 Gy, due to increased dose coverage in the anterior-lateral region at the expense of the posterior-lateral region. The effect of shearing movement on whole prostate D90 was small compared to elastic decompression due to the subset of peripheral seeds involved, but is expected to have greater consequences for local dose coverage

Intravenous paracetamol for relief of pain during transrectal-ultrasound-guided biopsy of the prostate: A prospective, randomized, double-blind, placebo-controlled study

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Ozcan Kilic

2015-11-01

Full Text Available Transrectal-ultrasound-guided prostate biopsy (TRUS-PBx is the standard procedure for diagnosing prostate cancer. The procedure does cause some pain and discomfort; therefore, an adequate analgesia is necessary to ensure patient comfort, which can also facilitate good-quality results. This prospective, randomized, double-blinded, placebo-controlled study aimed to determine if intravenous (IV paracetamol can reduce the severity of pain associated with TRUS-PBx. The study included 104 patients, scheduled to undergo TRUS-PBx with a suspicion of prostate cancer, that were prospectively randomized to receive either IV paracetamol (paracetamol group or placebo (placebo group 30 minutes prior to TRUS-PBx. All patients had 12 standardized biopsy samples taken. Pain was measured using a 10-point visual analog pain scale during probe insertion, during the biopsy procedure, and 1 hour postbiopsy. All biopsies were performed by the same urologist, whereas a different urologist administered the visual analog pain scale. There were not any significant differences in age, prostate-specific antigen level, or prostate volume between the two groups. The pain scores were significantly lower during probe insertion, biopsy procedure, and 1 hour postbiopsy in the paracetamol group than in the placebo group. In conclusion, the IV administration of paracetamol significantly reduced the severity of pain associated with TRUS-PBx.

Detection and localization of carcinoma within the prostate using high resolution transrectal gamma imaging (TRGI) of monoclonal antibody directed at prostate specific membrane antigen (PSMA)—Proof of concept and initial imaging results

International Nuclear Information System (INIS)

Franc, Benjamin L.; Cho, Steve Y.; Rosenthal, Seth A.; Cui, Yonggang; Tsui, Benjamin; Vandewalker, Kristen M.N.; Holz, Andrew L.; Poonamallee, Uday; Pomper, Martin G.; James, Ralph B.

2013-01-01

Purpose: Molecular imaging methods may identify primary prostate cancer foci and potentially guide biopsy and optimal management approaches. In this exploratory study, safety and first human imaging experience of a novel solid state endocavity transrectal gamma-imaging (TRGI) device was evaluated. Methods: Twelve patients received 5 ± 0.5 mCi In-111 capromab pendetide (ProstaScint ® ) intravenously and the prostate of each was imaged 4 days later transrectally using an endoluminal cadmium zinc telluride (CZT)-based compact gamma camera (ProxiScan™, Hybridyne Imaging Technologies, Inc.). Immediate and 5–7-day post imaging safety assessments were performed. In those patients with a prostate cancer diagnosis (N = 10), single photon emission computed tomography (SPECT-CT) and magnetic resonance imaging (MRI) of the pelvis were also acquired. Images were reviewed and sites of suspected cancer were localized by prostate quadrant by consensus of two nuclear medicine physicians. Pathology from TRUS biopsy, or surgical pathology following prostatectomy (N = 3) when available, served as the gold standard. Results: There were no serious adverse events associated with TRGI. No focal signal was detected in patients without a diagnosis of prostate cancer (N = 2). Of 40 quadrants evaluated in the cancer cohort (N = 10), 22 contained malignancy. In 8 of these 10 patients, the most focal site of uptake on TRGI corresponded to a prostatic quadrant with biopsy-proven malignancy. In 6 cancer-containing quadrants, TRGI was positive where SPECT-CT was negative; MRI showed a detectable abnormality in only 1 of these 6 quadrants. Qualitative image review of the planar TRGI images for prostate cancer localization was severely limited in some cases by scatter artifact within the vicinity of the prostate gland arising from physiologic urine and blood pool activity from nearby structures. Conclusions: TRGI is a safe imaging method that can potentially detect radiopharmaceutical uptake

Avances en el diagnostico ecografico del cancer de prostate

NARCIS (Netherlands)

Laguna, M.P.; Wondergem, N.; Wink, M.H.; Wijkstra, H.; Rosette, de la J.J.M.C.H.

2010-01-01

OBJETIVO: La biopsia guiada por ecografía posee un papel primordial en el diagnóstico del cáncer de próstata. Diversos protocolos de biopsia prostática guiada mediante ultrasonidos se han diseño en un intento de mejorar el diagnóstico del cáncer de próstata. La incorporación de los contrastes

Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications

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Ihezue, C.U. [Department of Radiology, Southampton General Hospital (United Kingdom); Smart, J. [Department of Radiology, Southampton General Hospital (United Kingdom); Dewbury, K.C. [Department of Radiology, Southampton General Hospital (United Kingdom)]. E-mail: keith.dewbury@suht.swest.nhs.uk; Mehta, R. [Department of Radiology, Southampton General Hospital (United Kingdom); Burgess, L. [Department of Radiology, Southampton General Hospital (United Kingdom)

2005-04-01

AIM: To determine the relation between warfarin use and the frequency of bleeding complications after biopsy of the prostate guided by transrectal ultrasound (TRUS). METHODS: Overall, 1022 consecutive patients with suspected prostatic disease were followed after biopsy. Warfarin and aspirin use was determined on the day of the procedure. A TRUS-guided biopsy was performed and patients were offered a questionnaire to complete 10 days after the procedure, to determine any immediate or delayed bleeding complications. Follow-up telephone calls were made to those who had not replied within the stipulated period. RESULTS: Of the 1000 patients who replied, 49 were receiving warfarin, 220 were receiving aspirin and 731 were not receiving any anticoagulant drugs. Of the 49 subjects reporting current use of warfarin, 18 (36.7%) experienced haematuria, compared with 440 (60.2%) of the patients receiving no anti-coagulant drugs who reported haematuria. This was statistically significant (p=0.001). Of the group receiving warfarin, 4 (8.2%) experienced haematospermia whereas 153 (21%) of the group receiving no anticoagulant medication reported haematospermia. This difference also was statistically significant (p=0.030). Rectal bleeding was experienced by 7 (14.3%) of the group receiving warfarin compared with 95 (13%) in the group without anticoagulant medication, but this was not statistically significant (p=0.80). We also demonstrated that there was no statistically significant association between the severity of the bleeding complications and medication with warfarin. CONCLUSION: None of the group receiving warfarin experienced clinically important bleeding complications. Our results suggest that the frequency and severity of bleeding complications were no worse in the warfarin group than in the control group and that discontinuing anticoagulation medication before prostate biopsy may be unnecessary.

Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications

International Nuclear Information System (INIS)

Ihezue, C.U.; Smart, J.; Dewbury, K.C.; Mehta, R.; Burgess, L.

2005-01-01

AIM: To determine the relation between warfarin use and the frequency of bleeding complications after biopsy of the prostate guided by transrectal ultrasound (TRUS). METHODS: Overall, 1022 consecutive patients with suspected prostatic disease were followed after biopsy. Warfarin and aspirin use was determined on the day of the procedure. A TRUS-guided biopsy was performed and patients were offered a questionnaire to complete 10 days after the procedure, to determine any immediate or delayed bleeding complications. Follow-up telephone calls were made to those who had not replied within the stipulated period. RESULTS: Of the 1000 patients who replied, 49 were receiving warfarin, 220 were receiving aspirin and 731 were not receiving any anticoagulant drugs. Of the 49 subjects reporting current use of warfarin, 18 (36.7%) experienced haematuria, compared with 440 (60.2%) of the patients receiving no anti-coagulant drugs who reported haematuria. This was statistically significant (p=0.001). Of the group receiving warfarin, 4 (8.2%) experienced haematospermia whereas 153 (21%) of the group receiving no anticoagulant medication reported haematospermia. This difference also was statistically significant (p=0.030). Rectal bleeding was experienced by 7 (14.3%) of the group receiving warfarin compared with 95 (13%) in the group without anticoagulant medication, but this was not statistically significant (p=0.80). We also demonstrated that there was no statistically significant association between the severity of the bleeding complications and medication with warfarin. CONCLUSION: None of the group receiving warfarin experienced clinically important bleeding complications. Our results suggest that the frequency and severity of bleeding complications were no worse in the warfarin group than in the control group and that discontinuing anticoagulation medication before prostate biopsy may be unnecessary

A novel method for accurate needle-tip identification in trans-rectal ultrasound-based high-dose-rate prostate brachytherapy.

Science.gov (United States)

Zheng, Dandan; Todor, Dorin A

2011-01-01

In real-time trans-rectal ultrasound (TRUS)-based high-dose-rate prostate brachytherapy, the accurate identification of needle-tip position is critical for treatment planning and delivery. Currently, needle-tip identification on ultrasound images can be subject to large uncertainty and errors because of ultrasound image quality and imaging artifacts. To address this problem, we developed a method based on physical measurements with simple and practical implementation to improve the accuracy and robustness of needle-tip identification. Our method uses measurements of the residual needle length and an off-line pre-established coordinate transformation factor, to calculate the needle-tip position on the TRUS images. The transformation factor was established through a one-time systematic set of measurements of the probe and template holder positions, applicable to all patients. To compare the accuracy and robustness of the proposed method and the conventional method (ultrasound detection), based on the gold-standard X-ray fluoroscopy, extensive measurements were conducted in water and gel phantoms. In water phantom, our method showed an average tip-detection accuracy of 0.7 mm compared with 1.6 mm of the conventional method. In gel phantom (more realistic and tissue-like), our method maintained its level of accuracy while the uncertainty of the conventional method was 3.4mm on average with maximum values of over 10mm because of imaging artifacts. A novel method based on simple physical measurements was developed to accurately detect the needle-tip position for TRUS-based high-dose-rate prostate brachytherapy. The method demonstrated much improved accuracy and robustness over the conventional method. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Hemodynamic evaluation of portal blood flow with transrectal scintigraphy using sup 123 I-iodoamphetamine with special reference to esophageal varices and bleeding

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Shirasaki, Keiji; Ishii, Kohdoh; Kokubu, Shigehiro; Shibata, Hisao; Ishii, Katsumi (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

1990-12-01

Portosystemic shunting was evaluated by portal scintigraphy with transrectally admininistered {sup 123}I-iodoamphetamine (IMP) in 21 patients with liver diseases. IMP was injected in an amount of 111 MBq (3 mCi) into the upper part of the rectum through the catheter. Images of the liver and lungs were monitores for up to 60 minutes with scintillation camera. The subjects were divided into three groups according to the images of the organs: the tracer was accumulated predominantly in the lungs (group A); almost equally accumulated in the both organs (group B); accumulated predominantly in the liver (group C). Advanced liver cirrhosis and IPH with esophageal varices were almost exclusively seen in group A, whereas early stage of liver cirrhosis and other mild hepatic lesions without esophageal varix remainded in group C. Patients of group A showed worse laboratory data than those of group C, including platelet count, serum levels of ch-E and {gamma}-globulin. It is noteworthy that in patients with esophageal bleeding, clear lung images appeared shortly after IMP administration in contrast with extremely delayed visualization of the liver. On the contrary, liver images was demonstrated early in cirrhotic patients without esophageal bleeding. It was coucluded that portal scintigraphy with IMP is useful for the evaluation of portosystemic shunting, especially in esophageal varices. (author).

O papel da biopsia pulmonar na indicação cirúrgica de cardiopatias congénitas The role of lung biopsy in the decision-making process for congenital heart disease

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Solange Bordignon

1992-12-01

Full Text Available Objetivando relacionar o aspecto morfológico dos vasos pulmonares com os dados clínicos para auxiliar na decisão da cirurgia de cardiopatias congênitas com hipertensão pulmonar severa, em casos previamente avaliados por critérios clínicos, angiográficos e/ou hemodinâmicos, foram realizadas, de 1980 a 1991, no Instituto de Cardiologia do Rio Grande do Sul, 49 biópsias pulmonares. As idades dos pacientes variaram de 5m a 28a6m (média = 7a7m e os diagnósticos foram: CIV (16, PCA (3, CIVe ESubAo (1, PCA e CIV (2, PCA e Cl A (1 DSAV (7, DSAV incompl. e PCA (1, PCA e CoAo (1, Inter Arco Ao com PCA e CIV e/ou ESupraM e Anel SubAo (2, DVSVD com CIV e/ou PCA (6, DVSVE e EP (1, ATe ESubP. (1, TGV (1, TGV corrigida e CIV (1 e truncus arteriosus (5. Houve 3 (6,1 % óbitos no pós-operatório da biopsia. Baseado na classificação de Heath-Edwards, foram para correção cirúrgica 11 pacientes com cardiopatias simples (CIV, PCA, DSAV, cuja mortalidade foi 36,4%. Dez pacientes com cardiopatias complexas (DVSVD, DVSVE, TGV, truncus, inter arco Ao foram para cirurgia, com mortalidade de 30%. A evolução pós-operatória tardia foi favorável em 13 (62% pacientes. Conclui-se que a biopsia pulmonar pode ser útil na indicação cirúrgica das cardiopatias congênitas com hipertensão pulmonar severa e, por envolver riscos, sua utilização deve ser criteriosa. E valiosa para os pacientes que apresentam dúvidas quanto ao grau de doença vascular pulmonar ou quanto à natureza das lesões e o estudo clínico e hemodinâmico não são esclarecedores, ou mesmo quando apontarem para a contra-indicação cirúrgica.Open lung biopsy has been performed in patients with congenital heart disease and severe pulmonary hypertension in order to complement the decision-making process for surgical correction. All patients had clinical, hemodynamic and angiographic evaluation previously and would not be surgical candidates by conventional criteria. The 49 patients

Preoperative assessment of intestinal endometriosis: A comparison of transvaginal sonography with water-contrast in the rectum, transrectal sonography, and barium enema.

Science.gov (United States)

Bergamini, Valentino; Ghezzi, Fabio; Scarperi, Stefano; Raffaelli, Ricciarda; Cromi, Antonella; Franchi, Massimo

2010-12-01

To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.

[Treatment with non-steroidal anti-inflammatory drugs in patients with amicrobial chronic prostato-vesiculitis: transrectal ultrasound and seminal findings].

Science.gov (United States)

Vicari, E; La Vignera, S; Battiato, C; Arancio, A

2005-03-01

The aim of this paper was to evaluate the efficacy (0= none; 3= fully) of the treatment with nonsteroidal anti-inflammatory (NSAI) drugs on (a) gland post-inflammatory echopattern, by transrectal ultrasound (TRUS); (b) seminal cytologic (WBC concentration and spermiophagies) and (c) >2 physicochemical inflammatory parameters in patients with chronic amicrobial prostato-vesiculitis (PV). Thirty-five patients with PV received NSAI drugs in the following intermittently steps (over a 3-month period): 1) Pygeum 100 mg twice a day for 14 consecutive days per month; 2) flavoxate-propyphenazone 400 mg twice a day plus Serratiopeptidase 10 000 U twice a day for the subsequent 14 days per month. All patients underwent semen analysis and TRUS scans in the pre-treatment and after 3 months of therapy. The fully (a+b+c) efficacy rate, through an improvement of TRUS prostatic or vesicular echopattern in 37.1% and 22.8% respectively, was higher than that registered with an improvement of only 1 or 2 endpoints. Altogether, the following TRUS findings showed reductions (range 25-40%): prostate volume and hypochogenicity (51.4%); vesicular antero-posterior diameter (APD) in the 43.5% and 28.6% of the uni- and bilateral PV respectively; vesicular wall tickness (25%); unilateral vesicular honeycomb aspect (36%). No efficacy, mainly related to immodified TRUS prostatic or vesicular echopattern in 51.4% and 65.7% respectively, was observed on: areas of prostatic hyperechogenicity; peri-prostatic venous congestion; vesicular APD 21 mm (with honeycomb aspect). In PV patients, the treatment with NSAI compounds was effective when it was enable to produce multiple positive effects, mainly through TRUS changes.

Utilidad de la elastografía de transición (Fibroscan® en la evaluación de la fibrosis hepática en pacientes con hepatopatía crónica

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Daniel Álvarez

2012-02-01

Full Text Available El pronóstico de la enfermedad crónica hepática depende de la extensión y la progresión de la fibrosis hepática. Actualmente la biopsia hepática es la técnica de elección para determinar el grado de fibrosis, pero es una prueba invasiva, no exenta de complicaciones. Por ello, el desarrollo de marcadores no invasivos de fibrosis hepática se convirtió en una necesidad indiscutible. Se propuso la elastografìa por transición (Fibroscan® para valorar la fibrosis hepática en pacientes con enfermedad crónica hepática, mediante la medición de la rigidez hepática. Nuestro objetivo fue evaluar la efectividad, la objetividad y la seguridad de esta técnica. Se estudiaron 68 pacientes a los que se les realizó una biopsia hepática en los 18 meses previos al estudio. Todos los procedimientos de elastografia y biopsia hepática fueron analizados por un mismo profesional (DA y MA, respectivamente. Para la valoración de la biopsia hepática se utilizó la escala METAVIR. El valor medio de rigidez en pacientes sin fibrosis o con fibrosis leve (F0-F1 y en los pacientes con fibrosis avanzada o cirrosis (F3-F4 fue 6.8 ± 3.0 kPa y 21.0 ± 15.1 kPa, respectivamente (con diferencia significativa, p < 0.01. Las áreas debajo de la curva ROC definieron los niveles de corte en cada grupo. Con independencia del diagnóstico etiológico de enfermedad hepática, hallamos una correlación positiva, en todos los pacientes, entre rigidez hepática medida por elastografìa y grado de fibrosis hepática en la biopsia. En conclusión, podemos considerar que el Fibroscan® es un método no invasivo, seguro, fácil y rápido, que lo convierte en la alternativa a la biopsia para identificar fibrosis significativa o cirrosis.

Ultrasonography and prostate-specific antigen (PSA) in differential diagnosis of prostate cancer and benign prostatic hyperplasia

International Nuclear Information System (INIS)

Mechev, D.S.; Shcherbyina, O.V.; Yatsik, V.Yi.; Gladka, L.Yu.

2003-01-01

The purpose of the work is analysis of diagnostic possibilities of transrectal ultrasonography and PSA in differential diagnosis of prostate cancer and benign prostatic hyperplasia. 142 patients have been investigated by transrectal ultrasonography. he transrectal ultrasonography and PSA are sensible tests in diagnosis of prostate cancer and in differential diagnosis of benign prostatic hyperplasia and prostate cancer

Relative contribution of digital rectal examination and transrectal ultrasonography in interpreting serum prostate-specific antigen values for screening prostate cancer in Arab men

International Nuclear Information System (INIS)

Sheikh, M.; Sinan, T.; Hussein, Ali Y.T.; Kehinde, Elijah O.; Al-Hunayan, Adel A.; Anim, Jehoram T.

2007-01-01

This study was conducted to determine the utility of digital rectal examination (DRE), transrectal ultrasonography (TRUS) and serum prostate-specific antigen (PSA) in the diagnosis of prostate cancer in men in Arabia, an are of the world with a relatively low incidence of this disease. 329 patients suspected of having prostate cancer on account of raised serum PSA level (>4 ng/ml), DRE or TRUS findings, underwent TRUS-guided prostate biopsy. Raised PSA individually as well as combined, or a lesion suspicious of carcinoma on DRE or TRUS was recorded as PSA (+), DRE (+) or TRUS (+), respectively. The contribution of DRE, TRUS and serum PSA to the diagnosis of prostate cancer was analysed. Of the 329 patients who had prostate biopsies 109 cases (33.1%) had PCa. Of these 109 patients 56 (51%) had DRE (+), 77 (42%) ha d TRUS (+) and 49 (66%) had both DRE (+) and TRUS (+). Statistical analysis revealed that DRE (+) tripled the probability for cancer. PSA over a range of 10-50 ng/mL demonstrated an increasing cancer probability ranging from 2to 3 fold. TRUS (+) was only significantly associated with cancer risk if PSA was elevated. The presence of all three factors increased the cancer probability by 6 to 7 fold. TRUS findings are dependent on PSA for interpretation while DRE (+) with elevated PSA makes PCa more likely. (author)

Proper Measurement of the Prostate Volume by Transrectal Ultrasound: Experimental Study about the Prostate with Focal Intravesical Protrusion of the Enlarged Central Gland

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Moon, Sung Kyoung; Kim, Hyoung Jung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Kyung Hee University Hospital, Seoul (Korea, Republic of)

2008-06-15

To evaluate the proper volume measurement of prostate with focal intravesical protrusion of enlarged central gland by comparison between methods using craniocaudal length from top of protruded central gland and from prostate base near bladder neck to prostate apex. We made 20 prostate models with focal intravesical protrusion (volume range: 20{approx}50 mL, height of protrusion: about 1 cm) using devil's tongue jelly. Two radiologists measured volume of models 3 times by two kinds of methods using craniocaudal length from top of protruded central gland (method 1) and from prostate base near bladder neck (method 2) by transrectal ultrasound. The accuracy of volume measurement of models was evaluated statistically by comparing their average volume to true volume. Intra- and interobserver agreement was also evaluated. Average true volume of models was 31.05 mL. Each average volume using method 1 by two observers was 37.07 mL and 38.56 mL. Each average volume using method 2 was 30.69 mL and 31.55 mL. Volume measurement using method 2 was approximated to true volume of prostate statistically (p = .654, .823). There was no significant inter- and intra-observer variation in both methods. To measure the accurate volume of prostate with focal intravesical protrusion of enlarged central gland, its craniocaudal length should be measured from prostate base near bladder neck

Post-treatment biopsy results following permanent transrectal ultrasound-guided interstitial brachytherapy in early stage prostate cancer

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Prestidge, Bradley R.; Blasko, John C.; Grimm, Peter D.; Hoak, David C.; Cavanagh, Bill; Ragde, Haakon

1995-01-01

PURPOSE/OBJECTIVE: Although some controversy remains, most authors agree that post-treatment prostatic biopsy is the best measure of local control in prostate cancer. Brachytherapy series reporting post-implant biopsy results have been few in number, limited in size, and involving older open or combined external beam techniques. The present study was undertaken to assess local control rates as determined by post-implant prostate biopsy in a large series of consecutive patients who have received permanent interstitial brachytherapy using a contemporary transrectal ultrasound directed, transperineal, computer generated, volume technique. METHOD/MATERIALS: From January 1988 to January 1994, 402 patients received permanent I-125 (285, 71%) or Pd-103 (117, 29%) interstitial brachytherapy as primary treatment for prostatic carcinoma at the Northwest Tumor Institute. Of these, 201 have consented to prostatic biopsy at least 12 months post-implant with a median follow-up of 40 months (range of 12 to 83 months). None had received hormone manipulation. A total of 361 biopsies were performed on 201 patients with a range of 1 to 6 yearly biopsies per patient; 91 receiving multiple biopsies. The other 201 patients were either unable (for geographic reasons) or unwilling to submit for biopsy. However, all patients with a rising PSA or clinical suspicion of recurrence underwent biopsy when possible. The 201 biopsy patients presented with a median age of 69 (range 47 to 89). Stages included 51 T1 (25%), 125 T2a (62%), 22 T2b (11%), and 3 T2c (1%). Gleason sums included 69 2-4 (34%), 117 5-6 (58%), 15 7-10 (7%), and 2 ungraded (1%). The initial PSA was 6.6 (range 0.7 to 74.6). There was no significant difference in the presenting characteristics or implant parameters between those patients biopsied and those that were not. 143 received I-125 (71%) prescribed to a minimum peripheral dose of 160 Gy with a median activity of 35.5 mCi, and 58 (29%) received Pd-103 prescribed to a

WE-A-17A-11: Implanted Brachytherapy Seed Movement Due to Transrectal Ultrasound Probe-Induced Prostate Deformation

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Liu, D; Usmani, N; Sloboda, R [Cross Cancer Institute, Edmonton, Alberta (Canada); University of Alberta, Edmonton, Alberta (Canada); Meyer, T; Husain, S; Angyalfi, S [Tom Baker Cancer Centre, Calgary, Alberta (Canada); University of Calgary, Calgary, Alberta (Canada); Kay, I [Canterbury District Health Board, Christchurch (New Zealand)

2014-06-15

Purpose: To characterize the movement of implanted brachytherapy seeds due to transrectal ultrasound probe-induced prostate deformation and to estimate the effects on prostate dosimetry. Methods: Implanted probe-in and probe-removed seed distributions were reconstructed for 10 patients using C-arm fluoroscopy imaging. The prostate was delineated on ultrasound and registered to the fluoroscopy seeds using a visible subset of seeds and residual needle tracks. A linear tensor and shearing model correlated the seed movement with position. The seed movement model was used to infer the underlying prostate deformation and to simulate the prostate contour without probe compression. Changes in prostate and surrogate urethra dosimetry were calculated. Results: Seed movement patterns reflecting elastic decompression, lateral shearing, and rectal bending were observed. Elastic decompression was characterized by anterior-posterior expansion and superior-inferior and lateral contractions. For lateral shearing, anterior movement up to 6 mm was observed for extraprostatic seeds in the lateral peripheral region. The average intra-prostatic seed movement was 1.3 mm, and the residual after linear modeling was 0.6 mm. Prostate D90 increased by 4 Gy on average (8 Gy max) and was correlated with elastic decompression. For selected patients, lateral shearing resulted in differential change in D90 of 7 Gy between anterior and posterior quadrants, and increase in whole prostate D90 of 4 Gy. Urethra D10 increased by 4 Gy. Conclusion: Seed movement upon probe removal was characterized. The proposed model captured the linear correlation between seed movement and position. Whole prostate dose coverage increased slightly, due to the small but systematic seed movement associated with elastic decompression. Lateral shearing movement increased dose coverage in the anterior-lateral region, at the expense of the posterior-lateral region. The effect on whole prostate D90 was smaller due to the subset

Addition of Ceftriaxone and Amikacin to a Ciprofloxacin plus Metronidazole Regimen for Preventing Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial

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Mohammad-Hossein Izadpanahi

2017-01-01

Full Text Available Background. The objective of this study was to evaluate the efficacy of adding single doses of ceftriaxone and amikacin to a ciprofloxacin plus metronidazole regimen on the reduction of infectious complications following transrectal ultrasound-guided prostate biopsy (TRUS Bx. Materials and Methods. Four hundred and fifty patients who were candidates for TRUS Bx were divided into two groups of 225 each. The control group received ciprofloxacin 500 mg orally every 12 hours together with metronidazole 500 mg orally every 8 hours from the day prior to the procedure until the fifth postoperative day. In the second group, single doses of ceftriaxone 1 g by intravenous infusion and amikacin 5 mg/kg intramuscularly were administered 30–60 minutes before TRUS Bx in addition to the oral antimicrobials described for group 1. The incidence of infection was compared between the groups. Results. The incidence of infectious complications in the intervention group was significantly lower than that in the control group (4.6% versus 0.9%, p=0.017. Conclusion. The addition of single doses of intramuscular amikacin and intravenously infused ceftriaxone to our prophylactic regimen of ciprofloxacin plus metronidazole resulted in a statistically significant reduction of infectious complications following TRUS Bx.

A comparison of pain control and complications using three different ways of anesthesia in patients undergoing transrectal ultrasound-guided prostate biopsy

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Hamid Mazdak

2018-01-01

Full Text Available Background: We aim to compare the degree of pain control and complications in three types of anesthesia using periprostatic nerve block (PPNB plus intrarectal local anesthesia (IRLA, low-dose spinal anesthesia, and intravenous (IV sedation in patients undergoing transrectal ultrasound (TRUS-guided prostate biopsy. Materials and Methods: In this clinical trial study, 106 patients were participated from December 2015 to December 2016 at Alzahra Hospital, Isfahan, Iran. Patients were randomly allocated into three groups to receive PPNB plus IRLA (n = 36, low-dose spinal anesthesia (n = 35 and IV sedation (n = 35 before TRUS-guided prostate biopsy. Pain scores were recorded using a 10 point visual analog scale right after the biopsy was done. Early and late complications were assessed using a questionnaire after the procedure and in follow-up of patients. Results: Overall, the pain score in the low-dose spinal anesthesia group was significantly lower than PPNB plus IRLA and IV sedation groups (P < 0.001. The differences in pain scores between PPNB plus IRLA group and IV sedation group were not significant (P = 0.30. Urinary retraction and fever were significantly more frequent in low-dose spinal anesthesia and IV sedation, retrospectively (P = 0.04, P = 0.03. No significant difference in late complications was found among the groups. Conclusion: This study demonstrates that low-dose spinal anesthesia is superior to PPNB plus IRLA and IV sedation in terms of pain controlling and was associated with higher tolerance of the examination and patient comfort.

Combination of Tramadol and Lidocaine for Pain Control During Transrectal Ultrasound-guided Prostate Biopsy: A Randomized Double-blinded Study.

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Sen, Haluk; Seckiner, Ilker; Bayrak, Omer; Sen, Elzem; Erturhan, Sakip; Yagci, Faruk

2015-06-01

To evaluate the efficacy of tramadol, lidocaine, and a combination of tramadol with lidocaine in pain relief using periprostatic nerve block technique by guidance of transrectal ultrasound (TRUS) before the prostate biopsy (PBx). For the indication of TRUS-PBx, the patients with a prostate-specific antigen (PSA) level >4.0 ng/mL or abnormal digital examination findings were selected. The patients were randomized through random method. Group 1: patients were administered 5 mL of 2% lidocaine; group 2: patients were administered 5 mL of 25-mg tramadol; and group 3: patients were administered 5 mL of 2% lidocaine + 25-mg tramadol. The procedures were completed in 10 minutes, and a visual pain scale was administered to the patients to question the pain severity. TRUS-guided PBx was performed in 60 patients with an age range of 57-77 years (mean age, 66.2 ± 7.49 years) and a PSA range of 1-1000 ng/mL. The mean PSA level of the groups was 28.5 (±7.5), 16.1 (±5.0), and 14.9 (±2.9) ng/mL, respectively. The postprocedural pain scores by visual pain scale were 4.6 ± 1.2, 5.4 ± 1.2, and 3.6 ± 0.9 in lidocaine, tramadol, and lidocaine + tramadol groups, respectively. Periprostatic nerve block is the current golden standard method owing to pain management and comfort provided, independent of the patient age and the number of core biopsies. We suggest that tramadol may also be used in this field to achieve better pain management by improving lidocaine's effect or as an alternative to lidocaine. Copyright © 2015 Elsevier Inc. All rights reserved.

[Changes in prostatic circulation in response to laser therapy and magnetic therapy in patients with benign prostatic hyperplasia].

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2005-01-01

The results of preoperative preparation were analysed in 59 patients with prostatic benign hyperplasia (PBH) subjected to TUR. Treatment outcomes were assessed by transrectal ultrasound (color Doppler mapping) in two groups of patients. Group 1 received combined therapy including transrectal laser radiation of the prostate, group 2--transrectal magnetotherapy. The analysis showed that laser radiation reduced insignificantly the size of the prostate and adenomatous node, improved microcirculation and circulation in the prostate. This resulted in relief of inflammation and reduction of the number of postoperative inflammatory complications. Transrectal magnetotherapy has a positive effect on vascularization and hemodynamics of the prostate, local immunity, contamination of the tissues with pathogenic flora.

Prostatic carcinoma. Diagnostic and stating: MR imaging. Cancer de la prostate Diagnostic et bilan: role de l'imagerie

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Roy, C; Spittler, G; Jacqmin, D [Centre Hospitalier Universitaire, 67 - Strasbourg (FR); Morel, M [Clinique Saint-Francois, 67 Haguenau (FR)

1991-01-01

Prostatic carcinoma is the second most commun cause of cancer death over 60 years. It is suspected by digital examination and prostatic specific antigen dosage. Transrectal ultrasound shows the tumor as an hypoechoic lesion. Sensitivity is good but specificity is low. Transrectal biopsy of prostate guided by transrectal ultrasound made the diagnosis. At present, MR Imaging is the most accurate diagnostic modality for loco-regional staging of prostatic carcinoma.

Lateral decubitus position vs. lithotomy position: which is the best way to minimize patient’s pain perception during transrectal prostate biopsy?

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Phil Hyun Song

Full Text Available ABSTRACT Introduction Considering the distinctive nature in terms of psychological stress and anal tone of position which is generally selected between lithotomy and left lateral decubitus (LLD, we postulated its effect on pain perception during biopsy, and investigated their association. Materials and Methods A prospective study for comparison of two biopsy positions which were perform in a different working day was conducted for 208 men (lithotomy position=86, LLD=122. The decision on the position was made solely based on the patient’s preference for the biopsy day, and all procedures were performed according to the identical protocol (12-core biopsy with intrarectal lidocaine gel, probe, and needle. The maximal degree of pain during the entire process was assessed using a visual analogue scale (VAS, immediately after biopsy. After propensity matching, a total of 152 patients were finally selected (lithotomy group=76, LLD=76, then peri-biopsy parameters were compared. Results Between groups, no differences were observed across all variables including age, obesity, prostate volume, serum PSA, international prostate symptom score, and cancer detection rate, except mean (±standard deviation VAS score (3.89±2.01 vs. 4.58±2.22, p=0.049. VAS score showed significant association solely with patient’s position (Pearson’s coefficient=-0.165, p=0.042. In multiple linear regression models regarding the effect of clinical variables on VAS score, patient position was a single independent predictor favoring lithotomy position to decrease perceived pain (B=-0.928, p=0.024. Conclusions These data suggest lithotomy position as a proper way to perform transrectal prostate biopsy with routine use of topical lidocaine gel in comparison with conventional LLD position.

Usefulness of transrectal ultrasound in diagnosing prostate cancer: comparison with digital rectal examination, prostate-specific antigen and prostate-specific antigen density

International Nuclear Information System (INIS)

Yoon, Jung Hwan; Kim, Bo Hyun; Choi, Sang Hee; Kim, Seung Hoon; Choi, Han Yong; Chai, Soo Eung; Yoon, Hye Kyung; Lee, Soon Jin; Choo, In Wook; Kim, Bo Kyung

1998-01-01

To determine the usefulness of transrectal ultrasonography (TRUS) in diagnosing prostate cancer by comparing the sensitivity, specificity, accuracy, and positive and negative predictive values of TRUS with those of serum prostate-specific antigen (PSA), prostate-specific antigen density (PSAD) and digital rectal examination (DRE). Two hundred and ten consecutive patients underwent TRUS-guided prostate biopsy due to elevated PSA and/or abnormal findings on TRUS or DRE. The TRUS findings were analyzed and correlated with pathological diagnosis. PSAD was calculated by dividing the serum PSA level by the prostate volume calculated on TRUS. The sensitivity, specificity, accuracy, and positive and negative predictive values of TRUS were compared with those of PSA, PSAD and DRE. Using ROC curve analysis, the combinations of these diagnostic methods were also evaluated for the determination of efficacy in diagnosing prostate cancer. The sensitivity and specificity of serum PSA (cut-off level, 4ng/ml), PSAD (cut-off level, 0.15ng/ml/cm 3 ), DRE, and TRUS were 96%/17%, 96%/37%, 72%/62%, and 89%/68%, respectively. On TRUS, the sensitivity and specificity of low echoic lesions and those of irregular outer margin were 89%/69%, and 60%/90%, respectively. TRUS was statistically more accurate than other diagnostic methods. Of the combinations of diagnostic methods, TRUS and PSAD were most accurate. TRUS demonstrated lower sensitivity but higher specificity than PSA or PSAD. Although it is an accurate modality for the diagnosis of prostate cancer, it cannot be used as a confirmative test due to its relatively low positive predictive value. A combination of diagnostic methods and random biopsy is needed in patients in whom prostate cancer is suspected.=20

Listening to music during transrectal ultrasound-guided prostate biopsy decreases anxiety, pain and dissatisfaction in patients: a pilot randomized controlled trial.

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Chang, Yun Hee; Oh, Tae Hoon; Lee, Jae Whan; Park, Seung Chol; Seo, Ill Young; Jeong, Hee Jong; Kwon, Whi-An

2015-01-01

To determine whether listening to music during transrectal ultrasound (TRUS)-guided 12-core needle prostate biopsy decreases anxiety, pain and dissatisfaction among patients and results in a more comfortable and better tolerated procedure. 76 male patients who underwent TRUS-guided prostate biopsy between March 2013 and June 2014 were randomized into the following groups: no music (group I, n = 38) or classical music (group II, n = 38) during the procedure. Before TRUS-guided prostate biopsy, lidocaine gel was instilled into the rectum. Patient anxiety levels were quantified using the State-Trait Anxiety Inventory. A visual analog scale (0-10) was used for self-assessment of satisfaction, discomfort and willingness among patients to have a repeat TRUS-guided prostate biopsy. Demographic characteristics, mean age, procedure duration and procedure indications did not differ statistically between the two groups. The mean anxiety level and mean pain score of group II were significantly lower than those of group I (p = 0.001 and p = 0.003, respectively). Group II also had a significantly higher mean satisfaction score than group I (p = 0.007). Before the procedure, heart rate and systolic blood pressure were similar in groups I and II; however, after the procedure, levels were lower in group II than in group I (heart rate, p = 0.014; systolic blood pressure, p = 0.011). Listening to music during TRUS-guided prostate biopsy significantly reduced patients' feelings of pain, discomfort and dissatisfaction. Music can serve as a simple, inexpensive and effective adjunct to sedation during TRUS-guided prostate biopsy. We recommend playing music during TRUS-guided prostate biopsy. 2014 S. Karger AG, Basel

Cromoendoscopia com azul de metileno para diagnóstico de esôfago de Barrett

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Saporiti Marcela Rocha Loures

2003-01-01

Full Text Available RACIONAL: O esôfago de Barrett é uma condição na qual a mucosa escamosa esofágica é substituída por metaplasia intestinal especializada, que predispõe o paciente ao desenvolvimento de adenocarcinoma esofágico. Este é precedido por displasia e carcinoma precoce; o rastreamento dessas lesões faz-se através de endoscopias digestivas periódicas com biopsias randomizadas. A incidência aumentada desse, tem despertado interesse no desenvolvimento de novas técnicas endoscópicas, como a cromoendoscopia com azul de metileno, para melhorar a identificação do esôfago de Barrett e suas complicações. OBJETIVO: Determinar se as biopsias dirigidas pela cromoendoscopia com azul de metileno oferecem vantagem em relação ao método convencional na detecção do esôfago de Barrett. MATERIAL E MÉTODO: Estudaram-se 45 pacientes com diagnóstico prévio de esôfago de Barrett, todos submetidos a dois exames de endoscopia digestiva alta com biopsias, em intervalo de 4 semanas, um convencional e outro com aplicação do corante, no período entre abril e outubro de 2002. RESULTADOS: Os resultados histológicos das biopsias de todos os exames foram comparados. Observou-se sensibilidade de 62,5%, especificidade de 15,4%, valor preditivo positivo de 57,7% e valor preditivo negativo de 18,2%. Não houve diferença significativa quanto ao número de biopsias. O tempo de duração da técnica de cromoendoscopia foi significativamente maior quando comparado ao da técnica convencional. CONCLUSÃO: Não se observou vantagem na utilização da cromoendoscopia em relação à técnica randomizada no diagnóstico do esôfago de Barrett.

The diagnostic ability of an additional midline peripheral zone biopsy in transrectal ultrasonography-guided 12-core prostate biopsy to detect midline prostate cancer

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Inpyeong Hwang

2016-01-01

Full Text Available Purpose: The goal of this study was to evaluate the diagnostic effect of adding a midline peripheral zone (PZ biopsy to the 12-core biopsy protocol used to diagnose prostate cancer (PC, and to assess the clinical and pathologic characteristics of midline-positive PC in order to identify a potential subgroup of patients who would require midline PZ biopsy. Methods: This study included 741 consecutive patients who underwent a transrectal ultrasonography-guided, 12-core prostate biopsy with an additional midline core biopsy between October 2012 and December 2013. We grouped patients by the presence or absence of PC and subdivided patients with PC based on the involvement of the midline core. The clinical characteristics of these groups were compared, including serum prostate-specific antigen (PSA concentrations, PSA density, and pathological features in the biopsy specimens. Results: PC was detected in 289 patients (39.0%. Among the PC patients, 66 patients (22.8% had midline PC. No patients were diagnosed with PC based only on a midline core. The Gleason scores, number of positive cores, tumor core length, serum PSA concentrations, and PSA density were significantly higher in patients with midline-positive PC (P<0.001. Furthermore, significant cancer was more frequent in the midline-positive group (98.5% vs. 78.0%. Conclusion: Patients showing a positive result for PC in a midline PZ biopsy were more likely to have multiple tumors or large-volume PC with a high tumor burden. However, our data indicated that an additional midline core biopsy is unlikely to be helpful in detecting occult midline PC.

The criteria for the decision of transrectal US-guided prostate biopsy: Can we reduce the number of unnecessary biopsies?

International Nuclear Information System (INIS)

Cho, Joon Hyung; Cho, Jae Ho; Ahn, Jay Hong; Chang, Jay Chun

2001-01-01

To establish the criteria which can safely reduce the number of unnecessary biopsies by comparing the transrectal ultrasonography (TRUS) findings, serum prostate-specific antigen (PSA), and prostate specific antigen density (PSAD) in the decision of criteria for the prostatic biopsy using TRUS. Two hundred and twenty patients underwent TRUS- guided prostate biopsy due to elevated PSA and/or focal nodule on TRUS were included. Sixty five (27.5%) patients were confirmed as prostate cancer, and remained 155 (70.5%) patients were reported as benign diseases including benign prostate hyperplasia. The sensitivity, specificity and accuracy of TRUS, PSA and PSAD were evaluated and the single criterion or the combination of the criteria which can safely reduce the unnecessary biopsies without missing prostatic cancer were investigated. The sensitivity, specificity and accuracy of TRUS, PSA (cut-off value, 4 ng/ml) and PSAD (cut-off level, 0.2 ng/ml/cm 3 ) were 78.5%/95.4%/95.4%/27.8%/51.6%/64/5%, 42.7%/64.5%/73.6%, respectively. PSAD cut-off level 0.2 ng/ml/cm 3 was the most excellent single criterion for the decision of prostatic biopsy and the number of unnecessary biopsies was 100 cases. But 3 cases of prostatic cancer which the PSAD level was below 0.2 ng/ml/cm 3 were included and in all these 3 cases, a focal nodule was detected on TRUS. Therefore, we applied these two criteria at once and the biopsies of 30 cases (13.6%) are unnecessary. With the single criterion, we could not obtain the satisfactory results but by the combinations of criteria (TRUS and PSAD), 30 (13.6%) cases are unnecessary biopsies without missing cancer. We think that the short term follow-up may be a substitute for the immediate when nodular lesion is suspicious on TRUS and serum PSAD level is below 0.2 ng/ml/cm 3 .

Leishmaniasis mucosa y otras lesiones destructivas centrofaciales

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G. Rodríguez

1994-12-01

Full Text Available Varias enfermedades producen lesiones del área centrofacial. Una de las más frecuentes en nuestro medio es la leishmaniasis destructivas mucosa. Como el INS es un centro de estudio de leishmaniasis, se atendieron pacientes o sus biopsias con afecciones del macizo centrofacial, primariamente remitidas con el diagnóstico clínico de leihsmaniasis mucosa. En un período de 7 años (1987-1993, se estudiaron 134 biopsias de estos pacientes. El diagnóstico de leishmaniasis mucosa fue definitivo en 26 casos, por demostración del amastigote con la coloración de hematoxilina eosina y el mismo diagnóstico se estableció por patrón histopatológico solamente, en 27 casos. Una técnica inmunoenzimática para demostrar los amastigotes no fue satisfactoria. La perforación banal del tabique nasal (52 biopsias es la entidad que el clínico y el patólogo confunden con mayor frecuencia con la leishmaniasis mucosa. Otras entidades demostradas fueron la paracoccidioidomicosis (3, histoplasmosis (2, rinosporidiosis (2. esporotricosis (l, tuberculosis bucal (3, lepra leprornatosa (l, escleroma nasal (2, granulomatosis de Wegener (2, linfomas angiocéntricos (4, aspiración crónica de cocaína (l, y carcinoma escamocelular palatino (1. La biopsia, luego de la historia clínica, es el pilar esencial para identificar y manejar adecuadamente estas lesiones, que pueden originar destrucción facial grave, a veces letal, si no se dispone del diagnóstico preciso y del tratamiento oportuno.

Frecuencia relativa de carcinoma escamoso y adenocarcinoma esofágicos en una serie de biopsias endoscópicas realizadas en Rosario, Argentina Relative frequency of esophageal squamous carcinoma and adenocarcinoma in a series of endoscopic biopsies performed in Rosario, Argentina

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Ariel Enrique Naves

2007-12-01

Full Text Available OBJETIVOS: Determinar en una serie de biopsias endoscópicas esofágicas consecutivas registradas en un laboratorio de anatomía patológica de la ciudad de Rosario, Argentina, la frecuencia relativa de adenocarcinoma y carcinoma escamoso, comparando los períodos 1992-1999 y 2000-2006. Verificar si se observa un aumento en la frecuencia relativa de adenocarcinoma esofágico con respecto al carcinoma escamoso, similar al notificado en otros países occidentales. MÉTODOS: Se estudiaron las biopsias endoscópicas esofágicas con diagnóstico de adenocarcinoma y carcinoma escamoso infiltrantes, y de esófago de Barrett (EB realizadas entre 1992 y 2006. Se compararon las frecuencias relativas de estos cánceres en los períodos 1992-1999 y 2000-2006 por la prueba de la Z y se analizó la distribución por edad y sexo mediante la prueba de la ji2, con un nivel de significación (alfa de 0,05. RESULTADOS: Se detectaron, en total, 125 carcinomas escamosos y adenocarcinomas infiltrantes. La frecuencia relativa adenocarcinoma/carcinoma escamoso fue 0,33/0,67 en toda la serie, 0,28/0,72 en el período 1992-1999 y 0,38/0,62 en el período 2000-2006. Las diferencias no fueron estadísticamente significativas. Los hombres representaron 75,6% de los casos de adenocarcinoma y 57,1% de los de carcinoma escamoso; esta diferencia resultó significativa (POBJECTIVES: To determine the relative frequency of adenocarcinoma and squamous carcinoma in a series of endoscopic biopsies of the esophagus registered in consecutive order in a pathology laboratory in the city of Rosario, Argentina, during two time periods: 1992-1999 and 2000-2006. To determine if the relative frequency of esophageal adenocarcinoma has increased over that of squamous carcinoma, in keeping with the trends noted in other Western countries. METHODS: We studied the endoscopic esophageal biopsies diagnosed with infiltrating adenocarcinoma and squamous carcinoma and Barrett's esophagus (BE between

The effect of ultrasound-guided compression immediately after transrectal ultrasound-guided prostate biopsy on postbiopsy bleeding: a randomized controlled pilot study.

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Park, Bong Hee; Kim, Jung Im; Bae, Sang Rak; Lee, Yong Seok; Kang, Sung Hak; Han, Chang Hee

2017-08-01

To evaluate whether ultrasound-guided compression performed immediately after transrectal ultrasound (TRUS)-guided prostate biopsy decreases bleeding complications. We prospectively evaluated a total of 148 consecutive patients who underwent TRUS-guided prostate biopsy between March 2015 and July 2016. Systematic 12-core prostate biopsy was performed in all patients. Of these, 100 patients were randomly assigned to one of two groups: the compression group (n = 50) underwent TRUS-guided compression on bleeding biopsy tracts immediately after prostate biopsy, while the non-compression group (n = 50) underwent TRUS-guided prostate biopsy alone. The incidence rate and duration of hematuria, hematospermia, and rectal bleeding were compared between the two groups. The incidence rates of hematuria and hematospermia were not significantly different between the two groups (60 vs. 64%, p = 0.68; 22 vs. 30%, p = 0.362, respectively, for compression vs. non-compression group). The rectal bleeding incidence was significantly lower in the compression group as compared to the non-compression group (20 vs. 44%, p = 0.01). However, there were no significant differences in the median duration of hematuria, hematospermia, or rectal bleeding between the two groups (2, 8, and 2 days vs. 2, 10, and 1 days, p > 0.05, respectively, for compression vs. non-compression group). TRUS-guided compression [p = 0.004, odds ratio (OR) 0.25] and patient age (p = 0.013, OR 0.93) were significantly protective against the occurrence of rectal bleeding after prostate biopsy in multivariable analysis. Although it has no impact on other complications, ultrasound-guided compression on bleeding biopsy tracts performed immediately after TRUS-guided prostate biopsy is an effective and practical method to treat or decrease rectal bleeding.

A quantitative analysis of two-dimensional manually segmented transrectal ultrasound axial images in planning high dose rate brachytherapy for prostate cancer

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Dabić-Stanković Kata

2017-01-01

Full Text Available Background/Aim. Prostate delineation, pre-planning and catheter implantation procedures, in high-dose rate brachytherapy (HDR-BT, are commonly based on the prostate manually segmented transrectal ultrasound (TRUS images. The aim of this study was to quantitatively analyze the consistency of prostate capsule delineation, done by a single therapist, prior to each HDR-BT fraction and the changes in the shape of the prostate capsule during HDR-BT, using two dimensional (2D TRUS axial image. Methods. A group of 16 patients were treated at the Medical System Belgrade Brachytherapy Department with definitive HDRBT. The total applied median dose of 52 Gy was divided into four individual fractions, each fraction being delivered 2– 3 weeks apart. Real time prostate axial visualization and the manual segmentation prior to each fraction were performed using B-K Medical ultrasound. Quantitative analyses, analysis of an area and shape were applied on 2D-TRUS axial images of the prostate. Area analyses were used to calculate the average value of the cross-sectional area of the prostate image. The parameters of the prostate shape, the fractal dimension and the circularity ratio of the prostate capsule contour were estimated at the maximum axial cross section of the prostate image. Results. The sample group consisted of four phases, each phase being performed prior to the first, second, third and fourth HDR-BT fraction, respectively. Statistical analysis showed that during HDR-BT fractions there were no significant differences in the average value of area, as well as in the maximum shape of prostate capsule. Conclusions. Quantitative analysis of TRUS axial prostate segmented images shows a successful capsule delineation in the series of manually segmented TRUS images, and the prostate maximum shape remaining unchanged during HDR-BT fractions.

52 Elective Abdominal Ultrasonography by Surgeons at MNH, Dar ...

African Journals Online (AJOL)

user

2006-04-01

USS) is an important diagnostic tool in most specialties of .... changes or could be neuronal in origin; USS detects only anatomical changes. ... with that of transrectal imaging but is limited by the pubic bone5. Transrectal imaging ...

A comparison of prostate tumor targeting strategies using magnetic resonance imaging-targeted, transrectal ultrasound-guided fusion biopsy.

Science.gov (United States)

Martin, Peter R; Cool, Derek W; Fenster, Aaron; Ward, Aaron D

2018-03-01

Magnetic resonance imaging (MRI)-targeted, three-dimensional (3D) transrectal ultrasound (TRUS)-guided prostate biopsy aims to reduce the 21-47% false-negative rate of clinical two-dimensional (2D) TRUS-guided systematic biopsy, but continues to yield false-negative results. This may be improved via needle target optimization, accounting for guidance system errors and image registration errors. As an initial step toward the goal of optimized prostate biopsy targeting, we investigated how needle delivery error impacts tumor sampling probability for two targeting strategies. We obtained MRI and 3D TRUS images from 49 patients. A radiologist and radiology resident assessed these MR images and contoured 81 suspicious regions, yielding tumor surfaces that were registered to 3D TRUS. The biopsy system's root-mean-squared needle delivery error (RMSE) and systematic error were modeled using an isotropic 3D Gaussian distribution. We investigated two different prostate tumor-targeting strategies using (a) the tumor's centroid and (b) a ring in the lateral-elevational plane. For each simulation, targets were spaced at equal arc lengths on a ring with radius equal to the systematic error magnitude. A total of 1000 biopsy simulations were conducted for each tumor, with RMSE and systematic error magnitudes ranging from 1 to 6 mm. The difference in median tumor sampling probability and probability of obtaining a 50% core involvement was determined for ring vs centroid targeting. Our simulation results indicate that ring targeting outperformed centroid targeting in situations where systematic error exceeds RMSE. In these instances, we observed statistically significant differences showing 1-32% improvement in sampling probability due to ring targeting. Likewise, we observed statistically significant differences showing 1-39% improvement in 50% core involvement probability due to ring targeting. Our results suggest that the optimal targeting scheme for prostate biopsy depends on

Correlation of endorectal coil magnetic resonance, transrectal ultrasound and radical prostatectomy findings in assessing extent of prostate cancer in referred urology patients

International Nuclear Information System (INIS)

Lavoipierre, A.; Little, A.F.; Greive, K.A.; Royce, P.L.; Snow, R.M.; Frydenberg, M.

2002-01-01

Full text: The aim of this study was to compare findings at prostate MR to ultrasound findings and pathology specimens in patients who subsequently underwent radical prostatectomy. Of the 61 patients who underwent composite MR prostate imaging, 39 patients with elevated PSA levels and / or abnormal DRE findings were found to have cancer on transrectal ultrasound (TRUS) and biopsy (random sextant and targeted biopsies). MRI was performed using composite phased array and endorectal coils, using axial T1 and axial, coronal and sagittal T2 weighted images through the prostate, together with axial T1 weighted imaging through the pelvis. Fifteen patients out the 39 patients with documented cancer then underwent radical prostatectomy. The resected specimen pathology was then compared with the MR and TRUS findings. Comparison of findings at MRI with those at prostatectomy indicated approximately 82.4% correlation comparing right side and left side disease (TRUS = 80%). There was a 13.3% false positive for seminal vesicle involvement on MR (TRUS = 0%) and a 10% false negative rate on MR (TRUS 10%) compared with pathology specimens.There was a 26.7% false positive rate of extracapsular extension on MR (TRUS = 0%) and a 6.6% false negative rate on MR (TRUS = 20%) compared with the pathology specimens. Of the 39 patients who had undergone TRUS and biopsy, the disease appeared more extensive on MRI than suspected at ultrasound in 14/39 (35.9%). High resolution MR imaging of the prostate is an acceptable method for assessing the presence of prostate cancer. However, our early experience, in this small series, suggests that there is a high mis-staging of disease on MR as is the case with TRUS, although MR is better than TRUS. The results underscore the need for additional assessment with MR spectroscopy. Copyright (2002) Blackwell Science Pty Ltd

Esporotricosis. Valor diagnóstico del cuerpo asteroide

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Gerzaín Rodríguez Toro

1985-06-01

Full Text Available Un hombre de 52 años presentó lesiones costrosas, verrucosas, fisuradas, acordonadas y cicatriciales en la rodilla, pierna y pie izquierdos, de 2 años de evolución, luego de trauma contra un Arbol. Clínicamente se pensó en esporotricosis y cromomicosis. El cultivo mostró un moho negro y el examen directo hifas y esporos pigmentados, por lo cual se diagnóstico cromomicosis. La biopsia no mostró levaduras carmelitas en la inflamación granulomatosa con microabscesos de la dermis, sino cuerpos asteroides esporotricósicos por lo cual se hicieron nuevos cultivos y biopsias. Aquellos revelaron el crecimiento del mismo moho negro y de Sporothrix schenkii. En los múltiples cortes seriados de todas las biopsias se vieron cuerpos asteroides esporotricósicos y nunca se demostraron en la dermis levaduras septadas, pigmentadas tan fáciles de ver en la cromomicosis. En algunos focos se observaron esporos marrones e hifas cortas pigmentadas en las costras. El paciente curó con loduro de Potasio. Pensamos que el moho negro es un saprofito presente únicamente en las costras, originando una contaminación superficial sin repercusión clínica y difícilmente demostrable histopatológicamente, pero muy aparente en el cultivo. Este, en la cromomicosis, debe ir acompañado de biopsia que confirme la presencia de levaduras pigmentadas en la dermis. El cuerpo asteroide de la esporotricosis es específico y característico. Cuando se ve, debe insistirse en el cultivo del hongo, pero si ello no es posible, es indicio suficiente para instaurar el tratamiento específico.

Estudo histológico e ultra-estrutural das lesões hepáticas e alterações enzimáticas causadas pela intoxicação por Myoporum laetum em ovinos e bovinos.

OpenAIRE

Josiane Bonel Raposo

2004-01-01

Amostras de Myoporum laetum foram colhidas durante a primavera e verão e administradas a sete ovinos e seis bovinos em doses únicas de 20 e 30g/kg. Amostras de sangue e biopsias hepáticas foram obtidas destes animais e de 4 ovinos e 3 bovinos controles, antes e 1, 3 e 7 dias após a administração da planta. As biopsias foram analisadas histológica e ultra-estruturalmente. A partir das amostras de sangue analisaram-se os níveis séricos de GGT, AST e bilirrubina total. Os sinais clínicos, em ovi...

Escleritis nodular posterior gigante compatible con sarcoidosis ocular simulando un melanoma de la coroides

OpenAIRE

Pérez-Campagne, E.; Guex-Crosier, Y.; Schalenbourg, A.; Uffer, S.; Zografos, L.

2007-01-01

Caso clínico: Un paciente de 30 años fue enviado a nuestro servicio oncológico de referencia con el diagnóstico de melanoma amelanótico de la coroides del ojo izquierdo. Se hicieron los siguientes exámenes: oftalmoscopía, angiografía fluoresceínica, angiografía con verde de indocianina, ecografía, resonancia magnética y biopsia. Discusión: El diagnóstico de escleritis nodular posterior gigante basado en la ecografía se confirmó mediante una biopsia. Se realizó un examen médico completo buscán...

In-Bore MR-Guided Biopsy Systems and Utility of PI-RADS

NARCIS (Netherlands)

Futterer, J.J.; Moche, M.; Busse, H.; Yakar, D.

2016-01-01

A diagnostic dilemma exists in cases wherein a patient with clinical suspicion for prostate cancer has a negative transrectal ultrasound-guided biopsy session. Although transrectal ultrasound-guided biopsy is the standard of care, a paradigm shift is being observed. In biopsy-naive patients and

Fuentes de variabilidad en el diagnóstico de gastritis atrófica multifocal asociada con la infección por Helicobacter pylori1

Science.gov (United States)

Bravo, Luis Eduardo; Bravo, Juan Carlos; Realpe, José Luis; Zarama, Guillermo; Piazuelo, MarÍa Blanca; Correa, Pelayo

2014-01-01

RESUMEN Introducción El mapeo de las diferentes regiones del estómago y el número de fragmentos de mucosa gástrica disponibles para evaluación histopatológica son fuentes importantes de variación en el momento de clasificar y hacer la gradación de la gastritis crónica. Objetivos Estimar la sensibilidad del número de fragmentos de mucosa gástrica necesarios para establecer los diagnósticos de gastritis atrófica con metaplasia intestinal (MI), displasia y estado de infección por Helicobacter pylori. Además evaluar la variabilidad intra-observador en la clasificación de estas lesiones precursoras del cáncer gástrico. Materiales y métodos En una cohorte de 6 años de seguimiento se evaluaron 1,958 procedimientos de endoscopia realizados por dos gastroenterólogos. En cada procedimiento y de cada participante se obtuvieron 5 biopsias de mucosa gástrica que representaban antro, incisura angularis y cuerpo. Un único patólogo hizo la interpretación histológica de las 5 biopsias y proporcionó un diagnóstico definitivo global que se utilizó como patrón de referencia. Cada fragmento de mucosa gástrica examinado condujo a un diagnóstico individual para cada biopsia que se comparó con el patrón de referencia. La variabilidad intra-observador se evaluó en 127 personas que corresponden a una muestra aleatoria de 20% del total de endoscopias hechas a los 72 meses de seguimiento. Resultados La sensibilidad del diagnóstico de MI y displasia gástrica aumentó de manera significativa con el número de fragmentos de mucosa gástrica evaluados El sitio anatómico de mayor sensibilidad para el diagnóstico de MI y displasia fue la incisura angularis. Para descubrir H. pylori se logró alta sensibilidad con el estudio de un solo fragmento de mucosa gástrica (95.9%) y fue independiente del sitio de obtención de la biopsia. El acuerdo intra-observador para el diagnóstico de gastritis crónica fue 86.1% con valor kappa de 0.79 IC 95% (0.76-0.85). Las

Fluoroquinolone-Resistant Escherichia coli Infections after Transrectal Biopsy of the Prostate in the Veterans Affairs Healthcare System

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Elie Antoun Saade

2016-09-01

Full Text Available Background: Recent reports suggest that infections due to fluoroquinolone-resistant Escherichia coli (E. coli are an increasingly common complication of transrectal biopsy of the prostate (TBP in the United States. A better understanding of the magnitude and scope of these infections is needed to guide prevention efforts. Our objective is to determine whether the incidence of infections due to fluoroquinolone-resistant E. coli after TBP has increased nationwide in the Veterans Affairs Health Care System and to identify risk factors for infection. Methods: We performed a retrospective, observational cohort study and a nested case-control study within the US Deparment of Veterans Affairs Healthcare System. The primary outcomes were the incidence of urinary tract infection (UTI and bacteremia with E. coli and with fluoroquinolone-resistant E. coli strains within 30 days after TBP. Secondary endpoints focused on the correlation between fluoroquinolone-resistance in all urinary E. coli isolates and post-TBP infection and risk factors for infection due to fluoroquinolone-resistant E. coli infection. Results: 245 618 patients undergoing 302 168 TBP procedures from 2000 through 2013 were included in the cohort study, and 59 469 patients undergoing TBP from 2011 through 2013 were included in the nested case-control study. Between 2000 and 2013, there was a 5-fold increase in the incidence of E. coli UTI (0.18%–0.93% and a 4-fold increase in the incidence of E. coli bacteremia (0.04%–0.18% after TBP that was attributable to an increase in the incidence of fluoroquinolone-resistant E. coli UTI (0.03%–0.75% and bacteremia (0.01%–0.14%. The increasing incidence of fluoroquinolone-resistant E. coli infections after TBP occurred in parallel with increasing rates of fluoroquinolone-resistance in all urinary E. coli isolates. By multivariable logistic regression analysis, independent risk factors for fluoroquinolone

Validez de los títulos de adenosina deaminasa en el diagnóstico de la pleuresía tuberculosa en el Hospital San Juan de Dios

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Azael de Jesús Hernández Castilla

1995-01-01

Full Text Available Se tomaron 46 pacientes adultos hospitalizados y ambulatorios con síndrome de derrame pleural y con aceptación para la práctica de toracentesis, biopsia pleural y estudio bioquímico, Se les practicó estudio citoquímico de líquido pleural; determinación de proteínas totales y de DLH en suero sanguíneo; luego biopsia pleural con estudio microscopio y examen directo y cultivo para BK; además  examen directo y cultivo para BK en líquido pleural y determinación de adenosina deaminasa en líquido pleural y suero sanguíneo.

High concordance of findings obtained from transgluteal magnetic resonance imaging - and transrectal ultrasonography-guided biopsy as compared with prostatectomy specimens.

Science.gov (United States)

Steurer, Stefan; Rico, Sebastian Dwertmann; Simon, Ronald; Minner, Sarah; Tsourlakis, Maria Christina; Krech, Till; Koop, Christina; Graefen, Markus; Heinzer, Hans; Adam, Meike; Huland, Hartwig; Schlomm, Thorsten; Sauter, Guido; Lumiani, Agron

2017-09-01

To determine the utility of our transgluteal magnetic resonance imaging (MRI)-guided prostate biopsy approach. A total of 960 biopsy series, taken within the period of 1 year, were evaluated, including 301 MRI-guided and 659 transrectal ultrasonography (TRUS)-guided biopsies. The positivity rate and proportion of high grade cancers were significantly higher in MRI-guided than in TRUS-guided biopsies. Of 301 MRI-guided biopsies, 65.4% contained cancer while 57.2% of 659 TRUS biopsies contained cancer (P = 0.016). Gleason grade 3 + 3 = 6 disease was observed in 16.8% of 197 MRI-guided and in 36.1% of 377 TRUS-guided biopsies (P guided biopsies. In all cancers, the mean cancer surface area was 64.8 ± 51.6 mm 2 in MRI-guided biopsies as compared with 23.0 ± 31.4 mm 2 in non-MRI-guided biopsies (P guided biopsy was highest in Gleason grade 3 + 3 = 6 cancers (20.9 ± 27.9 vs 5.1 ± 10.2 mm 2 ; P guided and in 170 patients with non-MRI-guided biopsies. This comparison showed a very high but almost identical concordance of TRUS- and MRI-guided biopsies with the prostatectomy specimen findings. With both approaches, undetected high-risk cancers were present in ~10% of patients with low-risk biopsy results. A significant difference was observed, however, in the proportion of patients who had clinically insignificant cancers and who underwent surgery. The proportion of patients with Gleason grade 3 + 3 = 6 carcinoma in their prostatectomy specimen was 11.2% in the post-TRUS biopsy cohort, but only 2.5% in the post-MRI biopsy cohort (P = 0.021). MRI-guided transgluteal prostate biopsy has a high detection rate for high-risk carcinomas, while the risk of detecting clinically insignificant carcinomas appears to be reduced. This may by itself lead to a reduction of unnecessary prostatectomies. Overtreatment may be further avoided by better applicability of molecular testing to MRI-guided biopsies because of the excessive amount of tissue available for analysis, especially in

In-Bore MR-Guided Biopsy Systems and Utility of PI-RADS.

Science.gov (United States)

Fütterer, Jurgen J; Moche, Michael; Busse, Harald; Yakar, Derya

2016-06-01

A diagnostic dilemma exists in cases wherein a patient with clinical suspicion for prostate cancer has a negative transrectal ultrasound-guided biopsy session. Although transrectal ultrasound-guided biopsy is the standard of care, a paradigm shift is being observed. In biopsy-naive patients and patients with at least 1 negative biopsy session, multiparametric magnetic resonance imaging (MRI) is being utilized for tumor detection and subsequent targeting. Several commercial devices are now available for targeted prostate biopsy ranging from transrectal ultrasound-MR fusion biopsy to in bore MR-guided biopsy. In this review, we will give an update on the current status of in-bore MRI-guided biopsy systems and discuss value of prostate imaging-reporting and data system (PIRADS).

Titulação de Anticorpos Séricos Anti-Epiteliais e Células Dendríticas no Pênfigo Foliáceo Endêmico

OpenAIRE

Maria Paula do Valle Chiossi

2001-01-01

Com o propósito de colaborar na elucidação da fisiopatologia do pênfigo foliáceo endêmico (PFE), realizou-se titulação de anticorpos séricos e quantificação das células de Langerhans (CL) e células dendríticas dérmicas (CD) na pele de pacientes com PFE. Sangue e biopsia de pele de lesão ativa foram colhidos de 22 pacientes com PFE e, em 13 deles realizou-se também biopsia de pele normal não adjacente à lesão, em área não exposta ao sol. Dos 22 pacientes, 13 apresentavam a forma clínica local...

Diagnosis of Helicobacter pylori infection using urease rapid test in patients with bleeding duodenal ulcer: influence of endoscopic signs and simultaneous corporal and antral biopsies Diagnóstico de la infección por Helicobacter pylori mediante el test rápido de la ureasa en pacientes con hemorragia por úlcera duodenal: influencia de los signos endoscópicos de sangrado y de la obtención simultánea de biopsias de cuerpo y antro gástrico

Directory of Open Access Journals (Sweden)

M. Castro Fernández

2004-09-01

patients with combined antral and fundic biopsies. In group A, urease test was positive in 90.5% of patients; in group B, it was positive in 89.5% of patients, and in group C, the test turned positive in 75.4% of patients. Statistical differences were only reached when patients in group C were compared to patients in groups A and B together (p = 0.037. Conclusions: 1. The presence of either blood in the stomach or recent bleeding endoscopic signs appeared not to be the conditioning factor for the decreased sensitivity of urease test among patients with bleeding duodenal ulcer. 2. The decreased sensitivity of this test in patients with upper gastrointestinal bleeding is more evident during the resolution stage, and it does not seem to occur because of H. pylori migration from the antrum to the corporal gastric region.Introducción: la sensibilidad de los métodos diagnósticos invasivos de infección por H. pylori, especialmente el test rápido de la ureasa, disminuye en los casos de úlcera gastro-duodenal y hemorragia digestiva. Objetivos: valorar la influencia de la presencia de sangre en estómago o de signos endoscópicos de sangrado en la sensibilidad del test rápido de la ureasa en pacientes con hemorragia por úlcera duodenal, así como la influencia de la obtención de biopsias de cuerpo y antro gástrico. Pacientes y métodos: incluimos 120 pacientes, 85 varones y 35 mujeres, con edad media de 62 (18-88 años, con hemorragia por úlcera duodenal y diagnóstico endoscópico en las primeras 24 horas del ingreso. Ningún paciente había consumido antiinflamatorios no esteroideos, inhibidores de la bomba de protones o antibióticos en las dos semanas previas a la hemorragia digestiva, ni había recibido tratamiento frente a H. pylori. En este grupo seleccionado de pacientes admitimos una tasa de infección de prácticamente el 100%. Investigamos la infección por H. pylori mediante biopsias de antro (69 casos o de cuerpo y antro (51 casos gástricos para test de

Trial Comparing a Combined Regimen of Amikacin and Ciprofloxacin to Ciprofloxacin Alone as Transrectal Prostate Biopsy Prophylaxis in the Era of High Fluoroquinolone-Resistant Rectal Flora.

Science.gov (United States)

Son, Kyung Chul; Chung, Ho Seok; Jung, Seung Il; Kim, Myung Soo; Hwang, Eu Chang; Kim, Jin Woong; Kwon, Dong Deuk

2018-04-09

To investigate whether addition of amikacin to fluoroquinolone (FQ) antimicrobial prophylaxis reduces infections after transrectal ultrasound-guided prostate biopsy (TRUSPB). A total of 503 patients undergoing rectal swab were divided into three groups. Patients with FQ-sensitive rectal flora (group 1, n = 248) were administered ciprofloxacin before TRUSPB, and patients with FQ-resistant rectal flora were either administered ciprofloxacin (group 2, n = 97) or amikacin and ciprofloxacin (group 3, n = 158) before TRUSPB. Based on the rectal swab, FQ resistance was 54.9%, and extended-spectrum β-lactamase (ESBL) positivity was 17.2%. The incidence of infectious complication in group 1 was 1.6%. Groups 2 and 3, with FQ-resistant rectal flora, tended to have increased infectious complications (5.2% and 4.4%, respectively) but the difference between those results is not statistically significant. The most common pathogens of infectious complications in patients with FQ-resistant rectal flora were FQ-resistant and ESBL-producing Escherichia coli. E. coli pathogens isolated in Group 3 were amikacin-susceptible species. The operation history and ESBL positivity of rectal flora increased the incidence of infectious complications (odds ratio [OR] = 3.68; P = 0.035 and OR = 4.02; P = 0.008, respectively). DM and antibiotics exposure were risk factors for FQ resistance (OR = 2.19; P = 0.002) and ESBL positivity of rectal flora (OR = 2.96; P = 0.005), respectively. Addition of amikacin to ciprofloxacin prophylaxis could not reduce infectious complications in patients with FQ-resistant rectal flora. Despite the amikacin sensitivity of infectious complications, single-dose amikacin addition to ciprofloxacin prophylaxis has limitations. © 2018 The Korean Academy of Medical Sciences.

Efficacy and safety of fosfomycin-trometamol in the prophylaxis for transrectal prostate biopsy. Prospective randomized comparison with ciprofloxacin.

Science.gov (United States)

Lista, F; Redondo, C; Meilán, E; García-Tello, A; Ramón de Fata, F; Angulo, J C

2014-01-01

Prostate biopsy is the standardized diagnostic method for prostate cancer. However, although there is not a standardized protocol, there are recommendations in order to reduce the incidence of complications. The objective of the present work is to assess the efficacy and safety of antibiotic prophylaxis in the prostate biopsy by comparing two antibiotic regimes: two doses of fosfomycin-trometamol 3g (FMT) every 48 hours with 10 doses of oral ciprofloxacin 500 mg every 12 hours during 5 days. Randomized prospective study was performed with 671 patients who had undergone to walking transrectal ultrasound guided prostate biopsy. Patients of group A (n=312) were treated with ciprofloxacin, and patients of group B (n=359) with FMT. Efficacy and tolerability of two prophylactic regimes were compared. Urine culture was carried out at 2 weeks after biopsy. Initially, patients with asymptomatic bacteriuria were not treated with antibiotics; urine culture was repeated after 1 month, persistent bacteriuria was treated according to antibiogram. No differences between groups were found in age (P=.78), cancer presence (P=.9) or number of biopsy cylinders (P=.93). The mean number of cores obtained was 11.3 ± 3.25 (range 6-20). Digestive intolerance was observed for 9 patients (2.9%) of group A and 10 patients (2.8%) in group B. One patient (.3%) of group A showed severe allergic reaction. In total, 167 patients (24.6%) had complications: 16 (2.4%) fever, 47 (6.9%) hemospermia, 81 (11.9%) hematuria, 7 (1%) rectal bleeding and 16 (2.4%) urinary retention. No statistically differences between groups were observed (27.6% vs. 22.6%; P=.17). However, hemospermia was more frequent in group A (9.9% vs. 4.5%; P=.006). Bacteriuria after biopsy was detected in 44 patients (6.6%), being more frequent in group B patients (4.2% vs. 8.6%; P=.02) although a higher number of second treatment cycles were not needed (53.9% vs. 29%; P=.17). The likelihood of resistance to ciprofloxacin in patients

RECTAL BIOPSY IN SHEEP AND GOATS FOR MONITORING AND ANTE-MORTEM DIAGNOSIS OF SCRAPIE: NUMBER OF LYMPHOID FOLLICLES IN TWO CONSECUTIVE COLLECTIONS

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Helen Caroline Raksa

2016-07-01

O acúmulo da PrPSc em tecidos linfoides levou ao desenvolvimento de procedimentos de biopsia para o diagnóstico ante mortem da scrapie em ovinos, utilizando tecidos acessíveis como a tonsila(5 e terceira pálpebra(6, e a técnica de imuno-histoquímica (IHQ. Por outro lado, a grande área de folículos linfoides presente no reto de ovinos(7 tornou a biopsia retal uma possibilidade de diagnóstico ante mortem da scrapie. Amostras da mucosa retal têm sido colhidas e analisadas por meio de provas de IHQ para avaliar a presença de PrPSc no tecido linfoide associado à mucosa retoanal (RAMALT, do inglês Recto-Anal Mucosa Associated Lymphoid Tissue(8,9. No Brasil, o primeiro relato de scrapie foi em 1978, em um ovino Hampshire Down, importado da Inglaterra(10. Segundo a OIE, de 2008 a 2014 foram sacrificados 41 animais no país, em surtos de scrapie(11. Desde 2008, o diagnóstico de scrapie é realizado por meio da técnica de IHQ a partir de amostras do SNC e tecidos linfoides(12. Porém, no caso de tecidos linfoides associados à mucosa retal, pode haver necessidade de novas colheitas em curtos intervalos de tempo devido à escassez de tecido para o diagnóstico da doença que, segundo Leal et al.(13, deve ser de no mínimo três folículos linfoides (FL por amostra. Visando ao reconhecimento de boas técnicas para o monitoramento e o diagnóstico ante mortem da scrapie, o presente estudo teve por objetivo avaliar a quantidade de tecido linfoide associado à mucosa retal obtido pela técnica de biopsia retal e com vistas à avaliação imuno-histoquímica, bem como a possibilidade de se realizarem dois procedimentos de biopsia consecutivos, em diferentes intervalos de tempo, em ovinos e caprinos.

Statin and fibrate associed myopathy: study of eight patients Miopatia associada a estatina e fibrato: estudo de oito pacientes

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Alzira A. Siqueira Carvalho

2004-06-01

Full Text Available Lipid-lowering drugs have been occasionally associated with neuromuscular symptoms and muscle biopsy changes. We reported the clinical course and the muscle biopsy in eight patients with hyperlipoproteinemia, treated with lipid -lowering drugs (statins/fibrates. Five patients had myalgias while; in two cases there was proximal muscle weakness. All patients became asymptomatic after the withdrawal of the drug, although creatine kinase remained elevated. We performed muscle biopsy in six cases from three months to two years after suspension of the drug. We found variation in fibers diameters in all cases, with necrosis of fibers in five cases, inflammatory infiltration in one case, the presence of vacuolated fiber in one patient and ragged-red fibers in three subjects. We concluded that although the muscle biopsy findings were not specific, the prolonged use of statins and or fibrates might induce a chronic myopathy even in the absence of symptoms.As drogas redutoras de colesterol são ocasionalmente associadas a sintomas neuromusculares e alterações morfológicas observadas na biopsia muscular. Relatamos o curso clínico e achado da biopsia muscular em oito pacientes com hiperlipoproteinemia tratados com drogas redutoras de colesterol (estatinas/fibratos. Cinco pacientes tiveram mialgia e em dois havia fraqueza muscular proximal. Todos os pacientes ficaram assintomáticos após retirada da medicação embora a creatinoquinase permanecesse elevada. Analisamos a biopsia muscular em seis casos realizados entre três meses e dois anos após a suspensão da droga. Encontramos variação no calibre das fibras em todos os casos com necrose de fibras em cinco, infiltrado inflamatório em um caso, presença de vacúolos em um e "ragged red fiber" em três deles. Concluímos que, embora os achados da biopsia muscular não fossem específicos, o uso prolongado de estatinas e/ou fibratos pode induzir a uma miopatia crônica até mesmo na ausência de

El cuerpo asteroide de la esporotricosis. Especificad y diferenciación de otras formas de asteroides

Directory of Open Access Journals (Sweden)

Gerzaín Rodríguez Toro

1985-06-01

Full Text Available El análisis de 86 biopsias de esporotricosis y de biopsias de otras enfermedades granulomatosas, así como los conceptos de la literatura, permiten concluir que hay dos tipos de cuerpos asteroides: 1. lntracitoplasmáticos, situados dentro de una vacuola, en células gigantes multinucleadas de diversas enfermedades granulomatosas. Son eosinófilos y constan de radiaciones aciculares, estelares, que parten de un centro amorfo. Los ilustramos en casos de lepra lepromatosa, sarcoidosis, paracoccidioidomicosis, labomicosis y granulomas a cuerpos extraños. Son morfológicamente idénticos, inespecíficos, no ayudan a ningún diagnóstico y se originan por fagocitosis de colágeno (59 o por modificaciones del citocentro (60. 2. Cuerpos asteroides resultantes del fenómeno de Splendore-Hoeppli, que es una reacción antígeno-anticuerpo (38-40. 44 el más conspicuo de los cuales es el cuerpo asteroide esporotricósico (CAE, extracelular, situado en el centro del granuloma supurado y que consiste en una levadura central rodeada de espículas intensamente eosinófilas. Es pues específico, morfológicamente característico, permite el diagnóstico concluyente de la enfermedad y en nuestros casos lo observamos en el 20% de las biopsias. La referencia al CAE como una estructura inespecífica (47.58.61 no tiene en cuenta la morfología y la patogenia involucradas en la formación de los cuerpos asteroides. En algunas micosis como aspergilosis, candidiasis sistémica. paracoccidioidomicosis lobomicosis. granuloma tricofítico, se pueden ver imágenes asteroides alrededor de una levadura, pero la morfología general del cuadro histológico no guarda parecido alguno con la esporotricosis. Es posible ver en una biopsia cuerpos asteroides de ambos tipos y el patólogo debe ser capaz de darles el significado apropiado.

Association between Helicobacter pylori concentration and the combining frequency of histopathological findings in gastric biopsies specimens Associação entre a concentração de Helicobacter pylori e a freqüência de combinação de alterações histopatológicas em biopsias gástricas

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Gisele Alborghetti Nai

2007-09-01

histopatológico. MÉTODOS: Foram analisadas, retrospectivamente, 200 biopsias gástricas endoscópicas consecutivas com o diagnóstico de gastrite crônica. A pesquisa de H. pylori foi realizada através da coloração de Warthin-Starry e foram analisados os seguintes parâmetros (segundo o sistema de Sydney: 1. infiltração de polimorfonucleares no cório e no epitélio (atividade, graduada em leve, moderada e acentuada; 2. presença de folículos linfóides; 3. presença de metaplasia intestinal; 4. presença de atipias celulares regenerativas, graduadas em leve, moderada e acentuada; e 5. concentração de H. pylori no muco que recobre o epitélio foveolar. RESULTADOS: A associação mais freqüente foi de gastrite crônica e atividade, independente da concentração de H. pylori. Associação de cinco achados histopatológicos numa mesma biopsia não ocorreu nos casos com maior concentração de H. pylori. CONCLUSÃO: Este estudo não demonstrou associação entre a concentração de H. pylori e aumento no número de alterações histopatológicas encontradas na mucosa gástrica, mostrando ser importante referir sua presença e não sua concentração.

Muerte cerebral causada por consumo de psicofármacos

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Iglesias Rozas, José Rafael, 1942-

1987-01-01

Tres imágenes de una biopsia de un cerebro en estado de muerte cerebral causada por consumo de psicofármacos. Three pictures of a biopsy of a brain that has died because of consumption of psychoactive drugs.

Impact of preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria on the incidence of sepsis following transrectal ultrasound guided prostate biopsy

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Farrell JJ

2017-02-01

for rectal colonization with fluoroquinolone-resistant bacteria prior to transrectal prostate biopsy. The observed risk reduction in the rectal screening group trended toward, but did not achieve, statistical significance. We suggest that preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria may be a useful step toward mitigating post-prostate biopsy sepsis. Keywords: sepsis, gram-negative infections, antimicrobial stewardship, preoperative antibiotic prophylactic treatment 

Doenças de equinos na região Sul do Rio Grande do Sul

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Clairton Marcolongo-Pereira

2014-03-01

Full Text Available Foi realizado um estudo retrospectivo dos diagnósticos de causas de morte e de lesões em equinos na região Sul do Rio Grande do Sul entre 1978 e 2012. Foram revisados os protocolos de necropsia e materiais desta espécie encaminhados ao Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas no período. Foram recebidos 514 cadáveres de equinos e 1500 materiais (biopsias, órgãos, suabes, fezes, sangue e raspado de pele, totalizando 2026 materiais de equinos recebidos no período. Dos 2026 casos 467 (23,05% corresponderam a neoplasmas e lesões tumorifores, 168 (8,29% a doenças parasitárias; 135 (6,66% a doenças bacterianas, 31 (1,53% a doenças virais, 86 (4,24% a doenças causadas por fungos e oomicetos, 50 (2,47% a intoxicações e micotoxicoses, nove (0,44% a doenças metabólicas, 60 (2,96% a outras doenças e 75 (3,70% a doenças não transmissíveis do trato digestivo. Trezentos e vinte (15,79% foram classificados como doenças de etiologia indeterminada. Outros diagnósticos representaram 489/2026 (24,14% casos. Em 44/514 (8,56% das necropsias e em 91/961 (9,47% de biopsias e órgãos remetidos ao laboratório o diagnóstico foi inconclusivo, perfazendo um total de 135/1475 (9,15% casos incluídos nesta categoria. Ficou evidenciado neste trabalho a importância das lesões dermatológicas em equinos, sendo que 31,88% (642/2014 dos casos recebidos eram biopsias de lesões observadas na pele dos animais. Os principais tumores encontrados foram o sarcoide equino com 33,18% e o carcinoma de células escamosas com 7,94% das biopsias recebidas. Algumas causas de morte mais importantes diagnosticadas no período foram a leucoencefalomalacia (7,59%, a raiva (3,70%, o tromboembolismo por Strongylus vulgaris (2,33% e a erliquiose monocítica (1,75%.

Factores analíticos, antropométricos y dietéticos asociados al desarrollo de fibrosis en pacientes con enfermedad por hígado graso no alcohólico

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Sara Gómez-de-la-Cuesta

Full Text Available RESUMEN Antecedentes: la esteatohepatitis no alcohólica (EHNA mantenida en el tiempo puede conducir a estadios avanzados de enfermedad hepática y al desarrollo de hepatocarcinoma. Objetivos: evaluar los factores analíticos, antropométricos y dietéticos asociados a la presencia de fibrosis hepática, evento que más influye en supervivencia y evolución. Métodos: fueron estudiados setenta y seis pacientes diagnosticados de enfermedad por hígado graso no alcohólica mediante biopsia. Las biopsias fueron clasificadas según el NAS-score (Kleiner. Se obtuvieron parámetros analíticos, antropométricos y dietéticos y se calculó el índice no invasivo NAFLD Fibrosis Score (NFLD-FS. Se determinaron los niveles séricos de leptina, adiponectina, resistina y TNF-alfa. Resultados: cincuenta y seis pacientes eran hombres (73,7%, con una edad media de 44,5 ± 11,3 años (19-68. Pacientes con fibrosis en biopsia: 39 (51,3% (F1-F2: 84,6%; F3-4: 15,4%. Univariante: 17 mujeres (85% presentaban fibrosis, frente a 22 hombres (39% (p = 0,000. Los pacientes con fibrosis avanzada tenían mayor edad, menor recuento de plaquetas, menor albúmina sérica, mayor resistencia a la insulina (homeostatic model assessment insulin resistance, HOMA-IR, menor ingesta de lípidos, mayor nivel de leptina sérica y valores más altos de NAFLD-FS. Este índice presenta para detectar fibrosis avanzada un valor predictivo negativo del 98% y un valor predictivo positivo del 60%. Variables asociadas de forma independiente a la presencia de fibrosis (regresión logística: sexo masculino (factor protector (0,09, IC 95%, 0,01-0,7; p < 0,05 y HOMA-IR (1,7, IC 95% 1,03-2,79; p < 0,05. Conclusiones: el sexo y el HOMA-IR son los únicos factores independientes que se asociaron a la presencia de fibrosis hepática en biopsia. El NAFLD-FS es un buen marcador no invasivo para descartar la presencia de fibrosis avanzada.

Carcinoma de células escamosas intraóseo primario derivado de un tumor odontogénico queratoquístico: reporte de un caso y revisión de la literatura

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Marcelo Mardones

2014-04-01

Se describen las características clínicas, radiológicas e histológicas, discutiendo la importancia de tomar biopsia de distintas zonas de una lesión quística caracterizada por afectar amplias zonas de los huesos maxilares.

Infective complications in patients after transrectal ultrasound-guided prostate biopsy and the role of ciprofloxacin resistant Escherichia coli colonization in rectal flora.

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Hamarat, Mustafa Bilal; Tarhan, Fatih; Horuz, Rahim; Öcal, Gülfem Akengin; Demirkol, Mehmet Kutlu; Kafkaslı, Alper; Yazıcı, Özgür

2017-06-01

In the present study, we aimed to invastigate the ciprofloxacin resistance in rectal flora of the patients undergoing prostate biopsy in our department. Additionally, the possible effects of the presence of ciprofloxacin resistant bacteria in faecal flora on the risk of infective complications after the procedure as well as the effect of antibiotic prophylaxis on such infectious complications have been evaluated. A total of 142 patients undergoing transrectal ultrasound-guided prostate biopsy were included into the study program. Rectal swab samples were taken from all patients prior to biopsy. The presence of complications have been evaluated after a week following the biopsy procedure. Patients with fever were also evaluated. The possible correlation between the presence of ciprofloxacin-resistant bacteria in faecal flora and the risk of urinary tract infection development and the other complications were evaluated. E. coli bacteria were present in all cultures of rectal swab samples obtained from 142 patients prior to prostate biopsy. Of all these patients, while ciprofloxacin-resistant E. coli (CR E. coli ) grew in 76 (53.5%) patients; ciprofloxacin susceptible E. coli (CS E. coli ) was obtained in 66 (46.5%) patients. In 16 patients (11.3%), infectious complications were observed. While the infective complications were present in the 14.5% of patients with CR E. coli ; they were present in the 7.6% of patients with CS E. coli (p=0.295). High fever was observed in nine patients (6.3%). Of these nine patients, although six had CR E. coli growth as detected during culture sensitivity tests; three had CS E. coli growth in their rectal swab culture tests. Sepsis was observed in three (2.1%) of these patients with high fever. Ciprofloxacin-resistant E. coli grew in all of the rectal swab cultures obtained from these patients with sepsis. In the light of our findings we may say that, it will be appropriate to reconsider the ciprofloxacin prophylaxis and prefer to use

Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy Biopsia do linfonodo sentinela em câncer na mama localmente avançado pós-quimioterapia neoadjuvante

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Paulo Henrique Walter Aguiar

2012-12-01

Full Text Available PURPOSE: To check the rate of sentinel lymph node (SLN identification in patients with locally advanced breast cancer who underwent neoadjuvant chemotherapy comparing intraoperative contact cytology (imprint and embedded in paraffin and validation of methods. METHODS: A cross-sectional validation of diagnostic test involving 34 patients from the outpatient clinic of the Maternity School Assis Chateaubriand. The patients had locally advanced breast cancer and were treated with neoadjuvant chemotherapy. Those with clinically negative axilla underwent SLN biopsy, studied by imprint and histopathology in paraffin. All patients underwent axillary dissection and its histopathological study. RESULTS: The SLN identification rate was 85.3% (29/34. The sensitivity of imprint associated with paraffin on detection of metastasis compared to histopathology of the axillary content was 84.62% and specificity of 100% with false-negative rate of 12.01% and an accuracy of 92.77%. CONCLUSION: The search for metastases in the SLN by imprint and histopathological analysis in paraffin compared to the gold standard (axillary dissection had a low sensitivity with high rate of false negatives in our sample.OBJETIVO: Verificar a taxa de identificação do linfonodo sentinela (LS em pacientes portadoras de câncer na mama localmente avançado e que foram submetidos à quimioterapia neoadjuvante comparando a citologia de contato intraoperatória (imprint e a inclusão em parafina e validação dos procedimentos. MÉTODOS: Estudo transversal de validação de teste diagnóstico envolvendo 34 pacientes oriundas do Ambulatório da Maternidade-Escola Assis Chateaubriand. As pacientes eram portadoras de câncer na mama localmente avançado e foram tratadas com quimioterapia neoadjuvante. Àquelas com axila clinicamente negativa foram submetidas à biopsia do LS, esse estudado por impint e histopatologia em parafina. Todas as pacientes foram submetidas a esvaziamento axilar e seu

Clinical efficacy of transrectal ultrasound-guided prostate biopsy in men younger than 50 years old with an elevated prostate-specific antigen concentration (>4.0 ng/mL).

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Lu, Chin-Heng; Lin, Tzu-Ping; Shen, She Huei; Huang, Yi-Hsiu; Chung, Hsiao-Jen; Kuo, Junne-Yih; Huang, William J S; Wu, Howard H H; Chang, Yen-Hwa; Lin, Alex T L; Chen, Kuang-Kuo

2017-07-01

Prostate cancer (PCa) is not commonly found in men younger than 50 years of age. However, serum prostate-specific antigen (PSA) concentration has been examined more frequently at a younger age in Asia partially due to an increased awareness of prostate cancer. The purpose of our study was to investigate the efficacy and complication of PSA-triggered transrectal ultrasonography-guided prostate (TRUSP) biopsies. We retrospectively reviewed TRUSP biopsies in young men with elevated PSA concentration in Taipei Veterans General Hospital. We reviewed the cases of patients younger than 50 years of age with elevated PSA concentration (>4.0 ng/mL), who received 12 cores TRUSP biopsies at TPEVGH from January 2008-December 2013. The age, family history, digital rectal examination (DRE) results, PSA concentration, free/total PSA ratio, total prostate volume, PSA density, lower urinary tract symptoms and complications after the procedure were reviewed. The pathologic findings of TRUSP biopsy and clinical follow-up were reviewed and analyzed according to the Epstein criteria. A total of 77 patients were included and were divided into 2 groups: 1) the younger group consisted of 20 patients <40 years of age; and 2) the elder group had 57 patients who were 40-50 years of age. The overall detection rate of PCa was 11.69% (9/77), and all of the PCa cases were diagnosed in the elder group (group detection rate: 15.8%). There was a significant difference in the severity of lower urinary tract symptoms (LUTS) between these 2 groups. All PCa patients were clinically significant according to the Epstein criteria. Two patients experienced fever (2.60%) after TRUSP biopsy. From our patient cohort, it appears that no benefit was apparent for patients younger than 40 years old who received TRUSP biopsy, even with elevated PSA. However, PCa detected in men between 40 and 50 years of age were all clinically significant. Overall, our results supported current major practice guidelines which

Why and Where do We Miss Significant Prostate Cancer with Multi-parametric Magnetic Resonance Imaging followed by Magnetic Resonance-guided and Transrectal Ultrasound-guided Biopsy in Biopsy-naïve Men?

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Schouten, Martijn G; van der Leest, Marloes; Pokorny, Morgan; Hoogenboom, Martijn; Barentsz, Jelle O; Thompson, Les C; Fütterer, Jurgen J

2017-06-01

Knowledge of significant prostate (sPCa) locations being missed with magnetic resonance (MR)- and transrectal ultrasound (TRUS)-guided biopsy (Bx) may help to improve these techniques. To identify the location of sPCa lesions being missed with MR- and TRUS-Bx. In a referral center, 223 consecutive Bx-naive men with elevated prostate specific antigen level and/or abnormal digital rectal examination were included. Histopathologically-proven cancer locations, Gleason score, and tumor length were determined. All patients underwent multi-parametric MRI and 12-core systematic TRUS-Bx. MR-Bx was performed in all patients with suspicion of PCa on multi-parametric MRI (n=142). Cancer locations were compared between MR- and TRUS-Bx. Proportions were expressed as percentages, and the corresponding 95% confidence intervals were calculated. In total, 191 lesions were found in 108 patients with sPCa. From these lesion 74% (141/191) were defined as sPCa on either MR- or TRUS-Bx. MR-Bx detected 74% (105/141) of these lesions and 61% (86/141) with TRUS-Bx. TRUS-Bx detected more lesions compared with MR-Bx (140 vs 109). However, these lesions were often low risk (39%). Significant lesions missed with MR-Bx most often had involvement of dorsolateral (58%) and apical (37%) segments and missed segments with TRUS-Bx were located anteriorly (79%), anterior midprostate (50%), and anterior apex (23%). Both techniques have difficulties in detecting apical lesions. MR-Bx most often missed cancer with involvement of the dorsolateral part (58%) and TRUS-Bx with involvement of the anterior part (79%). Both biopsy techniques miss cancer in specific locations within the prostate. Identification of these lesions may help to improve these techniques. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Teaching of diagnostic skills in equine gynecology: simulator-based training versus schooling on live horses.

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Nagel, Christina; Ille, Natascha; Aurich, Jörg; Aurich, Christine

2015-10-15

Transrectal palpation and ultrasonography of the genital tract in mares are first-day skills for equine veterinarians. In this study, the learning outcome in equine gynecology after four times training on horses (group H4, n = 8), training on horses once (group H1, n = 9), and four times simulator-based training (group Sim, n = 8) was assessed in third-year veterinary students with two tests in live mares 14 days apart. The students of group H4 always scored better for transrectal palpation than students of group Sim and H1 (P < 0.05). Overall, the students reached better results for palpating the left versus the right ovary (P < 0.001), but group H1 students were least successful in obtaining correct ovarian findings (P < 0.05 vs. both other groups). Students' self-assessment reflected test results with palpation of the right ovary experienced as most difficult for group H1 students (P < 0.01 vs. both other groups). Groups did not score differentially for ultrasound examinations. Sim students were nearly as successful in transrectal palpation of the genital tract in mares as H4 students, and for most parameters assessed, they performed better than H1 students. After training four times on horses, students scored best but nevertheless the overall effect of intensive training was limited. Repeated simulator-based training is a useful tool to prepare veterinary students for transrectal palpation of the genital tract in mares and is more effective than one training session on horses. Copyright © 2015 Elsevier Inc. All rights reserved.

Preparation and management of complications in prostate biopsies

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Chiang Jeng Tyng

2013-12-01

Full Text Available Transrectal ultrasonography-guided biopsy plays a key role in prostate sampling for cancer detection. Among interventional procedures, it is one of the most frequent procedures performed by radiologists. Despite the safety and low morbidity of such procedure, possible complications should be promptly assessed and treated. The standardization of protocols and of preprocedural preparation is aimed at minimizing complications as well as expediting their management. The authors have made a literature review describing the possible complications related to transrectal ultrasonography-guided prostate biopsy, and discuss their management and guidance to reduce the incidence of such complications.

Variability among pathologists in the histological diagnosis of helicobacter pylori infection: is it a subjective diagnosis? Variabilidad entre patólogos en el diagnóstico histológico de la infección por Helicobacter pylori: ¿un diagnóstico subjetivo?

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Luis Fernando Arias Restrepo

2006-01-01

Full Text Available Histopathologic diagnosis of Helicobacter pylori (Hp infection is not necessarily easy, and reproducibility is not perfect. Our aim was to determine differences in the frequency of Hp infection according to the pathologists interpreting gastric biopsies in Medellín (Colombia. Materials and methods: All gastric biopsy reports of eight pathologists during one year were reviewed. We excluded cases with intestinal metaplasia, atrophy, dysplasia or carcinoma. We registered patient age, positivity or negativity for H. pylori, and pathologist. We determined the percentage with H. pylori infection and the percentage of each pathologist in order to determine differences. Results: 2.023 cases were included. Each pathologist evaluated a mean of 252.9 ± 154.9 cases (range: 102-445. Patients were 43.5 ± 15.1 years-old (range: 12-90. H. pylori was diagnosed in 1.034 cases (51.1%. The range of positivity according to the pathologist was 38.8-71.1%; mean 51.1% ± 8.7% (p < 0,001. Conclusion: Among pathologists, there is a significant variability in the frequency of diagnosis of H. pylori infection. This result suggests the need to achieve greater homogeneity of concepts and criteria for the diagnosis of this infection, and of its severity. El diagnóstico histológico de la infección por Helicobacter pylori (Hp puede ser difícil, principalmente en casos con pocos microorganismos. Nuestro objetivo fue determinar si hay diferencias significativas en la frecuencia del diagnóstico de la infección por Hp entre patólogos que laboran en Medellín. Materiales y métodos: revisamos todos los informes de biopsias gástricas de ocho patólogos durante un año. Excluimos las biopsias con metaplasia, atrofia, displasia o carcinoma. Registramos la edad del paciente, la presencia o ausencia de Hp y el patólogo que estudió la biopsia. Calculamos el porcentaje de casos con la infección y el porcentaje por patólogo. Finalmente, comparamos estos porcentajes para

Estudio de 100 casos de hemorragia uterina con legrado-biopsia

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Germán Jordán

1953-01-01

Full Text Available El cáncer del cuerpo uterino se presenta con mayor frecuencia en la sexta década de la vida, y en relación con el cáncer del cuello uterino en una proporción de un caso por ocho, respectivamente. Su evolución y sintomatología, mucho más benignas y lentas que las del cáncer del cuello, hacen mas fácil su tratamiento y favorable su pronostico.

Dermatomiosite como primeira manifestação de uma neoplasia pulmonar

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A.S. Castro

2013-07-01

Full Text Available Resumo: A dermatomiosite (DM é uma doença rara, caracterizada por fraqueza muscular proximal associada a exantema cutâneo típico. A biopsia muscular apresenta lesões inflamatórias compatíveis com miosite, estando associada a um aumento de risco de neoplasia, frequentemente considerada como síndrome paraneoplásico. Os autores apresentam um caso de um homem de 63 anos, com quadro de fraqueza muscular proximal progressiva e exantema cutâneo com 2 meses de evolução. A biopsia cutânea e muscular foram compatíveis com DM. A tomografia tórax mostrou imagem nodular paracardíaca esquerda e a biopsia brônquica confirmou diagnóstico de carcinoma pulmão pequenas células. Este caso clínico pretende realçar a importância da realização do estudo diagnóstico exaustivo em doentes com DM, visto que esta patologia surge frequentemente como síndrome paraneoplásico. Abstract: Dermatomyositis (DM is a rare disease characterised by proximal muscle weakness and a typical cutaneous rash. The muscle biopsy shows inflammatory lesions consistent with myositis, being related to an increased risk of cancer, often considered as a paraneoplastic syndrome. The authors present a case of a 63-year-old man, with progressive proximal muscle weakness and cutaneous rash, appearing in two months. The muscle and skin biopsies were consistent with DM. Chest tomography showed a nodular image in the lingular region and bronchy biopsy confirmed the diagnosis of small cell lung carcinoma (SCLC. This clinical case intends to enhance the importance of a thorough diagnostic study in patients with DM, as it is often a paraneoplastic syndrome. Palavras-chave: Dermatomiosite, Síndrome paraneoplásico, Neoplasias pulmonares, Keywords: Dermatomyositis, Paraneoplastic syndrome, Lung neoplasms

Dermatomyositis as the first manifestation of a lung tumor

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A. Castro

2013-07-01

Full Text Available Dermatomyositis (DM is a rare disease characterized by proximal muscle weakness and a typical cutaneous rash. The muscle biopsy shows inflammatory lesions consistent with myositis, being related to an increased risk of cancer, often being considered as a paraneoplastic syndrome. The authors present a case of a 63-year-old man, with progressive proximal muscle weakness and cutaneous rash, appearing in two months. The muscle and skin biopsies were consistent with DM. Chest tomography showed that a nodular image in the lingular region and bronchy biopsy confirmed the diagnosis of small cell lung carcinoma (SCLC. This clinical case intends to enhance the importance of a thorough diagnostic study in patients with DM, as it is often a paraneoplastic syndrome. Resumo: A dermatomiosite (DM é uma doença rara, caracterizada por fraqueza muscular proximal associada a exantema cutâneo típico. A biopsia muscular apresenta lesões inflamatórias compatíveis com miosite, estando associada a um aumento de risco de neoplasia, frequentemente considerada como síndrome paraneoplásico. Os autores apresentam um caso de um homem de 63 anos, com quadro de fraqueza muscular proximal progressiva e exantema cutâneo com 2 meses de evolução. A biopsia cutânea e muscular foram compatíveis com DM. A tomografia tórax mostrou imagem nodular paracardíaca esquerda e a biopsia brônquica confirmou diagnóstico de carcinoma pulmão pequenas células. Este caso clínico pretende realçar a importância da realização do estudo diagnóstico exaustivo em doentes com DM, visto que esta patologia surge frequentemente como síndrome paraneoplásico. Keywords: Dermatomyositis, Lung neoplasms, Paraneoplastic syndrome, Palavras-chave: Dermatomiosite, Neoplasias pulmonares, Síndrome paraneoplásico

CIRUGÍA ENDOSCÓPICA TRANSLUMINAL: ¡ES POSIBLE!

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Arecio Peñaloza-Ramírez

2015-03-01

Full Text Available Introducción: La cirugía endoscópica transluminal es una técnica de ingreso a través de orificios naturales a la cavidad peritoneal y a los órganos allí contenidos, que busca disminuir los efectos adversos y las complicaciones de los procedimientos abiertos, acorde con la tendencia mundial de obtener resultados iguales a través de abordajes menos invasivos. Objetivo: Determinar las complicaciones de la cirugía endoscópica transluminal para la revisión de la cavidad peritoneal y la toma de biopsia hepática en cerdos. Metodología: Estudio experimental en 12 cerdos. Se tomó biopsia hepática transgástrica y se hizo un seguimiento durante 30 días, evaluando complicaciones y mortalidad. Al final se realizó autopsia al animal. Resultados: No se encontró mortalidad intraoperatoria. La mediana de tiempo quirúrgico fue de 84,5 minutos (RIQ 76-99. Se utilizaron para el cierre de la gastrotomía en promedio 7,8 clips (DE 3.5. En la peritoneoscopia se observó el intestino delgado, bazo, hígado y colon en la mayoría de los casos. La calidad de la biopsia hepática fue buena en 10 especímenes. La cicatrización gástrica fue adecuada en el 81.8%. Se encontraron cultivos de líquido peritoneal positivos en 9 casos. Conclusiones: La técnica requiere destreza y la peritoneoscopia es difícil por la falta de apoyo del equipo al maniobrar en retroflexión. El potencial de la técnica y el enorme beneficio para los pacientes son razones suficientes para continuar avanzando en este tipo de abordajes

Linfoma de Hodgkin con depleción linfocítica e infiltración difusa de médula ósea

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Fernando Carballo

2011-04-01

Full Text Available Se presenta el caso clínico de un paciente varón de 38 años de edad, agricultor, natural de Lamas, San Martín (selva peruana, quien desde hacía 8 meses presentaba diarreas, fiebre intermitente, dolor abdominal, pérdida ponderal y anemia severa. Aunque lúcido, a su ingreso el paciente exhibía mal estado general, palidez y adenopatías generalizadas de menos de 0,5 cm, hepatoesplenomegalia y matidez desplazable. La tomografía computarizada abdominal reveló hepatoesplenomegalia y múltiples adenopatías retroperitoneales, mesentéricas y otras. La biopsia de ganglio mostró células de Reed Sternberg, células mononucleares, eosinófilos y escasos linfocitos. La inmunohistoquímica ganglionar fue positiva para anticuerpos CD15 y CD30. La biopsia de hueso señaló fibrosis difusa, células mononucleares y marcada escasez de linfocitos. La hibridización in situ para EBV-virus de Epstein Barr fue positiva en las células neoplásicas.

Toward a 3D transrectal ultrasound system for verification of needle placement during high-dose-rate interstitial gynecologic brachytherapy.

Science.gov (United States)

Rodgers, Jessica Robin; Surry, Kathleen; Leung, Eric; D'Souza, David; Fenster, Aaron

2017-05-01

Treatment for gynecologic cancers, such as cervical, recurrent endometrial, and vaginal malignancies, commonly includes external-beam radiation and brachytherapy. In high-dose-rate (HDR) interstitial gynecologic brachytherapy, radiation treatment is delivered via hollow needles that are typically inserted through a template on the perineum with a cylinder placed in the vagina for stability. Despite the need for precise needle placement to minimize complications and provide optimal treatment, there is no standard intra-operative image-guidance for this procedure. While some image-guidance techniques have been proposed, including magnetic resonance (MR) imaging, X-ray computed tomography (CT), and two-dimensional (2D) transrectal ultrasound (TRUS), these techniques have not been widely adopted. In order to provide intra-operative needle visualization and localization during interstitial brachytherapy, we have developed a three-dimensional (3D) TRUS system. This study describes the 3D TRUS system and reports on the system validation and results from a proof-of-concept patient study. To obtain a 3D TRUS image, the system rotates a conventional 2D endocavity transducer through 170 degrees in 12 s, reconstructing the 2D frames into a 3D image in real-time. The geometry of the reconstruction was validated using two geometric phantoms to ensure the accuracy of the linear measurements in each of the image coordinate directions and the volumetric accuracy of the system. An agar phantom including vaginal and rectal canals, as well as a model uterus and tumor, was designed and used to test the visualization and localization of the interstitial needles under idealized conditions by comparing the needles' positions between the 3D TRUS scan and a registered MR image. Five patients undergoing HDR interstitial gynecologic brachytherapy were imaged using the 3D TRUS system following the insertion of all needles. This image was manually, rigidly registered to the clinical

[Protective measures in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery].

Science.gov (United States)

Fu, Chuangang; Zhou, Zhuqing; Han, Junyi; Lu, Bin; Gao, Wei; Zhu, Zhe; Jiang, Qixin; Ji, Fang; Du, Tao

2017-10-25

To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve. Operation indication: (1) Rectum and sigmoid colon cancer with the distance of more than 6 cm from tumor inferior margin to dentate line. (2) The maximum diameter of intestine together with mesangial and tumor <7 cm by intraoperative judgment. (3) No anal and distal rectal surgery, no anorectal stenosis or lack of expansion capacity caused by trauma. (4) No ulcerative colitis, Crohn's disease or radiation proctitis. After transecting the rectum, the specimen protective sleeve was inserted through the right lower 12 mm main Trocar (This sleeve was tailored from the laparoscopic protective sleeve produced by China 3L Corporation, which was intercepted with 25-35 cm from one end of the sleeve according to the length of distal rectal retention. One end was ligated and the other was open with a ligature band. About 5 ml paraffin oil was used to rinse and lubricate during the operation). The rectal stump retained 7-8 cm in abdominal cavity. The transanal ligation part of the protective sleeve was cut off, then the stapler nail seat was inserted and specimen was pull out through the sleeve and rectum. There were 30 males and 18 females. The average age was (64.5±14.1) years, the BMI was (25.4±3.9) kg/m 2 , the tumor diameter was (3.3±1.1) cm, the maximum diameter of specimen was (5.4±1.5) cm and the length of specimen was (18.6±4.3) cm. Among these 48 cases, specimens of 36 patients were pulled out through inside of the

Histopatologia das lâminas do casco de equinos com laminite aguda induzida e tratados com ketoprofeno, fenilbutazona e flunixin meglumine Histopathology of the digital laminae from horses with acute induced laminitis treated with ketoprophen, phenylbutazone, and flunixin meglumin

Directory of Open Access Journals (Sweden)

F.O. Paes Leme

2010-04-01

Full Text Available Avaliaram-se as alterações histológicas do tecido laminar, obtido por biopsia, em 20 equinos portadores de laminite induzida por sobrecarga de carboidratos e tratados com ketoprofeno, fenilbutazona ou flunixin meglumine. A biopsia foi colhida dos dígitos torácicos 72 horas após a indução. Os achados histológicos foram comparados com os achados de amostras de equinos isentos de laminite. Infiltrado inflamatório neutrofílico foi observado em 80%, congestão em 50%, hemorragia em 35% e hiperplasia na túnica íntima das arteríolas das lâminas dérmicas primárias em 15% das amostras. As taxas de microtrombos e coágulos foram 15% e 20%, respectivamente. Estes achados parecem decorrer dos distúrbios circulatórios que ocasionaram edema, congestão e hiperemia, seguidos de degeneração. Em 70% das análises realizadas nos animais tratados, as lesões histológicas foram inferiores aos graus de claudicação observados. Conclui-se que a biopsia de tecido laminar digital de equinos é viável, os artefatos decorrentes da técnica de biopsia não prejudicam a análise histológica das amostras e os anti-inflamatórios não esteroidais não são capazes de evitar as lesões laminares quando administrados após o início da sintomatologia clínica de laminite.Experimental laminitis caused by carbohydrate overload was induced in 20 healthy horses. Seventy two hours after induction, samples of the laminar tissue were obtained by biopsy from the thoracic limbs digits for histopathology. The histological findings were compared to samples from horses without laminitis. Neutrophilic infiltrate was observed in 80% of the samples, congestion in 50%, hemorrhage in 35%, and hyperplasia of the arteriolar intima layer of the primary dermal lamina in 15%. Thrombi and intravascular blood clots were observed in 15% and 20% of the samples, respectively. Apparently, these findings were due to circulatory changes that resulted in edema, congestion, and

Comparison between target magnetic resonance imaging (MRI) in-gantry and cognitively directed transperineal or transrectal-guided prostate biopsies for Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 MRI lesions.

Science.gov (United States)

Yaxley, Anna J; Yaxley, John W; Thangasamy, Isaac A; Ballard, Emma; Pokorny, Morgan R

2017-11-01

To compare the detection rates of prostate cancer (PCa) in men with Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 abnormalities on 3-Tesla multiparametric (mp) magnetic resonance imaging (MRI) using in-bore MRI-guided biopsy compared with cognitively directed transperineal (cTP) biopsy and transrectal ultrasonography (cTRUS) biopsy. This was a retrospective single-centre study of consecutive men attending the private practice clinic of an experienced urologist performing MRI-guided biopsy and an experienced urologist performing cTP and cTRUS biopsy techniques for PI-RADS 3-5 lesions identified on 3-Tesla mpMRI. There were 595 target mpMRI lesions from 482 men with PI-RADS 3-5 regions of interest during 483 episodes of biopsy. The abnormal mpMRI target lesion was biopsied using the MRI-guided method for 298 biopsies, the cTP method for 248 biopsies and the cTRUS method for 49 biopsies. There were no significant differences in PCa detection among the three biopsy methods in PI-RADS 3 (48.9%, 40.0% and 44.4%, respectively), PI-RADS 4 (73.2%, 81.0% and 85.0%, respectively) or PI-RADS 5 (95.2, 92.0% and 95.0%, respectively) lesions, and there was no significant difference in detection of significant PCa among the biopsy methods in PI-RADS 3 (42.2%, 30.0% and 33.3%, respectively), PI-RADS 4 (66.8%, 66.0% and 80.0%, respectively) or PI-RADS 5 (90.5%, 89.8% and 90.0%, respectively) lesions. There were also no differences in PCa or significant PCa detection based on lesion location or size among the methods. We found no significant difference in the ability to detect PCa or significant PCa using targeted MRI-guided, cTP or cTRUS biopsy methods. Identification of an abnormal area on mpMRI appears to be more important in increasing the detection of PCa than the technique used to biopsy an MRI abnormality. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Punción pancreática ecodirigida: estudio multicéntrico Ultrasound-guided biopsy of the pancreas: A multicenter study

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M. C. Garre Sánchez

2007-09-01

Full Text Available Objetivo: en el seno de la Asociación de Ecografía Digestiva se decidió realizar un estudio retrospectivo multicéntrico sobre la punción-aspiración con aguja fina (PAAF de lesiones ocupantes de espacio pancreáticas, mediante control ecográfico y por vía percutánea, con el objetivo de valorar el rendimiento de dicha técnica y poder compararla con la punción mediante ultrasonografía endoscópica. Participantes: en el estudio han participado 10 hospitales con 222 pacientes con lesiones pancreáticas entre 8 y 120 mm, sospechosas de malignidad. Resultados: el análisis de los resultados muestra una sensibilidad del 89%, especificidad 98%, valor predictivo positivo 99% y negativo 74%, con precisión diagnóstica global 91%. No encontramos ninguna complicación significativa. Conclusión: la PAAF de lesiones pancreáticas por vía percutánea es de alta rentabilidad diagnóstica y con pocas y leves complicaciones.Objective: members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic guidance and via the percutaneous route in order to assess this technique's performance versus endoscopic ultrasound-guided biopsy. Subjects: 10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study. Results: the analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred. Conclusion: percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.

Interfaz Gráfica de Usuario (GUI) para la Manipulación Interactiva de Imágenes en Aplicaciones Web

OpenAIRE

Luján Vásquez, Renzo

2011-01-01

Desarrollar una aplicación cliente con interfaz gráfica para un software de búsqueda de imágenes de biopsias ópticas, con el propósito de ayudar a endoscopistas a obtener un diagnóstico médico a partir de la manipulación y análisis de imágenes estáticas.

Biopsia por punción con aguja fina sin aspiración en el diagnóstico prequirúrgico del nódulo del tiroides Fine needle biopsy without aspiration in the presurgical diagnosis of thyroid nodule

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Francisco Ochoa Torres

2001-12-01

Full Text Available Se estudió un grupo de 100 pacientes operados de nódulo único del tiroides en el Servicio de Cirugía General del Hospital “Cmdte. Manuel Fajardo”, para validar el método de la biopsia por punción con aguja fina sin aspiración (citopunción en el diagnóstico prequirúrgico de esa afección. A cada paciente se le realizó una citopunción con aguja No. 25 antes de la intervención quirúrgica; los resultados se clasificaron en negativos (benignos y positivos (malignos y sospechosos y la histología posoperatoria, en benigna y maligna, según los intereses de nuestro trabajo y de criterios preestablecidos en el Departamento de Anatomía Patológica del hospital. El 100 % de las muestras fue útil para diagnóstico con una correspondencia entre citopunción e histología del 83 %. Los valores de los indicadores de validación fueron: sensibilidad: 76 %, especificidad: 85 %, valor predictivo positivo: 57 %, valor predictivo negativo: 93 % y eficacia general del método: 85 %. Concluimos que la citopunción es un método diagnóstico útil en el nódulo único del tiroides y que logra iguales resultados que la BAF, pero la primera es más recomendable por ser de más fácil aplicación, menos traumático y más económico.A group of 100 patients operated on of thyroid nodule at the Service of General Surgery of “Comandante Manuel Fajardo” Hospital was studied aimed at validating the method of biopsy by fine needle puncture without aspiration (cytopuncture in the presurgical diagnosis of this disease. Every patient underwent cytopuncture with needle No. 25 before the operation. The results were classified into negative (benign and positive (malignant and suspected, and postoperative histology into benign and malignant, according to the interests of our investigation and to the criteria preestablished at the Department of Pathological Anatomy of the hospital. 100 % of the samples were useful for the diagnosis with a correspondence

Prostate cancer

International Nuclear Information System (INIS)

Spera, G.

2010-01-01

This work is about diagnosis, treatment and monitoring of prostate cancer. The techniques used are: transrectal ultrasound, laparascopy, bone scan, chest x-ray, radiography, chemoterapy and radiotherapy

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

Science.gov (United States)

Gersak, Mariana M; Badea, Radu; Graur, Florin; Hajja, Nadim Al; Furcea, Luminita; Dudea, Sorin M

2015-06-01

Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examination methodology. All these aspects are additional methods for gray-scale endoscopic ultrasound, capable of increasing diagnostic accuracy. This paper aims at reviewing the progress of transrectal and transvaginal ultrasound, generically called endoscopic ultrasound, for rectal tumor diagnosis and staging, with emphasis on the current state of the method and its development trends.

Correlación clínico patológica del cáncer cervical y precursores en una población de Lima periférica

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Victoria Valer

2005-06-01

Full Text Available Objetivo: Determinar la prevalencia y los factores de riesgo del cáncer cervical y sus precursores en un grupo poblacional, con especial énfasis en el manejo de la enfermedad cervical preinvasiva. Diseño: Estudio prospectivo y descriptivo no aleatorio. Materiales y Métodos: Estudio realizado durante el año 2003, en mujeres del Centro de Salud de Piedra Liza (San Juan de Lurigancho en 120 pacientes con diagnóstico citológico de ASC, AGC, L-SIL, H-SIL y carcinoma; se realizó biopsia de las lesiones cervicales en 49 casos, para confirmar el diagnóstico citológico y correlacionarlo con el cuadro clínico y la colposcopia. Resultados: De los 120 casos de estudio citológico, 14 (11,5% fueron ASC; 67 (56% L-SIL, 34 (29% H-SIL, 3 (2,5% carcinoma escamoso y 2 (2% adenocarcinoma. De 49 biopsias, 12 casos fueron L-SIL, 32 H-SIL, 3 carcinoma escamoso invasor y 2 adenocarcinoma cervical, uno de ellos in situ. Conclusiones: Los resultados citológicos muestran que las lesiones escamosas intraepiteliales y el carcinoma cervical tuvieron alta prevalencia en este grupo poblacional.

Prostate Ultrasound

Medline Plus

Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Prostate ultrasound, also called transrectal ultrasound, provides ...

Distrofia neuroaxonal infantil: diagnóstico em vida por biopsia conjuntival

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S. Rosemberg

1985-03-01

Full Text Available São relatados três casos de distrofia neuroaxonal infantil cujo diagnóstico foi feito mediante o estudo ultrastrutural de biópsia da conjuntiva. Nesta, algumas fibras nervosas amielínicas e, mais raramente, as mielínicas, mostravam, no axoplasma, agregados densos membrano-tubulares, idênticos aos dos esferóides ocorrentes no SNC nesta doença. O achado destas estruturas é o único meio diagnóstico em vida. A biópsia da conjuntiva, pela facilidade de sua execução e por sua inocuidade, é o procedimento preferido para este estudo. Clinicamente, a enorme hipotonia aliada a sinais piramidais, a ausência de crises convulsivas, a atrofia cerebelar visível à tomografia e o modo evolutivo, sugerem fortemente o diagnóstico de distrofia neuroaxonal infantil.

Caracterización de lesiones cervicouterinas en pacientes atendidas en el hospital “Ernesto Guevara de la Serna”

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Alicia María Yabor Palomo

2015-11-01

Full Text Available Fundamento: en los últimos años ha existido un incremento en la incidencia de cáncer cérvicouterino en pacientes pertenecientes a la provincia de Las Tunas.Objetivo: caracterizar a las pacientes con lesiones cervicales, cuyas biopsias fueron analizadas en el departamento de anatomía patológica, perteneciente al Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período comprendido entre enero de 2013 y diciembre de 2014.Métodos: se realizó un estudio descriptivo, de corte transversal, en 1369 pacientes con lesiones cervicales, atendidas en el lugar y período de tiempo antes señalado, se utilizó el modelo oficial de biopsia como fuente secundaria de recolección de la información. Los datos fueron procesados utilizando la estadística descriptiva.Resultados: del total de la muestra, la frecuencia de positividad de las biopsias para lesiones cervicales pertenecieron: al año 2013 el 44,4 % y 55,6 % al 2014. Predominaron las mujeres en edad comprendida entre 26 y 35 años, 47,4 %, seguido del grupo de 36 a 55 años, 43,46 %; la neoplasia intraepitelial grado I estuvo presente en el 42,73 %. El 33,6 % de la muestra presentó infección por el virus del papiloma humano, de ellas el 35,28 % correspondieron al 2013 y el 32,19 % al 2014. La neoplasia intraepitelial cervical grado III reportó la mayor cantidad de pacientes con cervicitis, para un 42,95 %, seguido por el carcinoma in situ, presente en el 93 % de la muestra.Conclusiones: se caracterizaron las lesiones cervicouterinas en pacientes de la provincia, predominó el grupo de edad comprendido entre 26 y 35 años, la neoplasia intraepitelial grado I, aproximadamente un tercio estaban infectadas con el virus del papiloma humano, y en las pacientes con neoplasia intraepitelial cervical grado III existió mayor incidencia de cervicitis.

Tamoxifeno y afecciones endometriales en pacientes con cáncer de mama

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Delia B. Dalbert

2013-04-01

Full Text Available Los objetivos fueron evaluar la prevalencia de afecciones endometriales en pacientes tratadas con tamoxifeno (TAM y analizar los aspectos epidemiológicos, ecográficos, histeroscópicos e histopatológicos. Desde enero de 1999 a diciembre 2008 se estudiaron 152 pacientes con cáncer de mama tratadas con TAM (20 mg/día, sintomáticas (con sangrado o asintomáticas, pre y postmenopáusicas, incluidas en forma consecutiva. El diseño fue prospectivo y observacional. Los métodos diagnósticos usados fueron ecografía transvaginal, histeroscopía y biopsia. Las pacientes fueron seguidas durante 5 años con ecografía cada 12 meses e histeroscopia con biopsia en casos que lo justificaran. Edad: 62.76 ± 10.24 años y tiempo de tratamiento: 36.2 ± 19.9 meses. El adenocarcinoma se observó en 3/87 (3.45% pacientes con factores de riesgo y en 1/65 (1.54% sin ellos (RA: 1.91, IC 95% 1.88 a 1.94. Las afecciones benignas se hallaron en 148 pacientes (97.37% y los adenocarcinomas en 4 (2.63%,1 en un pólipo de aspecto benigno. Los 4 se observaron en mujeres postmenopáusicas (2 asintomáticas con grosor endometrial igual o mayor a 16 mm. El riesgo de cáncer fue significativamente mayor en sintomáticas (2.36 versus 0.42 en asintomáticas. Tres adenocarcinomas se detectaron entre 24 y 48 meses del tratamiento. Recomendamos un seguimiento con ecografía transvaginal de las pacientes asintomáticas, resección de los pólipos evaluando factores de riesgo y tiempo de exposición, en especial luego de los 24 meses. Consideramos aceptable un cut-off = 10 mm en el grosor del endometrio en postmenopáusicas asintomáticas para realizar histeroscopía y biopsia.

Transrectal ultrasound imaging and prostate cancer

NARCIS (Netherlands)

Goossen, Tjerk; Wijkstra, Hessel

2003-01-01

Prostate cancer is one of the most important causes of death from cancer in men. Ultrasound imaging is frequently used in the diagnosis of prostate cancer. This paper presents an overview of currently available ultrasound imaging techniques. The underlying principles and methods are discussed

Contribuição para o diagóstico diferencial da distrofia muscular progressiva

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José Antonio Levy

1964-06-01

Full Text Available Os dados fornecidos pela anamnese assim como a sintomatologia nem sempre permitem estabelecer, com segurança, o diagnóstico de distrofia muscular progressiva (DMP; o diagnótico é facilitado quando são obtidos dados heredológicos depondo por afecção de caráter familiar ou quando se trate de casos de longa evolução, mostrando a característica fundamental da irreversibilidade. As provas laboratoriais propostas até agora, embora úteis para a avaliação do estado da consunção do tecido muscular, não fornecem elementos seguros para o diagnóstico diferencial, pois os resultados podem ser idênticos tanto na DMP (especialmente nas fases, iniciais ou de evolução subaguda como nas polimiosites e nas neuromiosites. De grande importância para o diagnóstico diferencial são a eletromio-grafia e a biopsia muscular: a eletromiografia mostra, na DMP, diminuição da voltagem e redução da duração média dos potenciais de ação, com elevada incidência de potenciais polifásicos; o exame histológico mostra grande variação no calibre e degeneração das fibras musculares com proliferação de tecido conjuntivo, sem infiltrações de caráter inflamatório e sem atividade regenerativa útil. Entretanto, êstes exames complementares não bastam, por si sós, para o diagnóstico diferencial de todos os casos e seus resultados devem ser interpretados cuidadosamente. Neste trabalho são referidos 21 casos que exigiram cuidadoso diagnóstico diferencial. Em 17 (casos 1 a 17, com base na anamnese e na sintomatologia, fôra feito o diagnóstico de DMP; entretanto em todos êles o exame mais minucioso, acrescido de dados fornecidos pela eletromiografia e especialmente pela biopsia, conduziu à formulação de outro diagnóstico. Em dois casos (18 e 19, ambos de moléstia de Charcot-Marie-Tooth, o exame histo-patológico sugeria o diagnóstico de DMP. Em um caso (20 o quadro clínico sugeria DMP e o exame eletromiográfico indicava haver les

Citometria de fluxo no cancro do pulmão. Eficácia da citologia como técnica de selecção dos espécimes a processar

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V. Hespanhol

1995-11-01

Full Text Available RESUMO: O cancro do pulmão é a neoplasia mais frequente no sexo masculino nos países da U.E., mostrando actualmente tendência crescente em todos os países. O cancro do pulmão é a maior causa de morte por neoplasia, tanto na E.U. como nos E.U.A. A sobrevida é geralmente curta, sendo a maioria dos doentes diagnosticados em fases avançadas da doença, dificultando a decisão terapêutica. Para estabelecer a opção terapêutica há necessidade de conhecimento mais aprofundado dos factores que podem influenciar a sobrevida, não só relativos ao doente, mas também em relação ao próprio tumor.O presente estudo insere-se numa avaliação prognóstica global, incluindo características do doente e do tumor. Na avaliação das características do tumor utilizamos citometria de fluxo (FCM que permite avaliar o conteúdo e o índice do ADN e a fracção de cálulas em Fase-S. As amostras a processar são colhidas por técnicas diagnósticas (biopsia, escovagem e lavagem brônquicas, biopsia aspirativa transtorácica - BAT e aspirado ganglionar, sendo utilizado no processamento o material restante, após ter sido obtido o diagnóstico. Pretendemos nesta investigação preliminar definir um controlo de qualidade dos espécimes a processar por FCM em relação à presença ou não de células neoplásicas, atravás de um rastreio citológico. Por outro lado, verificar se é exequível utilizando amostras tão exíguas obter resultados de FCM fláveis. Estudámos 78 doentes suspeitos de terem neoplasia maligna do pulmão. Só nos 43 em que se provou existir neoplasia maligna se procedeu á realização de FCM. Obtivemos resultados avaliáveis de FCM em 62% (27/43. As técnicas de colheita mais reotáveis, após rastreio citológico, foram a biopsia brônquica (76% e a escovagem brônquica (100%. Encontramos uma deficiente rentabilidade utilizando a BAT (31%. A citologia é um bom método de selecção para espécimes colhidos por biopsia br

Limitations of CT and ultrasound diagnoses in the evaluation of uterine cancer involvement

International Nuclear Information System (INIS)

Sato, Yasumi; Maki, Masahiro; Seki, Haruo; Saito, Yoshiharu.

1988-01-01

The concordance rates between preoperative diagnostic imagings and postoperative pathologic findings were examined in a total of 36 patients with resectable uterine cancer (19 with cervical cancer and 27 with endometrial cancer). The accuracy of CT was 47 % in the evaluation of cervical cancer involvement to the parametrium; and was 83 % in the evaluation of wall involvement of endometrial cancer. The concordance rate was 74 % in the evaluation of stage-grouping in endometrial cancer. Out of 8 patients with resectable stage II cervical cancer, four (50 %) were found to have had involvement to the parametrium by transrectal echography. The results indicate that CT scanning and transrectal echography have limitations in the diagnosis of cervical cancer involvement to the parametrium. (Namekawa, K.)

Managing Caesarean Scar Pregnancy in low Resource Settings: 2 ...

African Journals Online (AJOL)

AJRH Managing Editor

ultrasound guided approach with dilatation of uterine cervix and subsequent evacuation of uterine ... Keywords: caesarean scar pregnancy, transrectal ultrasound guided surgical approach. ... a viable embryo with a crown rump length (CRL).

Science.gov (United States)

Real Delor, Raúl Emilio

2018-04-23

Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal. La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio. Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... is used to evaluate the: bladder seminal vesicles prostate Transrectal ultrasound, a special study usually done to provide detailed evaluation of the prostate gland, involves inserting a specialized ultrasound transducer into ...

Neoplasmas bovinos diagnosticados no Setor de Patologia Veterinária da UFRGS, Porto Alegre (2005-2014

Directory of Open Access Journals (Sweden)

Matheus de O. Reis

Full Text Available RESUMO: Realizou-se um estudo retrospectivo com o objetivo de determinar os tipos de neoplasmas em bovinos e a sua frequência. Foram analisados os casos de necropsias e biopsias de bovinos com diagnóstico de neoplasia, submetidos ao Setor de Patologia Veterinária da Universidade Federal do Rio Grande do Sul (SPV-UFRGS, entre janeiro de 2005 e dezembro de 2014. De um total de 4.188 exames realizados em bovinos, 154 foram diagnosticados como neoplasmas. Destes, 100 casos foram a causa da morte, 41 foram achados de frigorífico e 13 casos eram biopsias de cirurgias realizadas por veterinários de campo. Os neoplasmas ocorreram com maior frequência em bovinos adultos (96/154, fêmeas (125/154 e a raça mais acometida foi a Holandesa (79/154. Os neoplasmas mais frequentes foram linfoma (73/154, carcinoma de células escamosas (28/154, papiloma (9/154, melanoma (6/154 e feocromocitoma (6/154. Os sistemas mais acometidos foram o hemopoiético (75/154 e tegumentar (25/154. Conclui-se que o linfoma e o carcinoma de células escamosas são os neoplasmas mais frequentes em bovinos diagnosticados no SPV-UFRGS, Brasil.

The end of the road for prostate specific antigen testing?

African Journals Online (AJOL)

2012-10-01

Oct 1, 2012 ... Abstract. Many candidate biomarkers for diagnosis of prostate cancer have been investigated, but ... prostate biopsy, the transrectal ultrasound (TRUS)‑guided .... secretions of PSA from tissues such as the breast have also.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently ... pelvic ultrasound: abdominal ( transabdominal ) vaginal ( transvaginal / endovaginal ) for women rectal ( transrectal ) for men A Doppler ultrasound exam ...

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... There are three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams ... are three types of pelvic ultrasound: abdominal ( transabdominal ) vaginal ( transvaginal / endovaginal ) for women rectal ( transrectal ) for men ...

Prostate Ultrasound

Medline Plus

Full Text Available ... rectum. top of page What are some common uses of the procedure? A transrectal ultrasound of the ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... object is as well as the object's size, shape and consistency (whether the object is solid or ... you lying on your back, possibly with your feet in stirrups similar to a gynecologic exam. Transrectal: ...

Prostate Ultrasound

Medline Plus

Full Text Available ... rectum. top of page What are some common uses of the procedure? A transrectal ultrasound of the ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

Prostate Ultrasound

Medline Plus

Full Text Available ... is located directly in front of the rectum, so the ultrasound exam is performed transrectally in order ... A follow-up examination may also be necessary so that any change in a known abnormality can ...

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently used to evaluate the ... vaginal ( transvaginal / endovaginal ) for women rectal ( transrectal ) for men A Doppler ultrasound exam may be part of ...

Bovine Reproductive Palpation Training: Does the Cow Make a Difference?

Science.gov (United States)

French, Hilari M; Dascanio, John J; Gilbert, Gregory E; Robinson, James Q

2018-01-01

Gaining experience and dexterity for trans-rectal cattle palpation requires substantial training. Simulation allows students to perform palpation without risks and to obtain feedback, but many believe live cattle palpation is essential. Limited research exists on the proper training method for live animal trans-rectal palpation. This study compared student improvement in laboratory palpation skills when assigned to the same cows versus choosing a cow at random. The hypothesis for the study was that students assigned the same cow, as compared to students choosing a cow at random, would be more accurate at palpation, would learn what structures are present on the ovaries and what size the reproductive tract measures, and would be able to follow the cyclicity of the cow. Cervical diameter, uterine tone, diameter of left and right uterine horns, and ovarian structures were recorded over time. Responses were compared to laboratory instructors' responses and Z-tests for proportions were used to test the differences in percentage correct at each time point for each palpation exercise. Overall the experiment showed that assigning students to certain cows will not improve their trans-rectal palpation training. However, asking students to identify specific landmarks with quantitative measurements did allow for more productive laboratory time and engaged students. The results of the present study also suggest that if there is limited time available for palpation instruction, choosing cows with behavior allowing easy handling is important to the educational process.

Sangrado vaginal anormal, hábitos de vida y biopsia de endometri

OpenAIRE

María Gamero de Ramos; Víctor Villasmil Araujo; Carlos Fonseca; Robert Silva

2008-01-01

Ir r egular or ex c es s ive uter ine bleeding is r efer r ed to as abnor mal uter ine bleeding; and when its c aus e is not k nown, tr eatment may be inadequate. The pur pos e of this des c r iptive s tudy was to es tablis h the r elations hip between uter ine bleeding, life habits and a his topathology s tudy of endometr ial biops y and endometr ial c ur ettage. The s ample c ons is ted of 100 appar ently healthy women attending a gynaec ology c linic between J une and December 2005 at “...

Multiparametric MRI in men with clinical suspicion of prostate cancer undergoing repeat biopsy

DEFF Research Database (Denmark)

Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

2018-01-01

Background Multiparametric magnetic resonance imaging (mpMRI) can improve detection of clinically significant prostate cancer (csPCa). Purpose To compare mpMRI score subgroups to systematic transrectal ultrasound-guided biopsies (TRUSbx) and prostate-specific antigen (PSA)-based findings...

Prostate Ultrasound

Medline Plus

Full Text Available ... uses sound waves to produce pictures of a man’s prostate gland and to help diagnose symptoms such ... also called transrectal ultrasound, provides images of a man's prostate gland and surrounding tissue. The exam typically ...

Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer

Directory of Open Access Journals (Sweden)

Waldemar Białek

2016-12-01

Full Text Available Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

Energy Technology Data Exchange (ETDEWEB)

Martin, Peter R., E-mail: pmarti46@uwo.ca [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Cool, Derek W. [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7, Canada and Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Romagnoli, Cesare [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Fenster, Aaron [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Ward, Aaron D. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Oncology, The University of Western Ontario, London, Ontario N6A 3K7 (Canada)

2014-07-15

Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm{sup 3} or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each

Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis.

Science.gov (United States)

Martin, Peter R; Cool, Derek W; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D

2014-07-01

Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm(3) or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each tumor was consistently greater when using

Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

International Nuclear Information System (INIS)

Martin, Peter R.; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

2014-01-01

Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm 3 or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each tumor was

Identificación del genotipo del virus del papiloma humano en pacientes portadoras de lesiones cérvico uterinas

Directory of Open Access Journals (Sweden)

Alexander Morales Fontaine

2016-02-01

Full Text Available Fundamento: en los últimos años se ha observado un elevado predominio de mujeres infestadas por genotipos del  Virus del Papiloma Humano considerados de alto riesgo por su elevada oncogenicidad.Objetivo: identificar los genotipos del Virus del Papiloma Humano en pacientes portadoras de este con lesiones cervicales, cuyas biopsias fueron analizadas en el departamento de anatomía patológica, perteneciente al Hospital General Docente ¨Ernesto Guevara de la Serna¨, en el período comprendido entre enero de 2013 a diciembre de 2014.Métodos: se realizó un estudio descriptivo, de corte transversal, en 45 pacientes cuyas biopsias fueron tomadas de forma aleatoria de un total de 456 casos en los que se encontraron evidencias histopatológicas de infección por el  Virus del Papiloma Humano, en el período referido período de estudio. Las biopsias fueron enviadas al Laboratorio de Biología Molecular del departamento de Virología del Instituto de Medicina Tropical ´´Pedro Kourí´, a fin de aislar e identificar los tipos de este virus, involucrados en la patogénesis de las lesiones premalignas en estudio. Se utilizaron fuentes secundarias dadas por los resultados de la identificación del genotipo del virus aislado enviados desde dicha institución. Los datos se procearon según la estadística descriptiva, mediante el análisis porcentual.Resultados: en el 88,8 % de la muestra se obtuvo infestación por el Virus del Papiloma Humano, de alto riesgo de oncogenicidad, de ellos hay una preponderancia del genotipo 16, con 26 casos (57,7 % seguido del 31 con 12 aislamientos (26,6 % y 2 pacientes presentaron el genotipo 52 para el 4,4 %. El 6,6 % de la muestra resultó estar infestadas por el genotipo 11, el cual es considerado de bajo riesgo y en 2 casos no fue posible realizar la tipificación.Conclusiones: Existió gran predominio de pacientes afectadas por Virus de Papiloma Humano de alto riesgo de oncogenicidad.

Urethral stricture disease after bipolar prostatectomy: Is it a concern?

African Journals Online (AJOL)

A.A. Zamel

2018-02-16

Feb 16, 2018 ... and transrectal ultrasound (TRUS) for total gland and adenoma vol- ume assessment. ... Germany) bipolar high-frequency generator was used. .... incident power (even if in short bursts), and a long operation time in case of a ...

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... vaginal sonogram is usually more comfortable than a manual gynecologic examination. For a transrectal exam: If no ... areas. Outside links: For the convenience of our users, RadiologyInfo .org provides links to relevant websites. RadiologyInfo. ...

Inoculation of Sphingobacterium multivorum in the prostate by prostate biopsy

DEFF Research Database (Denmark)

Kjær Nielsen, Torben; Pinholt, Mette; Nørgaard, Nis

2014-01-01

Abstract This report describes three cases of infection with Sphingobacterium multivorum after transrectal ultrasound-guided prostate biopsy. The pathogen is ubiquitous in water and soil but has been described fewer than 10 times causing infections in humans. An infection hygiene evaluation...

Ultrasound Imaging of the Pelvic Floor: linking anatomical findings with clinical symtoms

NARCIS (Netherlands)

A.B. Steensma (Anneke)

2009-01-01

textabstractFor evaluation of pelvic floor and lower urinary tract dysfunction the use of transabdominal ultrasound was first documented in the early eighties, with the translabial [1], transrectal [2] and transvaginal [3, 4] techniques developing somewhat later. To obtain a translabial

Transrectal echography in cancer of the rectum

International Nuclear Information System (INIS)

Lozano Barriga, Mauricio; Mejia Pineres, Fernando; Uriza, Felipe

1996-01-01

Study of the accuracy of trans rectal sonography for the establishment of tumour invasion to the rectal wall and detection of peri rectal ganglia, in patients with known rectal carcinoma and surgical confirmation of findings. Trans rectal sonography is the method of choice for the evaluation of rectal cancer

Tratamiento de la tiroiditis de Riedel con triamcinolona

Directory of Open Access Journals (Sweden)

Germán Brito Sosa

Full Text Available Se presenta el primer paciente con una tiroiditis de Riedel que se le aplica un tratamiento alternativo con triamcinolona creado por el profesor Juan Gualberto Vivó Núñez. Es el caso de una mujer de 48 años de edad, que acude al cuerpo de guardia por aumento de volumen de la región anterior del cuello y referir ligera disfagia. Tiene antecedente inicialmente de hipertiroidismo, a los 9 años comenzó con hipotiroidismo y hace aproximadamente un año se le diagnosticó una tiroiditis de Hashimoto, con seguimiento por endocrinología. La ecografía del tiroides muestra un aumento marcado de la glándula tiroidea y las imágenes de la biopsia por aspiración con aguja fina (BAAF son compatibles con una tiroiditis de Hashimoto. Con estos resultados se decide intervenirla quirúrgicamente eliminando así los signos compresivos. La biopsia postoperatoria describe una tiroiditis de Riedel. Por el gran tamaño de los lóbulos tiroideos, se le infiltra triamcinolona 1/2 cc en cada lóbulo, una vez al mes durante cuatro meses; logrando reducir aproximadamente el 50 % de los lóbulos tiroideos. Por lo que se puede apreciar los resultados obtenidos con el uso de la triamcinolona.

Avances en las técnicas ecográficas para el diagnóstico y estadiaje del cáncer de próstata. Elastografía, ecografía doppler, contrastes ecográficos, métodos de cuantificación ecográfica y fusión con resonancia magnética nuclear

NARCIS (Netherlands)

Westendarp, M.; Postema, A.; de la Rosette, J.J.M.C.; Wijkstra, H.; Laguna, M.P.

OBJECTIVES: Transrectal ultrasound-guided prostate biopsy remains the gold standard in the diagnosis of prostate cancer. Various Ultrasound modalities have been proposed to increase the cancer detection rate. Our purpose is to evaluate each of these methods , and to present its current literature

EAMJ The Diagnostic Sep 09.indd

African Journals Online (AJOL)

East African Medical Journal Vol. 86 No. 9 September 2009. DIAGNOSTIC VALUES OF DIGITAL RECTAL EXAMINATION, PROSTATE SPECIFIC ANTIGEN AND TRANS-RECTAL. ULTRASOUND IN MEN WITH PROSTATISM. J. P. Manyahi, MD, MMed (Surg), MSc (Urol), Peramiho Hospital, P. O. Box 19, Peramiho.

Prostate-specific antigen density: correlation with histological diagnosis of prostate cancer, benign prostatic hyperplasia and prostatitis

NARCIS (Netherlands)

van Iersel, M. P.; Witjes, W. P.; de la Rosette, J. J.; Oosterhof, G. O.

1995-01-01

To assess the additional value of prostate-specific antigen density in the diagnosis of prostate cancer in patients who undergo prostate biopsies. The study comprised 376 patients with symptoms of prostatism who were undergoing prostate biopsy. Digital rectal examination (DRE) and transrectal

Effect of alternate day collection on semen quality of Asian elephants (Elephas maximus) with poor initial fresh semen quality

NARCIS (Netherlands)

Imrat, P.; Mahasawangkul, Sittidet; Thitaram, Chatchote; Suthanmapinanth, P.; Kornkaewrat, K.; Sombutputorn, P.; Jansittiwate, S.; Thongtip, Nikorn; Pinyopummin, A.; Colenbrander, B.; Holt, W.V.; Stout, Tom

2014-01-01

In captivity, male Asian elephants often yield poor quality semen after transrectal manually assisted semen collection; however, the reasons for the disappointing semen quality are not clear. Here we test the hypothesis that accumulation of senescent spermatozoa is a contributory factor, and that

Comparison of sonographic features in benign prostate hyperplasia and prostate cancer

International Nuclear Information System (INIS)

Choi, Won Young; Hong, Hyun Sook; Kang, Eun Young; Seol, Hae Young; Suh, Won Hyuck

1988-01-01

Transrectal sonography of prostate was sensitive to textural changes produced by both benign prostate hyperplasia (BPH) and prostate cancers. During recent 4 years, twenty cases of BPH and twenty cases of prostate cancers proven histologically were analyzed in their sonographic features, retrospectively, by using transrectal prostate sonography and suprapubic prostate sonography. The results were as follows: 1. Mean weights of BPH and prostate cancers was 40.4g and 47.6g, respectively. 2. Sonographic features of BPH revealed isoechogenecity in 11 cases, homogeneity in 18 cases, well defined capsular margins in 19 cases, and calcification in 16 cases. 3. Sonographic features of prostate cancers revealed mixed echogenecity in 14 cases, inhomogeneity in 15 cases, poorly defined capsular margin in 14 cases, and calcifications in 13 cases. 4. Authors concluded that prostate sonography were valuable diagnostic modality in the differentiation of BPH and prostate cancers.

Miocardiopatía diabética: un punto de vista retrospectivo

OpenAIRE

Rafael Ramírez; Montserrat Durán; Javier Márquez

2018-01-01

Objetivo: Estimar la prevalencia de pacientes con probable miocardiopatía diabética (sin exigir biopsia endomiocárdica), analizando sus características y comparándolas con pacientes no diabéticos con insuficiencia cardiaca idiopática. Métodos: Estudio retrospectivo sobre una cohorte de 270 pacientes que ingresaron de manera consecutiva por insuficiencia cardiaca. De estos se excluyeron del estudio todos aquellos que tuvieran una causa conocida de insuficiencia cardiaca (cardiopatía isquémi...

La anemia ferropénica como presentación de enfermedad celíaca subclínica en una población argentina

OpenAIRE

J.S. Lasa; P. Olivera; L. Soifer; R. Moore

2017-01-01

Introducción: Existe una extensa heterogeneidad en los reportes de la prevalencia de enfermedad celíaca en el contexto de la anemia ferropénica. Objetivo: Determinar la prevalencia de enfermedad celíaca en pacientes con anemia ferropénica. Materiales y métodos: Pacientes adultos con anemia ferropénica fueron reclutados para realizarse una endoscopia digestiva alta con biopsia duodenal. Se reclutaron asimismo voluntarios sanos de la comunidad como controles. Resultados: Se reclutó a 1...

Identificación del genotipo del virus del papiloma humano en pacientes portadoras de lesiones cérvico uterinas

OpenAIRE

Alexander Morales Fontaine; Odalys Rufina Peña Pérez; Alicia María Yabor Palomo; Vicente de Jesús Alvarez Yabor

2016-01-01

Fundamento: en los últimos años se ha observado un elevado predominio de mujeres infestadas por genotipos del  Virus del Papiloma Humano considerados de alto riesgo por su elevada oncogenicidad.Objetivo: identificar los genotipos del Virus del Papiloma Humano en pacientes portadoras de este con lesiones cervicales, cuyas biopsias fueron analizadas en el departamento de anatomía patológica, perteneciente al Hospital General Docente ¨Ernesto Guevara de la Serna¨, en el período comprendido entre...

Sensibilidad y especificidad de los exámenes de anticuerpos antigliadina y antiendomisio

OpenAIRE

LOZANO, WINSTON; MéNDEZ, VIRGINIA; FERREIRA, MARíA INéS; GUTIéRREZ, CARMEN

2002-01-01

La enfermedad celíaca se presenta con una gran heterogeneidad: formas sintomáticas, silentes y latentes. La determinación de anticuerpos antigliadina y antiendomisio es útil para definir a qué pacientes realizar biopsia de intestino delgado y para el seguimiento de los celíacos ya conocidos. Estas técnicas fueron incorporadas en 1994 en el Centro Hospitalario Pereira Rossell. Objetivo: conocer la sensibilidad y especificidad de los anticuerpos antigliadina (IgG) y antiendomisio (IgA) para el ...

The Healing Effect of Hydroalcoholic Extract of Hypericum Perforatum on Acetic Acid-Induced Ulcerative Colitis in Male Rats

Directory of Open Access Journals (Sweden)

Nader Tanideh

2017-02-01

Full Text Available Background & Objective: Anti-inflammatory effect of Hypericum have long been considered. Ulcerative Colitis (UC is a form of Inflammatory Bowel Disease (IBD. In this study, the effects of Hypericum perforatum on histopathological changes and tissue malondialdehyde (MDA level of colonic tissue in rats with induced UC were evaluated. Materials & Methods: 70 rats were divided into seven equal groups. Colitis was induced by acetic acid.. Groups I and II received 1 mL of 600 and 300 mg/kg H. perforatum extract orally per day respectively; groups III and IV received 1 mL of 20% and 10% intra-colonic gel form of H. perforatum extract daily respectively; group V, as positive control, received 1 mL of intra-colonic Asacol; group VI received 1 mL of normal saline as negative control; group VII received just intra-colonic gel base. All the animals were evaluated for histological changes and tissue MDA level of colon seven days after the treatment. Results: H. perforatum extract in the two forms of trans-rectal and oral administration could result in a more healing effect on acetic acid-induced damaged colonic tissue with a reduction in the MDA activity. In trans-rectal administration, the 20% gel had a better healing response than the 10% gel. In oral administration, the 600 mg/kg dosage had a better healing response than the 300 mg/kg. Conclusions: Therefor, H. perforatum can be considered as a treatment of choice for UC especially in trans-rectal gel form.

Avances en las Técnicas Ecográficas para el diagnóstico y estadiaje del cáncer de próstata. Elastografía, Ecografía doppler, Contrastes Ecográficos, Métodos de Cuantificación ecográfica y fusión con Resonancia Magnética Nuclear

NARCIS (Netherlands)

Westendarp, M.; Postema, A.; de la Rosette, J. J. M. C.; Wijkstra, H.; Laguna, M. P.

2015-01-01

Transrectal ultrasound-guided prostate biopsy remains the gold standard in the diagnosis of prostate cancer. Various Ultrasound modalities have been proposed to increase the cancer detection rate. Our purpose is to evaluate each of these methods , and to present its current literature and clinical

MRI, CT and TRUS imaging of seminal vesicle metastasis

International Nuclear Information System (INIS)

Larsson, P.; Blomqvist, L.; Norming, U.

1997-01-01

We present a case of a testicular germ-cell metastasis in the seminal vesicle. Diagnostic imaging with transrectal ultrasonography (TRUS), CT, and MRI was performed. This case emphasizes the role of MRI in the evaluation of patients with pathology in the pelvic region. (orig.)

Lycopene Supplementation in the Complementary Management of PSA Failure: A Randomized Placebo-Controlled Trial for Prostate Cancer Survivors

Science.gov (United States)

2007-01-01

N Wells, JA Smith, Jr. and MS Cookson. Intrarectal Lidocaine During Transrectal Prostate Biopsy. Journal of Urology 166: 2178-2180, 2001. -113...steroid hormone and growth factor activation/ synthesis and signaling in the prostate (55, 56). These ability to reduce normal and cancerous cell

MRI of the prostate: potential role of robots

NARCIS (Netherlands)

Fütterer, Jurgen J.; Misra, Sarthak; Macura, Katarzyna J.

2010-01-01

Prostate cancer is the most frequently diagnosed malignancy in the male population. Transrectal ultrasound- guided biopsy is still the imaging modality of choice in detecting prostate cancer. However, with prostate cancer being detected at an earlier stage, most prostate cancers tend to be isoechoic

Utilidad de la elastografía de transición (Fibroscan® en la evaluación de la fibrosis hepática en pacientes con hepatopatía crónica Usefulness of transient elastography (Fibroscan® in the assessment of fibrosis in patients with chronic liver disease

Directory of Open Access Journals (Sweden)

Daniel Álvarez

2012-02-01

Full Text Available El pronóstico de la enfermedad crónica hepática depende de la extensión y la progresión de la fibrosis hepática. Actualmente la biopsia hepática es la técnica de elección para determinar el grado de fibrosis, pero es una prueba invasiva, no exenta de complicaciones. Por ello, el desarrollo de marcadores no invasivos de fibrosis hepática se convirtió en una necesidad indiscutible. Se propuso la elastografìa por transición (Fibroscan® para valorar la fibrosis hepática en pacientes con enfermedad crónica hepática, mediante la medición de la rigidez hepática. Nuestro objetivo fue evaluar la efectividad, la objetividad y la seguridad de esta técnica. Se estudiaron 68 pacientes a los que se les realizó una biopsia hepática en los 18 meses previos al estudio. Todos los procedimientos de elastografia y biopsia hepática fueron analizados por un mismo profesional (DA y MA, respectivamente. Para la valoración de la biopsia hepática se utilizó la escala METAVIR. El valor medio de rigidez en pacientes sin fibrosis o con fibrosis leve (F0-F1 y en los pacientes con fibrosis avanzada o cirrosis (F3-F4 fue 6.8 ± 3.0 kPa y 21.0 ± 15.1 kPa, respectivamente (con diferencia significativa, p The prognosis and management of chronic liver disease largely depends on the extent and progression of liver fibrosis. Unfortunately, liver biopsy, an invasive and painful technique with several limitations, continues to be the gold standard for the staging and grading of fibrosis. Therefore, accurate noninvasive tests for liver injury are urgently needed. During the last years, transient elastography (Fibroscan® has been proposed for the assessment of hepatic fibrosis in patients with chronic liver disease, by measuring liver stiffness. The aim of this study was to evaluate the effectiveness, objectivity and safety of this technique. We included 68 patients who underwent a liver biopsy in the last 18 months with a wide spectrum of chronic liver

Prevalence of membranoproliferative glomerulonephritis at Hospital General de México “Dr. Eduardo Liceaga” over a 5-year period

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C.A. Mendoza-Cerpa

2017-10-01

Full Text Available Background: Membranoproliferative glomerulonephritis is a pattern of glomerular lesion with a variety of causes. It can be classified by using direct immunofluorescence into immune complex-mediated membranoproliferative glomerulonephritis and complement-mediated membranoproliferative glomerulonephritis. Objective: Determine the prevalence of membranoproliferative glomerulonephritis by biopsy (light microscopy, direct immunofluorescence and electron microscopy, categorise them according to the most recent classification, identify possible causes and determine certain epidemiological and clinical characteristics. Material and method: A descriptive, cross-sectional study was carried out, selecting renal biopsies with a membranoproliferative pattern at 5 years at Hospital General de México. Age, gender, clinical syndrome and immunofluorescence and electron microscopy results were obtained. Biopsies lacking immunofluorescence or electron microscopy results were excluded. Results: 133 biopsies diagnosed as membranoproliferative glomerulonephritis were obtained. The average annual rate was 3.37%, while average age was 31.35 ± 16 years. The disorder affected mostly women (60.15%, n = 80. Nephrotic syndrome was the most common clinical presentation (48.12%, n = 64, while autoimmune disease was the most common cause (77.77%, n = 91. Conclusions: Direct immunofluorescence is indispensable for classifying membranoproliferative glomerulonephritis. Resumen: Antecedentes: La glomerulonefritis membranoproliferativa es un patrón de lesión glomerular con diferentes etiologías. Se clasifica por inmunofluorescencia directa en: glomerulonefritis membranoproliferativa mediada por complejos inmunes y glomerulonefritis membranoproliferativa mediada por complemento. Objetivo: Determinar la prevalencia de las glomerulonefritis membranoproliferativas mediante la biopsia (microscopía de luz, inmunofluorescencia directa y microscop

Frecuencia de diagnósticos histopatológicos en un periodo de 20 años (1989-2008 Histopathological diagnosis frequency during 20 years (1989-2008

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Elías Romero de León

2010-03-01

Full Text Available Presentar datos sobre el diagnóstico histopatológico que se realizó en el Departamento de Patología Oral de la Facultad de Odontología de la Universidad Autónoma de Nuevo León, Monterrey, México, durante el periodo 1989 a 2008. De 2 183 biopsias, las lesiones de tejido óseo comprendieron 637 casos (29,2 % y las de tejido blando sumaron 1 529 (70,0 %, de tejido dental se procesaron 17 muestras (0,8 %. Los diagnósticos más frecuentes para tejido óseo fueron: granuloma periapical, quiste periapical, quiste dentígero y queratoquiste odontogénico (tumor odontogénico queratoquístico. Los diagnósticos más frecuentes de tejido blando fueron: fibroma, granuloma piógeno, mucocele, carcinoma epidermoide y papiloma. En el maxilar se presentaron 292 casos, en la mandíbula 258 y en 87 muestras no se especificó el maxilar de donde se obtuvo la biopsia. En el tejido blando, de encía se obtuvieron 505 biopsias; labio inferior 164, tejido blando sin especificar 157, lengua 147, mucosa alveolar 146, paladar duro 89 y otras áreas presentaron 321 muestras. De pacientes femeninos fueron 1 370 muestras (62,8 % y los masculinos con 796 biopsias (36,4 %. Hubo coincidencia entre el diagnóstico clínico con el histopatológico de 1 482 casos (67,9 %, los casos no coincidentes fueron 172 (7,9 % y 529 casos (24,2 % donde no se proporcionó diagnóstico clínico, lo cual es aceptable de acuerdo a estudios similares, pero puede ser mejorado substancialmente a través de educación continua.To submit data on the histopathological diagnosis made in the Oral Pathology Department of Stomatology of Autonomous University in Nuevo León, Monterrey, Mexico during from 1989 to 2008. From 2 183 biopsies, bone tissue lesions accounted for 637 cases (29.2 % and those that soft tissue summarized 1 529 (70 %, from dental tissue 17 samples (0.8 % were processed. For bone tissue the more frequent diagnoses were: periapical granulomas, periapical cyst, dentigerous cyst

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... with you lying on your back, possibly with your feet in stirrups similar to a gynecologic exam. Transrectal: ... RTAnswers.org Radiation Therapy for Gynecologic Cancers Radiation Therapy for Prostate ... April 01, 2017 Send us your feedback Did you find the information you were ...

Prostate Ultrasound

Medline Plus

Full Text Available ... the prostate. help diagnose the cause of a man's infertility. A transrectal ultrasound of the prostate gland is typically used to help diagnose symptoms such as: a nodule felt by a physician during a routine physical exam or prostate cancer screening exam. an elevated ...

Biomechanical modeling constrained surface-based image registration for prostate MR guided TRUS biopsy

NARCIS (Netherlands)

Ven, W.J.M. van de; Hu, Y.; Barentsz, J.O.; Karssemeijer, N.; Barratt, D.; Huisman, H.J.

2015-01-01

Adding magnetic resonance (MR)-derived information to standard transrectal ultrasound (TRUS) images for guiding prostate biopsy is of substantial clinical interest. A tumor visible on MR images can be projected on ultrasound (US) by using MR-US registration. A common approach is to use surface-based

MR demonstration of a prostate gland in a female pseudohermaphrodite

International Nuclear Information System (INIS)

Subramanian, Subramanian; Gamanagatti, Shivanand; Sharma, Raju

2006-01-01

We present the rare case of a 14-year-old female pseudohermaphrodite due to congenital adrenal hyperplasia (CAH). MRI revealed the presence of a hypoplastic uterus, ovaries, clitoromegaly, and prostate gland with its typical zonal anatomy. Transrectal sonography also confirmed the presence of a prostate gland. (orig.)

Prostate biopsy with image fusion: system validation and clinical results (abstract)

NARCIS (Netherlands)

Kruecker, J.; Kadoury, S.; Xu, S.; Turkbey, B.; Choyke, P.; Pinto, P.; Wood, B.

2011-01-01

Purpose Prostate cancer (PCA) is the second most frequent cause of cancer-related death in men in the United States and Europe. Transrectal ultrasound (TRUS) guided systematic prostate biopsy is the standard of care for detection and diagnosis of PCA. However, due to inadequate visualization of PCA

Is extended biopsy protocol justified in all patients with suspected ...

African Journals Online (AJOL)

2012-01-03

Jan 3, 2012 ... Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended.

VERIFICATION OF A TUMOR LESION OF INTRAPELVIC LYMPH NODES AFTER RADICAL PROSTATECTOMY. THE FIRST EXPERIENCE

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V. V. Kapustin

2014-08-01

Full Text Available Objective: to study the possibilities of transrectal ultrasound scan (TRUS and magnetic resonance imaging (MRI in identifying and verifying a tumor lesion of intrapelvic lymph nodes (LN in patients with biochemical recurrence after radical prostatectomy.Subjects and methods. Metastatic tumor lesion of intrapelvic LNs was verified in 4 patients by transrectal ultrasound (US-guided needle biopsies. All the patients underwent multi-parametric MRI studies and TRUS.Results. The application of current MRI technologies (for qualitative and quantitative analysis of diffusion-weighted images and for postcontrast sequences could detect and judge with confidence the metastatic lesion of intrapelvic LNs. TRUS permits clearly visualizing pathologically altered LNs, by taking into account their MRI pattern and verifying their tumor lesion by US-guided core needle biopsy.Conclusion. The combined use of multi-parametric MRI and TRUS provides a means for diagnosing and verifying the tumor lesion of pelvic LNs in patients after prostatectomy.

VERIFICATION OF A TUMOR LESION OF INTRAPELVIC LYMPH NODES AFTER RADICAL PROSTATECTOMY. THE FIRST EXPERIENCE

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V. V. Kapustin

2012-01-01

Full Text Available Objective: to study the possibilities of transrectal ultrasound scan (TRUS and magnetic resonance imaging (MRI in identifying and verifying a tumor lesion of intrapelvic lymph nodes (LN in patients with biochemical recurrence after radical prostatectomy.Subjects and methods. Metastatic tumor lesion of intrapelvic LNs was verified in 4 patients by transrectal ultrasound (US-guided needle biopsies. All the patients underwent multi-parametric MRI studies and TRUS.Results. The application of current MRI technologies (for qualitative and quantitative analysis of diffusion-weighted images and for postcontrast sequences could detect and judge with confidence the metastatic lesion of intrapelvic LNs. TRUS permits clearly visualizing pathologically altered LNs, by taking into account their MRI pattern and verifying their tumor lesion by US-guided core needle biopsy.Conclusion. The combined use of multi-parametric MRI and TRUS provides a means for diagnosing and verifying the tumor lesion of pelvic LNs in patients after prostatectomy.

Actitud clínica frente a la disfunción renal en receptores de un trasplante renal en España

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Josep M. Campistol

2015-05-01

Conclusiones: Con frecuencia los marcadores secundarios y los factores de progresión de la DRC siguen sin estar controlados después del TR, principalmente la anemia. Solo aproximadamente el 2% de pacientes se benefician de una intervención terapéutica basada en una biopsia. Existe una disparidad entre la percepción clínica y los parámetros objetivos, que conduce a una clara inercia clínica del control de los factores de riesgo de estos pacientes.

Enfermedad de depósito glomerular: a propósito de un caso de glomerulonefritis fibrilar

OpenAIRE

Jorge de Jesús Cantillo; Rocío del Pilar López; Rafael Enrique Andrade

2009-01-01

En el diagnóstico rutinario por biopsia renal encontramos enfermedades glomerulares que tienen depósitos estructurales fibrilares en la matriz extracelular del glomérulo, visibles por microscopía electrónica. La amiloidosis es la glomerulopatía más común con depósitos de estas características ultraestructurales. Sin embargo, hay otras glomerulopatías con depósitos similares, negativas con rojo Congo, pero positivas para inmunoglobulinas. La glomerulonefritis fibrilar es una entidad diagnós...

A PROSPECTIVE, RANDOMIZED STUDY OF PERIPROSTATIC

African Journals Online (AJOL)

is not very sensitive to pain, and transrectal lignocaine gel will presumably provide anesthesia to the rectal mucosa only“. Periprostatic lignocaine injection has been used to provide anesthesia for a number of indications, including laser prostatectomy, brachytherapy and TRUS guided prostate biopsyg. All but one of the 17 ...

Diagnosis of prostate cancer with needle biopsy: Should all cases ...

African Journals Online (AJOL)

Background: The triad of digital rectal examination (DRE), serum prostate specific antigen, and transrectal ultrasound‑guided prostate biopsy is used in the detection of prostate cancer (PCa). It is recommended that all cases of PCa should be diagnosed with needle biopsy before treatment. The exclusion criteria for those ...

Prostate Ultrasound

Medline Plus

Full Text Available ... an example of a transrectal transducer (probe). A prostate-specific antigen (PSA) test, which measures the amount of PSA in the blood, may be administered to determine if a patient is at high risk for ... of the prostate gland. When the examination is complete, you may ...

Is extended biopsy protocol justified in all patients with suspected ...

African Journals Online (AJOL)

Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended 10-core digitally guided ...

Validación del KDRI/KPDI para la selección de donantes renales con criterios expandidos

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Raimundo M García del Moral Martín

2018-05-01

Full Text Available Resumen: Introducción: El KDRI y su variante KDPI son dos herramientas utilizadas para la valoración del donante renal. Se ha propuesto la utilidad del KDPI como sustituto/complementario a la biopsia renal preimplantación. Estos scores no están validados en España. Objetivo: 1 Investigar la concordancia entre los scores KDPI e histológico (biopsia renal preimplantación, y 2 valorar la relación entre el KDRI, KDPI y la puntuación histológica sobre la supervivencia del injerto, en donantes con criterios expandidos (ECD. Metodología: Estudio de cohortes, unicéntrico, retrospectivo desde el 1 de enero de 1998 hasta el 31 de diciembre de 2010. Resultados: Se reclutaron 120 donantes y 220 biopsias preimplantación. Ciento cuarenta y cuatro (65,5% injertos fueron aptos para trasplante. Setenta y seis (34,5% fueron descartados. Tiempo medio de seguimiento 6,4 años (ds 3,9. Edad media de los donantes 63,1 años (ds 8,2, varones (145; 65,9%, no diabéticos (191; 86,8% y sin otros factores de riesgo cardiovascular (173; 78,6%. Causa de muerte mayoritaria ACV hemorrágico (153; 69,5%. La puntuación KDPI media entre los grupos riñón válido (1,56/89; ds 0,22 y no válido (1,66/93; ds 0,15 es estadísticamente significativa (p < 0,01. El KDPI mostró una concordancia y correlación moderadas con el score histológico (AUC 0,64/coeficiente de correlación 0,24, p < 0,01. Los scores KDPI (HR 24,3, p < 0,01 y KDRI (HR 23,3, p < 0,01 están relacionados con la supervivencia del injerto en el análisis multivariante. Conclusión: 1 Los scores KDPI e histológico presentan una concordancia moderada. 2 Las puntuaciones KDPI, y sobre todo KDRI, son válidas para estimar la supervivencia de los injertos y pueden ser utilizadas de forma combinada con la biopsia para la toma de decisiones individualizadas en el grupo de donantes con criterios expandidos. Abstract: Introduction: KDRI / KDPI are tools use in kidney donor evaluation. It has been proposed as

Validation of KDRI/KDPI for the selection of expanded criteria kidney donors

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Raimundo M. García del Moral Martín

2018-05-01

Full Text Available Introduction: KDRI/KDPI are tools use in kidney donor evaluation. It has been proposed as a substitute of, or complementary to preimplantation renal biopsy. These scores have not been validated in Spain. Objective: (1 To investigate the concordance between KDPI and histological scores (preimplantation renal biopsy and (2 to assess the relationship between KDRI, KDPI and histological score on graft survival in the expanded criteria donors group. Methodology: Retrospective cohort study from 1 January 1998 to 31 December 2010. Results: During the study 120 donors were recruited, that resulted in 220 preimplantation renal biopsies. 144 (65% grafts were considered suitable for kidney transplantation. 76 (34.5% were discarded. Median follow up has been 6.4 years (sd 3.9. Median age 63.1 years (sd 8.2, males (145; 65.9%, non-diabetic (191; 86.8% and without another cardiovascular risk factors (173; 78.6%. 153 (69.5% donors died of cerebrovascular disease. There were significant differences in KDRI/KDPI score in both groups 1.56/89 (sd 0.22 vs 1.66/93 (sd 0.15, p < 0.01. The KDPI showed moderate concordance and correlation with the histological score (AUC 0.64/correlation coefficient 0.24, p < 0.01. KDPI (HR 24.3, p < 0.01 and KDRI (HR 23.3, p < 0.01 scores were associated with graft survival in multivariate analysis. Conclusion: (1 KPDI and histological scores show moderate concordance. The utility of both scores as combined tools it has to be determined. (2 KDPI score, and especially KDRI score, are valid for estimating graft survival and combined with the biopsy can help to individualized decision making in the expanded criteria donors pool. Resumen: Introducción: El KDRI y su variante KDPI son dos herramientas utilizadas para la valoración del donante renal. Se ha propuesto la utilidad del KDPI como sustituto/complementario a la biopsia renal preimplantación. Estos scores no están validados en España. Objetivo: 1 Investigar la

Respuesta a los esteroides en el síndrome nefrótico idiopático

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Sandalio Durán Álvarez

1999-12-01

Full Text Available Se analiza retrospectivamente la respuesta a la prednisona de 290 niños con síndrome nefrótico idiopático; de éstos, 190 lo constituían varones. En el estudio con microscopia óptica de las biopsias renales 234 pacientes mostraron lesión mínima y sólo 5 (2,2 % no respondieron inicialmente al tratamiento; 27 de ellos (11,6 % no recayeron en un período de seguimiento de 5 años o más. Veinte y seis niños (9,0 % tenían glomeruloesclerosis focal segmentaria en la biopsia renal y 17 de éstos no respondieron a la prednisona; todos los que respondieron presentaron recaídas evolutivamente. Treinta niños (11,0 % mostraban proliferación mesangial difusa y 8 (26,7 % no respondieron al tratamiento; 1 solo paciente con proliferación mesangial difusa no recayó y en este niño el cuadro nefrótico coincidió con una picadura de abeja. Se considera actualmente que por el reducido porcentaje de niños con lesión mínima que no responden a la prednisona, la biopsia renal se debe reservar para los que no responden a este tratamiento.The response to prednisone treatment by 290 children -190 males- with idiophatic nephrotic syndrome was retrospectively analyzed. The study of kidney biopsies by optical microscopy revealed that 234 had minimal changes and only 5(2,2 % did not response to initial treatment; 27(11,6 % did not have any relapse ina a 5 year or over follow- up period. Twenty-six children (9 % suffered from focal segmental glomerulosclerosis acording to their kidney biopsies, 17 of them did not respond to prednisone treatment whereas the others who did, had relapses in their recovery. Thirtly children (11,0 % showed diffuse messangial proliferation and 8 (26,7 % did not respond to treatment. Only one child with this disease did not have any relapse and his nephrotic condition coincided with a bee sting. At present, it is believed that since the percent of children with minimal change disease who did not respond to prednisone therapy is

Validación del Protocolo para el Estudio de la Hemorragia Uterina Anormal con Ecografía endovaginal y medio de Contraste (Sonohisterografía.

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Ricardo Rueda Saenz

2003-08-01

Full Text Available

La evaluación del sangrado uterino anormal (SUA especialmente en los años postreproductivos, convencionalmente se hace recurriendo a las biopsias y aspiraciones endometriales ciegas en el consultorio, o al curetaje uterino bajo anestesia general. Dichos procedimientos, además de ser invasivos, han mostrado ser poco sensibles y específicos en la detección y el tratamiento de la patología focal del endometrio (pólipos, leiomiomas submucosos, y además pueden resultar costosos. Con el advenimiento de la histeroscopia, se han obviado muchas de las dificultades atribuidas a la biopsia ciega y el curetaje uterino, pero aquella, además de requerir un entrenamiento específico y un equipo costoso, requiere de anestesia local o general, en ocasiones dilatación del cervix y en muchas instancias arroja resultados negativos.

De otro lado, la histeroscopia sólo permite evaluar el canal cervical y la cavidad endometrial, sin poder visualizar la pared miometrial, los anexos y otras estructuras pélvicas, lo cual desvirtúa su uso en una gran proporción de pacientes como investigación inicial rutinaria en el sangrado uterino anormal.

La utilización de la ecografía transvaginal con contraste líquido (sonohisterografía o histerosonografía permite, por el contrario, no solamente una evaluación precisa y detallada del canal cervical y la cavidad endometrial, sino que permite evaluar la pared miometrial, los ovarios y otras estructuras pélvicas, así como la permeabilidad de las trompas uterinas.

Este procedimiento tiene además un bajo costo, no requiere de entrenamiento especial, tampoco de anestesia ni de dilatación cervical y tiene bajas tasas de complicaciones. Con la sonohisterografía se pueden seleccionar en forma eficiente y rápida, las mujeres que realmente se benefician de una histeroscopia diagnóstica-operatoria o de una biopsia endometrial ciega de consultorio para evaluar el SUA.

El presente estudio

Estudio de cinco años en pacientes de Las Tunas con cáncer cutáneo no melanoma

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Odalys Rufina Peña Pérez

2015-11-01

Full Text Available Fundamento: el cáncer cutáneo no melanoma ha mostrado un incremento paulatino a nivel mundial, en Las Tunas, Cuba, existe un comportamiento similar.Objetivo: caracterizar los pacientes diagnosticados histopatológicamente con cáncer cutáneo no melanoma, cuyas biopsias fueron analizadas en el departamento de anatomía patológica del Hospital General Docente "Dr. Ernesto Guevara de la Serna", en el período comprendido entre enero de 2010 a diciembre 2014.Métodos: se realizó un estudio descriptivo de corte transversal en 3970 pacientes, atendidos en el lugar y período de tiempo antes señalado, se utilizó el modelo oficial de biopsia como fuente secundaria de recolección de la información. Los datos fueron procesados utilizando la estadística descriptiva.Resultados: la frecuencia de aparición de este cáncer en el 2010 fue de 15,6 %, se incrementó en el 2011 a 21,7 %, en 2012 y 2013 osciló, con valores de 20,62 % y 22,5 %, respectivamente, y en el 2014 mostró una disminución de los casos positivos a 19,5 %. El tipo histológico predominante fue el carcinoma basocelular, por encima del 50 % en todos los años y estuvo presente en el 65,4 % del total de la muestra estudiada. Se obtuvieron cifras muy cercanas entre ambos sexos: masculino (51,5 % y femenino (48,5 %. El grupo de edad de mayores de 60 años predominó, con el 61,2 % del total de pacientes. La mayoría procedían de las consultas de atención secundaria (76,62 % y la especialidad que más biopsias indicó fue dermatología con un 42,84 %.Conclusiones: la variedad histológica que predominó en los pacientes con cáncer cutáneo no melanoma fue el carcinoma basocelular y su frecuencia fue mayor en pacientes con más de 60 años, la atención primaria no constituyó el principal eslabón de pesquisa y tratamiento de esta afección y los pacientes fueron mayormente atendidos por dermatólogos y cirujanos maxilofaciales.

[Ultrasound physiotherapy treatment of prostatitis].

Science.gov (United States)

Talberg, P I; Andryukhin, M I; Mazina, S E; Nikolaev, A L

2016-12-01

Develop a method of treatment of prostatitis based on the use of a standard antibiotic, immunomodulatory therapy, and transrectal ultrasound physiotherapy. The dynamics of the accumulation of the antibiotic was investigated in male rats. Sonication was performed immediately before the administration of the antibiotic and its accumulation in the process at 10, 20, 40, 60, 80, 100 min after dosing. The clinical study included 138 patients with chronic prostatitis. Patients of the experimental group, in addition to standard therapy, 10 sessions of transrectal ultrasound physical therapy was performed. The efficacy of treatment was assessed after 14 and 28 days after initiation. and its discussion. Experiments on laboratory animals have shown that the highest concentration and the residence time of antibiotic in the prostate tissue is noted ultrasonic treatment in the period of maximum blood concentration of the test drug. The data obtained allow to determine that the ultrasonic treatment must be performed considering the pharmacokinetics of the antibiotic. In conducting clinical trials on day 14 of treatment and clinical manifestations of prostatitis bacterial microflora in prostatic secretions were no patients in both groups. In 15% of patients of the experimental group the number of leukocytes decreased to the normal range. After 28 days the amount of leukocytes was normal in 51% of patients in the control and 85% in the experimental group. In animal experiments defined the optimal time interval separating the moment of injection of the antibiotic from the beginning of sonication. Clinical studies have shown that the transrectal ultrasound exposure during the period of maximum concentration of the antibiotic in the blood, improves patient outcomes by 33.8%.

Aspectos clínicos y endoscópicos del adenocarcinoma gástrico en pacientes de Las Tunas, enero de 2013 a enero de 2014

Directory of Open Access Journals (Sweden)

Liem Fonseca Chong

2014-08-01

Full Text Available Se realizó un estudio descriptivo de corte transversal, con el objetivo de caracterizar los pacientes atendidos por adenocarcinoma gástrico en el Hospital General Docente “Dr. Ernesto Guevara de la Serna” de provincia de Las Tunas, durante el periodo comprendido entre el 1 de enero de 2013 y el 1 de enero de 2014. El universo quedó constituido por todos los pacientes a los que se les realizó biopsia de estómago, por lesión sospechosa de adenocarcinoma gástrico, y la muestra por todos los pacientes con diagnóstico histológico de esta enfermedad. Para la obtención de los datos primarios se revisaron los expedientes clínicos de 23 pacientes con biopsia positiva. A partir de un cuestionario se recogieron y procesaron los datos y se interpretaron los resultados. Se encontró un predominio en el sexo masculino (69,5%, en los mayores de 51 años (30,4% y en la población de raza negra (47,8% con antecedentes de infección por helicobacter pylori (69,5%. El 43,4% de los pacientes debutó con una dispepsia prolongada, como síntoma predominante, y la imagen endoscópica más observada fue la úlcera cancerosa (12 casos, en relación con el patrón histológico difuso

Correlación clínico-histopatológicaen la enfermedad periodontal inflamatoriacrónica

Directory of Open Access Journals (Sweden)

Nereyda Riesgo Lobaina

1999-12-01

Full Text Available Se realizó el estudio de 40 biopsias seleccionadas en el Departamento de Anatomía Patológica de la Facultad de Estomatología de La Habana, 20 correspondientes a pacientes con diagnóstico clínico de gingivitis crónica y 20 pacientes con periodontitis, con la finalidad de conocer los principales cambios que se producen en el epitelio y la lámina propia. Estos casos tuvieron la condición de no referir al interrogatorio enfermedad sistémica, lo cual se verificó al consultar las historias clínicas de los casos seleccionados. El análisis de las muestras de biopsias obtenidas demostró la alta correspondencia del diagnóstico clínico y los hallazgos histomorfológicos encontrados, lo cual corrobora una serie de estudios realizados en nuestro país y a nivel mundial.Study of 40 selected biopsies was carried out in Pathologic Anatomy Department of Dentistry Faculty of Havana City, 20 ot them corresponding to patients with clinical diagnosis of chronic gingivitis, in order to know main changes produced in epithelium and lamina propria. These cases, when they were interviewed not refered systemic disease, which was verified by searching in medical records of selected patients. Analysis of sample biopsies obtained demonstrate a high corrspondence between clinical diagnosis and histomorphologic findings, what corroborates a serie of studies carried out in our country and worldwide.

A rare prostatic diagnosis of an old man: a pure prostatic leiomyoma

NARCIS (Netherlands)

Ulden-Bleumink, W.M. van; Dom, P.G.; Ramakers, B.P.C.; Adrichem, N.P. van

2013-01-01

A pure leiomyoma of the prostate is a rare benign tumor. An 82-year-old man was referred to our urology department with gross hematuria and complete urinary retention. Examination revealed a benign prostatic hyperplasia. Transrectal ultrasound showed a prostate of 125 mL. Serum PSA was 1.9 microg/L.

Adenocarcinoma de endometrio de patrón sertoliforme

OpenAIRE

Baquedano M, Laura; Puig F, Fernando; Rubio C, Patricia; Angel Ruiz C, Miguel

2012-01-01

Se presenta el caso de una paciente que consultó por metrorragia posmenopaúsica. En la biopsia histeroscópica dirigida se informó de adenocarcinoma de endometrio endometrioide bien diferenciado. Se practicó histerectomía, doble anexectomía y lavados peritoneales. Durante el acto quirúrgico se valoró el grado de infiltración miometrial, que al revelar afectación del útero hasta la serosa, implicó la realización de linfadenectomía de espacios pélvicos y paraaórtico. El diagnóstico definitivo an...

Estudio de la enfermedad celíaca mediante el desarrollo de un ensayo inmunocromatográfico para la determinación de anticuerpos antitransglutaminasa

OpenAIRE

Galván Cabrera, José Armando

2012-01-01

En el presente trabajo se muestran los resultados del desarrollo y la evaluación de un sistema inmunocromatográfico rápido y sencillo para la detección de anticuerpos antitransglutaminasa, que es un importante marcador serológico en el diagnóstico de la enfermedad celíaca (EC). Con este sistema se pueden detectar en una misma prueba tanto anticuerpos de tipo IgA como IgG. Se obtuvieron niveles de sensibilidad, especificidad y concordancia elevados cuando se compararon con la biopsia de yeyuno...

Espondilodiscitis cervicales

OpenAIRE

Barrecheguren, E.Gª. (E.Gª); Barriga, A. (A.); Barroso, J.L. (J.L.); Villas, C. (C.)

2001-01-01

Se revisaron nueve casos de discitis infecciosas de localización cervical de una serie de ochenta pacientes con espondilodiscitis (10%). Se valoraron mediante historia clínica, analítica y radiología simple todos ellos. Además, seis de ellos se valoraron por Resonancia Magnética, tres por gammagrafía ósea, y un caso por punción-biopsia. Los factores predisponentes eran claros en seis de los pacientes, encontrando entre ellos tres sepsis por Stafilococcus aureus, dos intervenciones quirúrgicas...

Características metabólicas del músculoGluteus medius de equinos mestizos con aptitud de tiro

OpenAIRE

MERINO, V.; ISLAS, A.; LOPEZ-RIVERO, J.; MORA, G.; QUEZADA, M.; LOPEZ, J.; REYES, J.

1998-01-01

De 16 equinos mestizos de tiro, de ambos sexos, clínicamente sanos, se obtuvieron biopsias del músculo Gluteus medius a 3, 6 y 9 cm de profundidad, con el objetivo de evaluar su metabolismo anaeróbico y aeróbico, determinando las actividades de las enzimas creatinquinasa (CK), deshidrogenasa láctica (LDH) y citrato sintetasa (CS) en animales inactivos y trabajando en faenas agrícolas. El tejido muscular se homogeneizó, sonicó y centrifugó; posteriormente en el sobrenadante se determinaron la...

Características metabólicas del músculoGluteus medius de equinos mestizos con aptitud de tiro Metabolic characteristics of the Gluteus medius musclein crossbreed draft horses

OpenAIRE

V. MERINO; A. ISLAS; J. LOPEZ-RIVERO; G. MORA; M. QUEZADA; J. LOPEZ; J. REYES

1998-01-01

De 16 equinos mestizos de tiro, de ambos sexos, clínicamente sanos, se obtuvieron biopsias del músculo Gluteus medius a 3, 6 y 9 cm de profundidad, con el objetivo de evaluar su metabolismo anaeróbico y aeróbico, determinando las actividades de las enzimas creatinquinasa (CK), deshidrogenasa láctica (LDH) y citrato sintetasa (CS) en animales inactivos y trabajando en faenas agrícolas. El tejido muscular se homogeneizó, sonicó y centrifugó; posteriormente en el sobrenadante se determinaron las...

Módulo para solicitudes de gammagrafía ósea en pacientes con cáncer

OpenAIRE

Morales, Rosanna; Vásquez, Edinson; Cano, Roque; Díaz, Pepe; Vásquez, Mario; Vásquez, María; Rojas, Peter

2014-01-01

Se reporta la aplicación de un software que permite registrar con datos completos y pertinentes del paciente, la solicitud para la realización de los exámenes de gammagrafía ósea, con la finalidad que cada información sea consultada adecuadamente y el paciente sea atendido con eficiencia en los servicios de medicina nuclear. La gammagrafía ósea es un estudio de uso frecuente que permite diagnosticar la existencia de un cáncer primario, dirigir un estudio para biopsia o reportar la diseminació...

p53 expresado en la mucosa gástrica de pacientes infectados por Helicobacter pylori

Directory of Open Access Journals (Sweden)

G.A. Morales-Fuentes

2013-01-01

Conclusiones: Se demuestra asociación significativa entre Hp y la expresión de p53, incluso en pacientes con lesiones preneoplásicas y ya sin la presencia del Hp. Ya que la identificación de lesiones preneoplásicas es importante para la prevención del cáncer; la toma de biopsias rutinarias durante la endoscopia para la detección de Hp podría verse beneficiada de la inmunohistoquímica, identificando a pacientes con expresión de p53, un importante oncogén regulador.

Seguimiento del perfil proteico urinario en el trasplante renal

OpenAIRE

Facio, María Laura; Madalena, Leticia; Bacqué, María del Carmen; Idiarte, Laura; Pandolfo, Marcela; Angerosa, Margarita; Alejandre, Mariel; Fraind, Susana; Bresciani, Pablo; Pizzolato, Marco

2010-01-01

La nefropatía crónica del trasplante (NCT) se caracteriza por fibrosis intersticial y atrofia tubular, pero su etiología es diversa. El objetivo del trabajo fue evaluar el seguimiento cualitativo de proteínas urinarias en pacientes con más de seis años de trasplante renal y compararlo con parámetros de laboratorio y con biopsia renal. Se evaluaron 17 pacientes durante un año, a través de creatinina sérica, proteinuria y fraccionamiento proteico por electroforesis en geles de poliacrilamida (S...

Paciente con tumor de cuerpo carotideo

Directory of Open Access Journals (Sweden)

Mariuska Forteza Sáez

Full Text Available Los tumores de cuerpo carotideo (paragangliomas son neoplasias altamente vascularizadas, muy poco frecuentes y generalmente benignas, originadas en los quimiorreceptores del cuerpo carotideo. Se presenta el caso de un paciente de 54 años, con aumento de volumen cervical derecho, asintomático, con estudio preoperatorio y angiografía realizados por tomografía axial computarizada, que resultan compatibles con tumor de cuerpo carotideo. Se realiza disección subadventicial, informando la biopsia paraganglioma. El tumor fue completamente resecado, sin evidencia de recurrencia y sin complicaciones.

Valoración de la citología exfoliativa como factor de predicción en lesiones de la mucosa oral.

OpenAIRE

Brunotto, M.; Zárate, A.M.; Cismondi, A.; Fernández, M.D.C.; Noher de Halac, R.I.

2005-01-01

El objetivo de este estudio fue inmunomarcar las oncoproteínas CK14, p53, p21 y Bc1-2 a fin de evaluar la magnitud de su expresión en lesiones estomatológicas premalignas y malignas en el epitelio oral, y comparar esta expresión con alteraciones en las citologías exfoliativas de los mismos pacientes. Se estudiaron biopsias y citologías de trece sujetos con líquenes plano oral con y sin infección con Virus Papiloma Humano (HPV), leucoplasias, y carcinomas espinoce...

Enfermedad pulmonar intersticial difusa en trabajadores de la limpieza

OpenAIRE

Bravo Graterol, Ricardo Alejandro

2011-01-01

En este trabajo se describen las características de 5 trabajadores de la limpieza que fueron diagnosticados de enfermedad pulmonar intersticial difusa no aguda de causa desconocida mediante biopsia pulmonar quirúrgica. La edad media fue de 64 años y 4 fueron mujeres. Las exposiciones más frecuentes fueron el salfumán y lejía, y ninguno de los pacientes utilizó protección adecuada. Las características más llamativas de estos pacientes se observaron en la TACAR y la histopatología que mostraron...

Amigdalitis hemorrágica: Presentación de un caso

OpenAIRE

Walbaum G, Benjamín; Winter D, Matías; Huidobro D, Bárbara

2016-01-01

La amigdalitis hemorrágica es una complicación poco frecuente de los cuadros faringoamigdalinos con reducido número de casos reportados en la literatura. Presentamos el caso de una paciente de 28 años que consultó al servicio de urgencia por un cuadro de un día de evolución de odinofagia, fiebre y tos hemoptoica, diagnosticándose una amigdalitis hemorrágica que requirió amigdalectomía de urgencia por la persistencia del sangrado. En la biopsia se encontró la presencia de actinomices. Se manej...

Tuberculosis abdominal Abdominal tuberculosis

OpenAIRE

T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría

2005-01-01

La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...

Susceptibilidad antibiótica de Helicobacter pylori : un estudio de prevalencia en pacientes con dispepsia en Quito, Ecuador

OpenAIRE

Reyes Ch, Jorge; Guzmán, Katherine; Morales, Eduardo; Villacís, José; Pazmiño Quirós, Galo Fernando; Pacheco Tigselema, Rosa Eugenia; Escalante, Luis Santiago

2017-01-01

Resumen Introducción: el Helicobacter pylori se asocia con patologías gastrointestinales, el incremento en la resistencia a los antibióticos utilizados para su erradicación es alarmante a nivel mundial. En este estudio se determinó la susceptibilidad a 5 antibióticos utilizados en la terapia de erradicación de H. pylori aislado de una población adulta con dispepsia recurrente en Quito, Ecuador. Materiales y métodos : previa aceptación del consentimiento informado, se tomaron biopsias de cu...

Evaluación de la fibrosis hepática en la hepatitis crónica por virus C mediante la aplicación prospectiva del Sabadell's NIHCED score: Sabadell's Non Invasive, Hepatitis C Related-Cirrhosis Early Detection Score Prospective evaluation of liver fibrosis in chronic viral hepatitis C infection using the Sabadell NIHCED: non-invasive hepatitis C related cirrhosis early detection index

Directory of Open Access Journals (Sweden)

G. Bejarano

2009-05-01

Full Text Available Introducción: la hepatitis crónica por VHC cursa de forma asintomática desarrollando cirrosis hepática y sus complicaciones en un 20-40% de los casos. En estudios previos se ha demostrado que la fibrosis avanzada es un factor pronóstico fundamental. El método gold standard para la valoración del grado de fibrosis es la biopsia hepática. Nuestro grupo ha validado un índice predictivo, el NIHCED (Sabadell's Non Invasive, Hepatitis C related-Cirrosis Early Detection Score, basado en datos demográficos, analíticos y ecográficos para determinar la presencia de cirrosis. Objetivo: nuestro objetivo es el de evaluar si el NIHCED predice la presencia de fibrosis avanzada en los pacientes con hepatitis crónica por virus C. Material y métodos: estudio prospectivo donde se incluyeron pacientes con hepatitis crónica por VHC. Se les realizó una biopsia hepática y el NIHCED. El grado de fibrosis se correlacionó con el valor del NIHCED mediante curva de ROC y el coeficiente de correlación de Spearman. Resultados: se incluyeron un total de 321 pacientes (ratio hombre/mujer 1,27 con una edad media de 48 ± 14 años. La biopsia hepática mostró que 131 (30,5% no tenían fibrosis o era expansión portal, mientras que 190 (69,5% tenían fibrosis avanzada o cirrosis. Para un punto de corte de 6 puntos, la sensibilidad fue del 72%, especificidad del 76,3%, VPP del 81%, VPN del 63,7% y una precisión diagnóstica del 72,5%, con un área bajo la curva fue de 0,787 y un coeficiente de correlación de Spearman de r = 0,65. Conclusiones: el NIHCED predice la presencia de fibrosis avanzada en un elevado porcentaje de pacientes sin necesidad de realizar biopsia hepática.Introduction: liver disease resulting from chronic hepatitis C virus (HCV infection follows an asymptomatic course towards cirrhosis and its complications in 20-40% of cases. Earlier studies demonstrated that advanced fibrosis is a prognostic factor. The "gold standard" for the evaluation

Early pregnancy diagnosis in goats by transrectal echography

International Nuclear Information System (INIS)

Acosta, JI

2007-01-01

Echography observations every 5 days from 20 until 45 days past-mating, were carried out to determine when the pregnancy in goats can he detected and which are the elements that can be used for the which are the elements that can be used for the diagnosis with are ultrasonic equipment Aloka SSD 500 with a 5.0 MHz probe. From 25 days the pregnancy can be detected when the embryonic vesicle the observed. However, the higher was used efficiency is attained between the 30 and 35 days when embryons with heart beat as main sign of viability are observed

Transrectal Near-Infrared Optical Tomography for Prostate Imaging

Science.gov (United States)

2011-03-01

ve IR contrasts within the region are plotted. NT: needle track. ig. 2 a The progression of peak NIR contrasts within the rectangula ongitudinal...engineering from the University of Okla- homa , Norman, OK, in 1996, and the M.D. degree from the University of Oklahoma Health Sciences Center...Oklahoma City, in 2000. Since 2005, he has been an Assistant Professor with the Department of Urology, University of Okla- homa Health Sciences Center

In vivo optoacoustic temperature imaging for image-guided cryotherapy of prostate cancer

Science.gov (United States)

Petrova, E. V.; Brecht, H. P.; Motamedi, M.; Oraevsky, A. A.; Ermilov, S. A.

2018-03-01

The objective of this study is to demonstrate in vivo the feasibility of optoacoustic temperature imaging during cryotherapy of prostate cancer. We developed a preclinical prototype optoacoustic temperature imager that included pulsed optical excitation at a wavelength of 805 nm, a modified clinical transrectal ultrasound probe, a parallel data acquisition system, image processing and visualization software. Cryotherapy of a canine prostate was performed in vivo using a commercial clinical system, Cryocare® CS, with an integrated ultrasound imaging. The universal temperature-dependent optoacoustic response of blood was employed to convert reconstructed optoacoustic images to temperature maps. Optoacoustic imaging of temperature during prostate cryotherapy was performed in the longitudinal view over a region of 30 mm (long)  ×  10 mm (deep) that covered the rectum, the Denonvilliers fascia, and the posterior portion of the treated gland. The transrectal optoacoustic images showed high-contrast vascularized regions, which were used for quantitative estimation of local temperature profiles. The constructed temperature maps and their temporal dynamics were consistent with the arrangement of the cryoprobe and readouts of the thermal needle sensors. The temporal profiles of the readouts from the thermal needle sensors and the temporal profile estimated from the normalized optoacoustic intensity of the selected vascularized region showed significant resemblance, except for the initial overshoot, that may be explained as a result of the physiological thermoregulatory compensation. The temperature was mapped with errors not exceeding  ±2 °C (standard deviation) consistent with the clinical requirements for monitoring cryotherapy of the prostate. In vivo results showed that the optoacoustic temperature imaging is a promising non-invasive technique for real-time imaging of tissue temperature during cryotherapy of prostate cancer, which can be combined

Effect of postpartum suppression of ovulation on uterine involution in dairy cows.

Science.gov (United States)

Heppelmann, M; Brömmling, A; Weinert, M; Piechotta, M; Wrenzycki, C; Bollwein, H

2013-09-15

The objective of this study was to investigate the effect of time of first postpartum ovulation after calving on uterine involution in dairy cows with and without uterine puerperal disease. Transvaginal follicular puncture (FP) of follicles >6 mm suppressed ovulation and development of a CL until Day 42 after calving. Fifty-three lactating Holstein Friesian cows (3.4 ± 1.2 years old, parity 2.5 ± 1.0 [median ± mean absolute deviation]) were divided into groups on the basis of the presence (UD+) or absence (UD-) of uterine disease and whether FP was carried out (FP+) or not (FP-). Uterine disease was defined as the occurrence of retained fetal membranes and/or metritis. This resulted in the following groups: UD-FP- (n = 15), UD-FP+ (n = 13), UD+FP- (n = 13), and UD+FP+ (n = 12). A general examination, vaginoscopy, transrectal palpation, and transrectal B-mode sonography of the reproductive organs were conducted on Days 8, 11, 18, and 25 and then every 10 days until Day 65 after calving. After hormonal synchronization of ovulation (cloprostenol between Days 55 and 60 postpartum and GnRH 2 days later), cows were inseminated in the next spontaneous estrus. On average, the cows ovulated on Day 21.0 ± 6.0 (UD-FP-), 50.0 ± 4.0 (UD-FP+), 16.0 ± 3.0 (UD+FP-), and 48.0 ± 2.0 (UD+FP+) postpartum. Calving-to-conception interval and first-service conception rates were not affected by FP (P > 0.05). Healthy cows with FP had smaller (P uterine horn and cervical diameters assessed sonographically than cows without FP. FP reduced the prevalence of purulent vaginal discharge and uterine size assessed transrectally in UD+ cows (P uterine involution in cows with and without uterine disease. Copyright © 2013 Elsevier Inc. All rights reserved.

Zinc in human prostate gland. Normal, hyperplastic and cancerous

International Nuclear Information System (INIS)

Zaichick, V.Ye.; Sviridova, T.V.; Zaichick, S.V.

1997-01-01

Zinc concentration in a prostate gland is much higher than that in other human tissues. Data about zinc changes for different prostate diseases are limited and greatly contradictory. Zinc content was determined for biopsy and resected materials of transrectal puncture tissues from benign prostate hyperplasia (BPH) and prostate cancer. There were 109 patients (50 BPH and 59 cancer) available for the present study. Control group consisted of 37 intact glands of men died an unexpected death (accident, murder, acute cardiac insufficiency, etc.). All materials studied were divided into two parts. One of them was morphologically examined, while another one was subjected to zinc analysis by INAA. Zinc contents (M ± SE) of normal, benign hyperplastic and cancerous prostate glands were found to be 1018 ± 124, 1142 ± 77, and 146 ± 10 μg/g dry tissue, respectively. It was shown that zinc assessments in the materials of transrectal puncture biopsy of indurated prostate sites can be used as an additional test for differential diagnostics of BPH and cancer. Accuracy, sensitivity and specificity of the test are 98 ± 2%. (author)

Superficial biopsy of the cervix: new technique

Directory of Open Access Journals (Sweden)

Ettore De Girolami

2002-06-01

Full Text Available Cytological examination of the cervix in all patients is considered a necessity. A new technique of superficial biopsy is described and advantages en. numeratedEl Autor presenta una nueva técnica para biopsia superficial, considerando la necesidad de hacer rutinariamente a todas las pacientes el examen citológico del cérvix. La muestra se toma con el extremo de un aplicador cubierto de gaza. Este dispositivo, humedecido previamente en una solución de etanol, metanol y éter etílico, se aplica inmediatamente al cérvix del útero y, dándole un movimiento como el de las manecillas del reloj, se toma la muestra con la que se hacen frotis por aposición que se colorean por el método de Giemsa. Esta técnica ofrece la ventaja de que el tejido en estudio se adhiere perfectamente a la gaza, la cual, con el movimiento de rotación, desprende las células del "os uteri", las que son fijadas al mismo tiempo. La preparación del dispositivo es sumamente sencilla. La prueba resulta de bajo costo como de breve y fácil realizaciónL' Autore prende in considerazione l'utilitá dell' esame citologico del collo dell'utero, fatto rutinariamente a tutte le pazienti. Si descrive una nuova tecnica di biopsia superficiale che oltfe ad offrire dei vantaggi é di poca spesa e si puó eseguire con facilitá ed in breve tempo

Comportamiento del quiste branquial en pacientes del Hospital General Docente "Ciro Redondo García", Artemisa, 1993-2009

Directory of Open Access Journals (Sweden)

Juan Carlos Quintana Díaz

2012-03-01

Full Text Available El quiste branquial de origen congénito que aparece en la región lateral del cuello es, con frecuencia, motivo de consulta. Se tuvo como objetivo determinar el comportamiento de los quistes branquiales en el Hospital "Ciro Redondo García", de Artemisa en el periodo de 1993 al 2009. Se realizó un estudio descriptivo transversal de los quistes branquiales diagnosticados en pacientes intervenidos quirúrgicamente en el Servicio de Cirugía Maxilofacial. Se estudiaron la edad, el sexo, el color de la piel, el lado del cuello afectado, el resultado histopatológico y los medios auxiliares empleados. Se encontraron 12 quistes branquiales que afectaron el 50 % de ambos sexos, un 75 % a pacientes entre 15 y 30 años y un 75 % de la piel blanca, un 66,7 % afectó el lado derecho del cuello y en un 100 % de los casos se utilizó la biopsia y el ultrasonido como medios auxiliares para su diagnóstico. Se encontró epitelio escamoso estratificado en un 100 % de los quistes y en un 91,6 % el tejido linfoide. No se encontró predilección por el sexo, la mayoría de los pacientes eran menores de 30 años, de piel blanca y presentaban los quistes en el lado derecho del cuello. En todos los pacientes se empleó la biopsia y el ultrasonido como medios auxiliares de diagnóstico. El epitelio escamoso estratificado y el tejido linfoide fueron los hallazgos histopatológicos más relevantes.

PCR para la confirmación de transmisión experimental de Leishmania chagasi a hámster sano por picadura de Lutzomyia longipalpis (Diptera: Psychodidae.

Directory of Open Access Journals (Sweden)

Olga L. Cabrera

2003-06-01

Full Text Available Se evaluó la efectividad de la PCR como herramienta en la detección de la transmisión experimental de Leishmania chagasi a hámster, Mesocricetus auratus, por picadura del insecto vector. Dos pares de hámsteres sanos y anestesiados fueron colocados en jaulas que contenían hembras de Lutzomyia longipalpis. Previamente, las hembras se infectaron experimentalmente con Leishmania chagasi y la infección se confirmó por disección en una submuestra. A los 37 y 51 días después de la exposición a los insectos infectados, las biopsias de hígado y bazo de cada hámster se sometieron a examen directo al microscopio, histopatología y PCR. El ADN se extrajo con Chelex 100®; en la amplificación se utilizó un par de iniciadores específicos para la región conservada de los minicírculos del ADN de Leishmania. El producto amplificado se separó en geles de agarosa y se visualizó bajo luz UV. En tres de las cuatro biopsias se observó una banda de 120 pares de bases, aproximadamente, correspondiente al tamaño esperado de la fracción del minicírculo. La técnica de PCR fue el único método que detectó la presencia del parásito. Estos resultados demostraron que la sensibilidad de la PCR acelera los procesos de incriminación vectorial de las especies vectoras de leishmaniasis.

Leucemia Cutis de presentación atípica An atypical presentation of Leukemia Cutis

Directory of Open Access Journals (Sweden)

F Pulgar Martín

2011-06-01

Full Text Available El trabajo aporta un nuevo caso de leucemia cutis, raro en frecuencia, que presenta un comienzo clínico muy poco habitual, a tener en cuenta. Fueron necesarias varias biopsias para llegar al diagnóstico de la paciente. La supervivencia de la paciente está por encima de la media en estos casos.The work presents a new case of leukemia cutis, rare in frequency, which has a very unusual clinical onset to take into account. It took several biopsies for the diagnosis of the patient. The survival of the patient is above average in these cases.

Monoartritis gotosa de muñeca asociada a necrosis del semilunar: a propósito de un caso clínico

OpenAIRE

Olmedo García, N.; Mackenney Carrasco, Enrique

1994-01-01

Se presenta un caso de monoartritis de muñeca asociada a imágenes radiológicas de necrosis avascular del semilunar que, tras biopsia de la sinovial, se diagnostica de artritis gotosa. Esta asociación es rara. La alteración metabólica que se produce en la gota da lugar a una sinovitis, que provoca un aumento de presión intraarticular. Esta hiperpresión en el carpo podría determinar una necrosis isquémica del semilunar, pero con una evolución diferente a la enfermedad de Kienböck...

Quiste dermoide en la cola de la ceja

OpenAIRE

Ramírez García, Lázara Kenia; Ortiz Ramos, Datia Liset; Gómez Cabrera, Clara Gisela; Vigoa Aranguren, Lázaro; Rojas Rondón, Irene; Abreu Perdomo, Franklyn Alain

2014-01-01

El quiste dermoide es un tipo de coristoma que corresponde a una anomalía congénita del desarrollo. Se presenta una transicional de dos años. Desde su nacimiento, la mamá notó un aumento de volumen a nivel de la cola de la ceja del ojo derecho, de bordes delimitados, blanda, movible, reborde orbitario libre, sin cambios de coloración, con un crecimiento acelerado clínico y ultrasonográfico en meses. Se decidió exéresis y biopsia para estudio anatomopatológico. Los resultados finales mostraron...

FIBROSIS PULMONAR IDIOPÁTICA

OpenAIRE

Álvaro Undurraga P., DR.

2015-01-01

La FPI predomina en el sexo masculino, en edades avanzadas, con tos y/o disnea progresivas. Un 5% se presenta como una forma familiar. La tomografía axial computarizada de tórax, fundamental en el diagnóstico, en al menos un 50% hace innecesaria la biopsia. El diagnóstico es conjunto con clínicos, radiólogos y patólogos. La sobrevivencia media es de tres a cinco años desde el diagnóstico. La historia natural es un deterioro progresivo, pero hay formas rápidas y también pueden aparecer e...

Urinalysis: a useful test in children diagnosis

OpenAIRE

Lozano-Triana, Carlos Javier

2016-01-01

El examen general de orina (EGO) es una biopsia líquida renal que ofrece excelente información acerca de la función renal y de los equilibrios ácido-base e hidroelectrolítico; también puede aportar datos sobre alteraciones metabólicas y de patologías renales y extra-renales. El propósito de esta revisión es describir los contenidos más importantes del examen general de orina para que el médico pediatra los utilice, interprete sus resultados correctamente y logre establecer un diagnóstico y tr...

Examen general de orina: una prueba útil en niños

OpenAIRE

Carlos Javier Lozano Triana

2016-01-01

El examen general de orina (EGO) es una biopsia líquida renal que ofrece excelente información acerca de la función renal y de los equilibrios ácido-base e hidroelectrolítico; también puede aportar datos sobre alteraciones metabólicas y de patologías renales y extra-renales. El propósito de esta revisión es describir los contenidos más importantes del examen general de orina para que el médico pediatra los utilice, interprete sus resultados correctamente y logre establecer un diagnóstico y...

Characterization of brain tissue phantom using an indentation device and inverse finite element parameter estimation algorithm

OpenAIRE

Mesa Múnera, Elizabeth

2011-01-01

La inserción de agujas es un procedimiento reconocido en la comunidad médica debido a sus aplicaciones en cirugías mínimamente invasivas (MIS), como biopsias, braquiterapia, neurocirugía, y remoción de tumores. La inserción neuro-quirúrgica de agujas es un tipo de MIS que contrario a la cirugía abierta (donde las manipulaciones quirúrgicas son guiadas por visión directa) se desarrollan con un campo de visión restringido, retroalimentación visual 2D y retroalimentación háptica distorsionada. ...

MASTITIS GRANULOMATOSA IDIOPÁTICA Y MASTITIS DE CÉLULAS PLASMÁTICAS: EXPERIENCIA DE TRES AÑOS

OpenAIRE

Barrero P., Raúl; Benavides M., Alicia; León B., Manuel; Barrero V., David; Vargas V., Victoria

2005-01-01

Se evaluó el manejo de 13 pacientes con mastitis granulomatosa idiopática y mastitis de células plasmáticas, tratadas en el Hospital Félix Bulnes, por un período de tres años. Se estudió la relación con la edad, anticoncepción, embarazo, lactancia y la atopia. Se evaluaron las limitaciones de la mamografía y de la ecotomografía mamaria y el uso de la biopsia trucut. Se compararon los resultados del tratamiento médico y quirúrgico 13 patients with granulomatous mastitis and plasmatic cell m...

Correlación clínico-histológica de la nefritis lúpica

OpenAIRE

Digna Ma. Espinosa López; José Florín Yrabién; María del Carmen Benítez García; Clara Zaida Alvarez Arias; Ester Lirola Estrada

2000-01-01

Se revisaron un total de 643 biopsias renales a pacientes ingresados en el Servicio de Nefrología del Hospital Pediátrico Universitario "Centro Habana" en el período comprendido entre enero de 1988 y diciembre de 1998; de éstas se seleccionaron 29 correspondientes a nefritis lúpica, para el 4,51 %. En el momento del diagnóstico, 25 pacientes tenían más de 6 años de edad (86,2 %), con predominio del sexo femenino, 20 pacientes, para el 68,9 %. En el 75,86 % de los casos estuvieron presentes la...

Efecto antiinflamatorio de la Ephedra americana HYB sobre la encía de cobayos en procedimiento quirúrgico

OpenAIRE

Arriola Guillén, Luis; Sacsaquispe-Contreras, Sonia

2014-01-01

Objetivo: Evaluar el efecto antiinflamatorio de la Ephedra americana HyB en cirugía gingival en cobayos. Materiales y Métodos: Estudio experimental en 32 cobayos: 16 cobayos a los que se les aplicó el extracto etanólico de la planta (grupo experimental) y 16 el grupo control. Se les realizó incisión tipo media luna en la encía inferior, con desprendimient o del colgajo y se suturó; luego se obtuvieron biopsias excisionales a las 48 horas y a los 7 días para evaluación histopatológica del proc...

Tipificación molecular del Virus Papiloma Humano en mujeres con lesiones cervicales de alto grado y cáncer de cérvix atentidas en el área de colposcopía en consulta externa del ION Solca Guayaquil, periodo 2013 - 2014.

OpenAIRE

Morocho Molina, Nancy Jannet

2015-01-01

El Virus del Papiloma Humano (VPH) está asociado directamente con el desarrollo del cáncer de cérvix. Objetivo: tipificación y asociación de VPH de alto riesgo en pacientes con LIEAG y cáncer de cérvix que acudieron a la consulta externa del ION SOLCA-GUAYAQUIL, durante el período 2013- 2014. Metodología: el presente estudio fue de tipo descriptivo, observacional y analítico, los exámenes utilizados fueron el papanicolaou, colposcopia, biopsia de cérvix y tipificación viral del VPH medi...

Amenorrea secundaria-mosaicismo 45,X/46,XX fertilidad y reinicio de funcion menstrual

OpenAIRE

Osuna C, Jesús A

2003-01-01

Objetivo: Presentación de una paciente de 17 años de edad, con un mosaicismo 45,X/46,XX que consultó por amenorrea secundaria, con posterior normalización del ciclo menstrual y fertilidad. Metodos: Historia clínica, estudios endocrinos, laparoscopia, biopsia de ovarios y estudio citogenético. Resultados: La paciente inició cambios puberales espontáneos a la edad de 11 años y menarca a los 13 años, seguida de ciclos regulares de 28 días, hasta el momento de su consulta por amenorrea secundaria...

Amenorrea secundaria—mosaicismo 45, X/46, XX— fertilidad y reinicio menstrual

OpenAIRE

Osuna Ceballos, Jesús A.

2009-01-01

Objetivo: Presentación de una paciente de 17 años de edad, con un mosaicismo 45,X/46,XX que consultó por amenorrea secundaria, con posterior normalización del ciclo menstrual y fertilidad. Metodos: Historia clínica, estudios endocrinos, laparoscopia, biopsia de ovarios y estudio citogenético. Resultados: La paciente inició cambios puberales espontáneos a la edad de 11 años y menarca a los 13 años, seguida de ciclos regulares de 28 días, hasta el momento de su consulta por amenorrea secund...

Validación de la punción aspiración con aguja fina (PAAF) en el diagnóstico de linfadenitis tuberculosa en pacientes con infección por el virus de la inmunodeficiencia humana (VIH)

OpenAIRE

Cabrera, Susana G; Ortega, Virginia; Medina, Julio C; Gualco, Gabriela; Viola, Marcelo; Pérez, Graciela; Musto, María L.; Zeballos, Justino; Savio, Eduardo

2009-01-01

Resumen Introducción: la punción aspiración aguja fina (PAAF) de ganglio linfático es una técnica sencilla, rápida y de bajo costo para la obtención de muestras para diagnóstico. Objetivo: el objetivo del estudio fue validar la PAAF en el diagnóstico de linfadenitis tuberculosa (TB) en pacientes infectados por el virus de la inmunodeficiencia humana (VIH), utilizando como "gold standard" el cultivo de Mycobacterium tuberculosis en biopsia ganglionar o la histopatología más la respuesta al tra...

Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

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Max Schindler

2014-02-01

Full Text Available La ictericia febril colestásica como forma de presentación de los linfomas de Hodgkin es un cuadro muy infrecuente. Describimos aquí un caso de síndrome febril prolongado asociado a ictericia progresiva, en el que el diagnóstico de la enfermedad se realiza a través de la biopsia hepática, dada la ausencia de afectación ganglionar que caracteriza a esta enfermedad. Destacamos asimismo el cuadro clínico avanzado y el compromiso multisistémico de una enfermedad rápidamente evolutiva.

Nevos sebáceo linear de Jadassohn: registro de um caso

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Aron J. Diament

1982-12-01

Full Text Available É relatado um caso de nevos sebáceo linear de Jadassohn, com sua forma clínica, apresentando a clássica tríade: 1 nevos facial; 2 crises focais; e 3 retardo mental progressivo, aparentemente. Apresenta-se no primeiro estadio de desenvolvimento, quando as glândulas sebáceas estão pouco desenvolvidas, à biopsia de pele. À TAC apresenta atrofias córtico-subcorticais discretas, contrastando com a intensidade do retardo mental e das crises convulsivas. Estas, foram controladas após várias combinações medicamentosas.

Medidas ultrasonográficas del espesor conjunto de la unión útero-placentaria en yeguas criollas colombianas

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Fernando Emilio Vega Díaz

2013-04-01

Full Text Available En el trabajo se determinaron los valores ultrasonográficos del espesor conjunto de la unión úteroplacentaria (ECUP, desde el cuarto mes hasta el final de la gestación, en 20 yeguas criollas colombianas, con edades entre 4 y 8 años y un promedio de peso de 348 kg, para un total de 640 mediciones en cada examen. Para el efecto se hicieron exámenes transrectal y transabdominal con transductor lineal de 6.0 MHz y transductor convexo R40 de 3.5 MHz, respectivamente. Durante el periodo de gestación se encontraron diferencias (P £ 0.05 entre los parámetros ECUP y divergencias cuando se compararon con los resultados reportados en hembras equinas de otras razas. La media de los valores ECUP incrementó con la edad gestacional; para la transrectal se encontró un mínimo de 3.1 ± 1.28 mm y un máximo de 7.3 ± 2.22 mm, y para transabdominal estos valores fueron de 6.3 ± 1.28 mm y 14.3 ± 2.22 mm.

Antibiotic prophylaxis for transrectal prostate biopsy-a new strategy

DEFF Research Database (Denmark)

Antsupova, Valeria; Nørgaard, Nis; Bisbjerg, Rasmus

2014-01-01

mutual synergistic activity and the combination of these agents has a broad coverage of the majority of microorganisms causing infectious complications after TRUBP and may be a valuable future prophylactic regimen. PATIENTS AND METHODS: This was a retrospective cohort study of 2624 men that underwent...... pivmecillinam and amoxicillin/clavulanic acid was used (5.9%). CONCLUSIONS: The combination of pivmecillinam and amoxicillin/clavulanic acid is an attractive prophylaxis for TRUBP from a clinical, bacteriological and ecological point of view as compared with ciprofloxacin....

Dual-Modality Prostate Imaging with PET and Transrectal Ultrasound

Science.gov (United States)

2011-09-01

Downloaded on April 07,2010 at 23:12:26 UTC from IEEE Xplore . Restrictions apply. HUBER et al.: MULTI-MODALITY PHANTOM DEVELOPMENT 2723 As soon as...allow Authorized licensed use limited to: Lawrence Berkeley National Laboratory. Downloaded on April 07,2010 at 23:12:26 UTC from IEEE Xplore ...April 07,2010 at 23:12:26 UTC from IEEE Xplore . Restrictions apply. HUBER et al.: MULTI-MODALITY PHANTOM DEVELOPMENT 2725 Fig. 3. Reconstructed

Dermatoses em pacientes com AIDS: estudo de 55 casos. Uberlândia, MG, Brasil

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GOMIDES MABEL DUARTE ALVES

2002-01-01

Full Text Available Foram estudados 55 pacientes com a síndrome da imunodeficiência adquirida (Aids, triados ao serviço de Dermatologia, apresentando doenças cutâneo-mucosas, algumas de caráter oportunista. As dermatoses são freqüentes nestes doentes e, às vezes, de difícil diagnóstico pelo caráter atípico das lesões. OBJETIVOS: Analisar a freqüência e apresentação clínica das dermatoses relacionadas à Aids. MÉTODOS: Cinqüenta e cinco pacientes com Aids e lesões tegumentares foram estudados, de modo transversal, no Serviço de Dermatologia da Universidade Federal de Uberlândia, de 1995 a 1997. Foram realizadas biopsias e culturas diversas para elucidação diagnóstica. RESULTADOS: Foram encontradas 116 dermatoses, com predomínio das fúngicas (78%, seguidas pelas virais (40%, eritêmato-escamosas (27%, pápulo-pruríticas (18%, causadas por drogas (10%, neoplásicas (9% e outras afecções cutâneo-mucosas (7%. A maioria dos pacientes apresentou mais de uma dermatose (67%. CONCLUSÕES: Confirmou-se a maior freqüência de dermatoses fúngicas, seguidas pelas virais, na Aids. Observou-se a necessidade de propedêutica bem elaborada para o diagnóstico preciso das dermatoses, devido à sua apresentação atípica em grande número de doentes. O exame dermatológico e a biopsia das lesões tiveram grande relevância na suspeita do diagnóstico de Aids.

Multiparametric ultrasound in the detection of prostate cancer: a systematic review

OpenAIRE

Postema, Arnoud; Mischi, Massimo; de la Rosette, Jean; Wijkstra, Hessel

2015-01-01

Purpose To investigate the advances and clinical results of the different ultrasound modalities and the progress in combining them into multiparametric UltraSound (mpUS). Methods A systematic literature search on mpUS and the different ultrasound modalities included: greyscale ultrasound, computerized transrectal ultrasound, Doppler and power Doppler techniques, dynamic contrast-enhanced ultrasound and (shear wave) elastography. Results Limited research available on combining ultrasound modal...

Infective endocarditis with spondylodiscitis after prostate biopsy

Directory of Open Access Journals (Sweden)

Fernando Pivatto Júnior

2014-04-01

Full Text Available Transrectal ultrasonography-guided prostate needle biopsy is the ideal method to obtain prostate specimens for histological analysis and is therefore frequently used in clinical practice. In the majority of the studies, prostate biopsy is considered a safe procedure with few major complications. In the present report, we describe a case of endocarditis with spondylodiscitis, two very rare complications of prostate biopsy.

MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis.

Science.gov (United States)

Kasivisvanathan, Veeru; Rannikko, Antti S; Borghi, Marcelo; Panebianco, Valeria; Mynderse, Lance A; Vaarala, Markku H; Briganti, Alberto; Budäus, Lars; Hellawell, Giles; Hindley, Richard G; Roobol, Monique J; Eggener, Scott; Ghei, Maneesh; Villers, Arnauld; Bladou, Franck; Villeirs, Geert M; Virdi, Jaspal; Boxler, Silvan; Robert, Grégoire; Singh, Paras B; Venderink, Wulphert; Hadaschik, Boris A; Ruffion, Alain; Hu, Jim C; Margolis, Daniel; Crouzet, Sébastien; Klotz, Laurence; Taneja, Samir S; Pinto, Peter; Gill, Inderbir; Allen, Clare; Giganti, Francesco; Freeman, Alex; Morris, Stephen; Punwani, Shonit; Williams, Norman R; Brew-Graves, Chris; Deeks, Jonathan; Takwoingi, Yemisi; Emberton, Mark; Moore, Caroline M

2018-05-10

Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited. In a multicenter, randomized, noninferiority trial, we assigned men with a clinical suspicion of prostate cancer who had not undergone biopsy previously to undergo MRI, with or without targeted biopsy, or standard transrectal ultrasonography-guided biopsy. Men in the MRI-targeted biopsy group underwent a targeted biopsy (without standard biopsy cores) if the MRI was suggestive of prostate cancer; men whose MRI results were not suggestive of prostate cancer were not offered biopsy. Standard biopsy was a 10-to-12-core, transrectal ultrasonography-guided biopsy. The primary outcome was the proportion of men who received a diagnosis of clinically significant cancer. Secondary outcomes included the proportion of men who received a diagnosis of clinically insignificant cancer. A total of 500 men underwent randomization. In the MRI-targeted biopsy group, 71 of 252 men (28%) had MRI results that were not suggestive of prostate cancer, so they did not undergo biopsy. Clinically significant cancer was detected in 95 men (38%) in the MRI-targeted biopsy group, as compared with 64 of 248 (26%) in the standard-biopsy group (adjusted difference, 12 percentage points; 95% confidence interval [CI], 4 to 20; P=0.005). MRI, with or without targeted biopsy, was noninferior to standard biopsy, and the 95% confidence interval indicated the superiority of this strategy over standard biopsy. Fewer men in the MRI-targeted biopsy group than in the standard-biopsy group received a diagnosis of clinically insignificant cancer (adjusted difference, -13 percentage points; 95% CI, -19 to -7; Pprostate cancer who had not undergone biopsy previously. (Funded by the National Institute for

Short communication: A reproductive tract scoring system to manage fertility in lactating dairy cows.

Science.gov (United States)

Young, C D; Schrick, F N; Pohler, K G; Saxton, A M; Di Croce, F A; Roper, D A; Wilkerson, J B; Edwards, J L

2017-07-01

We developed a reproductive tract size and position score (SPS) system as a reproductive management tool to identify lactating dairy cows with decreased fertility. This system, relying solely on transrectal palpation, considers the size (cervical and uterine) and position of the reproductive tract relative to the pelvis. Cows undergoing pre-breeding exams were identified as having reproductive tracts that were small (SPS1), medium (SPS2), or large (SPS3). Cows designated SPS1 had small and compact uterine horns that rested within the pelvic cavity; SPS2 cows had reproductive tracts that were intermediate in cervical and uterine horn diameter, with longer uterine horns resting partially outside the pelvic cavity; and SPS3 cows had reproductive tracts that were larger and rested mostly outside the pelvic cavity. Cows that were SPS1 had a higher rate of pregnancy per artificial insemination (43.3 ± 3.7%) than cows that were SPS2 (36.9 ± 3.6%) or SPS3 (27.7 ± 4.3%). The percentage of cows with an SPS2 score differed in pregnancies per artificial insemination compared with SPS3 cows. The average days in milk was similar for SPS1, SPS2, and SPS3 cows (104.3 ± 3.5, 98.4 ± 3.4, and 94.7 ± 7.7, respectively). Ultrasound measurements of the uterine horn and cervical diameter, and length measurements of the uterine horns, cervix, and vagina confirmed differences among the SPS groups derived by transrectal palpation. The ease with which transrectal palpation can be used to determine the size and position of the reproductive tract attests to the relevance and usefulness of this scoring system to identify less fertile lactating dairy cows. The ability to do so with ease provides an opportunity to make economically relevant management decisions and maximize reproductive efficiency in a given herd. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Necrológicas reiterativas o sobre El pozo de la muerte

OpenAIRE

Ortiz Giraldo, Mateo

2016-01-01

El siguiente texto realiza un análisis a la película Deadpool, que hace parte del universo Marvel y es dirigida por Tim Miller. En esta suerte de biopsia a un cuerpo vivo se hace, a luz de las muertes del arte iniciadas por Hegel, un recorrido que busca hallar en este filme de la cultura pop, un interés artístico y una percepción desde las estéticas teorizadas por Hans-Georg Gadamer, Umberto Eco y Félix Duque. En últimas, este texto busca hallar, en el intersticio de una película de corte apa...

Encefalitis a citomegalovirus en un paciente inmunocompetente: análisis clinico, neuropatologico y ultraestructural

Directory of Open Access Journals (Sweden)

Salamano Ronald

2001-01-01

Full Text Available Las encefalitis por citomegalovirus en pacientes inmunocompetentes son excepcionales, siendo un patógeno reconocido en pacientes inmunodeprimidos (SIDA, transplantados. Se reporta el caso clínico de una encefalitis por Citomegalovirus en un adulto joven, sin evidencia de enfermedad inmunosupresora, cuyo diagnóstico fue posible mediante la detección de ADN viral en la biopsia cerebral. Se describen además las singularidades clínicas de este caso y los hallazgos de la anatomía patológica y de la microscopía electrónica comparándolos con los reportados en pacientes inmunodeprimidos.

Tratamiento del síndrome nefrótico idiopático en niños

OpenAIRE

Luis Velásquez Jones

2014-01-01

La incidencia anual del síndrome nefrótico se ha estimado en 1-3 por cada 100,000 niños menores de 16 años de edad. En niños, la causa más común del síndrome nefrótico es el síndrome nefrótico idiopático (SNI), que se define por la presencia de proteinuria e hipoalbuminemia y es, por definición, una enfermedad primaria. En el estudio de la biopsia renal se pueden encontrar alteraciones histológicas renales no específicas que incluyen lesiones mínimas, glomeruloesclerosis segmentaria y foca...

Actualización sobre estreñimiento crónico funcional en niños

OpenAIRE

Carlos Alberto Velasco

2005-01-01

El estreñimiento crónico es un problema frecuente en la edad pediátrica; 95% de los casos es funcional, es decir, no debido a causas orgánicas, anatómicas o por ingesta de alimentos. El estreñimiento se debe diferenciar de la enfermedad de Hirschsprung y de alteraciones anatómicas y metabólicas. La evaluación clínica incluye una historia clínica completa, examen físico adecuado y paraclínicos como radiología, manometría anorrectal y biopsia rectal. El manejo incluye cambios en el medio ambien...

Diagnóstico molecular del Cáncer de mama por el oncogén HER-2/NEU mediante la técnica de Fish para el Departamento del Cauca (Colombia

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M. Osorio

2001-07-01

Full Text Available Se evaluó la presencia del gen Her2-/neu en una muestra de 28 pacientes con diagnóstico decáncer de mama a quienes se les realizaron biopsias o mastectomías desde enero de 2000 afebrero de 2002. Las láminas embebidas en parafina fueron suministradas por la Compañía dePatólogos del Cauca y el Departamento de Patología del Hospital Universitario San Joséde Popayán; Cauca. Se utilizó la técnica de Hibridización in situpor Fluorescencia (FISH paravisualizar copias del gen Her-2/neu.

Premio Aventis – Proyectos de Investigación: «Análisis de Longitud Telomérica y Actividad Telomerasa en Carcinogénesis Gástrica»

Directory of Open Access Journals (Sweden)

Humberto Arboleda

2005-06-01

En el estudio se incluirán pacientes que lleguen al servicio de Gastroenterología de las Clínicas Carlos Lleras y San Pedro Claver de Bogotá D.C, para realización de endoscopia de vías digestivas altas mas biopsia. Con previo consentimiento informado, se obtendrán muestras de mucosa gástrica lesionada y sana del mismo paciente la cual se utilizará como control. Además también se estudiarán especímenes quirúrgicos de pacientes de la Clínica Fundadores y el Instituto Nacional de Cancerología...

Relación citohistológica en mujeres con diagnóstico de papiloma virus humano

OpenAIRE

Sánchez Morffiz, Yanelis; Barrios Rodríguez, María Antonia; Acosta Fernández, Rosario; Polo Pérez, Herenia

2008-01-01

Fundamento: En la actualidad el cáncer cérvicouterino es la segunda causa de cáncer ginecológico a nivel mundial después del de mama. Objetivo: Describir la relación citohistológica en mujeres con diagnóstico de papiloma virus humano (PVH) por biopsia del municipio Camagüey. Método: Se realizó un estudio descriptivo en el Hospital Docente Gineco-Obstétrico «Ana Betancourt de Mora» en los años 2005-2006. La muestra la constituyeron 159 mujeres con diagnóstico de PVH en las que se estudió la ed...

Participação da apoptose na rejeição aguda do transplante intestinal em ratos Apoptosis participation in the acute rejection of intestinal transplantation in rats

Directory of Open Access Journals (Sweden)

André Dong Won Lee

2004-09-01

Full Text Available RACIONAL: O transplante de intestino delgado é procedimento cirúrgico em estudo visando sua aplicação no tratamento dos pacientes portadores da síndrome do intestino curto, com vistas à reabilitação oral. A grande barreira, porém, se deve à rejeição pela grande quantidade de tecido linfóide presente no intestino delgado. OBJETIVO: Estudo da apoptose em alotransplante heterotópico intestinal. MATERIAL E MÉTODOS: Realizaram-se 24 alotransplantes intestinais em ratos da raça Brown-Norway (doador para Lewis (receptor, sendo subdivididos em três subgrupos de oito animais, sacrificados respectivamente no terceiro dia de pós-operatório (Tx(3, no quinto dia de pós-operatório (Tx(5 e no sétimo dia de pós-operatório (Tx(7 para coleta das biopsias dos enxertos intestinais. Compararam-se os resultados com o grupo isotransplante (C que envolveu oito animais da raça Lewis (doador para Lewis (receptor, porém neste grupo realizaram-se biopsias seriadas no mesmo animal, sendo subdivididos em três momentos: biopsia no terceiro dia de pós-operatório (C(3, no quinto dia de pós-operatório (C(5 e sacrificados no sétimo dia de pós-operatório (C(7 para coleta da biopsia. Realizou-se, inicialmente, análise intragrupo entre os momentos C(3, C(5 e C(7 para todos os parâmetros de rejeição citados anteriormente, como também para os três subgrupos Tx(3, Tx(5 e Tx(7. Posteriormente, realizou-se a análise intergrupo de forma transversal e pareada comparando-se o grupo isotransplante com o grupo alotransplante. (C(3 com Tx(3; C(5 com Tx(5 e C(7 com Tx(7. No grupo isotransplante não houve expressão estatística quanto aos marcadores analisados. Porém, no grupo alotransplante observou-se que alterações da apoptose foram marcantes a partir do terceiro dia de pós-operatório.BACKGROUND: Intestinal transplantation is a possible treatment for patients with short bowel syndrome, aiming the reintroduction of oral diet. However, the major

Infección por Helicobacter pylori en la Ciudad de La Habana, Cuba.Prevalencia de las cepas cagA positivas

Directory of Open Access Journals (Sweden)

Beatriz Gutiérrez

2005-12-01

Full Text Available Existe una gran falta de información acerca de la infección por Helicobacter pylori en los países de la región del Caribe. Nuestros objetivos en este estudio fueron determinar la prevalencia, la resistencia a los antibióticos y los factores de virulencia de la bacteria. La medida de la prevalencia de la infección por H. pylori se determinó en un grupo de pacientes a los que se les practicó una endoscopia en tres centros hospitalarios de La Ciudad de La Habana, lo que nos permitió evaluar la resistencia a la claritromicina y la presencia de cagA + en las cepas obtenidas. De las endoscopias realizadas se obtuvieron 117 biopsias gástricas, procedentes de tres centros hospitalarios de La Ciudad de La Habana, Cuba: Instituto de Oncología, Instituto de Gastroenterología y el Hospital Calixto García. Las biopsias fueron mantenidas a –70 ºC para posterior cultivo en tres medios diferentes (dos selectivos y uno no selectivo y su posterior incubación por 7 días a 37 ºC en una atmósfera de microaerofilia. La presencia de H. pylori fue identificada por la presencia de diferentes enzimas (oxidasa, catalasa, ureasa. Se realizó la extracción del DNA y la PCR, donde se utilizó el primer H2761676 y se amplificó con 397 fragmentos del gen cagA. La susceptibilidad a la claritromicina fue medida por el método de difusión en gel. Diagnóstico endoscópico: (1 cáncer gástrico; (19 úlcera duodenal; (8 úlcera gástrica; (89 dispepsias no ulcerosas, incluyendo (62 gastritis; (9 hernia hiatal; (2 reflujo biliar; (1 pólipo gástrico; (15 panendoscopias normales. Del total de 117 biopsias realizadas, 83 fueron positivas a la infección por H.pylori (70,9% . De las 35 cepas a las que se les realizó presencia de cagA+ resultaron positivas 31 (88,5%. Solo el 3% de las cepas fueron resistentes a la claritromicina. La prevalencia de la infección por H. pylori en la población sintomática de La Ciudad de La Habana es la misma que la reportada en

Transurethral light delivery for prostate photoacoustic imaging

OpenAIRE

Lediju Bell, Muyinatu A.; Guo, Xiaoyu; Song, Danny Y.; Boctor, Emad M.

2015-01-01

Photoacoustic imaging has broad clinical potential to enhance prostate cancer detection and treatment, yet it is challenged by the lack of minimally invasive, deeply penetrating light delivery methods that provide sufficient visualization of targets (e.g., tumors, contrast agents, brachytherapy seeds). We constructed a side-firing fiber prototype for transurethral photoacoustic imaging of prostates with a dual-array (linear and curvilinear) transrectal ultrasound probe. A method to calculate ...

Short-lag spatial coherence beamforming of photoacoustic images for enhanced visualization of prostate brachytherapy seeds

OpenAIRE

Lediju Bell, Muyinatu A.; Kuo, Nathanael; Song, Danny Y.; Boctor, Emad M.

2013-01-01

Prostate brachytherapy, administered by implanting tiny radioactive seeds to treat prostate cancer, currently relies on transrectal ultrasound imaging for intraoperative visualization of the metallic seeds. Photoacoustic (PA) imaging has been suggested as a feasible alternative to ultrasound imaging due to its superior sensitivity to metal surrounded by tissue. However, PA images suffer from poor contrast when seeds are distant from the light source. We propose a transperineal light delivery ...

Nonspecific Presentation of a Multiloculated Prostatic Abscess After Transurethral Prostatic Biopsy for Elevated Prostate-specific Antigen Level

OpenAIRE

Gandhi, Nilay M.; Lin, Joseph; Schaeffer, Edward

2014-01-01

Prostate postbiopsy infectious complications typically present in the form of prostatitis and uncommonly urosepsis. Prostatic abscesses are generally found after multiple bouts of prostatitis and are associated with a clinically septic picture requiring intensive care unit admission and resuscitation. We report the case of a 65-year-old man who presented with prostatic abscess in the setting of nonspecific urinary symptoms after transrectal ultrasonography–guided prostate biopsy. At 4-month f...

Hepatoportal sclerosis clinical different evolutionary stages: presentation of 3 cases and literature review Esclerosis hepatoportal en estadios clínicos evolutivos diferentes: presentación de 3 casos y revisión de la literatura

Directory of Open Access Journals (Sweden)

Alejandro Martínez-Caselles

2012-02-01

Full Text Available Hepatoportal sclerosis (HPS is characterized by presinusoidal intrahepatic portal hypertension associated with splenomegaly and anemia in patients with non-cirrhotic liver. Liver biopsy is essential, especially to rule out other processes. Being a disease of unknown etiology, the majority of cases have been described in eastern countries. However, it may be an underdiagnosed disease in the West. Symptoms are related to portal hypertension and the clinical spectrum is wide, ranging from anemia with normal liver function tests to bleeding due to esophageal varices. Treatment is directed to the complications and the prognosis is better than in patients with cirrhosis. We report three cases of HPS presenting at different clinical stages and the findings of liver biopsies, the clinical outcomes and a review of scientific literature.La esclerosis hepatoportal se caracteriza por hipertensión portal intrahepática presinusoidal asociada a esplenomegalia y anemia en pacientes con un hígado no cirrótico. La biopsia hepática es fundamental, sobre todo para descartar otros procesos. Se trata de un cuadro de etiología desconocida cuya gran mayoría de los casos se ha descrito en países orientales, si bien podría estar infradiagnosticada en Occidente. Se manifiesta con síntomas asociados a la hipertensión portal y el espectro clínico es muy amplio: desde anemia con pruebas de función hepática normales hasta hemorragia por varices esofagogástricas. Su tratamiento es el de las complicaciones y el pronóstico es mejor que en los pacientes con cirrosis. Presentamos tres casos de EHP que presentan estadios clínicos diferentes, así como los hallazgos de las biopsias hepáticas, su evolución clínica posterior y una revisión de la literatura científica.

Mieloma osteosclerótico (síndrome poems. Presentación de un caso: A case report Osteosclerotic Myeloma- POEMS syndrome

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Daniel Hernández Díaz

2005-03-01

Full Text Available Se presentó el caso de una paciente de 42 años de edad, raza blanca, que presentó hiperpigmentación dérmica en cara, cuello y parte superior del tórax, decaimiento, cefalea occipital y pérdida de peso, posteriormente le aparecen manchas blanquecinas en las zonas hiperpigmentadas que le producen prurito y ardentía intensa. En los estudios que se le realizaron la eritrosedimentación siempre tuvo cifras elevadas, se informó una marcada agrupación eritrocitaria y hepatomegalia ligera, en las dos biopsias de piel que se le hicieron no se concluyó diagnóstico, el informe de la biopsia de médula ósea fue: infiltrado intersticial por células plasmáticas maduras e inmaduras, marcada osteosclerosis, compatible con un mieloma osteosclerótico. En los días que se esperaba el resultado de este estudio inició un síndrome febril agudo acompañado de sudoración, falta de aire intensa y fallece.A 42 year old Caucasian female patient presented dermic hyperpigmentation in face, neck and upper thoracic part. Depression, occipital headache and weight loss were other presenting symptoms; some whitish spots appeared in those hyperpigmented zones producing itch and burning pain. Erytrosedimentation tests always had augmented level a marked erythrocyte aggregation and mild hepatomegaly were observed. Diagnosis was not concluded in two skin biopsies performed. The report of bone marrow biopsy was: interstitial infiltration by mature and immature plasmatic cells a marked osteosclerosis associated with osteosclerotic myeloma. While expecting for the results of this study an acute fevered syndrome and sweating and severe dyspnea appeared and the patient died.

¿Oncocercosis en Colombia? Una revaluación del foco de López de Micay

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Gloria I. Palma

1995-09-01

Full Text Available En 1965 se describió el primer foco de oncocercosis humana en Colombia en López de Micay, en la costa pacífica. Doce años después, una visita de seguimiento mostró que la prevalencia de infección había disminuido del 15 al 7,5%. Ya que no se volvieron a reportar pacientes, se consideró extinguido el foco hasta 1989, cuando un niño con queratitis ocular fue remitido al Hospital Universitario de Cali. Se confirmó el diagnóstico de oncocercosis con una biopsia de piel. En julio de 1989 se hizo una nueva visita al área y se tomaron muestras a 170 personas. La prevalencia de infección detectada por biopsia de piel fue de 4,1% (71170. Se detectaron microfilarias (mf en piel en 10% de los hombres muestreados y 0,9% de las mujeres. La microfilarodermia varió entre 0,5 mf por miligramo de piel y 47mflmg y estaba directamente relacionada con la edad. No se encontraron nódulos subcutáneos palpables ni alteraciones dérmicas atribuibles al parásito en ningún paciente. Dos pacientes presentaron cambios oculares: queratitis bilateral y degeneración de la retina, respectivamente. Durante la visita, la actividad de los simúlidos fue muy baja y no se intentaron capturas. Es probable que la transmisión ocurra en sitios río arriba, donde la actividad de los vectores es mayor. Con la construcción de vías de acceso y una planta hidroeléctrica se espera un aumento de la población no inmune en el área. Cabe preguntar, cúal será el impacto de esta población susceptible sobre este foco hipoendémico.

Paracoccidioidomicosis perianal asociada a lepra lepromatosa: Presentación de un caso clínico Perianal paracoccidioidomycosis associated with lepromatous leprosy: A clinical case report

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M A Reyes

2008-06-01

Full Text Available Se presenta el caso de un paciente alcoholista con una ulceración perianal y manifestaciones cutáneas de enfermedad de Hansen. La biopsia de la lesión perianal y otros estudios arribaron al diagnóstico de una forma diseminada de paracoccidioidomicosis, así como también las biopsias cutáneas y los estudios baciloscópicos fueron diagnósticos de lepra lepromatosa. La respuesta a la terapéutica fue satisfactoria con desaparición de las lesiones cutáneas. La disminución de la respuesta inmunológica celular genera un terreno propicio para la infección de estos gérmenes y al compartir área endémica la asociación entre ambas patologías puede ocurrir.Lepra and Paracoccidioidomycosis are endemic diseases in Argentina. We report a case of a patient with an unusual perianal ulceration and cutaneous manifestations of Hansen's disease. The biopsy of perianal lesion and subsequent studies revealed a disseminated form of paracoccidioidomycosis, as well as skin biopsy and baciloscopic finding diagnostic of Lepromatous Leprosy. The main portal of entry of paracoccidioides is the lung. Hematogenous dissemination of the fungus may occur at this time, with the establishment of metastatic foci in any organ. Anal and perianal lesions are present only in 1.3 to 2.4% of the patients. The pathogenesis of anal lesions remains unclear, it may be secondary from a systemic or a local disease. The patient response to the therapeutic was notable, with disappearance of lesions up to the third month of started itraconazole orally 400 mg/day leading just atrophy scars in perianal areas. The treatment of Hansen's disease was made according to OMS guidelines for multibacillary disease.

Meduloepitelioma en el adulto

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Nelson Inzulza Barrientos

2014-07-01

Full Text Available El meduloepitelioma es un tumor muy poco frecuente en adultos, encontrándose descritos en la literatura solo una decena de casos. Se presenta la historia de un paciente sometido a enucleación de su ojo derecho por sospecha de melanoma coroideo. La biopsia informó neoplasia de estirpe neural de comportamiento biológico incierto, y el estudio inmunohistoquímico informó neoplasia neuroendocrina de bajo grado. Se realizó estudio de extensión sistémica que resultó negativo. El paciente no se somete a controles durante 6 años, volviendo a consultar por una gran ocupación orbitaria derecha, manejada mediante exenteración orbitaria. La biopsia informó neoplasia maligna de estirpe neural, y la histoquímica concluyó meduloepitelioma pigmentado maligno ocular con extensión a la órbita. El paciente evolucionó con signos de remisión completa de la lesión, sin embargo un año y medio después comenzó con un aumento de volumen rápidamente progresivo, que compromete toda la región orbitaria derecha. Se presenta el caso a comité oncológico, indicando estudio de extensión sistémica mediante citología de LCR, TAC de tórax, abdomen y pelvis que resultaron normales; el cintigrama óseo evidenció actividad osteoblástica patológica en macizo facial, y la RMN de cerebro evidenció invasión intra y extracraneal, con ocupación de los senos paranasales. Con estos antecedentes se le ingresó en el programa de cuidados paliativos y alivio del dolor, realizándose radioterapia paliativa, con remisión parcial de tamaño tumoral y sintomatología.

Dual-Modality PET/Ultrasound imaging of the Prostate

Energy Technology Data Exchange (ETDEWEB)

Huber, Jennifer S.; Moses, William W.; Pouliot, Jean; Hsu, I.C.

2005-11-11

Functional imaging with positron emission tomography (PET)will detect malignant tumors in the prostate and/or prostate bed, as well as possibly help determine tumor ''aggressiveness''. However, the relative uptake in a prostate tumor can be so great that few other anatomical landmarks are visible in a PET image. Ultrasound imaging with a transrectal probe provides anatomical detail in the prostate region that can be co-registered with the sensitive functional information from the PET imaging. Imaging the prostate with both PET and transrectal ultrasound (TRUS) will help determine the location of any cancer within the prostate region. This dual-modality imaging should help provide better detection and treatment of prostate cancer. LBNL has built a high performance positron emission tomograph optimized to image the prostate.Compared to a standard whole-body PET camera, our prostate-optimized PET camera has the same sensitivity and resolution, less backgrounds and lower cost. We plan to develop the hardware and software tools needed for a validated dual PET/TRUS prostate imaging system. We also plan to develop dual prostate imaging with PET and external transabdominal ultrasound, in case the TRUS system is too uncomfortable for some patients. We present the design and intended clinical uses for these dual imaging systems.

Dual-Modality PET/Ultrasound imaging of the Prostate

International Nuclear Information System (INIS)

Huber, Jennifer S.; Moses, William W.; Pouliot, Jean; Hsu, I.C.

2005-01-01

Functional imaging with positron emission tomography (PET)will detect malignant tumors in the prostate and/or prostate bed, as well as possibly help determine tumor ''aggressiveness''. However, the relative uptake in a prostate tumor can be so great that few other anatomical landmarks are visible in a PET image. Ultrasound imaging with a transrectal probe provides anatomical detail in the prostate region that can be co-registered with the sensitive functional information from the PET imaging. Imaging the prostate with both PET and transrectal ultrasound (TRUS) will help determine the location of any cancer within the prostate region. This dual-modality imaging should help provide better detection and treatment of prostate cancer. LBNL has built a high performance positron emission tomograph optimized to image the prostate.Compared to a standard whole-body PET camera, our prostate-optimized PET camera has the same sensitivity and resolution, less backgrounds and lower cost. We plan to develop the hardware and software tools needed for a validated dual PET/TRUS prostate imaging system. We also plan to develop dual prostate imaging with PET and external transabdominal ultrasound, in case the TRUS system is too uncomfortable for some patients. We present the design and intended clinical uses for these dual imaging systems

DIÂMETRO DO FOLÍCULO NO MOMENTO DA INSEMINAÇÃO ARTIFICIAL EM TEMPO FIXO E TAXA DE CONCEPÇÃO EM VACAS NELORE

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Antonio de Lisboa Ribeiro Filho

2013-12-01

Full Text Available The objective of this study was to evaluate the influence of the diameter of the largest follicle at the time of TAI (DFOL on conception rate of Nellore cows submitted to TAI protocol. Therefore, 348 females were synchronized on day 0 (D0 with an intravaginal progesterone device (P4 associated with 2.0 mg of estradiol benzoate intramuscularly (im. On day 8 (D8, after P4 removal, 500 μg Sodium cloprostenol (im, 0.6mg of estradiol cypionate (im and 300 UI equine chorionic gonadotropin (eCG (im were administered. On day 10 (D10, immediately before each TAI, DFOL was measured in all animals by transrectal ultrasonography. Pregnancy diagnosis was performed 30 days after TAI by transrectal ultrasonography. Data were analyzed by SPSS (version 19 and DFOL means were compared by Student's t-test. The overall conception rate was 57.47% and DFOL overall average was 12.43±2.84mm. There were differences (P=0.0001 in the comparison of DFOL of pregnant (13.33±2.40mm and nonpregnant (11.27±2.75mm cows. The results showed a positive effect of DFOL on fertility of cows submitted to synchronization protocol.

Fast prostate segmentation for brachytherapy based on joint fusion of images and labels

Science.gov (United States)

Nouranian, Saman; Ramezani, Mahdi; Mahdavi, S. Sara; Spadinger, Ingrid; Morris, William J.; Salcudean, Septimiu E.; Abolmaesumi, Purang

2014-03-01

Brachytherapy as one of the treatment methods for prostate cancer takes place by implantation of radioactive seeds inside the gland. The standard of care for this treatment procedure is to acquire transrectal ultrasound images of the prostate which are segmented in order to plan the appropriate seed placement. The segmentation process is usually performed either manually or semi-automatically and is associated with subjective errors because the prostate visibility is limited in ultrasound images. The current segmentation process also limits the possibility of intra-operative delineation of the prostate to perform real-time dosimetry. In this paper, we propose a computationally inexpensive and fully automatic segmentation approach that takes advantage of previously segmented images to form a joint space of images and their segmentations. We utilize joint Independent Component Analysis method to generate a model which is further employed to produce a probability map of the target segmentation. We evaluate this approach on the transrectal ultrasound volume images of 60 patients using a leave-one-out cross-validation approach. The results are compared with the manually segmented prostate contours that were used by clinicians to plan brachytherapy procedures. We show that the proposed approach is fast with comparable accuracy and precision to those found in previous studies on TRUS segmentation.

Size of ovulatory follicles in cattle expressing multiple ovulations naturally and its influence on corpus luteum development and fertility.

Science.gov (United States)

Echternkamp, S E; Cushman, R A; Allan, M F

2009-11-01

Long-term genetic selection of cattle for fraternal twins has increased the frequency of twin and triplet ovulations. In contrast, the ratio of fetal numbers to ovulation sites in pregnant females with twin (0.83) or triplet (0.73) ovulations is conception in cyclic cattle expressing multiple ovulations naturally, including the effect of ovulation rate on follicle or corpus luteum (CL) size, and their relationship to conception. Diameter of the individual ovulatory follicles was measured by transrectal ultrasonography at AI and ranged from 8 to 30 mm, with a trend for diameter of the individual follicles, and associated CL, to decrease with increasing ovulation rate. Independent of ovulation rate, ovulatory follicles were smaller (P or =2.5 yr). Pregnancy and fetal status were diagnosed by transrectal ultrasonography between 42 and 72 d after AI. Fertility was reduced (P or =22 vs. 14 to 17.9 mm). Plasma progesterone concentrations increased with ovulation rate and were correlated positively with total CL or ovulatory follicle volume per female, indicating that CL size and function were influenced by the size of the follicle of origin. Progesterone was greater (P uterine crowding, especially when 2 or more fetuses were contained within 1 uterine horn.

Percutaneous transperineal placement of gold 198 seeds for treatment of carcinoma of the prostate

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Crusinberry, R.A.; Kramolowsky, E.V.; Loening, S.A.

1987-01-01

Thirty-one patients have been treated for carcinoma of the prostate with /sup 198/Au seeds placed transperineally using transrectal ultrasonic guidance. Twenty patients have been followed postoperatively for periods ranging from 3 to 31 months, with an average follow-up time of 12 months. Cumulative dose of radiation to the prostate calculated by dosimetry was either 9000 rads or 15,000 rads. Serial transrectal ultrasound examinations performed on these patients showed a decrease in prostate size in all patients within 6 months of treatment, with a statistically significant decrease observed between the third and sixth months. No significant difference in amount or rate of tumor regression was noted when tumor stage and grade were correlated to volume decrease after treatment. Patients who received the larger doses of radiation (15,000 rads) showed a significantly greater rate of decline in prostatic volume than those who received 9000 rads. Seven patients underwent prostate biopsy between 12 and 18 months after treatment; six biopsies showed residual tumor. Complications after treatment included urinary retention because of prostatic edema (three), radiation urethritis (three), and rectal ulceration (one). Transperineal placement of /sup 198/Au is well tolerated and offers an alternative to external beam radiation for treatment of carcinoma of the prostate.

Modified uterine allotransplantation and immunosuppression procedure in the sheep model.

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Li Wei

Full Text Available OBJECTIVE: To develop an orthotopic, allogeneic, uterine transplantation technique and an effective immunosuppressive protocol in the sheep model. METHODS: In this pilot study, 10 sexually mature ewes were subjected to laparotomy and total abdominal hysterectomy with oophorectomy to procure uterus allografts. The cold ischemic time was 60 min. End-to-end vascular anastomosis was performed using continuous, non-interlocking sutures. Complete tissue reperfusion was achieved in all animals within 30 s after the vascular re-anastomosis, without any evidence of arterial or venous thrombosis. The immunosuppressive protocol consisted of tacrolimus, mycophenolate mofetil and methylprednisolone tablets. Graft viability was assessed by transrectal ultrasonography and second-look laparotomy at 2 and 4 weeks, respectively. RESULTS: Viable uterine tissue and vascular patency were observed on transrectal ultrasonography and second-look laparotomy. Histological analysis of the graft tissue (performed in one ewe revealed normal tissue architecture with a very subtle inflammatory reaction but no edema or stasis. CONCLUSION: We have developed a modified procedure that allowed us to successfully perform orthotopic, allogeneic, uterine transplantation in sheep, whose uterine and vascular anatomy (apart from the bicornuate uterus is similar to the human anatomy, making the ovine model excellent for human uterine transplant research.

Miocarditis eosinofílica como causa de disfunción ventricular izquierda reversible

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María Juliana Rodríguez-González

2017-01-01

Se logra el destete del soporte circulatorio, presenta mejoría de la función sistólica del ventrículo izquierdo con recuperación total del cuadro clínico. Este caso es relevante en cuanto a diagnóstico de disfunción ventricular aguda, con una asociación previamente no descrita con antimoniato de meglumina (glucantime, nos recuerda la importancia de realizar: la biopsia endomiocárdica para definir la etiología, la toma de decisiones de terapias avanzadas, conociendo que en ciertas circunstancias puede presentarse reversibilidad de la disfunción miocárdica y mejoría del cuadro clínico.

Cáncer de mama bilateral sincrónico. Revisión de la literatura y presentación de un caso

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Lidia Torres Ajá

2012-05-01

Full Text Available Se conoce como cáncer bilateral sincrónico a los tumores primarios en ambas mamas, que son diagnosticados simultáneamente. Su aparición es poco frecuente, y se presenta aproximadamente en el 1- 2,5 % de todos los pacientes. Se informa el caso de una paciente de 57 años, que acudió a consulta por presentar nódulos mamarios bilaterales, diagnosticados, mediante biopsia por parafina, como cánceres mamarios histológicamente diferentes. Es el primer caso de cáncer mamario bilateral sincrónico diagnosticado en la provincia de Cienfuegos, por lo cual consideramos de interés su publicación y divulgación.

Confirmación histología del diagnóstico de cáncer cérvico uterino en Costa Rica, 1982-84

OpenAIRE

Oberle, Mark W.; Rosero Bixby, Luis; Mekbel Achit, Saeed

1990-01-01

Un panel de patologías costarricenses efectuó un análisis histológico de las biopsias de 677 casos de cáncer de cuello de útero in situ e invasor diagnosticados en Costa Rica en 1982 - 1984. El panel confirmó el diagnóstico inicial del 81% de los casos de cáncer in situ y del 72% de los casos de cáncer invasor. El panel redujo la severidad del diagnóstico a displasia u otra lesión no cancerosa en el 12% de los casos de cáncer in situ y en el 3% de los casos de cáncer invasor. El 8% de los cas...

Necrobiosis lipoídica diabética

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Rubén Pérez Armas

2014-02-01

Full Text Available Se describe el caso clínico de una fémina de 39 años de edad, con diabetes mellitus de tipo II, quien ingresó en el Servicio de Dermatología del Hospital Provincial Clinicoquirúrgico Docente "Celia Sánchez Manduley" de la provincia de Granma por presentar, desde hacía más de un año, múltiples lesiones en los miembros inferiores, superiores y tronco. Teniendo en cuenta los resultados de los exámenes físico y complementarios, incluida la biopsia, se le diagnóstico necrobiosis lipoídica diabética. Se le indicó tratamiento con triamcinolona y evolucionó favorablemente.

The effect of Zataria multiflora extract on the clinical endometritis and reproductive indices in lactating Holstein dairy cows

OpenAIRE

Hajibemani, Abolfazl; Mirzaei, Abdolah; Rowshan Ghasrodashti, Abbas; Memarzadeh, Mohammad Reza

2016-01-01

In the present study, the effect of intrauterine infusion of Zataria multiflora extract on the clinical endometritis was investigated. Vaginal examination, transrectal palpation and ultrasonography were used to inspect the genital tract at 30-40 days in milk and two weeks later the same approach was applied. Cows with clinical endometritis were randomly divided into three treatment groups: Z. multiflora extract (n = 56), penicillin + streptomycin (pen + strep, n = 55), and placebo (n = 20). C...

Primary Gleason pattern in biopsy Gleason score 7 is predictive of adverse histopathological features and biochemical failure following radical prostatectomy

DEFF Research Database (Denmark)

Berg, Kasper Drimer; Røder, Martin Andreas; Brasso, Klaus

2014-01-01

+3. No difference in age, PSA, percentage of biopsies with cancer, clinical tumour stage or volume on transrectal ultrasonography was found. Primary Gleason pattern 4 was associated with worse pathological stage (p = 0.049). On multivariate analysis, primary Gleason pattern 4 (p ... (p analysis, Gleason score 3+4 had a significantly lower biochemical failure rate compared with Gleason score 4+3 (p = 0.0035). PSA (p 4 (p = 0.001) and percentage of biopsies...

Effect of using different U/S probe Standoff materials in image geometry for interventional procedures: the example of prostate

OpenAIRE

Dimos Baltas; George Sakas; Pawel Zogal; Vasiliki Kefala; Zaira Katsilieri; Saeed Butt; Natasa Milickovic; Stefanos Diamantopoulos

2011-01-01

Purpose This study investigates the distortion of geometry of catheters and anatomy in acquired U/S images, caused by utilizing various stand-off materials for covering a transrectal bi-planar ultrasound probe in HDR and LDR prostate brachytherapy, biopsy and other interventional procedures. Furthermore, an evaluation of currently established water-bath based quality assurance (QA) procedures is presented. Material and methods Image acquisitions of an ultrasound QA setup were carried out at 5...

Transrectal ultrasound applicator for prostate heating monitored using MRI thermometry

International Nuclear Information System (INIS)

Smith, Nadine Barrie; Buchanan, Mark T.; Hynynen, Kullervo

1999-01-01

Purpose: For potential localized hyperthermia treatment of tumors within the prostate, an ultrasound applicator consisting entirely of nonmagnetic materials for use with magnetic resonance imaging (MRI) has been developed and tested on muscle tissue ex vivo and in vivo. Methods and Materials: A partial-cylindrical intracavitary transducer consisting of 16 elements in a 4 x 4 pattern was constructed. It produced a radially propagating acoustic pressure field. Each element of this array (1.5 x 0.75 cm), operating at 1.5 MHz, could be separately powered to produce a desired energy deposition pattern within a target volume. Spatial and temporal temperature elevations were determined using the temperature-dependent proton resonant frequency (PRF) shift and phase subtraction of MR images acquired during ultrasonic heating. Four rabbits were exposed to the ultrasound to raise the local tissue temperature to 45 deg. C for 25 minutes. Six experiments compared thermocouple temperature results to PRF shift temperature results. Results: The tests showed that the multi-element ultrasound applicator was MRI-compatible and allowed imaging during sonication. The induced temperature distribution could be controlled by monitoring the RF power to each transducer element. Therapeutic temperature elevations were easily achieved in vivo at power levels that were about 16% of the maximum system power. From the six thermocouple experiments, comparison between the thermocouple temperature and the PRF temperature yielded an average error of 0.34 ± 0.36 deg. C. Conclusions: The MRI-compatible intracavitary applicator and driving system was able to control the ultrasound field and temperature pattern in vivo. MRI thermometry using the PRF shift can provide adequate temperature accuracy and stability for controlling the temperature distribution

Transrectal bladder prolapse secondary to pelvic fracture in two dogs.

Science.gov (United States)

Crivellenti, L Z; Silveira, M P; Silva, A N; Borin-Crivellenti, S; Raposo, T M M; Honsho, D K

2014-08-01

This report describes the exteriorisation of the urinary bladder in two dogs as a result of a laceration of the rectum from a traumatic pelvic fracture. Clinical examination and contrast radiography of the bladder were used as diagnostic tools. Both patients were treated with exploratory laparotomy, where traction of the bladder was utilised to pull the bladder through the traumatic rectal laceration allowing the organ to return to its normal anatomical position. This procedure was followed by surgical reconstruction of the rectum, resulting in effective resolution of each case. © 2014 British Small Animal Veterinary Association.

A review of transrectal ultrasound guided prostate biopsies: Is there ...

African Journals Online (AJOL)

K.S. Jehle

primary outcome measure was prostate cancer detection. We documented our findings on TRUS including the findings of peripheral calcifications, hypoechoic lesions and capsular distortion ..... One weakness of this study is that our two study.

Seminal, clinical and colour-Doppler ultrasound correlations of prostatitis-like symptoms in males of infertile couples.

Science.gov (United States)

Lotti, F; Corona, G; Mondaini, N; Maseroli, E; Rossi, M; Filimberti, E; Noci, I; Forti, G; Maggi, M

2014-01-01

'Prostatitis-like symptoms' (PLS) are a cluster of bothersome conditions defined as 'perineal and/or ejaculatory pain or discomfort and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) pain subdomain score ≥4' (Nickel's criteria). PLS may originate from the prostate or from other portions of the male genital tract. Although PLS could be associated with 'prostatitis', they should not be confused. The NIH-CPSI is considered the gold-standard for assessing PLS severity. Although previous studies investigated the impact of prostatitis, vesiculitis or epididymitis on semen parameters, correlations between their related symptoms and seminal or scrotal/transrectal colour-Doppler ultrasound (CDU) characteristics have not been carefully determined. And no previous study evaluated the CDU features of PLS in infertile men. This study was aimed at investigating possible associations among NIH-CPSI (total and subdomain) scores and PLS, with seminal, clinical and scrotal/transrectal CDU parameters in a cohort of males of infertile couples. PLS of 400 men (35.8 ± 7.2 years) with a suspected male factor were assessed by the NIH-CPSI. All patients underwent, during the same day, semen analysis, seminal plasma interleukin 8 (sIL-8, a marker of male genital tract inflammation), biochemical evaluation, urine/seminal cultures, scrotal/transrectal CDU. PLS was detected in 39 (9.8%) subjects. After adjusting for age, waist and total testosterone (TT), no association among NIH-CPSI (total or subdomain) scores or PLS and sperm parameters was observed. However, we found a positive association with current positive urine and/or seminal cultures, sIL-8 levels and CDU features suggestive of inflammation of the epididymis, seminal vesicles, prostate, but not of the testis. The aforementioned significant associations of PLS were further confirmed by comparing PLS patients with age-, waist- and TT-matched PLS-free patients (1 : 3 ratio). In conclusion, NIH

Ultrasound Imaging of the Pelvic Floor: linking anatomical findings with clinical symtoms

OpenAIRE

Steensma, Anneke

2009-01-01

textabstractFor evaluation of pelvic floor and lower urinary tract dysfunction the use of transabdominal ultrasound was first documented in the early eighties, with the translabial [1], transrectal [2] and transvaginal [3, 4] techniques developing somewhat later. To obtain a translabial or transperineal image of the pelvic floor, the transducer (ideally a 3.5-6 MHZ curved array abdominal probe) is placed on the perineum, after covering the transducer with an unpowered glove or thin plastic wr...

Usefulness of an index score as a predictor of hepatic fibrosis in obese patients undergoing bariatric surgery Utilidad de un índice de puntuación como predictor de fibrosis hepática en pacientes obesos sometidos a cirugía bariátrica

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R. Díez Rodríguez

2009-08-01

Full Text Available Objective: to evaluate the usefulness of a non-invasive clinical score to predict liver fibrosis in the steatosis associated with morbid obesity. Patients and methods: we included 88 patients, who underwent bariatric surgery in the Sanitary Area of León, Spain, and who showed a liver biopsy with steatosis greater than 5%. This is a retrospective study in which the rate of fibrosis is calculated from tests performed during the preoperative period, and is then compared to data from intraoperative hepatic biopsies. The analysis population was grouped according to the presence of advanced fibrosis in the liver biopsy (grade 3-4 or its absence (grade 0-2. The cutoff used for diagnosing advanced fibrosis was 0.676 (high cutoff point, and the cutoff point to exclude advanced fibrosis was -1.455 (low cutoff. Results: the prevalence of advanced fibrosis in the histological samples was 5.5%, and 65.9% of patients had no fibrosis. The cutoff for a low negative predictive value was 100%, and sensitivity was 100%. The cutoff point for a high positive predictive value was 1.7%, and specificity was 31.3%. Conclusions: this scoring system for morbidly obese patients eligible for bariatric surgery allows to identify those without advanced fibrosis, but cannot predict who may have advanced fibrosis.Objetivo: evaluar la utilidad de un índice de puntuación clínica no invasivo para predecir fibrosis hepática en la esteatosis asociada a la obesidad mórbida. Pacientes y métodos: se incluyeron 88 pacientes, intervenidos de cirugía bariátrica en el área sanitaria de León, que presentaron en la biopsia hepática una esteatosis mayor del 5%. Se trata de un estudio retrospectivo en el que se calculó el índice de fibrosis a partir de los datos analíticos del preoperatorio, y se comparó su resultado con los datos de la biopsia hepática intraoperatoria realizada. Para el análisis los pacientes fueron agrupados según presentaban en la biopsia hep

Pregnancy Loss in Dairy Cattle: Relationship of Ultrasound, Blood Pregnancy-Specific Protein B, Progesterone and Production Variables.

Science.gov (United States)

Gábor, G; Kastelic, J P; Abonyi-Tóth, Z; Gábor, P; Endrődi, T; Balogh, O G

2016-08-01

Objectives were to determine associations between percentage pregnancy loss (PPL) in dairy cattle and: (i) pregnancy diagnosis by ultrasonography; (ii) pregnancy diagnosis by serum pregnancy-specific protein B (PSPB) concentrations, with or without serum progesterone concentrations; and (iii) production and environmental factors. This study included 149 822 pregnancy diagnoses conducted over 13 years in Holstein-Friesian cows in Hungarian dairy herds. The following were determined: PPL in cows diagnosed pregnant by transrectal ultrasonography 29-42 days after artificial insemination (AI; n = 11 457); PPL in cows diagnosed pregnant by serum PSPB 29-35 days after AI (n = 138 365); and PPL and its association with serum progesterone concentrations, PSPB and production/environmental variables. The definition of PPL was percentage of cows initially diagnosed pregnant based on ultrasonography or PSPB, but not pregnant when examined by transrectal palpation 60 -70 days after AI. The PPL was lower (p 1.1 ng/ml) was lowest (15.0%), whereas cows with low concentrations of both PSPB and progesterone (0.6-1.1 and production, when ambient temperatures were high, although body condition score (BCS) had no effect on PPL. Finally, there were no significant associations between serum PSPB and environmental temperatures or number of post-partum uterine treatments. © 2016 Blackwell Verlag GmbH.

Transperineal template-guided prostate saturation biopsies in men with suspicion of prostate cancer: a pilot study from Pakistan.

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Mehmood, K; Mubarak, M; Dhar, M; Rafi, M; Kinsella, J

2017-12-01

Traditionally, transrectal ultrasound (TRUS)-guided biopsies are done for the diagnosis of prostate cancer (PCa) in Pakistan. The transperineal template-guided saturation biopsy (TTSB) approach has been recently introduced in Pakistan and we share diagnostic yields and pathological findings of specimens taken for PCa diagnosis in men with elevated serum total prostate specific antigen (PSA) and negative TRUS-guided prostate biopsies. In all, 16 patients investigated at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), underwent TTSB. The mean age of patients was 67.8 ± 8.8 (range: 55 - 84) years. The median PSA was 9.5 (IQR: 7.9 - 19.8) ng/ ml. The duration of symptoms before biopsy ranged from 1 month to 144 months. The prostate was enlarged with mean weight of 73.5 ± 55.5 g. Histopathology revealed PCa in 5 of 16 (31.2%) cases. The Gleason score was 6 (3+3), 7 (3+4) and 8 (4+4) in 1 case each (6.3%) and 10 (5+5) in 2 cases (12.5%). At least two cores were positive in all positive cases. None of the patients required antibiotics post-procedure. In conclusion, the TTSB technique is a promising option for patients with elevated PSA level and negative transrectal prostate biopsies for the detection of PCa in our setting.

Cáncer injertado en tejido mamario aberrante

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Lidia Torres Ajá

2012-02-01

Full Text Available Entre las anomalías del desarrollo embrionario de las mamas se encuentran las mamas supernumerarias y el tejido ectópico aberrante. Ambas pueden ser asiento de tumores malignos de la mama, en mayor número  el tejido aberrante. Se presenta el caso de una paciente femenina de 73 años, que refiere tiene desde siempre una “mamita pequeña en el surco submamario izquierdo la cual nunca le ocasiono molestias hasta hace 2 meses en que aumentó de volumen y se le retrajo la piel". Mediante biopsia escisional se le diagnostica un carcinoma ductal infiltrante, siendo así  el primer caso de carcinoma injertado en tejido mamario aberrante diagnosticado en nuestra provincia.

ENFOQUE DIAGNÓSTICO EN EL PACIENTE CON DERRAME PLEURAL

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Maite Oyonarte W., DRA.

2015-05-01

Full Text Available En el estudio diagnóstico del paciente con derrame pleural se deben considerar la historia clínica y el análisis de las imágenes para acotar el diagnóstico diferencial. El uso adecuado de las técnicas de imágenes contribuye a realizar procedimientos en forma segura. Se debe realizar una toracocentesis diagnóstica y/o evacuadora y se debe analizar completamente el líquido pleural. A veces es necesario realizar biopsia pleural para lo cual existen diversas técnicas disponibles. En los pacientes con pleuritis crónica inespecífica se debe hacer seguimiento por dos años para evaluar el desarrollo de malignidad.

Transformação carcinomatosa de endometriose retroperitoneal

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João Augusto dos Santos Martines

2012-08-01

Full Text Available Os autores apresentam o caso de uma paciente de 45 anos de idade, portadora de dor abdominal crônica, sendo evidenciada massa retroperitoneal cuja biopsia por agulha revelou tratar-se de endometriose. Submetida a ooforectomia bilateral. A paciente evoluiu, durante 4 anos, sem controle do quadro álgico, com perda de peso e aumento das dimensões da massa tumoral. A exérese cirúrgica total da massa tumoral não foi possível devido às aderências às estruturas vasculares. O pós-operatóriofoi complicado com quadro séptico evoluindo a óbito. O resultado anatomopatológico fornecido pela autópsia foi de adenocarcinoma de padrão endometrióide.

PREOVULATORY FOLLICLE DEVELOPMENT IN HIGH YIELDING COWS

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Radovan Tomášek

2013-06-01

Full Text Available The aim of the study was to examine the development of preovulatory follicles in pregnant and non-pregnant high yielding cows. The treatment by supergestran and oestrophan was used to synchronize the estrous cycle. Ovaries were monitored by transrectal ultrasonography. The linear increase of preovulatory follicles was observed in pregnant (P < 0,001 and non-pregnant (P < 0,001 cows during 8 days before ovulation. In conclusion, preovulatory follicles in pregnant and non-pregnant high yielding cows developed similarly.

Estudo das alterações das citocinas inflamatórias na rejeição aguda do transplante intestinal em ratos Cytokine participation in the acute rejection of intestinal transplantation in rats

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André Dong Won Lee

2004-06-01

Full Text Available RACIONAL: O transplante de intestino delgado é procedimento cirúrgico em estudo visando sua aplicação no tratamento dos pacientes portadores da síndrome do intestino curto, com vistas à reabilitação oral. Porém a grande barreira se deve à "rejeição" pela grande quantidade de tecido linfóide presente no intestino delgado. OBJETIVO: Avaliar a atuação das citocinas, interleucina-6 e interferon-gama em alotransplante heterotópico intestinal. MATERIAL E MÉTODOS: Realizaram-se 24 alotransplantes intestinais em ratos da raça Brown-Norway (doador para Lewis (receptor, sendo subdivididos em três subgrupos de oito animais, sacrificados respectivamente no terceiro dia de pós-operatório (Tx(3, no quinto dia de pós-operatório (Tx(5 e no sétimo dia de pós-operatório (Tx(7 para coleta das biopsias dos enxertos intestinais. Enquanto que no grupo isotransplante (C envolveu oito animais da raça Lewis (doador para Lewis (receptor, porém neste grupo realizaram-se biopsias seriadas no mesmo animal, sendo subdivididos em três momentos: biopsia no terceiro dia de pós-operatório (C(3, no quinto dia de pós-operatório (C(5 e sacrificados no sétimo dia de pós-operatório (C(7 para coleta da biopsia. Realizou-se inicialmente análise intragrupo entre os momentos C(3, C(5 e C(7 para todos os parâmetros de rejeição citados anteriormente, como também para os três subgrupos Tx(3, Tx(5 e Tx(7. Posteriormente, realizou-se a análise intergrupo de forma transversal e pareada comparando-se o grupo isotransplante com o grupo alotransplante (C(3 com Tx(3; C(5 com Tx(5 e C(7 com Tx(7. RESULTADOS: No grupo isotransplante não houve diferença estatisticamente significante quanto à imunoexpressão das citocinas estudadas, todavia no grupo alotransplante observou-se que alterações da interleucina-6 e de interferon-gama ocorreram a partir do quinto dia de pós-operatório.BACKGROUND: Intestinal transplantation is a possible treatment for

Protocol for the realization of transrectal prostatic biopsy guided by ultrasound

International Nuclear Information System (INIS)

Arce Montero, Jairo

2013-01-01

A general protocol is proposed for the realization of the ultrasound-guided prostatic biopsy in patients with positive screening. The screening should be performed taking into account risk antecedents, rectal examination and prostate-specific antigen (PSA) levels in the patients. However, patients that have presented without alteration in the PSA and suspect rectal examination, should be considered for biopsy endorectal with ultrasound guidance even more with positive risk factors. The generalities of prostate cancer are described. The general prostatic anatomy and echographic are reviewed. The echographic technique is analyzed in the exploration endorectal. The echographic findings suspects of prostate cancer are characterized. The different biopsy sampling techniques are described; and based on appropriate knowledge of prostatic echographic anatomy, could increase the effectiveness in the early detection of prostate cancer in patients with positive screening. The complications derived from the process are enumerated. The final recommendations are noted on the protocol described [es

Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

Energy Technology Data Exchange (ETDEWEB)

Schouten, Martijn G. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); University Medical Centre Nijmegen, Department of Radiology, Nijmegen (Netherlands); Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Rothgang, Eva [Pattern Recognition Lab, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen (Germany); Center for Applied Medical Imaging, Siemens Corporate Research (Germany); Center for Applied Medical Imaging, Siemens Corporate Research, Baltimore, MD (United States); Misra, Sarthak [University of Twente, MIRA-Institute of Biomedical Technology and Technical Medicine, Enschede (Netherlands)

2012-02-15

To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

International Nuclear Information System (INIS)

Schouten, Martijn G.; Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J.; Rothgang, Eva; Misra, Sarthak

2012-01-01

To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

Cáncer de próstata metastásico asociado a valores bajos de antígeno prostático específico Metastatic prostate cancer associated with low levels of prostate-specific antigen

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Silvia Diaz

2012-12-01

Full Text Available Se reporta el caso de un paciente de 67 años que presenta dolor en el glúteo derecho que se irradia hacia los muslos afectando la bipedestación y la marcha. Con tiempo de enfermedad de cuatro meses, asociado con la disminución de 15 kg de peso; se realizaron exámenes de imágenes donde se encontró un proceso infiltrativo de hueso sacro. La biopsia se informó como lesión de tejido óseo infiltrado por adenocarcinoma poco diferenciado. La evaluación urológica clínica, a pesar del valor del antígeno prostático específico (PSA total: 4,62 mg/dL, encontró una lesión nodular menor a un centímetro en el examen de tacto rectal. La biopsia de próstata evidenció un adenocarcinoma pobremente diferenciado (score de Gleason: 8. La gammagrafía ósea mostró lesiones activas relacionadas con metástasis en tercio medio de clavícula derecha, hueso sacro y región púbica derecha.A case was reported of a 67-year-old patient with right buttock pain radiating to the thighs and affecting his bipedalism and gait. With four months into the disease and a weight loss of 15 kilos, the patient underwent imaging tests which showed sacrum infiltration. The biopsy diagnosis was injury of bone tissue infiltrated by poorly differentiated adenocarcinoma. The rectal examination performed as part of the clinical urologic examination revealed a nodular lesion of less than one centimeter, despite the level of prostate-specific antigen (total PSA: 4.62 mg/dL. The prostate biopsy evidenced a poorly differentiated adenocarcinoma (Gleason score: 8. The bone scan showed active lesions associated with metastasis in the middle third of the right clavicle, the sacrum and the right pubic region.

Adenopatías generalizadas como presentación de la reacción leprótica tipo 2.

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Gerzaín Rodríguez

2003-12-01

Full Text Available Las reacciones en los pacientes con lepra son manifestaciones clínicas graves de inflamación aguda en las lesiones crónicas del enfermo, capaces de producir daño irreversible e incapacitante. Estudiamos un hombre de 46 años con reacción leprótica tipo 2, que consultó por fiebre, malestar general, sensación de obstrucción nasal, nódulos cutáneos y adenopatías generalizadas. El cuadro hemático mostró leucocitosis con neutrofilia. Entre varios diagnósticos clínicos sugeridos no se pensó en lepra. Una biopsia ganglionar demostró necrosis extensa del órgano que estaba infiltrado por polimorfonucleares y macrófagos espumosos, con necrosis de vénulas y depleción linfoide. No se hizo coloración de ZN, pero sí de Gomori, que tiñó muy bien los bacilos de Hansen, pero no se detectaron por el patólogo, que no hizo un diagnóstico concluyente. Veinte meses después, el paciente presentó síntomas semejantes con adenopatías generalizadas y nódulos cutáneos más numerosos, la biopsia de uno de los cuales demostró lepra lepromatosa con eritema nodoso leproso o reacción tipo 2. El tratamiento antileproso con poliquimioterapia y antirreaccional con talidomida curó al paciente, que 3 años después no presenta secuelas, pese a los 20 meses transcurridos para precisarse el diagnóstico. Comentamos este caso clínico y revisamos los factores predisponentes, la histopatología, los diagnósticos diferenciales de la adenopatía leprosa, la patogenia, el pronóstico y el tratamiento de la reacción tipo 2 en lepra, que constituye una urgencia médica, capaz de originar incapacidad grave y que, como en este enfermo, puede cursar con adenopatías como signos y síntomas predominantes.

¿Cuál es la supervivencia de los injertos de grasa en la cara? ¿Cómo cuantificarla?: medicina basada en la evidencia

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E. Serna-Cuéllar

Full Text Available Muchos de los artículos publicados acerca del éxito de los injertos autólogos de grasa (IAG en humanos son muy subjetivos o, en el mejor de los casos, semicuantitativos Hasta hoy, se necesitan estudios adicionales, tanto clínicos como básicos, antes de que podamos llegar a precisar el valor de esta técnica. Diseñamos un estudio prospectivo y randomizado con el objetivo de cuantificar la supervivencia de los autoinjertos de grasa en cara, en una serie seleccionada de 71 pacientes con defectos subcutáneos de partes blandas faciales que cumplieron criterios de inclusión, en dos grupos, según fueran casos de Cirugía Reconstructiva o de Cirugía Estética. El procedimiento quirúrgico estándar empleado fue la técnica de lipoestructura facial; se tomó biopsia del tejido adiposo injertado a los 14 meses de seguimiento. Empleamos el método estereológico para medir los parámetros volumétricos cuantitativos de la grasa en el momento de la inyección y en el momento de la biopsia. Por medio de simples ecuaciones matemáticas, pudimos extraer las tasas de prendimiento tanto volumétrica como numérica. También se practicaron análisis estadísticos descriptivos y cuantitativos de todos los datos. Los injertos de grasa autólogos en la cara sobreviven en dos tercios del volumen inyectado a los 14 meses de seguimiento. La única prueba confirmatoria de supervivencia de los autoin-jertos de grasa es la evidencia y demostración histológica de tejido adiposo viable en las zonas receptoras y su cuantificación mediante un método de evaluación volumétrico, preciso y objetivo, como el que permite la Estereología.

Identification of threshold prostate specific antigen levels to optimize the detection of clinically significant prostate cancer by magnetic resonance imaging/ultrasound fusion guided biopsy.

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Shakir, Nabeel A; George, Arvin K; Siddiqui, M Minhaj; Rothwax, Jason T; Rais-Bahrami, Soroush; Stamatakis, Lambros; Su, Daniel; Okoro, Chinonyerem; Raskolnikov, Dima; Walton-Diaz, Annerleim; Simon, Richard; Turkbey, Baris; Choyke, Peter L; Merino, Maria J; Wood, Bradford J; Pinto, Peter A

2014-12-01

Prostate specific antigen sensitivity increases with lower threshold values but with a corresponding decrease in specificity. Magnetic resonance imaging/ultrasound targeted biopsy detects prostate cancer more efficiently and of higher grade than standard 12-core transrectal ultrasound biopsy but the optimal population for its use is not well defined. We evaluated the performance of magnetic resonance imaging/ultrasound targeted biopsy vs 12-core biopsy across a prostate specific antigen continuum. We reviewed the records of all patients enrolled in a prospective trial who underwent 12-core transrectal ultrasound and magnetic resonance imaging/ultrasound targeted biopsies from August 2007 through February 2014. Patients were stratified by each of 4 prostate specific antigen cutoffs. The greatest Gleason score using either biopsy method was compared in and across groups as well as across the population prostate specific antigen range. Clinically significant prostate cancer was defined as Gleason 7 (4 + 3) or greater. Univariate and multivariate analyses were performed. A total of 1,003 targeted and 12-core transrectal ultrasound biopsies were performed, of which 564 diagnosed prostate cancer for a 56.2% detection rate. Targeted biopsy led to significantly more upgrading to clinically significant disease compared to 12-core biopsy. This trend increased more with increasing prostate specific antigen, specifically in patients with prostate specific antigen 4 to 10 and greater than 10 ng/ml. Prostate specific antigen 5.2 ng/ml or greater captured 90% of upgrading by targeted biopsy, corresponding to 64% of patients who underwent multiparametric magnetic resonance imaging and subsequent fusion biopsy. Conversely a greater proportion of clinically insignificant disease was detected by 12-core vs targeted biopsy overall. These differences persisted when controlling for potential confounders on multivariate analysis. Prostate cancer upgrading with targeted biopsy increases

Melanoma lentiginoso acral en una paciente adulta

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Yoandra Seara Govea

Full Text Available Se presenta el caso clínico de una paciente ecuatoriana de 58 años, blanca, con antecedentes de hernias discales en regiones cervical y lumbar, quien hace 2 años asistió a la Consulta de Dermatología por presentar cambio de coloración en la uña del tercer dedo de la mano derecha, síntomas que se correspondían con un lentigo simple. En esta ocasión acude con destrucción de la lámina ungueal y aumento de la coloración que se extiende a todo el pulpejo del dedo, por lo cual se le realizó otra biopsia y se confirmó el diagnóstico histológico de melanoma lentiginoso acral (in situ

Características clínicas, bioquímicas y epidemiológicas de un grupo de pacientes con diagnóstico imaginológico de hígado graso

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Juan Carlos Restrepo

2001-04-01

Full Text Available En nuestro medio, la esteatosis o infiltración hepática grasa se
convierte casi siempre en un hallazgo imaginológico incidental, al cual
se la da muy poca importancia desde el punto de vista clínico, y por
ende no se realizan estudios posteriores para determinar su causa, las condiciones asociadas que lo expliquen (1, y mucho menos se realiza biopsia hepática para determinar, cuáles de estos pacientes tienen esteatohepatitis, algún grado de fibrosis o incluso cirrosis. Este trabajo tuvo como objetivo describir las características epidemiológicas, clínicas y bioquímicas de un grupo de pacientes con diagnóstico imaginológico de hígado graso.

Quiste dermoide en la cola de la ceja

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Lázara Kenia Ramírez García

Full Text Available El quiste dermoide es un tipo de coristoma que corresponde a una anomalía congénita del desarrollo. Se presenta una transicional de dos años. Desde su nacimiento, la mamá notó un aumento de volumen a nivel de la cola de la ceja del ojo derecho, de bordes delimitados, blanda, movible, reborde orbitario libre, sin cambios de coloración, con un crecimiento acelerado clínico y ultrasonográfico en meses. Se decidió exéresis y biopsia para estudio anatomopatológico. Los resultados finales mostraron confirmación del diagnóstico de quiste dermoide en la cola de la ceja. La evolución posoperatoria fue satisfactoria sin recidiva de la lesión.

Compromiso nodular hepático secundario a mieloma múltiple

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Fernando J. Vázquez

2010-08-01

Full Text Available El mieloma múltiple (MM es una enfermedad maligna caracterizada por una proliferación clonal de células plasmáticas atípicas en la médula ósea, que produce una inmunoglobulina (Ig con estructura homogénea en la sangre y/o en la orina (cadenas livianas. El compromiso del parénquima hepático con masa ocupante en los pacientes con MM es excepcional. Describimos 3 casos clínicos confirmados histológicamente. La ecografía y la tomografía computarizada tienen una sensibilidad intermedia y las imágenes no son patognomónicas, por lo tanto es necesaria la confirmación a través de la biopsia. Se desconoce la implicancia pronóstica de este hallazgo.

Hepatite aguda colestática pelo propiltiouracil: relato de caso

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PAROLIN Mônica Beatriz

2000-01-01

Full Text Available Propiltiouracil é uma droga amplamente utilizada no tratamento do hipertiroidismo. A hepatotoxicidade é um dos efeitos colaterais mais raros e também mais graves associados a ela. Relata-se um caso de hepatite aguda colestática que acomete um jovem de 15 anos em uso de propiltiouracil para tratamento de hipertiroidismo. Causas virais, metabólicas e autoimunes foram excluídas e a biopsia hepática revelou achados histopatológicos sugestivos de hepatite colestática induzida por droga. Com a suspensão da droga, houve remissão dos sintomas e normalização progressiva das provas de função hepática. Raramente, os pacientes em uso de propiltiouracil podem desenvolver injúria hepática grave.

Acute Bacterial Prostatitis: Diagnosis and Management.

Science.gov (United States)

Coker, Timothy J; Dierfeldt, Daniel M

2016-01-15

Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy.

Sequential evaluation of prostate edema after permanent seed prostate brachytherapy using CT-MRI fusion

International Nuclear Information System (INIS)

Taussky, Daniel; Austen, Lyn; Toi, Ants; Yeung, Ivan; Williams, Theresa; Pearson, Shannon; McLean, Michael; Pond, Gregory; Crook, Juanita

2005-01-01

Purpose: To analyze the extent and time course of prostate edema and its effect on dosimetry after permanent seed prostate brachytherapy. Methods and Materials: Twenty patients scheduled for permanent seed 125 I prostate brachytherapy agreed to a prospective study on postimplant edema. Implants were preplanned using transrectal ultrasonography. Postimplant dosimetry was calculated using computed tomography-magnetic resonance imaging (CT-MRI) fusion on the day of the implant (Day 1) and Days 8 and 30. The prostate was contoured on MRI, and the seeds were located on CT. Factors investigated for an influence on edema were the number of seeds and needles, preimplant prostate volume, transitional zone index (transition zone volume divided by prostate volume), age, and prostate-specific antigen level. Prostate dosimetry was evaluated by the percentage of the prostate volume receiving 100% of the prescribed dose (V 100 ) and percentage of prescribed dose received by 90% of the prostate volume (D 90 ). Results: Prostate edema was maximal on Day 1, with the median prostate volume 31% greater than preimplant transrectal ultrasound volume (range, 0.93-1.72; p 100 on Day 1 was 93.6% (range, 86.0-98.2%) and was 96.3% (range, 85.7-99.5%) on Day 30 (p = 0.079). Patients with a Day 1 V 100 >93% were less affected by edema resolution, showing a median increase in V 100 of 0.67% on Day 30 compared with 2.77% for patients with a V 100 100 >93%)

Tandem-robot assisted laparoscopic radical prostatectomy to improve the neurovascular bundle visualization: a feasibility study.

Science.gov (United States)

Han, Misop; Kim, Chunwoo; Mozer, Pierre; Schäfer, Felix; Badaan, Shadie; Vigaru, Bogdan; Tseng, Kenneth; Petrisor, Doru; Trock, Bruce; Stoianovici, Dan

2011-02-01

To examine the feasibility of image-guided navigation using transrectal ultrasound (TRUS) to visualize the neurovascular bundle (NVB) during robot-assisted laparoscopic radical prostatectomy (RALP). The preservation of the NVB during radical prostatectomy improves the postoperative recovery of sexual potency. The accompanying blood vessels in the NVB can serve as a macroscopic landmark to localize the microscopic cavernous nerves in the NVB. A novel, robotic transrectal ultrasound probe manipulator (TRUS Robot) and three-dimensional (3-D) reconstruction software were developed and used concurrently with the daVinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) in a tandem-robot assisted laparoscopic radical prostatectomy (T-RALP). After appropriate approval and informed consent were obtained, 3 subjects underwent T-RALP without associated complications. The TRUS Robot allowed a steady handling and remote manipulation of the TRUS probe during T-RALP. It also tracked the TRUS probe position accurately and allowed 3-D image reconstruction of the prostate and surrounding structures. Image navigation was performed by observing the tips of the daVinci surgical instruments in the live TRUS image. Blood vessels in the NVB were visualized using Doppler ultrasound. Intraoperative 3-D image-guided navigation in T-RALP is feasible. The use of TRUS during radical prostatectomy can potentially improve the visualization and preservation of the NVB. Further studies are needed to assess the clinical benefit of T-RALP. Copyright © 2011 Elsevier Inc. All rights reserved.

Repeatability and accuracy of reproductive tract scoring to determine pubertal status in beef heifers.

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Rosenkrans, Kelly S; Hardin, David K

2003-03-01

The objective of this study was to compare the repeatability and accuracy of palpation per rectum to transrectal ultrasonography and serum progesterone concentrations for determining pubertal status in beef heifers. One hundred and seventy-four rectal examinations were performed on 29 predominantly Angus heifers by two veterinarians (A and B) and assigned individual reproductive tract scores (RTS) during monthly examinations over a 3-month period. Heifers were examined in the morning by both veterinarians, randomized, and re-examined in the afternoon. The size and location of ovarian structures of each heifer were determined by ultrasonography. Heifers with follicles >10mm in diameter or corpora lutea were classified as pubertal. Serum progesterone concentrations at the time of the examination and 10 days later were determined by radioimmunoassay and used to classify heifers as prepubertal (or=1 ng/ml). Kappa, which describes degree of agreement beyond chance, was used to determine repeatability of the RTS system. Multicategory Kappa for agreement was 0.64 within veterinarian, 0.46 between veterinarian, and 0.35 between palpation per rectum and transrectal ultrasonography. Sensitivity and specificity of palpation per rectum for diagnosis of pubertal status compared to serum progesterone levels were higher (82 and 69%, respectively) than sensitivity and specificity of ultrasonography (79 and 59%, respectively). This study validates the RTS system as a repeatable and accurate screening test to evaluate pubertal status in groups of heifers prior to the onset of the breeding season.

Ultrasound-guided endocavitary drainage of pelvic abscesses: Technique, results and complications

International Nuclear Information System (INIS)

Ryan, R.S.; McGrath, F P.; Haslam, P.J.; Varghese, J.C.; Lee, M.J.

2003-01-01

AIM: To evaluate the experience in our institution with ultrasound-guided transrectal and transvaginal (endocavitary) drainage of pelvic abscesses. MATERIALS AND METHODS: Eighteen patients (four male, 14 female; mean age 55 years, range 30-78 years) presenting with pelvic abscesses were referred to our institution for therapeutic drainage over a 4 year period. Patients received broad-spectrum antibiotics prior to drainage, which was performed by either the transvaginal or transrectal route under ultrasound guidance. Patients were given sedo-analgesia in the form of midazolam and fentanyl and local anaesthesia was also employed. Eight French catheters were inserted into the abscess cavities, and patients were subsequently monitored on a daily basis by a member of the interventional radiology team until such time as it was deemed appropriate to remove the catheter. RESULTS: Eighteen catheters were placed in 17 patients, and transvaginal aspiration alone was performed in one patient. Drainage was successful in 16 of 17 patients, but a transgluteal approach was ultimately required in the remaining patient to enable passage of a larger catheter into an infected haematoma. The mean duration of drainage was 5 days, mean time to defervesce 2 days. Spontaneous catheter dislodgement occurred in four patients associated with straining, but this did not have any adverse effect in three of the four patients. CONCLUSION: Endocavitary drainage is an effective method of treatment for pelvic abscesses. Spontaneous catheter dislodgement does not affect patient outcome

Ultrasound-guided endocavitary drainage of pelvic abscesses: Technique, results and complications

Energy Technology Data Exchange (ETDEWEB)

Ryan, R.S.; McGrath, F P.; Haslam, P.J.; Varghese, J.C.; Lee, M.J

2003-01-01

AIM: To evaluate the experience in our institution with ultrasound-guided transrectal and transvaginal (endocavitary) drainage of pelvic abscesses. MATERIALS AND METHODS: Eighteen patients (four male, 14 female; mean age 55 years, range 30-78 years) presenting with pelvic abscesses were referred to our institution for therapeutic drainage over a 4 year period. Patients received broad-spectrum antibiotics prior to drainage, which was performed by either the transvaginal or transrectal route under ultrasound guidance. Patients were given sedo-analgesia in the form of midazolam and fentanyl and local anaesthesia was also employed. Eight French catheters were inserted into the abscess cavities, and patients were subsequently monitored on a daily basis by a member of the interventional radiology team until such time as it was deemed appropriate to remove the catheter. RESULTS: Eighteen catheters were placed in 17 patients, and transvaginal aspiration alone was performed in one patient. Drainage was successful in 16 of 17 patients, but a transgluteal approach was ultimately required in the remaining patient to enable passage of a larger catheter into an infected haematoma. The mean duration of drainage was 5 days, mean time to defervesce 2 days. Spontaneous catheter dislodgement occurred in four patients associated with straining, but this did not have any adverse effect in three of the four patients. CONCLUSION: Endocavitary drainage is an effective method of treatment for pelvic abscesses. Spontaneous catheter dislodgement does not affect patient outcome.

Calm temperament improves reproductive performance of beef cows.

Science.gov (United States)

Kasimanickam, R; Asay, M; Schroeder, S; Kasimanickam, V; Gay, J M; Kastelic, J P; Hall, J B; Whittier, W D

2014-12-01

Profitability of a beef operation is determined by the proportion of cows attaining pregnancy early in the breeding season and those that are pregnant at the end of breeding season. Many factors, including temperament, contribute to those reproductive parameters. The objective of this study was to evaluate effects of temperament on reproductive performance of beef cows. In Experiment 1, Angus and Angus-cross beef cows (n = 1546) from eight locations were assigned a body condition score (BCS; 1 = emaciated; 9 = obese) and chute exit and gait score (1 = slow exit, walk; calm temperament; 2 = jump, trot or run; excitable temperament). Cows were grouped with bulls (1 : 25 to 1 : 30; with satisfactory breeding potential and free of venereal disease) for an 85-day breeding season. Pregnancy status and stage of gestation were determined (transrectal palpation) 35 days after the end of the breeding season. Controlling for BCS (p score interaction (p scores for body condition and chute exit and gait (as described in Experiment 1) and assigned to bulls (breeding sound and free of venereal disease; 1 : 25 to 1 : 30) for 85 days. Pregnancy status was determined by transrectal palpation at 2 and 6 months after the onset of the breeding season. Controlling for BCS (p reproductive performance than calmer cows. The modified two-point chute exit-gait scoring method was repeatable and identified cattle with an excitable temperament. © 2014 Blackwell Verlag GmbH.

Correlación cito-histológica de las lesiones premalignas y malignas de cuello uterino Cyto-histological correlation of the pre-malignant and malignant lesions of the cervix

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Gladys Rafaela Cirión Martínez

2010-03-01

Full Text Available El control de la calidad es obligatorio para cualquier programa. Es importante en el diagnóstico de lesiones de cuello uterino puesto que el cáncer cervical es la segunda causa de mortalidad en la mujer. Objetivos: Determinar la correlación cito-histológica de las lesiones premalignas y malignas de cuello uterino. Hospital Clínico Quirúrgico "Abel Santamaría" en el período 2004-2007 Diseño: Se realizó un estudio de validación externa de la citología orgánica del cuello uterino mediante un diseño observacional, descriptivo y transversal. Sujetos y método. Universo: 7174 mujeres con biopsia del cuello uterino, de las cuales 3240 provenían del Programa de Detección Precoz del Cáncer Cérvico-Uterino (PDPCCU. Se determinó la edad, correspondencia diagnóstica entre citología y biopsia y el rendimiento de la citología orgánica según tipo de lesión. Se usó la estadística descriptiva para resumir las variables categóricas y cuantitativas continuas. Se calculó la sensibilidad y la especificidad de los diagnósticos. Resultados. Se produjo un aumento progresivo de las biopsias de cuello realizadas, con un incremento significativo de los casos del PDPCCU. Predominó el diagnóstico de lesiones premalignas; las más frecuentes fueron las NIC I. La correlación cito-histológica y la sensibilidad aumentaron con la severidad de las lesiones. La especificidad se mantuvo constante para todas las lesiones. Conclusión. Se comprobó que la calidad se mantiene entre los estándares internacionales.Quality control is compulsory for any programs, being of a great importance the diagnosis of the lesions in the cervix, cervical cancer is the second cause of death in women. Objectives: To determine the cyto-histological correlation of the pre-malignant and malignant lesions of the cervix. This research paper was carried out at "Abel Santamaria Cuadrado" University Hospital during 2004-2007. Design: An external validation study was conducted

Treatment of cancer of the prostate by use of physiotherapy

International Nuclear Information System (INIS)

Ballanger, R.; Ballanger, P.

1987-01-01

For more than twenty five years, the authors have been physical agents in the treatment of cancer of the prostate at its initial stage. Obviously, in the course of this long period the technique of external irradiation has been improved upon (high energy photons, location of the irradiated mass using C-T scan, multiple beams) and also the screening of patients thanks to transrectal ultrasonography, bone scinitscans and lympography with cyto-puncture. It is hence probable that the results the authors are presenting in the forthcoming years will even be enhanced

Rehabilitation of the short pelvic floor. II: Treatment of the patient with the short pelvic floor.

Science.gov (United States)

FitzGerald, M P; Kotarinos, R

2003-10-01

Several urogynecologic syndromes are associated with the clinical finding of a short, painful, tender and weak pelvic floor and a variety of connective tissue abnormalities. Techniques for rehabilitation include the avoidance of perpetuating factors, rehabilitation of extrapelvic musculoskeletal abnormalities, the use of manual techniques and needling to promote resolution of connective tissue problems, closure of any diastasis recti, and transvaginal/transrectal manual release of muscular trigger points and contractures. Therapy can be facilitated by pudendal or epidural nerve block. Patients contribute to their success through home maintenance programs.

Ectopic prostatic tissue in the rectum: A case report

Energy Technology Data Exchange (ETDEWEB)

Seol, Myung Jin; Noh, Kyung Hee; Jeon, Doo Sung; Lee, Kwang Min [Presbyterian Medical Center, Jeonju (Korea, Republic of)

2017-02-15

Ectopic prostatic tissue (EPT) outside the male genitourinary tract is an unusual finding, and it is very rarely found in the rectum or around the peri-rectal region. In addition, the radiologic features of EPT are seldom reported. Also, it is difficult to differentiate EPT found in the rectal subepithelium from the other types of subepithelial tumors. We present here a unique case of EPT found in the retrorectal region, along with the radiologic findings of transrectal ultrasonography, computed tomography, and magnetic resonance imaging with their pathologic correlations.

Prostatic Utricle Cyst as the Most Likely Cause in a Case of Recurrent Episodes of Hematospermia

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Grégoire Feutry

2017-01-01

Full Text Available Hematospermia is a clinical symptom that raises anxiety in patients and has various causes, benign and malignant. We report a case of hematospermia for which appropriate multidisciplinary expertise favored a conservative management of a benign prostatic cyst, namely, a prostatic utricle cyst. A cystic lesion found by transrectal ultrasound in the context of hematospermia related to masturbation in a young virgin male patient was investigated with a high-field magnetic resonance imaging (MRI and an endorectal coil. The association of high-field MRI and endorectal coil leads to high quality images.

A Rare Prostatic Diagnosis of an Old Man: A Pure Prostatic Leiomyoma

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W. M. van Ulden-Bleumink

2013-01-01

Full Text Available A pure leiomyoma of the prostate is a rare benign tumor. An 82-year-old man was referred to our urology department with gross hematuria and complete urinary retention. Examination revealed a benign prostatic hyperplasia. Transrectal ultrasound showed a prostate of 125 mL. Serum PSA was 1.9 µg/L. A simple retropubic prostatectomy was performed. Histopathological examination showed a pure leiomyoma of the prostate, without the presence of glandular prostate tissue. The diagnosis, characteristics, and treatment of this tumor are described.

Magnetic resonance imaging-guided biopsies may improve diagnosis in biopsy-naive men with suspicion of prostate cancer

DEFF Research Database (Denmark)

Winther, Mads Dochedahl; Balslev, Ingegerd; Boesen, Lars

2017-01-01

INTRODUCTION: The purpose of this pilot study was to investigate whether a short prostate biparametric magnetic resonance imaging (bp-MRI) protocol provides a valuable diagnostic addition for biopsy guidance in biopsy-naive men with a suspicion of prostate cancer (PCa). METHODS: A total of 62...... biopsy-naive patients referred to a systematic transrectal ultrasound biopsy (TRUS-bx) due to suspicion of PCa were prospectively enrolled. Bp-MRI was performed before biopsy. All lesions were scored according to the modified Prostate Imaging Reporting and Data System (PI-RADS) version 2. All patients...

Ultrasonically guided 125iodine seed implantation with external radiation in management of localized prostatic carcinoma

DEFF Research Database (Denmark)

Iversen, P; Bak, M; Juul, N

1989-01-01

Thirty-three patients with localized prostatic carcinoma (16 poorly differentiated) were treated with transperineal 125Iodine seed implantation (160 Gy) guided by transrectal ultrasonography and subsequent external beam irradiation (47.4 Gy). The observation time was six to sixty-eight months...... with a median follow-up of thirty-five months. Median change in prostatic volume was a reduction of 35 percent. Re-biopsy or transurethral resection of the prostate was performed in 25 patients after one to two years, revealing still malignant histology in 12 (48%). Development of distant metastases occurred...

The eternal enigma in prostatic biopsy access route

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Andrea Fabiani

2017-10-01

Full Text Available Dear Editors,We read with interest the article by Di Franco and co-workers (1. The introduction of prostatic magnetic resonance and the relative fusion-biopsy have not yet allowed the expected improvements in prostate biopsy. To our knowledge, there are no works that demonstrate the superiority of fusion techniques on the remaining ultrasound guided prostate biopsies that are still the widely used in the diagnosis of prostate cancer. Furthemore, these technologies are expensive exams and they are not yet available in all centers, especially in those minors. We work at a “minor” center and we always keep in mind that the goal of  prostatic biopsy is the diagnosis and the staging of prostatic neoplasms.. However, it remains uncertain which of the two techniques, transperineal (TP or transrectal (TR, is superior in terms of detection rate during first biopsy setting. Several studies have compared the prostate cancer detection rate but TR and TP access route in prostatic gland sampling seems to be equivalent in terms of efficiency and complications, as reported by Shen PF et al. (2, despite several methodological limitations recognized in their work. The results reported by Di Franco CA et al. represent the real life experience of most urologists that perform the PB based on their own training experience and available technical devices. From an historical viewpoint, the TP route has been the first one to be used to reach the prostate, both for diagnostic and therapeutic purposes. To date, because it seems to be more invasive and difficult, the TP route is less used worldwide than the TR one (2. Theoretically, the TP approach should detect more prostate cancer than the TR way  because the cores of the TP approach are directed longitudinally to the peripheral zone and the anterior part of the prostate (4. The results reported by Di Franco et al. seems to confirm these considerations. However, our real life experience differ from the conclusions

The eternal enigma in prostatic biopsy access route.

Science.gov (United States)

Fabiani, Andrea; Principi, Emanuele; Filosa, Alessandra; Servi, Lucilla

2017-10-03

Dear Editors,We read with interest the article by Di Franco and co-workers (1). The introduction of prostatic magnetic resonance and the relative fusion-biopsy have not yet allowed the expected improvements in prostate biopsy. To our knowledge, there are no works that demonstrate the superiority of fusion techniques on the remaining ultrasound guided prostate biopsies that are still the widely used in the diagnosis of prostate cancer. Furthemore, these technologies are expensive exams and they are not yet available in all centers, especially in those minors. We work at a "minor" center and we always keep in mind that the goal of  prostatic biopsy is the diagnosis and the staging of prostatic neoplasms.. However, it remains uncertain which of the two techniques, transperineal (TP) or transrectal (TR), is superior in terms of detection rate during first biopsy setting. Several studies have compared the prostate cancer detection rate but TR and TP access route in prostatic gland sampling seems to be equivalent in terms of efficiency and complications, as reported by Shen PF et al. (2), despite several methodological limitations recognized in their work. The results reported by Di Franco CA et al. represent the real life experience of most urologists that perform the PB based on their own training experience and available technical devices. From an historical viewpoint, the TP route has been the first one to be used to reach the prostate, both for diagnostic and therapeutic purposes. To date, because it seems to be more invasive and difficult, the TP route is less used worldwide than the TR one (2). Theoretically, the TP approach should detect more prostate cancer than the TR way  because the cores of the TP approach are directed longitudinally to the peripheral zone and the anterior part of the prostate (4). The results reported by Di Franco et al. seems to confirm these considerations. However, our real life experience differ from the conclusions reached in their

Experiencia con rituximab en miopatía inflamatoria idiopática refractaria

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Elmer R. García-Salazar

2013-10-01

Full Text Available Se describe las características clínicas y de laboratorio de dos pacientes que recibieron rituximab por miopatía inflamatoria idiopática (MII. Ellas eran refractarias a tratamiento convencional con DARMES, por lo que recibieron rituximab 1 gramo cada 14 días, en dos infusiones en ciclo semestral. En las historias clínicas se obtuvo los datos clínicos de fuerza muscular proximal, lesiones cutáneas patognomónicas, elevación de CPK, TGO, DHL y VSG, resultados de electromiografía, biopsia muscular y de piel. Ninguno de los dos casos presentó reacción medicamentosa ni infecciones durante y posterior a las infusiones. Rituximab mostró efectividad en la respuesta clínica y enzimática en estas pacientes con dermatomiositis refractarias a corticoides y DARMES tradicionales.

Systematic Assessment Reveals Lack of Understandability for Prostate Biopsy Online Patient Education Materials.

Science.gov (United States)

Maciolek, Kimberly A; Jarrard, David F; Abel, E Jason; Best, Sara L

2017-11-01

To evaluate the accuracy, readability, understandability, and actionability of Internet patient education materials (PEM) about transrectal ultrasound-guided prostate biopsy. A comprehensive Internet search was performed to find PEM with pre- or postbiopsy instructions. PEM that were duplicates, government affiliated, international, or video based were excluded. Biopsy instructions were evaluated for accuracy and presence of essential topics. Readability was assessed via word count and Flesch-Kincaid Grade Level. Understandability and actionability were measured using the Patient Education Materials Assessment Tool (PEMAT). Effects of authorship and geographical variation were determined using Fischer exact and Kruskal-Wallis tests. We identified 148 unique PEM. Only 31 (21%) sites adhered to the recommended reading level. Most PEM did not contain recommended graphics (14%), checklists (2%), or summaries (6%). The PEMAT understandability score for academic PEM was higher than private (P = .02) and unaffiliated PEM (P = .01). No websites had inaccurate content. Only 2 PEM sites (1%) included all essential content (stop anticoagulants, antibiotics, need for urinalysis, biopsy pain, when to resume activity, and bleeding complications). Few significant differences based on geographic region were observed for word count, readability, PEMAT scores, or content. Transrectal ultrasound-guided prostate biopsy PEM adhere poorly to guidelines for easy-to-understand materials. Most PEM lack vital information and are written at a reading level that is too complex for patient comprehension. The urology community can construct better websites by consulting PEM advisory materials and providing nontechnical language, figures, and specific instructions. Published by Elsevier Inc.

The characteristics and spatial distributions of initially missed and rebiopsy-detected prostate cancers

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Myung-Won You

2016-07-01

Full Text Available Purpose: The purpose of this study was to analyze the characteristics of initially missed and rebiopsy-detected prostate cancers following 12-core transrectal biopsy. Methods: A total of 45 patients with prostate cancers detected on rebiopsy and 45 patients with prostate cancers initially detected on transrectal ultrasound-guided biopsy were included in the study. For result analysis, the prostate was divided into six compartments, and the cancer positive rates, estimated tumor burden, and agreement rates between biopsy and surgical specimens, along with clinical data, were evaluated. Results: The largest mean tumor burden was located in the medial apex in both groups. There were significantly more tumors in this location in the rebiopsy group (44.9% than in the control group (30.1%, P=0.015. The overall sensitivity of biopsy was significantly lower in the rebiopsy group (22.5% vs. 43.4%, P<0.001. The agreement rate of cancer positive cores between biopsy and surgical specimens was significantly lower in the medial apex in the rebiopsy group compared with that of the control group (50.0% vs. 65.6%, P=0.035. The cancer positive rates of target biopsy cores and premalignant lesions in the rebiopsy group were 63.1% and 42.3%, respectively. Conclusion: Rebiopsy-detected prostate cancers showed different spatial distribution and lower cancer detection rate of biopsy cores compared with initially diagnosed cancers. To overcome lower cancer detection rate, target biopsy of abnormal sonographic findings, premalignant lesions and medial apex which revealed larger tumor burden would be recommended when performing rebiopsy.

Widespread high grade prostatic intraepithelial neoplasia on biopsy predicts the risk of prostate cancer: A 12 months analysis after three consecutive prostate biopsies

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Cosimo De Nunzio

2013-06-01

Full Text Available Purpose: To evaluate the risk of prostate cancer (PCa on a third prostate biopsy in a group of patients with two consecutive diagnoses of high grade intraepithelial neoplasia (HGPIN. Materials and methods: From November 2004 to December 2007, patients referred to our clinic with a PSA ! 4 ng/ml or an abnormal digital rectal examination (DRE were scheduled for trans-rectal ultrasound (TRUS guided 12-core prostate biopsy. Patients with HGPIN underwent a second prostate biopsy, and if the results of such procedure yielded a second diagnosis of HGPIN, we proposed a third 12-core needle biopsy regardless of PSA value. Crude and adjusted logistic regressions were used to assess predictors of PCa on the third biopsy. Results: A total of 650 patients underwent 12 cores transrectal ultrasound prostatic biopsy in the study period. Of 147 (22% men with a diagnosis of HGPIN, 117 underwent a second prostatic biopsy after six months and 43 a third biopsy after other six months. After the third biopsy, 19 patients (34% still showed HGPIN, 15 (35% were diagnosed with PCa and 9 (21% presented with chronic prostatitis. Widespread HGPIN on a second biopsy was significantly associated with PCa on further biopsy (!2 = 4.04, p = 0.04. Moreover, the presence of widespread HGPIN significantly predicted the risk of PCa on crude and adjusted logistic regressions. Conclusions: Widespread HGPIN on second biopsy is associated with the presence of PCa on a third biopsy. Nonetheless, the relationship between HGPIN and PCa remains complex and further studies are needed to confirm our findings.

Prostate calcifications: A case series supporting the microbial biofilm theory

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Tommaso Cai

2018-05-01

Full Text Available Purpose: Prostate calcifications are a common finding during transrectal prostate ultrasound in both healthy subjects and patients, but their etiopathogenesis and clinical significance are not fully understood. We aimed to establish a new methodology for evaluating the role of microbial biofilms in the genesis of prostate calcifications. Materials and Methods: Ten consecutive patients who had undergone radical prostatectomy were enrolled in this study. All of the patients presented with prostate calcifications during transrectal ultrasound evaluation before surgery and underwent Meares-Stamey tests and clinical evaluation with the National Institutes of Health Chronic Prostatitis Symptom Index and the International Prostate Symptom Score. At the time of radical prostatectomy, the prostate specimen, after removal, was analyzed with ultrasonography under sterile conditions in the operating room. Core biopsy specimens were taken from the site of prostate calcification and subjected to ultrastructural and microbiological analysis. Results: The results of the Meares-Stamey test showed only 1 of 10 patients (10% with positive cultures for Escherichia coli. Two of five patients (40% had positive cultures from prostate biopsy specimens. Enterococcus faecalis, Enterococcus raffinosus, and Citrobacter freundii were isolated. Ultrastructural analysis of the prostate biopsy specimens showed prostate calcifications in 6 of 10 patients (60%, and a structured microbial biofilm in 1 patient who had positive cultures for E. faecalis and E. raffinosus. Conclusions: Although the findings are supported by a low number of patients, this study highlights the validity of the proposed methodology for investigating the role of bacterial biofilms in the genesis of prostate calcification.

The 3DBiopsy Prostate Biopsy System: Preclinical Investigation of a Needle, Actuator, and Specimen Collection Device Allowing Sampling of Individualized Prostate Lengths Between 20 and 60 mm.

Science.gov (United States)

Stone, Nelson N; Mouraviev, Vladimir; Schechter, David; Lucia, M Scott; Smith, Elizabeth E; Arangua, Paul; Hoenemeyer, John; Rosa, Jim; Bawa, Rajan; Crawford, E David

2017-09-01

To increase the likelihood of detecting anterior cancers within the prostate and provide a specimen that spans the length of the gland. Newly designed 17- and 15-gauge (G) biopsy needles, a variable actuator, and an integrated pathology system intended for the longer cores were developed and tested for this purpose. Testing was performed comparing 2 common cannula tip grinds, a Vet-point (sharp tip) and a Menghini-point (atraumatic tip), and were tested against 18-G Bard Monopty in porcine kidney. A variable actuator was developed to fire the needle 20-60 mm and tested in cadaver prostates. The aggregate firings for 3 different shot lengths comparing the Vet- with the Menghini-tip cannulas demonstrated 91% vs 85.2% fill (length of specimen/length of core bed, P = .007). A 15-G trocar needle with the Vet-tip cannula also had the best performance, with an aggregate standard deviation of 6.4% across 3 firing ranges and a minimum to maximum specimen length of 81%-105% of potential fill. Cadaver testing with the Vet-tip needles in the actuator for the transrectal (17-G) and transperineal (15-G) biopsies demonstrated mean fills of 93.3% and 76.5%, respectively. The new transrectal ultrasound needle obtained a 2-fold increase in specimen length over the standard Bard device (P actuator, the physician can obtain specimens that include peripheral and anterior zone tissue in 1 core. Determination of cancer location on the longer specimens could enhance focal therapy planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Presacral abscess as a rare complication of sacral nerve stimulator implantation.

Science.gov (United States)

Gumber, A; Ayyar, S; Varia, H; Pettit, S

2017-03-01

A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement. The patient was treated with broad spectrum antibiotics, and the sacral nerve stimulator and electrode were removed. Attempts were made to drain the abscess transrectally using minimally invasive techniques but these were unsuccessful and CT guided transperineal drainage was then performed. Despite this, the presacral abscess progressed, developing enlarging gas locules and extending to the pelvic brim to involve the aortic bifurcation, causing hydronephrosis and radiological signs of impending sacral osteomyelitis. MRI showed communication between the rectum and abscess resulting from transrectal drainage. In view of the progressive presacral sepsis, a laparotomy was performed with drainage of the abscess, closure of the upper rectum and formation of a defunctioning end sigmoid colostomy. Following this, the presacral infection resolved. Presacral abscess formation secondary to an infected sacral nerve stimulator electrode has not been reported previously. Our experience suggests that in a similar situation, the optimal management is to perform laparotomy with drainage of the presacral abscess together with simultaneous removal of the sacral nerve stimulator and electrode.

Local control after brachytherapy for localized prostatic carcinomas

International Nuclear Information System (INIS)

Wachter, T.; Peneau, M.; Sabattier, R.; Breteau, N.

1996-01-01

From 1991 to 1995; 31 patients (mid-age: 70 years) underwent prostatic brachytherapy for localized prostate cancers using Iridium 192 transperineal percutaneous interstitial implantation guided by transrectal ultrasonography. Initial staging included among other evaluations a bilateral staging, iliac and obturator lymph nodes dissection. Classification according to stage was : T1b=16%, T1c=36%, T2a=19%, T2b=13%, T2c=13%, T3a=3%. All patients were N (-). Gleason score was 5 for 55%. 77% of the initial PSA was < 25μg/l. Follow-up included one clinical control and psa determination at 1-3-6-12 and 18 months, bone scanning at 12 months and prostate biopsy guided by transrectal ultrasonography at 18, 24, 30 months. Up to now, mean follow-up is 32 months. At one month, psa was normal (< 2,5μg/l) in 21% of the patients, at 12 months 60% and 67% two years after brachytherapy. Biopsies at 18 months were negative for 60% of the patients and 63% at 24 months. 3 patients were metastased after 3 years. 4 patients had severe complications with colostomy and/or urinary derivation. This technic seems to be interesting for localized prostate cancers T1 and T2 with initial psa < 25μg/l. Two third of the patients had normal psa and negative biopsies after 2 years. The rate of ano-rectal and urinary morbidity is high but is explained by the technic used at the beginning of this study

Impact of the National Health Fund policy on hormone treatment for prostate cancer in Jamaica Repercusión de un subsidio del Fondo Nacional de Salud en la hormonoterapia para el cáncer de próstata en Jamaica

Directory of Open Access Journals (Sweden)

Belinda F. Morrison

2011-06-01

hospital para identificar a los pacientes a quienes se les había practicado una biopsia de próstata entre enero del 2000 y diciembre del 2007. Los datos se combinaron con los registros de biopsias llevadas a cabo en instituciones externas. Se estudiaron las historias clínicas de todos los pacientes con resultados positivos en la biopsia de próstata para determinar si habían recibido tratamiento de supresión androgénica. Los pacientes se clasificaron en dos grupos, según se hubieran tratado mediante castración quirúrgica (orquiectomía bilateral o farmacológica. Se usó la prueba de la ji al cuadrado para determinar la diferencia en las proporciones entre los pacientes que escogieron la castración quirúrgica y los que escogieron la opción farmacológica antes y después de marzo del 2005, la fecha en la que el NHF empezó a subsidiar los medicamentos de supresión androgénica. RESULTADOS: Entre las 1 529 biopsias de próstata realizadas durante el período de estudio, hubo 680 (44,0% casos con diagnóstico de cáncer de próstata. De estos, 458 pacientes habían recibido tratamiento de supresión androgénica y se disponía de sus registros completos para el análisis. La edad media de los pacientes fue de 72 años. Durante el período de estudio, se les practicó castración quirúrgica a 265 pacientes (58,0% y castración farmacológica a 193 (42,0%. La proporción de orquiectomías fue mayor antes de marzo del 2005 que después de esa fecha (P < 0,001. Los estrógenos fueron el método de castración farmacológica más común antes de la creación del subsidio del NHF (62,0%; a partir de ese momento se eligieron con mayor frecuencia los análogos de la hormona liberadora de la hormona luteinizante (38,0% y los antiandrógenos (36,5%. CONCLUSIONES: La castración quirúrgica era más común que la castración farmacológica antes de marzo del 2005. Después de que el NHF empezó a subsidiar el costo de los medicamentos para el tratamiento hormonal, la opci

HEPATIC STEATOSIS ASSESSMENT: a comparative study between surgeon evaluation and forward histopathologic findings

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Aline M. A. MARTINS

2013-03-01

pacientes hepatopatas, em estágio terminal da doença. Muitas estratégias têm sido usadas para aumentar o número de órgãos disponíveis e diminuir a demora em lista de espera. No entanto, a presença de esteatose hepática é uma das principais limitações quanto ao uso de órgãos para transplante, devido a sua importância como relevante fator de risco para disfunção primária pós-transplante. Neste cenário, a avaliação do órgão pelo cirurgião, no momento da captação no doador, é de grande importância para a correta alocação do mesmo. Objetivo Avaliar retrospectivamente o grau de esteatose estabelecido pelo cirurgião e confrontar estes dados com os achados histopatológicos da biopsia. Métodos Analisaram-se 117 pacientes hepatopatas terminais sub-metidos ao transplante de fígado no Hospital Universitário Walter Cantídeo, Fortaleza, CE. Uma tabela matriz foi organizada para avaliação dos dados categóricos observados. Os indivíduos foram classificados quanto ao grau de esteatose apresentado pelo órgão: leve (0%-30% e moderada (30%-60% e agrupados sob os critérios clínicos de adequação de órgãos para transplante. Os órgãos foram descritos como adequado para transplante de órgãos e como não adequado para transplante de órgãos. As avaliações entre as duas primeiras situações, antes da perfusão vs biopsia e após a perfusão vs biopsia foram analisadas; bem como realizada comparação entre as duas situações de perfusão (antes e após. Resultados Na primeira avaliação, obtiveram-se 93% de concordância (n = 109 entre as duas observações, mostrando grande grau de concordância entre as classificações do órgão antes da perfusão e na biopsia. Na segunda avaliação, obteve-se um grau de discordância de 8%, levando a erros de alocação em nove situações. Na comparação entre as avaliações realizadas entre antes e após a perfusão, obteve-se forte concordância através do índice kappa entre os espectadores

Serological screening for celiac disease in symptomatic 12 to 36 month-old children

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Inês Cristina Modelli

2010-03-01

ássicos sintomas da doença celíaca. OBJETIVO: Determinar a prevalência de doença celíaca em um grupo de crianças com idades compreendidas entre 12 e 36 meses, utilizando a pesquisa de anticorpos antigliadina (IgG e IgA-AGA, antiendomísio (IgA-EMA e antitransglutaminase recombinante humana (IgA-tTG como método de rastreio. MÉTODOS: Foram incluídas no estudo 214 crianças (114 meninos, com 12 a 36 meses de idade, todas em uso de dieta contendo glúten. Em todos os soros foi pesquisada a presença de anticorpos anti-IgG e IgA-AGA, anti-IgA-EMA e anti-IgA-tTG humana. Biopsia jejunal foi sugerida e efetuada em todas as crianças com resultados positivos em um ou mais testes sorológicos, excetuando-se as crianças em que o IgG-AGA tinha sido o único teste positivo. Nesta última situação, efetuou-se genotipagem para identificação de possíveis alelos HLA predisponentes por meio do método de PCR. Para confirmação do diagnóstico, a genotipagem dos alelos HLA também foi efetuada nas crianças identificadas como celíacas com base a testes sorológicos positivos e resultado da biopsia jejunal compatível. RESULTADOS: Em 131 crianças os resultados dos testes sorológicos foram normais. Em 68 delas, foi detectada apenas a presença de anticorpos anti-IgG-AGA. Em 10 destas, por terem apresentado presença de alelos HLA predisponentes, foi realizada biopsia jejunal, que revelou mucosa sem alterações. Todos os testes sorológicos foram positivos em quatro crianças. Os testes igG e IgA-AGA e IgA-tTG foram positivos numa quinta criança que, no entanto, apresentou teste IgA-EMA negativo. A biopsia jejunal dessas cinco crianças revelou lesões de mucosa típicas e compatíveis com o diagnóstico de doença celíaca. CONCLUSÃO: Prevalência de 2,3% foi encontrada entre crianças de 12 a 36 meses de idade, não previamente diagnosticadas como celíacas.

Prevalencia de la enfermedad celiaca en donantes de sangre de la Comunidad de Madrid Prevalence of celiac disease in apparently healthy blood donors in the Autonomous Community of Madrid

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M. D. García Novo

2007-06-01

Full Text Available Objetivo: conocer la prevalencia de enfermedad celiaca en la población adulta de la Comunidad de Madrid utilizando como método de despistaje los anticuerpos frente a la transglutaminasa tisular. Población y métodos: han participado de modo voluntario 2.215 donantes de sangre. Todos ellos rellenaron una encuesta. Se determinó la IgA sérica total y los anticuerpos antitransglutaminasa tisular. A los donantes con anticuerpos positivos, se les ofreció la realización de biopsia intestinal por endoscopia. La histología de la mucosa intestinal se graduó según los criterios de Marsh. Resultados: mediante la encuesta se identificaron tres celiacos diagnosticados previamente. Once donantes presentaban anticuerpos positivos, todos ellos asintomáticos. Cuatro rechazaron la biopsia intestinal. De los siete en los que se realizó, tres tenían atrofia vellositaria y cuatro infiltrado linfocitario con vellosidades normales. En nuestro estudio el número total de donantes con enfermedad celiaca confirmada por biopsia fue de seis, lo que supone una prevalencia del 1/370. Considerando el grado I de Marsh, la prevalencia de la enteropatía por gluten sería de 1/222. La respuesta inmunológica anómala al gluten medida por la positividad de los anticuerpos fue de 1/201 que alcanza valores de 1/158 si consideramos los tres celiacos diagnosticados previamente. Conclusiones: los datos de prevalencia hallados en este estudio confirman que la enfermedad celiaca constituye un problema sanitario de primer orden, que podría justificar la instauración de un programa de despistaje universal. Se ha detectado un alto número de casos de enteritis linfocitaria lo que obliga a plantearse la actitud a seguir.Objective: the aim of this study was to determine the prevalence of celiac disease among the adult population of Madrid by measuring antibodies against tissue transglutaminase as serologic screening method. Population and methods: 2,215 subjects participated

Iron overload and genotype 3 are associated with liver steatosis in chronic hepatitis C Sobrecarga de hierro y genotipo 3 se asocian a la presencia de esteatosis en la hepatitis C

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L. I. Fernández Salazar

2004-12-01

excluyeron pacientes con otros virus. Se revisaron las biopsias hepáticas de forma protocolizada. Se obtuvieron los datos epidemiológicos, analíticos y virológicos. La talla y el peso de los pacientes se recogieron en el momento de la biopsia hepática. Se estudió la asociación estadística de las variables cualitativas y cuantitativas con la presencia de esteatosis y se realizó un análisis multivariante. Resultados: se identificó esteatosis en el 52% de las biopsias. No hubo asociación estadísticamente significativa con edad, sexo, vía de contagio, tiempo de evolución, ingesta de alcohol, presencia de enfermedades asociadas, índice de masa corporal, glucosa, triglicéridos, colesterol, AST, ALT, GGT, FA, bilirrubina, carga viral. Se asoció a mayor sideremia, IST y ferritina. Se demostró asociación con el genotipo 3. La esteatosis se asoció a necrosis piecemeal, degeneración hepatocelular, hiperplasia de células de Kupffer, hierro hepático y fibrosis portal. El hierro hepático, la hiperplasia de las células de Kupffer y el genotipo 3 se asociaron de manera independiente a la esteatosis hepática. Conclusiones: la esteatosis en la hepatitis C se asocia a la infección por genotipo 3, a la hiperplasia de las células de Kupffer y a sobrecarga de hierro. También se asocia a mayor inflamación y fibrosis por lo que debe ser considerada factor agravante.

Postoperative follow-up studies in biliary atresia using radioisotope

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Kanto, Kei; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Sanbonmatsu, Toru; Matsufuji, Hiroshi; Ishii, Katsumi

1988-09-01

With increasing numbers of long survival patients in biliary atresia, associated diseases such as liver cirrhosis and portal hypertension seem to be more important in their course. We use liver scintigraphy, hepatobiliary scintigraphy and transrectal portal scintigraphy as the follow-up study. Three studies generally correlate the present state of the patients, but there seems to be dissociation in the group of cirrhosis without icterus which are encountered most often in biliary atresia. That can be seen in hepatobiliary scintigraphy especially. So we emphasis that to choose several isotope studies are essential in determination of the postoperative state in biliary atresia.

Monophasic Synovial Sarcoma of Prostatic Fascia: Case Report and Literature Review

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Lucio Olivetti

2015-01-01

Full Text Available Synovial sarcoma (SS primarily occurs in the para-articular soft tissue of the lower extremities in young adults and it is extremely rare in the prostatic region. We report a case of a 46-year-old man who presented with urinary retention. Pelvic ultrasound (US examination, computed tomography (CT, and magnetic resonance imaging (MRI demonstrated an 8.5 cm mass that appeared to originate in the prostatic fascia of the right lobe. Preoperative prostatic ultrasound transrectal needle biopsy revealed mesenchymal neoplastic tissue. Patient underwent surgery. The final pathologic findings were consistent with the diagnosis of monophasic synovial sarcoma.

Monophasic Synovial Sarcoma of Prostatic Fascia: Case Report and Literature Review.

Science.gov (United States)

Olivetti, Lucio; Benecchi, Luigi; Corti, Serena; Del Boca, Carlo; Ferrari, Matteo; Sergio, Pietro; Bercich, Luisa; Tanzi, Giulia

2015-01-01

Synovial sarcoma (SS) primarily occurs in the para-articular soft tissue of the lower extremities in young adults and it is extremely rare in the prostatic region. We report a case of a 46-year-old man who presented with urinary retention. Pelvic ultrasound (US) examination, computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated an 8.5 cm mass that appeared to originate in the prostatic fascia of the right lobe. Preoperative prostatic ultrasound transrectal needle biopsy revealed mesenchymal neoplastic tissue. Patient underwent surgery. The final pathologic findings were consistent with the diagnosis of monophasic synovial sarcoma.

New noninvasive treatment for prostate outflow obstruction

International Nuclear Information System (INIS)

Richards, D.; Milroy, E.; Chapple, C.; Eldin, A.; Wallstein, H.

1989-01-01

Sixteen patients with prostatic outflow obstruction underwent implantation of the Wallstent endoprothesis, a woven mesh of fine stainless steel, mounted on a 9-F delivery system with an unconstrained diameter of 14 mm. The stent was inserted under local anesthesia, and placement was guided by linear transrectal US and flexible urethroscopy. In no patient was the distal sphincter mechanism compromised. In four, stent balloon dilation was needed. Urodynamic parameters (especially flow rate, voiding detrusor pressure, and postvoid residual) improved in all patients. Our experience showed the Wallstent endoprosthesis to be a safe, clinically acceptable, and minimally invasive alternative to prostatectomy

Aborto en una yegua debido a mellizos, ¿porque conviene reducirlos manualmente?: reporte de un caso - Abortion in a Mare caused by twins pregnancy, the convenience of the manual reduction of one of the twins. A case report

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González del Pino, Francisco Javier.

2010-01-01

ResumenEl artículo describe el caso clínico de un cuadro de aborto en un yegua deraza Peruano de Paso de 10 años de edad, debido a una preñez de mellizoscon fijación bicornual. La misma fue diagnosticada en forma precozmediante ecografía transrectal, pero su desenlace final en un abortoindeseable se debió a que el propietario del animal, no quiso su resoluciónmediante la técnica de reducción manual de uno de los mellizos.SummaryThis article describes a clinical case of an abortion in a 10 yea...

Resposta inflamatória uterina em éguas submetidas a inseminação artificial

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Carmona, Julieta Maria Peixoto

2011-01-01

Dissertação de Mestrado Integrado em Medicina Veterinária A inseminação artificial de éguas resulta invariavelmente numa resposta inflamatória uterina transitória e fisiológica cuja função é eliminar o excesso de espermatozóides, plasma seminal, diluidores e microrganismos do lúmen uterino. Esta inflamação é caracterizada por um influxo de polimorfonucleares neutrófilos (PMNs) para o lúmen uterino. A sua presença e magnitude pode ser diagnosticada através de ecografia uterina transrectal e...

Prostate cancer - epidemiology, etiology, diagnostics, clinical symptoms, screening

International Nuclear Information System (INIS)

Ondrus, D.

2006-01-01

Prostate cancer presents a real important medical and social problem at present. It is one of the most common malignancy in males. In global point of view it means permanent incidence increase of this disease. Despite improvement of prostate cancer diagnosis and complex treatment mortality does not decreased significantly. Knowledge of etiological factors are relatively limited. Important factors are: genetic disposition, age, life style, race, positive familial history, circulated androgens. Diagnostics is well known, based on routine clinical methods: digital rectal examination, measurement of PSA a transrectal ultrasound. Benefit of prostate cancer screening is until now unclear, controversial. (author)

Observación de la conducta homosexual en un rebaño de vacas mestizas de doble propósito

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Lozada Melero, Rafael Enrique

2011-01-01

La identificación de la conducta homosexual de las hembras bovinos de la ganadería mestiza de doble propósito en la República Bolivariana de Venezuela, particularmente en el estado Trujillo; ha sido poco estudiada a pesar de ser una importante herramienta en la unidad de producción bajo programas de inseminación artificial. Para determinar la frecuencia de los principales síntomas y signo del celo, así como su relación con el diagnostico de la gestación por vía transrectal, en una finca (...

Transanal endoscopic microsurgery for giant polyps of the rectum

DEFF Research Database (Denmark)

Levic, K; Bulut, O; Hesselfeldt, P

2014-01-01

in the rectum. We present our results with TEM in the removal of giant polyps equal or greater than 4 cm in diameter. METHODS: In the period between 1998 and 2012, TEM was performed in 39 patients with rectal polyps measuring at least 4 cm in diameter. Transrectal ultrasound and/or magnetic resonance imaging......, these recurrences were treated with endoscopic removal or re-TEM. The remaining 5 underwent total mesorectal excision and/or chemotherapy. CONCLUSIONS: Full-thickness TEM provides a safe and efficient treatment for excision of giant polyps. In case of unexpected cancer, TEM can be curative. Local recurrence can...

¿Es la resistencia de Mycobacterium leprae a los medicamentos un verdadero motivo de preocupación? Primera aproximación a la vigilancia molecular de pacientes colombianos multibacilares con tratamiento previo para lepra y sin él

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Martha Inírida Guerrero

2014-04-01

Full Text Available Introducción. Colombia no dispone de información sobre farmacorresistencia primaria y secundaria de Mycobacterium leprae al esquema de terapia múltiple de la Organización Mundial de la Salud (OMS y las autoridades de salud pública del mundo han emitido varias recomendaciones, entre las cuales está organizar de inmediato la vigilancia a la resistencia empleando métodos moleculares simples. Objetivo. Determinar la prevalencia de la resistencia de M. leprae a rifampicina, ofloxacina y dapsona en pacientes del Centro Dermatológico Federico Lleras Acosta con tratamiento previo y sin él durante el período de 1985 a 2004. Materiales y métodos. Se realizó un estudio retrospectivo. Mediante muestreo electivo se incluyeron biopsias de pacientes multibacilares: 381 de pacientes nuevos y 560 de pacientes previamente tratados. Se obtuvieron con micrótomo seis cortes de cada biopsia de piel incluida en parafina, y se realizó la extracción de ADN de M. leprae. Se llevó a cabo la amplificación de tres blancos moleculares mediante PCR y se obtuvieron los patrones de resistencia a los medicamentos dapsona, rifampicina y ofloxacina por hibridación inversa. Se recolectaron datos epidemiológicos, clínicos y demográficos para llevar a cabo los análisis. Resultados. De las 941 muestras estudiadas, 4,14 % era resistente a uno o más fármacos, y se detectaron 5,77 y 3,04 % con genotipos resistentes en pacientes nuevos y previamente tratados, respectivamente. La resistencia total para cada fármaco fue de 0,43 % a dapsona, 3,19 % a rifampicina y 1,17 % a ofloxacina. Se encontró una diferencia estadísticamente significativa para rifampicina y para la población total al comparar los resultados de los pacientes no tratados con los de los pacientes tratados previamente. Dos tercios de las muestras resistentes lo fueron a rifampicina sola o combinada. Conclusiones. Los esquemas de terapia múltiple estándar siguen siendo efectivos para los casos de

PROGRESSION OF LIVER FIBROSIS IN MONOINFECTED PATIENTS BY HEPATITIS C VIRUS AND COINFECTED BY HCV AND HUMAN IMMUNODEFICIENCY VIRUS

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Cristiane Valle TOVO

2013-03-01

Full Text Available Context The progression of liver fibrosis in patients coinfected by hepatitis C virus and human immunodeficiency virus (HCV/HIV has been increasingly studied in the past decade. Studies made before the highly active antiretroviral therapy suggest that HIV can change the natural history of the HCV infection, leading to a faster progression of the liver fibrosis. Objective To evaluate and compare the fibrosis progression in two groups of patients (HCV/HIV coinfected and HCV monoinfected Methods Seventy patients HCV monoinfected and 26 patients HCV/HIV coinfected who had not undertaken HCV treatment and were submitted to serial percutaneous liver biopsies were retrospectively evaluated. There was no difference in the fibrosis progression between the two groups. Conclusion The fibrosis grade evolution was not worse in the coinfected patients. The immunosuppression absence and the shortest time period between the biopsies in the coinfected group are possible explanations. Contexto A progressão da fibrose hepática em pacientes coinfectados pelos vírus da hepatite C (VHC e da imunodeficiência humana (VHC/HIV tem sido mais estudada na última década. Estudos realizados antes da terapia antiretroviral de alta potência (HAART sugerem que o HIV pode mudar a história natural da infecção pelo VHC, levando a uma progressão mais rápida da fibrose hepática. Objetivo Avaliar e comparar a progressão de fibrose em duas populações de pacientes (coinfectados VHC/HIV e monoinfectados VHC. Métodos Foram avaliados retrospectivamente 70 pacientes monoinfectados VHC e 26 coinfectados VHC/HIV nunca tratados para o VHC e que haviam realizado duas biopsias hepáticas seriadas. Não houve diferença na progressão de fibrose entre os dois grupos. Conclusão A evolução do grau de fibrose não foi pior nos pacientes coinfectados. A ausência de imunodepressão e o menor intervalo de tempo entre as biopsias no grupo de coinfectados são poss

Diagnóstico genético preimplantacional: análisis de aneuploidías únicas

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Paul W. López

2013-01-01

Full Text Available Introducción: De las causas más conocidas en cuanto a la falta del éxito en el embarazo con tratamientos de reproducción asistida son aquellas relacionadas a las aneuploidías cromosómicas presentes en los embriones. El diagnóstico genético preimplantacional (PGD es una técnica empleada en reproducción asistida para detectar estas anomalías, seleccionando aquellos que sean cromosómicamente normales, para luego transferirlos al útero de la paciente. Los embriones con aneuploidías únicas podrían tener la capacidad de sobrevivir y lograr la implantación, y por lo tanto, sin diagnóstico previo, estas podrían pasar desapercibidas. Objetivos: Determinar la incidencia de aneuploidías únicas en embriones de buena calidad embrionaria en el día 3 de desarrollo hasta blastocisto. Diseño: Estadístico y experimental. Instituciones: Reprogenetics Latinoamérica y Centro de Reproducción asistida, de la Clínica Concebir. Material Biológico: Muestras de biopsia embrionaria. Metodología: Análisis comparativo de resultados a partir de la evaluación de cada muestra obtenida por biopsia en el día tercero y día quinto de desarrollo embrionario, realizando el PGD por hibridación in situ (FISH y genómica comparada (aCGH, respectivamente. Resultados: El 62,9% de embriones que presentaron monosomías únicas al tercer día de desarrollo embrionario resultaron ser de 8 células. Pero cuando se evaluó por aCGH en día cinco, 42,3% resultó anormal, y de estos 37,5% perteneció al estadio de 8 células. El índice de monosomías únicas en blastocisto resultó ser 57,9% de un total de 84,2% de aneuploidías únicas. Conclusiones: Los embriones de 8 células en el tercer día de desarrollo embrionario son los más probables de llegar al estadio de blastocisto, así como presentar aneuploidías únicas.

Lipoperoxidación de membranas y daño ultraestructural por estrés oxidativo en isquemia-reperfusión miocárdica

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José Milei

2006-01-01

Full Text Available Introducción En modelos experimentales, la formación de especies reactivas del oxígeno durante la reperfusión posisquémica induce “estrés oxidativo” que afecta al miocardio. Dado que los pacientes sometidos a cardioplejía sufren isquemia-reperfusión, se sugirió que en ellos habría estrés oxidativo. Sin embargo, este fenómeno aún no se ha caracterizado correctamente. Objetivo El propósito del presente trabajo fue correlacionar la liberación de glutatión (el paso inicial de estrés oxidativo con marcadores de progresión del daño oxidativo, como peroxidación de lípidos de membrana y desarrollo de alteraciones ultraestructurales. Material y métodos En 24 pacientes sometidos a cirugía de puente aortocoronario se investigaron cambios en varios marcadores de estrés oxidativo y daño tisular durante la reperfusión posisquémica. Se obtuvieron muestras de sangre y biopsias cardíacas basales y luego de la reperfusión a 40,9 ± 11,9 minutos de la cardioplejía. La liberación de glutatión basal fue insignificante (0,02 ± 0,04 µmol/L, pero aumentó a los 15 minutos de la reperfusión (1,10 ± 0,40 µmol/L; p < 0,05; también disminuyeron los niveles tisulares de ubiquinol, de 144,5 ± 52 a 97,6 ± 82 nmol/g (p < 0,05. Aunque estos cambios documentan el estrés oxidativo cardíaco, no hubo alteraciones bioquímicas indicativas de daño celular, ya que no se produjo un incremento de marcadores de peroxidación lipídica, tanto en sangre del seno coronario como en las biopsias cardíacas. Tampoco se observaron alteraciones ultraestructurales importantes. Conclusiones A pesar de observarse estrés oxidativo en pacientes sometidos a cirugía cardíaca, en las condiciones descriptas, no induce lesiones progresivas de membranas ni daño celular irreversible

Nefropatía membranosa secundaria a exposición laboral con mercurio metálico

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Ana Voitzuk

2014-10-01

Full Text Available Las nefropatías tóxicas secundarias a la exposición ocupacional a metales han sido ampliamente estudiadas. La nefropatía membranosa por mercurio es poco frecuente.La intoxicación ocupacional con mercurio sí es frecuente, siendo las principales formas de presentación las manifestaciones clínicas neurológicas. La afectación renal secundaria a la exposición crónica a mercurio metálico puede desarrollar enfermedad glomerular por depósito de inmunocomplejos. La glomerulopatía membranosa y a cambios mínimos son las más frecuentemente comunicadas.Se presenta el caso de un paciente con exposición ocupacional a mercurio metálico, con síndrome nefrótico y biopsia renal con glomerulopatía membranosa que presentó respuesta favorable luego del tratamiento quelante e inmunosupresor.

Desintegración de las praxias en la enfermedad de Alzheimer

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Carlos A. Bardeci

1972-03-01

Full Text Available Se describe la sintomatologia clínica, los resultados de métodos auxiliares y de la punción biopsia cerebral de una paciente con enfermedad de Alzheimer. Se analizan los diversos aspectos clínicos, sosteniendose como posible determinar la individualidad clínica de la enfermedad de Alzheimer, dentro del capítulo de las demencias preseniles y su diagnóstico en vida. Las formas de apraxia presentes en esta observación confirman la correlación estrecha que existe entre los distintos niveles de su desintegración, à su relación con las perturbaciones del espacio al cual están genéticamente vinculadas; el espacio euclidiano para la apraxia constructiva, el espacio centrado en el propio cuerpo para la ideomotora y el concreto de manipulación de objetos para la ideatoria.

Atypical presentations of celiac disease

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Balasa Adriana Luminita

2016-08-01

Full Text Available In this study we evaluated the association of celiac disease in 81 children with autoimmune disease and genetic syndromes over a two years periods (January 2014 to July 2016 in Pediatric Clinic in Constanta. Because the extraintestinal symptoms are an atypical presentation of celiac disease we determined in these children the presence of celiac disease antibodies: Anti-tissue Transglutaminase Antibody IgA and IgA total serum level as a screening method followeds in selective cases by Anti-tissue Transglutaminase Antibody IgG, anti-endomysial antibodies, deamidated gliadin antibodies IgA and IgG and intestinal biopsia. In our study 8 patients had been diagnosed with celiac disease with extraintestinal symptoms, of which 4 with type 1 diabetes, 1 patient with ataxia, 2 patients with dermatitis herpetiformis and 1 patient with Down syndrome that associate also autoimmune thyroiditis, alopecia areata, enamel hypoplasia.

La enfermedad de Kimura: comunicación de un caso en un varón caucásico y revisión de la literatura Kimura disease: Report of a case in a Caucasian male and revision of the literature

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J.M. López-Arcas Calleja

2006-12-01

Full Text Available La enfermedad de Kimura es un trastorno inflamatorio que afecta principalmente a sujetos de origen asiático. Se manifiesta por la existencia de masas de tejido subcutáneo y subplatismal generalmente en la cabeza y el cuello. Suele acompañarse de linadenopatías, y aumento de los niveles de eosinófilos e IgE en sangre periférica. Comunicamos un caso de enfermedad de Kimura, descubierto en un varón caucasiano, tras una biopsia excisional de una masa cervical.Kimura disease is a chronic inflammatory disorder mainly involving Asians. It often presents as soft-tissue nodes or lymphadenopathy of the head and neck. Commonly associated with increased levels of eosinophils and IgE in peripheral blood. We report a case of Kimura disease in a Caucasian, diagnosed after lymph node and submaxillary gland removal.

Successful artificial insemination in the Asian elephant (Elephas maximus using chilled and frozen-thawed semen

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Wongkalasin Warut

2009-07-01

Full Text Available Abstract Background Artificial insemination (AI using frozen-thawed semen is well established and routinely used for breeding in various mammalian species. However, there is no report of the birth of elephant calves following AI with frozen-thawed semen. The objective of the present study was to investigate the fertilizing ability of chilled and frozen-thawed semen in the Asian elephant following artificial insemination (AI. Methods Semen samples were collected by from 8 bulls (age range, 12-to 42-years by manual stimulation. Semen with high quality were either cooled to 4°C or frozen in liquid nitrogen (-196°C before being used for AI. Blood samples collected from ten elephant females (age range, 12-to 52-years were assessed for estrus cycle and elephants with normal cycling were used for AI. Artificial insemination series were conducted during 2003 to 2008; 55 and 2 AI trials were conducted using frozen-thawed and chilled semen, respectively. Pregnancy was detected using transrectal ultrasonography and serum progestagen measurement. Results One female (Khod inseminated with chilled semen became pregnant and gave birth in 2007. The gestation length was 663 days and the sex of the elephant calf was male. One female (Sao inseminated with frozen-thawed semen showed signs of pregnancy by increasing progestagen levels and a fetus was observed for 5 months by transrectal ultrasonography. Conclusion This is the first report showing pregnancy following AI with frozen-thawed semen in the Asian elephant. Successful AI in the Asian elephant using either chilled or frozen-thawed semen is a stepping stone towards applying this technology for genetic improvement of the elephant population.

Prostate cancer outcome in Burkina Faso

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Yameogo Clotaire

2011-09-01

Full Text Available Abstract Introduction African-American black men race is one of non-modifiable risk factors confirmed for prostate cancer. Many studies have been done in USA among African- American population to evaluate prostate cancer disparities. Compared to the USA very few data are available for prostate cancer in Sub-Saharan African countries. The objective of this study was to describe incident prostate cancer (PC diagnosis characteristics in Burkina Faso (West Africa. Methods We performed a prospective non randomized patient’s cohort study of new prostate cancer cases diagnosed by histological analysis of transrectal prostate biopsies in Burkina Faso. Study participants included 166 patients recruited at the urology division of the university hospital of Ouagadougou. Age of the patients, clinical symptoms, digital rectal examination (DRE result, serum prostate-specific antigen (PSA level, histological characteristics and TNM classification were taking in account in this study. Results 166 transrectal prostate biopsies (TRPB were performed based on high PSA level or abnormal DRE. The prostate cancer rate on those TRPB was 63, 8 % (n=106. The mean age of the patients was 71, 5 years (52 to 86. Urinary retention was the first clinical patterns of reference in our institution (55, 7 %, n = 59. Most patients, 56, 6 % (n = 60 had a serum PSA level over than 100 ng/ml. All the patients had adenocarcinoma on histological study of prostate biopsy cores. The majority of cases (54, 7 % n = 58 had Gleason score equal or higher than 7. Conclusion Prostate cancer is diagnosed at later stages in our country. Very high serum PSA level and poorly differentiated tumors are the two major characteristics of PC at the time of diagnosis.

In vivo cryoablation of prostate tissue with temperature monitoring by optoacoustic imaging

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Petrova, Elena V.; Motamedi, Massoud; Oraevsky, Alexander A.; Ermilov, Sergey A.

2016-03-01

Cryoablation of prostate cancer is an FDA approved clinical procedure, which involves repetitive rapid cooling of a lesion to lethal temperatures of -40°C and below. The major drawback of the technique is the insufficient control over the fast thermal processes that may result in severe complications (impotence, incontinence, perforation of the rectal wall) and morbidity. The developed optoacoustic imaging technique provides non-invasive real-time temperature mapping of tissue adjacent to prostate and enables more efficient control over the procedure, which is necessary to reduce side effects and accelerate the physician's learning curve. In these studies we successfully demonstrated real-time transrectal optoacoustic imaging during prostate cryoablation in live canine model focused on optoacoustic thermography of the rectal wall within the depth of 1cm. Our method utilized previously discovered universal thermal dependence of the normalized optoacoustic response of blood. Nanosecond-pulse radiation of Ti-Sapphire laser tuned to the isosbestic point of hemoglobin (802+/-3 nm) was delivered via fiberoptic illuminators assembled on both sides of the linear array of the 128-channel transrectal ultrasound probe. Temperature readouts at discrete locations inside and nearby prostate were also performed using standard transperineal needle sensors. The effect of homeostasis on optoacoustic imaging in live tissue was examined during cooling and shown to be significant only within the range of +/-1.5°C in respect to the body temperature. Accuracy of in vivo optoacoustic temperature measurements was determined as +/-2°C for the range of temperature from +35 to -15°C, which is more than sufficient for tracking the essential isotherms in the course of clinical procedures.

CT colonography combined with fistulography - a case of periannal fistula of a 6 months old child

International Nuclear Information System (INIS)

Sirakov, N.; Velkova, K.; Sirakov, V.; Tashev, P.

2007-01-01

We present a 6 months old child with perianal fistula with repeated secretion from it. The child was examined by double contrast barium enema and transrectal ultrasonography that gave suggestions of perianal fistula with no communication to the rectum and suspicion of a anal duplication of the rectum. The child was examined by CT colonography combined with fistulography. The exam was carried out on a axial CT Somatom Emotion by Siemens. The purpose of our report is to present the results of the combination of CT colonography and fistulography, applied to a 6-month-old child, as well as to present the specific protocol that we used for this examination. (authors)

Local radiological staging of rectal cancer

International Nuclear Information System (INIS)

Goh, V.; Halligan, S.; Bartram, C.I.

2004-01-01

Rectal cancer is a common malignancy with a highly variable outcome. Local recurrence is dependent upon tumour stage and surgical technique. The role of pre-operative imaging is to determine which patients may be safely managed by surgery alone and which need additional therapy in order to facilitate surgery and improve outcome. This decision depends on the distinction between those with early and advanced disease. While trans-rectal ultrasound has traditionally been used to answer this question, a role for magnetic resonance imaging (MRI) is increasingly argued. This review will focus on the treatment options for rectal cancer and the clinical questions that subsequently arise for the radiologist to answer

Espondilite tuberculosa: uma revisão de 31 pacientes do Hospital Santa Marcelina Espondilitis tuberculosa: una revisión de 31 pacientes del Hospital Santa Marcelina Tuberculous spondylitis: a report of thirty one cases from Santa Marcelina Hospital

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Luiz Cláudio Lacerda Rodrigues

2010-09-01

Full Text Available INTRODUÇÃO: a infecção da coluna vertebral pelo bacilo de Koch costuma ser devastadora, sendo necessários seu diagnóstico e tratamento precoce. OBJETIVO: avaliar o tratamento e o seguimento em relação à dor, cifose residual, imagem por ressonância magnética (RM, e a importância da biópsia correlacionando-a com o tratamento clínico. Métodos: estudo retrospectivo de 31 pacientes com diagnóstico de espondilite tuberculosa, fazendo uma análise estatística dos dados descritivos: sexo, idade, status neurológico, segmento vertebral acometido, presença de abscesso e cifose residual, e suas correlações clínicas importantes comparando nossos casos com a literatura e correlacionando seus dados, tais como sexo e faixa etária mais comum, se a presença do abscesso influencia no déficit neurológico ou na cifose residual. RESULTADOS: a amostra identificou uma incidência em 23 homens e 8 mulheres. Foi identificado abscesso frio em 4 pacientes, sendo os que apresentaram uma grave deformidade final: a biopsia percutânea foi realizada em 19 pacientes com positividade em 5, não influenciando o tratamento do paciente. A dor pós-tratamento clínico apresentou melhora importante; foi utilizado esquema tríplice por um ano. CONCLUSÃO: o tratamento clínico da tuberculose deve ser iniciado assim que se suspeitar da doença e tiver imagens compatíveis com: corpo vertebral, diminuição da altura do espaço discal e elevação do ligamento longitudinal anterior. Na presença de cifose, o uso de um colete rígido deve ser ponderado, sendo ele o de Boston ou um colete gessado. A avaliação neurológica deve ser acompanhada com um intervalo curto, quinzenalmente nos primeiros três meses, pois se o tratamento clínico for ineficaz e o paciente apresentar déficit neurológico, o tratamento cirúrgico deve ser considerado. A biopsia é um exame de alta especificidade, mas de baixa sensibilidade. Quando positiva, reforça o tratamento

Association between placentome size, measured using transrectal ultrasonography, and gestational age in cattle

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Adeyinka, F.D.; Laven, R.A.; Lawrence, K.E.; Bosch, van den M.; Blankenvoorde, G.; Parkinson, T.J.

2014-01-01

AIM: The aim of this study was to estimate whether fetal age could be accurately estimated using placentome size. METHODS: Fifty-eight cows with confirmed conception dates in two herds were used for the study. The length of the long axis and cross-sectional area of placentomes close to the cervix

Sarcoma de Kaposi bucal en pacientes con trasplante de riñón

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Gladys Aída Estrada Pereira

2015-02-01

Full Text Available Se realizó un estudio descriptivo y transversal de 25 pacientes con trasplante renal y sarcoma de Kaposi bucal, atendidos en la consulta estomatológica del Policlínico de Especialidades del Hospital Clinicoquirúrgico Docente "Saturnino Lora Torres" de Santiago de Cuba, desde marzo de 2008 hasta igual mes de 2013, para describir los resultados clínicos e histopatológicos. Entre los hallazgos principales predominaron el sexo masculino, el grupo etario de 40-49 años y los afectados de piel negra. Por otra parte, como alteraciones hísticas sobresalieron los espacios vasculares atípicos, los cuerpos eosinófilos y la extravasación de hematíes; asimismo, la mayoría de las lesiones correspondieron al paladar duro y a la encía. La biopsia resultó ser un medio de diagnóstico valioso para confirmar esta enfermedad

Histoplasmosis suprarrenal incidental

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C. Nine

2002-12-01

Full Text Available El hallazgo de masas adrenales detectadas mediante técnicas ecográficas o tomográficas solicitadas por algún otro motivo, y por ello incidentales, constituye un nuevo desafío diagnóstico. El paciente que presentamos se encontraba asintomático y no refería antecedentes patológicos. Una ecografía mostró agrandamiento de la glándula suprarrenal derecha, que medía 66 por 33mm. La tomografía computada mostró agrandamiento irregular de ambas suprarrenales. Se descartaron neoplasias extra-adrenales y tumores hiperfuncionantes. Se realizó una biopsia guiada por tomografía, y el estudio histopatológico informó Histoplasma capsulatum. El paciente vivía en una zona endémica para esta enfermedad y, por exposición laboral, tenía contacto diario con excremento de aves. La histoplasmosis es una causa infrecuente de masas adrenales bilaterales en el huesped inmu-nocompetente.

Tumor de Wilms extrarrenal: Un caso inusual Extrarenal Wilm's tumor: An unusual case

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Caridad Verdecia Cañizares

2004-09-01

Full Text Available El tumor de Wilms extrarrenal es extremadamente raro en la infancia. Se reporta el caso de una niña de 4 años de edad a la que se le realizó diagnóstico en nuestro hospital de esta variante hística de localización retroperitoneal, con buena evaluación posoperatoria, y fue el objetivo dar a conocer esta localización inusual y el valor de la biopsia espirativa con aguja fina en el diagnóstico de esta afección.Extrarenal Wilms' tumor is extremely rare in children. It is reported the case of a 4-year-old girl that was diagnosed this histic variant of retroperitoneal localization in our hospital with a good postoperative evaluation. The objective of this paper was to make known this unsual localization and the value ot the fine needle aspiration biopsy in the diagnosis of this affection.

Tumor del corpúsculo carotídeo: Presentación de 1 caso

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Miguel García Rodríguez

2001-03-01

Full Text Available Se presenta un paciente que acude a consulta por presentar cuadros sincopales con una pequeña tumoración en la región lateral izquierda del cuello de más de 6 meses de evolución. Se le realiza ecografía del cuello, arteriografía carotídea y biopsia por aspiración con aguja fina y se llega al diagnóstico preoperatorio de tumor del corpúsculo carotídeo. Se interviene y realiza resección subadventicia de forma exitosaA patient who attends the physician's office for having syncopal pictures with a small tumor in the left region of the neck of more than 6 months of evolution is presented. Neck echography, carotid arteriography and fine needle biopsy aspiration are carried out. Carotid body tumor is preoperatively diagnosed. He is operated on and subadventitious resection is successfully performed

Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon Toxoplasmosis diseminada en un paciente inmunocompetente procedente de la Amazonía peruana

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Juan Nunura

2010-04-01

Full Text Available We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.Reportamos un caso de toxoplasmosis severa en un paciente inmunocompetente caracterizado por neumonía, retinocoroiditis, hepatitis y miositis. El diagnóstico fue confirmado por serología, el hallazgo de T. gondii en gota gruesa y la presencia de bradizoitos en biopsia muscular. El tratamiento con pirimetamina mas sulfadoxina fue exitoso pero solo hubo una parcial recuperación de la agudeza visual y de la capacidad de extensión de la cadera. Este es el primer reporte de un caso de toxoplasmosis severa en el Perú.

Síndrome coronario agudo y enfermedad de Erdheim-Chester. Patogénesis e implicaciones terapéuticas

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José Carlos Alarcón-García

2017-05-01

Full Text Available La enfermedad de Erdheim-Chester es una histiocitosis celular diferente a la histiocitosis de Langerhans, de origen incierto. Se caracteriza por una implicación multi-orgánica debida a la infiltración de los histiocitos CD68+/CD1a-, en forma de xantogranulomas, que afectan principal y comúnmente a la metáfisis y diáfisis de huesos largos. El diagnóstico se realiza mediante biopsia, donde se revelan histiocitos CD68+/CD1a-, carencia de proteína S, y presencia de gránulos de Birbeck. Se ha subestimado la implicación cardiovascular. Reportamos un caso de un varón de 67 años con la enfermedad de Erdheim-Chester e infarto de miocardio agudo, debido a implicación coronaria, además de enfermedad ósea, vascular, pituitaria y retroperitoneal. Revisamos la literatura relevante y describimos el tratamiento clínico de estos pacientes.

Factores predictivos de nefropatía no diabética en pacientes diabéticos. Utilidad de la biopsia renal

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Sheila Bermejo

2016-09-01

Conclusiones: La causa más frecuente de NND fue nefropatía IgA. Los pacientes con mayor edad, creatinina, menor duración de diabetes, ausencia de retinopatía diabética y menor proteinuria presentan mayor riesgo de NND. Los pacientes con ND y proteinuria en rango nefrótico tuvieron peor pronóstico renal.

Infections after fiducial marker implantation for prostate radiotherapy: are we underestimating the risks?

International Nuclear Information System (INIS)

Loh, Jasmin; Baker, Katie; Sridharan, Swetha; Greer, Peter; Wratten, Chris; Capp, Anne; Gallagher, Sarah; Martin, Jarad

2015-01-01

The use of gold fiducial markers (FM) for prostate image-guided radiotherapy (IGRT) is standard practice. Published literature suggests low rates of serious infection following this procedure of 0-1.3%, but this may be an underestimate. We aim to report on the infection incidence and severity associated with the use of transrectally implanted intraprostatic gold FM. Three hundred and fifty-nine patients who underwent transrectal FM insertion between January 2012 and December 2013 were assessed retrospectively via a self-reported questionnaire. All had standard oral fluoroquinolone antibiotic prophylaxis. The patients were asked about infective symptoms and the treatment received including antibiotics and/or related hospital admissions. Potential infective events were confirmed through medical records. 285 patients (79.4%) completed the questionnaire. 77 (27.0%) patients experienced increased urinary frequency and dysuria, and 33 patients (11.6%) reported episodes of chills and fevers after the procedure. 22 patients (7.7%) reported receiving antibiotics for urinary infection and eight patients (2.8%) reported hospital admission for urosepsis related to the procedure. The overall rate of symptomatic infection with FM implantation in this study is 7.7%, with one third requiring hospital admission. This exceeds the reported rates in other FM implantation series, but is in keeping with the larger prostate biopsy literature. Given the higher than expected complication rate, a risk-adaptive approach may be helpful. Where higher accuracy is important such as stereotactic prostate radiotherapy, the benefits of FM may still outweigh the risks. For others, a non-invasive approach for prostate IGRT such as cone-beam CT could be considered. The online version of this article (doi:10.1186/s13014-015-0347-2) contains supplementary material, which is available to authorized users

[Technique of abdominal ultrasonography in newborn foals and normal findings].

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Behn, C; Bostedt, H

2000-09-01

Under field conditions, the diagnosis of foal's diseases relies almost exclusively on the physical examination. As the signs of illness in the equine neonate are frequently vage and non-localizing, the diagnosis of diseases may be problematic. This often causes misinterpretations and leads to ineffective prophylaxis and treatment. The purpose of this study was to evaluate the usefulness of diagnostic ultrasonography of the foal's abdomen under field conditions to provide an optimized technique and to describe the normal findings. Diagnostic ultrasonography of the abdomen was performed after obtaining clinical history and passing the physical examination of 25 foals without signs of abdominal problems. The foals were scanned in a stable box, being restrained by three persons in semi-lateral recumbency. Usually, sedation was not necessary. The ventral abdominal wall was clipped, a generous amount of ultrasound coupling gel was applied and massaged on the skin surface. The ultrasonographic examination was carried out using a portable sector scanner ("Microimager 2000", Ausonics) with 5.0 and 7.5-MHz transducers or a combined 5.0 and 7.5-MHz transrectal linear-array scanner ("450 Enhanced", Pie Medical). Employing the 5.0-MHz sector scanner first, the abdomen was explored from caudal to cranial in left and right semi-lateral recumbency. The 7.5-MHz scanner was used to attain higher resolution of certain structures. The sector scanner turned out to be suitable under field conditions and adequate to examine the abdominal organs. The transrectal linear-array scanner also provided the most important informations, although it was difficult to maintain a good contact area of the scan head. By ultrasonography it was possible to identify the urinary bladder, kidneys, spleen, liver and part of the gastrointestinal tract. Thus, application of ultrasound could successfully be performed on newborn foals under field conditions.

Real-time virtual sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data

International Nuclear Information System (INIS)

Miyagawa, Tomoaki; Ishikawa, Satoru; Kimura, Tomokazu; Suetomi, Takahiro; Tsutsumi, Masakazu; Irie, Toshiyuki; Kondoh, Masanao; Mitake, Tsuyoshi

2010-01-01

The objective of this study was to evaluate the effectiveness of the medical navigation technique, namely, Real-time Virtual Sonography (RVS), for targeted prostate biopsy. Eighty-five patients with suspected prostate cancer lesions using magnetic resonance imaging (MRI) were included in this study. All selected patients had at least one negative result on the previous transrectal biopsies. The acquired MRI volume data were loaded onto a personal computer installed with RVS software, which registers the volumes between MRI and real-time ultrasound data for real-time display. The registered MRI images were displayed adjacent to the ultrasonographic sagittal image on the same computer monitor. The suspected lesions on T2-weighted images were marked with a red circle. At first suspected lesions were biopsied transperineally under real-time navigation with RVS and then followed by the conventional transrectal and transperineal biopsy under spinal anesthesia. The median age of the patients was 69 years (56-84 years), and the prostate-specific antigen level and prostate volume were 9.9 ng/mL (4.0-34.2) and 37.2 mL (18-141), respectively. Prostate cancer was detected in 52 patients (61%). The biopsy specimens obtained using RVS revealed 45/52 patients (87%) positive for prostate cancer. A total of 192 biopsy cores were obtained using RVS. Sixty-two of these (32%) were positive for prostate cancer, whereas conventional random biopsy revealed cancer only in 75/833 (9%) cores (P<0.01). Targeted prostate biopsy with RVS is very effective to diagnose lesions detected with MRI. This technique only requires additional computer and RVS software and thus is cost-effective. Therefore, RVS-guided prostate biopsy has great potential for better management of prostate cancer patients. (author)

Age and prostate volume are risk factors for transient urinary incontinence after transurethral enucleation with bipolar for benign prostatic hyperplasia.

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Hirasawa, Yosuke; Kato, Yuji; Fujita, Kiichiro

2018-01-01

To investigate the predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. We retrospectively analyzed the data of 584 patients who underwent transurethral enucleation with bipolar between December 2011 and September 2016 operated by a single surgeon. Urinary incontinence after transurethral enucleation with bipolar was defined as involuntary leakage of urine that required the use of pads. It was evaluated at 1 week, and 1, 3, 6, 12 and 24 months after transurethral enucleation with bipolar. We defined transient urinary incontinence as urinary incontinence persisting up to 1 month after transurethral enucleation with bipolar. Based on independent risk factors identified by a multivariate stepwise logistic regression analysis, a nomogram to predict transient urinary incontinence was developed. Of the 584 patients, 17.3%, 13.5%, 3.1%, 0.41%, and 0% patients had urinary incontinence at 1 week, 1, 3, 6 and 12 months after transurethral enucleation with bipolar, respectively. The mean (±standard error) age was 69.6 ± 0.26 years, estimated prostate volume was 54.7 ± 0.91 cm 3 , operative time was 58.0 ± 1.1 min and the prostate specimen weight was 30.6 ± 0.69 g. On univariate analysis, age, prostate volume estimated by transrectal ultrasonography, prostate-specific antigen, prostate specimen weight, operative time, prostate specimen weight/prostate volume and prostate specimen weight/operative time were significant predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. On multivariate analysis, age (hazard ratio 1.07, P-value = 0.0034) and prostate volume (hazard ratio 1.03, P-value bipolar. Age and prostate volume estimated by transrectal ultrasonography seem to represent significant independent risk factors for transient urinary incontinence after transurethral enucleation with bipolar. This should be well discussed with the patient before surgery. © 2017 The Japanese

Results of vardenafil mediated power Doppler ultrasound, contrast enhanced ultrasound and systematic random biopsies to detect prostate cancer.

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Morelli, Girolamo; Pagni, Riccardo; Mariani, Chiara; Minervini, Riccardo; Morelli, Andrea; Gori, Francesco; Ferdeghini, Ezio Maria; Paterni, Marco; Mauro, Eva; Guidi, Elisa; Armillotta, Nicola; Canale, Domenico; Vitti, Paolo; Caramella, Davide; Minervini, Andrea

2011-06-01

We evaluated the ability of the phosphodiesterase-5 inhibitor vardenafil to increase prostate microcirculation during power Doppler ultrasound. We also evaluated the results of contrast and vardenafil enhanced targeted biopsies compared to those of standard 12-core random biopsies to detect cancer. Between May 2008 and January 2010, 150 consecutive patients with prostate specific antigen more than 4 ng/ml at first diagnosis with negative digital rectal examination and transrectal ultrasound, and no clinical history of prostatitis underwent contrast enhanced power Doppler ultrasound (bolus injection of 2.4 ml SonoVue® contrast agent), followed by vardenafil enhanced power Doppler ultrasound (1 hour after oral administration of vardenafil 20 mg). All patients underwent standard 12-core transrectal ultrasound guided random prostate biopsy plus 1 further sampling from each suspected hypervascular lesion detected by contrast and vardenafil enhanced power Doppler ultrasound. Prostate cancer was detected in 44 patients (29.3%). Contrast and vardenafil enhanced power Doppler ultrasound detected suspicious, contrast enhanced and vardenafil enhanced areas in 112 (74.6%) and 110 patients (73.3%), and was diagnostic for cancer in 32 (28.5%) and 42 (38%), respectively. Analysis of standard technique, and contrast and vardenafil enhanced power Doppler ultrasound findings by biopsy core showed significantly higher detection using vardenafil vs contrast enhanced power Doppler ultrasound and standard technique (41.2% vs 22.7% and 8.1%, p power Doppler ultrasound was 10% and 11.7% (p not significant). Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Diagnosis of prostate cancer in patients with persistently elevated PSA and tumor-negative biopsy in ambulatory care. Performance of MR imaging in a multi-reader environment

International Nuclear Information System (INIS)

Scheidler, J.; Weoeres, I.; Scharf, M.; Siebels, M.; Brinkschmidt, C.; Zeitler, H.; Heuck, A.; Panzer, S.

2012-01-01

Purpose: False-negative results are obtained in approx. 20 % of prostate cancer (PCa) patients (pts) at initial systematic transrectal biopsy (Bx), in particular when digital rectal examination (DRE) or transrectal ultrasound (TRUS) is negative. The aim of this study was to assess whether MR endorectal imaging of the prostate in a multi-reader ambulatory care setting may assist in patient selection for re-biopsy. Materials and Methods: 115 consecutive pts with persistent PSA elevation, negative Bx, DRE and TRUS were examined using T2w axial and coronal and T1w axial sequences for tumor diagnosis. MR images were prospectively read as tumor-suspicious or tumor-negative by the MR radiologist on duty. Additionally, a retrospective readout of a prostate MR expert and an abdominal imaging fellowship-trained radiologist was performed to evaluate the effect of the reader's experience on tumor detection. Imaging findings were compared to the results of the repeat Bx (61 pts) or the clinical course of at least two years. Results: For the prospective reading, the sensitivity of MRI was 83 %, the specificity was 69 %, the PPV was 33 % and the NPV was 96 %. ROC analysis revealed a significantly better performance of the prostate MR imaging expert compared to the abdominal imaging radiologist (area under ROC 0.88 vs. 0.66, p < 0.001). Based on the prospective reading, a pre-test probability for PCa of 17.4 % as in our study can be reduced to 5 % when obtaining a tumor-negative result in MRI. Conclusion: MR imaging in a multi-reader ambulatory care setting assists in patient selection for re-biopsy. Reducing the post-test probability for PCa to 5 % allows for further follow-up instead of re-biopsy in MR tumor-negative patients. Specific training and experience improve tumor detection in prostate MR imaging. (orig.)

A feasibility study of magnetic resonance electrical impedance tomography for prostate cancer detection

International Nuclear Information System (INIS)

Liu, Yang; Zhang, Yingchun

2014-01-01

Magnetic resonance electrical impedance tomography (MREIT) is an imaging technique that reconstructs the conductivity distribution inside the subject using magnetic flux density or current density measurements acquired by a magnetic resonance imaging system. Since the primary prostate cancer diagnostic method, prostate biopsy, has limited accuracy in cancer diagnosis and malignant tissues have shown significantly different electrical properties from normal or benign tissues, MREIT has potential application in prostate cancer detection. The feasibility of utilizing MREIT in detecting prostate cancer was evaluated via a series of well-designed computer simulations in the present study. MREIT techniques with three different electrode configurations (external, trans-rectal, and trans-urethral electrode arrays) and two different reconstruction algorithms (J-substitution algorithm and harmonic B z  algorithm) were successfully developed. The performance of different MREIT techniques were evaluated and compared based on the imaging accuracy of the reconstructed conductivity distribution in the prostate. Without the presence of noise, the external MREIT achieves a better imaging accuracy than the two endo-MREIT (trans-rectal and trans-urethral) techniques, while the trans-urethral MREIT achieves the best imaging accuracy in noisy environments. We also found that the J-substitution reconstruction algorithm consistently offered better imaging accuracy than the harmonic B z  algorithm. When Gaussian distributed random noise with a standard deviation of 0.25 nT was added, the relative errors (RE) between the reconstructed and target conductivity distributions inside the prostate were observed to be 14.18% and 17.35% by the trans-urethral MREIT with the J-substitution and harmonic B z  algorithms respectively. The lower REs of 9.64% and 11.17% were achieved respectively when the standard deviation of noise was reduced to 0.05 nT. The simulation results demonstrate the

Prostate ultrasound imaging: evaluation of a two-step scoring system in the diagnosis of prostate cancer.

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Gao, Yong; Liao, Xin-Hong; Ma, Yan; Lu, Lu; Wei, Li-Yan; Yan, Xue

2017-12-01

This study aims to investigate the feasibility and performance of a two-step scoring system of ultrasound imaging in the diagnosis of prostate cancer. 75 patients with 888 consecutive histopathologically verified lesions were included in this study. Step 1, an initial 5-point scoring system was developed based on conventional transrectal ultrasound (TRUS). Step 2, a final scoring system was evaluated according to contrast-enhanced transrectal ultrasound (CE-TRUS). Each lesion was evaluated using the two-step scoring system (step 1 + step 2) and compared with only using conventional TRUS (step 1). 888 lesions were histologically verified: 315 of them were prostate cancer from 46 patients and 573 were benign prostatic hypertrophy (BPH) from 29 patients. According to the two-step scoring system, 284 lesions were upgraded and 130 lesions were downgraded from step 1 to step 2 (this means using step 2 to assess the results by step 1). However, 96 cases were improperly upgraded after step 2 and 48 malignant lesions were still missed after step 2 as score-1. For the two-step scoring system, the sensitivity, specificity, and accuracy were 84.7%, 83.2%, and 83.7%, respectively, versus 22.8%, 96.6%, and 70.4%, respectively, for conventional TRUS. The area under the ROC curve (AUC) for lesion diagnosis was 0.799-0.952 for the two-step scoring system, versus 0.479-0.712 for conventional TRUS. The difference in the diagnostic accuracy of the two-step scoring system and conventional TRUS was statistically significant (Pstep scoring system was straightforward to use and achieved a considerably accurate diagnostic performance for prostate cancer. The application of the two-step scoring system for prostate cancer is promising.

SU-F-T-41: 3D MTP-TRUS for Prostate Implant

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Yan, P [Columbia University, New York, NY (United States)

2016-06-15

Purpose: Prostate brachytherapy is an effective treatment for early prostate cancer. The current prostate implant is limited to using 2D transrectal ultrassound (TRUS) or machenical motor driven 2D array either in the end or on the side. Real-time 3D images can improve the accuracy of the guidance of prostate implant. The concept of our system is to allow realtime full visualization of the entire prostate with the multiple transverse scan. Methods: The prototype of 3D Multiple-Transverse-Plane Transrectal Ultrasound probe (MTP-TRUS) has been designed by us and manufactured by Blatek inc. It has 7 convex linear arrays and each array has 96 elements. It is connected to cQuest Fire bird research system (Cephasonics inc.) which is a flexible and configurable ultrasound-development platform. The size of cQuest Firebird system is compact and supports the real-time wireless image transferring. A relay based mux board is designed for the cQuest Firebird system to be able to connect 672 elements. Results: The center frequency of probe is 6MHz±10%. The diameter of probe is 3cm and the length is 20cm. The element pitch is 0.205 mm. Array focus is 30mm and spacing 1.6cm. The beam data for each array was measured and met our expectation. The interface board of MTP-TURS is made and able to connect to cQuest Firebird system. The image display interface is still under the development. Our real-time needle tracking algorithm will be implemented too. Conclusion: Our MTP-TRUS system for prostate implant will be able to acquire real-time 3D images of prostate and do the real-time needle segmentation and tracking. The system is compact and have wireless function.

Effect of using different U/S probe Standoff materials in image geometry for interventional procedures: the example of prostate

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Dimos Baltas

2011-12-01

Full Text Available Purpose: This study investigates the distortion of geometry of catheters and anatomy in acquired U/S images, caused by utilizing various stand-off materials for covering a transrectal bi-planar ultrasound probe in HDR and LDR prostatebrachytherapy, biopsy and other interventional procedures. Furthermore, an evaluation of currently established waterbathbased quality assurance (QA procedures is presented. Material and methods: Image acquisitions of an ultrasound QA setup were carried out at 5 MHz and 7 MHz. The U/Sprobe was covered by EA 4015 Silicone Standoff kit, or UA0059 Endocavity balloon filled either with water or one ofthe following: 40 ml of Endosgel®, Instillagel®, Ultraschall gel or Space OAR™ gel. The differences between imageswere recorded. Consequently, the dosimetric impact of the observed image distortion was investigated, using a tissueequivalent ultrasound prostate phantom – Model number 053 (CIRS Inc., Norfolk, VA, USA. Results: By using the EA 4015 Silicone Standoff kit in normal water with sound speed of 1525 m/s, a 3 mm needleshift was observed. The expansion of objects appeared in radial direction. The shift deforms also the PTV (prostate inour case and other organs at risk (OARs in the same way leading to overestimation of volume and underestimationof the dose. On the other hand, Instillagel® and Space OAR™ “shrinks” objects in an ultrasound image for 0.65 mm and0.40 mm, respectively. Conclusions: The use of EA 4015 Silicone Standoff kit for image acquisition, leads to erroneous contouring of PTVand OARs and reconstruction and placement of catheters, which results to incorrect dose calculation during prostatebrachytherapy. Moreover, the reliability of QA procedures lies mostly in the right temperature of the water used foraccurate simulation of real conditions of transrectal ultrasound imaging.

Assessment of prostatic fiducial marker introduction: patient morbidity, staff satisfaction and improved treatment field placement

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Brown, Simon; Lehman, Margot; Ferrari-Anderson, Janet; Glyde, Alan; Burmeister, Elizabeth; Nicol, David

2011-01-01

Increased accuracy when using fiducial markers for prostate localisation is well documented. This project aimed to establish the improvement in accuracy when using gold markers for daily prostate localisation, to assess patient satisfaction and morbidity from the transrectal implantation of gold seed markers and establish staff attitudes towards the newly introduced processes. Twenty patients with prostate cancer had three gold seeds implanted into the base, apex and central zone of the prostate transrectally using ultrasound guidance. Surveys were conducted to assess staff and patient satisfaction with the process of gold seed localisation. The gold markers were used to localise the prostate on a daily basis using megavoltage electronic portal imaging. Measurements were taken to establish the increase in accuracy when using gold fiducial markers compared with using the surrounding bony anatomy. Inter-fraction motion (1 standard deviation (SD)) of the fiducial markers was 2.20, 4.28 and 4.27 mm in the LR, SI and AP directions, respectively. Intra-fraction prostate motion (1 SD) was measured as 0.8 mm LR, 1.1 mm SI and 2.0 mm AP. The patient survey showed that the insertion and associated side effects were acceptable, with 5% of patients stating that the seed insertion was worse than the prostate biopsy, and 23.1% of patients experienced short duration (1–2 days) haematuria. The staff survey showed that daily online image guidance was achievable without affecting patient throughput. Thirty percent of treatment staff believed that performing online daily localisation did not add any extra time to a standard treatment, and the remaining 70% thought that the added time was minimal (2–4 min). Gold fiducial markers are an accurate, reliable and tolerable method of daily prostate localisation.

Diagnosis of prostate cancer in patients with persistently elevated PSA and tumor-negative biopsy in ambulatory care. Performance of MR imaging in a multi-reader environment

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Scheidler, J. [Radiologisches Zentrum Muenchen-Pasing, Muenchen (Germany); Weoeres, I.; Scharf, M.; Siebels, M. [Urologische Gemeinschaftspraxis Pasing (Germany); Brinkschmidt, C. [Gemeinschaftspraxis Pathologie, Starnberg (Germany); Zeitler, H.; Heuck, A. [Radiologisches Zentrum Muenchen (Germany); Panzer, S. [Unfallklinik Murnau (Germany). Radiologie

2012-02-15

Purpose: False-negative results are obtained in approx. 20 % of prostate cancer (PCa) patients (pts) at initial systematic transrectal biopsy (Bx), in particular when digital rectal examination (DRE) or transrectal ultrasound (TRUS) is negative. The aim of this study was to assess whether MR endorectal imaging of the prostate in a multi-reader ambulatory care setting may assist in patient selection for re-biopsy. Materials and Methods: 115 consecutive pts with persistent PSA elevation, negative Bx, DRE and TRUS were examined using T2w axial and coronal and T1w axial sequences for tumor diagnosis. MR images were prospectively read as tumor-suspicious or tumor-negative by the MR radiologist on duty. Additionally, a retrospective readout of a prostate MR expert and an abdominal imaging fellowship-trained radiologist was performed to evaluate the effect of the reader's experience on tumor detection. Imaging findings were compared to the results of the repeat Bx (61 pts) or the clinical course of at least two years. Results: For the prospective reading, the sensitivity of MRI was 83 %, the specificity was 69 %, the PPV was 33 % and the NPV was 96 %. ROC analysis revealed a significantly better performance of the prostate MR imaging expert compared to the abdominal imaging radiologist (area under ROC 0.88 vs. 0.66, p < 0.001). Based on the prospective reading, a pre-test probability for PCa of 17.4 % as in our study can be reduced to 5 % when obtaining a tumor-negative result in MRI. Conclusion: MR imaging in a multi-reader ambulatory care setting assists in patient selection for re-biopsy. Reducing the post-test probability for PCa to 5 % allows for further follow-up instead of re-biopsy in MR tumor-negative patients. Specific training and experience improve tumor detection in prostate MR imaging. (orig.)