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Sample records for biopsia transrectal ecodirigida

  1. Estudo comparativo entre três técnicas de anestesia geral para biópsia de próstata dirigida por ultrassonografia transretal Estudio comparativo entre tres técnicas de anestesia general para biopsia de próstata dirigida por ultrasonido transrectal A comparative study among three techniques of general anesthesia for ultrasound-guided transrectal prostate biopsy

    Directory of Open Access Journals (Sweden)

    Ricardo Antônio Guimarães Barbosa

    2010-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A biópsia de próstata dirigida por ultrassonografia transretal constitui referência no diagnóstico das neoplasias da próstata. Quanto maior o número de amostras colhidas, maiores a dor e o desconforto relatados pelo paciente. O objetivo do estudo foi comparar três técnicas anestésicas neste grupo de pacientes. MÉTODO: Foram estudados 45 pacientes separados em três grupos: 1 - Propofol; 2 - Propofol + Bloqueio de Plexo Prostático; 3 - Propofol + Fentanil. Os pacientes foram monitorados com pressão arterial não invasiva, eletrocardioscopia contínua, oximetria de pulso (SpO2 e Índice Bispectral. Não receberam medicação pré-anestésica. Foram avaliados os parâmetros hemodinâmicos no intra e pós-operatório, Índice bispectral no intraoperatório, avaliação da dor pela escala numérica verbal (ENV no pós-operatório imediato e uso de dipirona como tratamento da dor pós-operatória. RESULTADOS: Não houve diferença significativa entre os três grupos: variáveis antropométricas, quantidade de propofol, número de fragmentos e tempo do exame. Os parâmetros hemodinâmicos e a SpO2 apresentaram comportamento semelhante nos três grupos durante o estudo. No grupo 1, a dor avaliada pela ENV foi mais elevada e houve maior necessidade de dipirona que nos outros grupos. CONCLUSÕES: Sedação com propofol isolado para biópsia causa maior dor e desconforto pós-operatório do que quando associado a bloqueio do plexo prostático ou a fentanil sistêmico. Além de hipnose, é necessária a realização de analgesia intraoperatória para garantir conforto pósoperatórioJUSTIFICATIVA Y OBJETIVOS: La biopsia de próstata dirigida por ultrasonido transrectal constituye una referencia en el diagnóstico de las neoplasias de la próstata. Mientras mayor es el número de muestras escogidas, mayores son el dolor y la incomodidad relatados por el paciente. El objetivo del estudio fue comparar tres técnicas anest

  2. Utilidad de la biopsia estereotáctica en lesiones del tallo cerebral

    OpenAIRE

    HERNÁNDEZ SALAZAR,MANUEL; LORENZANA GALICIA,RODRIGO DANIEL; RAMÍREZ CASTAÑEDA,VICENTE; ZÁRATE MÉNDEZ,ANTONIO; CERVERA MALTOS,ULISES; CEVALLOS MEDINA,JAVIER

    2004-01-01

    La biopsia estereotáctica para lesiones del tallo cerebral (LTC), es de reciente desarrollo a partir de los 80s y es sin duda uno de los campos más revolucionados y prometedores de la medicina, a pesar de su potencial complicación, sin embargo la mayoría de los estudios han mostrado su confiabilidad y certeza. Material y métodos: de 85 biopsias estereotácticas consecutivas, se realizaron 11 biopsias de LTC por estereotaxia (13%). Los diagnósticos se obtuvieron por RM cerebral y TC preoperator...

  3. La biopsia asistida por vacío como alternativa a la biopsia quirúrgica en las lesiones proliferativas de riesgo de la mama

    OpenAIRE

    Merino Rasillo, Paula

    2016-01-01

    RESUMEN: Introducción y objetivos. La importancia del diagnóstico en una paciente de una lesión proliferativa de riesgo (LPR) radica no sólo en que aumenta el riesgo relativo para cáncer de mama, sino en la posible infravaloración histológica de un carcinoma cuando se diagnostica en una biopsia percutánea. Este estudio valora el rendimiento diagnóstico de la biopsia asistida por vacío (BAV) en las LPR, así como aquellos factores que pueden relacionarse con un aumento en las tasas de infravalo...

  4. Utilidad del color doppler, power doppler y el contraste sonográfico en el diagnóstico por imagen del cáncer de próstata localizado

    OpenAIRE

    Delgado Oliva, Francisco José

    2012-01-01

    Objetivos: 1º. Estudiar el rendimiento diagnóstico de la ecografía transrectal en escala de grises, power doppler y del contraste sonográfico en el diagnóstico precoz por imagen del cáncer de próstata localizado. 2º. Comparar la rentabilidad diagnóstica de la biopsia prostática aleatoria con la biopsia ecodirigida mediante power doppler y contraste sonográfico, en el diagnóstico precoz por imagen del cáncer de próstata localizado. Material y métodos: Se diseñó un estudio epidem...

  5. Approach of trans-rectal NIR optical tomography probing for the imaging of prostate with trans-rectal ultrasound correlation

    Science.gov (United States)

    Piao, Daqing; Jiang, Zhen; Xu, Guan; Musgrove, Cameron; Bunting, Charles F.

    2008-02-01

    The trans-rectal implementation of NIR optical tomography makes it possible to assess functional status like hemoglobin concentration and oxygen saturation in prostate non-invasively. Trans-rectal NIR tomography may provide tissue-specific functional contrast that is potentially valuable for differentiation of cancerous lesions from normal tissues. Such information will help to determine if a prostate biopsy is needed or can be excluded for an otherwise ambiguous lesion. The relatively low spatial resolution due to the diffuse light detection in trans-rectal NIR tomography, however, limits the accuracy of localizing a suspicious tissue volume. Trans-rectal ultrasound (TRUS) is the clinical standard for guiding the positioning of biopsy needle owing to its resolution and convenience; nevertheless, TRUS lacks the pathognomic specificity to guide biopsy to only the suspicious lesions. The combination of trans-rectal NIR tomography with TRUS could potentially give better differentiation of cancerous tissue from normal background and to accurately localize the cancer-suspicious contrast obtained from NIR tomography. This paper will demonstrate the design and initial evaluation of a trans-rectal NIR tomography probe that can conveniently integrate with a commercial TRUS transducer. The transrectal NIR tomography obtained from this probe is concurrent with TRUS at matching sagittal imaging plane. This design provides the flexibility of simple correlation of trans-rectal NIR with TRUS, and using TRUS anatomic information as spatial prior for NIR image reconstruction.

  6. Role of transrectal ultrasonography in evaluating the cause of azoospermia

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    Yassa, N.A.; Keesara, S. [Univ. of Southern California, Dept. of Radiology, Los Angeles, California (United States)

    2001-08-01

    To assess the role of transrectal ultrasonography in the investigation of azoospermia, a significant cause of infertility. Over a 2-year period, 35 patients with azoospermia underwent an infertility workup, which included transrectal ultrasonography. Sonograms of 10 of the 35 patients were normal; 8 patients had enlarged seminal vesicles containing cysts, 6 had ejaculatory duct dilation, 5 had seminal vesicle calcification, 3 had seminal vesicle atrophy-hypoplasia and 3 patients had midline prostatic cysts. Transrectal sonography is a useful modality to evaluate seminal duct abnormalities, some of which may cause azoospermia. (author)

  7. TRANSRECTAL ULTRASOUND GUIDED PROSTATIC NERVE BLOCKADE FOR PAIN CONTROL DURING TRANSRECTAL PROSTATE BIOPSY

    Institute of Scientific and Technical Information of China (English)

    YANG Liu-ping; DENG Jun-hong; ZHONG Hong; HU Jian-bo; WEI Hong-ai; WANG Liang-sheng

    2005-01-01

    Objective: To assess the effect of transrectal ultrasound guided prostatic nerve blockade on the discomfort associated with systematic biopsy of the prostate. Methods: 73 patients receiving systematic 13 cores biopsy of the prostate were randomized into two groups. Group A(37 cases) received an injection of 5 ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance and group B(36 cases) received 5 ml saline injection (0.9% sodium chloride) at the same site. Pain during biopsy was assessed by using a 10-point linear visual analog score (VAS) immediately after the biopsy. Results: The mean pain scores during transrectal prostate biopsy were significantly lower in group A than group B(1.1±0.6 versus 5.9±3.1, t=4.81, P<0.01). During this study no patient in either group had any adverse effect from the injection. Conclusion: Transcrectal ultrasound guided prostatic nerve blockade is a safe and efficacious method for providing satisfactory anesthesia in transrectal prostate biopsy. We recommend its routine administration in all patients during this procedure.

  8. Biopsy needle detection in transrectal ultrasound.

    Science.gov (United States)

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  9. Local staging of prostate cancer with transrectal ultrasound

    DEFF Research Database (Denmark)

    Lorentzen, T; Nerstrom, H; Iversen, P;

    1992-01-01

    A literature review was undertaken to investigate whether transrectal ultrasound can predict the local stage of prostate cancer. Twelve papers were found which correlated ultrasound findings with surgical findings and another paper reported on strategic staging biopsies guided by transrectal...... ultrasound. Eleven of these papers reported on ultrasound findings in patients in whom digital rectal examination had defined localized disease. One paper compared ultrasound findings and digital rectal findings. One paper indicated that transrectal ultrasound, though not suited to patients with clinically...... localized disease defined by digital rectal examination, may be superior as the initial staging tool. We conclude that transrectal ultrasound has too low a specificity to upgrade the diagnostic results of digital rectal examination, but that it may be more useful as the primary staging tool and for guidance...

  10. Antibiotic prophylaxis for transrectal prostate biopsy-a new strategy

    DEFF Research Database (Denmark)

    Antsupova, Valeria; Nørgaard, Nis; Bisbjerg, Rasmus;

    2014-01-01

    BACKGROUND: Fluoroquinolones are extensively used as prophylaxis for transrectal ultrasound-guided biopsy of the prostate (TRUBP). Emerging fluoroquinolone resistance and selection of multiresistant organisms warrant new prophylactic strategies. Pivmecillinam and amoxicillin/clavulanic acid have ...

  11. Life-threatening meningitis resulting from transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Zhou-Jun Shen; Shan-Wen Chen; Hua Wang; Xie-Lai Zhou; Ju-Ping Zhao

    2005-01-01

    After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma.Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.

  12. 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.......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....

  13. Utilización de criosondas para la realización de la biopsia pulmonar transbronquial

    OpenAIRE

    Pajares Ruiz, Virginia

    2015-01-01

    La biopsia pulmonar transbronquial es una técnica broncoscópica indicada en el estudio de las enfermedades pulmonares difusas. Hasta el momento, la técnica diagnóstica utilizada para la obtención de muestras pulmonares de una forma no quirúrgica es la biopsia pulmonar transbronquial con pinza convencional, pero tal y como se detalla en la presente exposición, el rendimiento diagnóstico de esta técnica es limitado y variable. Esta variabilidad es debida, entre otros factores, al pequeño tamaño...

  14. Transrectal ultrasound in the diagnosis and staging of prostatic carcinoma.

    Science.gov (United States)

    Hauzeur, C; Corbusier, A; Vanden Bossche, M; Schulman, C C

    1990-01-01

    In this retrospective study we try to evaluate the benefit of transrectal ultrasonography of the prostate in the diagnostic, the screening and the preoperative staging of prostatic carcinoma. Five hundred and sixty-six patients with histologically proved prostatic carcinoma were evaluated. For the diagnosis, our specificity was 80%. The specificity of preoperative staging was 85% concerning the extraprostatic extension of the tumor. The screening seems to be of poor interest.

  15. Infection after transrectal ultrasound-guided prostate biopsy

    OpenAIRE

    Lee, Seung-Ju

    2015-01-01

    Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) appear to be increasing, which reflects the high prevalence of antibiotic-resistant strains of Enterobacteriaceae. Identifying patients at high risk for antibiotic resistance with history taking is an important initial step. Targeted prophylaxis with a prebiopsy rectal swab culture or augmented antibiotic prophylaxis can be considered for patients at high risk of antibiotic resistance. If infectious complic...

  16. Transrectal ultrasonography of the left adrenal gland in healthy horses.

    Science.gov (United States)

    Durie, Inge; Van Loon, Gunther; Vermeire, Simon; De Clercq, Dominique; Vanschandevijl, Katleen; Deprez, Piet

    2010-01-01

    Little information is available on medical imaging of the adrenal glands in horses. We investigated the feasibility of transrectal ultrasonography to characterize the normal equine adrenal gland. Transrectal ultrasonography was performed in 25 healthy horses using a 7.5 MHz linear array probe at a displayed depth of 8 cm. Transrectal ultrasonography of the right adrenal gland was not feasible. For the left adrenal gland, the left kidney, the abdominal aorta, the left renal artery, the left renal vein, and the cranial mesenteric artery were used as landmarks. The size of the left adrenal gland was variable, but it generally appeared as a long, flat structure with a hyperechoic medulla surrounded by a hypoechoic cortex. The most cranial part of the gland could not be delineated appropriately in 11 horses (44%). The mean (+/-SD) thickness of the gland and medulla was 0.66 +/- 0.15cm (n = 25) and 0.28 +/- 0.09 cm (n = 25) near the caudal pole, 0.87 +/- 0.25 cm (n = 14) and 0.40 +/- 0.18 cm (n = 12) near the cranial pole, and 0.89 +/- 0.18 cm (n = 25) and 0.36 +/- 0.13 cm (n = 25) in the middle of the gland, respectively. The mean (+/-SD) length of the entire adrenal gland and of the medulla was 6.22 +/- 0.77 cm (n = 14) and 5.45 +/- 0.71 cm (n = 6), respectively. Transrectal ultrasonography allowed adequate visualization of the left adrenal gland in horses. PMID:20973389

  17. 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

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

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    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

  19. Integrated transrectal probe for translational ultrasound-photoacoustic imaging

    Science.gov (United States)

    Bell, Kevan L.; Harrison, Tyler; Usmani, Nawaid; Zemp, Roger J.

    2016-03-01

    A compact photoacoustic transrectal probe is constructed for improved imaging in brachytherapy treatment. A 192 element 5 MHz linear transducer array is mounted inside a small 3D printed casing along with an array of optical fibers. The device is fed by a pump laser and tunable NIR-optical parametric oscillator with data collected by a Verasonics ultrasound platform. This assembly demonstrates improved imaging of brachytherapy seeds in phantoms with depths up to 5 cm. The tuneable excitation in combination with standard US integration provides adjustable contrast between the brachytherapy seeds, blood filled tubes and background tissue.

  20. Optimizing prostate biopsy for repeat transrectal prostate biopsies patients

    Institute of Scientific and Technical Information of China (English)

    Xiaojun Deng; Jianwei Cao; Feng Liu; Weifeng Wang; Jidong Hao; Jiansheng Wan; Hui Liu

    2014-01-01

    Objective:Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re-mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods:In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45° angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontal y inwardly inclined 45°. Results:A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8%(8/45), and prostate intraepithelial neoplasm (PIN) was 6.7%(3/45). The pa-tients receiving repeat transrectal prostate biopsies were pathological y diagnosed as lower Gleason grade prostate cancers. Conclusion:The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrectal prostate biopsies patients.

  1. Application of reinforcement learning for segmentation of transrectal ultrasound images

    Directory of Open Access Journals (Sweden)

    Tizhoosh Hamid R

    2008-04-01

    Full Text Available Abstract Background Among different medical image modalities, ultrasound imaging has a very widespread clinical use. But, due to some factors, such as poor image contrast, noise and missing or diffuse boundaries, the ultrasound images are inherently difficult to segment. An important application is estimation of the location and volume of the prostate in transrectal ultrasound (TRUS images. For this purpose, manual segmentation is a tedious and time consuming procedure. Methods We introduce a new method for the segmentation of the prostate in transrectal ultrasound images, using a reinforcement learning scheme. This algorithm is used to find the appropriate local values for sub-images and to extract the prostate. It contains an offline stage, where the reinforcement learning agent uses some images and manually segmented versions of these images to learn from. The reinforcement agent is provided with reward/punishment, determined objectively to explore/exploit the solution space. After this stage, the agent has acquired knowledge stored in the Q-matrix. The agent can then use this knowledge for new input images to extract a coarse version of the prostate. Results We have carried out experiments to segment TRUS images. The results demonstrate the potential of this approach in the field of medical image segmentation. Conclusion By using the proposed method, we can find the appropriate local values and segment the prostate. This approach can be used for segmentation tasks containing one object of interest. To improve this prototype, more investigations are needed.

  2. La biopsia oral en el contexto del precáncer y del cáncer oral Oral biopsy in the context of oral cancer and precancer

    Directory of Open Access Journals (Sweden)

    J.M. Seoane

    2008-02-01

    Full Text Available Es este artículo se revisa el papel de la biopsia oral en el diagnóstico de lesiones precancerosas y en el diagnóstico precoz del cáncer oral. Se discuten diferentes técnicas, procedimientos, materiales, indicaciones y aspectos quirúrgicos. Se propone efectuar biopsias incisionales en lesiones malignas y sospechosas de malignidad, en tanto se preconizan biopsias escisionales, cuando el tamaño lo permita, en lesiones precancerosas.This article reviews the paper of oral biopsy on the precancerous lesions diagnosis and on the oral cancer early diagnosis. Different techniques, procedures, materials, indications and other surgical aspects are debated. It proposes to do incisional biopsies on malignant lesions and on malignant suspicious lesions, while doing excisional biopsies on precancerous lesions when the size allows it.

  3. [Calcifications of the prostate: a transrectal echographic study].

    Science.gov (United States)

    Bock, E; Calugi, V; Stolfi, V; Rossi, P; D'Ascenzo, R; Solivetti, F M

    1989-05-01

    Prostatic lithiasis is a well know phenomenon. It has little clinical significance and is not easily shown by conventional radiography, which has poor sensitivity and specificity. The authors have studied 612 patients with both suprapubic and transrectal US in order to 1) assess US sensitivity and specificity and 2) report the frequency, spatial distribution, number and features of prostatic calcifications with special emphasis on differential diagnosis between prostatic neoplasms and chronic prostatitis. The authors have also studied the relationship between morphology and symptoms and the results agree with those reported in the scanty literature. The authors conclude that the parameters studied are directly related to age, except for a younger group with clear evidence of genital inflammation. The authors emphasize the impossibility to correlate morphology of prostatic calcifications with pathologic conditions: there are no specific symptoms clearly connected with calcification even though the inflammation is often associated with calcifications.

  4. Transrectal Ultrasound Guided Prostate Biopsy: Current Status and Controversy

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Sung Il; Lee, Hak Jong; Hong, Sung Kyu; Lee, Sang Eun [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University Hospital, Seoul (Korea, Republic of)

    2007-09-15

    In Korea, the incidence of prostate cancer in 2002 was sixth among the malignancies diagnosed in men, but it was the most rapidly increasing cancer. As many prostate cancers are indistinguishable from normal prostate tissue as determined on an ultrasound examination, the randomized systematic transrectal ultrasound guided prostate biopsy is the gold standard for the detection of prostate cancer. Indications for a TRUS guided prostate biopsy including an elevated level of prostate specific antigen (PSA) and an abnormal digital rectal exam, as well as patient preparation and procedure techniques including anesthesia are reviewed in this report. This report also considers controversies about a prostate biopsy such as the ideal number of biopsy cores, usefulness of PSA derivatives, effective methods for local anesthesia, and the use of patient preparation questionnaires covering topics such as the paucity of anticoagulants and the use of antibiotics and enemas

  5. 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.

  6. Ultrasound-guided transrectal extended prostate biopsy: a prospective study

    Institute of Scientific and Technical Information of China (English)

    Mohammed Ahmed Al-Ghazo; Ibrahim Fathi Ghalayini; Ismail Ibrahim Matalka

    2005-01-01

    Aim: To evaluate the diagnostic value of the 10 systematic transrectal ultrasound-guided (TRUS) prostate biopsy compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: One hundred and fifty-two patients with suspected prostate cancer were included in the study. Patients were entered in the study because they presented with high levels of prostate specific antigen (PSA) (over 4 ng/mL) and/or had undergone an abnormal digital rectal examination (DRE). In addition to sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone with additional cores from each suspicious area revealed by transrectal ultrasound. Sextant, lateral peripheral zone and suspicious area biopsy cores were submitted separately to the pathological department. Results: Cancer detection rates were 27.6% (42/152) and 19.7% (30/152) for the 10-core and sextant core biopsy protocols, respectively. Adding the lateral peripheral zone (PZ) to the sextant prostate biopsy showed a 28.6% (12/42) increase in the cancer detection rate in patients with positive prostate cancer (P < 0.01).The cancer detection rate in patients who presented with elevated PSA was 29.3% (34/116). When serum PSA was 4-10 ng/mL TRUS-guided biopsy detected cancer in 20.6%, while the detection rate was 32.4% and 47.0% when serum PSA was 10-20 ng/mL and above 20 ng/mL, respectively. Conclusion: The 10 systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer by 28.6% when compared with the sextant biopsy technique alone, without increase in the morbidity. We therefore recommend the 10-core biopsy protocol to be the preferred method for early detection of prostate cancer.

  7. The diagnostic value of transrectal ultrasonographic features in prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Xiaoli Zou; Guang Yang; Hui Wang

    2012-01-01

    Objective: The aim of the study was to detect the valuable ultrasonographic features in diagnosing prostate cancer.Methods: The patients who underwent transrectal ultrasound in the period from May 2005 to October 2009 at the 1st Affiliated Hospital of Dalian Medical University, China, were included, with needle biopsy diagnosis for patients with the prostate cancer and prostatic hyperplasia.Seventy-four cases of prostate cancer were diagnosed as adenocarcinoma, compared with 51 cases diagnosed as prostatic hyperplasia.Retrospective analysis of patients with transrectal ultrasound were done, comparing the difference between the two groups in the echo level (hypoechogenic), outlines (ill-defined margin), posterior acoustic attenuation, periphery halo, microcalcification incidence, the blood supply level, peak systolic velocity (Vs) and resistance index (RI).Results: The ratios of hypoechogenic lesions in the prostate cancer group and prostatic hyperplasia group were 56.76% and 35.90%, respectively (P 0.05).Vs of the two groups were (44.00 ± 15.30) cm/s and (17.32 ± 4.65) cm/s, respectively (P < 0.05).RI of the two groups were 0.76 ± 0.10, and 0.51 ± 0.03 respectively (P < 0.05).The significant correlation was designated in the blood supply level between the prostate cancer group and prostatic hyperplasia group (r = -0.388, P < 0.01).Higher revascularization grade was seen in the prostate cancer group compared to benign prostatic hyperplasia group.Conclusion: (1) The significant roles for diagnosing prostate cancer are hypoechogenic, irregular outlines, spiculation, microcalcification, high revascularization grade, posterior acoustic attenuation, high Vs and high RI.(2) It could not help in diagnosing prostate cancer with ultrasonographic periphery halo or not.

  8. Risk Factors for Acute Prostatitis after Transrectal Biopsy of the Prostate

    OpenAIRE

    Kim, Sang Jin; Kim, Sun Il; Ahn, Hyun Soo; Choi, Jong Bo; Kim, Young Soo; Kim, Se Joong

    2010-01-01

    Purpose To investigate the incidence, clinical features, pathogenic bacteria, and risk factors associated with acute prostatitis after transrectal prostate biopsy. Materials and Methods We retrospectively reviewed the medical records of 923 transrectal ultrasound-guided needle biopsies of the prostate in 878 patients performed at our institution from June 2004 to May 2009. The indications for biopsy were generally serum prostate-specific antigen (PSA) elevation, abnormal findings on a digital...

  9. Análisis del valor de la biopsia del ganglio centinela en el melanoma cutáneo

    Directory of Open Access Journals (Sweden)

    C. Carrasco-López

    2015-09-01

    Full Text Available El melanoma cutáneo es una neoplasia cuya incidencia va en aumento en nuestro medio. Presentamos un estudio sobre 1023 casos de esta patología recogidos a lo largo de 20 años, distribuidos en 2 grupos: grupo A tratados antes del 2000, y grupo B tratados después del 2000. Comparamos la supervivencia de ambos grupos en base al cambio de tratamiento por la introducción del estudio del ganglio centinela a partir del año 2000. No observamos diferencias significativas entre los 2 grupos en la supervivencia de los pacientes con melanoma a pesar de realizar tratamientos más conservadores. Por tanto, gracias a la biopsia de ganglio centinela, se pueden evitar un 75% de linfadenectomías electivas realizadas en este tipo de patología sin modificar los índices de supervivencia.

  10. Biopsia cerebral a mano alzada guiada por tomografía Cerebral biopsy by a handfree procedure

    Directory of Open Access Journals (Sweden)

    Juan Carlos Arango

    1998-03-01

    Full Text Available Se presenta la experiencia del Servicio de Neurocirugía del Hospital Universitario San Vicente de Paúl con un procedimiento alternativo para realizar una biopsia cerebral, el cual se lleva a cabo a mano alzada y guiado por tomografía sin utilizar un marco estereotáxico. Se resalta su utilidad en los casos de lesiones supratentoriales y con tamaño mayor de 3 centímetros, en centros donde no se disponga de los métodos estereotáxicos tradicionales. We report the experience at the Neurosurgery Service, Saint Vincent's University Hospital (Medellín, Colombia with a hand free procedure for performing brain biopsies, without stereotactical frames. It is considered useful in supratentorial lesions larger than 3 cm, in places lacking stereotactical technology.

  11. 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.

  12. AVALIAÇÃO QUANTITATIVA E QUALITATIVA, DA TÉCNICA DE BIOPSIA RENAL “DE JANELA” EM CÃES

    Directory of Open Access Journals (Sweden)

    Veridiana Maria Brianezi Dignani de Moura

    2006-10-01

    Full Text Available Foram biopsiados os rins de 86 cães pela técnica “de janela”, utilizando agulhas Vim Tru-Cut, com o objetivo de avaliar o número de glomérulos presentes nas amostras, determinar a qualidade diagnóstica delas, bem como estabelecer o melhor rim a ser biopsiado nos casos de nefropatia canina em que a biopsia é indicada como meio de diagnóstico. A média de glomérulos presentes nas biopsias dos rins direito e esquerdo foi 17,53 e 15,93 glomérulos por amostra, respectivamente, o que significa que não houve diferença estatística significativa. No entanto, as biopsias dos rins esquerdos apresentaram maior número de amostras sem glomérulos, dado que indica que elas são impróprias para o diagnóstico. Diante desses resultados conclui-se que o rim direito é o mais apropriado para a realização dessa técnica, uma vez que ele apresenta menor possibilidade de ocorrência de amostras sem glomérulos. PALAVRAS-CHAVE: Cão, biopsia renal “de janela”, glomérulo.

  13. Framework for 3D TransRectal Ultrasound

    CERN Document Server

    Mozer, Pierre; Chevreau, G; Daanen, Vincent; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne

    2008-01-01

    Prostate biopsies are mainly performed under 2D TransRectal UltraSound (TRUS) control by sampling the prostate according to a predefined pattern. In case of first biopsies, this pattern follows a random systematic plan. Sometimes, repeat biopsies can be needed to target regions unsampled by previous biopsies or resample critical regions (for example in case of cancer expectant management or previous prostatic intraepithelial neoplasia findings). From a clinical point of view, it could be useful to control the 3D spatial distribution of theses biopsies inside the prostate. Modern 3D-TRUS probes allow acquiring high-quality volumes of the prostate in few seconds. We developed a framework to track the prostate in 3D TRUS images. It means that if one acquires a reference volume at the beginning of the session and another during each biopsy, it is possible to determine the relationship between the prostate in the reference and the others volumes by aligning images. We used this tool to evaluate the ability of a si...

  14. 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.

  15. Análisis de las complicaciones de la biopsia renal en el paciente trasplantado renal Analysis of renal biopsy complications in renal transplant patients

    Directory of Open Access Journals (Sweden)

    David Berlango Martín

    2012-09-01

    Full Text Available Antecedentes: La biopsia renal es una técnica fundamental en el estudio de la patología del injerto renal. Es fundamental conocer sus complicaciones ya que es el procedimiento más agresivo por su morbimortalidad. Objetivos: El objetivo principal de nuestro estudio fue analizar e identificar las complicaciones clínicas derivadas de la biopsia renal percutánea en pacientes trasplantados renales. Evaluamos si algún factor clínico de los pacientes influye en la aparición de dichas complicaciones. Pacientes y Métodos: Se realizó un estudio observacional, retrospectivo de todos los pacientes a los que se les realizó una biopsia renal percutánea de injerto renal entre enero de 2009 y enero 2012. Se analizaron: edad, sexo, hipertensión arterial, creatinina sérica, proteinuria y hemoglobina previa y posterior a la biopsia. Definimos complicaciones menores (caída hemoglobina mayor 1 g/dl, hematuria macroscópica y complicaciones mayores (necesidad de transfusión, cirugía, nefrectomía, arteriografía, embolización o muerte. Todas las biopsias se realizaron con control ecográfico. Resultados: El número de biopsias realizadas fue de 92. La edad media de los pacientes fue de 47.9 ± 13.2 años y el 70.7% eran hombres. Se observaron 2 complicaciones mayores (2.2% y en ambas los pacientes presentaron sangrado y sepsis urológica, precisando uno de ellos de transfusión. Las complicaciones menores fueron del 14.1%. No se encontró ninguna pérdida del injerto ni muerte por biopsia renal. Conclusión: La biopsia percutánea en injerto renal realizada por médicos nefrólogos con experiencia y bajo control ecográfico en tiempo real, es un procedimiento con bajo riesgo, semejante al observado en riñón nativo. La cumplimentación cuidadosa de nuestro protocolo de biopsia renal, optimiza la relación riesgo beneficio de esta técnica.Background: Renal biopsy is a fundamental technique in the study of renal allograft pathology. It is essential

  16. Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia

    Institute of Scientific and Technical Information of China (English)

    Sandro La Vignera; Aldo E. Calogero; Alessandro Arancio; Roberto Castighone; Gaetano De Grande; Enzo Vicari

    2008-01-01

    Aim: To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection (MAGI) who failed to respond to antibacterial treatment. Methods: We selected 67 consecutive patients with MAGI and persistently elevated bacteriospermia (≥ 106 colony forming units [CFU]/mL) after three antibiotic courses. Fourteen infertile patients with initial chronic microbial (≥ 106 CFU/mL) MAGI who responded to antibac- terial treatment (< 103 CFU/mL) served as a control group. All patients and controls underwent transrectal ultrasonog- raphy (TRUS) scans and semen analysis. Patients with low seminal plasma volume (< 1.5 mL) underwent both pre- ejaculatory and post-ejaculatory TRUS examination. Results: TRUS revealed multiple abnormalities indicative of: (I) bilaterally extended prostato-vesiculitis (group A: 52 cases, 77.6%) (nine of these patients also had micro-emphyse- matous prostate abscess); and (ii) prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatory ducts (group B: 15 cases, 22.4%). Mean sperm concentration, total sperm number, ejaculate volume and pH value were significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normal forms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A. Group B patients had all sperm parameters, but their pH values, significantly different from those of controls. Confusion: Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs). Thus, TRUS may be helpful in the follow-up of these patients.

  17. Trans-rectal interventional MRI: initial prostate biopsy experience

    Science.gov (United States)

    Greenwood, Bernadette M.; Behluli, Meliha R.; Feller, John F.; May, Stuart T.; Princenthal, Robert; Winkel, Alex; Kaminsky, David B.

    2010-02-01

    Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate gland when evaluated along with T2-weighted images, diffusion-weighted images (DWI) and their corresponding apparent diffusion coefficient (ADC) maps can yield valuable information in patients with rising or elevated serum prostate-specific antigen (PSA) levels1. In some cases, patients present with multiple negative trans-rectal ultrasound (TRUS) biopsies, often placing the patient into a cycle of active surveillance. Recently, more patients are undergoing TRIM for targeted biopsy of suspicious findings with a cancer yield of ~59% compared to 15% for second TRUS biopsy2 to solve this diagnostic dilemma and plan treatment. Patients were imaged in two separate sessions on a 1.5T magnet using a cardiac phased array parallel imaging coil. Automated CAD software was used to identify areas of wash-out. If a suspicious finding was identified on all sequences it was followed by a second imaging session. Under MRI-guidance, cores were acquired from each target region3. In one case the microscopic diagnosis was prostatic intraepithelial neoplasia (PIN), in the other it was invasive adenocarcinoma. Patient 1 had two negative TRUS biopsies and a PSA level of 9ng/mL. Patient 2 had a PSA of 7.2ng/mL. He underwent TRUS biopsy which was negative for malignancy. He was able to go on to treatment for his prostate carcinoma (PCa)4. MRI may have an important role in a subset of patients with multiple negative TRUS biopsies and elevated or rising PSA.

  18. Biopsia hepática endoscópica transvaginal em cadelas Endoscopic transvaginal liver biopsy in bitches

    Directory of Open Access Journals (Sweden)

    Leonardo Alves Coutinho Souza

    2012-02-01

    Full Text Available Esse trabalho teve o objetivo de propor uma técnica de biopsia hepática endoscópica transvaginal em cadelas, evitando-se o acesso através da parede abdominal, técnica essa internacionalmente conhecida por NOTES (natural orifice transluminal endoscopic surgery. Para tanto, foram utilizadas sete cadelas, as quais foram submetidas a dois procedimentos. O primeiro constou de biopsia hepática pela técnica proposta. Para isso, realizou-se a incisão vaginal após exteriorização através da vulva. Pela ferida vaginal foi introduzido um endoscópio flexível de 11mm de diâmetro com dois canais de trabalho. Este foi empregado na obtenção das amostras hepáticas. O segundo procedimento foi de avaliação laparoscópica aos 53 dias após a biopsia. As variáveis analisadas para a verificação de viabilidade, segurança e qualidade dessa técnica foram: as dificuldades técnicas, as complicações cirúrgicas, o tempo operatório, a qualidade do material coletado, a formação de aderências vaginais e as alterações bioquímicas hepáticas. Conclui-se que a biópsia hepática por NOTES flexível transvaginal é viável em cães, pois permite a obtenção de fragmentos apropriados para o exame histológico sem ocasionar alterações significativas dos parâmetros de avaliação hepática e formação de aderências intraperitoneais.A technique of hepatic biopsy by transvaginal approach (NOTES - Natural Orifice Transluminal Endoscopic Surgery is proposed. Seven dogs were used, and the experiment was divided into two stages including the liver biopsy and the evaluation of laparoscopic abdominal conditions after biopsy (53 days after. The animals were submitted to vaginal incision after exposition through the vulva. Through the vaginal incision was introduced a flexible endoscope of 11mm with two working channels, was introduced through the vaginal incision and used to obtain liver samples. The variables analyzed to verify the feasibility of the

  19. Our experience on developing urinary tract infections after transrectal prostate biopsy

    Directory of Open Access Journals (Sweden)

    Gülay Dede

    2014-03-01

    Full Text Available Objective: Prostate cancer is a common disease in men proportionally with age. For the diagnosis of prostate cancer, prostate biopsy be performed routinely in all centers so it has become today. Complications after prostate biopsy is a surgical procedure can be seen. The most important complications are urinary tract infection and sepsis. The use of prophylactic antibiotics before the procedure reduces the risk of infectious complications. In this study, infectious complications after transrectal prostate needle biopsy were evaluated for risk reduction practices are discussed. Methods: We evaluated infective complications after transrectal prostate needle biopsy in 276 patients admitted to our hospital in October 2009- October 2011 with high level of prostate-specific antigen, abnormal signs in transrectal ultrasound, abnormal digital rectal examination due to done transrectal prostate needle biopsy. Results: Transrectal prostate needle biopsy was performed to 276 cases and 59 (21% cases with hematuria, 21 (7% cases with hematospermia, 23 (8% cases with rectal bleeding, 6 (2.1% cases with asymptomatic bacteriuria, 12 (5.3% cases with in complicated urinary tract infection was detected. Three patients (1% had sepsis. 21 (7.3% patients had positive urine culture. Of them there were 20 positive cultures of E. coli and one Klebsiella spp. respectively. All of the bacteria cultured in twenty-one patients resistant to ciprofloxacin, while 90% to amikacin, 10% to amoxicillin-clavulanate, 35% to cefuroxime sodium and 40% were susceptible to ceftriaxone. Conclusion: Transrectal prostate needle biopsies of 276 patients, 21 (7.3% patients had positive urine culture. The most frequent complication was hematuria. The most serious complication of sepsis detected in three (1% patients.

  20. Transrectal Ultrasound-guided Systematic 13-Core Prostate Biopsy to Diagnose Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Liuping Yang; Junhong Deng; Hong Zhong; Jianbo Hu; Hongai Wei; Liangsheng Wang

    2005-01-01

    OBJECTIVE To evaluate the clinical value of transrectal ultrasound guided systematic 13-core prostate biopsy.METHODS A total of 213 patients referred for abnormal digital rectal examination and/or with a prostate specific antigen of 4 ng/ml or greater underwent transrectal ultrasound guided systematic 13-core prostate biopsy. This procedure was conducted in addition to the standard sextant biopsies in which cores were taken from the far lateral and middle regions of the gland as described by Eskew. Fathological findings of the additional regions were compared with those of the sextant regions.RESULTS Of the 213 patients 31% had cancer on biopsy (66/213). Of the 66 patients with prostate cancer 14 (21%) had carcinoma only in the additional regions, which would have remained undetected had the sextant biopsy technique been used alone (P<0.05). No severe complications occurred among the patients who underwent transrectal ultrasound guided systematic 13-core prostate biopsy.CONCLUSION Our data demonstrated that transrectal ultrasound guided systematic 13-core prostate biopsy can significantly increase the cancer detection rate. It is safe and efficacious, and should be recommended for use clinically.

  1. Feasibility of a pneumatically actuated MR-compatible robot for transrectal prostate biopsy guidance

    NARCIS (Netherlands)

    Yakar, D.; Schouten, M.G.; Bosboom, D.G.H.; Barentsz, J.O.; Scheenen, T.W.J.; Futterer, J.J.

    2011-01-01

    PURPOSE: To assess the feasibility of using a remote-controlled, pneumatically actuated magnetic resonance (MR)-compatible robotic device to aid transrectal biopsy of the prostate performed with real-time 3-T MR imaging guidance. MATERIALS AND METHODS: This prospective study was approved by the ethi

  2. Comparison of transrectal photoacoustic, Doppler, and magnetic resonance imaging for prostate cancer detection

    Science.gov (United States)

    Ishihara, Miya; Horiguchi, Akio; Shinmoto, Hiroshi; Tsuda, Hitoshi; Irisawa, Kaku; Wada, Takatsugu; Asano, Tomohiko

    2016-03-01

    Transrectal ultrasonography (TRUS) is the most popular imaging modality for diagnosing and treating prostate cancer. TRUS-guided prostate biopsy is mandatory for the histological diagnosis of patients with elevated serum prostatespecific antigen (PSA), but its diagnostic accuracy is not satisfactory due to TRUS's low resolution. As a result, a considerable number of patients are required to undergo an unnecessary repeated biopsy. Photoacoustic imaging (PAI) can be used to provide microvascular network imaging using hemoglobin as an intrinsic, optical absorption molecule. We developed an original TRUS-type PAI probe consisting of a micro-convex array transducer with an optical illumination system to provide superimposed PAI and ultrasound images. TRUS-type PAI has the advantage of having much higher resolution and greater contrast than does Doppler TRUS. The purpose of this study was to demonstrate the clinical feasibility of the transrectal PAI system. We performed a clinical trial to compare the image of the cancerous area obtained by transrectal PAI with that obtained by TRUS Doppler during prostate biopsy. The obtained prostate biopsy cores were stained with anti-CD34 antibodies to provide a microvascular distribution map. We also confirmed its consistency with PAI and pre-biopsy MRI findings. Our study demonstrated that transrectal identification of tumor angiogenesis under superimposed photoacoustic and ultrasound images was easier than that under TRUS alone. We recognized a consistent relationship between PAI and MRI findings in most cases. However, there were no correspondences in some cases.

  3. Técnicas de biopsia para el diagnóstico de lesiones mamarias no palpables Biopsy techniques for the diagnosis of non-palpable mammary lesions

    Directory of Open Access Journals (Sweden)

    L. Pina

    2004-12-01

    Full Text Available Ante una lesión mamaria no palpable que precise una biopsia diagnóstica debe valorarse el método de guiado idóneo para acceder a la misma. En la actualidad se emplean tres métodos: la estereotaxia (fundamentalmente en casos de microcalcificaciones, la ecografía (sobre todo en los nódulos y la resonancia magnética (para lesiones no visibles mediante los anteriores sistemas. El siguiente paso es elegir la técnica de biopsia más adecuada. La técnica más clásica y fiable es la biopsia quirúrgica con marcaje previo con un arpón metálico, pero tiene los inconvenientes de ser una técnica agresiva para el diagnóstico de la patología benigna, además de presentar un alto coste. Como alternativas se han desarrollado múltiples sistemas de punción. La punción con aguja fina es de fácil realización técnica y puede dar buenos resultados en los nódulos mamarios, pero la existencia de resultados falsos positivos y negativos han limitado progresivamente su utilización. Como alternativa, los sistemas de biopsia con aguja gruesa han permitido la obtención de múltiples cilindros con gran fiabilidad diagnóstica, sobre todo en el caso de los nódulos mamarios. Sin embargo, su empleo en las microcalcificaciones continúa mostrando resultados falsos negativos. El advenimiento de los sistemas de biopsia asistida por vacío ha permitido la obtención de cilindros de mayor calidad, mejorando claramente los resultados de los sistemas anteriores, sobre todo en los casos de microcalcificaciones. Por último, los sistemas de biopsia escisional percutánea mediante cánulas de hasta 22 mm de diámetro consiguen la extracción completa de lesiones de tamaño inferior al de la cánula, con una fiabilidad similar al de la biopsia quirúrgica.Facing a non-palpable mammary lesion requiring a diagnostic biopsy, consideration must be given to the most suitable guiding method for obtaining the latter. Three methods are employed at present: stereotaxy

  4. Mapping of transrectal ultrasonographic prostate biopsies: quality control and learning curve assessment by image processing

    CERN Document Server

    Mozer, Pierre; Chevreau, Gregoire; Moreau-Gaudry, Alexandre; Bart, Stephane; Renard-Penna, Raphaele; Comperat, Eva; Conort, Pierre; Bitker, Marc-Olivier; Chartier-Kastler, Emmanuel; Richard, Francois; Troccaz, Jocelyne

    2009-01-01

    Objective: Mapping of transrectal ultrasonographic (TRUS) prostate biopsies is of fundamental importance for either diagnostic purposes or the management and treatment of prostate cancer, but the localization of the cores seems inaccurate. Our objective was to evaluate the capacities of an operator to plan transrectal prostate biopsies under 2-dimensional TRUS guidance using a registration algorithm to represent the localization of biopsies in a reference 3-dimensional ultrasonographic volume. Methods: Thirty-two patients underwent a series of 12 prostate biopsies under local anesthesia performed by 1 operator using a TRUS probe combined with specific third-party software to verify that the biopsies were indeed conducted within the planned targets. RESULTS: The operator reached 71% of the planned targets with substantial variability that depended on their localization (100% success rate for targets in the middle and right parasagittal parts versus 53% for targets in the left lateral base). Feedback from this ...

  5. 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.

  6. A trial of semen collection by transrectal electroejaculation method from Amur leopard cat (Prionailurus bengalensis euptilurus)

    OpenAIRE

    TAJIMA, Hideo; YOSHIZAWA, Madoka; Sasaki, Shinichi; YAMAMOTO, Fujio; NARUSHIMA, Etsuo; Ogawa, Yuka; Orima, Hiromitsu; Tsutsui, Toshihiko; TOYONAGA, Mari; KOBAYASHI, Masanori; KAWAKAMI, Eiichi; HORI, Tatsuya

    2016-01-01

    We collected semen from a male Amur leopard cat using the transrectal electroejaculation method and investigated the semen qualities for about four years. In addition, the influence of the season on the spermatogenic function of the Amur leopard cat was investigated with regard to the semen qualities, testicular volume and serum testosterone level. As a result, we could collect semen with good sperm qualities that would be useable for artificial insemination. Some seasonality was noted in the...

  7. 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.

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

    OpenAIRE

    Valeria Fiaschetti; Guglielmo Manenti; Isabelle Di Poce; Maria Fornari; Aurora Ricci; Enrico Finazzi Agrò; Giovanni Simonetti

    2012-01-01

    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...

  9. A pilot study of transrectal endoscopic ultrasound elastography in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Opacic Milorad

    2011-10-01

    Full Text Available Abstract Background Using standard diagnostic algorithms it is not always possible to establish the correct phenotype of inflammatory bowel disease which is essential for therapeutical decisions. Endoscopic ultrasound elastography is a new endoscopic procedure which can differentiate the stiffness of normal and pathological tissue by ultrasound. Therefore, we aimed to investigate the role of transrectal ultrasound elastography in distiction between Crohn's disease and ulcerative colitis. Methods A total 30 Crohn's disease, 25 ulcerative colitis, and 28 non-inflammatory bowel disease controls were included. Transrectal ultrasound elastography was performed in all patients and controls. In all ulcerative coltis patients and 80% of Crohn's disease patients endoscopy was performed to assess disease activity in the rectum. Results Significant difference in rectal wall thickness and strain ratio was detected between patients with Crohn's disease and controls (p = 0.0001. CD patients with active disease had higher strain ratio than patients in remission (p = 0.02. In ulcerative colitis group a significant difference in rectal wall thickness was found between controls and patients with active disease (p = 0.03. A significant difference in rectal wall thickness (p = 0.02 and strain ratio (p = 0.0001 was detected between Crohn's disease and ulcerative colitis patient group. Crohn's disease patients with active disease had a significantly higher strain ratio compared to ulcerative colitis patients with active disease (p = 0.0001. Conclusion Transrectal ultrasound elastography seems to be a promising new diagnostic tool in the field of inflammatory bowel disease. Further study on a larger cohort of patients is needed to definitely assess the role of transrectal ultrasound elastography in inflammatory bowel disease.

  10. A pilot study of transrectal endoscopic ultrasound elastography in inflammatory bowel disease

    OpenAIRE

    Opacic Milorad; Radić Davor; Brinar Marko; Cukovic-Cavka Silvija; Rustemovic Nadan; Ostojic Rajko; Vucelic Boris

    2011-01-01

    Abstract Background Using standard diagnostic algorithms it is not always possible to establish the correct phenotype of inflammatory bowel disease which is essential for therapeutical decisions. Endoscopic ultrasound elastography is a new endoscopic procedure which can differentiate the stiffness of normal and pathological tissue by ultrasound. Therefore, we aimed to investigate the role of transrectal ultrasound elastography in distiction between Crohn's disease and ulcerative colitis. Meth...

  11. 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.

  12. Sensitivity study of an ultrasound coupled transrectal electrical impedance tomography system for prostate imaging

    International Nuclear Information System (INIS)

    In 2009, prostate cancer ranked as the most common cancer and the second most fatal cancer in men in the United States. Unfortunately, the current clinical diagnostic methods (e.g. prostate-specific antigen (PSA), digital rectal examination, endorectal MRI, transrectal ultrasound, biopsy) used for detecting and staging prostate cancer are limited. It has been shown that cancerous prostate tissue has significantly different electrical properties when compared to benign tissues. Based on these electrical property findings, a transrectal electrical impedance tomography (TREIT) system is proposed as a novel prostate imaging modality. The TREIT system comprises an array of electrodes interfaced with a clinical transrectal ultrasound (TRUS) probe. We evaluate this imaging system through a series of phantom imaging experiments to assess the system's ability to image high and low contrast objects at various positions. We found that the TREIT system can easily discern high contrast inclusions of 1 cm in diameter at distances centered at two times the radius of the TREIT probe away from the probe surface. Furthermore, this technology's ability to detect low contrast inclusions suggests that it has the potential to successfully detect prostate cancer

  13. Sensitivity study of an ultrasound coupled transrectal electrical Impedance Tomography system for prostate imaging

    Science.gov (United States)

    Wan, Y.; Halter, R.; Borsic, A.; Manwaring, P.; Hartov, A.; Paulsen, K.

    2010-04-01

    In 2009, prostate cancer ranks as the most common cancer and the second most fatal cancer in men in the United States. Unfortunately, the current clinical diagnostic methods (e.g. prostate-specific antigen (PSA), digital rectal examination, endorectal MRI, transrectal ultrasound, biopsy) used for detecting and staging prostate cancer are limited. It has been shown that cancerous prostate tissue has significantly different electrical properties when compared to benign tissues. Based on these electrical property findings, a TransRectal Electrical Impedance Tomography (TREIT) system is proposed as a novel prostate imaging modality. The TREIT system is comprised of an array of electrodes interfaced with a clinical TransRectal UltraSound (TRUS) probe. We evaluate this imaging system through series of phantom imaging experiments to assess the system's ability to image high and low contrast objects at various positions. We found that the TREIT system can easily discern high contrast inclusions of 1 cm in diameter at distances centered at 2 times the radius of the TREIT probe away from the probe surface. Furthermore, this technology's ability to detect low contrast inclusions suggests that it has the potential to successfully detect prostate cancer.

  14. Comparación entre las biopsias gástricas sin fijar 24 horas frente a la biopsia convencional para el diagnóstico de Helicobacter pylori en un hospital de referencia de Perú Comparison between gastric biopsies without fixation for 24 hours and conventional biopsy for the diagnosis of Helicobacter pylori in a reference hospital in Peru

    Directory of Open Access Journals (Sweden)

    César Tadeo Vela-Velásquez

    2011-03-01

    Full Text Available Objetivos. Comparar biopsias gástricas fijadas inmediatamente con formol al 10% frente a biopsias fijadas tras 24 horas en la detección de Helicobacter pylori (Hp en un hospital de referencia en Perú. Materiales y métodos. Se realizó un estudio de test diagnóstico sobre las biopsias gástricas de 72 pacientes que acudieron al Servicio de Gastroenterología del Hospital Essalud Alberto Sabogal en el Callao. Las muestras de cada paciente fueron repartidas en dos frascos de vidrio, una de ellas se fijó inmediatamente con formol al 10% y a la otra se fijó luego de 24 horas. Se procesaron ambos grupos de muestras con la técnica convencional de inclusión en parafina y coloración con hematoxilina-eosina. Resultados. Se evidenció Hp en 56,9% del grupo de biopsias fijadas inmediatamente y en el 79,2% del grupo de biopsias fijadas tras 24 horas, encontrándose diferencia estadística (pObjectives. To compare gastric biopsies immediately fixed with 10% formalin with biopsies fixed after 24 hours for the detection of Helicobacter pylori (Hp in a reference hospital in Peru. Materials and methods. A diagnostic test study on gastric biopsies from 72 patients attending the Gastroenterology service of hospital Essalud Alberto Sabogal in Callao was performed. Samples from each patient were divided into two glass jars, one of which was fixed immediately with 10% formalin and the other was fixed after 24 hours. Both groups of samples were processed with the conventional technique of paraffin embedding and staining with hematoxylin-eosin. Results. Hp was found in 56.9% of the group of biopsies which were inmediatly fixed and in 79.2% of the group of biopsies fixed after 24 hours, showing statistical difference (p <0.001. Conclusions. There is an increased frequency of diagnosis of Hp in the samples that were fixed after 24 hours, which may suggest that this would act as a biological culture for Hp, which would facilitate its diagnosis.

  15. A trial of semen collection by transrectal electroejaculation method from Amur leopard cat (Prionailurus bengalensis euptilurus).

    Science.gov (United States)

    Tajima, Hideo; Yoshizawa, Madoka; Sasaki, Shinichi; Yamamoto, Fujio; Narushima, Etsuo; Ogawa, Yuka; Orima, Hiromitsu; Tsutsui, Toshihiko; Toyonaga, Mari; Kobayashi, Masanori; Kawakami, Eiichi; Hori, Tatsuya

    2016-07-01

    We collected semen from a male Amur leopard cat using the transrectal electroejaculation method and investigated the semen qualities for about four years. In addition, the influence of the season on the spermatogenic function of the Amur leopard cat was investigated with regard to the semen qualities, testicular volume and serum testosterone level. As a result, we could collect semen with good sperm qualities that would be useable for artificial insemination. Some seasonality was noted in the testicular volume and serum testosterone level. We clarified that the semen qualities were favorable before and during the female breeding season compared with those after the breeding season. PMID:26935841

  16. 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.

  17. Random Walk Based Segmentation for the Prostate on 3D Transrectal Ultrasound Images

    Science.gov (United States)

    Ma, Ling; Guo, Rongrong; Tian, Zhiqiang; Venkataraman, Rajesh; Sarkar, Saradwata; Liu, Xiabi; Nieh, Peter T.; Master, Viraj V.; Schuster, David M.; Fei, Baowei

    2016-01-01

    This paper proposes a new semi-automatic segmentation method for the prostate on 3D transrectal ultrasound images (TRUS) by combining the region and classification information. We use a random walk algorithm to express the region information efficiently and flexibly because it can avoid segmentation leakage and shrinking bias. We further use the decision tree as the classifier to distinguish the prostate from the non-prostate tissue because of its fast speed and superior performance, especially for a binary classification problem. Our segmentation algorithm is initialized with the user roughly marking the prostate and non-prostate points on the mid-gland slice which are fitted into an ellipse for obtaining more points. Based on these fitted seed points, we run the random walk algorithm to segment the prostate on the mid-gland slice. The segmented contour and the information from the decision tree classification are combined to determine the initial seed points for the other slices. The random walk algorithm is then used to segment the prostate on the adjacent slice. We propagate the process until all slices are segmented. The segmentation method was tested in 32 3D transrectal ultrasound images. Manual segmentation by a radiologist serves as the gold standard for the validation. The experimental results show that the proposed method achieved a Dice similarity coefficient of 91.37±0.05%. The segmentation method can be applied to 3D ultrasound-guided prostate biopsy and other applications.

  18. Sonablate-500TM Transrectal High-intensity Focused Ultrasound (HIFU) for Benign Prostatic Hyperplasia Patients

    Institute of Scientific and Technical Information of China (English)

    L(U) Jun; HU Weilie; WANG Wei; ZHANG Yuanfeng; CHEN Zhaoyang; YE Zhangqun

    2007-01-01

    To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH pa- tients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500TM HIFU treatment. A sili- con-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3,P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 rain. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.

  19. Transrectal high-intensity focused ultrasound ablation of prostate cancer: Effective treatment requiring accurate imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, Olivier [Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Pavillon P Radio, Hopital Edouard Herriot, F-69437 Lyon cedex 03 (France); Universite de Lyon, Lyon F-69003 (France); Universite de Lyon 1, Faculte de Medecine Lyon Nord, Lyon F-69003 (France); INSERM, Unit 556, 151 cours Albert Thomas, F-69424 Lyon cedex 03 (France)], E-mail: Olivier.rouviere@netcourrier.com; Souchon, Remi [INSERM, Unit 556, 151 cours Albert Thomas, F-69424 Lyon cedex 03 (France)], E-mail: souchon@lyon.inserm.fr; Salomir, Rares [INSERM, Unit 556, 151 cours Albert Thomas, F-69424 Lyon cedex 03 (France)], E-mail: salomir@lyon.inserm.fr; Gelet, Albert [Hospices Civils de Lyon, Department of Urology, Pavillon P Radio, Hopital Edouard Herriot, F-69437 Lyon cedex 03 (France)], E-mail: Albert.gelet@chu-lyon.fr; Chapelon, Jean-Yves [INSERM, Unit 556, 151 cours Albert Thomas, F-69424 Lyon cedex 03 (France)], E-mail: chapelon@lyon.inserm.fr; Lyonnet, Denis [Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Pavillon P Radio, Hopital Edouard Herriot, F-69437 Lyon cedex 03 (France); Universite de Lyon, Lyon F-69003 (France); Universite de Lyon 1, Faculte de Medecine Lyon Nord, Lyon F-69003 (France); INSERM, Unit 556, 151 cours Albert Thomas, F-69424 Lyon cedex 03 (France)], E-mail: Denis.lyonnet@chu-lyon.fr

    2007-09-15

    Transrectal HIFU ablation has become a reasonable option for the treatment of localized prostate cancer in non-surgical patients, with 5-year disease-free survival similar to that of radiation therapy. It is also a promising salvage therapy of local recurrence after radiation therapy. These favourable results are partly due to recent improvements in prostate cancer imaging. However, further improvements are needed in patient selection, pre-operative localization of the tumor foci, assessment of the volume treated and early detection of recurrence. A better knowledge of the factors influencing the HIFU-induced tissue destruction and a better pre-operative assessment of them by imaging techniques should improve treatment outcome. Whereas prostate HIFU ablation is currently performed under transrectal ultrasound guidance, MR guidance with real-time operative monitoring of temperature will be available in the near future. If this technique will give better targeting and more uniform tissue destruction, its cost-effectiveness will have to be carefully evaluated. Finally, a recently reported synergistic effect between HIFU ablation and chemotherapy opens possibilities for treatment in high-risk or clinically advanced tumors.

  20. Detection of Fluoroquinolone-Resistant Organisms from Rectal Swabs by Use of Selective Media Prior to a Transrectal Prostate Biopsy▿

    OpenAIRE

    Liss, Michael A; Peeples, Amy N.; Peterson, Ellena M.

    2011-01-01

    Sepsis caused by fluoroquinolone-resistant Escherichia coli is a risk for patients undergoing an ultrasound-guided, transrectal prostate biopsy. A method incorporating selective broth and media was evaluated using rectal swabs obtained from 136 patients prior to a biopsy procedure. Fluoroquinolone-resistant organisms were isolated from 22% of the patients included in this study.

  1. Resultados de biopsia guiada por tomografía axial computarizada en el síndrome de destrucción vertebral, evaluados en dos instituciones distintas

    Directory of Open Access Journals (Sweden)

    Barón Zarate-Kalfopulos

    2013-01-01

    Full Text Available OBJETIVO: Comparar resultados de biopsias vertebrales guiadas por tomografía axial computarizada, reportados por dos servicios de Anatomía Patológica distintos en pacientes con síndrome de destrucción vertebral para confirmar confiabilidad y utilidad en el diagnóstico. MÉTODOS: Se obtuvieron muestras de tejido de 21 pacientes en el periodo comprendido del 1 de marzo al 15 de julio del 2011 con el diagnóstico del síndrome de destrucción vertebral y a quienes se les realizó biopsia guiada por tomografía axial computarizada. Las muestras se enviaron en forma cegada a dos servicios de patología distintos. Los resultados fueron analizados con el método de comparación de dos proporciones. RESULTADOS: 14 pacientes fueron del género masculino (67% y 7 del femenino (23%, edades de 28-82, con afección principalmente lumbar (48% y torácica (38%; afectados en una vértebra en 62%, en dos en un 33% y en 3 o más niveles en 5%. Las vértebras más afectadas fueron L1, L2 y L3 (12/30 [40%], T4 (3/30 [10%] y T9 (3/30 [10%]. Los resultados se agruparon en categorías: 1. Osteomielitis (9/21 [43%], 2. Tumores (7/21 [33%], 3. Metástasis (3/21 [14%], 4. Tejido normal (2/21 [10%], 5. Inflamación (0/21 [0%], 6. Muestra inadecuada (0/21 [0%], 7. Mal de Pott (0/21 [0%]. CONCLUSIONES: De acuerdo a los valores de Z obtenidos mediante la prueba de comparación de dos proporciones no se encontró diferencia significativa entre los resultados reportados por dos los dos servicios de patología en el síndrome estudiado, determinándose que esta parte del proceso es confiable y útil en un 90%.

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

    CERN Document Server

    Baumann, Michael; 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 a...

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

    Institute of Scientific and Technical Information of China (English)

    Sung Gu Kang; Bum Sik Tae; Sam Hong Mine; Young Hwu Ko; Seok Ho Kang; Jeong Gu Lee; Je Jong Kim; Jun Cheon

    2011-01-01

    @@ Sedation may result in reduction in pain during transrectal ultrasound(TRUS)-guided prostate biopsies.We aimed to evaluate the efficacy and safety of a combination of propofol and remifentanil infusion during TRUS-guided prostate biopsy and the related increases in health care costs.From January to September 2010,100 men undergoing a transrectal prostate biopsy were randomized into two groups.In Group 1,[50]patients received a combined infusion of propofol and remifentanil; in Group 2,[50]patients received lidocaine jelly.After TRUS-guided biopsies were performed,pain and patient satisfaction were evaluated by a 10-point visual analog scale (VAS),and a cost-related patient satisfaction questionnaire was completed by all patients.Patients were also asked whether they would be willing to undergo repeat biopsy by the same method.Patients in Group 1 showed a significantly lower VAS score than those in Group 2 (mean VAS score: 0.9士1.1 versus 6.312.5; P<0.001).In addition,the patient satisfaction scale was significantly higher in Group 1(P=0.002).Although the overall cost was significantly higher in Group 1(P=0.006),patient satisfaction scales considering cost were also higher in this group (P=0.009).A combination of propofol and remifentanil is a safe and effective way to decrease patient pain and increase patient satisfaction during TRUS-guided prostate biopsy.Although the costs were higher in the group that received sedation,as expected,the patients exhibited heightened satisfaction and willingness to repeat biopsies by the same method.

  5. Optical biopsy of the prostate: can we TRUST (trans-rectal ultrasound-coupled spectral tomography)?

    Science.gov (United States)

    Piao, Daqing; Jiang, Zhen; Bartels, Kenneth E.; Holyoak, G. Reed; Ritchey, Jerry W.; Rock, Kendra; Ownby, Charlotte L.; Bunting, Charles F.; Slobodov, Gennady

    2011-03-01

    Needle-based core-biopsy to locate prostate cancer relies heavily upon trans-rectal ultrasound (TRUS) imaging guidance. Ultrasonographic findings of classic hypoechoic peripheral zone lesions have a low specificity of ~28%, a low positive predictive value of ~29%, and an overall accuracy of ~43%, in prostate cancer diagnosis. The prevalence of isoechoic or nearly invisible prostate cancers on ultrasonography ranges from 25 to 42%. As a result, TRUS is useful and convenient to direct the needle trajectory following a systematic biopsy sampling template rather than to target only the potentially malignant lesion for focal-biopsy. To address this deficiency in the first-line of prostate cancer imaging, a trans-rectal ultrasound-coupled spectral tomography (TRUST) approach is being developed to non-invasively resolve the likely optical signatures of prostate malignancy. The approach has evolved from using one NIR wavelength to two NIR bands, and recently to three bands of NIR spectrum information. The concept has been evaluated on one normal canine prostate and three dogs with implanted prostate tumor developed as a model. The initial results implementing TRUST on the canine prostate tumor model includes: (1) quantifying substantially increased total hemoglobin concentration over the time-course of imaging in a rapidly growing prostate tumor; (2) confirming hypoxia in a prostatic cystic lesion; and (3) imaging hypoxic changes of a necrotic prostate tumor. Despite these interesting results, intensive technologic development is necessary for translating the approach to benefiting clinical practice, wherein the ultimate utility is not possibly to eliminate needle-biopsy but to perform focal-biopsy that is only necessary to confirm the cancer, as well as to monitor and predict treatment responses.

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

    Directory of Open Access Journals (Sweden)

    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

  7. Doença de Lafora: diagnóstico pela biopsia de músculo esquelético (relato de caso Lafora's disease: diagnosis by muscle biopsy (case report

    Directory of Open Access Journals (Sweden)

    ALZIRA ALVES DE SIQUEIRA CARVALHO

    2000-12-01

    Full Text Available Uma paciente de 16 anos apresentava epilepsia mioclônica causada pela doença de Lafora. A biopsia muscular mostrou padrão vacuolar nas fibras musculares com as reações nicotinamida adenina tetrazolium redutase desidrogenase, hematoxilina-eosina e PAS. O aspecto morfológico permite o diagnóstico através da biopsia muscular. Este é um procedimento menos agressivo que a biopsia de fígado e de cérebro. A microscopia eletrônica deve ser reservada para casos nos quais as alterações musculares à microscopia óptica são muito discretas deixando dúvidas quanto ao diagnóstico.A 16-year-old female patient had myoclonic epilepsy caused by Lafora's disease. Muscle biopsy showed a prominent splitting pattern in muscle fibers with the nicotinamide adenine nucleotide dehydrogenase-tetrazolium reductase reaction, hematoxylin-eosin, and PAS stains. This morphologic appearance of the tissue permits diagnosis using the benign technique of muscle biopsy. The ultrastructural examination of muscle may be necessary to confirm the diagnosis of Lafora myoclonus epilepsy if light microscopical findings are equivocal.

  8. Effect of Oral Administration of Acetaminophen and Topical Application of EMLA on Pain during Transrectal Ultrasound-Guided Prostate Biopsy

    OpenAIRE

    Kim, Seol; Yoon, Byung Il; Kim, Su Jin; Cho, Hyuk Jin; Kim, Hyo Sin; Hong, Sung Hoo; Lee, Ji Youl; Hwang, Tae-Kon; Kim, Sae Woong

    2011-01-01

    Purpose Transrectal ultrasound-guided prostate biopsy is the procedure of choice for diagnosing prostate cancer. We compared with pain-relieving effect of acetaminophen, a known drug for enhancing the pain-relieving effect of tramadol, and eutectic mixture of local anesthetics (EMLA), a local anesthetic agent, with that of the conventional periprostatic nerve block method. Materials and Methods This was a prospective, randomized, single-blinded study. A total of 430 patients were randomly ass...

  9. Annular and Cylindrical Phased Array Geometries for Transrectal High-Intensity Focused Ultrasound (HIFU) using PZT and Piezocomposite Materials

    Science.gov (United States)

    Seip, Ralf; Chen, Wohsing; Carlson, Roy; Frizzell, Leon; Warren, Gary; Smith, Nadine; Saleh, Khaldon; Gerber, Gene; Shung, Kirk; Guo, Hongkai; Sanghvi, Narendra T.

    2005-03-01

    This paper presents engineering progress and the latest in-vitro and in-vivo results obtained with a 4.0 MHz, 20 element, PZT annular transrectal HIFU array and several 4.0 MHz, 211 element, PZT and piezocomposite cylindrical transrectal HIFU arrays for the treatment of prostate cancer. The geometries of both arrays were designed and analyzed to steer the HIFU beams to the desired sites in the prostate volume using multi-channel electronic drivers, with the intent to increase treatment efficiency and reliability for the next generation of HIFU systems. The annular array is able to focus in depth from 25 mm to 50 mm, generate total acoustic powers in excess of 60W, and has been integrated into a modified Sonablate®500 HIFU system capable of controlling such an applicator through custom treatment planning and execution software. Both PZT- and piezocomposite cylindrical arrays were constructed and their characteristics were compared for the transrectal applications. These arrays have been installed into appropriate transducer housings, and have undergone characterization tests to determine their total acoustic power output, focusing range (in depth and laterally), focus quality, efficiency, and comparison tests to determine the material and technology of choice (PZT or piezocomposite) for intra-cavity HIFU applications. Array descriptions, characterization results, in-vitro and in-vivo results, and an overview of their intended use through the application software is shown.

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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.

  12. Emphysematous cystitis following a transrectal needle guided biopsy of the prostate

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    Hashimoto Takeshi

    2012-11-01

    Full Text Available Abstract Background Emphysematous cystitis (EC is a comparatively rare urinary tract infection characterized by air within the bladder wall and lumen and is usually associated with immunosuppression or poorly controlled diabetes mellitus. Case presentation We report a case of EC in a 70-year-old man who recently underwent transrectal ultrasound needle-guided prostate biopsy, after which he underwent pylorogastrectomy. He did not have any history of diabetes mellitus or any immunosuppressive disease. The patient developed severe sepsis, requiring intravenous antibiotics and urinary catheterization. Despite therapy, the patient developed disseminated intravascular coagulopathy and acute respiratory distress syndrome. Therefore, he was admitted to the intensive care unit, antibiotic coverage was broadened, and danaparoid sodium and sivelestat sodium hydrate was administered. After 20 days, the patient’s condition improved, and on the 28th day, the patient was discharged to home in a good condition without any sequelae. Conclusion Prompt diagnosis and treatment are warranted to prevent potential morbidity of and mortality in cases of EC.

  13. The Comparison of Two Different Anesthetical Methods in Transrectal Ultrasound Guided Biopsy

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    Kursad Zengin

    2014-03-01

    Full Text Available Aim: We aimed to compare the two groups, topical plus intrarectal local anesthesia and periprostatic nerve blockage in Transrectal ultrasound guided biopsy (TRUS-Biopsy by means of pain perception. Material and Method: Between October 2012 and 2013, 190 patients included in the study with increased prostate specific antigen (PSA levels and/or abnormal digital rectal examination findings whom underwent 12 core TRUS biopsy. Some patients are medicationed with perianal %5 lidocaine firstly, and then with intrarectal 10 cc %2 lidocaine gel (Group 1, other group was medicationed with periprostatic 10cc %2 lidocaine solution with 20 Gauche needle (Group 2. There was 103 patients in Group 1, and 87 patients in Group 2. Results: There was no statistically significant relation between visual analog scale (VAS scores and prostate volume, age, pathology result, Gleason score, and perineural invasion. The mean VAS score was 3,02 (0,3-7,6 in Group 1; and 1.9 (0,3-3,9 in Group 2. When the VAS score was compared between groups, statistically significant difference was found (p=0,01. Discussion: While we used 2 agents topically around anus and intrarectally in Group 1, pain perception was decreased more in the periprostatic blockage group. This showed us puncturing of needle through prostate capsule results in higher pain perception. Because this procedure is mostly done in the outpatient clinics, periprostatic blockage should be the choice of local anesthesia for relieving pain.

  14. 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.

  15. Transrectal ultrasonographic characterization of the accessory sex glands, pelvic urethra, and ureters in normal geldings.

    Science.gov (United States)

    Schnobrich, Maria Raymond; Turner, Regina Orstaglio; Belcher, Carolyn Niles; Slack, JoAnn

    2016-01-15

    Transrectal ultrasound of the internal urogenital tract may be used to aid in the diagnosis of reproductive tract and urinary tract pathology in both stallions and geldings. Abnormalities of the accessory sex glands of geldings are uncommon, although prostatic masses have recently been described in adult geldings presenting with dysuria, stranguria, and/or hematuria. The purpose of this study was to describe the normal ultrasonographic features and sizes of the accessory sex glands, caudal ureters, and pelvic urethra in clinically normal geldings. Eleven healthy geldings with no history of urogenital tract pathology were evaluated by a single observer experienced in ultrasound of the stallion accessory sex glands. The ultrasonographic appearance, relative anatomic relationships and sizes of the accessory sex glands, caudal ureters, and pelvic urethra were investigated using both rectal linear array and microconvex array transducers. Summary statistics including mean, standard error, confidence intervals, and range were calculated for each structure. There were no statistically significant differences in measurements between the left and right sides of paired structures or between measurements obtained with different transducers. Fluid was present in the seminal vesicles of 7 of 9 subjects. Midline cysts of the urethra as well as bulbourethral gland and prostatic cysts were identified. The normal reference ranges defined in this study will be useful in the clinical evaluation of geldings with suspected internal urogenital tract pathology. PMID:26483314

  16. Effects of induced endometritis on uterine blood flow in cows as evaluated by transrectal Doppler sonography.

    Science.gov (United States)

    Debertolis, Letizia; Mari, Gaetano; Merlo, Barbara; Merbach, Sabine; Schoon, Heinz-Adolf; Iacono, Eleonora; Bollwein, Heinrich

    2016-06-30

    This study was conducted to evaluate the effects of induced endometritis on uterine blood flow in cows. Transrectal Doppler sonography was performed on uterine arteries of six cyclic cows before and for 4 days after inducing acute endometritis by intrauterine infusion of 720 mg of policresulen, and for 4 days of the following estrous cycle. Time-averaged maximum velocity (TAMV) increased (p 0.05) in the next 4 days of the same cycle. TAMV and PI values in the subsequent cycle did not differ (p > 0.05) from the values measured before infusion and showed no changes (p > 0.05) within the cycle. Blood flow parameters were not related (p > 0.05) to plasma concentrations of progesterone and estrogen. All cows showed an acute endometritis determined by histopathological findings of biopsy samples taken 1 day after infusion and fibrotic endometrial alterations detected in the subsequent cycle. No relationships were observed between fibrotic changes of the endometrium and uterine blood flow during either cycle. In conclusion, acute inflammation is accompanied by a rise in uterine blood flow, but fibrotic alterations do not seem to be related to Doppler sonographic findings. PMID:26645345

  17. Effects of induced endometritis on uterine blood flow in cows as evaluated by transrectal Doppler sonography

    Science.gov (United States)

    Debertolis, Letizia; Mari, Gaetano; Merbach, Sabine; Schoon, Heinz-Adolf; Iacono, Eleonora; Bollwein, Heinrich

    2016-01-01

    This study was conducted to evaluate the effects of induced endometritis on uterine blood flow in cows. Transrectal Doppler sonography was performed on uterine arteries of six cyclic cows before and for 4 days after inducing acute endometritis by intrauterine infusion of 720 mg of policresulen, and for 4 days of the following estrous cycle. Time-averaged maximum velocity (TAMV) increased (p 0.05) in the next 4 days of the same cycle. TAMV and PI values in the subsequent cycle did not differ (p > 0.05) from the values measured before infusion and showed no changes (p > 0.05) within the cycle. Blood flow parameters were not related (p > 0.05) to plasma concentrations of progesterone and estrogen. All cows showed an acute endometritis determined by histopathological findings of biopsy samples taken 1 day after infusion and fibrotic endometrial alterations detected in the subsequent cycle. No relationships were observed between fibrotic changes of the endometrium and uterine blood flow during either cycle. In conclusion, acute inflammation is accompanied by a rise in uterine blood flow, but fibrotic alterations do not seem to be related to Doppler sonographic findings. PMID:26645345

  18. 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

  19. 3D transrectal ultrasound prostate biopsy using a mechanical imaging and needle-guidance system

    Science.gov (United States)

    Bax, Jeffrey; Cool, Derek; Gardi, Lori; Montreuil, Jacques; Gil, Elena; Bluvol, Jeremy; Knight, Kerry; Smith, David; Romagnoli, Cesare; Fenster, Aaron

    2008-03-01

    Prostate biopsy procedures are generally limited to 2D transrectal ultrasound (TRUS) imaging for biopsy needle guidance. This limitation results in needle position ambiguity and an insufficient record of biopsy core locations in cases of prostate re-biopsy. We have developed a multi-jointed mechanical device that supports a commercially available TRUS probe with an integrated needle guide for precision prostate biopsy. The device is fixed at the base, allowing the joints to be manually manipulated while fully supporting its weight throughout its full range of motion. Means are provided to track the needle trajectory and display this trajectory on a corresponding TRUS image. This allows the physician to aim the needle-guide at predefined targets within the prostate, providing true 3D navigation. The tracker has been designed for use with several end-fired transducers that can be rotated about the longitudinal axis of the probe to generate 3D images. The tracker reduces the variability associated with conventional hand-held probes, while preserving user familiarity and procedural workflow. In a prostate phantom, biopsy needles were guided to within 2 mm of their targets, and the 3D location of the biopsy core was accurate to within 3 mm. The 3D navigation system is validated in the presence of prostate motion in a preliminary patient study.

  20. 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.

  1. BIOPSIAS LUTEAIS EM VACAS NELORE

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    Ian Martin

    2010-10-01

    Full Text Available The present study describes a technique to obtain consecutiveluteal samples by colpotomy. The animals received an epidural anesthesia and local anesthesia (vaginal vault and after ten minutes the vaginal vault was incised with a scalpel blade and tissue was dissected to provide access to the pelvic cavity and to retract the ovary into the vagina. Then, a luteal biopsy was performed with a Yomann biopsy nipper. Signs indicative of pain and stress during the vaginal vault incision, traction of ovary or luteal biopsy were observed only in two collections. However, these signs were observed in ten collections during dissection of the vaginal wall and peritoneum. The occurrence of ataxia was observed in 26 collections and it was usually related to a longer duration of the procedure. Ataxia could be divided in light (15/26, moderate (6/26 and severe (5/26. The occurrence of ovarian adhesions ipsilateral to the incision was evaluated only in the initial four collections. Adhesions were present in 16 collections. The protocol described above provided a safe and efficient method to acquire luteal samples. The low incidence of adhesions allows the consecutive use of females without any interference in subsequent ovulations and collections.

  2. Transrectal ultrasound and magnetic resonance imaging measurement of extramural tumor spread in rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Sφren R Rafaelsen; Chris Vagn-Hansen; Torben Sφrensen; John Plφen; Anders Jakobsen

    2012-01-01

    AIM:To evaluate the agreement between transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) in classification of ≥ T3 rectal tumors.METHODS:From January 2010 to January 2012,86consecutive patients with ≥ T3 tumors were included in this study.The mean age of the patients was 66.4years (range:26-91 years).The tumors were all ≥T3 on TRUS.The sub-classification was defined by the penetration of the rectal wall:a:0 to 1 mm; b:1-5 mm; c:6-15; d:> 15 mm.Early tumors as ab (≤ 5 mm) and advanced tumors as cd (> 5 mm).All patients underwent TRUS using a 6.5 MHz transrectal transducer.The MRI was performed with a 1.5 T Philips unit.The TRUS findings were blinded to the radiologist performing the interpretation of the MRI images and measuring the depth of extramural tumor spread.RESULTS:TRUS found 51 patients to have an early ≥T3 tumors and 35 to have an advanced tumor,whereas MRI categorized 48 as early ≥ T3 tumors and 38 as advanced tumors.No patients with tumors classified as advanced by TRUS were found to be early on MRI.The kappa value in classifying early versus advanced T3 rectal tumors was 0.93 (95% CI:0.85-1.00).We found a kappa value of 0.74 (95% CI:0.63-0.86) for the total sub-classification between the two methods.The mean maximal tumor outgrowth measured by TRUS,5.5 mm ± 5.63 mm and on MRI,6.3 mm ± 6.18 mm,P =0.004.In 19 of the 86 patients the following CT scan or surgery revealed distant metastases; of the 51 patients in the ultrasound ab group three (5.9%)had metastases,whereas 16 (45.7%) of 35 in the cd group harbored distant metastases,P =0.00002.The odds ratio of having distant metastases in the ultrasound cd group compared to the ab group was 13.5(95% CI:3.5-51.6),P =0.00002.The mean maximal ultrasound measured outgrowth was 4.3 mm (95% CI:3.2-5.5 mm) in patients without distant metastases,while the mean maximal outgrowth was 9.5 mm (95%CI:6.2-12.8 mm) in the patients with metastases,P =0.00004.Using the MRI

  3. NOTE: Prostate cancer multi-feature analysis using trans-rectal ultrasound images

    Science.gov (United States)

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

    2005-08-01

    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.

  4. The results of transperineal versus transrectal prostate biopsy: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Peng-Fei Shen; Yu-Chun Zhu; Wu-Ran Wei; Yong-Zhong Li; Jie Yang; Yu-Tao Li; Ding-Ming Li; Jia Wang; Hao Zeng

    2012-01-01

    This systematic review was performed to compare the efficacy and complications of transperineal (TP) vs.transrectal (TR) prostate biopsy.A systematic research of PUBMED,EMBASE and the Cochrane Library was performed to identify all clinical controlled trials on prostate cancer (PCa) detection rate and complications achieved by TP and TR biopsies.Prostate biopsies included sextant,extensive and saturation biopsy procedures.All patients were assigned to a TR group and a TP group.Subgroup analysis was performed according to prostate-specific antigen (PSA) levels and digital rectal examination (DRE) findings.The Cochrane Collaboration's RevMan 5.1 software was used for the meta-analysis.A total of seven trials,including three randomized controlled trials (RCTs) and four case- control studies (CCS),met our inclusion criteria.There was no significant difference in the cancer detection rate between the sextant TR and TP groups (risk difference (RD),-0.02; 95% confidence interval (Cl),-0.08-0.03; P=0.34).Meta-analysis for RCTs combined with CCS showed that there was no difference in the cancer detection rate between the extensive TR and TP group (RD,-0.01; 95% CI,-0.05-0.04; P=0.81).There was no significant difference in PCa detection rate between the saturation TR and TP approaches (31.4% vs.25.7%,respectively; P=0.3).There were also no significant differences in cancer detection between the TR and TP groups in each subgroup.Although the data on complications were not pooled for the meta-analysis,no significant difference was found when comparing TR and TP studies.TR and TP biopsies were equivalent in terms of efficiency and related complications.TP prostate biopsy should be an available and alternative procedure for use by urologists.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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 

  7. Tolerance of local anesthetic for transrectal ultrasound-guided prostate biopsy: our experience and a literature review

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, M.R.E.; Bryant, N.J.; Brown, J.A.; Tiwari, P.; Cooperberg, P.L.; Wong, A.D. [St Paul' s Hospital, Ultrasound Dept., Vancouver, British Columbia (Canada)]. E-mail: twong@providcencehealth.bc.ca

    2006-06-15

    To determine whether local anesthetic injection or gel reduced pain during transrectal ultrasound-guided prostate biopsies and whether there was significant difference between quadrant and apex-only anesthesia. Between September 2001 and May 2002, 240 male patients with elevated prostate-specific antigen and (or) abnormal digital rectal examination were randomized into 1 of 4 groups: 1) transrectal lidocaine gel, 2) quadrant lidocaine injections, 3) apex-only lidocaine injections, or 4) no local anesthetic. Patients scored their pain on a numerical rating scale where 0 indicated no pain and 10 indicated worst pain. We analyzed mean and standard deviations of scores, using a 1-way analysis of variance (ANOVA) and post hoc multiple comparisons with Tukey's honestly significant difference (HSD) studentized range test to determine whether there were significant differences across the groups. There was no significant difference between local anesthetic gel (mean 3.1, SD 1.9) and no anesthetic (mean 3.5, SD 1.9) or between quadrant (mean 1.7, SD 1.7) and apex-only (mean 2.0, SD 1.8) local anesthetic injections. There was significant difference between quadrant injections (mean 1.7, SD 1.7) and no local anesthetic (mean 3.5, SD 1.9) and between apex-only injections (mean 2.0, SD 1.8) and no local anesthetic (mean 3.5, SD 1.9). There was significant pain reduction with local anesthetic injections but not with gel, and since there was no significant difference in efficacy between quadrant and apex-only injections, we recommend apex-only local anesthetic injections for transrectal ultrasound-guided prostate biopsies because it simplifies the injection procedure. (author)

  8. A new technique for performing Syed-Neblett template interstitial implants for gynecologic malignancies using transrectal-ultrasound guidance

    International Nuclear Information System (INIS)

    Purpose: Interstitial brachytherapy plays an important role in the treatment of advanced and recurrent gynecologic malignancies. Unfortunately, the inability to visualize the tumor and surrounding normal structures during the implant has hampered the accuracy and safety of the implant. Transrectal ultrasound guided Syed-Neblett template implantation is a new technique for performing interstitial implants under direct visualization. The details of the technique are presented to demonstrate the ability to accurately guide needle placement into tumor and avoid needle insertion into critical surrounding normal structures. Methods and Materials: The transrectal ultrasound is positioned so that it can visualize the tumor, and normal surrounding structures in both transverse and longitudinal planes. The Syed-Neblett template is positioned and sutured into the perineum. Needles are inserted into the target area under direct visualization through transverse imaging. The bladder and rectum can be directly imaged and thus avoided. Longitudinal imaging is then used to guide the needles to the appropriate depth. In addition, it can be used to assess the length of the target volume and aid in determining the active length of the sources. Results: A total of 12 procedures have been performed on seven patients from August 30, 1995 to April 12, 1996. The presenting diseases included: Stage IIIb cervical cancer in four cases, recurrent endometrial cancer in two cases, and Stage III vaginal cancer in one case. The total length of time for implantation of the needles ranged from 45 to 165 min (median--130 min). Conclusion: Transrectal ultrasound guidance provides real-time visualization of the target volume and normal tissues during interstitial implantation of gynecologic malignancies and allows for accurate needle placement

  9. Transrectal ultrasound-integrated spectral optical tomography of hypoxic progression of a regressing tumor in a canine prostate.

    Science.gov (United States)

    Jiang, Z; Piao, D; Bartels, K E; Holyoak, G R; Ritchey, J W; Ownby, C L; Rock, K; Slobodov, G

    2011-12-01

    The objective of this study was to evaluate if transrectal optical tomography implemented at three wavelength bands for spectral detection could monitor changes of the hemoglobin oxygen saturation (StO2) in addition to those of the total hemoglobin concentration ([HbT]) in lesions of a canine prostate, including an induced tumor modeling canine prostate cancer. Near-infrared (NIR) optical tomography was integrated with ultrasound (US) for transrectal imaging. Multi-spectral detection at 705_nm, 785_nm and 808_nm rendered measurements of [HbT] and StO2. Canine transmissible venereal tumor (TVT) cells were injected into the right lobe of a dog's prostate gland, which had a pre-existing cyst in the left lobe. Longitudinal assessments of the prostate were performed weekly over a 63-day duration by NIR imaging concurrent with grey-scale and Doppler US. Ultrasonography revealed a bi-lobular tumor-mass regressing from day-49 to day-63. At day-49 this tumor-mass developed a hypoxic core that became larger and more intense by day-56 and expanded further by day-63. The tumor-mass presented a strong hyper-[HbT] feature on day-56 that was inconsistent with US-visualized blood flow. Histology confirmed two necrotic TVT foci within this tumor-mass. The cyst appeared to have a large anoxic-like interior that was greater in size than its ultrasonographically delineated lesion, and a weak lesional elevation of [HbT]. On day-56, the cyst presented a strong hyper-[HbT] feature consistent with US-resolved blood flow. Histology revealed acute and chronic hemorrhage in the periphery of the cyst. The NIR imaging features of two other TVT nodules and a metastatic lymph node were evaluated retrospectively. Transrectal US-integrated spectral optical tomography seems to enable longitudinal monitoring of intra-lesional oxygenation dynamics in addition to the hemoglobin content of lesions in the canine prostate.

  10. Nomogram using transrectal ultrasound-derived information predicting the detection of high grade prostate cancer on initial biopsy

    OpenAIRE

    Jeong, In Gab; Lim, Ju Hyun; Hwang, Seung-Sik; Kim, Sung Cheol; You, Dalsan; Hong, Jun Hyuk; Ahn, Hanjong; Kim, Choung-Soo

    2013-01-01

    Purpose: To develop a nomogram using transrectal ultrasound (TRUS)-derived information for predicting high grade (HG) prostate cancer (PCa) on initial biopsy. Methods: Data were collected on 1,048 men with serum prostate-specific antigen (PSA) levels 4.0 to 9.9 ng/mL who underwent an initial prostate biopsy. Two logistic regression-based nomograms were constructed to predict the detection of PCa. Nomogram-1 incorporated age, digital rectal examination, PSA and percent free PSA data, whereas n...

  11. Correlation of transrectal ultrasonographic findings of the prostate with the occurrence of detrusor instability in patients with benign prostatic hyperplasia.

    Science.gov (United States)

    Tong, Y C; Lin, Y M; Yang, W H; Tzai, T S; Lin, J S

    1995-01-01

    Forty patients with benign prostatic hyperplasia were evaluated with urodynamics and transrectal ultrasonography. Seventeen patients were found to have detrusor instability while the remaining 23 did not. No significant differences were noted during ultrasonography in the estimated prostatic volume, the presumed circle area ratio and the incidence of finding prostatic calcification between these two groups. However, the incidence of detecting intravesical protrusion of the prostate is significantly higher in patients with instability than in patients with stable bladder (53 vs. 13%, p prostate and alter the stability status of the urinary bladder.

  12. Transrectal ultrasonography-guided transperineal bilateral seminal vesicle puncture and continuous irrigation for the treatment of intractable hematospermia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-ru; GU Bao-jun; XU Yue-min; CHEN Rong; ZHANG Jiong; QIAO Yong

    2008-01-01

    @@ Hematospermia is a rare condition, but often causes frustration. The reason for this frustration is that the exact incidence of hematospermia remains unknown and its cause is difficult to determine.1 Many reports in the past decades have focused on the etiology of hematospermia.2 Hematospermia is treated initially by administration of antibiotics, coagulants, and sex steroid hormones. However, some cases may prove resistant to this therapy and the condition may continue. For some intractable and agnogenic cases, the therapeutic strategy mentioned above is not very effective. Recently, we treated 63 such nonresponsive patients by direct continuous antibiotic irrigation into the bilateral seminal vesicles through puncture under transrectal ultrasonography (TRUS) guidance.

  13. Three-axis MR-conditional robot for high-intensity focused ultrasound for treating prostate diseases transrectally

    OpenAIRE

    Yiallouras, Christos; Ioannides, Kleanthis; Dadakova, Tetiana; Pavlina, Matt; Bock, Michael; Damianou, Christakis

    2015-01-01

    Background A prototype magnetic resonance image (MRI)-conditional robot was developed for navigating a high-intensity focused ultrasound (HIFU) system in order to treat prostate cancer transrectally. Materials and methods The developed robotic device utilizes three PC-controlled axes: a linear axis for motion along the rectum, an angular axis for rotation in the rectum, and a linear axis to lift the robot up and down. Experiments with the system were performed in a 1.5-T MRI system using gel ...

  14. Valor preditivo positivo da ecografia prostática transrectal na detecção de carcinoma da próstata

    OpenAIRE

    Rosado, E.; João, P; Penha, D; Paixão, P; Pinto, E.,; Ferreira, S.

    2012-01-01

    INTRODUÇÃO: As lesões prostáticas identificadas por ecografia prostática trans-rectal (EPTR) são muitas vezes inespecificas, podendo corresponder a lesões neoplasicas ou a nódulos prostáticos benignos, sendo indispensável um diagnóstico anátomo-patológico. OBJECTIVO: Determinar o valor preditivo positivo (VPP) da ecografia prostática transrectal no diagnóstico de carcinoma da prostata. MATERIAL E MÉTODOS: Entre 2008 e 2011 registaram-se todos os casos de lesões suspeitas de carcinoma ...

  15. 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.)

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience

    Directory of Open Access Journals (Sweden)

    Jigish B Vyas

    2013-01-01

    Full Text Available Objectives: The safety and efficacy of transrectal ultrasound (TRUS guided aspiration of prostatic abscess (PA is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. Materials and Methods: After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS. Success was defined as complete resolution of the abscess and/or symptoms. Results: Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79 years. The DRE diagnosed PA in 22 (45.83% patients, while abdominal sonography diagnosed PA in 13 (27.08% patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100% patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8 cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml. Complete resolution after first aspiration was observed in 20 (41.66% patients. An average of 4.1 (range 1-7 aspirations was required for complete resolution which was seen in 41 patients (85.42%. Seven (14.58% patients required transurethral resection (deroofing of the abscess cavity. We formulated a treatment algorithm based on the above findings. Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are

  18. [Improvement of transrectal ultrasound. Artificial neural network analysis (ANNA) in detection and staging of prostatic carcinoma].

    Science.gov (United States)

    Loch, T; Leuschner, I; Genberg, C; Weichert-Jacobsen, K; Küppers, F; Retz, M; Lehmann, J; Yfantis, E; Evans, M; Tsarev, V; Stöckle, M

    2000-07-01

    As a result of the enhanced clinical application of prostate specific antigen (PSA), an increasing number of men are becoming candidates for prostate cancer work-up. A high PSA value over 20 ng/ml is a good indicator of the presence of prostate cancer, but within the range of 4-10 ng/ml, it is rather unreliable. Even more alarming is the fact that prostate cancer has been found in 12-37% of patients with a "normal" PSA value of under 4 ng/ml (Hybritech). While PSA is capable of indicating a statistical risk of prostate cancer in a defined patient population, it is not able to localize cancer within the prostate gland or guide a biopsy needle to a suspicious area. This necessitates an additional effective diagnostic technique that is able to localize or rule out a malignant growth within the prostate. The methods available for the detection of these prostate cancers are digital rectal examination (DRE) and Transrectal ultrasound (TRUS). DRE is not suitable for early detection, as about 70% of the palpable malignancies have already spread beyond the prostate. The classic problem of visual interpretation of TRUS images is that hypoechoic areas suspicious for cancer may be either normal or cancerous histologically. Moreover, about 25% of all cancers have been found to be isoechoic and therefore not distinguishable from normal-appearing areas. None of the current biopsy or imaging techniques are able to cope with this dilemma. Artificial neural networks (ANN) are complex nonlinear computational models, designed much like the neuronal organization of a brain. These networks are able to model complicated biologic relationships without making assumptions based on conventional statistical distributions. Applications in Medicine and Urology have been promising. One example of such an application will be discussed in detail: A new method of Artificial Neural Network Analysis (ANNA) was employed in an attempt to obtain existing subvisual information, other than the gray scale

  19. Treatment of anastomotic leakage after rectal resection with transrectal vacuum-assisted drainage (VAC). A method for rapid control of pelvic sepsis and healing

    DEFF Research Database (Denmark)

    Nagell, Carl Frederik Otto; Holte, Kathrine

    2006-01-01

    OBJECTIVE: Anastomotic leakage after rectal resection is associated with high morbidity and mortality. Patients without peritonitis can be treated conservatively by transrectal rinsing and drainage. However, healing is often very slow, and formation of abundant scar tissue resulting in a poor fun...

  20. COMPLEX TRANSRECTAL US WITH COLOR FLOW MAPPING, DOPPLER SONOGRAPHY AND SONOELASTOGRAFIEY IN PROSTATE CANCER EVALUATION

    Directory of Open Access Journals (Sweden)

    А. I. Mukhomor

    2014-07-01

    Full Text Available Oncology statistics shows steady increase of prostate cancer, since early diagnosis and adequate treatment are crucial. Among prostate imaging modalities sonoelastography (SEG has a special value for identifying suspicious dense foci in prostate, however more studies are still required to establishing accuracy and specificity with different SEG techniques for updating the prostate cancer diagnostics protocol.The aim of study was to evaluate sonoelastography capabilities for ultrasound guided prostate biopsy, comparing with gray scale and Doppler modalities.512 consecutively selected patients were examined (mean age of 56 years, mean prostate volume was 54 cm3, the average PSA about 14.3 ng/ml. All patients underwent prostate cancer diagnostic algorithm, including direct rectal exam, PSA level, transrectal ultrasound (TRUS with Doppler and SEG identification of suspicious foci, mostly in peripheral zones, followed by 10-point biopsy guided by ultrasound. According to aim we assigned patients to 4 groups: group 1 (n = 327 underwent gray scale and Doppler US guided prostate biopsy; in patients of group 2 (n = 106 – additionally SEG was applied (3 patients of this group was also performed MRI and MRS of the prostate; in group 3 there were patients with high level of PSA and negative TRUS guided biopsy; group 4 – of 41 patiens with prostatectomy and biochemical recidive of prostate.Among 430 cases included to this study in 318 patients (74 % prostate adenocarcinoma was revealed, in 270 (63 % patients – benign hyperplasia (BH. In group 1 cancer was diagnosed in 236 (72.1 ± 2.4 % patients, in group 2 – in 84 (79.2 ± 3.8 %. 19 false negative and 6 false positive results were registered in SEG enchanced US guided prostate biopsy. Routine TRUS indicate lesions with mean sizes about 0.8 ± 0,21 sm in compare with 0,5 ± 0,08 sm which were diagnose by SEG. Locuses which were marked as benign byTRUS with SEG hade never conatained neoplastic cells

  1. 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...

  2. Abdominal masses in the pediatric age. Characterization by CT guided fine needle aspiration biopsy; Masse addominali nell'eta' pediatrica. Caratterizzazione mediante biopsia computerizzata con ago sottile guidata con Tomografia Computerizzata

    Energy Technology Data Exchange (ETDEWEB)

    Marano, I.; Soscia, E.; Salvatore, M. [Naples Univ. Federico 2. (Italy). Dipt. di Scienze Biomorfologiche e Fuzionali, Cattedra di Radiologia

    1999-04-01

    CT-guided fine needle aspiration biopsy (FNAB) is known to improve diagnosis of expansive abdominal lesions, especially relative to more invasive procedure like explorative laparotomy. FNAB in not commonly use in pediatric patients because of their poor collaboration and of associated risks. The authors investigated the feasibility of FNAB in the pediatric age. [Italian] Sono noti i vantaggi che la biopsia percutanea con ago sottile guidato con TC puo' apportare per la diagnosi delle lesioni espansive addominali, soprattutto se confrontata con procedure piu' invasive come la laparatomia esplorativa. Questo tipo di metodica e' attalmente poco utilizzato nel caso di pazienti pediatrici a causa della scarsa collaborazione e dei rischi associati. Gli autori valutano l'applicabilita' di tale procedura nell'eta' pediatrica alla luce delle propria esperienza.

  3. [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. PMID:16708596

  4. Comparison of Pudendal Nerve Blockade, Tenoxicam Suppository and Rectal Lidocaine Gel Anesthesia for Transrectal Ultrasound-Guided Biopsy of the Prostate

    OpenAIRE

    Güzel, Cüneyt Özden; Bulut, Süleyman; Aktaş, Binhan Kağan; PALA, Yaşar; Memiş, Ali

    2009-01-01

    Aim: We assessed the safety and efficacy of three different local anesthesia methods (pudendal nerve blockade, tenoxicam suppository and rectal lidocaine gel) before transrectal ultrasound (TRUS)-guided biopsy of the prostate in this study. Materials and Methods: In our prospective and controlled study, 136 consecutive patients were randomized into four groups: men in group 1 (n=41) received no anesthesia, group 2 (n=30) received intrarectal 10 cc 2% lidocaine gel 10 mins before biopsy, g...

  5. Manual transrectal palpations performed by veterinary students in cows: a Surrey - Palpaciones transrectales realizadas por estudiantes de veterinaria en las vacas: una encuesta

    Directory of Open Access Journals (Sweden)

    João Simões

    2012-03-01

    Full Text Available AbstractVeterinary education of novice veterinary students in bovine reproduction field, like rectum palpation training, represent some handicaps mainly related with animal welfare.ResumenLa educación veterinaria de estudiantes de veterinaria en el campo de la reproducción bovina, en el caso del entrenamiento mediante la palpación transrectal, tiene algunas desventajas, principalmente relacionadas con el bienestar animal.

  6. 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

    Directory of Open Access Journals (Sweden)

    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

  7. Comparison of diffusion weighted imaging and transrectal ultrasound-guided biopsy in predicting aggressiveness of prostate cancer

    International Nuclear Information System (INIS)

    Objective: To retrospectively evaluate the utility of apparent diffusion coefficient (ADC) values in predicting aggressiveness of prostate cancer. Comparison was made with transrectal ultrasound-guided biopsy Gleason scores (GS) and prostatectomy GS. Methods: Diffusion weighted images of 51 patients with biopsy-proven prostate cancer were obtained using 1.5 T MR with a pelvic phased-array coil. Regions of interest (ROIs) were drawn on areas of the suspicious lesion and the ADC values were calculated. The correlations between the ADC values and prostatectomy GS were assessed with Pearson correlation. The relationship between biopsy GS and prostatectomy GS were also evaluated. Meanwhile, receiver operating characteristic (ROC) curves were used to determine the ability of ADC values and biopsy GS in differentiating low-grade prostate cancer from intermediate/high grade prostate cancer. Results: The accuracy of transrectal ultrasound-guided biopsy in predicting prostatectomy GS was 41.2%(21/51). Compared with prostatectomy GS, up to 11.8% of the patients (n=6) was overestimated by biopsy, while 47.0% (n=24) were underestimated. These 51 patients had a mean ADC value of (0.974 ±0.194) × 10-3 mm2/s. The mean ADC value of intermediate/high-grade tumors (n=35) was (0.907 ±0.160) ×10-3 mm2/s while that of low-grade tumors was (1.121 ±0.185) × 10-3 mm2/s (n=16). A significant negative correlation was found between mean ADC values of suspicious lesions and their prostatectomy GS (r=-0.761, P <0.01). No significant correlation was found between biopsy GS and prostatectomy GS (r=0.187, P=0.189). The area under the ROC curves of ADC and biopsy GS was 0.827 and 0.689, respectively. Conclusion: The ADC values of cancerous areas in prostate perform better than biopsy GS in predicting aggressiveness of prostate cancer. (authors)

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Bravo Luis Eduardo

    2011-08-01

    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 m��todos 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.

  10. 3D non-rigid registration using surface and local salient features for transrectal ultrasound image-guided prostate biopsy

    Science.gov (United States)

    Yang, Xiaofeng; Akbari, Hamed; Halig, Luma; Fei, Baowei

    2011-03-01

    We present a 3D non-rigid registration algorithm for the potential use in combining PET/CT and transrectal ultrasound (TRUS) images for targeted prostate biopsy. Our registration is a hybrid approach that simultaneously optimizes the similarities from point-based registration and volume matching methods. The 3D registration is obtained by minimizing the distances of corresponding points at the surface and within the prostate and by maximizing the overlap ratio of the bladder neck on both images. The hybrid approach not only capture deformation at the prostate surface and internal landmarks but also the deformation at the bladder neck regions. The registration uses a soft assignment and deterministic annealing process. The correspondences are iteratively established in a fuzzy-to-deterministic approach. B-splines are used to generate a smooth non-rigid spatial transformation. In this study, we tested our registration with pre- and postbiopsy TRUS images of the same patients. Registration accuracy is evaluated using manual defined anatomic landmarks, i.e. calcification. The root-mean-squared (RMS) of the difference image between the reference and floating images was decreased by 62.6+/-9.1% after registration. The mean target registration error (TRE) was 0.88+/-0.16 mm, i.e. less than 3 voxels with a voxel size of 0.38×0.38×0.38 mm3 for all five patients. The experimental results demonstrate the robustness and accuracy of the 3D non-rigid registration algorithm.

  11. Intrarectal ice application prior to transrectal prostate biopsy: a prospective randomised trial accessing pain and collateral effects

    Directory of Open Access Journals (Sweden)

    Baris Çaliskan

    2015-02-01

    Full Text Available Objectives To analyze the efficacy of intrarectal ice application as an anesthetic method prior to transrectal ultrasound (TRUS guided prostate biopsy. Materials and Methods A total of 120 consecutive men were included into the study prospectively. Patients were equally randomized as group 1 and 2 with 60 patients each. Ice was applied as an anesthetic method 5 minutes before procedure to the patients in group 1. Patients in group 2 were applied 10 ml of 2% lidocaine gel 10 minutes before procedure. Twelve core biopsy procedure was performed for all patients. The pain level was evaluated using a visual analogue scale (VAS. Results Median pain score was 3.5 (1-8 in group 1 and 5 (1-8 in group 2. There is significantly difference between groups regarding the mean sense of pain level during the procedure. (p=0.007 There was also no difference in complications between two groups about presence and duration of macroscopic hematuria and rectal bleeding. Conclusions Intrarectal ice application prior to TRUS prostate biopsy has an effect on reducing pain. Development of new techniques about cold effect or ice can make this method more useful and decrease complication rates.

  12. Transjugular liver biopsy: histological diagnosis success comparing the trucut to the modified aspiration Ross needle Biopsia hepática transjugular: comparação do sucesso diagnóstico histológico entre as agulhas trucut e a aspirativa modificada de Ross

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Maciel

    2003-06-01

    Full Text Available BACKGROUND: Transjugular liver biopsy is an alternative procedure for patients who present contraindications to standard percutaneous procedure. AIM: To compare the rate of histological diagnosis obtained on transjugular liver biopsy with an automated trucut needle and with a modified Ross needle. PATIENTS / METHOD: Eighty-five patients with suspicion of chronic liver diseases and presenting contraindications for percutaneous liver biopsy (coagulopathy, massive ascites, morbid obesity, or chronic renal problems were submitted to 89 transjugular liver biopsies between March 1994 and April 2001 at ''Hospital São José, Irmandade da Santa Casa de Misercórdia'', Porto Alegre, RS, Brazil. Thirty-five patients underwent 36 biopsies with an automated trucut needle, and 50 patients underwent 53 biopsies with a modified Ross needle. RESULTS: Histological diagnosis was reached in 32/35 subjects submitted to transjugular liver biopsy with the trucut needle (91% and in 35/50 (70% submitted to biopsy with the modified Ross needle. Specimens obtained with the trucut needle were significantly larger and less fragmented than those obtained with the Ross needle. CONCLUSION: Transjugular liver biopsy with the automated trucut needle allowed a higher rate of histological diagnosis when compared to the modified Ross needle in patients with suspicion of chronic liver diseases.RACIONAL: A biopsia hepática transjugular é um procedimento alternativo para pacientes que apresentam contra-indicações ao procedimento padrão (percutâneo. OBJETIVO: Comparar o índice de diagnóstico obtido por meio da biopsia hepática transjugular utilizando uma agulha automatizada trucut e uma agulha Ross modificada. MÉTODOS: Oitenta e cinco pacientes com suspeita de doenças hepáticas crônicas e apresentando contra-indicações para biopsia hepática percutânea (coagulopatia, ascite maciça, obesidade mórbida ou problemas renais crônicos foram submetidos a 89 biopsias hep

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. Oral antibiotics in trans-rectal prostate biopsy and its efficacy to reduce infectious complications: Systematic review

    Directory of Open Access Journals (Sweden)

    Mohand Deeb Yaghi

    2015-01-01

    Full Text Available For the diagnosis of prostate cancer trans-rectal prostate biopsy (TRPB is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx decrease infective events after TRPB, but different regimens are used. To systematically review different regimens of prophylactic oral ABx in TRPB. MEDLINE, EMBASE, clinical trials site, and Cochrane library were searched, experts were consulted for relevant studies. Randomized clinical trials conducted in the last 20 years, which investigated the different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Primary outcomes were bacteriuria, urinary tract infection (UTI, fever, bacteremia, and sepsis. Secondary outcomes were the hospitalization rate and the prevalence of ABx-resistant bacteria. Nine trials were eligible with 3012 patients. ABx prevented bacteriuria (3.5% vs. 9.88%, UTI (4.46% vs. 9.75%, and hospitalization (0.21% vs. 2.13% significantly in comparison with placebo or no treatment. No significant difference was found in all the outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple doses except in bacteriuria (6.75% vs. 3.25%, and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%. Quinolones reduced only UTI significantly in comparison with other ABx (chloramphenicol, trimethoprim-sulfamethoxazol. It is essential to prescribe prophylactic ABx in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria were identified more often in the single dose cohorts.

  16. Association between Seminal Vesicle Invasion and Prostate Cancer Detection Location after Transrectal Systemic Biopsy among Men Who Underwent Radical Prostatectomy.

    Directory of Open Access Journals (Sweden)

    Young Ik Lee

    Full Text Available Our hypothesis is that the location of the seminal vesicles near the base of the prostate, the more positive cores are detected in the base, the greater the risk of seminal vesicle invasion. Therefore we investigate the clinical outcomes of base dominant prostate cancer (BDPC in transrectal ultrasound (TRUS -guided biopsies compared with anteromiddle dominant prostate cancer (AMPC.From November 2003 to June 2014, a total of 990 intermediate and high risk prostate cancer (PCa patients who underwent radical prostatectomy (RP were enrolled and stratified into two groups according to proportion of positive cores-BDPC group had ≥ 33.3% ratio of positive cores from the prostate base among all positive cores and AMPC group < 33.3% in systemic biopsy. Between two groups, we compared the rate of pathologic outcomes and biochemical recurrence (BCR. We performed multivariate logistic regression model to confirm the significance of BDPC to seminal vesicle invasion (SVI and Cox proportional hazard analysis to BCR.Among these 990 PCa patients, the 487 patients in BDPC group had more advanced clinical stage (p<0.001, a higher biopsy GS (p = 0.002, and a higher rate of extracapsular extension (ECE, SVI and BCR (all p<0.001 than AMPC group. The patients in BDPC group had poor BCR free survival rate via Kaplan-meier analysis (p<0.001. The ratio of the base positive cores was a significant predictor to SVI in multivariate analysis (p < 0.001 and significant predictor of BCR in multivariate Cox proportional analysis (hazard ratio: 1.466, p = 0.004.BDPC in TRUS-guided prostate biopsies was significantly associated with SVI and BCR after adjusting for other clinical factors. Therefore, BDPC should be considered to be a more aggressive tumor despite an otherwise similar cancer profile.

  17. Prostate cancer transrectal HIFU ablation: detection of local recurrences using T2-weighted and dynamic contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, Olivier; Lyonnet, Denis [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France); Universite de Lyon, Lyon (France); Universite de Lyon 1, Faculte de medecine Lyon Nord, Lyon (France); Inserm, U556, Lyon (France); Girouin, Nicolas; Glas, Ludivine; Ben Cheikh, Alexandre [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France); Universite de Lyon, Lyon (France); Universite de Lyon 1, Faculte de medecine Lyon Nord, Lyon (France); Gelet, Albert [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France); Inserm, U556, Lyon (France); Mege-Lechevallier, Florence [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Pathology, Lyon (France); Rabilloud, Muriel [Hospices Civils de Lyon, Department of Biostatistics, Lyon (France); Universite de Lyon 1, UMR CNRS, Laboratoire Biostatistiques-Sante, Pierre-Benite (France); Chapelon, Jean-Yves [Inserm, U556, Lyon (France)

    2010-01-15

    The objective was to evaluate T2-weighted (T2w) and dynamic contrast-enhanced (DCE) MRI in detecting local cancer recurrences after prostate high-intensity focused ultrasound (HIFU) ablation. Fifty-nine patients with biochemical recurrence after prostate HIFU ablation underwent T2-weighted and DCE MRI before transrectal biopsy. For each patient, biopsies were performed by two operators: operator 1 (blinded to MR results) performed random and colour Doppler-guided biopsies (''routine biopsies''); operator 2 obtained up to three cores per suspicious lesion on MRI (''targeted biopsies''). Seventy-seven suspicious lesions were detected on DCE images (n=52), T2w images (n=2) or both (n=23). Forty patients and 41 MR lesions were positive at biopsy. Of the 36 remaining MR lesions, 20 contained viable benign glands. Targeted biopsy detected more cancers than routine biopsy (36 versus 27 patients, p=0.0523). The mean percentages of positive cores per patient and of tumour invasion of the cores were significantly higher for targeted biopsies (p<0.0001). The odds ratios of the probability of finding viable cancer and viable prostate tissue (benign or malignant) at targeted versus routine biopsy were respectively 3.35 (95% CI 3.05-3.64) and 1.38 (95% CI 1.13-1.63). MRI combining T2-weighted and DCE images is a promising method for guiding post-HIFU biopsy towards areas containing recurrent cancer and viable prostate tissue. (orig.)

  18. 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)

    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

  19. Treatment of anastomotic leakage after rectal resection with transrectal vacuum-assisted drainage (VAC). A method for rapid control of pelvic sepsis and healing

    DEFF Research Database (Denmark)

    Nagell, Carl Frederik Otto; Holte, Kathrine

    2006-01-01

    OBJECTIVE: Anastomotic leakage after rectal resection is associated with high morbidity and mortality. Patients without peritonitis can be treated conservatively by transrectal rinsing and drainage. However, healing is often very slow, and formation of abundant scar tissue resulting in a poor...... functional result is not uncommon. Vacuum-assisted closure (VAC) has been shown to accelerate wound healing by increasing local blood flow, reducing bacterial load and stimulating growth of granulation tissue. In this paper, we describe VAC as a method for treating anastomotic leakage after rectal resection...

  20. Impact of Fecal Carriage of Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae on the Outcomes of Transrectal Needle Biopsies of the Prostate.

    OpenAIRE

    Ergönül, Önder; Tükenmez-Tigen, Elif; Altinkanat, Gülşen; Özgen, Mahir Bülent; Ertük Şengel, Buket; Odabaşi, Zekaver; Türkerí, Levent N.; Mülazimo?lu, Lütfye; Korten, Volkan

    2013-01-01

    Objective: This study aimed to address the prevalence, the risk factors and the results of fecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) in patients who had undergone transrectal needle biopsy of the prostate (TRNBP). Patients and Methods: A total of 143 patients who had undergone TRNBP were included. Of these, 33(23%) had fecal carriage of ESBL-PE. The mean age of the patients was 62 ± 7.5 (43-81) years. Results: A univariate analysis showed that q...

  1. To compare the clinical value of transperineal and transrectal prostate biopsy guided by transrectal ultrasonography in diagnosis of prostate cancer%直肠超声引导下经直肠与经会阴前列腺穿刺活检的临床价值比较

    Institute of Scientific and Technical Information of China (English)

    叶政

    2013-01-01

    Objective To compare the clinical value of transperineal and transrectal prostate biopsy guided by transrectal ultrasonography in diagnosis of prostate cancer. Methods From July 2009 to December 2012, there were 78 and 83 patients underwent transrectal and transperineal prostate biopsy, respectively. Retrospective analysis their materials, and compared their pre-operation data, positive rate of prostate cancer and complication rate. Results There is no significant difference of serum PSA, prostatic volume and positive rate of nodules of these two groups. The complication rate of fever of patients underwent transrectal prostate biopsy were significant higher than patients underwent transperineal prostate biopsy, but the positive rate of prostate cancer, pain, hematuria, bloody stools urinary retention was similar. Conclusion Both of transperineal and transrectal prostate biopsy guided by transrectal ultrasonography are effective way for diagnosis prostate cancer. When choosing appropriate way for biopsying, the result of digital rectal examination, transrectal ultrasound and patients' condition should be considered.%  目的比较直肠超声引导下经直肠与经会阴前列腺穿刺活检术在诊断前列腺癌的临床价值。方法回顾分析2009年7月-2012年12月间在本院行直肠超声引导下经直肠前列腺穿刺活检术的78例患者与行直肠超声引导下经会阴前列腺穿刺活检术的83例患者资料,比较两组患者的术前资料、前列腺癌阳性检出率及穿刺并发症。结果两组患者的术前血清PSA、前列腺体积及结节阳性率无明显差别,经直肠穿刺术后患者并发发热的比例明显高于经会阴穿刺的患者,而前列腺癌阳性检出率,术后疼痛、血尿、血便和尿潴留的发生率无明显差异。结论经直肠超声引导下的经直肠穿刺和经会阴穿刺前列腺活检术都是有效的活检方法。应根据患者直肠指检是否扪及肿块、经直

  2. Cryopreservation of aoudad (Ammotragus lervia sahariensis) sperm obtained by transrectal ultrasound-guided massage of the accessory sex glands and electroejaculation.

    Science.gov (United States)

    Santiago-Moreno, J; Castaño, C; Toledano-Díaz, A; Esteso, M C; López-Sebastián, A; Guerra, R; Ruiz, M J; Mendoza, N; Luna, C; Cebrián-Pérez, J A; Hildebrandt, T B

    2013-01-15

    This study examines (1) the effectiveness of transrectal, ultrasound-guided massage of the accessory sex glands (TUMASG) combined with electroejaculation for obtaining aoudad (Ammotragus lervia sahariensis) sperm samples for cryopreservation, and (2) the effectiveness of a Tris-citric acid-glucose-based medium (TCG; usually used for freezing ibex sperm) and a TES-Tris-glucose-based medium (TTG; typically used in the cryopreservation of mouflon sperm) as sperm extenders. After TUMASG, just one to three electrical pulses were required for ejaculation to occur in five of the six animals studied; one ejaculated after TUMASG alone. Transrectal, ultrasound-guided massage of the accessory sex glands would therefore appear to be useful in obtaining sperm samples from this species, requiring few subsequent electrical electroejaculation stimuli and sometimes none at all. After thawing, the membrane integrity (assessed by nigrosin-eosin staining) of sperm extended with TTG was greater than that of sperm extended with TCG (P < 0.05). The total percentage of sperm showing an intact acrosome, as assessed by fluorescein isothiocyanate-conjugated peanut (Arachis hypogea) agglutinin, was also higher in the TTG-extended sperm (P < 0.05), and the percentage of dead sperm with a damaged acrosome was lower (P < 0.05). No differences were seen between TCG and TTG in terms of apoptotic manifestations (DNA damage, caspase activity, mitochondrial membrane potential, and plasmalemma stability). Therefore, TTG appears to be a better extender than TCG for cryopreserving aoudad sperm. PMID:23158213

  3. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Joon Hyung; Cho, Jae Ho; Ahn, Jay Hong; Chang, Jay Chun [Yeungnam University College of Medicine, Taegu (Korea, Republic of)

    2001-09-15

    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{sup 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{sup 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{sup 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{sup 3}.

  5. Local anesthesia for pain control during transrectal ultrasound-guided prostate biopsy: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yan P

    2016-10-01

    Full Text Available Pu Yan,* Xiao-yan Wang,* Wei Huang, Yong Zhang Beijing Tian Tan Hospital, Capital Medical University, Neurology Research Division, China National Clinical Research Center for Neurological Disease, Beijing, People’s Republic of China *These authors contributed equally to this work. Background: A meta-analysis was performed to evaluate the efficacy and safety of intrarectal local anesthestic (IRLA, periprostatic nerve block (PPNB, and the combined modalities in alleviating the pain during transrectal ultrasound (TRUS-guided prostate biopsy.Materials and methods: A literature review was performed to identify all published randomized controlled trials (RCTs about IRLA vs no anesthesia or placebo gel; PPNB vs no injection, periprostatic placebo injection, or IRLA; combined PPNB and IRLA vs PPNB alone; and combined PPNB and intraprostatic nerve block (IPNB vs PPNB alone before TRUS-guided biopsy. Sources included MEDILINE, EMBASE, and Cochrane Library from 1980 to 2016. The main outcomes were biopsy pain score, probe manipulation pain score, and anesthetic infiltration pain score assessed by the visual pain scale.Results: A total of 26 articles involving 36 RCTs were used in this analysis: Although IRLA can lead to pain reduction, the result was not statistically significant when compared with no anesthesia or placebo gel (weighted mean difference [WMD]: -0.22, 95% CI: -0.45 to 0, P=0.06. PPNB can lead to significantly lower biopsy pain scores when compared with no analgesia (WMD: -1.32, 95% CI: -1.68 to -0.95, P<0.00001, placebo injection (WMD: -2.62, 95% CI: -3.16 to -2.07, P<0.00001, or IRLA (WMD: -1.31, 95% CI: -1.40 to -1.22, P<0.00001. PPNB + IRLA can lead to significantly lower biopsy pain scores when compared with PPNB alone (WMD: -0.45, 95% CI: -0.62 to -0.28, P<0.00001. PPNB + IPNB can lead to significantly lower biopsy pain scores when compared with PPNB alone (WMD: -0.73, 95% CI: -0.92 to -0.55, P<0.00001. There were no severe

  6. EMBOLIA GASEOSA CEREBRAL SECUNDARIA A BIOPSIA PULMONAR

    Directory of Open Access Journals (Sweden)

    Luís Rafael Moscote Salazar

    2008-01-01

    Full Text Available A 68-year-old male patient, underwent a lung biopsy. During the procedure, the patient had sudden loss of consciousness. A simple brain computed tomography was performed. Brain images showed multiple hypodenses areas in the brain parenchyma and subarachnoid space, making the diagnosis of cerebral gaseous embolism.Our case demonstrates the importance of considering the gaseous cerebral embolism when presented sudden loss of consciousness during invasive procedures such as lung biopsy or introduction of arterial and venous catheters.

  7. MRI-TRUS融合导航成像引导前列腺癌穿刺活检的临床应用%A fusion system of transrectal ultrasound with magnetic resonance imaging in guidance of prostate cancer biopsy

    Institute of Scientific and Technical Information of China (English)

    孙彦(综述); 崔立刚(审校)

    2016-01-01

    Transrectal ultrasound (TRUS) in the guidance of prostate cancer biopsy is the deifnite method, however, some limitations still exist, such as high number of biopsy cores, low sensitivity and so on. Many researchers continue to ifnd new technical methods to improve the sensitivity and efifciency of prostate cancer diagnosis. This paper reviews and comments the fusion system of transrectal ultrasound with magnetic resonance imaging (MRI) in the guidance of prostate cancer biopsy, including the situation and development of transrectal ultrasound in the guidance of prostate cancer biopsy, the application of the fusion system of transrectal ultrasound with MRI in the guidance of prostate cancer biopsy, the progress on the fusion system and existing problems, so as to objectively and comprehensively evaluate the fusion system.%超声引导下系统性穿刺活检前列腺一直是前列腺癌的确诊方法,由于存在穿刺针数多、灵敏度较低等局限性,人们一直在不断探索新的成像方法来提高超声引导的灵敏度,从而提高诊断效率。本文综述了融合导航成像应用于前列腺癌诊断,包括经直肠超声(transrectal ultrasound,TRUS)引导前列腺穿刺的现状、MRI-TRUS融合导航成像引导前列腺穿刺的应用、目前融合导航成像研究新进展和成果及存在问题,旨在客观全面地评价融合导航成像在前列腺癌穿刺活检中的价值。

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

    Directory of Open Access Journals (Sweden)

    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

  9. Can pain during digital rectal examination help us to decide the necessity and the method of anesthesia for transrectal ultrasound guided prostate needle biopsy?

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    Onur Kaygisiz

    2007-08-01

    Full Text Available OBJECTIVE: Transrectal ultrasound (TRUS guided prostate biopsy is well tolerated by patients but the lack of an effective marker to predict pain prevents us from determining pre-procedurally which patient group needs local anesthesia for biopsy and probe pain. Thus in this study, we investigated predictor factors for prostate biopsy and probe insertion pain. MATERIALS AND METHODS: 71 patients who were undergoing prostate biopsy without anesthesia were included in the study retrospectively. Pain had been assessed with visual analogue scale (VAS 0-10. Digital rectal examination (DRE pain was analyzed for biopsy and probe insertion pain. RESULTS: DRE pain was related to both probe pain and biopsy pain. CONCLUSION: Although level of pain during DRE determines patients in need of local anesthesia, since the number of patients with moderate-severe pain is rather big, it seems efficient in determining the patients in need of additional anesthesia due to probe pain.

  10. 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

    2011-09-01

    Full Text Available 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 entéricas y las características de las biopsias colorectales realizadas para estudio del paciente con estreñimiento en el laboratorio de patología de la Fundación Hospital de la Misericordia en un periodo de cinco años. Material y métodos. Se revisaron y clasificaron las biopsias rectales remitidas para estudio por estreñimiento. Resultados. Se evaluaron 854 biopsias correspondientes a 272 casos, con un promedio de 3,13 muestras por paciente. En 183 casos se encontró histología normal (67,29%, en cincuenta y seis se estableció el diagnóstico de aganglionosis o enfermedad de Hirschsprung (20,59%, en dos el de displasia neuronal intestinal (DNI (0.74%, 8 pacientes se consideraron sospechosos de DNI (2.94% y los 22 restantes (8,1% fueron informados como material inadecuado para el estudio de neuropatía entérica. Conclusiones. Las biopsias rectales son un método útil para el diagnóstico de las neuropatías entéricas, sin embargo un porcentaje de ellas no permiten una adecuada interpretación. La disganglionosis más frecuente en esta serie fue la enfermedad de Hirschsprung con 56 casos, seguida por la displasia neuronal intestinal con tan sólo dos pacientes.Background. Straining occurs in around 8% of paediatric aged children. Most patients do not have base structural pathology and an organic cause, such as enteric neuropathy (also called Hirschsprung's disease or intestinal aganglionosis, is only found in a small percentage of them

  11. BACILOS ÁCIDO ALCOHOLRESISTENTES EN BIOPSIAS EMBEBIDASEN PARAFINA EN CASOS DE INFLAMACIÓNGRANULOMATOSA CRÓNICA. Detection of Acid-Fast Bacilli in Formalin-Fixed,Paraffin-Embedded Tissues of Patientswith Chronic Granulomatous Inflammation.

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    JAVIER ANDRÉS BUSTAMANTE

    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 pa-cientes 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, correspon-dientes 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 tres 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 diagnóstico (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 signi-ficativas 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.Detection of acid fast bacilli (AFB in smears is a significant aid in diagnosis and treatment of individuals with chronic granulomatous inflammation (CGI. This study was designed in order to detect the presence of AFB in several tissues of patients with

  12. 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

  13. 经直肠腔内超声诊断后尿道结石的临床价值%The Clinical Value of Transrectal Ultrasonography in Diagnosing Hind Urethra Calculus

    Institute of Scientific and Technical Information of China (English)

    李庆; 谢江凌

    2013-01-01

    目的 探讨经直肠腔内超声对后尿道结石的诊断价值.方法 对36例后尿道结石患者采用经直肠腔内超声检查,并将超声诊断结果与临床结果进行对比分析.结果 经直肠腔内超声检查诊断后尿道结石35例,误诊1例.后尿道结石中,位于后尿道前列腺部22例,后尿道膜部14例,经直肠腔内超声检查诊断后尿道结石符合率为97.22%.结论 经直肠腔内超声检查对后尿道结石的诊断率高,可为临床治疗提供可靠的依据,值得临床推广应用.%Objective To study the value of transrectal ultrasonography in diagnosing hind urethra calculus. Methods Using intracavity probe, combined with high frequency rectum transducer and line transducer necessary, to check the hind urethra calculus by transrectal ultrasonography. Results By transrectal ultrasonography, 35 cases have been diagnosed as hind urethra calculus, misdiagnosis 1 case, 22 as prostate calculus of hind urethra and 14 as membrane calculus of hind urethra,the coincidence rate is 97. 22%. Conclusion Transrectal ultrasonography can improve the diagnostic rate of hind urethra calculus, provide reliable basis for the clinical diagnosis and treatment, worthy of clinical application.

  14. Application progress of transrectal ultrasound in diagnosis and treatment of prostate cancer%经直肠超声在前列腺癌诊断和治疗中的应用进展

    Institute of Scientific and Technical Information of China (English)

    林洁; 郭道宁

    2011-01-01

    经直肠超声是诊断前列腺癌的重要手段.随着超声技术的发展,经直肠超声检测前列腺癌的敏感性和特异性有了很大的提高,并且在前列腺癌的治疗中也取得了新的进展.本文主要就经直肠超声在前列腺癌的诊断和治疗等方面的应用进展作一综述.%Transrectal ultrasound is an important means for diagnosis of prostate cancer. With the development of ultrasound technology, the sensitivity and specificity of transrectal ultrasound in diagnosis of prostate cancer have been greatly improveD, and new progresses have heen made in the treatment of prostate cancer. This article reviews the application of transrectal ultrasound in diagnosis and treatment of prostate cancer.

  15. 经直肠前列腺穿刺活检的临床分析%The Clinical Analysis of Transrectal Ultrasound Prostate Biopsy

    Institute of Scientific and Technical Information of China (English)

    王国民; 孙晓辉; 岳栋; 何乐业

    2011-01-01

    Obiectives To explore the clinical value of ultrasound guided transrectal prostate biopsy for diagnosing prostate carcinoma.Methods Systemic biopsy were performed on 194 patients who had normal level of prostate specific antigen (PSA)or who had prostate nodules by digital rectal examination or on ultrasound.Results Prostate carcinoma were detected in 51 cases;Benign prostatic hyperplasia 87 cases;prostatitis 14 cases;Prostatic intraepithelial neoplasia 36 cases;Prostatic infarction 6 cases.38 patients had transient gross hematuria,20 patients had hematochezia;fever was seen in 16 patients;5 patients got Sepsis;there were no hematospermia,prostate abscess and other complications occurred.Conclusions Transrectal Ultrasound Prostate Biopsy can increase the cancer early detection and in diffematiul diagnosis with other prostate disease.It is safe and efficacioious.%目的 探讨经直肠前列腺穿刺活检诊断前列腺癌的临床价值.方法 194例前列腺特异性抗原(PSA)升高或直肠指诊阳性或经直肠前列腺超声发现可疑结节的患者,行超声引导下经直肠前列腺穿刺活检.结果 194例患者中前列腺癌患者51例,前列腺增生患者87例,前列腺炎患者14例,前列腺上皮内瘤(PIN)患者36例,前列腺梗死患者6例.有38例出现一过性肉眼血尿,血便20例;发热16例;败血症5例;无血精、前列腺脓肿等并发症发生.结论 经直肠前列腺穿刺活检是一种安全的方法,有助于提高前列腺癌的早期诊断及前列腺疾病的鉴别诊断.

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

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    Bustamante Rengifo Javier Andres

    2010-08-01

    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

  17. 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

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    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

  18. 经会阴及经直肠前列腺穿刺活检术的临床应用及护理%Ultrasound-guided transrectal prostate biopsy and transperineal prostate biopsy:a comparative study

    Institute of Scientific and Technical Information of China (English)

    冯梅; 袁利荣; 张承广; 鲁来兴; 阮磊

    2015-01-01

    Objective To understand the efficacy of ultrasound-guided transrectal prostate biopsy and that of transperineal prostate biopsy and to review our nursing work.Method A retrospective analysis was first conducted into 166 cases of prostate biopsy, which included 102 cases of ultrasound-guided transrectal biopsy and 64 cases of transperineal biopsy.The symptoms of gross hematuria, lower urinary tract symptoms, dysuria, acute urinary retention, fever, bloody stools, perineum swelling, and comfort level were observed and documented.Findings The positive rate of the transrectal group and that of the transperineal group was 46.1%and 42.2%respectively.No significant difference was observed between the two biopsy methods ( P >0.05 ) .No significant difference was either observed in the common complications such as hematuria, lower urinary tract symptoms, dysuria and acute urinary retention between the two groups.However, the infection and rectal bleeding rates of transrectal biopsy were higher than transperineal biopsy, while perineum swelling was more common in the transperineal group.Comfort of transrectal biopsy group was better than that of the transperineal biopsy group(t=9.69, P<0.05).Conclusion Ultrasound-guided transrectal and transperineal biopsies are both effective for the diagnosis of prostate cancer.Complications resulting from the two methods may vary, but the transrectal biopsy method is much more convenient and has a higher comfort level.%目的:比较超声引导下经直肠及经会阴两种前列腺穿刺活检术的结果,总结护理体会。方法回顾性分析166例前列腺穿刺活检病例,其中经直肠径路102例,经会阴径路64例,记录穿刺后肉眼血尿、下尿路症状、排尿困难、急性尿潴留、发热、血便、会阴部肿胀及患者舒适度。结果经直肠径路组穿刺阳性率为46.1%,经会阴途径组穿刺阳性率为42.2%,两组差异无统计学意义(P>0.05);穿刺后血尿、

  19. Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level: what to expect in the Chinese population?

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    Jeremy YC Teoh

    2015-01-01

    Full Text Available We investigated the prostate cancer detection rates upon transrectal ultrasound (TRUS-guided biopsy in relation to digital rectal examination (DRE and prostate-specific antigen (PSA, and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of 50 ng ml−1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA 50 ng ml−1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA 50 ng ml−1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses (P < 0.001. Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.

  20. The prevalence of urinary tract infection, or urosepsis following transrectal ultrasound-guided prostate biopsy in a subset of the Saudi population and patterns of susceptibility to flouroquinolones

    Science.gov (United States)

    AlKhateeb, Sultan S.; AlShammari, Nayf A.; AlZughaibi, Mohand A.; Ghazwani, Yahya G.; Alrabeeah, Khalid A.; Albqami, Nasser M.

    2016-01-01

    Objectives: To study the prevalence of urinary tract infections (UTI), or sepsis secondary to trans-rectal ultrasound-guided (TRUS) biopsy of the prostate, the pathogens involved, and patterns of antibiotic resistance in a cohort of patients. Methods: This is a descriptive study of a consecutive cohort of patients who underwent elective TRUS biopsy at King Abdulaziz Medical City Riyadh, Saudi Arabia between January 2012 and December 2014. All patients who underwent the TRUS guided prostate biopsy were prescribed the standard prophylactic antibiotics. Variables included were patients’ demographics, type of antibiotic prophylaxis, results of biopsy, the rate of UTI, and urosepsis with the type of pathogen(s) involved and its/their antimicrobial sensitivity. Results: Simple descriptive statistics were used in a total of 139 consecutive patients. Urosepsis requiring hospital admission was encountered in 7 (5%) patients and uncomplicated UTI was observed in 4 (2.8%). The most common pathogens were Escherichia coli (90.1%) and Klebsiella pneumoniae (9.1%). Resistance to the routinely used prophylaxis (ciprofloxacin) was observed in 10 of these patients (90.9%). Conclusion: This showed an increase in the rate of infectious complications after TRUS prostate biopsy. Ciprofloxacin resistance was found in 90.9% of patients with no sepsis. PMID:27464862

  1. [Analgesic effect of oral tramadol on transrectal ultrasound-guided needle biopsy of the prostate in a randomized double-blind study].

    Science.gov (United States)

    Nomi, Hayahito; Azuma, Haruhito; Segawa, Naoki; Inamoto, Teruo; Takahara, Kiyoshi; Komura, Kazumasa; Koyama, Kohei; Ubai, Takanobu; Katsuoka, Yoji

    2011-08-01

    A total of 121 Japanese patients scheduled for prostate biopsy were randomly and double-blindly assigned to be given a single oral dose of 100 mg Tramadol mixed with 20 ml of sugar syrup or placebo, 30 minutes before the procedure. Pain severity was measured by verbal rating scale (VRS) and visual analog scales (VAS). We also analyzed cardio-respiratory parameters and complications. Of 121 patients, 117 replied validly to VRS and VAS ; and 91 of 117 patients replied to the cohort questionnaire for analysis of the late disorder, patient's impression, prolonged pain and past history of hemorrhoid treatment. Tramadol showed no significant effect on pain severity indicated by VRS and VAS, and no change in cardiorespiratory parameters. Furthermore, 70 patients without a history of hemorrhoid treatment, showed no significant analgesic benefits of Tramadol during the biopsy. In total, 3 patients had side effects of vomiting (CTCAE : grade 1)6), which subsided spontaneously. The oral administration of a single dose of 100 mg Tramadol 30 minutes before a transrectal needle biopsy of the prostate was safe, but was not effective to calm down the pain severity. PMID:21894078

  2. 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)

    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

  3. 经直肠超声造影鉴别诊断前列腺结节%Contrast-enhanced transrectal ultrasound in differential diagnosis of prostate nodules

    Institute of Scientific and Technical Information of China (English)

    张翠; 张艳华; 程文; 刘莹; 李洁冰

    2012-01-01

    Objective To compare contrast-enhanced transrectal ultrasound (CETRUS) features of benign and malignant nodules of prostate, and to explore the diagnosis value of CETRUS. Methods Sixty patients with 68 nodules underwent CERTUS, and nodule-target transrectal ultrasonography (TRUS) guided biopsy was performed. Contrast enhancement pattern of the nodules were recorded in inner gland and external gland. And auto tracking contrast quantification was used to calculate the parameters and differences between benign and malignant nodules. Results Among 68 nodules, 46 were malignant and 22 were benign. Most malignant nodules showed strong contrast enhancement (40/46), nonhomegeneous enhancement (41/46) , rapid enhancement (36/46), rapid clearance (30/46) or diffused enhancement (37/46). The arrival time and time to peak of malignant nodules were shorter than those of benign nodules, but the differences were not significant (P>0. 05). Peak intensity of malignant nodules was obviously greater than that of benign nodules (P<0. 05). Most benign nodules showed homogeneous enhancement compared with periprostatic tissue. Conclusion CETRUS can reflect the performance of vasculature within the nodules of prostate cancer directly and objectively. Analysis of relevant parameters contributes to differential diagnosis between benign and malignant nodules.%目的 比较前列腺良恶性疾病的经直肠超声造影(CETRUS)声像图表现,探讨其诊断价值.方法 对60例患者68个结节行CETRUS检查,观察内、外腺结节的增强特征,并对结节进行超声引导穿刺活检,利用ACQ软件定量分析前列腺良恶性结节增强方式的差异.结果 68个结节中,恶性46个,良性22个.前列腺癌CETRUS多表现为明显增强(40/46)、不均匀增强(41/46)、快进(36/46)、快出(30/46)、弥漫性增强(37/46).恶性结节始增时间、达峰时间均短于良性结节,但差异无统计学意义(P>0.05);达峰强度明显大于良性结节(P<0.05).良性

  4. Effect of semen collection by transrectal massage of accessory sexual glands or artificial vagina on the outcome of breeding soundness examinations of Italian yearling beef bulls.

    Science.gov (United States)

    Sylla, Lakamy; Palombi, Claudio; Stradaioli, Giuseppe; Vagniluca, Antonio; Monaci, Maurizio

    2015-03-15

    Although semen quality is one of the major traits that influence breeding soundness examination outcomes in bulls, field conditions occasionally do not allow for the collection of semen samples by means of an artificial vagina. The aims of the present study were to report the results of a large number of semen collections that were performed via the transrectal massage (TRM) of the accessory sexual glands of Italian yearling beef bulls and compare this semen collection method to the artificial vagina (AV) method in term of breeding soundness examination outcomes; furthermore, we determined whether the breed affected the semen characteristics. In the TRM group (n = 475), the semen samples were collected via TRM of the accessory sexual glands, and in the AV group (n = 502), the AV method was used. In the TRM group, semen samples were obtained from 81.3% of the bulls and penile protrusion was observed in 87.6% of the animals during semen collection. The sperm concentrations (920.5 ± 439.0 vs. 281.0 ± 259.8 × 10(6)/mL) and the percentages of total abnormal spermatozoa (22.8 ± 15.0 vs. 18.8 ± 12.9) were significantly higher in the AV group than those in the TRM group. The percentage of bulls that did not meet the minimum requirement for normal cells (≥70%) was 6.2% higher in the AV group than that in the TRM group (P libido and mating ability of the yearling bulls, a significant reduction of the number of spermatozoa collected, and an increase in the variability of the semen characteristics due to breed. In conclusion, despite the drawbacks, TRM guarantees that semen evaluation can be conducted in cases in which the semen samples cannot be collected with the AV method. PMID:25488791

  5. 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)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, In Pyeong; Kim, Sang Youn; Cho, Jeong Yeon; Lee, Myoung Seok; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of)

    2016-01-15

    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. 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. 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%). 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.

  7. Ultrasound guided transrectal prostate biopsy:11-year experience%B超引导下经直肠前列腺穿刺临床分析

    Institute of Scientific and Technical Information of China (English)

    朱刚; 芦志华; 马宏; 闫伟; 万奔; 王建业

    2009-01-01

    Objective To summarize the experience in ultrasound guided transrectal prostate biopsy and analyze the influeneing factors of the biopsy results.Methods 687 patients with prostate specific antigen(PSA)>4μg,tubemles in prostate detected by digital rectal examination and/or prostate abnormality detected by magnetic resonance imaging,aged(70±8),underwent ultrasound guided transrectal 6-12 core prostate biopsy 1996-2007.Since 2006 the criteria for biopsy ineluded PSA of 4-10μg/ml,free PSA/total PSA ratio(F/T ratio)≤0.16,and PSA density>0.15.Results 269 of the 687 cases.witll the mean age of(72±8),were diagnosed as wlth pmstate cancer.294 and 121 of the 687patients(42.8%and 17.6%respectively)accepted prostate biopsy beeanse of elevated PSA or abnormality of DRE.The number of patients accepting prostate biopsy increased yearly(10 cases in 1996 to 98 cases in 2007).The positive biopsy rate was 39.8%.with the highest rate of 60.0%in 1999 and lowest rate of 30.4%in 2005.The highest number of prostate cancer diagnosed was the highest(42 cases)in 2007 and the lowest(4 cases)in 1996.PSA level was positively co-related with positive biopsy rate.The application of F/T ratio improved the positive biopsy rate in the patient with the PSA of 4-10μg/ml.The incidence rates of the main complications hematuria,bloody stool,and fever were 46.3%,8.7%,and 1.9%respectively.Conclusion Elevated PSA has become the most common resson for prostate biopsy.The combination with PSA.F/T ratio.and increased biopsy core number improve the positive biopsy rate.The ultrasound guided transrectal prostate biopsy is efficient and safe in the diagnosis of prostate cancer.%目的 总结B超引导下经直肠前列腺穿刺的经验并分析影响前列腺穿刺结果的因素.方法 统计卫生部北京医院1996-2007年行B超引导下经直肠前列腺穿刺病例.患者入选条件为前列腺特异抗原(PSA)>4μg/L,和(或)直肠指检发现前列腺结节,和(或)B超或磁共振成像(MRI)检

  8. 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

    Directory of Open Access Journals (Sweden)

    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.

  9. Determinación de la utilidad de la relación APE l/t (Antígeno Prostático Específico libre sobre el total en pacientes con sospecha de cáncer de próstata estudiados por biopsia ecográfica endorrectal Utility of Free/Total Serum Prostate-Specific Antigen Ratio in prostatic cancer studied with endorectal ultrasound biopsy

    Directory of Open Access Journals (Sweden)

    Alberto Marangoni

    2008-09-01

    Full Text Available Introducción: Los marcadores tumorales son importantes al momento de decidir la realización de biopsias para el diagnóstico de cáncer de próstata. El objetivo de este trabajo es evaluar la exactitud diagnóstica del APE libre como marcador tumoral en casos de pacientes con sospecha de cáncer prostático en su relación con el APE total (APEL/T y determinar un valor de corte ajustado. Material y Método: En total, fueron evaluados 248 pacientes de entre 38 y 88 años de edad, en un período comprendido entre noviembre de 2001 y junio de 2007, con un análisis del APE libre, identificación de la presencia de un área hipoecogénica como ayuda diagnóstica y un análisis anatomopatológico para confirmación pospunción prostática endorrectal, realizado en forma prospectiva. Resultados: La identificación de pacientes con cáncer de próstata a través de la sospecha por el APE libre es relativa pero puede ser potenciada con otros hallazgos. Un 23,3% de pacientes con APEL/T por debajo de 0,20 presentaron biopsias positivas, pero, con un valor de 0,14, el porcentaje fue del 60%. Discusión: La identificación de pacientes para ser estudiados mediante Biopsia Prostática Endorrectal (BPE es un problema de la práctica diaria en los consultorios de Urología. Debido a que la BPE es un procedimiento diagnóstico medianamente invasivo y no exento de morbilidad, es que se debería ajustar su indicación. La relación APEL/T debe ser considerada en este contexto con mayor importancia. Conclusión: La identificación de valores alterados de la relación APE L/T con un valor de corte ajustado a 0,14 puede ayudar en el diagnóstico presuntivo de cáncer de próstata y a la elección de pacientes para biopsia a fin de ahorrar biopsias innecesarias.Introduction: The tumor markers are important to decide to perform biopsies in the prostate cancer diagnosis. The goal of this article is to evaluate the diagnosis precision of FPSA (Free Prostatic Specific

  10. Physiological responses and characteristics of sperm collected after electroejaculation or transrectal ultrasound-guided massage of the accessory sex glands in anesthetized mouflons (Ovis musimon) and Iberian ibexes (Capra pyrenaica).

    Science.gov (United States)

    Ungerfeld, Rodolfo; López-Sebastián, Antonio; Esteso, Milagros; Pradiee, Jorgea; Toledano-Díaz, Adolfo; Castaño, Cristina; Labrador, Beatriz; Santiago-Moreno, Julián

    2015-10-15

    The objective was to characterize the stress response and the seminal parameters obtained with electroejaculation (EE) or transrectal ultrasound-guided massage of the accessory sex glands (TUMASG) in two captive but nondomestic ruminants, the mouflons and the Iberian ibex under general anesthesia. In mouflons, the physiological responses (heart and respiratory rate, rectal temperature, cortisol, creatine kinase, potassium and glucose concentrations) changed similarly with both procedures. The TUMASG procedure was faster than EE in mouflons (21.7 ± 1.4 vs. 12.4 ± 1.2 minutes, P Electroejaculation provided better results in some sperm parameters (mouflons: sperm score: 3.4 ± 0.3 vs. 2.6 ± 0.2 [P < 0.01]; total number of sperm ejaculated: 982.4 ± 299 vs. 710.0 ± 542.2 [P < 0.05]; ibexes: sperm with progressive motility: 47.7 ± 6.2 vs. 20.5 ± 8.3 [P < 0.05]). The transrectal ultrasound-guided massage of the accessory sex glands appears to be an alternative technique to collect sperm from wild ruminants, reducing the need for electrical stimuli and thus decreasing the undesired responses of EE in the more sensitive species. On the other hand, better fresh sperm may be collected with EE. However, TUMASG provides practical advantages in animal welfare, firstly in these wild species more sensible to stress management and capture myopathy. PMID:26174035

  11. Diagnostic and therapeutic utility of transrectal ultrasound in urological office prostatic abscess management: A short report from a single urologic center

    Directory of Open Access Journals (Sweden)

    Andrea Fabiani

    2014-12-01

    Full Text Available Objectives: Prostatic abscess (PA is an infrequent condition in the modern antibiotic era. The everyday use of transrectal ultrasound (TRUS during diagnostic work-up and the widespread recurrence to prostatic biopsies may lead to an increase of PA diagnosis. In this short report we analyze the patients characteristics and the management of seven recent cases of PA diagnosed in our institution. Materials and Methods: The records of 7 patients admitted to our Center for LUTS associated to septic fever or acute urinary retention, was prospectively collected. Suspect of PA was done on digital rectal examination (DRE and confirmed by TRUS performed after urinary system ultrasound (UUS evaluation. Patients were admitted to hospital only in case of septic signs. A sovrapubic (SPC or urethral catheter (UC was placed depending on symptoms. A TRUS-guided aspiration of PA was performed with patient in lithotomic position, using a 18 gauge two-part needle, side/end fire needle access. Patient was discharged with antibiotic therapy and followed up until complete resolution of the PA and symptoms. Results: Mean age was 62 years (range 24-82. Two patients were diabetics and one was affected by the immunodeficiency acquired syndrome (HIV. In one case, PA was detected after a persistent fever post TRUS guided prostate biopsy. Average prostate volume was 69 ml (range 19-118 ml. DRE was able to diagnose PA only in 2 cases (29%, UUS evaluation in 1 case (14%. All cases were confirmed by TRUS as hypo-anechoic areas with or without internal echoes in all patients. Mean PA dimension was 3.64 cm (range 1.5-8. SPC was placed in 3 cases (43%, UC in 3 patients (43%. Only 1 patient refused catheterization. Side fire needle aspiration was performed in all cases and in combination with end fire access in case of particular location of abscess cavities. Second look was needed in 2 cases (29%. Antibiotics were administered in all cases. The aspirated pus showed a positive

  12. Transrectal ultrasound combined with contrast enhanced CT scan in preoperative staging of rectal carcinoma and the clinical value%经直肠超声联合增强CT扫描对直肠癌术前分期的临床价值

    Institute of Scientific and Technical Information of China (English)

    周妮; 陈华芳; 施龙

    2015-01-01

    Objective To investigate the transrectal ultrasound combined with contrast enhanced CT scan in preoperative staging of rectal cancer and the clinical value. Method 69 cases of patients with ractal were selected and underwent transrectal ultrasound and enhanced CT scan, and compared the T, N results with the postoperative pathological staging of rectal cancer. Analysed of transrectal ultrasound combined with contrast enhanced CT scan in preoperative diagnosis of rectal cancer T staging and N staging accuracy. Result Transrectal ultrasound in diagnosis of colorectal cancer T staging accuracy was higher than that of contrast enhanced CT scan, transrectal ultrasound combined with enhanced CT scan in the diagnosis of rectal cancer T staging accuracy was higher than that of single application of transrectal ultrasound and enhanced CT scan, the difference was signiifcant (P<0.05). Transrectal ultrasound in the diagnosis of preoperative N staging accuracy was higher than that of contrast enhanced CT scan, transrectal ultrasound combined with contrast enhanced CT scan diagnosis accurate rate was higher than the single application of transrectal ultrasound and enhanced CT scan, the difference was signiifcant (P < 0.05). Conclusion Transrectal ultrasound combined with contrast enhanced CT scan in preoperative staging of rectal cancer can improve the accuracy rate of diagnosis, provide an important basis for evaluating the state of illness and treatment options.%目的:探讨经直肠超声联合增强CT扫描对直肠癌术前分期的临床价值。方法选取69例直肠癌患者,分别行经直肠超声及增强CT扫描,并同术后直肠癌病理T、N分期结果作对照,分析经直肠超声联合增强CT扫描对直肠癌术前T分期及N分期的诊断准确率。结果经直肠超声诊断直肠癌术前T分期准确率高于增强CT扫描,经直肠超声联合增强CT扫描诊断直肠癌T分期准确率高于单独经直肠超声及增强CT扫描

  13. Changes of Abdominal Ultrasound and Transrectal Ultrasound Detection of Prostate%腹部超声与直肠腔超声检测前列腺疾病的差异变化

    Institute of Scientific and Technical Information of China (English)

    王硕

    2015-01-01

    目的:探讨腹部超声与直肠腔超声检测前列腺疾病的差异变化。方法选取72例前列腺疾病患者,比较腹部超声和直肠腔内超声检测的差异。结果经腹部超声及直肠腔内超声检测,3组患者的前列腺前后径、左右径均超出正常范围,C组患者前列腺前后径、左右径明显长于A组、B组,差异有统计学意义(P<0.05)。直肠腔内超声诊断前列腺疾病癌、囊肿、增生、钙化的准确率均明显高于腹部超声,差异均有统计学意义(均P<0.05)。结论与腹部超声比较,直肠腔内超声在诊断前列腺疾病方面具有更高的灵敏性和准确性。%Objective To observe the difference of abdominal ultrasound and endorectal ultrasound in detection of prostatic diseases.Methods According to the age characteristics,72 patients with prostate disease in our hospi- talpatients were divided into 3 groups,A group(50~59 years old),B group(60~69 years old),C group(70~79 years old),24 cases in each group,the compared the difference between abdominal ultrasound and endorectal ultrasound. Results The abdominal ultrasound and transrectal ultrasound,3 groups of patients before and after the prostate size,diameter were beyond the normal range,and C group of patients with prostate size,diameter was significantly longer than that in A group,B group,the difference was statisticaly significant(P<0.05).The accuracy of transrectal ultrasound in diagnosis of prostate diseases, cancer, proliferation,calcification of the cyst was significantly higher than that of abdominal ultrasound,the differences were statisticaly significant(P<0.05).Conclusion Compared with transabdominal ultrasound,transrectal ultrasonography has higher sensitivity and accuracy in the diagnosis of prostate disease.

  14. 经直肠彩色多普勒超声对前列腺癌的诊断价值%Value of transrectal color Doppler ultrasound in diagnosis of prostatic carcinoma

    Institute of Scientific and Technical Information of China (English)

    易发现; 李永忠; 李响

    2012-01-01

    Objective To evaluate the clinical value of transrectal color Dopplei ultrasound in diagnosis of prostatic carcinoma. Methods Thiity-one patients with prostatic carcinoma were examined by transrectal color Dopplei ultrasound, and 31 patients with benign hyperplasia were involved as the control group. Then the shape, lesion size, internal echo oi prostate, membranes and whether metastasis in surrounding organs in two groups were observed. Blood flow distribution of prostate and interior and periphery of the lesions were observed with color Doppler flow imaging( CDFI) , the internal diameter, the peak velocity and resistance index of the art ray were measured. Results Prostatic carcinoma was associated with calcification with the form of cluster, weak echoes, increased blood flow, increased resistance index, respectively. Multivariant logistic regression showed increased blood flow and increased resistance index were independent risk factors of prostatic carcinoma( P= 0. 011 ,OR= 17. 3 16 ;P= 0. 007 , OR = 14. 068). Conclusion Transrectal color Doppler ultrasound can improve the diagnostic accurate rate of prostate cancer.%目的 评价经直肠彩色多普勒超声诊断前列腺癌的临床价值.方法 应用经直肠彩色多普勒超声对31例前列腺癌(试验组)进行检查,同时选取31例良性前列腺增生患者为对照组,观察两组前列腺形态、病灶大小及内部回声情况,包膜的完整及周边邻近器官是否有转移灶.然后应用彩色多普勒超声观察前列腺及结节内部、周边血流分布状态、测量血管内径并记录动脉频谱的峰值,计算阻力指数.结果 前列腺癌与簇状钙化、低回声、回声不均、血流信号增强、阻力指数升高等有关,经Logistic回归分析,血流信号增强和阻力指数增高分别是前列腺癌的独立危险因素(P=0.011,OR=17.316;P=0.007,OR=14.068).结论 经直肠彩色多普勒超声能提高前列腺癌的诊断准确率.

  15. Diagnostic Value of Transrectal Ultrasonics in Prostatic Adenocarcinoma and Urethral Invasion%直肠超声对前列腺癌及其侵及尿道的诊断价值

    Institute of Scientific and Technical Information of China (English)

    林礼务; 林晓东; 俞丽云; 叶真; 薛恩生; 何以敉; 高上达

    2001-01-01

    目的提高直肠超声检查对前列腺癌(PCA)及其侵及尿道的诊断水平。方法对42例病理证实的PCA(其中6例侵及尿道)及15例正常前列腺进行经腹壁与直肠超声检查、直肠指诊及血清PSA测定的对比观察。结果直肠超声、直肠指诊、PSA测定与腹部超声对42例PCA患者的诊断阳性率分别为66.7%(28/42)、42.9%(18/42)、81.0%(34/42)与33.3%(14/42)。对PCA侵及尿道的诊断阳性率也分别为83.3%(5/6)、66.7%(4/6)、83.3%(5/6)与33.3%(2/6)。结论直肠超声检查如发现前列腺不对称增大,包膜欠光滑或突向膀胱或前列腺内见低回声结节与杂乱回声区,应高度怀疑PCA并应结合血清PSA测定与直肠指诊等综合判断。%PurposeTo raise the transrectal ultrasonic diagnostic level of the prostatic adenocarcinoma as well as the urethral invasion. MethodsForty-two patients with the prostatic adenocarcinoma and fifteen cases with the normal prostata were respectively examined by the transrectal ultrasonography, the transabdominal ultrasonography and the rectal touch. The serum PSA of each case was also examined. Results The positive rates of the transrectal ultrasonography, the rectal touch., the serum PSA determination and the transabdominal ultrasonography of the prostatic adenocarcinomas of the 42 patients were 66.7%(28/42), 42.9%(18/42), 81.0%(34/42) and 33.3%(14/42) respectively. The positive rates of the methods mentioned above of the urethral invasion were 83.3%(5/6), 66.7%(4/6), 83.3%(5/6) and 33.3%(2/6). Conclusion The diagnostic accurate rate would be raised if the patients who are suspected with the prostatic adenocarcinoma are examined by the different ways mentioned above.

  16. Puesta a punto e interpretación de la aspiración con aguja fina en el diagnóstico de hiperplasia prostática y prostatitis crónica canina

    OpenAIRE

    González, Griselda; Maffrand, C.; Guendulain, Corina F.; Otegui, F.; Gobello, Cristina

    2008-01-01

    La hiperplasia prostática benigna (HPB) y sus complicaciones infecciosas son las enfermedades prostáticas más prevalentes en perros de edad avanzada. Aunque la biopsia ofrece el diagnóstico definitivo, la aspiración con aguja fina (AAF) con guía ecográfica es una herramienta rápida y segura para el diagnóstico citológico presuntivo de las alteraciones prostáticas. El objetivo del presente trabajo fue poner a punto la técnica de AAF prostática ecodirigida y la interpretación del material obten...

  17. 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)

    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 cm3 or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each tumor was

  18. 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

  19. Estudio de la subestimación histológica e incidencia de falsos negativos en biopsias de mama por vacío con guía estereotáxica Evaluation of the histological underestimation and incidence of false-negative using vacuum assisted breast biopsy and stereotactic equipment

    Directory of Open Access Journals (Sweden)

    Javier Rodríguez Lucero

    2011-06-01

    Full Text Available Objetivo. Comparar los resultados histológicos en biopsias percutáneas bajo guía mamográfica y sistema de vacío con los resultados anatomopatológicos de las ulteriores cirugías. Evaluar falsos negativos al control mamográfico tras seis meses del procedimiento. Materiales y Métodos. Entre mayo de 2008 y mayo de 2010 en 148 mujeres se realizaron 157 biopsias. Del total biopsiado, se obtuvieron 137 grupos cálcicos, 6 nódulos, 9 densidades focales asimétricas y 5 blancos mixtos. Se colocaron clips en 85 blancos (85/157; 54,14%. Se compara la histología obtenida por punción con la surgida de las cirugías para analizar discrepancias o subestimaciones. En las biopsias negativas se indica control mamográfico a los 6 meses para evaluar falsos negativos. Resultados: En 41 pacientes (41/157; 27,70% se decidió completar con cirugía por el resultado histológico de la punción. Accedimos al resultado histológico quirúrgico en 34 casos, observando una concordancia entre la anatomía patológica de la punción y la quirúrgica en los 34 casos. De los 116 casos en los que no se realizó cirugía, logramos seguir mamográficamente a 67 mujeres reconociendo 1 falso negativo (1/67; 1,49% vinculado a un grupo cálcico. Conclusiones. Encontramos una correlación histológica en el 100% de los casos en los que accedimos a la anatomía patológica quirúrgica y pudimos reconocer durante el seguimiento posbiopsia 1 falso negativo. En el grupo que pudo evaluarse no hallamos subestimación. El falso negativo fue en una de las primeras pacientes biopsiadas, por lo que podría interpretarse como probable causa la falta de experiencia con el sistema. Creemos conveniente contar con grupos poblacionales más numerosos para obtener mayores conclusiones.Objective. To compare the histological findings in percutaneous biopsies under stereotactic guidance and vacuum assisted breast biopsy, with the pathological results from subsequent surgery. To evaluate false

  20. Preoperative judging of T-staging of rectal cancer by transrectal biplane ultrasound%经直肠双平面超声判断直肠癌术前T分期

    Institute of Scientific and Technical Information of China (English)

    李敬; 焦彤; 吴中权

    2012-01-01

    Objective To explore the accuracy of judging the T-staging of rectal cancer by biplane transrectal ultrasound.Methods Pathological enteroscopic biopsy was carried out for 197 cases of rectal cancer.Cases of middle and lower rectal cancer without serious obstruction were examined by means of transrectal biplane ultrasound through which to observe the changes of the echoes and to detect the depth of the infiltration in the intestinal walls and the presence of invasions in prostate glands,seminal in male or vesicles,uterine cervix in female.On the basis of the findings,the preoperative tumor staging was made.Postoperatively,the ultrasound results were compared with the pathological examination.Their consistency was evaluated by using Kappa test.Results Transrectal biplane ultrasound examination showed the total accuracy rate in T-staging of rectal cancer was as high as 83.8% with the diagnostic sensitivity rate for T1to T4 as 77.8 %,73.1%,89.3% and 94.4%,while its diagnostic specificity rate degree was 97.3%,93.1 %,85.1 %,97.8% respectively,The k -value was 0.732 which suggested that the ultrasound staging was highly consistent with the pathological staging(P<0.05).Conclusions Transrectal biplane ultrasound has a great value in the preoperative T-staging of rectal cancer and is helpful in the planning of treatment.%目的 探讨经直肠双平面超声判断直肠癌T分期的准确性.方法 197例经肠镜活检病理证实、无严重肠梗阻的中低位直肠癌患者,应用经直肠双平面超声观察肠壁回声改变、癌肿浸润肠壁深度及有无前列腺、精囊腺或宫颈、阴道等侵犯,并进行术前分期,将检查结果与术后病理对照,Kappa检验评估两者结果的一致性.结果 经直肠双平面超声判断直肠癌T分期的总正确率为83.8%,T1~T4诊断敏感度分别为77.8%、73.1%、89.3%和94.4%,特异度分别为97.3%、93.1%、85.1%、97.8%.k值为0.732,超声分期与

  1. Ultrasonographic features of prostate carcinoma with transrectal ultrasound guided biopsies%超声引导前列腺穿刺活检及前列腺癌经直肠超声表现特征

    Institute of Scientific and Technical Information of China (English)

    周丽仪; 马洪

    2016-01-01

    目的:探讨前列腺癌(prostate cancer,PCa)经直肠超声声像图特征进一步提高 PCa 穿刺活检阳性率。方法:前列腺特异性抗原升高和(或)直肠指诊阳性或经直肠超声发现前列腺可疑结节的159例患者,分成对照组与观察组,对照组(70例)行超声引导经直肠12点前列腺系统穿刺;对确诊为 PCa 患者的声像图总结分析。观察组(89例)在对照组总结出的 PCa 声像图特征的基础上行经直肠超声引导系统6点加目的性穿刺。结果:对照组中确诊为 Pca 22例,阳性率31.4%(22/70),观察组中确诊为 Pca 29例,阳性率32.6%(29/89),两组比较差异无统计学意义( P >0.05)。结论:前列腺形态失常或包膜不完整、外腺低回声结节、团块、血流异常丰富的结节及血流弥漫增多均提示 PCa,是穿刺活检的重点。%Objective:To investigate ultrasonographic features of prostate carcinoma( PCa)with transrectal ultrasound guided biopsies and increase the positive rate of prostate biopsy. Nethods:159 cases of patients referred for high prostate specific antigen and/ or abnormal digital rectal examination or suspicious prostate nodules found by transrectal ultrasound were divided into control group and improvement group. The 70 cases in the control group were treated with transrectal ultrasound guided systematic 12 cores prostate biopsy and the ultrasonographic features of the patients confirmed with PCa were analyzed and summarized. The 89 cases in the improvement group were given transrectal ultrasound guided systematic 6 cores plus purpose puncture on the basis of the ultrasonographic features summarized in the control group.Results:22 cases in the control group were diagnosed with PCa with the positive rate as 31. 4 % ,and 29 cases in the improvement group were confirmed as 32. 6 % . There was no significant difference between the two groups( P > 0. 05). Conclusions:PCa is highly doubted

  2. 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

    Energy Technology Data Exchange (ETDEWEB)

    Franc, Benjamin L., E-mail: francbl@radiological.com [Radiological Associates of Sacramento Medical Group, 1500 Expo Parkway, Sacramento, CA 95815 (United States); Cho, Steve Y. [Department of Radiology, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD 21287 (United States); Rosenthal, Seth A. [Radiological Associates of Sacramento Medical Group, 1500 Expo Parkway, Sacramento, CA 95815 (United States); Cui, Yonggang [Brookhaven National Laboratory, 2 Center Street, Upton, NY 11973 (United States); Tsui, Benjamin [Department of Radiology, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD 21287 (United States); Vandewalker, Kristen M.N. [Diagnostic Pathology Medical Group, 3301 C. Street, Suite 200E, Sacramento, CA 95816 (United States); Holz, Andrew L.; Poonamallee, Uday [Radiological Associates of Sacramento Medical Group, 1500 Expo Parkway, Sacramento, CA 95815 (United States); Pomper, Martin G. [Department of Radiology, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD 21287 (United States); James, Ralph B. [Brookhaven National Laboratory, 2 Center Street, Upton, NY 11973 (United States)

    2013-11-01

    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{sup ®}) 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

  3. Role of axillary lymph node ultra-sound and large core biopsy in the preoperative assessment of patients selected for sentinel node biopsy; Ruolo dell'ecografia e della microbiopsia istologica nella valutazione del cavo ascellare in pazienti candidate a biopsia del linfonodo sentinella

    Energy Technology Data Exchange (ETDEWEB)

    Nori, Jacopo; Boeri, Cecilia; Vanzi, Ermanno; Nori Bufalini, Filippo; Masi, Andrea [Azienda Ospedaliero-Universitaria Careggi, Firenze (Italy). Diagnostica senologica; Bazzocchi, Massimo; Londero, Viviana [Udine Univ., Udine (Italy). Istituto di radiologia universitaria; Mangialavori, Giuseppe [Ospedale di Merano, Bolzano (Italy). Servizio di radiologia; Distante, Vito; Simoncini, Roberta [Firenze Univ., Firenze (Italy). Clinica chirurgica I

    2005-04-01

    important sonographic alteration was the gradual reduction in hilar echogenicity (seen in 100% metastatic nodes); conversely, hilar denting of irregularities, as well as dimensional criteria, proved to be poorly specific. Conclusions: The sonographic assessment of axillary and internal mammary chain nodes, possibly in addition to core biopsy, improve the preoperative evaluation of breast cancer patients scheduled for conservative surgery of the breast (quadrantectomy) and the axilla (sentinel node biopsy). US findings suspicious for metastatic involvement of axillary lymph nodes should be considered as an exclusion criterion for sentinel node biopsy. A more widespread use of axillary node biopsy and an accurate sonographic evaluation of the excised lymph node increase the specificity of the procedure, allowing a better correlation between sonographic findings and definitive histology. [Italian] Scopo: Valutare l'accuratezza diagnostica preoperatoria dell'esame ecografico del cavo ascellare con studio dei linfonodi, associato eventualmente a microbiopsia ecoguidata-ove esista indicazione-in pazienti con carcinoma mammario candidate a quadrantectomia associata a biopsia del linfonodo sentinella. Materiale e metodi: Nel periodo compreso tra Luglio 2001 e Dicembre 2002 presso la nostra Diagnostica Senologica abbiamo studiato con ecografia e, ove indicato, microbiopsia istologica, 117 pazienti affette da neoplasia mammaria; le lesioni avevano diametri compresi tra 4.0 e 26 mm (diametro medio 11 mm). Rispetto al totale, 15 pazienti sono state escluse: nove di queste non soddisfacevano i requisiti richiesti dalla preliminare valutazione ecografica del cavo ascellare (non erano dicumentabili linfonodi oppure erano visibili solamente due linfoghiadole) mentre le altre 6 pazienti (con citologia prechirurgica dubbia o sospetta) sono risultate, all'istologia intraoperatoria, portatrici di patologia mammaria benigna. In 11 pazienti (10.7%), in relazione al dubbio

  4. The diagnostic values of serum prostate specific antigen and transrectal contrast-enhanced ultrasonography of prostate cancer%血清 PSA 指标与经直肠超声造影对前列腺癌的诊断

    Institute of Scientific and Technical Information of China (English)

    朱林; 黄君; 詹洁群; 贾天利; 刘灿

    2015-01-01

    目的:探讨血清前列腺特异性抗原(PSA)指标,游离前列腺特异性抗原(f-PSA)、总前列腺特异性抗原(T-PSA),前列腺特异性抗原密度(PSAD)与经直肠前列腺超声造影对前列腺癌(Prostate Cancer,PCa)的诊断价值。方法:获取59例血清 PSA 升高的患者的 fPSA 及 T-PSA、前列腺体积的三个径(L、W、H),所有病例均经直肠超声造影检查,并在超声引导下进行前列腺穿刺。结果:前列腺癌组患者的发病年龄要比良性前列腺增生(Benign prostate hyperplasia,BPH)组大,PSAD 比 BPH 组高。前列腺癌组的 f/T-PSA 比良性前列腺增生组低。前列腺癌组患者的显影时间、达峰时间、加速时间较良性前列腺增生组患者短,绝对增强强度较良性前列腺增生组高。前列腺癌组患者的强度减半时间比良性前列腺增生组患者短。结论:前列腺癌组的前列腺造影结果表现为“快进快出”。血清 f/T-PSA、PSAD 及经直肠超声造影技术对前列腺良恶性病变的鉴别诊断具有一定的临床价值。%Aim:To study the value of serum PSA indicator (f/T-PSA,PSAD)and CETRUS (con-trast-enhanced transrectal ultrasound)in diagnosis of prostate cancer.Methods:Fifty-nine patients were elevated with serum PSA had fPSA (free prostate specific antigen)and T-PSA (total prostate specific an-tigen),three size (Long,Wide,Height),the 59 patients carry through CETRUS (contrast-enhanced transrectal ultrasound)and biopsy.Results:Prostate cancer patients’age of onset are older than benign prostate hyperplasia group,PSAD in prostate cancer group are higher than that of benign prostate hyper-plasia group,f/T-PSA in prostate cancer group are lower than that of benign prostate hyperplasia group. AT (arrival time),TTP (time to peak),ACT (acceleration time)in prostate cancer group are shorter than those of benign prostate hyperplasia group,absolute enhance intense (△PI =PI

  5. Cambios histológicos en muestras de agrandamientos gingivales obtenidas a través de biopsias con electrobisturí y bisturí convencional Histological changes in samples of gingival overgrowth biopsies obtained through conventional scalpel and electro surgical scalpel

    Directory of Open Access Journals (Sweden)

    A. Herrera Herrera

    2012-06-01

    Full Text Available Antecedentes: Es poco lo que se dice en la literatura sobre cambios histológicos observados en la encía y aun menos comparándolo en caso de agrandamiento gingival obtenido de tejidos humanos. Al realizar estos recortes surge la pregunta si existe alguna diferencia histológica al comparar las muestras obtenidas con electrobisturí y bisturí convencional. Métodos: Se implementó un estudio descriptivo comparativo, sobre 21 pacientes obteniendo 90 muestras. La asignación de los sitios quirúrgicos para cada uno de los tratamientos se hizo con la estrategia de control cruzado, evaluando ambos tratamientos en el mismo sujeto (electrobisturí y bisturí convencional, en forma aleatoria en ambas hemiarcadas. Los datos se incluyeron en una base de datos en Excel, se analizaron en un software estadístico STATA 9.1. Se utilizó el test exacto de Fischer, con significancia p=0,05. Resultados: Se observó carbonización y coagulación del colágeno en el 72,7% siendo superior en las muestras obtenidas con electrobisturí en el tejido conectivo, el 79,5% de diferencia de carbonización siendo superior con el electrobisturí en el tejido epitelial. Con respecto al bisturí convencional en el tejido conectivo en un 95,6% esta inflamación estaba mediada por linfocitos y células plasmáticas y solo en un 17,8% se encontró presencia de neutrófilos y con respecto al electrobisturí en el tejido conectivo el 100% de las muestras presentaron inflamación, el cual estaba constituido por un 97,8% de linfocitos y células plasmáticas, solo un 37,8% de neutrófilos. Conclusiones: Se observaron diversos fenómenos histológicos en las biopsias de encía obtenidas tanto con bisturí convencional como con electrobisturí que ayudan a la comprensión de las ciencias básicas para futuras investigaciones y así poder llegar a la práctica clínica. Se observaron daños en las biopsias tanto en los cortes de bisturí convencional como con los cortes de bistur

  6. EVALUACIÓN DE DOS MÉTODOS DE EXTRACCIÓN DE ADN A PARTIR DE BIOPSIAS FIJADAS EN FORMALINA Y EMBEBIDAS EN PARAFINA EN CONDICIONES NO ÓPTIMAS Evaluation of Two Methods DNA Extraction from Formalin-Fixed, Paraffin-Embedded Tissues on Non-Optimal Conditions

    Directory of Open Access Journals (Sweden)

    JAVIER ANDRÉS BUSTAMANTE

    2011-08-01

    Full Text Available Los tejidos de archivo son 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 óptimas, se seleccionaron 47 bloques en parafina que contenían biopsias de pleura, pulmón y pericardio correspondientes a 24 pacientes (66,6% hombres mayores de 18 años, con inflamación granulomatosa crónica, remitidos al Departamento de Patología, Hospital Universitario del Valle entre 2002 y 2007. Se realizaron 10 cortes a cada muestra 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 65,52 ng/µL ±11,47 (promedio ± EE y la relación 260/280 varió entre 0,52 y 2,30. De las muestras extraídas por el método comercial, la concentración media de ADN fue 60,89 ng/µL ± 6,02, con una absorbancia que osciló entre 0 y 2,64. El ADN obtenido fue sometido a PCR, de 47 muestras extraídas por ambos métodos, 25 y 23 respectivamente amplificaron 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.Paraffin wax embedded tissues are an invaluable material for retrospective studies requiring the application of molecular analysis. Multiple methods are available to extract DNA from these kind of samples. However, the most common methods are slow and the reagents often

  7. Value of Trans-rectal Prostate Puncture in the Diagnosis of Prostatic Diseases%经直肠超声引导下前列腺穿刺在前列腺疾病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    匡驰; 李文彬; 唐水娟; 欧阳涛; 秦昂

    2014-01-01

    【目的】探讨经直肠超声(TRUS)引导下前列腺穿刺活检术在前列腺疾病诊断中的价值。【方法】收集前列腺特异性抗原(PSA)升高、经 TRUS发现前列腺异常的患者105例进行超声引导下前列腺穿刺活检术,采用经直肠6点穿刺法取组织条送病检。【结果】105例患者中前列腺炎3例、前列腺增生38例,前列腺癌64例,取材成功率100%,无血精、前列腺脓肿、败血症等严重并发症发生。【结论】超声引导下经直肠前列腺穿刺活检是诊断前列腺疾病的重要方法,其安全简便、准确性和成功率高,能有效的进行良恶性的鉴别及组织学诊断。%[Objective]To explore the value of trans-rectal prostate puncture biopsy in the diagnosis of prostatic diseases.[Methods]Totally 105 patients with elevated PSA and abnormal prostates detected by trans-rectal ultrasonic examination(TRUS)underwent prostate puncture biopsy.Trans-rectal six-point punc-ture method was used to collect tissues for pathological examination.[Results]Among 105 patients,3 pa-tients were prostatitis,and 38 patients were prostatic hyperplasia,and 64 patients were prostate cancer.The success rate of tissue collection reached 100%.No severe complications such as hemospermia,prostate abscess and sepsis occurred.[Conclusion]Trans-rectal prostate puncture biopsy guided by ultrasonography is an im-portant method of diagnosing prostatic diseases.It is safe and accurate,and has high success rate,and can be effective in the differential and histological diagnosis of benign and malignant disease.

  8. The Impact of Free/Total PSA Ratio on Prostate Cancer Diagnosis in Patients with PSA Level Between 2,5-10 mg/dl Undergoing Transrectal Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Nevzat Sener

    2014-02-01

    Full Text Available Aim:  In this study, we aimed to compare the outcomes of pathologic results of patients underwent transrectal prostate biopsy (TRIB with free/total PSA ratio. Material and Method: Patients having a PSA level between 2.5-10 ng/ml and underwent TRIB were retrospectively analyzed. Patients were divided into two groups as having a free/total PSA ratio below and over 20%. The ratio below 20% was in Group 1 and over 20% were in Group 2. Results: There were 60 patients in Group 1 and 82 patients in Group 2. PSA levels were 7,45 ± 2,14 and 6,31 ± 1,89 for groups 1 and 2, respectively (p=0.067. Fourteen patients in Group 1 (23% and 15 patients in Group 2 (18% were diagnosed with prostate cancer. Sensitivity was 100% and specificity was 23% when PSA level was between 2.5 and 10. Discussion: Free/Total PSA ratio can be applied to PSA levels between 2.5 and 10. Even though it has a low specificity, with high sensitivity, it can be used in urologic practice.

  9. Complications and risk factors in transrectal prostate biopsies%经直肠前列腺穿刺活检术后并发症的原因分析

    Institute of Scientific and Technical Information of China (English)

    庄红雨; 彭涛; 许学敏

    2013-01-01

    目的 分析经直肠前列腺穿刺活检术后并发症发生的原因,提高诊治水平.方法 收集2002年1月至2012年6月北京安贞医院经直肠前列腺穿刺活检术1127例患者的病历资料进行回顾性分析.分析年龄、前列腺体积、总前列腺特异抗原(tPSA)、穿刺针数、口服抗凝药及病理结果等与并发症的关系.结果 1127例经直肠前列腺穿刺活检术患者发生并发症81例.1127例患者中,因感染中毒性休克死亡1例,发生血尿40例(3.5%),直肠出血8例(0.7%),其中5例较严重直肠出血,可于直肠镜下见直肠前壁黏膜点状缺损伴活动性出血;尿潴留21例(1.9%),发热10例(0.9%),迷走性晕厥2例(0.2%).并发症组平均年龄[(65±5)岁]高于无并发症组[(64±6)岁],差异有统计学意义(P =0.048).2组患者的平均前列腺体积、tPSA水平相近,组间差异均无统计学意义(均P>0.05).不同穿刺针数(6、8~12、>12针)及是否口服抗凝药者血尿、直肠出血、尿潴留、发热和迷走性晕厥发生率的差异均无统计学意义(均P>0.05).前列腺增生患者经直肠前列腺穿刺活检术后直肠出血发生率[0.5% (5/997)]低于前列腺癌者[2.3% (3/130)],差异有统计学意义(P=0.021);血尿、尿潴留、发热和迷走性晕厥发生率的差异无统计学意义(均P>0.05).结论 经直肠前列腺穿刺活检术是安全的,但对于高龄患者、高度怀疑前列腺癌者应警惕术后并发症的发生.%Objective To analyze the causes of the following complications after the trans-rectal prostate biopsy.Methods Transrectal prostate biopsy medical records of 1127 patients from January 2002 to June 2012 in Beijing Anzhen hospital were analyzed retrospectively,including age,prostate volume,tPSA level,biopsy needles,oral anticoagulants and pathological characters.Results 1 of 1127 patients died of septic shock.Major complications showed hematuria in 40 patients (3.5%),rectal bleeding in 8

  10. 经直肠超声造影引导和监控下前列腺射频消融的实验研究%Experimental study of contrast enhanced transrectal ultrasound for monitoring radiofrequency ablation of prostate

    Institute of Scientific and Technical Information of China (English)

    许尔蛟; 李凯; 毛仁; 张奥华; 刘吉斌; 郑荣琴

    2009-01-01

    目的 通过动物实验验证经直肠超声造影引导和监控下行前列腺整体射频消融的可行性及安全性.方法经直肠超声造影引导下,采用内冷却针电极对7只犬前列腺行整体射频消融.通过尿管灌注和膀胱直肠隐窝注入冷蒸馏水双重冷却措施,以期保护尿道和直肠.超声造影显示的消融结果与病理标本所见作对比性分折.结果造影声像图清晰显示热消融灶呈无灌注区.所需整体前列腺消融的平均穿刺次数4.3次(3~6次),平均消融率达96.55%.超卢造影与TTC染色标本显示的消融范围[(9.16 ±5.20)cm3对(8.62±3.13)cm3]相关性良好·两者间差别无统计学意义(P=0.583),相关系数r=0.94(P=0.002).膀胱和直肠均未发现热损伤,尿道热损伤范围在1/4周径以内.结论经直肠超声造影引导前列腺整体射频消融是可行的;超声造影监控是获得整体消融的关键;双重冷却技术可有效保护尿道和直肠.%Objective To determine the feasibility and safety of radiofrequeney(RF)ablation of entire prostate guided and monitored by contrast-enhanced transrectal ultrasound(CE-TRUS)in canine model.Methods Contrast ultrasound-guided RF ablation of entire prostate was preformed transrectally using Cool-tiptm electrodes in 7 normal canines under general anesthesia.The urethra/bladder and rectum were protected by infusion of cold distilled water through a Foley catheter and injection of cold distilled water into the prostate-rectum space,respectively.CE-TRUS findings were compared with TTC-stained pathologic results.Results All the 7 canines tolerated the ablation procedures.CE-TRUS clearly demonstrated hypoechoic thermal lesions as avascular/nonperfusion areas.The average number acquired for entire prostate ablation was 4.3(3 to 6).The average ablation volume achieved on pathology was 96.55%.There was no statistically significant difference when compared average ablative volumes between CE-TRUS and TTC

  11. 经直肠高强度聚焦超声治疗局限性前列腺癌的疗效分析%Transrectal High-Intensity Focused Ultrasound in the Treatment of Localized Prostate Cancer

    Institute of Scientific and Technical Information of China (English)

    童亮; 吕军; 沈文; 王尉; 淡明江; 吴浩明; 胡卫列; 徐文峰

    2012-01-01

    Objective To evaluate the efficacy of transrectal high -intensity focused ultrasound (HIFU) therapy in the treatment of patients with localized prostate cancer. Methods 85 localized prostate cancer patients admitted to our hospital from December 2002 to October 2009 were divided into lower risk group , intermediate risk group and high risk group. Sonablate 500 was used to perform transrectal HIFU local treatment. Prostate special antigen (PSA) and prostate biopsy negative rate were dynamically observed after operation. Results The levels of PSA were significantly decreased three months , six months and twelve months after operation compared with before operation (P <0. 01 ).66 patients (77. 6% ) had PSA nadir≤0. 5 μg/L, and two -year biochemical free survival rate (BFSR) was 57. 8% (48/83). The prostate biopsy negative rate was 72. 9% (62/ 85) and 51. 8% (43/83) respectively six months and twelve months after operation. Conclusion This study shows that HIFU can achieve good efficacy for low risk and intermediate risk localized prostate cancer , especially for low risk group. But for high risk prostate cancer, HIFU monotherapy cannot achieve satisfactory result.%目的 观察经直肠高强度聚焦超声(HIFU)治疗局限性前列腺癌的临床疗效.方法 将我院2002年12月-2009年10月临床诊断为局限性前列腺癌的85例患者分为低危、中危、高危组,使用Sonablate 500型经直肠HIFU系统行HIFU局部治疗,术后动态观察各组血清前列腺特异性抗原(PSA)变化及前列腺穿刺活检阴性率.结果 术后第3个月、第6个月、第12个月的PSA水平较治疗前明显下降(P<0.01).术后有66例(77.6%)患者PSA最低值≤0.5 μg/L,而2年生化无病生存率达到57.8%(48/83).术后第6个月和第12个月前列腺穿刺阴性率分别为72.9%(62/85)和51.8%(43/83).结论 对于低危和中危局限性前列腺癌,经直肠HIFU治疗可获得良好的肿瘤控制效果,特别对于低危组;而对于高危组局

  12. Nursing care of one case of Escherichia colisepsis after transrectal ultrasound guided prostate biopsy%前列腺穿刺合并大肠埃希菌败血症1例的护理

    Institute of Scientific and Technical Information of China (English)

    马燕舞; 张伟; 秦梅

    2014-01-01

    报道1例前列腺穿刺合并大肠埃希菌败血症患者的观察和护理。住院期间患者多次出现无诱因寒战、高热,护理工作中做到随时观察病情并积极采取相应措施,根据该患者的病情及心理、生理特点采取了物理降温、血检及肠道准备等,加强了对该患者及其家属的心理护理,使其积极配合治疗和护理。患者病情得到控制,经相应治疗和护理取得了较为显著的效果。%We have a case of Escherichia colisepsis after transrectal ultrasound guided prostate biopsy.High fever with no clear trigger occurred many times when patient was in hospital.According to the patient's condition and the psychological, physiological characteristics,physical drop in temperature and some pertinent psychological nursing measures should be apply in patient and their families. The anxiety of the patient was reduced by those nursing measures. And then the patient cooperated with treatment and care.Keeping a strict watch over the patient and taking corresponding nursing measures are important to control the complication and it has obtained good results.

  13. A comparative study of two histological techniques for the identification of cytomegalovirus infection in colorectal biopsies from patients with chronic inflammatory bowel disease Estudio comparativo entre dos técnicas histológicas para el diagnóstico de infección por citomegalovirus en biopsias colorrectales de pacientes con enfermedad inflamatoria intestinal crónica idiopática

    Directory of Open Access Journals (Sweden)

    M. L. de Castro

    2009-10-01

    ímica (IHC. Nuestro objetivo fue comparar la sensibilidad de ambas técnicas histológicas para establecer este diagnóstico. Pacientes y métodos: estudio caso-control, identificando en el periodo 1997-2007 aquellos pacientes CMV positivos con HE o IHQ. Sus controles fueron apareados por edad y año de diagnóstico de CMV en los casos. Se realizaron ambas técnicas en las biopsias de casos y controles obtenidas 6 meses antes y tras su inclusión en el estudio. En el análisis estadístico consideramos significativos los valores de p < 0,05. Resultados: encontramos infección por CMV en 10 pacientes. Estos sujetos presentaban más frecuentemente una EII resistente o dependiente de esteroides (p = 0,03 y un mayor número de biopsias de colon (p = 0,03. De 97 biopsias analizadas, 12 fueron HE-negativas e IHC-positivas y 3 mostraron resultados inversos. La sensibilidad de HE fue 58,6% IC95 (38,9-78,3 y para IHQ 89,7% IC95 (76,8-100. No encontramos una buena concordancia entre ambas técnicas histológicas: kappa 0,55 IC95 (0,36-0,75. La positividad para CMV se asoció al uso de más de un fármaco inmunosupresor, OR 13,5 IC95 (1,2-152,2. El tratamiento antiviral fue útil en la EII refractaria o dependiente de esteroides. Conclusiones: la IHQ posee una sensibilidad superior a HE (30% para el diagnóstico de infección por CMV en la EII, no existiendo buena concordancia entre ambas técnicas histológicas.

  14. 利多卡因直肠表面麻醉在经直肠前列腺穿刺活检术中的应用%Application of lidocaine rectal surface anesthesia in transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    王勇; 张华莉

    2012-01-01

    Objective To investigate the effect and safety of rectal surface anesthesia with 2% lidocaine-sterlized cotton used in transrectal prostate biopsy. Methods 109 patients were divided into group A and group B. Before the operation, the patients in group A received rectal surface anesthesia with 1% lidocaine-sterlized cotton for 5 min, and the patients in group B received saline sterlized cotton for 5 min. After operation, visual analogue scale( VAS) was used to evaluate the pain degree during operation. Results The VAS score in group A was significantly lower than that in group B. Conclusions Rectal surface anesthesia with 2% lidocaine is an easy, safe and effective local anesthesia, which could significantly reduce the pain of the patients undergoing prostate biopsy, and ease the tension and fear of the patients.%目的 评价应用经直肠塞入2%利多卡因浸泡的消毒棉纱进行直肠表面麻醉在经直肠前列腺穿刺活检术中的镇痛有效性及安全性. 方法 109例需行经直肠前列腺穿刺活检术的患者随机分成A、B组.术前A组以2%盐酸利多卡因20 ml浸泡的消毒棉纱塞入直肠行表面麻醉5 min后取出,B组患者以20 ml生理盐水浸泡的消毒棉纱塞入直肠5 min后取出,术后采用视觉模拟评分(VAS)评估其术中疼痛程度. 结果 2组患者术中平均VAS分值存在明显差异(P<0.05),A组平均VAS分值明显低于B组. 结论 应用利多卡因以保留灌肠方式将2%盐酸利多卡因10 ml浸泡的消毒棉纱塞入直肠行直肠表面麻醉是一种方便易行、安全有效的局麻方法,可明显减轻前列腺活检术患者的疼痛,缓解患者紧张与恐惧心理.

  15. Needle Detection Based on Phase Grouping in 3D Transrectal Ultrasound Images%基于相位编组的三维直肠超声导引图像中针检测算法研究

    Institute of Scientific and Technical Information of China (English)

    邱武; 尉迟明; 张旭明; 赵四英; 丁明跃

    2011-01-01

    This paper proposes a robust and efficient needle detection method, which is used to localize and track the needle in three-dimensional (3D) transrectal ultrasound (TRUS) guided prostate therapy. First, all voxels are grouped into different line support regions (LSR) based on the outer product of adjacent voxels' gradient vectors. The needle axis is extracted by least square fitting in LSR. The needle endpoint is localized by finding an intensity drop along the needle axis. Evaluation results in synthetic da ta, tissue-mimicking agar, chicken breast phantoms and 3D TRUS patient images obtained during the prostate cryotherapy show that the proposed methods is with a relatively higher robustness and accuracy.The result of the in-vivo test also shows that our method outperformed several alternative methods in needle endpoint localization accuracy and TP rate. It is concluded that the proposed method is suitable for 3D TRUS guided prostate transperineal therapy.%本文针对三维直肠超声导引前列腺介入式治疗中,针状手术器械定位难的问题,提出了一种三维超声图像中基于三维相位编组的针检测算法.该算法首先将体素按照梯度相位角进行分组,在得到的分组中用最小二乘拟合方法进行针状物体轴线提取,然后利用轴线体素的灰度统计特性进行端点定位.提出的方法在三维模拟数据、Agar 和鸡肉假体数据,以及三维直肠超声导引前列腺冷冻治疗中采集的病人数据进行试验,获得了较高的定位精度以及鲁棒性.与其他方法比较,发现本文提出的方法从定位精度以及分割鲁棒性方面,体现了其优越性.试验结果证明本文方法可以适用于临床应用.

  16. Artificial neural network analysis on computerized transrectal ultrasound in early detection of prostate cancer%人工智能超声CT检查在前列腺癌早期诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    谢立平; 郑祥义; 王潇; 朱意; 纪阿林; 刘犇

    2015-01-01

    Objective To investigate the application of artificial neural network analysis on computerized transrectal ultrasound (ANNAcTRUS) in early detection of prostate cancer.Methods Sixty men with or without prior biopsies, either due to elevated PSA or abnormal digital rectal findings, were included in this study from January 2014 to July 2015.Patient's mean age was (65.6 ± 8.9) years (51-89 years).Their PSA level was (9.8 ± 4.9)μg/L.The patients received the ANNAcTRUS targeted 6-core biopsy.Each patient received six targeted biopsies of suspicious regions, which was identified by ANNAcTRUS online system.Histopathologic examination was further carried out to confirm the result of the targeted biopsies.Results According to the results of ANNAcTRUS,52 of 60 patients received biopsy in ANNAcTRUS group.ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 24 (46.2%) of 52 patients.The distribution of Gleason Score was as follows : 3 + 3 (n =9), 3 + 4 (n =8), 4 + 3 (n =4), 4 +4 (n =2) and 5 +4 (n =1).For patients without prior negative biopsy,ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 17 (51.5%) of 33 patients.Conclusions ANNAcTRUS targeted 6-core biopsy illustrates a higher detection rate of prostate cancer.Furthermore, ANNAcTRUS targeted 6-core biopsy tends to detect low-grade prostate cancer.%目的 探讨人工智能超声CT(artificial neural network analysis/computerized transrectal ultrasound,ANNAcTRUS)在前列腺癌早期诊断中的价值.方法 选取2014年1月至2015年7月收治的60例PSA>4μg/L或直肠指检异常、有前列腺穿刺指征的患者,年龄51~89岁,平均(65.6±8.9)岁;PSA平均(9.8 ±4.9)μg/L.患者取左侧卧位,行经直肠超声检查,自前列腺尖部至精囊水平,每隔5 mm留取超声影像.将超声图像传送至德国超声CT中心,进行实时在线分析,对原始超声图像中的肿瘤可疑区域进行标记(亮红色),根据结果评估穿刺的必要性

  17. A comparative study of transrectal contrast-enhanced ultrasound assisted prostate biopsy and system-ic prostate biopsy%经直肠超声造影辅助前列腺穿刺活检与前列腺系统穿刺活检的比较研究

    Institute of Scientific and Technical Information of China (English)

    张帆; 汪维; 张士伟; 连惠波; 黄海锋; 郭宏骞

    2014-01-01

    目的:比较经直肠超声造影辅助前列腺穿刺活检和前列腺系统穿刺活检的穿刺效率。方法2010年1月至2011年12月采用简单随机抽样方法选择213例可疑前列腺癌患者,在经直肠超声造影辅助下,针对造影异常区域行前列腺穿刺活检(造影穿刺组),年龄54~83岁,平均(71.0±8.9)岁。 PSA 4.1~150.0μg/L,平均(22.5±19.4)μg/L。直肠指检触及结节或质地不均者119例(55.9%),经直肠超声检查发现异常结节或回声不均质者80例(37.6%)。相同随机方法选择同期218例可疑前列腺癌患者行前列腺系统穿刺活检(系统穿刺组),年龄36~94岁,平均(65.0±9.1)岁。 PSA 4.6~147.0μg/L,平均(23.3±18.9)μg/L,经直肠超声检查发现异常结节或回声不均质者125例(57.3%),经直肠超声检查发现异常结节或回声不均质者83例(38.1%)。两组的PSA、前列腺体积、直肠指检阳性率及经直肠超声检查阳性率比较差异均无统计学意义( P>0.05)。比较两组的穿刺针数、单针阳性率、Gleason评分等。结果造影穿刺组与系统穿刺组比较,前列腺癌阳性率分别为38.0%(81/213)和34.9%(76/218),差异无统计学意义(P>0.05);人均穿刺针数分别为9.5针和12.0针,差异有统计学意义(P<0.05);单针阳性率分别为18.2%(369/2025)和11.5%(301/2616),差异有统计学意义( P<0.05);Gleason评分分别为7.1分和6.6分,差异有统计学意义( P<0.05)。%Objective To evaluate the advantages of transrectal contrast-enhanced ultrasound assis-ted prostate biopsy by comparing with systemic prostate biopsy . Methods From Jan.2010 to Dec.2011, 213 cases were selected randomly.Patient's mean age was 71.0±8.9 (54-83) years.Their PSA level was 22.5±19.4 (4.1-150.0) μg/L.The positive rates of DRE and

  18. Hiperplasia estromal pseudoangiomatosa de la mama (PASH: presentación de dos casos Pseudoangiomatous stromal hyperplasia

    Directory of Open Access Journals (Sweden)

    Marta Machado

    2009-12-01

    Full Text Available La hiperplasia estromal pseudoangiomatosa (PASH es una lesión mamaria benigna infrecuente, que afecta comúnmente a mujeres premenopáusicas y que se presenta como un nódulo único, móvil, de consistencia firme y por lo general unilateral. Hay un sobrecrecimiento benigno de tejido conectivo fibroso de la mama que produce numerosos espacios que semejan estructuras vasculares. En la actualidad, la alternativa diagnóstica la provee la punción biopsia percutánea eco-dirigida o por estereotaxia, la que permite determinar la naturaleza de la lesión y descartar patología maligna, como el angiosarcoma, a fin de evitar la realización de biopsias quirúrgicas innecesarias. Presentamos dos casos que fueron categorizados en el control inicial por mamografía como BI-RADS 4c, lo que determinó la realización de una punción biopsia.Pseudoangiomatous stromal hyperplasia (PASH is a rare benign breast lesion, which commonly affects premenopausal women. It occurs as a single node, which is mobile, firm and usually unilateral. PASH is characterized by a benign overgrowth of fibrous connective tissue of the breast, which produces numerous spaces resembling vascular structures. The diagnostic alternative is currently provided by the ultrasound guided percutaneous biopsy or stereotactic biopsy, which determines the nature of the lesion and rules out malignancy, such as angiosarcoma, in order to avoid unnecessary surgical biopsies. We present two lesions that were classified as BI-RADS 4c in the initial control by mammography, which led to a needle biopsy.

  19. 经直肠超声引导前列腺10+X系统穿刺活检及围手术期护理%Peri Operation Period Nursing of Transrectal Ultrasound Guided Prostate Puncture Biopsy of 10+X System

    Institute of Scientific and Technical Information of China (English)

    王蕊红

    2015-01-01

    目的:探讨经直肠超声引导下前列腺10+X系统穿刺活检术诊断前列腺癌的临床价值及围手术期护理。方法对298例直肠指诊阳性和(或)PSA>4 ng/ml和(或)影像学检查异常的患者行经直肠超声引导下前列腺10+X系统穿刺活检术。结果298例患者中病理确诊为前列腺癌者133例(44.6%)。133例患者如仅行前列腺10点穿刺,将有26例患者漏诊(19.5%)。298例患者术后均无严重并发症。结论经直肠超声引导下前列腺10+X系统穿刺活检术检出率较高,加强围手术期护理能有效降低术后并发症。%Objective To investigate by transrectal ultrasound guided prostate biopsy in the diagnosis of 10+X system the clinical value of prostate cancer and perioperative care. Methods 298 cases of positive and (or) on a digital rectal exam PSA>4 ng/ml and (or) imaging examination in patients with abnormal menstruation transrectal ultrasound guided prostate biopsy 10+X system. Results Pathological diagnosed with prostate cancer in 298 patients, 133 cases (44.6%). If only in 133 patients at 10 prostate puncture, there will be 26 patients in diagnosis (19.5%). 298 patients had no serious postoperative complications. Conclusion By transrectal ultrasound guided prostate 10+X systematic biopsy detection rate is higher, to strengthen perioperative nursing can effectively reduce the postoperative complications.

  20. 经直肠三维超声对良性前列腺增生分度的诊断价值%Value of three-dimensional transrectal ultrasonography in the diagnosis of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    皮永前; 潘永寿; 熊思

    2013-01-01

    目的 探讨经直肠三维超声对良性前列腺增生分度的诊断价值.方法 对104例前列腺增生患者应用经直肠三维超声进行常规扫查前列腺,测量前列腺全腺和内腺的上下径、左右径、前后径及前列腺内腺动脉阻力指数;采用三维体积自动测量技术测量前列腺全腺、内腺体积和重量,计算内外腺宽度之比、内外腺厚度之比及移行带指数.结果 依据前列腺全腺重量将前列腺增生分为Ⅰ、Ⅱ、Ⅲ和Ⅳ四组,前列腺内腺重量、移行带指数、内外腺宽度之比、内外腺厚度之比以及前列腺内腺动脉阻力指数在四组间均为Ⅳ>Ⅲ>Ⅱ>Ⅰ(P<0.01),且与前列腺重量呈正相关(P<0.01),是前列腺增生分度较好的指标.结论 前列腺体积及形态改变是超声诊断前列腺增生的重要依据,经直肠三维超声可以准确测量前列腺全腺及内腺体积,为前列腺增生分度提供最直观的形态学指标,移行带指数、内外腺宽度之比等前列腺参数有助于前列腺增生的分度.%Objective To evaluate the value of three-dimensional transrectal ultrasonography (3D-TRUS) in the graduation of benign prostatic hyperplasia (BPH).Methods A total of 104 patients with BPH were checked by 3D-TRUS.The vertical diameter,transverse diameter,anteroposterior diameter of prostate whole gland and inner gland were measured,as well as artery resistance indexes of inner gland.3D-TRUS was used to measure the volume and weight of prostate whole gland,the inner gland.The ratio of the width of the inside and outside the gland,the ratio of the thickness of the inside and outside the gland,and transition zone index (TZI) were calculated.Results According to the weight of prostate whole gland,prostatic hyperplasia was classified into four levels:Ⅰ,Ⅱ,Ⅲ and Ⅳ BPH.The weight of inner gland,TZI,RI of the inner gland artery,the ratio ofinner and outer gland width and the ratio of inner and outer gland

  1. 定向抗菌预防法在防治经直肠前列腺穿刺活检术后感染中的应用价值%Antibiotic prophylaxis for transrectal prostate biopsy:the value of rectal swab culture and targeted antimicrobial treatment

    Institute of Scientific and Technical Information of China (English)

    李九智; 王雪怡; 文彬; 宋超

    2012-01-01

    目的 探讨通过肛拭子培养结果采取定向抗菌预防法在防治经直肠前列腺穿刺活检术后感染中的临床应用价值.方法 回顾性分析新疆自治区人民医院泌尿一科2008年7月-2012 年4月在经直肠B超引导下行前列腺穿刺活检术的344例患者的病例资料,将344例患者分成3组,A组:n=105,常规术前稀碘伏灌肠;B组:n=117,术前稀碘伏灌肠联合经验性应用环丙沙星组;C组:n=122,术前稀碘伏灌肠联合根据肛拭子培养结果定向抗菌预防.穿刺后监测患者体温变化,血尿培养结果,按标准认定感染结果 A组105例中,17例发热,3例出现前列腺脓肿,1例出现败血症;R组117例中,3例出现发热,1例出现菌血症,1例出现前列腺炎,无前列腺脓肿出现;C组122例病例中无一例出现术后发热、前列腺炎、脓肿及败血症等临床感染.结论 前列腺穿刺活检前后预防性应用抗生素可减少前列腺穿刺引起的尿路感染;虽然环丙沙星可具有良好的抗感染效果,但定向抗菌预防法更可显著降低患者术后并发症的发病率及患者抗生素应用率.%Objective To evaluate the targeted antimicrobial prophylaxis in men undergoing trans-rectal ultrasound guided prostate biopsy based on rectal swab culture results.Methods From July 2008 to April 2012 we studied differences in infectious complications in men who received targeted vs standard empirical ciprofloxacin prophylaxis before transrectal ultrasound guided prostate biopsy.All 344 patients were divided into 3 groups according to their hospital records,inculding group A:without antimicrobial prophylaxis(105 eases) ;group B:antimicrobial prophylaxis with fluoroquinolone(117 cases) ;group C:targeted prophylaxis used rectal swab cultures results(122eases).All cases received enema with diluted iodophors before biopsy.We identified men with infectious complications within 7 days after transrectal ultrasound guided prostate biopsy

  2. 经直肠彩色多普勒超声对增生前列腺内腺低回声前列腺痛与低回声增生结节的鉴别%A study of the hypoechoic hypertrophic lesions and hypoechoic cancer lesions in hypertrophic prostate inner glands with transrectal color doppler ultrasonography

    Institute of Scientific and Technical Information of China (English)

    Hui Wang; Rui Hou; Guang Yang; Wenin Xue; Shen Lv

    2008-01-01

    Objective: To observe the sonographic and hemodynamic features of hypoechoic hypertrophic lesions and hy-poechoic cancer lesions in the hypertrophic prostate inner glands, in order to raise the accuracy of early diagnosis rate for prostate cancer. Methods: 31 cases of hypoechoic hypertrophic lesions and 18 cases of hypoechoic cancer lesions in the hypertrophic prostata inner glands were observed by transrectal ultrasonography and comparatively analyze the shape, edge and the systolic peak velocity (Vs), resistance index (RI) and pulsatility index (PI) of the lesions. Results: In contrast with hypertrophic group, the cancer group presented irregular shape and unclear edge, and obviously higher Vs, RI and PI. Con-clusion: The sonographic appearance and Vs. RI. PI have important value in distinguishing hypoechoic hypertrophic lesions and hypoechoic cancer lesions in the hypertrophic prostate inner glands.

  3. Application of transrectal ultrasound-guided transperineal prostate puncture biopsy in diagnosis of prostate cancer%基于直肠超声图像分析引导下的经会阴前列腺穿刺活检在前列腺癌诊断中应用

    Institute of Scientific and Technical Information of China (English)

    张进

    2014-01-01

    目的:探讨经直肠超声引导下经会阴前列腺穿刺活检对于前列腺癌诊断的价值。方法:通过9+X穿刺方法,对82例临床拟诊前列腺癌的患者进行经直肠超声引导下经会阴前列腺穿刺活检,对穿刺结果进行分析。结果:全部患者均活检成功,前列腺癌的阳性率为25.6%(21/82),穿刺并发症轻微。结论:经直肠超声引导下经会阴前列腺穿刺活检相对阳性率更高,并发症相对较少、较轻,适应范围更广,必将有更广阔的应用前景。%Objective:To investigate the value of the transrectal ultrasound-guided transperineal prostate puncture biopsy in diagnosis of prostate cancer. Methods:Transperineal prostate puncture biopsy was performed under tran-srectal guidance in 82 patients suspected of suffering from prostate cancer with 9+X method. Results:All the patients were completed the biopsy successfully. 21 patients were positive for cancer in 82 patients (25.6%).There were few-er and lighter complications. Conclusion:Transperineal prostate puncture biopsy would be gotten extensive usage be-cause of the higher positive rate, fewer and lighter complications and wider extent of application.

  4. 经直肠B超引导下经会阴注射A型肉毒毒素治疗老年良性前列腺增生症的疗效观察%The Observation of Injection of the BTX-A from Perineum in Gerontic Benign Prostatic Hyperplasia Guided by the Transrectal Ultrasound

    Institute of Scientific and Technical Information of China (English)

    向川南; 罗黔; 姚健; 王宁

    2014-01-01

    Objective To explore the feasibility of the injection of BTX-A in perineum in the benign prostatic hyperplasia. Methods Retrospectively analysis the 31 cases who are 60 years above, from October 2010 to June 2013, who got the injection of BTX-A from the perineum guided by the transrectal ultrasound, and to evaluate the value . Results No complication happened after the injection;4 cases had no ef icacy;19 cases had the urinary problem again in 6 months. Conclusion The method of the injection of the BTX-A from perineum guided by the transrectal ultrasound is convenient, less complication and high ef icacy.%目的:探讨A型肉毒毒素(Botulinum toxin type A, BTX-A)在老年良性前列腺增生症(Benign Prostatic Hyperplasia ,BPH)中应用的可行性。方法回顾性地分析2010年10月~2013年6月来我院就诊的31例进行经直肠B超引导下经会阴注射BTX-A的60岁以上BPH患者的治疗疗效,评价BTX-A在BPH治疗中的价值。结果0例出现BTX-A术后并发症;4例出现注射后无效;19例出现术后6个月后排尿困难。结论经直肠B超引导下经会阴 A型肉毒毒素注射治疗老年BPH具有操作简便、并发症少、有效率高的特点。

  5. Meta分析抗生素对经直肠前列腺活检术后感染性并发症的预防效果%Meta-analysis of antibiotic prophylaxis use in transrectal prostatic biopsy

    Institute of Scientific and Technical Information of China (English)

    杨明根; 赵晓昆; 吴志平; 肖宁; 吕晨

    2009-01-01

    ObjectiveTo determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in men undergoing transrectal prostatic biopsy (TPB) who had sterile preoperative urine.MethodsMEDLINE, EMBASE, Cochrane Collaboration Reviews, Chinese Medical Current Contents (CMCC), and National Knowledge Infrastructure (CNKI) were searched for rando-mized controlled trials that compared the effect of antibiotic prophylaxis with placebo or active controls for men undergoing TPB with preoperative sterile urine. Two reviewers independently extracted the data of patient characteristics and outcomes based on a prospectively developed protocol.ResultsA total of 12 trials (3 placebo controlled, 3 non-treatment controlled, and 6 activly controlled) involving 1 987 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing TPB significantly decreased bacteriuria and middle degree fever incidence, but could not decrease the incidence of bacteremia. The relative risk for post-TPB bacteriuria, middle degree fever, and bacteremia were 0.32 (95% CI 0.23 to 0.46), 0.37 (95% CI 0.17 to 0.77), and 0.96 (95% CI 0.61 to 1.50), respectively. Effective antibiotic classes included quinolone, co-quinolone and nitroimidazole, and co-trimethoprim and sulfamethoxazole. Treatment protocols of any duration were effective.ConclusionAntibiotic prophylaxis obviously decreases the incidence of bacteriuria and middle degree fever but not bacteremia in men with preoperative sterile urine undergoing TPB. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and co-quinolone and nitroimidazole. Treatment protocols of any duration are effective with no heterogeneity.%目的:分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者的术后感染性并发症.方法:制定原始文献的纳入标准、排除标准及检索策略,

  6. O papel atual da ultra-sonografia transretal da próstata na detecção precoce do câncer prostático Current role of transrectal ultrasonography in the early detection of prostate cancer

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    Viviane Cristine Tavares Santos

    2006-06-01

    Full Text Available OBJETIVO: Determinar o papel real que a ultra-sonografia da próstata, notadamente com a associação do Doppler colorido, desempenha no diagnóstico de lesões malignas na próstata. MATERIAIS E MÉTODOS: Foram estudados, prospectivamente, 84 pacientes submetidos a biópsia guiada por ultra-sonografia transretal. Em todos os pacientes foram feitos estudo com Doppler colorido, à procura de focos de hipervascularização, e o exame ultra-sonográfico habitual. Os resultados foram comparados com os diagnósticos histopatológicos obtidos. RESULTADOS: A ultra-sonografia transretal habitual (escala de cinza apresentou sensibilidade de 67,7%, especificidade de 52,8%, valor preditivo positivo de 45,6% e valor preditivo negativo de 73,6%. A adição do estudo com Doppler colorido ocasionou aumento importante da especificidade (de 52,8% para 79,2% e do valor preditivo positivo (de 45,6% para 62,0%, porém causou queda na sensibilidade (de 67,7% para 58,0%. Além disso, houve perda de 32,2% dos cânceres, que não foram diagnosticados por nenhum dos dois métodos, e esses pacientes, apesar de possuírem cânceres menos extensos, eram todos clinicamente significativos (Gleason 6 ou mais. CONCLUSÃO: Mesmo com a associação do Doppler colorido, a ultra-sonografia transretal não possui capacidade suficiente para definir, através dos seus achados, quais pacientes devem ou não realizar biópsia.OBJECTIVE: To determine the role of transrectal ultrasound, especially in association with color Doppler, in the diagnosis of prostate cancer. MATERIALS AND METHODS: Eighty-four cases of patients who underwent transrectal biopsy were prospectively analyzed. In all patients, besides the traditional gray-scale sonogram, color Doppler study was performed in search of hypervascular foci. The results were compared with the histopathologic diagnosis. RESULTS: The gray-scale sonogram showed a 67.7% sensitivity, 52.8% specificity, positive predictive value of 45.6% and

  7. 超声引导下经直肠前列腺饱和穿刺在首次活检阴性人群中的诊断价值%Diagnostic value of transrectal ultrasound-guided saturation prostate biopsy after initial negative result

    Institute of Scientific and Technical Information of China (English)

    许宁; 毛厚平; 薛学义; 李晓东; 魏勇; 江涛; 高锐; 周辉良; 郑清水; 黄金杯

    2012-01-01

    Objective To investigate diagnostic value of transrectal ultrasound-guided saturation prostate biopsy protocols after initial negative biopsy result and to assess the efficacy and safety. Methods A total of 120 patients with elevated prostate specific antigen (PSA) and/or abnormal digital rectal examination after initial negative biopsy enrolled in this study and were randomly divided into extended biopsy group and saturation biopsy group, each group had 60 patients with repeat biopsy. The extended biopsy group used 12-core repeat biopsy and the saturation biopsy group used 24-core repeat biopsy. Periprostatic nerve block was performed in the two groups. The pain and discomfort were estimated based on visual analog scale (VAS). Results There was no significantly different in age, serum total PSA, PSA density, prostate volume, transition zone volume, previous pathology, digital rectal examination VAS and postoperative complications between the two groups (all P>0. 05). The total cancer detection rate of saturation biopsy group was higher than that of extended biopsy group (31. 67% vs 15. 00%, P= 0. 031) , the improvement of cancer detection rate was higher only when the prostate volume was greater than 60 ml (P=0. 033). Conclusion The transrectal ultrasound-guided saturation prostate biopsy can improve the detection rate of prostate cancer after initial negative result, and does not increase complications.%目的 探讨超声引导下经直肠饱和穿刺在临床疑诊为前列腺癌但首次活检阴性患者中的诊断价值,评价其有效性和安全性.方法 将120例医前列腺特异抗原(PSA)和(或)直肠指检异常而接受前列腺12针穿刺活检、且结果为阴性的患者纳入研究,随机分为扩大穿刺组(采用12针扩大穿刺法)和饱和穿刺组(采用24针饱和穿刺法),行超声引导下经直肠重复穿刺活检.对两组患者均行前列腺周围神经阻滞术,穿刺活检过程中观察患者情况,并采用视觉模拟评

  8. 直肠超声引导下8点及12点前列腺穿刺活组织检查常见并发症比较%comparison of complications incidence of 8-and 12-core prostate biopsy guided with transrectal ultrasound

    Institute of Scientific and Technical Information of China (English)

    张雅娟; 夏国兵; 蒋建新; 陈维开; 金秋龙

    2015-01-01

    Objective To compare complications incidence rates of 8-core and 12-core prostate biopsies guided with transrectal ultrasound retrospectively,and to study intervention ways to decrease complications.Methods The data of 260 consecutive patients undergoing first-time transrectal ultrasound-guided biopsy were analyzed.132 patients underwent 8-core biopsy and 128 patients underwent 12-core biopsy.Results In 8-core group,there were 7 cases of infections,15 cases of gross hematuria,7 cases of rectal bleeding and 6 cases of acute urinary retention,and in 12-core group,5 cases of infections,19 cases of gross hematuria,9 cases of rectal bleeding and 7 cases of acute urinary retention in 12-core group.There are no statistical differences of complications incidence rate between two groups (P > 0.05).when prostate volume > 45 ml,detection rate of prostate cancer in 12-core group was significantly higher than that in 8-core group.Conclusions There are no statistical differences of complications incidence rate between 8-and 12-core prostate biopsy.Homologous measure must be taken to reduce complications.12-core prostate biopsy is recommended as prostate volume > 45 ml.%目的 比较8点及12点前列腺穿刺活组织检查术后的并发症发生情况,探讨减少相关并发症的措施.方法 回顾性分析260例直肠超声引导下前列腺穿刺活组织检查患者的相关资料,其中132例患者接受8点穿刺,128例患者接受12点穿刺.结果 260例患者中感染12例,其中8点组7例,12点组5例;肉眼血尿34例,其中8点组15例,12点组19例;直肠出血16例,其中8点组7例,12点组9例;急性尿潴留13例,其中8点组6例,12点组7例,两组患者并发症的发生率差异均无统计学意义(均P> 0.05),但是当前列腺体积≥45 ml时,12点的前列腺癌检出率高于8点(P<0.05).结论 8点及12点穿刺的并发症发生率相当,采取针对性的措施可以明显降低前列腺穿刺活组织检查并发症的发生率,当

  9. 经直肠超声引导下的前列腺活检术后感染相关并发症的研究进展%Research Progress in Postoperative Infection Related Complications after Prostate Biopsy Guided by Transrectal Ultrasound

    Institute of Scientific and Technical Information of China (English)

    王娟霞(综述); 王志平(审校)

    2016-01-01

    With the improvement of living standards,the extension of human life,and the growth of age-ing population,the incidence of prostate cancer is an uptrend .However,there is no obvious symptom of early prostate cancer, most patients miss the best treatment timinge when diagnosed at middle-late stage,so early diagnosis of prostate cancer is critical.Prostate biopsy is the gold standard in the diagnosis of prostate cancer. Here is to make a review of the epidemiology,risk factors,prevention and treatment of the infection caused by prostate biopsy guided by transrectal ultrasound.%随着生活水平的提高、人类寿命的延长,人口老龄化增长,前列腺癌的发病率呈上升趋势。但由于前列腺癌早期无明显症状,大部分患者就诊时已属于中晚期,往往失去了最佳的治疗时机,因此早期诊断前列腺癌十分关键。前列腺穿刺活检术是诊断前列腺癌的金标准,该文对经直肠超声引导下的前列腺活检术后引发的感染相关并发症的流行病学,危险因素,预防及治疗进行综述。

  10. Clinical study of value of targeted antimicrobial method in prevention of postoperative infections in patients undergoing transrectal prostate biopsy%定向抗菌法预防经直肠前列腺穿刺活检术后感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    张喆; 陈建义; 梁俊峰

    2015-01-01

    OBJECTIVE To explore the clinical value of targeted antimicrobial method in prevention of postoperative infections in patients undergoing transrectal prostate biopsy so as to provide guidance for preoperative preparation of the transrectal prostate biopsy .METHODS A total of 300 prostate cancer patients who had biopsy indications and were treated in the hospital from Jan 2009 to Dec 2013 were recruited as the study objects and randomly divid‐ed into the group A ,B ,and C ,with 100 cases in each ;the group A was treated with conventional povidone iodine enemas ,the group B was given the oral administration of 500mg of ciprofloxacin at one hour before the biopsy on the basis of the conventional povidone iodine enemas and then was continuously treated with oral administration of 500mg of ciprofloxacin ,twice a day ,for three consecutive days ,while the control group received the targeted drug therapy in combination with rectal swab culture on the basis of the conventional povidone iodine enemas .RESULTS After the prostate biopsy ,the total infection rate was 20 .0% in the group A ,5 .0% in the group B ,0 in the group C ;the incidence of blood system infections was 9 .0% in the group A ,2 .0% in the group B ,0 in the group C ;the incidence of urinary system infections was 11 .0% in the group A ,3 .0% in the group B ,0 in the group C .Totally 25 strains of pathogens have been isolated from the rectal swab ,blood ,and urine specimens ,among which 15 (72 .0% ) strains of Escherichia coli were isolated from the group A ,3 strains from the group B .CONCLUSION The preoperative and postoperative antibiotics prophylaxis can reduce the incidence of postoperative infections in the patients undergoing transrectal prostate biopsy ,ciprofloxacin can achieve good effect on prevention of infec‐tions ,and the targeted antimicrobial method can remarkably reduce the incidence of postoperative infections .%目的:探讨定向抗菌法在预防经直肠前列腺穿刺活检术后

  11. 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

  12. Do apparent diffusion coefficient (ADC) values obtained using high b-values with a 3-T MRI correlate better than a transrectal ultrasound (TRUS)-guided biopsy with true Gleason scores obtained from radical prostatectomy specimens for patients with prostate cancer?

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    Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Takahashi, Satoru; Ueno, Yoshiko [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Miyake, Hideaki; Fujisawa, Masato [Department of Urology, Kobe University Graduate School of Medicine, Kobe (Japan); Kawakami, Fumi [Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2013-08-15

    Objective: To investigate the usefulness of apparent diffusion coefficient (ADC) values in predicting true Gleason scores from radical prostatectomy specimen (tGS), compared with systematic transrectal ultrasound (TRUS)-guided biopsy GS (bGS). Materials and methods: One hundred and five patients with biopsy-proven prostate cancer underwent preoperative DWI (b-values of 0, 1000, and 2000 s/mm{sup 2}) of 3-T MRI. The mean and minimum ADCs of visible tumors were calculated for either of a pair of b-values: 0 and 1000 s/mm{sup 2} (ADC{sub 1000}), or 0 and 2000 s/mm{sup 2} (ADC{sub 2000}), and relationships between the four ADC parameters and tGS evaluated for the peripheral zone (PZ) and transition zone (TZ). For multiple tumors, the dominant tumor's GS and ADCs were estimated for cancer aggressiveness assessment by computing ROC curves. Results: Significant negative correlations were observed between tGS and mean ADC{sub 1000}, mean ADC{sub 2000}, minimum ADC{sub 1000}, and minimum ADC{sub 2000} (r = −0.41, −0.39, −0.39, and −0.37, respectively) of 100 visible PZ tumors and 66 visible TZ tumors (r = −0.40, −0.42, −0.29, and −0.21, respectively). For distinguishing high-grade from low/intermediate-grade PZ lesions, the areas under the curve (AUCs) of mean ADC{sub 1000} (0.751), mean ADC{sub 2000} (0.710), minimum ADC{sub 1000} (0.768), and minimum ADC{sub 2000} (0.752) were similar to that of the highest bGS (0.708) (p = 0.61, p = 0.98, p = 0.47, and p = 0.60, respectively). For distinguishing high-grade from low/intermediate-grade TZ lesions, AUCs of mean ADC{sub 1000} (0.779), and mean ADC{sub 2000} (0.811) were similar to that of the highest bGS (0.805) (p = 0.83 and p = 0.97). Conclusion: Tumor ADCs obtained with high b-values could predict prostate cancer aggressiveness as effectively as systematic TRUS-guided biopsy.

  13. The significance of transrectal ultrasound guided transperineal seminal vesicle biopsy in evaluating the clinical stage of prostate cancer%直肠超声引导下经会阴精囊腺穿刺活检术在评价前列腺癌临床分期中的意义

    Institute of Scientific and Technical Information of China (English)

    卢圣铭; 丁雪飞; 肖芹; 周广臣; 顾晓; 齐小康; 陈骥

    2015-01-01

    目的 探讨直肠超声引导下经会阴精囊腺穿刺活检术在评价前列腺癌临床分期中的可行性和安全性.方法 回顾性分析2010年7月至2015年1月收治的57例伴有精囊异常的疑似前列腺癌患者的临床资料.年龄50 ~ 78岁,平均(65±7)岁.血清总前列腺特异性抗原(tPSA)3.2 ~ 131.1 μg/L,平均(23.7±11.3) μg/L.22例直肠指检可触及前列腺结节.结合MRI检查结果,临床分期均为T3b期.局麻下,57例均行超声及模板引导下经会阴前列腺及精囊腺分区穿刺活检,前列腺分为11区,每区穿刺1~4针;两侧精囊腺分别自外侧向中央穿刺3针,尽量靠近膀胱底部.穿刺组织送病理检查.结果 57例均顺利完成穿刺.穿刺病理检查发现前列腺癌44例,Gleason评分6~10分.其中累及精囊腺32例(阳性组),肿瘤分期T3b期;未累及12例(阴性组),肿瘤分期T2期.阳性组中20例行根治性前列腺切除术,术后病理诊断均提示前列腺癌累及精囊腺,术后病理分期为T3b期.阴性组中11例行根治性前列腺切除术,2例术后病理诊断提示累及精囊腺,肿瘤分期为T3b期.精囊腺穿刺敏感性为91% (20/22),特异性为100% (9/9),阳性预测值为100%(20/20),阴性预测值为82% (9/11).57例穿刺后均无发热,发生肉眼血尿23例(40%)、血精20例(35%)、尿潴留1例(2%),对症处理后症状消失.结论 直肠超声引导下经会阴精囊腺穿刺安全、可靠,有助于提高前列腺癌术前临床分期的准确率.%Objective To explore the safty and feasibility of transrectal ultrasound guided transperineal seminal vesicle biopsy in the evaluation of clinical staging of prostate cancer.Methods Retrospectively study 57 suspected prostate cancer patients with seminal abnormality during 2010.7-2015.1,age ranged from 50 to 78 years,average 65 ±7 years,serum total prostate specific antigen (tPSA) 3.2-131.1 μg/L, average (23.7 ± 11.3) μg/L.Twenty-two cases had palpable prostate

  14. Biopsym : a learning environment for transrectal ultrasound guided prostate biopsies

    CERN Document Server

    Thomas, Janssoone; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2010-01-01

    This paper describes a learning environment for image-guided prostate biopsies in cancer diagnosis; it is based on an ultrasound probe simulator virtually exploring real datasets obtained from patients. The aim is to make the training of young physicians easier and faster with a tool that combines lectures, biopsy simulations and recommended exercises to master this medical gesture. It will particularly help acquiring the three-dimensional representation of the prostate needed for practicing biopsy sequences. The simulator uses a haptic feedback to compute the position of the virtual probe from three-dimensional (3D) ultrasound recorded data. This paper presents the current version of this learning environment.

  15. 经直肠超声检查在男性梗阻性无精子症病因筛查中的作用(附695例病例分析)%Transrectal ultrasonography in the etiological diagnosis of male obstructive azoospermia:Analysis of 695 cases

    Institute of Scientific and Technical Information of China (English)

    王道虎; 陈凌武; 丘少鹏; 邓春华; 梁辉; 赵红伟; 吴荣佩; 陈炜; 陈羽; 罗俊航; 陈俊星; 梁月有

    2011-01-01

    Objective: To assess the role of transrectal ultrasonography (TRUS) in the etiological diagnosis of male obstructive azoospermia. Methods: We retrospectively analyzed the clinical data and TRUS findings of 695 patients with obstructive azoospemia from January 2007 to May 2009. Results: Concerning the etiology of obstructive azoospemia, the main TRUS findings included ejaculatory duct abnormality (29.2%), seminal vesicle abnormality (25.4%) and prostate midline cyst ( 18.5% ). TRUS revealed 203 cases of ejaculatory duct dilation, 177 cases of seminal vesicle abnormality (including 108 with absence or agenesis and 51 with dilation of the seminal vesicle), and 128 cases of prostate midline cyst ( including 75 with ejaculatory duct cyst and 39 with Miillerian cyst). Calcification of the verumontanum or ejaculatory duct was suspected to be the causes of obstructive azoospermia in 34 cases.However, no significant etiological abnormality was found in 153 cases. Obvious etiology was shown by TRUS in 78.0% of the patients. Conclusion: TRUS can clearly display the structural abnormality of the ejaculatory duct and seminal vesicle, and provide important information on the etiology of male obstructive azoospermia.%目的:探讨经直肠超声(THUS)在男性梗阻性无精子症病因筛查中的作用.方法:回顾性分析我院2007年1月至2009年5月695例男性梗阻性无精于症患者的TRUS的病因诊断结果.结果:695例梗阻性无精子症患者中,TRUS检查发现病变以射精管病变(29.2%)、精囊腺病变(25.4%)以及前列腺中线囊肿病变(18.5%)为主.TRUS检查共发现射精管扩张203例;精囊腺病变177例,其中先天性精囊腺缺如或者发育不全108例,精囊腺扩张51例;另外,TRUS诊断发现前列腺中线囊肿128例,其中75例(58.5%)射精管囊肿,39例(30.5%)苗勒管囊肿.34例患者的梗阻性无精于症可能由于钙化性疾病导致.而153例患者(22.0%)TRUS检查未见明显异常.TRUS在本组

  16. 经直肠超声引导精囊穿刺注射药物冲洗治疗精囊炎的研究%Study on Puncturing Seminal Vesicle and Injecting Drugs Under the Guidance of Transrectal Ultrasound to Treat Vesiculitis

    Institute of Scientific and Technical Information of China (English)

    黄进; 李文伦; 张明荣; 张华民; 付世文; 李莉

    2001-01-01

    目的:探讨经直肠超声(TRUS)引导精囊穿刺注射药物冲洗并保留治疗精囊炎的效果。方法:将76例患者随机分为A、B、C三组,A组28例在TRUS引导下穿刺精囊,用灭滴灵250ml冲洗精囊后,注入丁胺卡那霉素0.4g保留;B组28例在TRUS引导下穿刺精囊,用生理盐水250ml冲洗精囊,注入丁胺卡那霉素0.4g保留,两组均每隔10天治疗一次,3次为一疗程;C组20例口服氟嗪酸及静脉应用丁胺卡那霉素。对三组的疗效进行评价。结果:A组治愈25例(89.3%),有效2例(7.1%),无效1例(3.6%),总有效率96.4%,B组治愈16例(57.1%),有效6例(21.4%),无效6例(21.4%),两组穿刺成功率100%。C组治愈3例(15%),有效3例(15%),无效14例(70%),A、B组比较治愈率、有效率有明显差异P<0.01,A、C两组比较有显著差异P<0.001。结论:TRUS引导精囊穿刺注射药物冲洗并保留抗生素治疗精囊炎是一种理想的治疗方法。%Objective:To explore the ideal result of puncturing seminalvesicle and injecting drugs with sluicing and retaining ways under the guidance of transrectal ultrasound(TRUS) to treat vesiculitis.Methods:Seventy six cases with vesiculitis were randomly divided into A,B,C groups. In group A 28 cases with seminal vesicles were punctured under the guidance of TRUS,sluiced with metronidazole,injected and retained with amikacin 0.4g. In group B other 28 cases with seminal vesicles were punctured with the same method, but sluiced with 0.9% NS, injected and retained with amikacin 0.4g.Each one of A,B groups were treated this way once in ten days.One course consisted of three times. In Group C 20 cases with seminal vesicle were treated with Ofloxacin capsules P.O. and amikacin in intravenous drip.Results:Twenty five cases of group A were cured(89.3%),the alleviations rate was 7.1%(2),one case was ineffective(3.6%),the total effective rate was 96.4%.sixteen cases in group B were cured(57.1%),the

  17. Meta-analysis of antibiotic prophylaxis for postoperative bacteriuria in patients undergoing transrectal prostatic biopsy%抗生素对经直肠前列腺活检术后菌尿预防效果的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    杨明根; 赵晓昆; 吴志平; 肖宁; 吕晨; 侯轶

    2009-01-01

    Objective To investigate whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in patients undergoing transrectal prostatic biopsy (TPB) who have sterile preoperative urine. Methods MEDLINE, EMBASE, Cochrane Collaboration Reviews, CMCC, and CNKI were searched for randomized controlled trials (RCTs) comparing antibiotic prophylaxis with placebo/blank controls for patients undergoing TPB with preoperative sterile urine. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed extraction form. The software RevMan4.2 was used to review management and data analysis. Results 67 relevant RCTs were found, of which 12 qualified ones were included into the analysis. Antibiotic prophylaxis significantly decreased the rate of bacteriuria within the period 1 week after TPB (corresponding pooled relative risk (RR) and 95% CI was 0. 32 ( 0. 23 - 0. 46, P < 0. 01 ). The effective antibiotics included quinolones and quinolones combined with nitroimidazole , with the pooled RR and 95% CI of 0. 31 (0. 18 - 0. 53, P<0. 01) and 0. 32 (0. 17 -0. 60, P=0. 0004) respectively. There was no significant difference in the effect between short treatment course protocol and long course protocol (P = 0. 41 ). Conclusion Prophylactic antibiotics can significantly decrease the incidence of post-TPB bacteriuria. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and-quinolones combined with nitroimidazole. Treatment protocols of any duration are effective.%目的 分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者术后菌尿的发生率.方法 制定原始文献的纳入标准、排除标准及检索策略,在美国医学索引MEDLINE(1966年1月至2007年12月)、荷兰医学文摘EMBASE(1988年1月至2007年12月)、Cochrane图书馆、中国生物

  18. 前列腺周围神经阻滞麻醉对缓解经直肠超声引导下前列腺穿刺活检术疼痛的效果%Efficacy of periprostatic nerve block anesthesia for pain control in transrectal ultrasound-guided systematic prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    谢毅; 周芳坚; 李永红; 蒋丽娟; 吴志明; 秦自科; 韩辉; 刘卓炜

    2016-01-01

    目的:评估前列腺周围神经阻滞麻醉(PPNB)对缓解经直肠超声引导下前列腺穿刺活检术时疼痛的效果。方法回顾性分析我院2013年11月~2015年1月经直肠超声引导下前列腺12针系统穿刺患者111例,根据是否采用PPNB,将患者分成PPNB组(52例)和非PPNB组(59例)。PPNB组在经直肠超声引导下注射1%利多卡因阻滞麻醉前列腺周围神经,然后行穿刺活检;非PPNB组未采用任何麻醉方法。穿刺结束后采用视觉模拟评分法对直肠指检(DRE)、经直肠超声检查、穿刺过程进行疼痛评分;穿刺结束后7天随访患者穿刺并发症。结果两组患者的年龄、前列腺体积、总前列腺特异性抗原(TPSA)、游离前列腺特异性抗原(FPSA)、DRE异常比例差异无统计学意义。两组患者DRE疼痛评分(1.40∶1.39,P=0.997)、经直肠超声检查疼痛评分(2.10∶2.07,P=0.834)差异无统计学意义;然而,PPNB组穿刺疼痛评分更低(2.54∶3.07,P=0.033)。两组患者穿刺并发症差异无统计学意义。结论相对于无麻醉,采用前列腺周围神经阻滞麻醉可减轻经直肠超声引导下前列腺穿刺活检术时疼痛不适。%Objective To evaluate the efficacy of periprostatic nerve block anesthesia (PPNB) for pain relief in transrectal ultrasound-guided systematic prostate biopsy (PBx). Methods We reviewed the data of patients undergoing initial PBx at our center from November, 2013 to January, 2015. Only the patients with 12-core systemic PBx were included and 111 patients were eligible for this study, among whom 52 patients received PPNB and 59 did not. PPNB was achieved by an injection of 5 mL of 1%lidocaine at the angle between the seminal vesicle and base of the prostate on each side before biopsy. The DRE pain score, probe insert pain score, and biopsy pain score were assessed by visual analogue scale (VAS) immediately after the biopsy. The complications

  19. Ultrasound-guided percutaneous biopsy of digestive tract lesions; Biopsia percutanea de lesiones del tubo digestivo guiada por ecografia

    Energy Technology Data Exchange (ETDEWEB)

    Gil, S.; Martin, I.; Ballesteros, J. M.; Gomez, C. [Hospital General Universitario de Alicante (Spain); Marco, S. F.; Fernandez, P. [Hospital Gneral de Castellon (Spain)

    1999-07-01

    To present our experience in ultrasound-guided percutaneous biopsy of lesions located in the digestive tract. We performed ultrasound-guided percutaneous biopsy in 14 patients (10 men and 4 women) ranging in age from 7 to 71 years (mean; 519 years). The lesions were located throughout the digestive tract, from the pyriform sinus to the sigmoid colon. The biopsy was carried out with a 5 MHz convex probe equipped with a device to direct the needle. An 18G automatic needle or a 20G Chiba needle was used to obtain specimens for histological study in every case, and additional samples were collected with a 22G needle for cytological examination in 13 of the patients. The ultrasound images corresponded to pseudokidney in 9 cases and extrinsic masses in 5. The diagnosis was obtained from the histological examination in every case (100%) and from cytology in 6 (44.4%), the latter results were less specific. The only complication corresponded to a case of bilioperitoneum. Ultrasound-guided percutaneous biopsy is a suitable technique for the histological diagnosis of those lesions of the digestive tract that are visible in ultrasound images, but that for some reason can not be examined by endoscopic biopsy. (Author) 20 refs.

  20. Prostate biopsies guided by three-dimensional real-time (4-D) transrectal ultrasonography on a phantom: comparative study versus two-dimensional transrectal ultrasound-guided biopsies

    CERN Document Server

    Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne; Rambeaud, Jean-Jacques; Descotes, Jean-Luc

    2007-01-01

    OBJECTIVE: This study evaluated the accuracy in localisation and distribution of real-time three-dimensional (4-D) ultrasound-guided biopsies on a prostate phantom. METHODS: A prostate phantom was created. A three-dimensional real-time ultrasound system with a 5.9MHz probe was used, making it possible to see several reconstructed orthogonal viewing planes in real time. Fourteen operators performed biopsies first under 2-D then 4-D transurethral ultrasound (TRUS) guidance (336 biopsies). The biopsy path was modelled using segmentation in a 3-D ultrasonographic volume. Special software was used to visualise the biopsy paths in a reference prostate and assess the sampled area. A comparative study was performed to examine the accuracy of the entry points and target of the needle. Distribution was assessed by measuring the volume sampled and a redundancy ratio of the sampled prostate. RESULTS: A significant increase in accuracy in hitting the target zone was identified using 4-D ultrasonography as compared to 2-D....

  1. Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection; Biopsia percutanea de massas pancreaticas guiada por tomografia computadorizada com pneumodisseccao

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Bitencourt, Almir Galvao Vieira; Almeida, Maria Fernanda Arruda; Barbosa, Paula Nicole Vieira; Martins, Eduardo Bruno Lobato; Junior, Joao Paulo Kawaoka Matushita; Chojniak, Rubens, E-mail: chiangjengtyng@gmail.com [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Imagem; Coimbra, Felipe Jose Fernandez [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Cirurgia Abdominal

    2013-05-15

    Objective: to describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and methods: in the period from June 2011 to May 2012, seven computed tomography guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results: in all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion: Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible. (author)

  2. Riesgo de recurrencia ganglionar y valoración evolutiva en pacientes con carcinoma de mama en estadios precoces y sometidas a la biopsia selectiva del ganglio centinela

    OpenAIRE

    Domènech Vilardell, Anna

    2011-01-01

    ANTECEDENTES DEL TEMA: El estado ganglionar axilar es el factor pronóstico más importante para determinar la supervivencia y la recurrencia en el carcinoma de mama, puesto que es conocido que la afectación axilar en estas pacientes, disminuye la supervivencia a los 5 años del 85-95 % al 55-70 % y conlleva a que presenten metástasis a distancia con más frecuencia . De todos modos, la introducción y amplia utilización del cribado mamográfico está aumentando la detección de tumores incipientes ...

  3. Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer : a multicenter study

    OpenAIRE

    UCHIDA, TOYOAKI; Baba, Shiro; Irie, Akira; Soh, Shigehiro; Masumori, Naoya; Tsukamoto, Taiji; Nakatsu, Hiroomi; Fujimoto, Hiroyuki; Kakizoe, Tadao; Ueda, Takeshi; Ichikawa, Tomohiko; Ohta, Nobutaka; Kitamura, Tadaichi; Sumitomo, Makoto; Hayakawa, Masamichi

    2005-01-01

    限局性前立腺癌に対する高密度焦点式超音波療法の多施設共同研究の成績について報告した.対象は,stageT1-2N0M0の72例の限局性前立腺癌で,症例の年齢中央値は72歳,血清PSA中央値は8.10n/mlであった.その結果,治療効果は全体では1年78%,2年76%が非再発生存であった.浸潤度別に2年目の生化学的非再発生存率を集計したところ,stage T1cが89%,stage T2a 67%,stage T2bは40%(p=0.0817)であった.悪性度別では,Gleason 2~4群は88%,Gleason 5~7群は72%,Gleason 8~10群は80%(p=0.6539)であった.術前の血清PSA値別2年非再発生存率は,PSAが10ng/ml以下群は75%,10~20ng/ml群は78%(p=0.6152)であった.術後6ヵ月目の前立腺生検では68%において癌細胞は認められなかった.前立腺体積は,術前24.2mlから術後6ヵ月目14.0mlと縮小していた(p...

  4. Comparison of medical of volume measurement of the prostate by transrectal ultrasound: Experiment with jelly models

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jeong Yeon; Lee, Hak Jong; Kim, Sung Hyun [Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2002-03-15

    To evaluate the accuracy of measuring the volume of the prostate using the prolate ellipsoid volume calculation method (antero-posterior (AP) diameter X length X width X {pi}6) when the antero-posterior diameter of the prostate was measured on midsagittal (sagittal volume) and axial plane (axial volume).The devil's tongue jelly was used for the creation of ultrasound model of the prostate (volume: 15-40 cc) by cutting and shaping the surface. The volume in 10 prostatic models and 30 patients was measured and calculated. First, the AP diameter and length of the prostate models in midsagittal plane, and the height and width of the models in axial plane were measured for 3 times. The volume was calculated in two ways, one using the AP diameter an midsagittal plane and the other using the AP diameter in axial plane. The true volume of the model was measured using mess cylinder. The calculated volume and true volume were compared, and the accuracy of two method of measuring the prostatic volume was evaluated by Friedman test. The intraobserver variation was evaluated by General Linear Model, Repeated Measure. The reproducibility was evaluated by Cronbach's {alpha}. In vivo study was also performed in 30 patients. The prostate volume was calculated in the same manner. These volume data were analyzed by statistical method, and the intraobeserver variation was evaluated. While there was a statistically significant difference between the sagittal and true volume of the models, there was no statistical significant difference between the axial and true volumes. There was no significant intraobserver variation between both methods. The reproducibility was high in both methods with Cronbach's {alpha} of 0.977 and 0.942. The sagittal volume was larger than the axial volume in 30 patients with a statistically significant difference. There was no significant intraobserver variation in both methods. The reproducibility was high in both methods Cronbach's {alpha} of 0.991 and 0994. The volumetric methods for the prostate using the antero-posterior diameter measured in axial plane was more accurate than on midsagittal plane.

  5. Impact of Benign Prostatic Hyperplasia Pharmacological Treatment on Transrectal Prostate Biopsy Adverse Effects

    OpenAIRE

    Marina Zamuner; Ciro Eduardo Falcone; Arnaldo Amstalden Neto; Tomás Bernardo Costa Moretti; Luis Alberto Magna; Fernandes Denardi; Leonardo Oliveira Reis

    2014-01-01

    Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients w...

  6. Dual-frequency super harmonic imaging piezoelectric transducers for transrectal ultrasound

    Science.gov (United States)

    Kim, Jinwook; Li, Sibo; Kasoji, Sandeep; Dayton, Paul A.; Jiang, Xiaoning

    2015-03-01

    In this paper, a 2/14 MHz dual-frequency single-element transducer and a 2/22 MHz sub-array (16/48-elements linear array) transducer were developed for contrast enhanced super-harmonic ultrasound imaging of prostate cancer with the low frequency ultrasound transducer as a transmitter for contrast agent (microbubble) excitation and the high frequency transducer as a receiver for detection of nonlinear responses from microbubbles. The 1-3 piezoelectric composite was used as active materials of the single-element transducers due to its low acoustic impedance and high coupling factor. A high dielectric constant PZT ceramic was used for the sub-array transducer due to its high dielectric property induced relatively low electrical impedance. The possible resonance modes of the active elements were estimated using finite element analysis (FEA). The pulse-echo response, peak-negative pressure and bubble response were tested, followed by in vitro contrast imaging tests using a graphite-gelatin tissue-mimicking phantom. The single-element dual frequency transducer (8 × 4 × 2 mm3) showed a -6 dB fractional bandwidth of 56.5% for the transmitter, and 41.8% for the receiver. A 2 MHz-transmitter (730 μm pitch and 6.5 mm elevation aperture) and a 22 MHz-receiver (240 μm pitch and 1.5 mm aperture) of the sub-array transducer exhibited -6 dB fractional bandwidth of 51.0% and 40.2%, respectively. The peak negative pressure at the far field was about -1.3 MPa with 200 Vpp, 1-cycle 2 MHz burst, which is high enough to excite microbubbles for nonlinear responses. The 7th harmonic responses from micro bubbles were successfully detected in the phantom imaging test showing a contrast-to-tissue ratio (CTR) of 16 dB.

  7. Is periprostatic nerve block a gold standard in case of transrectal ultrasound-guided prostate biopsy?

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2013-01-01

    Conclusions: PNB provides better pain control in TRUS-guided prostate biopsy but still there is need of additional analgesic in the form of tramadol or INB. Tramadol has advantage of oral intake and analgesic effect at time of probe insertion and at nerve block. Both tramadol and INB may be used in combination along with PNB.

  8. Safety of ultrasound-guided transrectal extended prostate biopsy in patients receiving low-dose aspirin

    Directory of Open Access Journals (Sweden)

    Ioannis Kariotis

    2010-06-01

    Full Text Available PURPOSE: To determine whether the peri-procedural administration of low-dose aspirin increases the risk of bleeding complications for patients undergoing extended prostate biopsies. MATERIALS AND METHODS: From February 2007 to September 2008, 530 men undergoing extended needle biopsies were divided in two groups; those receiving aspirin and those not receiving aspirin. The morbidity of the procedure, with emphasis on hemorrhagic complications, was assessed prospectively using two standardized questionnaires. RESULTS: There were no significant differences between the two groups regarding the mean number of biopsy cores (12.9 ± 1.6 vs. 13.1 ± 1.2 cores, p = 0.09. No major biopsy-related complications were noted. Statistical analysis did not demonstrate significant differences in the rate of hematuria (64.5% vs. 60.6%, p = 0.46, rectal bleeding (33.6% vs. 25.9%, p = 0.09 or hemospermia (90.1% vs. 86.9%, p = 0.45. The mean duration of hematuria and rectal bleeding was significantly greater in the aspirin group compared to the control group (4.45 ± 2.7 vs. 2.4 ± 2.6, p = < 0.001 and 3.3 ± 1.3 vs. 1.9 ± 0.7, p < 0.001. Multivariate logistic regression analysis revealed that only younger patients (mean age 60.1 ± 5.8 years with a lower body mass index (< 25 kg/m2 receiving aspirin were at a higher risk (odds ratio = 3.46, p = 0.047 for developing hematuria and rectal bleeding after the procedure. CONCLUSIONS: The continuing use of low-dose aspirin in patients undergoing extended prostatic biopsy is a relatively safe option since it does not increase the morbidity of the procedure.

  9. Comparison of 3 different methods of anesthesia before transrectal prostate biopsy: a prospective randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Oebek, C.; Oezkan, B.; Tunc, B.; Can, G.; Yalcin, V.; Solok, V. [University of Istanbul (Turkey). Cerrahpasa School of Medicine. Depts. of Urology and Public Health (GC)

    2004-09-15

    Purpose: Periprostatic nerve block (PNB) is the most common anesthesia technique used before prostate biopsy. However, needle punctures for anesthetic infiltration may be painful and cause higher infectious complications. We assessed whether addition of rectal lidocaine gel would improve its efficacy. We also investigated the efficacy and safety of tramadol, a codeine derivative, as a noninvasive method. Materials and Methods: A total of 300 patients who underwent prostate biopsies were randomized into 4 groups of controls, PNB, perianal/intrarectal lidocaine gel plus PNB and tramadol. Pain was assessed with a numeric analog scale. Results: Each group consisted of 75 patients, and there was a statistically significant difference among pain scores (p = 0.001). Mean pain scores were 4.63 for controls, 2.57 for PNB, 2.03 for infiltration plus gel group and 3.11 for tramadol. Pain and discomfort were least in PNB plus gel arm. The difference of pain score between PNB alone and tramadol group did not reach statistical significance. Infectious complications were higher in the combination group, whereas there were no complications with tramadol. Conclusions: Any form of analgesia/anesthesia was superior to none. The combination of PNB plus gel provided significantly better analgesia compared to PNB alone or tramadol. If this can be duplicated in other trials, the combination may be accepted as the new gold standard of anesthesia for prostate biopsy. The efficacy of tramadol was similar to that of PNB, and was free of complications. Therefore, tramadol may have a role before prostate biopsy, which needs to be explored. (author)

  10. Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin

    Directory of Open Access Journals (Sweden)

    Pawan Vasudeva

    2015-12-01

    Full Text Available Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters included for statistical analysis were: age, serum prostate specific antigen (PSA, prostate volume, hemoglobin (Hb %, number of hematuria episodes, number of patient reporting hematuria, hematuria requiring intervention, number of patient reporting hematospermia and number of patient reporting rectal bleeding. Results: Of 681 eligible patients, Group A and B had 191 and 490 patients respectively. The mean age, prostate volume, serum PSA and pre-biopsy hemoglobin were similar in both Groups with no significant differences noted between them. None of the post-biopsy complications, including number of hematuria episodes (p=0.83, number of patients reporting hematuria (p=0.55, number of patients reporting hematospermia (p=0.36 and number of patients reporting rectal bleeding (p=0.65, were significantly different between Groups A and B respectively. None of the hemorrhagic complication in either group required intervention and were self limiting. Conclusion: Continuing low dose aspirin during TRUS guided prostate biopsy neither alters the minor bleeding episodes nor causes major bleeding complication. So, discontinuation of low dose aspirin prior to TRUS guided prostate biopsy is not required.

  11. Lidocaine spray administration in transrectal ultrasound-guided prostate biopsy: Five years of experience

    Directory of Open Access Journals (Sweden)

    Lucio Dell’Atti

    2014-12-01

    Full Text Available Objectives: We report in this singlecenter study our results of a five-year experience in the administration of lidocaine spray (LS during ultrasound-guided prostate biopsy (TPB. Material and Methods: Between August 2008 and July 2013 a total of 1022 consecutive male patients scheduled for TPB with elevate PSA (≥ 4 ng/ml and (or abnormal digital rectal and (or suspect TRUS were considered eligible for the study. Each patient was treated under local anaesthesia with LS (10 gr/100 ml, applied two minutes before the procedure. TPB was performed with the patient in the left lateral decubitus using multi-frequency convex probe “end-fire”. Two experienced urologists performed a 14-core biopsy, as first intention. After the procedure each patient was given a verbal numeric pain scale (VNS. The evaluation was differentiated in two scales VNS: VNS 1 for the insertion of the probe and the manoeuvres associated, while VNS 2 only for the pain during needle’s insertion. Results: Pain scores were not statistically significant different with regard to the values of PSA and prostate gland volume. Pain score levels during probe insertion and biopsy were significantly different: the mean pain score according to VNS was 3.3 (2-8 in the first questionnaire (VNS1 (p < 0.001 and 2.1 (1-7 in the second one (VNS2 (p < 0.125. The 8.2% of cases referred severe or unbearable pain (score ≥ 7, 74% of patients referred no pain at all. Only 21 patients would not ever repeat the biopsy or would request a different type of anaesthesia, while 82% of them would repeat it in the same way. In only eight patients we have not been able to insert TRUS probe. Conclusions: Our pain score data suggest that LS provides efficient patient comfort during TPB reducing pain both during insertion of the probe and the needle. This non-infiltrative anaesthesia is safe, easy to administer, psychologically well accepted by patients and of low cost.

  12. Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin

    OpenAIRE

    Pawan Vasudeva; Niraj Kumar; Anup Kumar; Harbinder Singh; Gaurav Kumar

    2015-01-01

    ABSTRACT Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters inclu...

  13. Protocol for the realization of transrectal prostatic biopsy guided by ultrasound

    International Nuclear Information System (INIS)

    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

  14. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Raja, J. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)]. E-mail: jowadraja@gmail.com; Ramachandran, N. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Munneke, G. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Patel, U. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)

    2006-02-15

    In contemporary practice, most prostate cancers are either invisible on ultrasound or indistinguishable from concurrent benign prostatic hyperplasia. Diagnosis therefore rests on prostate biopsy. Biopsies are not simply directed at ultrasonically visible lesions, as these would miss many cancers; rather the whole gland is sampled. The sampling itself is systematic, using patterns based on prostate zonal anatomy and the geographical distribution and frequency of cancer. This review explains the evolution of the prostate biopsy technique, from the classical sextant biopsy method to the more recent extended biopsy protocols (8, 10, 12, >12 and saturation biopsy protocols). Extended protocols are increasingly being used to improve diagnostic accuracy, especially in those patients who require repeat biopsy. This trend has been facilitated by the ongoing improvement in safety and acceptability of the procedure, particularly with the use of antibiotic prophylaxis and local anaesthesia. The technical details of these extended protocols are discussed, as are the current data regarding procedure-related morbidity and how this may be minimized.

  15. Transrectal high-intensity focused ultrasound for the treatment of prostate cancer: Past, present, and future

    OpenAIRE

    Mearini, Luigi; Porena, Massimo

    2010-01-01

    Upon a review of recently published articles on high-intensity focused ultrasound (HIFU) in the treatment of prostate cancer, we evaluated the current status of HIFU as a primary treatment option for localized prostate cancer and its use as salvage therapy when radiation failed. We also briefly discuss current issues in indications, definition of response, and finally the future of HIFU development.

  16. Transrectal ultrasonography and magnetic resonance imaging in the staging of rectal cancer. Effect of experience

    DEFF Research Database (Denmark)

    Rafaelsen, Søren R; Sørensen, Torben; Jakobsen, Anders;

    2008-01-01

    .5-Tesla MRI unit and TRUS using a 6.5-MHz transducer. An experienced gastrointestinal radiologist (R1) or a general radiologist (R2) performed the evaluations. All patients (78 M, 56 F, mean age 69.1 years, range 38-89) were treated with surgery alone. The mean size of the tumour was 4.0 cm (range 1...

  17. Utility of color Doppler transrectal ultrasound in the diagnosis of prostate cancer: a study of 101 cases; Utilidad de la ecografia transrectal con Doppler color en el diagnostico del cancer de prostata. Estudio de 101 casos

    Energy Technology Data Exchange (ETDEWEB)

    Morales, F. J.; Jornet, J.; Cervera, J.; Labrador, T. [Instituto Valenciano de Oncologia. Valencia (Spain)

    2001-07-01

    To determine the value of color Doppler ultrasound in the detection of prostate cancer. To relate asymmetries in vascularisation with the results of directed biopsy. Between May and November 2000, we studied 101 patients suspected of having prostate cancer. The selection criteria were a prostate-specific antigen level of over 3 ng/ml, suspicious digital rectal examination or both. The volume, capsule and internal architecture were assessed, focusing on nodules, suspicious hypoechoic areas and asymmetric color intensity. Sextant biopsies were carried out with an 18-gauge needle and samples were also taken of the areas of increased color intensity. (Author) 16 refs.

  18. 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alexandre Peltier

    2013-01-01

    Full Text Available Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice. Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol. Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05. There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection. Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

  19. Intra-operative dosimetry of trans-rectal ultrasound guided 125I prostate implants using C-arm fluoroscopic images

    Directory of Open Access Journals (Sweden)

    Ravindran Paul

    2006-01-01

    Full Text Available Permanent implantation of radioactive seeds is a viable and effective therapeutic option widely used today for early-stage prostate cancer. The implant technique has improved considerably during the recent years due to the use of image guidance; however, real-time dose distributions would allow potential cold spots to be assessed and additional seeds added. In this study, we investigate the use of a conventional C-arm fluoroscopy unit for image acquisition and evaluation of dose distribution immediately after the implant. The phantom study indicates that it is possible to obtain seed positions within ±2 mm. A pilot study carried out with three patients indicated that it is possible to obtain seed positions and calculate the dose distribution with C-arm fluoroscopy and about 95% of the seeds were reconstructed within ±2 mm. The results could be further improved with better digital imaging.

  20. Transrectal impalement of an incense stick in a child presenting as foreign body in the urinary bladder.

    Science.gov (United States)

    Mahapatra, Rajkumar Singha; Priyadarshi, Vinod; Madduri, Vijay Kumar Sarma; Pal, Dilip Kumar

    2014-06-12

    The diversity of objects that can be found in the urinary bladder often surpasses the urologist's imagination and mostly they are introduced per urethrally. Impalement injuries of the rectum with bladder perforation have been rarely reported. A high index of clinical suspicion is required to make the diagnosis of bladder perforation while assessing patients presenting with rectal impalement. In this interesting case, a young male child presented with haematuria and dysuria. He had a history of accidentally sitting on an agarbatti (Indian incense stick) stand while playing, followed by perianal pain which subsided spontaneously. Next day he presented with haematuria and dysuria. Clinical examination was inconclusive. On thorough investigation, a linear echogenic foreign body was found in the urinary bladder. The child was operated and the foreign body (incense stick) was removed. This is the first reported case of rectal impalement injury with incense stick, migrated to the urinary bladder in a 2-year-old child.

  1. Location studies of prostate volume measurement by using transrectal ultrasonography: Experimental study by self-produced prostate phantom

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon; Byeon, Il Kyun; Lee, Hoo Min [Dept. of Radiological Science, (Korea, Republic of); Kim, Yun Min; Kim, Hyeong Gyun [Dept. of Radiological Technology, Dongnam Health University, Suwon (Korea, Republic of)

    2015-12-15

    Accurate volume measurement of the prostate is a significant role in determining the result of diagnosis and treatment of benign prostate hyperplasia. The purpose of this study was to determine, when measuring prostate volume by TRUS, whether location is more accurately determined by transaxial or longitudinal scanning. With reference to the patient’s image, it was produced six prostate model. It compares the actual volume and the measurement volume, and find the optimal measurement position of each specific model. Prostate volume measured by TRUS closely correlates with prostate phantom volume. There was no significant difference(p = .156). To measure the accurate volume of prostate with focal protrusion, its length should be measured exclude the protrusions.

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

    OpenAIRE

    Bravo Luis Eduardo; Pazos Moncayo Alvaro Jairo; Astudillo Miryam; Bustamante Javier Andres

    2011-01-01

    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 m��todos 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 ...

  3. Comparação entre a citopatologia por biopsia com agulha fina e a histopatologia no diagnóstico das neoplasias cutâneas e subcutâneas de cães

    Directory of Open Access Journals (Sweden)

    Paulo H. Braz

    2016-03-01

    Full Text Available Resumo: Os neoplasmas cutâneos estão entre os mais diagnosticados em medicina veterinária, diante disso busca-se que o diagnóstico desses tumores seja rápido e eficaz. Em medicina veterinária o uso da citopatologia como método para diagnóstico tornou-se crescente. Diante disso, é necessário que estudos comprovem a eficiência da técnica para que a mesma possa ser usada de maneira isolada. Este trabalho teve como objetivo comparar o diagnóstico obtido pelas técnicas citopatológica e histopatológica de tumores cutâneos e subcutâneos de cães, determinar qual o tipo neoplásico mais facilmente diagnosticado pela citopatologia e a neoplasia mais prevalente nesses animais, atendidos em dois hospitais veterinários de Campo Grande/MS, no período de março de 2012 a dezembro de 2013. Foram coletadas amostras celulares de tumores de 91 cães, através de punção aspirativa por agulha fina e punch cirúrgico Os resultados citopatológicos demonstraram uma eficácia de 69,69%, em relação à histopatologia. Para a diferenciação entre tumores neoplásicos e não neoplásicos, a eficiência aumenta, com resultados iguais em 91,91%. Para diferenciar tumores benignos de malignos, foi possível chegar a uma concordância na ordem de 68,13%. Os tumores mais prevalentes foram o mastocitoma, seguido do lipoma, fibrossarcoma e tumor de célula basal.

  4. Development of a software of quantification of tumour density from images of biopsies from caner of head and neck; Desarrollo de un software de cuantificacion de densidad tumoral a partir de imagenes de biopsias de cancer de cabeza y cuello

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, J. M.; Alba, J. L.; Mera, M.; Lorenzo, Y.; Iglesias, M. B.; Lopez Medina, A.; Munoz, A.

    2013-07-01

    It has developed a software for automatic quantification of tumoral tissues biopsied density and tinted with Cytokeratin, using information colorimetric and morphologic, that also allows to distinguish between malignant cells and healthy cells. The software allows you to find, within the area biopsied, the area 1 mm{sub 2} with higher tumor density, which in the future may be associated with ADC minimum of the number of patients included in the ARTFIBio project and be able to check the inverse correlation between the two measures. (Author)

  5. Epidemiología retrospectiva y análisis de las características múltiples del carcinoma espinocelular de la mucosa bucal con estudio histopatológico de biopsias

    OpenAIRE

    Baudo, Judith Ethel

    2000-01-01

    La Organización Mundial de la Salud ha venido estableciendo parámetros de estudio histológico y clasificaciones de las enfermedades precancerosas y carcinoma oral. Ha efectuado distintas revisiones con el fin de implicar los conceptos para los patólogos de todas las naciones. El objetivo general de este trabajo fue actualizar los aspectos epidemiológicos, clínicos, condicionantes, etiológicos, y de diagnóstico, pronóstico y tratamiento del carcinoma a células escamosas de la mucosa bucal. ...

  6. Rectal palpation and transrectal fine needle aspiration of the prostate in the monitoring of prostate cancer: a study of 59 patients during treatment with estramustine phosphate or estrogens.

    Science.gov (United States)

    Hedlund, P O; Das, D; Löwhagen, T; Esposti, P

    1989-01-01

    Fifty-nine hormonally treated prostatic carcinoma patients were prospectively followed by rectal palpation and fine needle aspiration cytology (FNAC) at 6 month intervals for periods ranging from 6 to 120 months (median follow-up, 48 months). The cytologic impressions and palpatory findings were divided into four categories, respectively, ranging from benign to clearly malignant. Cytologic material and palpatory descriptions suitable for evaluation were available for 306 follow-up examinations, with a mean number of follow-up examinations per patient of five (range, 1-13). Tumor relapse was noted in 26 patients and was diagnosed at the same time by FNAC and palpation in six patients. In 16 of the patients tumor progression was first noted by cytology, and in four patients relapse was first detected by rectal palpation. Different patterns of cytologic and palpatory findings during the development of remission and progression of the tumors and drawbacks of the methods are discussed. PMID:2594583

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

    OpenAIRE

    Guevar Maselli; Giacomo Tucci; Daniele Mazzaferro; Asim Ettamimi; Giulia Sbrollini; Marco Cordari; Gaetano Donatelli; Andrea Benedetto Galosi

    2014-01-01

    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 ...

  8. 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

    . MATERIAL AND METHODS: Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI......-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...

  9. Surgical management of a retro-rectal cystic hamartoma (tailgut cyst) using a trans-rectal approach: a case report and review of the literature

    OpenAIRE

    Kildušis, Edvinas; Samalavičius, Narimantas Evaldas

    2014-01-01

    Introduction Retro-rectal cystic hamartoma (tailgut cyst) is a rare congenital developmental lesion arising from post-natal primitive gut remnants in the retro-rectal space. The rarity of the lesion and its anatomical position usually leads to difficulty in diagnosis and surgical management. Complete surgical resection remains the cornerstone of treatment. A dozen or so surgical approaches have been described in the literature to date to make the operation as simple as possible, but the trans...

  10. Experimental investigation of MRgHIFU sonication with interleaved electronic and mechanical displacement of the focal point for transrectal prostate application

    Science.gov (United States)

    Petrusca, Lorena; Ngo, Jacqueline; Brasset, Lucie; Blanc, Emmanuel; Murillo, Adriana; Auboiroux, Vincent; Cotton, François; Chapelon, Jean-Yves; Salomir, Rares

    2012-08-01

    High intensity focused ultrasound (HIFU) under MRI guidance may provide minimally invasive treatment for localized prostate cancer. In this study, ex vivo and in vivo experiments were performed using a prostate-dedicated endorectal phased array (16 circular elements arranged on a truncated spherical cap of radius 60 mm) and a translation-rotation mechanical actuator in order to evaluate the lesion formation and the potential interest of dual-modality (electronic and mechanical) interleaved displacement of the focus for volumetric sonication paradigms. Different sonication sequences, including elementary lesions, line scan, slice sweeping and volume sonications, were investigated with a clinical 1.5 T MR scanner. Two orthogonal planes (axial and sagittal) were simultaneously monitored using rapid MR thermometry (PRFS method) and the temperature and thermal dose maps were displayed in real time. No RF interferences were detected in MR acquisition during sonications. The shape of the thermal lesions in vivo was examined at day 5 post-treatment by MRI follow-up (T2w sequence and Gd-T1w-TFE) and postmortem histological analysis. This study suggests that electronic displacement of the focus (along the ultrasound propagation axis) interleaved with mechanical X-Z translations and rotation around B0 can be a suitable modality to treat patient-specific sizes and shapes of a pathologic tissue. The electronic displacement of focus (achieved in less than 0.1 s) is an order of magnitude faster than the mechanical motion of the HIFU device (1 s latency). As an example, for an in vivo volumetric sonication with foci between 32 and 47 mm (7 successive line scans, 11 lines/slice, 4 foci/line) with applied powers between 17.4 and 39.1 Wac, a total duration of sonication of 408.1 s was required to ablate a volume of approximately 5.7 cm3 (semi-chronic lesion measured at day 5), while the maximum temperature elevation reached was 30 °C. While electronic focusing is necessary to speed up the procedure, one should consider as a potential drawback the non-negligible risk for generating secondary lobes with full steering in 3D. Reference-free PRFS thermometry accurately removed the effects of Bo dynamic perturbation in the vicinity of the moving transducer. Therefore, the dual-modality volumetric sonication paradigm represents a cost-effective technological compromise to induce the desired shape of the lesion in the prostate through the limited endorectal space, in a reasonable period of time and without side effects.

  11. Comparison of Transrectal Prostate Biopsy Results with Histology of Transurethral Resection of the Prostate in Men Undergoing High-Intensity Focused Ultrasound

    OpenAIRE

    Rogenhofer, Sebastian; Walter, Bernhard; Hartmann, Arndt; Wieland, Walter Ferdinand; Mueller, S.C.; Blana, Andreas

    2014-01-01

    Introduction: The aim of our study was to evaluate the significance of transurethral resection of the prostate (TURP) to detect prostate cancer (PCa). A comparison was performed of the TURP specimens of patients undergoing high-intensity focused ultrasound (HIFU) with the core biopsies. Materials and Methods: TURP before undergoing HIFU therapy was performed in 106 patients without neoadjuvant treatment. The resected tissue was subjected to histopathological evaluation...

  12. Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: Review of technical incidents and morbidity after 5 years of use

    OpenAIRE

    RIPERT, Thomas; AZEMAR, Marie Dominique; MENARD, Johann; BAYOUD, Younes; Messaoudi, Rabah; Duval, François; Staerman, Frédéric

    2010-01-01

    Abstract OBJECTIVE To report on technical incidents, and early and late complications, occurring on high-intensity focused ultrasound (HIFU) treatment of patients with localized prostate cancer. PATIENTS AND METHODS We performed a retrospective review of patients who were treated by Ablatherm? in our centre. We recorded all technical incidents, treatment discontinuations, and early (< 1 month) and late complications. RESULTS A total of 74 HIFU procedures were perfor...

  13. Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy

    Directory of Open Access Journals (Sweden)

    Farooq Ahmad Ganie

    2013-01-01

    Conclusion: Prostatic biopsy directed with endorectal coil MRI and MR-spectroscopic imaging findings in patients with elevated serum PSA and prior negative biopsy, improves the early diagnosis of prostatic carcinoma and accurate localization of prostate cancer within the gland.

  14. Evaluación de la subestimación diagnóstica e incidencia en nódulos mamarios BI-RADS 3, 4 y 5 estudiadas mediante biopsia-core guiada por ecografía Evaluation of diagnostic underestimation and incidence in BI-RADS 3, 4 and 5 nodules studied by ultrasound- guided core biopsy.

    Directory of Open Access Journals (Sweden)

    María Paula Tiscornia

    2011-12-01

    Full Text Available Objetivos. Determinar retrospectivamente el índice de falsos negativos y el grado de subestimación de la punción con aguja gruesa eco-guiada de nódulos mamarios. Establecer la incidencia de las diferentes lesiones que se manifiestan como nódulos mamarios. Materiales y Métodos. Se estudiaron las punciones de nódulos mamarios desde enero del 2000 a septiembre del 2010. Las mismas fueron realizadas por un radiólogo con 10 años de experiencia y se utilizaron agujas de corte de 14-gauge y 10 cm de longitud. Para la guía ecográfica se usaron dos ecógrafos con transductores lineales de 5-12 MHz. Se punzaron lesiones de moderada y alta sospecha de malignidad (BI-RADS 4 y 5 y algunas lesiones probablemente benignas (BI-RADS 3. Se correlacionaron los hallazgos histológicos de la punción y de la cirugía para cada lesión. A los casos con resultado benigno que no fueron operados se les realizó un seguimiento clínico de entre uno y diez años. Resultados. Se realizaron 190 punciones. El índice de falsos negativos fue del 3%, la sensibilidad de 95% y la especificidad de 100% (VPP de 100% y VPN de 95%. Discusión. Hubo coincidencia entre los resultados de las punciones y la cirugía en un 94%. El índice de falsos negativos es aceptable en comparación con otros reportes donde varía entre 0 y 8%. Conclusiones. Este estudio indica que la punción con aguja de corte eco-guiada es un método válido, con alto grado de precisión y bajo índice de subestimación y falsos negativos para el diagnóstico de nódulos mamarios malignos y benignos. Esto fue comprobado mediante la escisión quirúrgica y/o el seguimiento clínico- imagenológico de las diferentes lesiones.Objectives. To retrospectively determine the false negatives rate and the extent of underestimation of ultrasound-guided core biopsy of breast nodules, and to determine the incidence of the various lesions presenting as breast nodules. Materials and Methods. We studied core biopsies of breast nodules from January 2000 to September 2010, performed by a radiologist with 10 years experience in breast imaging, using 14-gauge and 10-cm needles. For ultrasound guidance, two ultrasound machines with a 5-12 MHz linear transducer were used. Biopsied lesions had a moderate or high suspicion of malignancy (BI-RADS 4 and 5 and some were probably benign lesions (BI-RADS 3. Histological findings of core-biopsy were correlated with those of surgery for each lesion. Cases of benign lesions which had not been operated on underwent a 1- to 10-year clinical and radiological follow-up. Results. A total of 190 biopsies were performed. The false negative rate was 3%, sensitivity was 95% and specificity was 100% (PPV 100% and NPV 95%. Discussion. There was 94% consistency between core biopsy results and surgery. The false negative rate is acceptable as compared to other reports, where it ranges from 0 to 8%. Conclusions. This study indicates that ultrasound-guided core biopsy is a valid method, with a high degree of accuracy and a low rate of false negatives and underestimation, in the diagnosis malignant and benign of breast nodules. This has been confirmed by surgical excision and / or clinical and imaging follow-up of different lesions.

  15. 丁卡因胶浆在经直肠前列腺穿刺活检中的临床应用价值%Tetracaine Hydrochloride Jelly for clinical value during Transrectal Ultrasound guided biopsy of the prostate

    Institute of Scientific and Technical Information of China (English)

    邓晓俊; 刘辉; 刘峰; 王伟峰; 郝继东; 万建省; 刘波

    2014-01-01

    目的 比较患者在行经直肠前列腺穿刺活检术时,在直肠内及肛周使用丁卡因胶浆或单纯润滑剂,患者所经历的疼痛情况.方法 回顾性分析2011年1月至2013年1月120例行经直肠前列腺穿刺患者的临床资料.其中术中采用单纯性润滑剂患者60例(组Ⅰ),采用丁卡因胶浆患者60例(组2).采用水平视觉疼痛评分法评估患者经历的疼痛程度.结果 通过组间比较,两组患者疼痛程度与患者年龄、PSA水平、DRE是否异常、穿刺数目及术后并发症发生等均无统计学意义(P>0.05),当穿刺器械进入肛门时患者疼痛不适评分组1为2.8±1.8分,组2为1.3±1.6分(P=0.000<0.05),当行前列腺穿刺活检术时患者疼痛不适评分组1为5.5±1.7分,组2为3.3±1.5分(P=0.211 >0.05).结论 麻药制剂并不能增加经直肠前列腺穿刺活检术的安全性,但采用麻药制剂(如丁卡因胶浆)后可明显减轻穿刺所带给患者的疼痛不适.%Objectives The aim of this study was to compare the level of pain experienced by patients during TRUS-guided prostate biopsy using intrarectal 1% Tetracaine Hydrochloride Jelly versus Liquid paraffin.Methods 120 men using intrarectal 1% Tetracaine Hydrochloride Jelly versus Liquid paraffin in a protocol for prostate-cancer screening were analyzed.In this study we compared the pain and discomfort associated with prostate biopsy between two group of patient.Group 1 consists of 60men who received simple Liquid paraffin,and group 2 consists of 60 men who were given 1% Tetracaine Hydrochloride Jelly before the biopsy.Pain score measured by horizontal visual analogue scales.Results There were no statistical differences between the two groups in terms of age,serum PSA,DRE,TURS,biopsy core number and complications after biopsy(P > 0.05).The average pain score at the time of insertion of the ultrasound probe were 28 ± 1.8 and 1.3 ± 1.6 (P =0.000 < 0.05) and the average pain score at the time of taking biopsy were 5.5 ± 1.7and 3.3 ± 1.5 (P =0.211 > 0.05),respectively.Conclusions TRUS-guided prostate biopsy of the prostate can be safely whether or not anaesthesia in patients.But used 1% Tetracaine Hydrochloride Jelly in the rectal and perianal before TURS-guided prostate biopsy is an effective method for relieving biopsy-relate pain during the procedure.

  16. 经直肠前列腺活检的单中心16年回顾%Transrectal prostate biopsy:a review of 16 years experience in single center

    Institute of Scientific and Technical Information of China (English)

    潘永昇; 王增军; 华立新; 成功; 汪骏; 李潇; 张成; 吴杰; 郑雨潇; 黄源; 秦超

    2016-01-01

    目的:分析前列腺活检技术变化对阳性率的影响,探讨活检阳性患者的流行病学变化,尤其PSA应用后对前列腺癌诊断及危险度分级的影响。方法回顾性分析本中心1999年3月至2015年3月3762例前列腺活检患者的临床资料。年龄22~93岁,平均69岁。所有患者均接受经直肠前列腺活检。分析PSA各区间的活检阳性率和并发症,比较手指引导下6针、8针活检法与经直肠超声( TRUS)引导下12+1针活检法的阳性率,总结历年活检阳性患者的PSA、年龄及Gleason评分变化趋势。结果本中心共行前列腺活检3762例,总体阳性率为39.3%。手指引导下6针活检1006例,阳性率为31.0%;8针活检398例,阳性率为36.2%;TRUS引导下12+1针活检2258例,阳性率43.9%,高于手指引导(43.9% vs.32.4%,P<0.001)。总前列腺特异抗原(tPSA)异常组(PSA>4 ng/ml)的阳性率低于直肠指检(DRE)异常组(37.8% vs.57.6%,P<0.001),tPSA异常组的Gleason评分均值也低于DRE异常组(6.88 vs.7.14,P<0.001)。前列腺外周6针的阳性率高于内侧6针(37.5%vs.31.4%,P<0.001),第13针的阳性率高于前12针平均阳性率(70.7% vs.56.6%,P<0.001)。术后发生轻微肉眼血尿或镜下血尿1312例(34.9%),肉眼血尿56例(1.5%),直肠出血72例(1.9%),发热63例(1.7%),肝肾功能衰竭及死亡各1例(0.03%,0.03%)。自1999年始,前列腺活检的阳性率逐渐上升。随着tPSA的升高,阳性患者的Gleason评分逐渐升高。近10年低危患者比例从6.5%逐渐上升到15.7%。2009年后因tPSA升高就诊行前列腺活检的患者较2009年以前显著增加(46.7%vs.34.1%, P<0.001)。因tPSA升高就诊行前列腺活检患者的阳性率较以下尿路症状(LUTS)为主诉的患者无明显差异(45.2% vs.43.2%,P=0.362),但其阳性患者的Gleason评分均值低于LUTS组(6.76 vs.7.25,P<0.001)。结论 TRUS引导下经直肠12+1针活检方案阳性率显著高于手指引导下6针及8针活检。随着PSA的应用,前列腺活检的阳性率逐渐增高,阳性者的年龄呈下降趋势;年龄越大,前列腺活检的阳性率越高;直肠指检阳性患者,活检的Gleason评分偏高;外周区的活检有利于前列腺癌的检出;tPSA水平越高,前列腺活检的Gleason评分越高。 TRUS引导的前列腺12+1针活检检出的低危患者有增加趋势,但多数仍为有临床意义的前列腺癌。%Objective To assess the improvement of prostate cancer detection rate ( PCDR) with the advance of prostate biopsy technologies and analyse the changing epidemiology of patients with positive prostate biopsy, especially the PCDR and classficaton of risk.Methods From March 1999 to March 2015, a total of 3 762 patients were recruited to the department of urology, the first affiliated hospital of Nanjing medical university.All patients underwent a systematic 6-, 8-or 13-core biopsy, guided by finger or TRUS. The PCDR of different prostate specific antigen ( PSA) interval was analyzed.The PCDR of 6-or 8-core biopsy guided by finger and 13-core biopsy guided by TRUS were compared.The trends of PSA level, age and Gleason score in the patients with positive biopsy were summarized.Results A total of 3 762 patients underwent prostate biopsies and PCa were detected in 1479 patients (39.3%).Finger-guided 6-core biopsy was performed on 1 106 patients, and PCa were detected in 343 cases ( 31.0%) .Finger-guided 8-core biopsy was performed on 398 patients, and PCa were diagnosed in 144 cases (36.2%).Since 2009, 2 258 patients underwent TRUS-guided 13-core biopsy, and 992 ( 43.9%) were diagnosed as PCa, higher than that of finger-guided biopsies ( 43.9% vs.32.4%, P4 ng/ml) were lower than that of positive in digital rectal examination.The PCDR of 6 needles biopsy was higher in

  17. Contemporary outcomes in the detection of prostate cancer using transrectal ultrasound-guided 12-core biopsy in Singaporean men with elevated prostate specific antigen and/or abnormal digital rectal examination

    Directory of Open Access Journals (Sweden)

    Alvin Lee

    2015-10-01

    Conclusion: In conclusion, using contemporary 12-core biopsy methods, the local prostate cancer detection rate based on serum PSA and DRE findings has increased over the past decade presumably due to multiple genetic and environmental factors. Post-biopsy sepsis remains an important complication worldwide.

  18. Transrectal high-intensity focused ultrasound combined with endocrine therapy for prostate cancer%经直肠高强度聚焦超声联合内分泌疗法治疗前列腺癌

    Institute of Scientific and Technical Information of China (English)

    陈照阳; 吕军; 胡卫列; 张源锋; 邱晓拂

    2008-01-01

    目的 探讨经直肠高强度聚焦超声联合内分泌疗法与单纯内分泌疗法治疗前列腺癌的疗效.方法 将40例前列腺癌患者分为A、B两组,其中A组采用HIFU联合内分泌治疗,B组采用单纯内分泌治疗.HIFU治疗采用Sonablate 500型经直肠HIFU治疗系统,内分泌治疗采用去势加用抗雄激素药物治疗.随访时间8~24个月,平均16个月.结果 A、B两组患者在治疗后,均出现了前列腺体积缩小,血清PSA均有不同程度下降,IPSS评分降低,Qmax明显提高,治疗前后差异有统计学意义(P<0.05).其中A组较B组改变更为明显,两者之间差异有统计学意义(P<0.05).结论 高强度聚焦超声联合内分泌疗法及单纯内分泌疗法对前列腺癌的近期疗效均较好,前者疗效更为明显.

  19. Rational scheme option of prostate biopsy guided by transrectal ultrasound%经直肠超声引导前列腺穿刺活检方案的合理选择

    Institute of Scientific and Technical Information of China (English)

    张步林; 胡兵

    2007-01-01

    经直肠超声(TRUS)引导前列腺穿刺活检是前列腺癌诊断和制定合理治疗方案的常规手段.制定扩大前列腺系统性穿刺方案时需综合考虑患者的年龄、前列腺体积及健康状况等因素.在系统性穿刺活检的基础上结合靶向性穿刺活检可提高前列腺癌的阳性率.

  20. Radiation dose to the patient and the radiologist while performing on chest computed tomography: a program of early diagnosis of lung cancer, biopsy and treatment simulation guided radiation oncologist breast cancer; Dosis de radiacion al paciente y al radiologo durante la realizacion de tomografia computarizada en torax: progrma de diagnostico precoz del cancer de pulmon, biopsia guiada y simulacion del tratamiento oncologo radioterapico del cancer de mama

    Energy Technology Data Exchange (ETDEWEB)

    Pastor Sanchis, V.; Martinez Sanchez, J. M.; Palma Copete, J. D.; Crispin Contreras, V.; Casal Zamorano, E.; Dolores Alemany, V. de los; Gonzalez Perez, V.; Gimeno Olmo, J.; Guardino de la Flor, C.

    2011-07-01

    In this paper we determine the equivalent dose received by the operator and patient lung biopsies using thermoluminescence dosimeters, are established recommendations that this dose is as low as possible. It also reviews the acquisition protocols in both CT scans in early diagnosis program cited as the acquisition of CT for treatment planning dosimetric radiation oncologist in breast cancer.

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

    Science.gov (United States)

    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. PMID:16419474

  2. Prostate cancer

    International Nuclear Information System (INIS)

    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

  3. Prevention program of cervical cancer - Enrique Pouey

    International Nuclear Information System (INIS)

    This work is about the first basic objectives in the prevention of cervical cancer in Uruguay. The Papanicolaou test, the biopsia, and the colposcopy are important studies for the early cervical cancer detection

  4. Three-dimensional grayscale ultrasound: evaluation of prostate cancer compared with benign prostatic hyperplasia.

    NARCIS (Netherlands)

    Sedelaar, J.P.M.; Roermund, J.G. van; Leenders, G.L. van; Hulsbergen-van de Kaa, C.A.; Wijkstra, H.; Rosette, J.J.M.H.C. de la

    2001-01-01

    OBJECTIVES: To compare the accuracy of the detection, localization, and staging of prostate cancer using transrectal three-dimensional (3D) grayscale ultrasonography (3D-US) with conventional transrectal two-dimensional grayscale ultrasonography (2D-US). METHODS: Fifty patients with clinical localiz

  5. [Resident of emergency attitude towards patients-physician relationship at the Hospital de Clínicas- Asunción, Paraguay].

    Science.gov (United States)

    Silvero, R A; Aranda, G R; Cristaldo, R; Recalde, M E; Arias, R; Presentado, D; Patiño, D; Acosta, A A; Apuril, E S; Hidalgo, D; Capurro, M H

    2015-01-01

    Se estudiaron retrospectivamente pacientes con diagnóstico de lupus eritematoso sistémico (LES) de acuerdo a criterios ACR 1982, con nefritis lúpica (NL) durante el período comprendido desde 2005 al 2012 y que fueran sometidos a una biopsia renal repetida. El número total de pacientes con NL atendidos fue de 120, de los cuales 18 (15%) pacientes fueron sometidos a biopsia renal repetida, 18 con 2 biopsias renales y 6 con 3 biopsias. 3 (16,7%) de los pacientes fueron fumadores; 1 (5,6%) poseía antecedentes de DBT previa, 2 (11,1%) poseían antecedentes de HTA; y 3 (16,7%) pacientes tenían obesidad previa. El tiempo de diagnóstico de LES al momento del estudio fue de 96 meses ± 15; el tiempo transcurrido entre la 1° y la 2° biopsia fue de 45 ± 11 meses y el tiempo entre la 2° y 3° biopsia fue de 56 ± 12 meses. Las indicaciones de la biopsia repetida fueron proteinuria en 10 biopsias (41,6%); proteinuria con alteración de la función renal en 2 biopsias (8,3%); proteinuria con sedimento patológico en 8 biopsias (33,3%); y proteinuria con sedimento patológico y alteración de la función renal en 4 biopsias (16,6%). Los cambios histológicos más frecuentes encontrados entre las primeras y las biopsias repetidas fueron: de clase IV a clase III: 2 (8,2%); clase IV a clase IV: 8 (33,3%), clase IV a clase III+V: 2 (8,2%); clase IV a clase IV+V: 3 (12,5%); clase IV a clase V: 2 (8,2%). Los cambios en las biopsias de NL proliferativas con índices de actividad y cronicidad (A/C) fueron: de A a A/C: 7 (29,1%), A/C a A/C: 7 (29,1%). La intensidad de la terapia inmunosupresora aumentó en 79,1%, se mantuvo el tratamiento inmunosupresor en 16.6%. Con respecto al cambio de medicación 7 (20%) pacientes recibieron Ciclofosfamida 1 gr cada 30 días, 9 (26%) Ciclofosfamida 500 mg cada 15 días, 8 (23%) tratamiento de reinducción con Micofenolato mofetil; Rituximab 8 (23%); y 3 (8%) Ciclosporina A. El tratamiento de mantenimiento se realizó con micofenolato

  6. 抗生素对经直肠前列腺活检术后感染并发症预防效果的Meta分析%Meta-analysis of prophylaxis value of antibiotic in preventing infection complications after transrectal prostatic biopsy

    Institute of Scientific and Technical Information of China (English)

    杨明根; 赵晓昆; 吴志平; 侯轶; 肖宁; 吕晨

    2009-01-01

    目的 分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者的术后感染并发症.方法 制定原始文献的纳入标准、排除标准及检索策略,在MEDLINE(1966年1月-2007年12月)、EMBASE(1988年1月-2007年12月)、Cochrane Collaboration Reviews(1993年1月-2007年12月)、中国生物医学期刊文献数据库(CMCC,1979年-2007年12月)、CNKI数字图书馆(1979年1月-2007年12月)进行相关的随机对照试验(RCT)的检索、质量评价和资料提取,采用Rev Man 4.2软件进行Meta分析.结果 共检索到相关随机对照试验68篇,排除57篇,符合纳入标准11篇进入Meta分析.结果 表明:术前清洁尿的患者,预防性抗生素能显著降低TPB术后1周内菌尿和术后发热的比率,疗效分析相对危险度(RR值)及其95%C1分别为0.36(0.25~0.52)和0.39(0.24~0.63),但不能减少菌血症的发生率,RR值及其95%CI为0.92(0.57~1.48):各疗程预防性抗生素能明显减少TPB术后菌尿的发生率;喹诺酮及喹诺酮联合硝基咪唑均能明显降低TPB术后发生菌尿的危险.结论 术前为清洁尿的患者,预防性应用抗生素能减少TPB术后菌尿和发热的发生率,但不能降低菌血症的发生率:喹诺酮及喹诺酮联合硝基咪唑均能明显降低TPB术后发生菌尿的危险;各疗程预防性抗生素能明显减少TPB术后菌尿的危险.

  7. Adenocarcinoma da próstata: a alteração hipoecogênica difusa da próstata é um achado ultra-sonográfico importante? Prostate adenocarcinoma: is transrectal ultrasound diffuse hypoechoic appearance of the prostate an important finding?

    OpenAIRE

    Greice Priscilla Kökeny; Giovanni Guido Cerri; Luciana Mendes de Oliveira Cerri; Nestor de Barros

    2001-01-01

    Avaliar se há associação entre a observação de alteração hipoecogênica difusa da próstata, com perda da demarcação entre a zona periférica e a glândula interna, e o diagnóstico de adenocarcinoma de próstata na biópsia prostática transretal. MATERIAIS E MÉTODOS: Avaliamos 143 homens com nível sérico de antígeno prostático específico maior do que 4 ng/ml. Todos os pacientes foram submetidos à ultra-sonografia endorretal e biópsia randomizada da próstata. RESULTADOS: Foi diagnosticado adenocarci...

  8. Transrectal High-intensity Focused Ultrasound with the Sonablate 500 for the Treatment of Prostate Cancer%经直肠高强度聚焦超声系统治疗前列腺癌57例疗效分析

    Institute of Scientific and Technical Information of China (English)

    吕军; 陈照阳; 王尉; 张源锋; 邱晓拂; 张利朝; 胡卫列; 徐文峰; 叶章群

    2007-01-01

    目的:探讨经直肠高强度聚焦超声系统(HIFU)治疗PCa的疗效.方法:使用Sonablate 500型经直肠HIFU治疗系统,对57例PCa患者进行HIFU治疗,其中局限性PCa 27例,晚期PCa 30例.在确定生化复发之前,对局限性PCa仅行经直肠HIFU治疗;对于晚期PCa,在行经直肠HIFU治疗的同时,联合应用内分泌治疗.结果:HIFU治疗平均手术操作时间为111(86~153)min,平均术后住院时间为3.2(2~18)d.平均随访时间18(6~30)个月.局限性PCa HIFU治疗后,生化检查阴性率(PSA<4.0 μg/L)在治疗后的1、2、3年分别为86%、81%和79%.30例晚期PCa治疗平均8个月(3~24个月)后,26例血清PSA<4.0μg/L(其中20例血清PSA<0.5μg/L)、21例患者前列腺体积缩小>50%.治疗后6个月时与治疗前相比,前列腺体积缩小、PSA水平降低、Qmax增加及IPSS改善差异均有显著性(P<0.05).HIFU治疗后无严重尿道直肠瘘、尿失禁等并发症发生.结论:经直肠HIFU治疗PCa,安全、有效,并发症少,近期疗效较好,是一种可选择的PCa微创治疗方法.

  9. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... have other tests, such as a trans-rectal ultrasound and a biopsy. Physician: Now, just relax -- the ... exam or PSA test indicates an abnormality, an ultrasound image is made of the prostate gland. Usually ...

  10. Ultrasound -- Pelvis

    Medline Plus

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

  11. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... such as a trans-rectal ultrasound and a biopsy. Physician: Now, just relax -- the best thing to ... prostate gland. Usually these are accompanied by a biopsy -- a sampling of the prostate tissue with a ...

  12. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... that suggests that further testing may be required. Physician: OK, what I'd like to do is ... as a trans-rectal ultrasound and a biopsy. Physician: Now, just relax -- the best thing to do ...

  13. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... bladder seminal vesicles prostate Transrectal ultrasound, a special study usually done to view the prostate gland, involves ... time to the procedure. If a Doppler ultrasound study is performed, you may actually hear pulse-like ...

  14. Metabolism of adrenal androgen and its impacts on prostate cancer after castration

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ With the extensive utilization of PSA,digital rectum examination and transrectal ultrasound for screening in the aging population,the diagnosis of prostate cancer in China has markedly increased during the past years,particularly in developed regions.

  15. AB102. Efficacy and safety of prostate biopsy at 12 points by 16 G puncture needle

    OpenAIRE

    Liu, Zhenxiang; Chen, Wei(Department of Physics, State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing, 100871, China); Wu, Wangwen

    2015-01-01

    Objective To investigate the efficacy and safety of transrectal prostate biopsy at 12 points by 16 G puncture needle under ultrasonic guidance. Methods One hundred cases of transrectal prostate biopsy patients under ultrasonic guidance were screened from urinary surgery of our hospital. They were taken as the research objects. All patients were in accordance with “disease diagnosis and treatment guidelines of China urinary surgery [2011]” and the operation indication of prostate biopsy. All p...

  16. Sistema óptico de "breath tracking"

    OpenAIRE

    MALDONADO ARANDA, JESÚS JAVIER

    2011-01-01

    En la realización de biopsias guiadas o en radioterapia de lesiones de hígado y otros órganos abdominales, es muy importante determinar con exactitud la posición del tejido patológico. El problema es que estos órganos están sometidos a movimientos (de 1 a 6 centímetros) y deformaciones debidos, en gran medida, a la respiración del paciente. Por ello, es necesario tener en cuenta dichos desplazamientos en procesos de biopsia guiada y en planificación de radioterapia de lesiones. En la actualid...

  17. Hallazgos histológicos de inmunohistoquímica y ultraestructura en hiperplasia epitelial focal

    Directory of Open Access Journals (Sweden)

    Blanca Silvia González López

    2000-01-01

    Full Text Available Se estudiaron 22 biopsias de Hiperplasia Epitelial Focal (tomadas de escolares del municipio de Chimalhuacán con el propósito de correlacionar los hallazgos histológicos y de ultraestructura con su posible etiología viral.

  18. Muerte cerebral causada por consumo de psicofármacos

    OpenAIRE

    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.

  19. Informes de patología

    Science.gov (United States)

    Hoja informativa que describe el tipo de información que puede aparecer en un informe de patología, el cual contiene los resultados de la examinación visual y microscópica del tejido extirpado durante una biopsia o cirugía.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Prostata carcinomas

    International Nuclear Information System (INIS)

    Pre-operative staging, using transrectal prostatic sonography and CT, was carried out in 30 patients with cytologically confirmed carcinomas of the prostate and the results compared with the clinical findings. All patients underwent radical prostatectomy and the pre-operative findings could be verified histologically. Transrectal prostatic sonography is better than CT or clinical examination for determining local tumour spread or penetration of the capsule. A high proportion of enlarged pelvic lymphnodes shown by CT had non-specific changes; failure to demonstrate enlarged nodes excludes lymph node metastases with considerable certainty. Transrectal prostatic sonography provides a higher degree of information regarding local tumour spread, whereas CT indicates the presence or absence of lymph node metastases. (orig.)

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

    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 < 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.

  3. Preparation and management of complications in prostate biopsies

    Directory of Open Access Journals (Sweden)

    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.

  4. Studio e valutazione della spermatogenesi e del gleason score in pazienti affetti da carcinoma prostatico

    OpenAIRE

    DI VICCARO, DOMENICO

    2012-01-01

    Il nostro studio si propone di voler studiare e valutare la qualità del liquido seminale di pazienti affetti da adenocarcinoma prostatico diagnosticato mediante biopsia transperineale ecoguidata.I pazienti che rientravano nei criteri di selezione venivano sottoposti ad intervento chirurgico di prostatectomia radicale retropubica con contestuale linfoadenectomia iliaco-otturatoria bilaterale ove ce ne fosse stata l’indicazione. I pazienti sono stati selezionati presso il nostro ambulatori...

  5. Erradicación de Helicobacter pylori: esquema triple tradicional versus mismo esquema más probiótico

    OpenAIRE

    José Ernesto Sahagún-Flores; Luis Salvador López-Peña; Juan de la Cruz Ramírez Jaimes; Mónica Susana García-Bravo; Rosalba Peregrina-Gómez; Javier Eduardo García de Alba-García

    2007-01-01

    Objetivo: Determinar la eficacia del tratamiento triple convencional adicionado con lactobacilos Casei cepa Shirota en comparación con tratamiento triple convencional sin lactobacilos, contra Helicobacter pylori. Material y métodos: Estudio clínico, aleatorio, comparativo, que incluyó pacientes de uno y otro sexo portadores de Helicobacter pylori, estudiados mediante endoscopia, biopsia y serología. El grupo control recibió tratamiento triple tradicional con claritromicina, amoxicilina y omep...

  6. Hepatotoxicidad inducida por azatioprina en paciente con enfermedad de Crohn

    Directory of Open Access Journals (Sweden)

    D. Ruiz-Clavijo

    2013-08-01

    Full Text Available Los inmunosupresores se encuentran entre los grupos farmacológicos con mayor potencial teórico de inducir reacciones adversas, entre ellas las hepáticas. Presentamos el caso de un paciente de 35 años con enfermedad de Crohn en tratamiento con azatioprina por corticodependencia al que se le diagnosticó tras realización de una biopsia hepática de hiperplasia nodular regenerativa secundaria a este tratamiento.

  7. Meccanismi coinvolti nel danno della mucosa celiaca. Determinazione nel siero dell’anticorpo anti-actina: un nuovo test diagnostico nella diagnosi di atrofia intestinale nella malattia celiaca

    OpenAIRE

    Musu, Maria Paola

    2006-01-01

    La celiachia (CD) è un’ enteropatia autoimmune causata dall’ingestione di alcuni cereali contenenti glutine, quali grano, orzo e segale, che colpisce soggetti geneticamente predisposti ed è caratterizzata da una alta variabilità delle manifestazioni cliniche e delle lesioni istologiche della mucosa duodenale. Le attuali metodiche sierologiche consentono solamente di avere un sospetto diagnostico di malattia celiaca e costituiscono l’indicazione ad eseguire una biopsia intestinale per una c...

  8. 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 se

  9. Pyometra and complete vaginal adhesion in a miniature horse

    OpenAIRE

    Cozens, Elizabeth R.W.

    2009-01-01

    A 4-year-old miniature horse experienced intermittent episodes of pyrexia, lethargy, and purulent vaginal discharge following dsytocia. Vaginal endoscopy and transrectal ultrasonography revealed a blind-ending vaginal cavity and distended uterus. Surgical treatment was declined and the mare was euthanized. Post-mortem examination confirmed the diagnosis of pyometra and vaginal adhesions.

  10. Evaluation of possible methods to reduce pain associated with electroejaculation in bulls.

    OpenAIRE

    Mosure, W L; Meyer, R A; Gudmundson, J.; Barth, A D

    1998-01-01

    Heart rate changes were recorded in attempt to objectively measure pain associated with 6 methods of semen collection, including transrectal massage, conventional electroejaculation, and electroejaculation after either intrarectal lidocaine, epidural lidocaine, epidural xylazine, or intravenous xylazine. Epidural anesthesia with lidocaine or xylazine tended to result in smaller heart rate changes.

  11. In vitro fertilization (IVF) using semi-defined culture conditions from low or high antral follicle count pubertal beef heifers

    Science.gov (United States)

    To compare the in vitro fertilization (IVF) and production (IVP) of embryos from low and high antral follicle count (AFC) heifers, AFC were determined on 106 heifers using transrectal ultrasonography. Ten heifers with the lowest AFC (avg. 13.2) and 10 heifers with the highest AFC (avg. 27.4) with ev...

  12. Leiomyoma of the seminal vesicles: laparoscopic excision.

    Science.gov (United States)

    Casado Varela, Javier; Hermida Gutiérrez, Juan Francisco; Castillón Vela, Ignacio T; León Rueda, Maria Eugenia; Ortega Medina, Luis; Moreno Sierra, Jesús

    2014-01-01

    Leiomyoma of the seminal vesicles is an extremely rare type of benign tumor of the genitourinary system and can cause lower urinary tract symptoms. Despite their low incidence, these tumors can be identified with transrectal ultrasound of the seminal vesicles during prostate examination. The removal of these tumors is facilitated by a laparoscopic approach.

  13. Preimplant factors affecting postimplant CT-determined prostate volume and the CT/TRUS volume ratio after transperineal interstitial prostate brachytherapy with 125I free seeds

    International Nuclear Information System (INIS)

    The aim was to identify preimplant factors affecting postimplant prostate volume and the increase in prostate volume after transperineal interstitial prostate brachytherapy with 125I free seeds. We reviewed the records of 180 patients who underwent prostate brachytherapy with 125I free seeds for clinical T1/T2 prostate cancer. Eighty-one (45%) of the 180 patients underwent neoadjuvant hormonal therapy. No patient received supplemental external beam radiotherapy. Postimplant computed tomography was undertaken, and postimplant dosimetric analysis was performed. Univariate and multivariate analyses were performed to identify preimplant factors affecting postimplant prostate volume by computed tomography and the increase in prostate volume after implantation. Preimplant prostate volume by transrectal ultrasound, serum prostate-specific antigen, number of needles, and number of seeds implanted were significantly correlated with postimplant prostate volume by computed tomography. The increase in prostate volume after implantation was significantly higher in patients with neoadjuvant hormonal therapy than in those without. Preimplant prostate volume by transrectal ultrasound, number of needles, and number of seeds implanted were significantly correlated with the increase in prostate volume after implantation. Stepwise multiple linear regression analysis showed that preimplant prostate volume by transrectal ultrasound and neoadjuvant hormonal therapy were significant independent factors affecting both postimplant prostate volume by computed tomography and the increase in prostate volume after implantation. The results of the present study show that preimplant prostate volume by transrectal ultrasound and neoadjuvant hormonal therapy are significant preimplant factors affecting both postimplant prostate volume by computed tomography and the increase in prostate volume after implantation

  14. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... rectal examination does not mean that they have prostate cancer. It means that we're concerned about it and they should go on to have other tests, such as a trans-rectal ultrasound ... made of the prostate gland. Usually these are accompanied by a biopsy -- ...

  15. Detecting Prostate Cancer

    Science.gov (United States)

    ... rectal examination does not mean that they have prostate cancer. It means that we're concerned about it and they should go on to have other tests, such as a trans-rectal ultrasound ... made of the prostate gland. Usually these are accompanied by a biopsy -- ...

  16. 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 or transperi

  17. In vivo testing of laser optoacoustic system for image-guided biopsy of prostate

    Science.gov (United States)

    Oraevsky, Alexander; Ermilov, Sergey; Mehta, Ketan; Miller, Tom; Bell, Brent; Orihuela, Eduardo; Motamedi, Massoud

    2006-02-01

    We have developed and used a laser optoacoustic imaging system with transrectal probe (LOIS-P) for detection of mechanical lesions in canine prostates in vivo. LOIS images have been acquired with a 128-channel transrectal probe and a 32-channel data acquisition system. Optoacoustic images showed a strong contrast enhancement for a blood containing lesion, when compared with ultrasound images. Our studies demonstrated that sufficient optoacoustic contrast exists between blood containing lesion and prostate tissue, although the lesion has been undetectable with ultrasound. The imaging results have been compared with visual examination of surgically excised prostates. Although axial resolution of the wide-band transducers employed in the transrectal probe provides good axial resolution of 0.5 mm, the convex arc geometry of the this array of transducers provides lateral resolution degrading with depth in tissue. A two step algorithm has been developed to improve the lateral resolution of deeply located objects. This algorithm employs optoacoustic image reconstruction based on radial back-projection to determine location and shape of the target object, then a procedure, we call Maximum Angular Amplitude Probability (MAAP), to determine true brightness of the object and simultaneously remove arc-shaped artifacts associated with radial back-projection. A laser optoacoustic imaging system (LOIS-P) with transrectal probe operating in backward detection mode empowered with the new image reconstruction algorithm seems promising as a modality for detection of prostate cancer and guiding prostate biopsy.

  18. 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

  19. Cromoendoscopia com azul de metileno para diagnóstico de esôfago de Barrett

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. Fuentes de variabilidad en el diagnóstico de gastritis atrófica multifocal asociada con la infección por Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Bravo

    2008-03-01

    Full Text Available 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

  2. 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

    Directory of Open Access Journals (Sweden)

    González del Pino, Francisco Javier.

    2010-12-01

    Full Text Available 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 year old PeruvianPaso mare, caused by twin pregnancies bilaterally fixed. It was earlydiagnosed by transrectal ultrasound, but its final outcome in an unwantedabortion because the animal's owner declined to its resolution through thetechnique of manual reduction of one of the twins.

  3. [Reliability of endorectal echography of the prostate in the screening and staging of prostatic cancer].

    Science.gov (United States)

    Corbusier, A; Vanden Bossche, M; Mendes Leal, A; Simon, J; Wespes, E; Van Regemorter, G; Schulman, C C

    1989-01-01

    1433 transrectal ultrasonographies were performed for prostatic disease. In 453 cases, histopathologic correlation was obtained and compared to digital rectal examination and transrectal ultrasonography done after the clinical examination. The sensitivity of digital rectal examination was 91% and the specificity was 85%. The sensitivity and the specificity of ultrasonography were respectively 95 and 81%. 4 prostatic cancers, not suspected by digital rectal examination, were diagnosed by ultrasound (0,9%). The total number of subclinical cancer was 9 (2%). Interest of ultrasound compared to digital rectal examination concerns less than 1% of the total number of controlled patients. The staging of local extension of prostatic cancer is better by ultrasound than by the digital rectal examination. On 9 cases of clinical unsuspected extracapsular invasion, 6 were diagnosed by ultrasound.

  4. Optimization of a wearable pudendal nerve stimulator using computational models.

    Science.gov (United States)

    Shiraz, Arsam N; Leaker, Brian; Demosthenous, Andreas

    2015-01-01

    After spinal cord injury, lower urinary tract functions may be disrupted. Trans-rectal stimulation of the pudendal nerve may enable patients to regain these functions via minimally invasive means. Using a finite element model of a wearable trans-rectal stimulator in the pelvic region, and a computational model of mammalian nerve fiber, various electrode configurations and the corresponding required current levels were studied. A configuration requiring considerably lower current level than previously reported was identified. For this configuration, the strength-duration curve was simulated and the effect of different stimulus waveforms on the required current was studied. In addition, the study examined whether a multi-electrode device could selectively activate different terminal branches of the pudendal nerve. PMID:26737021

  5. Neuroendocrine carcinoma of the seminal vesicles presenting with Lambert Eaton syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Burger Maximilian

    2010-10-01

    Full Text Available Abstract Introduction Primary tumors of seminal vesicles are rare and only a few cases have been reported. Diagnosis is difficult due to the absence of early clinical signs. Prognosis is generally poor. Case presentation We present the case of a 70-year-old Caucasian man with a seminal vesicle mass and concomitant lymph node metastasis detected by computed tomography and body positron emission tomography/low-dose computed tomography scan carried out for evaluation of Lambert Eaton syndrome. Transrectal ultrasound-guided biopsy showed a poorly differented neuroendocrine carcinoma with an immunhistochemical profile similar to small cell lung cancer. Following chemotherapy the disease was stable and active surveillance was initiated. Conclusions Lambert Eaton syndrome may be the initial symptom of a seminal vesicle mass. Diagnosis needs to be obtained by transrectal biopsy and chemotherapy may delay progression of the tumor.

  6. Photoacoustic imaging of prostate brachytherapy seeds

    OpenAIRE

    Su, Jimmy L.; Bouchard, Richard R.; Karpiouk, Andrei B.; Hazle, John D.; Emelianov, Stanislav Y.

    2011-01-01

    Brachytherapy seed therapy is an increasingly common way to treat prostate cancer through localized radiation. The current standard of care relies on transrectal ultrasound (TRUS) for imaging guidance during the seed placement procedure. As visualization of individual metallic seeds tends to be difficult or inaccurate under TRUS guidance, guide needles are generally tracked to infer seed placement. In an effort to improve seed visualization and placement accuracy, the use of photoacoustic (PA...

  7. Usefulness and Limitation of Ultrasonography in the Diagnosis of Intestinal Intussusception in Cows

    OpenAIRE

    Shivali Sharma; De, Amit Kumar; Arvind Sharma; Adarsh Kumar; S. P. Tyagi; Sheikh Imran

    2011-01-01

    The present study was conducted on 6 chronically ill Jersey/Red Sindhi cross-bred cows, which were suspected for intestinal obstruction on the basis of history and clinical signs. These cows were ultimately diagnosed with intestinal intussusception based on a combination of clinical, ultrasonographic and surgical examinations. “Bull's eye lesion” was the most prominent ultrasonographic finding, diagnostic for intussusception either trans-abdominally or transrectally. Dilated intestinal loops ...

  8. Raising cut-off value of prostate specific antigen (PSA) for biopsy in symptomatic men in India to reduce unnecessary biopsy

    OpenAIRE

    Shalini Agnihotri; Mittal, R. D.; Kapoor, R; Anil Mandhani

    2014-01-01

    Background & objectives: The characteristics of prostate specific antigen (PSA) for trans-rectal ultrasonography guided prostate biopsy in men with lower urinary tract symptoms (LUTS) are not well defined. This study was carried out to analyse the threshold of PSA for biopsy in symptomatic men in India. Methods: From January 2000 to June 2011, consecutive patients who had digital rectal examination (DRE) and PSA testing done for LUTS were included in this study. PSA was done with ELISA te...

  9. Prevalence of Antibiotic-Resistant Bacteria on Rectal Swabs and Factors Affecting Resistance to Antibiotics in Patients Undergoing Prostate Biopsy

    OpenAIRE

    Kim, Jong Beom; Jung, Seung Il; Hwang, Eu Chang; Kwon, Dong Deuk

    2014-01-01

    Purpose The prevalence of antibiotic-resistant bacteria on rectal swabs in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy and the factors affecting resistance to antibiotics were evaluated. Materials and Methods Two hundred twenty-three men who underwent TRUS-guided prostate biopsy from November 2011 to December 2012 were retrospectively evaluated. Rectal swabs were cultured on MacConkey agar to identify antibiotic-resistant bacteria in rectal flora before TRUS-guide...

  10. Multiparametric magnetic resonance imaging predicts the presence of prostate cancer in patients with negative prostate biopsy

    OpenAIRE

    Lista, F; Castillo, Ernesto; Gimbernat, H.; Rodríguez-Barbero, José M.; Panizo, J.; Angulo Cuesta, Javier

    2015-01-01

    The objective of this study is to assess the ability of multiparametric prostate magnetic resonance imaging (mpMRI) to detect prostate cancer in patients with prior negative transrectal prostate biopsy (TPB). mpMRI (TSE-T2-w, DWI and DCE sequences) was performed on 1.5 T (Magnetom Avanto; Siemens Healthcare Solutions) in 150 patients suspicious of prostate cancer and with negative TPB. European Society of Urogenital Radiology (ESUR) criteria were used. PSA measurement (total and free), digita...

  11. Can Western Based Online Prostate Cancer Risk Calculators Be Used to Predict Prostate Cancer after Prostate Biopsy for the Korean Population?

    OpenAIRE

    Lee, Dong Hoon; Jung, Ha Bum; Park, Jae Won; Kim, Kyu Hyun; Kim, Jongchan; Lee, Seung Hwan; Chung, Byung Ha

    2013-01-01

    Purpose To access the predictive value of the European Randomized Screening of Prostate Cancer Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) in the Korean population. Materials and Methods We retrospectively analyzed the data of 517 men who underwent transrectal ultrasound guided prostate biopsy between January 2008 and November 2010. Simple and multiple logistic regression analysis were performed to compare the result of prostate biopsy. Area u...

  12. Effects of epidural lidocaine anesthesia on bulls during electroejaculation.

    OpenAIRE

    Falk, A J; Waldner, C L; Cotter, B S; Gudmundson, J.; Barth, A D

    2001-01-01

    Two experiments were conducted to determine whether caudal epidural lidocaine anesthesia reduces a stress response to electroejaculation. In the 1st experiment, changes in cortisol and progesterone concentrations in serial blood samples were used to assess the stress response to restraint (control), transrectal massage, caudal epidural injection of saline, electroejaculation after caudal epidural injection of lidocaine, and electroejaculation without epidural lidocaine. In the 2nd experiment,...

  13. Collection, analysis and cryopreservation of semen from Malayan gaur (Bos gaurus hubbacki): A preliminary study

    OpenAIRE

    M.S. Khairiah; I. Zawawi; H. Wahid; Hajarian, H.; Fahrul, F.J.; M.D. Hafiz; Hafiz, M.M.; Z.F. Ann; M.I. Iswadi; O.A. Mazni

    2012-01-01

    The Malayan gaur (Bos gaurus hubbacki) or Seladang is classified as vulnerable by the International Union for Conservation of Nature and Natural Resources (IUCN). The Malayan gaur is mainly distributed in the tropical woodlands of Peninsular Malaysia and Southern Thailand. The aim of this study was to collect, analyze and cryopreserve the semen of wild Malayan gaur. Transrectal massage (TM) and electroejaculation (EEJ) technique was applied in semen collection of the Malayan gaur. The semen w...

  14. Minimizing Stimulus Current in a Wearable Pudendal Nerve Stimulator Using Computational Models.

    OpenAIRE

    Shiraz, A. N.; Craggs, M.; Leaker, B; Demosthenous, A.

    2016-01-01

    After spinal cord injury, functions of the lower urinary tract may be disrupted. A wearable device with surface electrodes which can effectively control the bladder functions would be highly beneficial to the patients. A trans-rectal pudendal nerve stimulator may provide such a solution. However, the major limiting factor in such a stimulator is the high level of current it requires to recruit the nerve fibers. Also, the variability of the trajectory of the nerve in different individuals shou...

  15. The Prevalence and Characteristic Differences in Prostatic Calcification between Health Promotion Center and Urology Department Outpatients

    OpenAIRE

    Hong, Chan Gyu; Yoon, Byung Il; Choe, Hyun-Sop; Ha, U-Syn; Sohn, Dong Wan; Cho, Yong-Hyun

    2012-01-01

    Purpose We evaluated the differences in calculi characteristics and their prevalence according to the presence of lower urinary tract symptoms between adult patients examined at the Urology Department and those examined at the Health Promotion Center (HPC). Materials and Methods The prevalence of prostatic calcification, characteristics of calculi (number, size, and location), and differences in lower urinary tract symptoms were compared and analyzed for 479 subjects who underwent transrectal...

  16. Hepatitis C Transmission after Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Karim Ferhi

    2013-01-01

    Full Text Available Prostate biopsy is a current and well-codified procedure; antibiotic prophylaxis and rectal enema limit the risk of infection. To date, there has been no reported viral transmission between patients due to a contaminated ultrasound probe. In this study, we report the case of a patient who contracted the hepatitis C virus after transrectal prostate biopsy as part of an individual screening for prostate cancer.

  17. Prostatic biopsy-related rectal bleeding refractory to medical and endoscopic therapy definitively managed by catheter-directed embolotherapy: a case report

    OpenAIRE

    De Beule, Tom; Carels, Kenneth; Tejpar, Sabine; Cleynenbreugel, Ben; Oyen, Raymond; Maleux, Geert

    2015-01-01

    Introduction Ultrasound-guided transrectal prostatic biopsy is generally a well-tolerated radiological technique with low overall complication ratio. If post-biopsy rectal bleeding occurs, conservative management is effective in the majority of cases. Endoscopic or interventional treatment is rarely required. Case presentation We report the case of an 82-year-old white man presenting with massive rectal bleeding after ultrasound-guided prostatic biopsy. Medical and endoscopic management were ...

  18. Endoclipping treatment of life-threatening rectal bleeding after prostate biopsy

    OpenAIRE

    Katsinelos, Panagiotis; Kountouras, Jannis; Dimitriadis, Georgios; Chatzimavroudis, Grigoris; Zavos, Christos; Pilpilidis, Ioannis; Paroutoglou, George; Germanidis, George; Mimidis, Kostas

    2009-01-01

    Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound (TRUS)-guided multiple biopsy of the prostate, but is usually mild and stops spontaneously. We report what is believed to be the first case of life-threatening rectal bleeding following this procedure, which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding. This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective...

  19. New horizons in prostate cancer imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ravizzini, Gregory; Turkbey, Baris; Kurdziel, Karen [Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Choyke, Peter L. [Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States)], E-mail: pchoyke@nih.gov

    2009-05-15

    Prostate cancer is the most common non-cutaneous malignancy among American men. Imaging has recently become more important in detection of prostate cancer since screening techniques such as digital rectal examination (DRE), prostate specific and transrectal ultrasound guided biopsy have considerable limitations in diagnosis and localization of prostate cancer. In this manuscript, we reviewed conventional, functional and targeted imaging modalities used in diagnosis and local staging of prostate cancer with exquisite images.

  20. CA 125が腫瘍マーカーとして有用と考えられた男子原発性尿道腺癌の1例

    OpenAIRE

    本多, 正人; 中村, 正広; 藤岡,秀樹

    1992-01-01

    A case of primary adenocarcinoma of the male urethra with high CA125 level is reported. A 66-year-old man was admitted to our hospital with dysuria and perineal discomfort. The urethrocystogram revealed an irregular urethral margin in the bulbo-membranous urethra. Computer-tomographic (CT) scan and transrectal ultrasonography revealed an irregular mass between the urethra and rectum. Cytologic examination of the urine was negative for malignancy. Endoscopy revealed an irregular bulbo-membrano...

  1. Lymphoma Presenting as Cancer of the Glans Penis: A Case Report

    OpenAIRE

    Konstantinos Stamatiou; Nikolaos Pierris

    2012-01-01

    Penile lymphoma is a very rare neoplasm. We report the case of an 82-year-old man who presented with phimosis. The patient also complained of frequent and painful urination. Upon examination a painless penile ulcer and multiple enlarged inguinal lymph nodes were found. The shaft of the penis and the prostate were hard on palpation. Abdominal and transrectal ultrasound examination confirmed the involvement of the penis shaft and the prostate and also revealed involvement of the urinary bladder...

  2. High-Intensity Focused Ultrasound as Salvage Therapy for Patients With Recurrent Prostate Cancer After Radiotherapy

    OpenAIRE

    Song, Wan; Jung, U Seok; Suh, Yoon Seok; Jang, Hyun Jun; Sung, Hyun Hwan; Jeon, Hwang Gyun; Jeong, Byung Chang; Seo, Seong Il; Jeon, Seong Soo; Choi, Han Yong; Lee, Hyun Moo

    2014-01-01

    Purpose To evaluate the oncologic outcomes and postoperative complications of high-intensity focused ultrasound (HIFU) as a salvage therapy after external-beam radiotherapy (EBRT) failure in patients with prostate cancer. Materials and Methods Between February 2002 and August 2010, we retrospectively reviewed the medical records of all patients who underwent salvage HIFU for transrectal ultrasound-guided, biopsy-proven locally recurred prostate cancer after EBRT failure (by ASTRO definition: ...

  3. Imaging and intervention in prostate cancer: Current perspectives and future trends

    OpenAIRE

    Sanjay Sharma

    2014-01-01

    Prostate cancer is the commonest malignancy in men that causes significant morbidity and mortality worldwide. Screening by digital rectal examination (DRE) and serum prostate-specific antigen (PSA) is used despite its limitations. Gray-scale transrectal ultrasound (TRUS), used to guide multiple random prostatic biopsies, misses up to 20% cancers and frequently underestimates the grade of malignancy. Increasing the number of biopsy cores marginally increases the yield. Evolving techniques of r...

  4. High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series

    OpenAIRE

    Ahmed, H. U.; Zacharakis, E.; Dudderidge, T; Armitage, J N; Scott, R.; Calleary, J.; Illing, R.; Kirkham, A; Freeman, A; Ogden, C.; Allen, C.; Emberton, M

    2009-01-01

    BACKGROUND: The use of minimally invasive ablative therapies in localised prostate cancer offer potential for a middle ground between active surveillance and radical therapy.METHODS: An analysis of men with organ-confined prostate cancer treated with transrectal whole-gland HIFU (Sonablate 500) between 1 February 2005 and 15 May 2007 was carried out in two centres. Outcome data (side-effects using validated patient questionnaires, biochemical, histology) were evaluated.RESULTS: A total of 172...

  5. EXPERIENCE WITH A HISTOSCANNING APPARATUS USED IN THE DIAGNOSIS OF RECURRENT PROSTATE CANCER AFTER HIFU ABLATION

    OpenAIRE

    P.V. Glybochko; Yu. G. Alyaev; A. V. Amosov; G. E. Krupinov; T. M. Ganzha; A. A. Obukhov; N. A. Amosov

    2012-01-01

    The new potentialities of 3D transrectal ultrasound study were realized in a HistoScanning diagnostic unit. It has been used at the R.M. Fronshtein Urology Clinic, Research Institute of Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, since September 2011. A study of the sensitivity and specificity of the technique enrolled patients undergoing high-intensity focused ultrasound (HIFU) ablation of the prostate of for its (PC) in the period 1 to 7 years...

  6. Evaluation of the ultrasound image attributes of developing ovarian follicles in the four follicular waves of the interovulatory interval in ewes

    OpenAIRE

    Toosi, B.M.; Seekallu, S.V.; Pierson, R A; Rawlings, N.C.

    2009-01-01

    Computer-assisted quantitative echotextural analysis was applied to ultrasound images of antral follicles in the follicular waves of an interovulatory interval in sheep. The ewe has three or four waves per cycle. Seven healthy, cyclic Western White Face ewes (Ovis aris) underwent daily, transrectal, ovarian ultrasonography for an interovulatory interval. Follicles in the third wave of the ovulatory interval had a longer static phase than that of those in Waves 1 and 2 (P < 0.05). The numeric ...

  7. Sialosis Parotídea Alcohólica: estudio Estructural y Ultraestructural

    OpenAIRE

    Carda Batalla, María del Carmen; Gómez de Ferraris, María Elsa; Arriaga, Adriana; Carranza, Miriam; Peydró Olaya, Amando

    2004-01-01

    Objetivos: El propósito del presente trabajo fue establecer posibles diferencias histopatológicas entre los estadíos iniciales y terminales de la sialosis alcohólica, patología que generalmente involucra hipertrofia parotídea y afecta estructuralmente en diverso grado a las demás glándulas salivales. Diseño del estudio: se analizaron y compararon las modificaciones estructurales y ultraestructurales de glándulas parótidas provenientes de: A) biopsias de alcohólicos crónic...

  8. Hepatite aguda colestática pelo propiltiouracil: relato de caso Acute cholestatic hepatitis induced by propylthiouracil: case report

    OpenAIRE

    Mônica Beatriz PAROLIN; Lopes, Reginaldo Werneck; José Ederaldo Queiroz TELLES; Ioshii, Sergio Ossamu, 1960-; Nemer HAJAR

    2000-01-01

    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 susp...

  9. Hepatite aguda colestática pelo propiltiouracil: relato de caso

    OpenAIRE

    Mônica Beatriz PAROLIN; Lopes, Reginaldo Werneck; José Ederaldo Queiroz TELLES; Ioshii, Sergio Ossamu, 1960-; Nemer HAJAR

    2000-01-01

    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 susp...

  10. Concordancia endoscópico-histológica de la gastritis crónica en Cali

    OpenAIRE

    Gustavo Mariño; Eduardo Lima; Fernado Tuffi García; Carlos Cuello; Harold Cuello; Alberto Alzate

    2009-01-01

    Se realizó un estudio prospectivo con el fin de evaluar la concordancia entre signos endoscópicos y diagnóstico histológico en 216 pacientes con gastritis y metaplasia intestinal. Se estableció un registro codificado de los signos sugestivos de gastritis, que se correlacionaron con los diagnósticos histológicos de las biopsias gástricas. Se seleccionaron aquellas asociaciones que tuvieran una correlación mayor que la esperada por azar. Estas fueron: gastritis atrófica y aumento de visibilidad...

  11. Espondilitis tuberculosa no es una metástasis vertebral: diagnóstico diferencial y tratamiento quirúrgico. A propósito de un caso

    OpenAIRE

    Pérez Vergara, S.; Moreno García, I.; Garcés Hernández, M.; Bas Hermida, T.; Bas Hermida, P.

    2011-01-01

    Presentamos el caso de una paciente con dorsalgia y clínica neurológica de varios meses de evolución que ante las pruebas de imagen fue erróneamente diagnosticada de metástasis vertebral sin confirmación previa con biopsia. El deterioro progresivo neurológico y las nuevas pruebas de imagen confirmaron el diagnóstico de tuberculosis vertebral. La paciente fue tratada mediante curetaje, desbridamiento, fusión intersomática y osteosíntesis anterior además del tratamiento médico. Hubo...

  12. Linfoma primario del sistema nervioso central en una paciente con lupus eritematoso sistémico

    OpenAIRE

    C. N. Pisoni; A. R. Grinberg; J. L. Plana; R. D. Freue; J. A. Manni; Paz, L.

    2003-01-01

    Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difus...

  13. 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.

  14. Estrategia de acceso al alimento y estado nutricional de la población celíaca adulta de la ciudad de Mar del Plata

    OpenAIRE

    Tuerdovsky, Natalia

    2010-01-01

    La enfermedad celíaca es una intolerancia del intestino delgado al gluten, proteína que se encuentra en el germen del trigo, el centeno, la cebada y la avena. La prevalencia de la misma ha aumentado, en Argentina es de 1 caso cada 167 individuos sanos. El diagnóstico se realiza mediante biopsia intestinal y el tratamiento consiste en una dieta libre de gluten. Se conoce que el precio de éstos productos es elevado, por lo que no todos pueden acceder a ellos.El problema de la pre...

  15. Tres casos de odontomas

    OpenAIRE

    Salvador Javier Santos Medina; Haideé Tamara Díaz Méndez; Giselle Ávila Chiong

    2015-01-01

    Los odontomas son los tumores odontogénicos más comunes, casi siempre se diagnostican accidentalmente, en exámenes radiográficos; pueden sospecharse al retardar el brote dentario o producir maloclusiones. Se clasifican en odontomas compuestos y complejos, ambos constituidos por estructuras dentales como: esmalte, dentina, cemento y tejido pulpar. Su eliminación quirúrgica y la biopsia es el tratamiento de elección. El propósito de este trabajo es reportar tres casos de pacientes atendidos en ...

  16. 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

    OpenAIRE

    Bejarano, G.; Vergara, M.; Gil, M.; B. Dalmau; Puig, J. (Josep); M. R. Bella; Suárez, D.; Calvet, X

    2009-01-01

    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 demog...

  17. Características histoquímicas, morfométricas y metabólicas del músculo Gluteus medius de equinos entrenados para competencias de salto Histochemical, morphometrical and metabolic characteristics of the Gluteus medius muscle from horses in training for jumping competition

    OpenAIRE

    A. Islas; M. QUEZADA; A. Bernales.; Mora, G. (Gonzalo); López-Rivero, J L; V. MERINO; P. Dossow; Rojas, V.

    2000-01-01

    Se obtuvieron biopsias a 3 y 6 cm de profundidad del músculo de 7 yeguas y 3 machos castrados de 4 años de edad, los cuales habían realizado previamente un programa de adiestramiento para salto por 6 meses. Las muestras fueron analizadas por las técnicas mATPasa miofibrilar, para determinar la composición fibrilar, y NADH-TR para determinar la capacidad oxidativa. La actividad metabólica de las fibras se determinó por la actividad de las enzimas CS, HAD, LDH y CK. Los promedios obtenidos para...

  18. Apoptosis de fibroblastos gingivales en periodontitis

    OpenAIRE

    Roger Mauricio Arce; Oscar Tamayo; Armando Cortés

    2007-01-01

    Introducción: Los fibroblastos gingivales humanos (FGH) tienen un papel importante en la enfermedad periodontal, pues alteran su normal funcionamiento en respuesta a estímulos pro-inflamatorios. Se cree que los fibroblastos se pueden eliminar anormalmente por medio de apoptosis en periodontitis. El propósito de este estudio es determinar y cuantificar la apoptosis de FGH en biopsias del periodonto de individuos sanos y con enfermedad periodontal. Métodos: Se realizó un estudio clínico descrip...

  19. Módulo pleuroscopía Toracoscopía Thoracoscopy

    OpenAIRE

    MAITE OYONARTE W

    2008-01-01

    la toracoscopía fue descrita el año 1910. Desde entonces se ha utilizado para el estudio y tratamiento de la patología pleural. las indicaciones hoy en día se centran en el estudio diagnóstico de exudados pleurales de etiología desconocida y para realizar pleurodesis mediante la insuflación de talco. la toracoscopía permite visualizar la cavidad pleural y tomar biopsias dirigidas sobre las lesiones sospechosas. Puede efectuarse en sala de endoscopía o en pabellón. El procedimiento se efectúa ...

  20. Granulomatosis sarcoidea necrosante con compromiso sistémico Necrotizing sarcoid granulomatosis with systemic involvement

    OpenAIRE

    María Elena Ceballos; José Hormazábal F; Carmen Torres; Maite Oyonarte W; Juan Carlos Rodríguez D; Manuel Meneses; Sara Chernilo S

    2006-01-01

    Mujer mapuche de 70 años quien en el curso de 1 año presentó baja de peso, ojo rojo bilateral y úlcera corneal que evolucionó hacia la perforación con herniación uveal y pérdida de la visión. Posteriormente se agregaron lesiones nodulares, violáceas, sensibles, algunas ulceradas en las zonas distales de ambas extremidades inferiores. La TAC de tórax demostró múltiples nódulos pulmonares. Tras un estudio exhaustivo se descartaron la tuberculosis y otras infecciones. Tanto la biopsia de las les...

  1. Caracterización inmunofenotípica de los fibroblastos peritoneales durante el tratamiento con diálisis peritoneal

    OpenAIRE

    Jiménez Heffernan, José Antonio

    2010-01-01

    Premio Extraordinario de Doctorado 2012 En esta tesis doctoral se recogen varios trabajos relacionados con fibrogénesis peritoneal, transición epitelio-mesenquimal de la célula mesotelial y correlación morfo-funcional entre datos obtenidos de biopsias peritoneales y transporte peritoneal. Durante el tratamiento crónico con diálisis peritoneal se produce una progresiva fibrosis del peritoneo así como cambios vasculares y disminución de la capacidad dialítica de la membrana pe...

  2. Evolución clínica y radiológica de una mujer con histiocitosis pulmonar de células de Langerhans durante 18 años Clinical and radiological evolution of a woman with pulmonary Langerhans cell histiocytosis during 18 years

    OpenAIRE

    XIMENA CEA B; PAULA BUSTOS B; ENRIQUE BELLOLIO J; MIGUEL VILLASECA H

    2008-01-01

    La histiocitosis pulmonar de células de Langerhans (HPCL) es una enfermedad pulmonar difusa quística poco frecuente. En esta revisión, presentamos un caso de HPCL diagnosticada en una adolescente, no fumadora, que consultó por disnea rápidamente progresiva asociada a dolor pleurítico izquierdo, debido a un neumotorax bilateral. El diagnóstico se confirmó por biopsia quirúrgica. Se indicó tratamiento con corticoides (prednisona) durante el primer año. Tras 18 años de seguimiento destaca una im...

  3. Identification and evaluation of molecular biomarkers in urine for the detection of prostate cancer

    OpenAIRE

    Sequeiros Fontán, Tamara

    2014-01-01

    El cáncer de próstata (CP) es una de las mayores causas de muerte entre los hombres de los países desarrollados. Sin embargo, los actuales métodos de diagnóstico presentan una elevada tasa de falsos positivos debido a su baja especificidad, lo que conlleva un elevado número de biopsias de próstata (BPs) practicadas innecesariamente. Además, en muchas BPs, alguna patología no cancerosa de la próstata es hallada. Una patología benigna particularmente relevante en la clínica es la Neoplasia I...

  4. Doenças de equinos na região Sul do Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    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%.

  5. Microscopía confocal de reflectancia in vivo en dermatología: Aplicación en el diagnóstico de tumores cutáneos.

    OpenAIRE

    Segura Tigell, Sonia

    2011-01-01

    [spa] La microscopía confocal de reflectancia in vivo (MCR) es una técnica no invasiva que permite obtener un diagnóstico de forma inmediata y en tiempo real de patología cutánea tumoral con una precisión diagnóstica que se acerca al diagnóstico histológico convencional. La MCR puede permitir un seguimiento clínico de respuesta a tratamientos no invasivos de patología tumoral, como la terapia fotodinámica, sin necesidad de realizar biopsias. El presente trabajo reúne cuatro estudios realizado...

  6. Mansonelosis en el area sur-oriental de la Orinoquia venezolana Mansonelliasis in the Southeast area of the Venezuelan Orinoquia

    OpenAIRE

    Clemencia E. Medrano; Gregorio S. Volcán; Gerardo A. Godoy

    1992-01-01

    En 26 asentamientos selváticos del Estado Bolívar, Venezuela, fueron muestreados el 10% o más de sus residentes mediante examen físico, biopsias de piel y toma de sangre periférica. En 13 de las comunidades se detectaron 153 indígenas y un mestizo infectados con Mansonelosis, representando un índice global de 36,40% para el área endémica. La parasitosis se concentró en tres focos: El mayor situado en la región Suroccidental y formando parte de una extensa superficie infectada, que abarca terr...

  7. Factores moleculares implicados en el desarrollo de la nefropatía IgA en la población pediátrica / Molecular factors involved in the development of IgA nephropathy in the pediatric population

    OpenAIRE

    Pérez Morales, Rodrigo

    2011-01-01

    La nefropatía IgA, es una glomerulopatía primaria, de presentación habitual en la infancia, que puede conducir a falla renal terminal en un 25 a 30% de los casos, el problema radica, en que es una entidad que se diagnostica tarde debido al bajo índice de sospecha, a la necesidad de biopsia renal para su diagnóstico y que los síntomas son discretos, durante el curso de la enfermedad. Muchos aspectos de esta patología entre ellos: La clasificación histopatológica, la etiología...

  8. Cromoendoscopia com azul de metileno para diagnóstico de esôfago de Barrett

    OpenAIRE

    Saporiti Marcela Rocha Loures; Souza Raquel Canzi de Almada e; Pisani Júlio César; Amarante Heda Maria Barska dos Santos; Carmes Eliane Ribeiro; Sakamoto Danielle Giacometti

    2003-01-01

    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 cromoendoscopi...

  9. Funciones del coordinador/a TIC : estudio de caso en un centro de la capital onubense

    OpenAIRE

    Rodríguez Miranda, Francisco de Paula

    2005-01-01

    En este artículo comenzamos ofreciendo una definición de coordinador/a TIC. Seguidamente analizamos cuáles son sus funciones, extraídas de nuestro estudio de casos desarrollado en un centro público de educación infantil y primaria (centro TIC) en la capital onubense. Para finalizar ofrecemos una biopsia sobre las funciones más relevantes del coordinador/a TIC, teniendo en cuenta las opiniones del equipo docente del colegio y del resto de sus compañeros en la coordinación TIC de...

  10. Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

    Directory of Open Access Journals (Sweden)

    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.

  11. Histiocitosis de células de Langerhans

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    J. Rojo Álvaro

    2014-04-01

    Full Text Available Se describe el caso de un varón con diagnóstico de histiocitosis de células de Langerhans. La histiocitosis X es una enfermedad intersticial con una incidencia real y una prevalencia desconocidas que puede sospecharse por datos epidemiológicos y radiológicos. El diagnóstico puede realizarse mediante BAL y/o estudio anatomo-patológico de biopsia. El principal tratamiento consiste en abandonar el hábito tabáquico. La evolución puede ser variable.

  12. 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.

  13. Minimizing Stimulus Current in a Wearable Pudendal Nerve Stimulator Using Computational Models.

    Science.gov (United States)

    Shiraz, Arsam N; Craggs, Michael; Leaker, Brian; Demosthenous, Andreas

    2016-04-01

    After spinal cord injury, functions of the lower urinary tract may be disrupted. A wearable device with surface electrodes which can effectively control the bladder functions would be highly beneficial to the patients. A trans-rectal pudendal nerve stimulator may provide such a solution. However, the major limiting factor in such a stimulator is the high level of current it requires to recruit the nerve fibers. Also, the variability of the trajectory of the nerve in different individuals should be considered. Using computational models and an approximate trajectory of the nerve derived from an MRI study, it is demonstrated in this paper that it may be possible to considerably reduce the required current levels for trans-rectal stimulation of the pudendal nerve compared to the values previously reported in the literature. This was corroborated by considering an ensemble of possible and probable variations of the trajectory. The outcome of this study suggests that trans-rectal stimulation of the pudendal nerve is a plausible long term solution for treating lower urinary tract dysfunctions after spinal cord injury. PMID:26415182

  14. Prostate cancer - diagnostic and staging; Prostatakarzinom - Diagnostik und Staging

    Energy Technology Data Exchange (ETDEWEB)

    Franiel, T.; Beyersdorff, D. [Charite, Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2007-06-15

    Prostate cancer is the most common malignancy of men in Germany. Transrectal ultrasound (TRUS) is the primary used imaging modality. Patients with elevated PSA levels undergo systematic TRUS-guided transrectal biopsy of the prostate for histologic confirmation of prostate cancer. Magnetic resonance imaging (MRI) using the combined endorectal body phased-array coil may be indicated in men with one or more negative prostate biopsies. The detection of prostate cancer by conventional MRI can be improved by an additional dynamic contrast-enhanced MR study and proton MR spectroscopy. Local staging of prostate cancer by MRI is more accurate compared with digital rectal examination and transrectal ultrasound. However, accuracies reported in the literature for these procedures vary widely. Bone scintigraphy with 99mTc-bisphosphonate is currently the method of choice for the detection of bone metastases. However, more recent techniques such as whole-body MRI and PET using 18F-FDG, 11C-choline or 11C-acetate as tracers were found to have higher sensitivities. (orig.)

  15. Photoacoustic image-guided drug delivery in the prostate

    Science.gov (United States)

    Tang, Shanshan; Chen, Jian; Samant, Pratik; Xiang, Liangzhong

    2016-03-01

    Image guided drug delivery is a novel strategy that combines the effect of therapy and visibility into one system. Here we apply photoacoustic (PA) imaging to visualize the drug delivery process, and perform a simulation study on monitoring the photosensitizer concentration in a prostate tumor during photodynamic therapy (PDT). A 3D optical model of the human prostate is developed, and the light absorption distribution in the prostate is estimated by the Monte Carlo simulation method. The filtered back-projection algorithm is used to reconstruct PA images. PA images of transurethral laser/transrectal ultrasound are compared to those of transrectal laser/ultrasound. Results show that the transurethral laser has a better penetration depth in the prostate compared with transrectal one. Urethral thermal safety is investigated via COMSOL Multiphysics, and the results show that the proposed pulsed transurethral laser will cause no thermal damage on the urethral surface. Regression analysis for PA signal amplitude and drug concentration demonstrates that the PA technique has the potential to monitor drug distributions in PDT, as well as in other laser-based prostate therapy modalities.

  16. Glomus tumor in a patient suffering from Von Recklinghausen disease. A case presentation. Tumor glómico en un paciente con la enfermedad de Von Recklinghausen. Presentación de un caso.

    Directory of Open Access Journals (Sweden)

    Ricardo Souza Bello

    Full Text Available This is a case of a pacient with Von Recklinghausen desease background, she suffers from pain since 2 years evolution in the pulpex of the second finger in the right hand. A physical and radiographic examination is done and a solitary glomal tumor is diagnosed. She goes under surgical treatment with exeresis and biopsia of the lesion. The anatomopathological examination confirmed the glomal tumor diagnosis.

    Se presenta el caso de una paciente con antecedentes de la enfermedad de Von Recklinghausen, que sufre dolor de aproximadamente 2 años de evolución en el pulpejo del segundo dedo mano derecha. Se realiza examen físico y radiográfico y se diagnostica un tumor glómico solitario. Se somete a tratamiento quirúrgico realizándose exéresis y biopsia de la lesión. El examen anatomopatológico confirmó el diagnóstico de tumor glómico.

  17. Fascitis nodular en la región frontal: a propósito de un caso excepcional y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Fátima Martínez Pérez

    2015-07-01

    Full Text Available La fascitis nodular es una entidad excepcional en el territorio maxilofacial, consiste en una proliferación benigna del tejido fibroblástico, de etiología desconocida y con características clínicas e histopatológicas similares a los sarcomas. La clínica habitual consiste en una masa de consistencia dura, indolora y de rápido crecimiento. Su diagnóstico se realiza mediante una biopsia y un estudio histopatológico. El tratamiento consiste en la exéresis quirúrgica completa de la lesión. El diagnóstico diferencial es esencial dado el alto potencial de confusión diagnóstica con lesiones sarcomatosas debido a la similitud de sus características clínicas e histopatológicas. Se presenta el segundo caso clínico en la literatura de fascitis nodular en la región frontal, un varón de 43 años de edad, sin sufrir traumatismo previo en dicha localización. Se procedió a la biopsia-exéresis de la lesión con el diagnóstico histológico de fascitis nodular. Sin evidencia de recurrencia del tumor y un resultado estético excelente.

  18. [Castleman disease].

    Science.gov (United States)

    Belletti, Gerardo A; Savio, Verónica; Minoldo, Daniel; Caminos, Susana; Yorio, Marcelo A

    2004-01-01

    A 66 years female, who was since last year under astenia, arthralgias, pimply lesions in spread plates and tests showing eritrosedimentation over 100 mm, anemi, leucocitosis with neutrofilia, policlonal hypergammaglobulinemia, slight proteinuria and IgE on 900. This patient was sporadically treated with corticoids. When made the medical consult had lost 34lb., was under anorexy, as well as dyspepsia. Hemoglobyn 6.9 gr/dl, leucocytes 20000/mm3, neutrofils at 90%, proteinogram the same as former, with hypoalbuminemia. She was taking prednisona, 16 mg/day. When examined showed depress of conscience, astenia, and dermic lesions already quoted. 4 cm nonpainful right axillary adenopaty adhered to deep planes. Medulogram with increased iron, hyperegenerative. Ganglionar biopsia: linfoid hyperplasic process linked to inmune response. Toracoabdominal tomography with adenomegalia in torax and retroperitoneo. Skin biopsia: neutrofilic vasculitis. The patient suspends the 16 mg of prednisona and fever as well as generalized adenopatias come up. After laying aside other ethiologies, and understanding as Castleman Multicentric disease, it is started to supply prednisona 1 mg/kg of weight with a clinical and biochemical fast and outstanding response. After 7 months it was progressively suspended the esteroids and 60 days later, the process fall back; for that, corticoids are restarted, with a good evolution. The illness of Castleman although it is not very frequent, it should be considered as differential diagnosis in those clinical cases that are accompanied with important general commitment, linphadenopaties and respons to steroid therapy.

  19. Apoptosis de fibroblastos gingivales en periodontitis

    Directory of Open Access Journals (Sweden)

    Roger Mauricio Arce

    2007-09-01

    Full Text Available Introducción: Los fibroblastos gingivales humanos (FGH tienen un papel importante en la enfermedad periodontal, pues alteran su normal funcionamiento en respuesta a estímulos pro-inflamatorios. Se cree que los fibroblastos se pueden eliminar anormalmente por medio de apoptosis en periodontitis. El propósito de este estudio es determinar y cuantificar la apoptosis de FGH en biopsias del periodonto de individuos sanos y con enfermedad periodontal. Métodos: Se realizó un estudio clínico descriptivo de corte transversal en personas con diagnóstico de salud periodontal (S, gingivitis (G y periodontitis crónica (PC. Se tomaron biopsias escisionales y se hicieron tinciones inmunohistoquímicas (hematoxilina-eosina, caspasa-3 y vimentina. Las placas se interpretaron por histopatología y se digitalizaron para cuantificar las células apoptóticas. Todos los datos se analizaron con un software estadístico para encontrar diferencias significativas (p0.5, r²=0.02; mientras que para las células inflamatorias se encontró una relación proporcional significativa (p<0.05, r²=0.2018. Conclusiones: Los resultados permiten concluir que tanto los fibroblastos gingivales como las células inflamatorias presentan apoptosis manifiesta por la expresión de caspasa-3, y ésta se incrementa significativamente en gingivitis y enfermedad periodontal.

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

    Directory of Open Access Journals (Sweden)

    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 scra

  1. Concordancia endoscópico-histológica de la gastritis crónica en Cali

    Directory of Open Access Journals (Sweden)

    Gustavo Mariño

    2009-10-01

    Full Text Available Se realizó un estudio prospectivo con el fin de evaluar la concordancia entre signos endoscópicos y diagnóstico histológico en 216 pacientes con gastritis y metaplasia intestinal. Se estableció un registro codificado de los signos sugestivos de gastritis, que se correlacionaron con los diagnósticos histológicos de las biopsias gástricas. Se seleccionaron aquellas asociaciones que tuvieran una correlación mayor que la esperada por azar. Estas fueron: gastritis atrófica y aumento de visibilidad de vasos en antro, Kappa 0.208 (0.041-0.376; gastritis atrófica y aumento de visibilidad de vasos en cuerpo gástrico, Kappa 0.195 (0.002-0.388; gastritis atrófica y superficie en empedrado en antro, Kappa 0.213 (0.044-0.381; inflamación aguda y pliegues engrosados en antro, Kappa 0.094 (0.018-0.16. Hubo una concordancia pobre entre la mayoría de los signos endoscópicos y los diagnósticos histológicos. El diagnóstico definitivo de la gastritis sólo se debe hacer con base en los estudios histológicos de las biopsias.

  2. An Overlap Syndrome involving systemic lupus erythematosus and autoimmune hepatitis in an adolescent girl.

    Science.gov (United States)

    Battagliotti, Cristina; Rispolo Klubek, Daniela; Karakachoff, Mario; Costaguta, Alejandro

    2016-06-01

    La superposición del lupus eritematoso sistémico y la hepatitis autoinmune se describe ocasionalmente. Aunque ambas enfermedades pueden compartir ciertos hallazgos, como poliartralgias, hipergammaglobulinemia y anticuerpo antinúcleo positivo, son consideradas dos diferentes. Se presenta a una paciente de 14 años con lupus eritematoso sistémico, que, luego de dos años, consultó por ictericia. Sin antecedentes de ingesta de drogas, alcohol o exposición a virus hepatotropos. Tenia un aumento de las enzimas hepáticas con anticuerpos antinúcleo, anti-ADN de doble cadena y LKM 1 positivos. La biopsia hepática mostró una hepatitis de interfase con infiltrado linfoplasmocitario. De esta manera, cumplia con los criterios diagnósticos tanto para lupus eritematoso sistémico como para hepatitis autoinmune. Tratada con corticoides y micofenolato mofetil, mejoró su clinica y laboratorio. Conclusión. La hepatitis autoinmune puede ocurrir en el curso del lupus eritematoso sistémico. Un diagnóstico temprano es importante para prevenir el avance de la enfermedad; es obligatoria la realización de la biopsia hepática.

  3. Síndrome de Alport: reporte de caso y revisión

    Directory of Open Access Journals (Sweden)

    José Augusto Urrego-Díaz

    2015-01-01

    Full Text Available Se presenta el caso de una paciente de 4 años de edad, con hermano gemelo dicigoto asintomático, hija de padres no consanguíneos y sin antecedentes familiares de enfermedad renal. Inicia su cuadro clínico con edemas y proteinuria severa como manifestación de un síndrome nefrótico primario de cambios mínimos; este se diagnosticó por biopsia renal y, en un principio, se manejó con esteroides. Su evolución no fue adecuada debido a múltiples recaídas que la clasificaron como síndrome nefrótico corticorresistente. Por ello, se requirió un cambio en su tratamiento y una segunda biopsia renal, cuyo resultado histológico sorprendió al grupo médico tratante porque los cambios en la membrana basal glomerular confirmaban que se trataba de un Síndrome de Alport.

  4. 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?

    Directory of Open Access Journals (Sweden)

    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

  5. 经直肠超声引导下前列腺系统穿刺活检术的临床引用

    Institute of Scientific and Technical Information of China (English)

    刘欢

    2013-01-01

    Objective To study the Transrectal Ultrasound guided prostate biopsy of the system clinical reference. Methods For 35 cases of rectal touch positive and (or) PSA>4ng/ml patients received a Transrectal Ultrasound guided prostate biopsy of the system in 12 point or 13 points.Results 35 patients diagnosed with prostate cancer in 12 cases of checking out the positive rate of 34.2, the positive rate of high. Conclusion Transrectal Ultrasound guided prostate biopsy of the system to substantially increase the detection rate of prostate cancer, early detection screening for prostate cancer have a higher Clinical Value.%目的探讨经直肠超声引导下前列腺系统活检术的临床引用。方法35例直肠指诊阳性和(或)PSA阳性,直肠超声发现可疑结节患者接受了经直肠超声引导12点前列腺系统穿刺活检术。结果35例患者中确诊为前列腺癌12例检出阳性率为34.2%,阳性率高。结论经直肠超声引导下前列腺系统穿刺活检术可明显提高前列腺癌的临床检出率,对筛选前列腺癌的早期发现具有较高的临床价值。

  6. Pudendal nerve latency time in normal women via intravaginal stimulation

    Directory of Open Access Journals (Sweden)

    Geraldo A. Cavalcanti

    2006-12-01

    Full Text Available INTRODUCTION & OBJECTIVES: Studies of motor conduction for the efferent functional assessment of the pudendal nerve in women with pelvic dysfunctions have been conducted through researching distal motor latency times. The transrectal approach has been the classic approach for this electrophysiological examination. The objective of the present study is to verify the viability of the transvaginal approach in performing the exam, to establish normal values for this method and to analyze the influence of age, stature and parity in the latency value of normal women. MATERIALS AND METHODS: A total of 23 volunteers without genitourinary pathologies participated in this study. In each, pudendal motor latency was investigated through the transvaginal approach, which was chosen due to patient’s higher tolerance levels. RESULTS: The motor response represented by registering the M-wave was obtained in all volunteers on the right side (100% and in 13 volunteers on the left side (56.5%. The mean motor latency obtained in the right and left was respectively: 1.99 ± 0.41 and 1.92 ± 0.48 milliseconds (ms. There was no difference between the sides (p = 0.66. Latency did not correlate with age, stature or obstetric history. The results obtained in the present study were in agreement with those found by other researchers using the transrectal approach. CONCLUSION: The vaginal approach represents an alternative for pudendal nerve distal motor latency time, with similar results to those achieved through the transrectal approach. Normative values obtained herein might serve as a comparative basis for subsequent physiopathological studies.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Características clínicas e histopatológicas del síndrome nefrótico primario.

    Directory of Open Access Journals (Sweden)

    Laercio Bolaños

    2009-11-01

    Full Text Available Introducción: La presentación del síndrome nefrótico con proteinuria masiva, hipoalbuminemia, presencia de anasarca y el manejo con altas dosis de esteroides obliga al clínico a reconocerlo oportunamente, manejarlo interdisciplinariamente y tener la habilidad para predecir el curso y pronóstico de la enfermedad después del manejo inicial. Objetivos: Conocer el comportamiento del síndrome nefrótico primario en niños de Cali y área de influencia, sus características demográficas, la presentación clínica, respuesta a tratamiento y clasificación histopatológica y recomendaciones sobre indicación de biopsia renal. Material y métodos: Se revisaron las historias clínicas de 264 niños con síndrome nefrótico entre enero 1986 y julio 2002 con edades entre 1 y 15 años. Resultados: El promedio de edad al diagnóstico fue 4 años y 60% de los pacientes eran del sexo masculino. Todos presentaron edema y proteinuria, 97% hipoalbuminemia, 94% hipercolesterolemia y 54% oliguria; 89% fueron corticosensibles y sólo 11% corticorresistentes. En 65 pacientes con recaídas frecuentes que recibieron citotóxicos se logró remisión de la enfermedad en 40%. Se realizó biopsia renal en 73 (28%; en 29% la indicación fue por resistencia a esteroides y en 71% por recaídas frecuentes o corticodependencia. Los hallazgos histopatológicos mostraron cambios glomerulares mínimos en 36%, proliferación mesangial en 46%, esclerosis focal y segmentaria en 11% y otras enfermedades 7%. Conclusiones: El porcentaje de casos resistentes a esteroides y la presencia de esclerosis segmentaria y focal son más bajos que los descritos en otras series. En niños con racaídas frecuentes o corticodependientes se recomienda intentar un ciclo con citotóxicos antes de programar biopsia renal, esta se debe reservar para los casos corticorresistentes. Sólo 40% del total son controlados en forma regular por el Servicio de Nefropediatría siendo necesario mejorar el

  10. Tamoxifeno y afecciones endometriales en pacientes con cáncer de mama

    Directory of Open Access Journals (Sweden)

    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.

  11. Billeddiagnostisk stadieinddeling af kolorektal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren R

    2005-01-01

    The main strength of MR is the ability to define the mesorectal facia. There is recent evidence suggesting that MR imaging can accurately predict the tumor-free circumferential resection margin before total mesorectal excision. However, the prediction of T stage is less accurate and more affected...... by the experience of the observer. Transrectal ultrasonography has proven useful for staging of rectal carcinoma. Computed tomography is one of the most useful imaging techniques for the evaluation of metastatic lesions in colorectal cancer. Udgivelsesdato: 2005-Oct-31...

  12. Análisis comparativo de la salud y costo en el período vaca parida en rodeos lecheros Comparative analysis of health and cost of fresh cow in dairy herds

    OpenAIRE

    Frias, M.; Landi, H; Montes, D.; F Palma Parodi

    2011-01-01

    Monitorear la vaca en transición es fundamental para detectar precozmente enfermedades. El objetivo fue evaluar la incidencia y costo de eventos en el período “vaca parida” en un tambo del partido de Tandil y compararla con resultados del grupo Clave. Se monitoreó diariamente por 12-14 días posparto la producción láctea, actitud, temperatura corporal, función ruminal, palpación transrectal, glándula mamaria y score de locomoción a 240 vacas y 102 vaquillonas Holstein, durante 3 meses desde el...

  13. A Rare Prostatic Diagnosis of an Old Man: A Pure Prostatic Leiomyoma

    Directory of Open Access Journals (Sweden)

    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.

  14. Reproductive endocrine profiles and follicular growth after estrus induction in the riverine water buffalo (Bubalus bubalis, 2n=50) and riverine-swamp hybrid buffalo (2n = 49)

    OpenAIRE

    Bondurant, R H; J.L. Zambrano-Varón

    2010-01-01

    Ten adult female water buffalo were used in the present study (5 x [2n = 50] and 5 x [2n= 49] hybrids). Ovarian activity was monitored daily by transrectal ultrasonography between two consecutive ovulations. Observed follicular wave numbers were: 1 (n=1), 2 (n=4), and 3 (n=5). The interovulatory interval ranged 17 to 23 days. Differences in mean follicular diameter between follicles of the normal karyotype (2n=50) and buffalo hybrids (2n=49) were found on the second subordinate group of folli...

  15. Diagnostic imaging of the prostate

    International Nuclear Information System (INIS)

    Modalities for the diagnostic imaging of the prostate are surveyed. Transrectal sonography is thought to be the best method for the purpose, because of its non-invasive nature, fine picture quality, sufficient reproductivity and less expensive cost. Up-to-date utilizations of the method are described, such as diagnostic capability, staging, monitoring, screening and intervention. CT is less effective but MRI is promising to visualize internal structure inside the prostate. Two very new techniques, namely, ultrasonic Doppler color flow mapping and positron emission CT (PET), of which application to the prostate is being investigated originally in our laboratory, are introduced. (author) 100 refs

  16. Prostatic sarcoma of the Ewing family in a 33-year-old male – A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lukas Esch

    2016-04-01

    Full Text Available Ewing sarcoma is the second most common primary bone tumor seen in children and adolescents, typically presenting between 10 and 20 years of age. Extraosseous sarcomas of the Ewing family in adults are rare. We report a manifestation of this tumor entity in the periprostatic tissue of a 33-year-old male and discuss our treatment approach. Transrectal biopsy is a feasible and simple diagnostic tool for unclear pelvic masses. Multi-modal therapy and central registries are needed to gain knowledge of rare pelvic tumors like Ewing sarcoma.

  17. OVARIAN FOLLICULAR DYNAMIC DURING EARLY PREGNANCY IN BUFFALO Bubalus bubalis HEIFERS DINÂMICA FOLICULAR DURANTE A GESTAÇÃO INICIAL EM NOVILHAS BÚFALAS Bubalus bubalis

    OpenAIRE

    Eunice Oba; Cássia Maria Barroso Orlandi; Lindsay Unno Gimenes; Christiane Rumi Irikura; Ian Martin; João Carlos Pinheiro Ferreira

    2008-01-01

    The aim of the present study was to characterize the follicular dynamics during early pregnancy in Murrah heifers. Ten heifers were submitted to daily transrectal ultrasonographic examination, from the 18th to 60th day of pregnancy. Three animals presented follicular waves of 9.67?0.58 days in duration and the dominant and largest subordinate follicles measured, respectively, 11.9?1.3 mm and 7.0?1.0 mm. The growth plateau was 6.00?1.00 days in duration. The remaining seven heifers presented a...

  18. Características del ciclo estral, desarrollo embrionario y determinación de la tasa de preñez en yeguas criollas colombianas

    OpenAIRE

    Paredes Higuera, María del Pilar

    2013-01-01

    Para contribuir al establecimiento de valores de referencia durante el ciclo estral (CE) y la gestación temprana en yeguas Criollas colombianas (CC), se realizó seguimiento de la dinámica folicular y del diámetro del cuerpo lúteo (CL) durante dos CE consecutivos por medio de ultrasonografía (US) transrectal diariamente. Se emplearon 30 yeguas entre 4 a 14 años de edad, ubicadas en Pereira (Colombia). Además se tomaron muestras de sangre cada 48 horas durante un CE para cuantifi...

  19. Metástasis al tracto uveal de un carcinoma pulmonar asociado a un carcinoma de piel. A propósito de un caso.

    Directory of Open Access Journals (Sweden)

    Esther Díaz Guzmán

    2006-07-01

    Full Text Available Se realiza la presentación de un caso de extremo interés oftalmológico, dermatológico, pero sobre todo oncológico; pues se trata de un paciente operado de un carcinoma epidermoide en la sien izquierda, que realmente era una metástasis, aunque posteriormente presentó cuadros de uveítis repetitivos evolucionando a la Pthisis bulbi del ojo izquierdo y recibiendo tratamiento quirúrgico con biopsia que arroja un carcinoma epidermoide. Todo lo anterior es seguido de una adenopatía supraclavicular a la cual se le toma muestra y permite concluir que la lesión primaria estaba en pulmón. Se realiza revisión del tema y además se presentan las láminas histológicas que muestran todo lo anterior.

  20. Asociación sincrónica de carcinoma de paratiroides con tumor pardo mandibular y carcinoma papilar de tiroides

    OpenAIRE

    Jaime Alonso Reséndiz-Colosia; Sergio Arturo Rodríguez-Cuevas; Sinuhé Barroso-Bravo; José Francisco Gallegos-Hernández; Martín Hernández-San Juan; Fernando Gómez-Acosta

    2008-01-01

    Introducción: Los nódulos tiroideos en pacientes con hiperparatiroidismo primario son frecuentes, pero la asociación sincrónica de carcinoma de paratiroides y carcinoma papilar de tiroides es un evento poco común. Caso clínico: Paciente de 42 años de edad con tumor en región mandibular derecha y nódulo en la cara anterior de cuello que dependía del lóbulo derecho de tiroides. La biopsia por aspiración de la lesión en cavidad oral indicó lesión de células gigantes. Se identificó hipercalcemia ...

  1. Cáncer folicular de tiroides y bocio tóxico difuso. Reporte de un caso

    OpenAIRE

    Ignacio Alejandro Martínez-Delgado; Graciela Gómez-Martínez; Jesús Manuel Ojeda-Ibarra

    2007-01-01

    Introducción: El cáncer folicular de tiroides raramente se manifiesta por una lesión metastásica. Reportamos el caso de un varón con cáncer folicular que presentó inicialmente tumoración esternal como lesión metastásica distante asociada con bocio tóxico difuso. Caso clínico: Hombre de 50 años con tumoración esternal de 6 x 6 cm, de consistencia blanda, no dolorosa, con aumento de temperatura y pulsátil. El diagnóstico por biopsia incisional fue de metástasis de cáncer folicular. En la valora...

  2. Tiroiditis autoinmune inducida por interferón en pacientes con infección por virus de la hepatitis C. Interferon-induced autoimmune thyroiditis in a patient with hepatitis C virus infection

    OpenAIRE

    José L. Pinto; Pinto, Miguel E.

    2011-01-01

    Se reporta el caso de un varón de 43 años de edad, sin antecedentes patológicos de importancia, que acudió por elevación asintomática de la alanino aminotransferasa (ALT). El paciente negó ser bebedor crónico de alcohol. Se hizo el diagnóstico serológico de infección activa por hepatitis C y la biopsia de hígado reveló inflamación crónica activa. Con estos resultados, se inició tratamiento con interferón-alfa y ribavirina. Durante el tratamiento de 48 semanas, el paciente presentó anticuerpos...

  3. Cambios bioquímicos del metabolismo óseo durante el movimiento ortodóncico

    OpenAIRE

    Barbieri Petrelli, Germán

    2015-01-01

    Desde la primera biopsia de un diente al que se le aplicó una fuerza allá por el año 1901 (Meikle, 2006; Wöstmann et al., 2008), la comunidad científica, en concreto la odontológica, siempre se preguntó cómo podía moverse un diente a través del hueso alveolar. Hoy, más de 100 años después, seguimos sin saber con exactitud todos los factores que influyen en este proceso pero hacemos un esfuerzo por conocerlo cada vez más a fondo. El entendimiento de los factores más influyentes en este remodel...

  4. Características clínicas, bioquímicas y epidemiológicas de un grupo de pacientes con diagnóstico imaginológico de hígado graso

    Directory of Open Access Journals (Sweden)

    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.

  5. Utilização do óleo de alho e da amoxilina, metronidazol e omeprazol no controle de Helicobacter spp. em cães Use of garlic oil and amoxicillin, metronidazole, and omeprazol in the control of Helicobacter spp. in dogs

    OpenAIRE

    M.C. Costa; P.R.S. Costa; J.C.P. Silva; R.E.N. Maia; J.C.L. Moreira; Carvalho, R. M.

    2009-01-01

    Avaliaram-se a eficácia do óleo de alho e da terapia tripla (amoxicilina, metronidazol e omeprazol) no tratamento de 21 cães infectados por Helicobacter spp., que apresentavam alterações histológicas nas biopsias endoscópicas da mucosa gástrica e reação positiva ao teste de urease. Os animais foram distribuídos, aleatoriamente, em três grupos de sete cães, os quais receberam os seguintes tratamentos: grupo 1 - cápsulas vazias; grupo 2 - 500mg de óleo de alho em cápsulas, diariamente, por um p...

  6. Contribuição para o diagóstico diferencial da distrofia muscular progressiva

    Directory of Open Access Journals (Sweden)

    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

  7. 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

    OpenAIRE

    Daniel Álvarez; María Anders; José Mella; Marcelo Amante; Federico Orozco; Ricardo Mastai

    2012-01-01

    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 enfermed...

  8. Evaluación de la fibrosis hepática en la hepatitis crónica por virus C mediante la aplicación de un índice indirecto no invasivo. Evaluación prospectiva de la utilidad de los índices indirectos no invasivos para la predicción de la evolución a cirrosis hepática

    OpenAIRE

    Bejarano Redondo, Guillermina

    2015-01-01

    La hepatitis C es una infección del hígado causada por el VHC. Aproximadamente 170 millones de personas están infectadas en todo el mundo. El pronóstico de la hepatopatía crónica por VHC depende en gran medida de la progresión de la fibrosis hepática. Diversos autores han desarrollado índices no invasivos para el diagnóstico de cirrosis o fibrosis significativa obviando la realización de la biopsia hepática, pero a pesar de la existencia de múltiples índices predictivos o del FibroScan® todav...

  9. Características histoquímicas y morfométricas del músculo Gluteusmedius en equinos en preparación para competencias de salto.: Estudio preliminar Histochemical and morphometricalcharacteristics of the Gluteus medius muscle in horses in preparation for jumpingcompetition: Preliminary study

    OpenAIRE

    A. Islas; M. QUEZADA; A. Bernales.; Mora, G. (Gonzalo); J.L. LOPEZ-RIVERO; V. MERINO; Briones, M.; C. ESCALONA; Marin, L

    1998-01-01

    Se obtuvieron biopsias a 3 y 6 centímetros de profundidad del músculo de 7 yeguas y 3 machos castrados de 3 a 4 años de edad, los cuales no habían realizado con anterioridad ningún programa específico de entrenamiento por 3 meses.Las muestras fueron analizadas por las técnicas mATPasa miofibrilar, para determinar la composición fibrilar, y NADH-TR para determinar la capacidad oxidativa. Los promedios obtenidos para la composición fibrilar fueron de 21.6%, 36.2%, 26.9% y 15.3% para las fibras ...

  10. Características histoquímicas y bioquímicas de las fibras del músculo Gluteus medius en equinos de tiro descendientes del Plan de Fomento Equino

    OpenAIRE

    A. Islas; J.L. LOPEZ-RIVERO; M. QUEZADA; Mora, G. (Gonzalo); V. MERINO; Briones, M.; Perez, P; Aguirre, G.; Marin, L

    1997-01-01

    Se tomaron biopsias a 3, 6 y 9 cm de profundidad del músculo Gluteus medius a 16 equinos de tiro descendientes del Plan de Fomento Equino, machos y hembras entre 5 y 15 años de edad en condiciones de reposo. Las muestras fueron analizadas por las técnicas histoquímicas de miosín ATPasa para determinar la composición fibrilar, área y diámetro mínimo y la técnica NADH-TR para determinar la capacidad oxidativa de las fibras; también se determinó la actividad de las enzimas CK, LDH y CS. Los valo...

  11. Relación de la susceptibilidad genética y de las características anatomopatológicas del cáncer de próstata con los polimorfismos de nucleótido simple

    OpenAIRE

    Ruiz Domínguez, Jose Manuel

    2012-01-01

    Actualmente no se disponen de marcadores biológicos específicos para la cáncer de próstata produciéndose en muchas ocasiones biopsias prostáticas innecesarias o un sobretratamientos para cánceres indolentes. Existen cada vez más un número mayor de publicaciones sobre cómo los polimorfismos de nucleótido simple (SNP) se relacionan con la susceptibilidad al cáncer de próstata o predecir con mayor precisión qué grado de agresividad adquiere la enfermedad. Se presenta una revisión bibliográfica d...

  12. Recidiva en bronquiolitis obliterante con neumonía en organización: BOOP RELAPSE IN BRONCHOLITIS OBLITERANS ORGANIZING PNEUMONIA: BOOP

    OpenAIRE

    JUAN I. VARGAS RT.; SARA CHERNILO S.

    2003-01-01

    Las recaídas son frecuentes en la bronquiolitis obliterante con neumonía en organización (BOOP), sin embargo, existe poca información con respecto a su causa. Se presenta el caso de una mujer de 63 años con un cuadro clínico radiológico compatible con BOOP. No se identificó una causa subyacente por lo que se planteó el diagnóstico de neumonía en organización criptogénica o COP. Se realizaron biopsias transbronquiales que demostraron una neumonía crónica organizada y bronquiolitis proliferativ...

  13. Principios de ENDOSCOPIA diagnóstica y terapéutica (endocirugía

    Directory of Open Access Journals (Sweden)

    Flores-Alés, Andrés J.

    2010-09-01

    Full Text Available ResumenSe hace una introducción general a las bases, terminología, material y a las indicaciones de interés practico en la clínica diaria, con especial incapie en las tomas de biopsias, cuerpos extraños, polipectomias y en menor grado en la dilatación de de estenosis y las gastrotomía percutánea endoscópica todas ellas abarcables bajo el concepto de endocirugía, finalizando con el informe endoscópico.SummaryThe meaning of the term is defined traqueobroncoscopia describing itself the necessary material, its utility in the diagnosis, its indications, the used technique, the preparation of instruments and the patient, the exploratory routine remembering the direction endoscópica anatomy to end up concluding with the benefits that contribute.

  14. 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

  15. Citologia oncológica, captura de híbridos II e inspeção visual no rastreamento de lesões cervicais

    OpenAIRE

    Gontijo Renata Clementino; Derchain Sophie Françoise Mauricette; Montemor Eliana Borin Lopes; Sarian Luis Otávio Zanatta; Serra Márcia Milena Pivatto; Zeferino Luiz Carlos; Syrjanen Kari Juhani

    2005-01-01

    Avaliar as alterações na citologia oncológica, na captura híbrida II e na inspeção visual com ácido acético (IVA) a 5% em 684 mulheres atendidas em uma unidade de saúde, e avaliar o desempenho e a concordância entre os exames. Procurar descrever as características sócio-demográficas e reprodutivas (SDR) destas mulheres e sua associação com a presença de doença. As mulheres foram submetidas à coleta de citologia, captura e IVA, e as com exame positivo foram submetidas à colposcopia com biopsia...

  16. Cáncer de próstata metastásico asociado a valores bajos de antígeno prostático específico Metastatic prostate cancer associated with low levels of prostate-specific antigen

    OpenAIRE

    Silvia Diaz; Michael Salirrosas

    2012-01-01

    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 antíge...

  17. Perforación duodenal espontánea en paciente intervenido de prostatectomía radical Spontaneous duodenal perforation in a radical prostatectomy patient

    OpenAIRE

    Tienza, A. (Antonio); J.M. Velis; Algarra, R. (Rubén); L.M. Romero; J. Barba; Berián, J.M. (J.M.)

    2012-01-01

    La prostatectomía radical es una cirugía para el cáncer localizado de próstata, muy conocida y con escaso número de complicaciones precoces postoperatorias. Presentamos el caso de un paciente de 54 años con PSA de 8 ng/ml y biopsia informada como adenocarcinoma de próstata Gleason 3+3=6 intervenido quirúrgicamente mediante prostatectomía radical retropúbica, que presentó una perforación espontánea de duodeno. Se manejó de forma conservadora ante el buen estado del paciente, resolviéndose a lo...

  18. Modulación en la expresión de biomarcadores (RE, RP y C-erbB2 en cáncer de mama tras tratamiento neoadyuvante Modulation of biomarkers expression (OR, PR and C-erbB2 in breast cancer following neoadjuvant treatment

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    A. Córdoba

    2006-12-01

    Full Text Available Introducción: El tratamiento oncológico pre y postoperatorio en pacientes con carcinoma de mama está condicionado entre otros factores, por el resultado del estudio inmunohistoquímico de los receptores hormonales y por la expresión de c-erbB2. El objetivo del estudio es determinar la influencia del tratamiento neoadyuvante en la expresión de receptores de estrógeno (RE, progesterona (PR y c-erbB2. Material y métodos. Estudiamos 53 pacientes con cáncer de mama diagnosticadas mediante biopsia "trucut". Las pacientes con carcinoma localmente avanzado (20 se someten a quimioterapia preoperatoria. Se realiza extirpación quirúrgica en todos los casos. Comparamos la expresión de receptores de estrógeno (RE, receptores de progesterona (PR y c-erbB2, en la biopsia"trucut" y en la pieza quirúrgica. Resultados. Encontramos diferencias significativas en la expresión de RE, RP entre biopsia/pieza quirúrgica, comparando el grupo de pacientes sometidas a tratamiento neoadyuvante frente al grupo de pacientes sin tratamiento oncológico prequirúrgico. Encontramos diferencias de signo (positivización y negativización entre un 10 y un 40% de casos en la expresión inmunohistoquímica para RE, RP y c-erbB2 entre la biopsia"trucut" y la resección quirúrgica en las pacientes tratadas con neoadyuvancia. Estas diferencias de signo no tienen significación estadística.Introducción: Pre and post-operative oncological therapy in patients with breast cancer is determined, amongst other factors, by hormone receptor status and by c-erbB2 expression. The aim of this study is to determine the influence of neoadjuvant therapy on the expression of oestrogen receptor (OR, progesterone receptor (PR and c-erbB2. Methods. Fifty-three patients with breast cancer diagnosed by tru-cut biopsy were studied. Patients with locally advanced carcinoma (20 had preoperative treatment. All patients underwent surgical resection. Expression of OR, PR and c-erbB2 in both the

  19. Tuberculosis peritoneal con niveles elevados de CA 125

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    Andrés José Gómez-Aldana

    2013-09-01

    Full Text Available Resumen La tuberculosis peritoneal hace parte de los diagnósticos diferenciales de ascitis; sin embargo, su documentación está dada por la presencia de granulomas necrotizantes al igual que el crecimiento de micobacterias en las muestras tomadas del peritoneo. Se presenta el caso de una paciente con dolor abdominal y ascitis en quien se documentaron lesiones nodulares en cavidad peritoneal, con niveles marcadamente elevados de "Antígeno Carbohidrato o Antígeno Cáncer" CA 125, sin cambios en otros órganos, realizando biopsias de peritoneo, con documentación de granulomas necrotizantes y crecimiento de micobacterias en el cultivo, por lo que se instauró tratamiento con adecuada respuesta logrando disminución progresiva de la ascitis y ganancia de peso.

  20. 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.

  1. Proteinosis alveolar pulmonar y patrón en empedrado ("crazy-paving") en tomografía computarizada de alta resolución Pulmonary alveolar proteinosis and crazy paving pattern in high resolution CT

    OpenAIRE

    C. de Arriba; Antón, C.; E. Arreche; M. P. Lorente

    2006-01-01

    Se presenta un caso de proteinosis alveolar pulmonar en un varón de 27 años en el que la tomografía computarizada de alta resolución muestra un típico patrón "crazy-paving" o en empedrado, siendo esta prueba la que orienta hacia un diagnóstico diferencial concreto, a pesar de la inespecificidad de la presentación clínica. El lavado broncoalveolar no es concluyente y el diagnóstico definitivo se hace con biopsia transbronquial. Se revisan los aspectos más característicos de esta rara enfermeda...

  2. 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.

  3. Hemangioma capilar de la parótida. Abordaje transoral

    Directory of Open Access Journals (Sweden)

    Luis Domingo Sarra

    2014-10-01

    Presentamos un caso en una paciente adulta que consultó por una masa en la región parotídea y parálisis facial periférica con el mayor componente tumoral que se manifestaba en la cavidad oral. La ecografía mostró una masa sólida. La punción aspiración con aguja fina fue negativa con material hemático en 2 oportunidades. No tuvimos sospecha de la presencia de un tumor de origen vascular, por lo que no fue solicitada una RMN. El caso fue resuelto a través de un abordaje quirúrgico poco utilizado, tras obtener una biopsia por congelación negativa.

  4. 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.

  5. Análisis comparativo entre la radiología y la fibrogastroscopia en el diagnóstico de úlcera, cáncer y hemorragia gástricos

    OpenAIRE

    Campos, Jaime; Argüello, Milton; Montoya, Ciro Alfonso; Camargo, Hernán

    2011-01-01

    De un total de 340 fibrogastroscopias practicadas durante 1 año en 286 pacientes, se analizan comparativamente con la radiología los resultados de la endoscopia y de la biopsia en el diagnóstico de la úlcera y del cáncer gástrico y en le etiología de la hemorragia digestiva. El  análisis de 76 pacientes en que se planteó el diagnóstico de úlcera gástrica permitió su comprobación en 62. La endoscopia logró mejorar el porcentaje diagnóstico de exactitud de un 63.2% de 76 estudios radiográficos ...

  6. 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

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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 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

  7. VARIANTE TRICOLEUCÉMICA DE CÉLULAS B, CON RESTRICCIÓN ISOTÍPICA KAPPA Y AFECTACIÓN DÉRMICA.

    OpenAIRE

    Miguel Ángel Martínez-González; Carmen Alonso-San Pablo; Montserrat Pérez; Dr. Ernesto Moro-Rodríguez,; Inmaculada de Prada-Vicente

    2004-01-01

    Resumen: Se presenta un caso inusual de una variante de leucemia de células peludas en una mujer de 75 años de edad que debutó con una infiltración dérmica de 15 meses de evolución con lesiones violáceas que se desarrollaron de forma progresiva en ambas mamas hasta ocasionar la deformidad de la areola. Se realizó una biopsia de la lesión cuntánea que se complementó con un estudio ultraestructural. Los marcadores inmunológicos en sangre periférica determinaron un fenotipo de células B con rest...

  8. Duplicidad tiroidea y carcinoma papilar en un tiroides ectópico. Presentación de caso

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    José Alberto Puerto Lorenzo

    2012-05-01

    Full Text Available Se presenta una paciente con tumor palpable ubicado en línea media de la región anterior del cuello, encima del hueso hioides, diagnosticado inicialmente como quiste del conducto tirogloso. Se realizó estudio preliminar, tanto clínico, como radiológico y citológico de la lesión. Mediante cirugía por técnica convencional, se extrajo el tumor. La biopsia por parafina definió la existencia de tiroides con carcinoma papilar. Añadido a dicha condición, la paciente presentaba glándula tiroidea en ubicación normal. Se considera un caso curioso, donde se mezclan los conceptos de duplicidad tiroidea y tiroides ectópico, con la presencia en este último de un carcinoma papilar.

  9. 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.

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

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    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.

  11. 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

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    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

  12. 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.

  13. Certeza diagnóstica en la mortalidad de una población de pacientes con trasplante cardíaco

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    Marcos Amuchástegui (h,

    2006-01-01

    Full Text Available Introducción A pesar de que la morbimortalidad en el trasplante cardíaco ha sido motivo de extenso análisis, la mayoría de los estudios y registros de mortalidad en pacientes trasplantados se basan sobre datos clínicos. En la bibliografía existen comunicaciones aisladas de autopsias en pacientes con trasplante cardíaco.Objetivo Determinar la importancia de la realización de estudios anatomopatológicos para el diagnóstico de causa de muerte en un programa de trasplante cardíaco.Material y métodosSe incluyeron todos los pacientes con trasplante cardíaco fallecidos entre enero 1990 y enero 2005. El diagnóstico definitivo de la causa de muerte fue corroborado por autopsia o biopsia de órgano sólido. Las causas de muerte evaluadas fueron falla precoz del injerto, rechazo celular, infección, enfermedad vascular del injerto, neoplasia y otros.ResultadosDurante el período en estudio 73 pacientes fueron sometidos a trasplante cardíaco; de ellos, fallecieron 31. Se obtuvieron 12 autopsias y 7 biopsias de órgano sólido que certificaron la causa de muerte (61%. La causa de muerte más frecuente fue el rechazo celular mayor de grado III. En el 12,9%, la anatomía patológica difirió de la sospecha clínica de la causa de muerte.ConclusiónLa información clinicopatológica derivada de estudios post mortem es un indicador de nuestra realidad asistencial y se constituye en un pilar fundamental para el conocimiento y el manejo futuro de los pacientes trasplantados, por lo que consideramos que la realización de autopsias en estos pacientes es de vital importancia.

  14. Thoracic splenosis. Report of a case and review of the diagnostic workup.

    Science.gov (United States)

    Bugiantella, Walter; Crusco, Federico; Avenia, Nicola; Fabio, Rondelli

    2016-07-29

    L’impianto di tessuto splenico in siti ectopici dopo un trauma della milza viene definito splenosi. Sebbene si verifichi più comunemente in addome, essa può localizzarsi anche nel torace in caso di rottura del diaframma. La splenosi toracica (TS) è spesso asintomatica ed è diagnosticata nel corso di indagini radiologiche del torace. Descriviamo il caso di un uomo, con storia di pregresso trauma toraco-addominale, che ha eseguito una radiografia del torace per routine con evidenza di immagini radioopache in adiacenza dell’arco inferiore sinistro dell’ombra cardiaca, che sono risultate essere noduli di TS confermate dalla CT con mezzo di contrasto. La CT o la MRI unite ad una anamnesi accurata sono di solito sufficiente per diagnosticare la TS, altrimenti è necessaria la scintigrafia con 99mTc. La biopsia guidata dall’imaging e la toracoscopia dovrebbero essere eseguite solo quando la scintigrafia non è disponibile o i risultati delle altre metodiche non sono risolutivi. Normalmente non è necessario rimuovere la TS perché il tessuto splenico ha una crescita lenta, non invasiva e benigna. Raramente la chirurgia può essere necessaria quando la TS è sintomatica (emottisi, tosse, dolore di tipo pleuritico). La TS può essere difficile da diagnosticare, specialmente se l’aspetto dei noduli non è univoco e l’anamnesi non è nota. Ciò può portare a un iter diagnostico eccessivo e a procedure non necessarie (biopsia, toracoscopia fino alla toracotomia). Nel work-up dei noduli toracici la TS dovrebbe essere considerata nei pazienti con storia di trauma e rottura della milza.

  15. Apoptosis of gingival fibroblasts in periodontitis.

    Directory of Open Access Journals (Sweden)

    Roger Mauricio Arce

    2009-11-01

    Full Text Available Introducción: Los fibroblastos gingivales humanos (FGH tienen un papel importante en la enfermedad periodontal, pues alteran su normal funcionamiento en respuesta a estímulos pro-inflamatorios. Se cree que los fibroblastos se pueden eliminar anormalmente por medio de apoptosis en periodontitis. El propósito de este estudio es determinar y cuantificar la apoptosis de FGH en biopsias del periodonto de individuos sanos y con enfermedad periodontal. Métodos: Se realizó un estudio clínico descriptivo de corte transversal en personas con diagnóstico de salud periodontal (S, gingivitis (G y periodontitis crónica (PC. Se tomaron biopsias escisionales y se hicieron tinciones inmunohistoquímicas (hematoxilina-eosina, caspasa-3 y vimentina. Las placas se interpretaron por histopatología y se digitalizaron para cuantificar las células apoptóticas. Todos los datos se analizaron con un software estadístico para encontrar diferencias significativas (p Resultados: La población celular total de fibroblastos tuvo un promedio de 430±67.6 en los individuos sanos y una disminución significativamente progresiva en gingivitis (270±37.1 y periodontitis crónica (206.5±69.8 (p0.5, r²=0.02; mientras que para las células inflamatorias se encontró una relación proporcional significativa (p Conclusiones: Los resultados permiten concluir que tanto los fibroblastos gingivales como las células inflamatorias presentan apoptosis manifiesta por la expresión de caspasa-3, y ésta se incrementa significativamente en gingivitis y enfermedad periodontal.

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

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    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

  17. [Usefulness of hepatobiliary scintigraphy in the follow-up of patients with biliary reconstruction].

    Science.gov (United States)

    Sánchez-Fernández, Patricio; Martínez-Ordaz, José Luis; Sánchez-Reyes, Karina; Ferat-Osorio, Eduardo

    2015-01-01

    Introducción: la importancia de casos de lesión de vía biliar no solo involucra el diagnóstico y el tratamiento oportuno, sino también el seguimiento a largo plazo por la posibilidad de complicaciones tardías y los aspectos médico-legales. La medicina nuclear ha desempeñado un papel importante en el diagnóstico de múltiples enfermedades hepatobiliares. Métodos: estudio observacional, retrospectivo, transversal y analítico. Revisión de pacientes con lesión de vía biliar y sometidos a reconstrucción bilio-digestiva y biopsia hepática en la cirugía. Seguimiento clínico, con laboratorio y colangiogamagrama. Resultados: de enero de 2001 a diciembre de 2009 se evaluaron cien pacientes, treinta y cinco hombres y sesenta y cinco mujeres con edad promedio de 38.8 años. Los tipos de lesión de acuerdo con la Clasificación de Strasberg fueron: Tipo E1 (13 %); Tipo E2 (17 %); Tipo E3 (38 %), y Tipo E4 (32 %). Todos los pacientes fueron sometidos a cirugía reconstructiva de la vía biliar, 84 con técnica de Hepp-Couinaud y 16 pacientes con técnica convencional de hepático-yeyuno anastomosis en Y de Roux. Por biopsia hepática, doce pacientes con inflamación, cuarenta nueve colestasis, diecinueve ductopenias y diecinueve fibrosis. Conclusiones: la colangiogamagrafía, es un estudio adecuado en el seguimiento al valorar la captación y eliminación, su mejor utilidad es en pacientes con resultado histopatológico de colestasis y ductopenia.

  18. Anisotropic Diffusion for Medical Image Enhancement

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    Nezamoddin N. Kachouie

    2010-10-01

    Full Text Available Advances in digital imaging techniques have made possible the acquisition of large volumes of Transrectal Ultrasound (TRUS prostate images so that there is considerable demand for automated segmentation. Prostate cancer diagnosis and treatment rely on segmentation of these Transrectal Ultrasound (TRUS prostate images, a challenging and difficult task due to weak prostate boundaries, speckle noise and the narrow range of gray levels, leading most image segmentation methods to perform poorly. The enhancement of ultrasound images is challenging, however prostate segmentation can be effectively improved in contrast enhanced images. Anisotropic diffusion has been used for image analysis based on selective smoothness or enhancement of local features such as region boundaries. In its formal form, anisotropic diffusion tends to encourage within-region smoothness and avoid diffusion across different regions. In this paper we extend the anisotropic diffusion to multiple directions such that segmentation methods can effectively be applied based on rich extracted features. A preliminary segmentation method based on extended diffusion is proposed. Finally an adaptive anisotropic diffusion is introduced based on image statistics.

  19. Pregnancy Loss in Dairy Cattle: Relationship of Ultrasound, Blood Pregnancy-Specific Protein B, Progesterone and Production Variables.

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    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 advanced parity and with high milk 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.

  20. 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.

  1. 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. PMID:26926407

  2. Metabolic syndrome and prostate abnormalities in male subjects of infertile couples.

    Science.gov (United States)

    Lotti, Francesco; Corona, Giovanni; Vignozzi, Linda; Rossi, Matteo; Maseroli, Elisa; Cipriani, Sarah; Gacci, Mauro; Forti, Gianni; Maggi, Mario

    2014-01-01

    No previous study has evaluated systematically the relationship between metabolic syndrome (MetS) and prostate-related symptoms and signs in young infertile men. We studied 171 (36.5 ± 8.3-years-old) males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal (including total testosterone (TT) and insulin), seminal (including interleukin-8 (IL-8), seminal plasma IL-8 (sIL-8)), scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS). Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components (Wald = 29.5, P prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound (Wald = 17.6 and 12.5, both P calcification size (Wald = 3.11, Pprostate enlargement, biochemical (sIL8) and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.

  3. Strategies for prevention of ultrasound guided prostate biopsy infections [Erratum

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    Lu DD

    2016-08-01

    Full Text Available Lu DD, Raman JD. Infect Drug Resist. 2016;9:161–169On page 168, Reference section, an error occurred with some of the numbering, relating to:15. Berger AP, Gozzi C, Steiner H, et al. Complication Rate of transrectal ultrasound guided prostate biopsy: a comparison among 3 protocols with 6, 10 and 15 cores. J Urol. 2004;171(4:1478–1481.16. Jeon SS, Woo S-H, Hyun J-H, Choi HY, Chai SE. Bisacodyl rectal preparation can decrease infectious complications of transrectal ultrasound-guided prostate biopsy. Urology. 2003;62(3:461–466.17. Pepe P, Aragona F. Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology. 2013;81(6:1142–1146.18. Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Is repeat prostate biopsy associated with a greater risk of hospitalization? Data from SEER-Medicare. J Urol. 2013;189(3:867–870.Read the original article

  4. THE FIRST EXPERIENCE IN USING THE ULTRASOUND AND MAGNETIC RESONANCE IMAGE FUSION TECHNOLOGY IN THE DIAGNOSIS OF PROSTATE CANCER

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    V. V. Kapustin

    2010-01-01

    Full Text Available Objective: to study the feasibility of the image fusion technology to choose a target portion for needle biopsy in prostate cancer (PC. Subjects and methods. Ultrasound (US-magnetic resonance imaging (MRI-guided needle biopsies were made in 12 patients. All the patients underwent intravenous bolus-enhanced MRI, then MRI and US images were fused during transrectal ultrasound studies (TRUS and targets were determined to make a needle biopsy. Results. The image fusion technology allows one to concurrently assess MRI and US images in the primary diagnosis of prostate cancer and after radical prostatectomy (RPE. The MRI and transrectal images are compared with a high degree of accuracy, providing the clear positioning of the portions substantially accumulating the MRI contrast agent during real-time TRUS. Conclusion. The MRI-US image fusion procedure enables the choice of the targets to be biopsied both in the primary diagnosis of PC and in its suspected recurrence in patients after RPE. The increased accumulation of a MRI contrast agent is a major criterion for choosing a target portion.

  5. Field use of ultrasonography to characterize the reproductive tract and early pregnancy in a phocid, the Weddell seal (Leptonychotes weddellii).

    Science.gov (United States)

    Shero, Michelle R; Adams, Gregg P; Burns, Jennifer M

    2015-12-01

    The utility of transrectal ultrasonography was tested in a field setting to characterize the reproductive tract and detect early pregnancy (embryonic vesicles guitar-pick shaped nonechogenic (black) vesicle with a clearly visible echogenic border within the lumen of the uterus. The stage of embryonic development (ostensibly the gestational age) varied markedly among individuals, ranging from a vesicle with no embryo proper to a large fetus with an ocular orbit, nose/mouth, limb buds, spinal column, umbilical cord, and prominent vasculature. Two of the pregnant seals were re-examined 3-6 days after the initial examination to obtain longitudinal growth rates. Images of one or both ovaries were obtained in nine and seven of the 19 examinations, respectively. Numerous ovarian follicles (3 to 12 mm diameter) were detected and animals typically had a single well-perfused corpus luteum (determined by Doppler color-flow) ipsilateral to the uterine horn containing the pregnancy. We conclude that real-time transrectal ultrasonography is an effective tool for characterizing reproductive events in phocids including ovarian dynamics, and for elucidating the nature of embryonic diapause. PMID:26340607

  6. 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.

  7. Analysis of Acoustic Access to the Prostate Through the Abdomen and Perineum for Extracorporeal Ablation

    Science.gov (United States)

    Hall, Timothy L.; Hempel, Christopher R.; Sabb, Brian J.; Roberts, William W.

    2010-03-01

    As part of the development of a noninvasive treatment for BPH using histotripsy, this study aimed to measure acoustic access for extracorporeal ablation of the prostate. Both transabdominal and transperineal approaches were considered. The objective was to measure the size and shape of a transducer aperture that could target the prostate without obstruction. CT images obtained from 17 subjects >56 years of age were used to create 3D reconstructions of the lower abdomen and pelvis. Target locations on the urethra at the base, mid, and apex in the prostate were marked along with a transrectal imaging probe. Evenly space rays spanning were traced from each target location towards the perineum and separately towards the abdomen with the maximum x-ray density encountered along each path recorded. The overall free aperture through the perineum was found to be a triangular shaped region bounded by the lower bones of the pelvis and the transrectal probe varying significantly in size between subjects. The free aperture through the abdomen was wedge shaped limited by the pubis also with great subject to subject variability. Average unblocked fractions of an f/1 transducer to target base, veru, and apex through the perineum were 77.0%, 94.4%, and 99.6%, respectively. Averages targeting through the abdomen were 86.1%, 52.3%, and 11.0%. Acoustic access to the prostate for through the perineum was judged to be feasible.

  8. MRI-Guided Prostate Biopsy of Native and Recurrent Prostate Cancer.

    Science.gov (United States)

    Woodrum, David A; Gorny, Krzysztof R; Greenwood, Bernadette; Mynderse, Lance A

    2016-09-01

    Prostate cancer is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive, curative treatment of the whole gland with either radical prostatectomy or radiation therapy. However, many men are reluctant to take the definitive step due to potential morbidity associated with either therapy. A growing interest in active surveillance or focal therapy has emerged as realistic alternatives for many patients. With each of these management strategies, it is critical to accurately quantify and stage the cancer with improved biopsy targeting and more precise imaging with magnetic resonance imaging (MRI). Furthermore, having dependable prostate imaging allows for targeted biopsies to improve the yield of clinically significant prostate cancer and decrease detection of indolent prostate cancer. MRI-guided targeted biopsy techniques include cognitive MRI/transrectal ultrasound fusion biopsy, in-bore transrectal targeted biopsy using a calibrated guidance device, and in-bore direct MR-guided transperineal biopsy with a software-based transperineal grid template. Herein we present a contemporary review of MRI-guided targeted biopsy techniques for new and recurrent cancerous foci of the prostate. PMID:27582607

  9. Targeted prostate biopsy and MR-guided therapy for prostate cancer.

    Science.gov (United States)

    Woodrum, David A; Kawashima, Akira; Gorny, Krzysztof R; Mynderse, Lance A

    2016-05-01

    Prostate cancer is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive treatment of the whole gland including radical prostatectomy, radiation therapy, and cryosurgery. Active surveillance is a growing alternative option for patients with documented low-volume, low-grade prostate cancer. With recent advances in software and hardware of MRI, multiparametric MRI of the prostate has been shown to improve the accuracy in detecting and characterizing clinically significant prostate cancer. Targeted biopsy is increasingly utilized to improve the yield of MR-detected, clinically significant prostate cancer and to decrease in detection of indolent prostate cancer. MR-guided targeted biopsy techniques include cognitive MR fusion TRUS biopsy, in-bore transrectal targeted biopsy using robotic transrectal device, and in-bore direct MR-guided transperineal biopsy with a software-based transperineal grid template. In addition, advances in MR compatible thermal ablation technology allow accurate focal or regional delivery of optimal thermal energy to the biopsy-proved, MRI-detected tumor, utilizing cryoablation, laser ablation, high-intensity focused ultrasound ablation under MR guidance and real-time or near simultaneous monitoring of the ablation zone. Herein we present a contemporary review of MR-guided targeted biopsy techniques of MR-detected lesions as well as MR-guided focal or regional thermal ablative therapies for localized naïve and recurrent cancerous foci of the prostate. PMID:26907717

  10. Effects of acclimation to handling on performance, reproductive, and physiological responses of Brahman-crossbred heifers.

    Science.gov (United States)

    Cooke, R F; Arthington, J D; Austin, B R; Yelich, J V

    2009-10-01

    The objective of this study was to evaluate the effects of acclimation to handling on growth, plasma concentrations of progesterone (P4) and cortisol, temperament, and reproductive performance of Brahman-crossbred heifers. Over 2 consecutive years, 37 Braford and 43 Brahman x Angus heifers were initially evaluated, within 30 d after weaning, for BW and puberty status via transrectal ultrasonography and plasma P4 concentrations (d 0 and 10), and for temperament by measurements of chute score, pen score, and exit velocity (d 10 only). On d 11, heifers were stratified by breed, puberty status, temperament score, BW, and age and randomly assigned to receive or not (control) the acclimation treatment. Acclimated heifers were exposed to a handling process 3 times weekly (Mondays, Wednesdays, and Fridays) for 4 wk (d 11 to 39 of the experiment). The acclimation treatment was applied individually to heifers by processing them through a handling facility, whereas control heifers remained undisturbed on pasture. Heifer puberty status, evaluated via plasma P4 concentrations and transrectal ultrasonography, and BW were assessed again on d 40 and 50, d 80 and 90, and d 120 and 130. Blood samples collected before (d 10) and at the end of the acclimation period (d 40) were also analyzed for plasma concentrations of cortisol. Heifer temperament was assessed again on d 40 of the study. No interactions containing the effects of treatment, breed, and year were detected. Acclimated heifers had reduced (P Brahman-crossbred heifers. PMID:19617508

  11. 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

  12. Adverse events of extracorporeal ultrasound-guided high intensity focused ultrasound therapy.

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    Tinghe Yu

    Full Text Available BACKGROUND: High-intensity focused ultrasound (HIFU is considered to be an alternative to surgery. Extracorporeal ultrasound-guided HIFU (USgFU has been clinically used to treat solid tumors. Preliminary trials in a small sample of a Western population suggested that this modality was safe. Most trials are performed in China thereby providing comprehensive data for understanding the safety profile. The aim of this study was to evaluate adverse events of USgFU therapy. METHODS AND FINDINGS: Clinical data were searched in 2 Chinese databases. Adverse events of USgFU were summarized and compared with those of magnetic resonance-guided HIFU (MRgFU; for uterine, bone or breast tumor and transrectal ultrasound-guided HIFU (for prostate cancer or benign prostate hyperplasia. USgFU treatment was performed using 7 types of device. Side effects were evaluated in 13262 cases. There were fewer adverse events in benign lesions than in malignant lesions (11.81% vs. 21.65%, p<0.0001. Rates of adverse events greatly varied between the disease types (0-280%, p<0.0001 and between the applied HIFU devices in both malignant (10.58-44.38%, p<0.0001 and benign lesions (1.67-17.57%, p<0.0001. Chronological analysis did not demonstrate a decrease in the rate of adverse events. Based upon evaluable adverse events, incidences in USgFU were consistent with those in MRgFU or transrectal HIFU. Some side effects frequently occurred following transrectal HIFU were not reported in USgFU. Several events including intrahepatic metastasis, intraoperative high fever, and occlusions of the superior mesenteric artery should be of particular concern because they have not been previously noted. The types of adverse events suggested that they were ultrasonic lesions. CONCLUSION: The frequency of adverse events depended on the location of the lesion and the type of HIFU device; however, side effects of USgFU were not yet understood. USgFU did not decrease the incidence of adverse events

  13. Search for the progression marker p16ink4a in squamous intraepithelial lesions, in women from Cartagena de indias

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    Álvarez-Coneo Álvaro

    2010-12-01

    Full Text Available Introduction and objective: numerous markers have been used in the diagnosis of squamous intraepithelial lesion; in this group is included p16INK4a, an important protein that inhibits ciclyns 4 and 6 dependant of quinases, reason it is considered a potent suppresor of tumors. Inactivación of this protein has been observed in patients with cancer and its overexpression has been related to improve prognosis and interpretation of the cervical biopsy.Materials and methods: for this study 37 patients, with abnormal cytology,who attended consultation of colposcopy in the Clínica de Maternidad Rafael Calvo (CMRC were selected, between March 2007 - 2008, for colposcopic, histological and immunohistochemical studies. For colposcopy MORREL equipment was used, with zoom lens of 4x to 15x and sample for the biopsy was reported according to Richard (CIN I-CIN II AND CIN III accredited e.g. Bethesda: Squamous Intraepithelial Lesions of Low Degree and High Degree L-SIL and H-SIL . For immunohistochemical analysis, biopsy sample 4 μm sections desparafinized, treated with monoclonal antibody anti p16INK4a 1:20 dilution, were taken (Clone E6H4, Dako Cytomation. Reaction was revealed with a streptavidin peroxidase system. Contrastation was made with hematoxylin, Data were analyzed with SPSS 12.0. X2 was used to determine significant differences between results of colposcopy, biopsy and immunohistochemical test. Results: of the 37 cases, 24 were positive to the marker (45,5 % in L-SIL and 93,3 % in H-SIL. The presence of the marker significantly correlated with the L-SIL diagnosed by Biopsia (Gold-standard (p≤0.05.Conclusions: p16INK4a is a useful marker in early prognosis of L-SIL that could progress to cancer.RESUMENIntroducción y objetivo: numerosos marcadores han sido utilizados en el estudio de la displasia cervical, en este grupo se destaca p16INK4a, una proteína que inhibe las quinasas dependientes de ciclinas 4 y 6 por lo que se considera supresor de

  14. Achados histopatológicos renais em idosos Histopathological findings in elderly patients

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    Priscylla Aparecida Vieira do Carmo

    2010-09-01

    Full Text Available INTRODUÇÃO: A população idosa mundial tem aumentado de forma expressiva e pesquisas apontam para um aumento da expectativa de vida dos brasileiros em cerca de 10 anos. Assim como outras comorbidades, as doenças glomerulares também são observadas em idosos e, neste contexto, a biopsia renal surge como ferramenta diagnóstica fundamental para auxiliar a tomada de conduta, evitando, muitas vezes, terapias desnecessárias. OBJETIVO: Estabelecer a frequência dos diagnósticos histológicos em idosos submetidos a biopsia renal, com destaque para as glomerulopatias (GPs, em dois centros universitários brasileiros. MÉTODOS: Avaliação retrospectiva dos laudos de biopsias renais do Departamento de Patologia da UNIFESP, incluindo pacientes com idade maior ou igual a 60 anos, no período de 01/01/1996 a 31/12/2003 e do ambulatório de GPs do NIEPEN. Os estudos de rins transplantados e de nefrectomias foram excluídos. Os dados considerados para análise foram: idade, sexo, síndrome clínica de apresentação e diagnóstico histológico (por microscopia óptica e imunofluorescência. As nefropatias foram classificadas em GP primárias, doenças renais secundárias, patologias não glomerulares e outras. RESULTADOS: Foram avaliados 113 casos, constatando-se: média de idade de 66,0 ± 6,0 anos e predomínio do sexo masculino (54,8%. A síndrome clínica de apresentação mais comum foi a síndrome nefrótica (32,7%, seguida de insuficiência renal aguda e crônica, com 18,6% cada. As doenças glomerulares foram: nefropatia membranosa (NM, 15%; nefroesclerose hipertensiva, 11,5%; glomerulosclerose segmentar e focal e vasculites/ GN com crescentes, 9,7% cada; amiloidose, glomerulonefrite crônica e doença de lesões mínimas, 7,1% cada; GN proliferativa difusa, 4,4%; nefropatia por IgA e nefrite lúpica, 2,7% cada. Houve um predomínio das GP primárias (45,2% quando comparadas às outras nefropatias. CONCLUSÃO: A principal indicação de biopsia

  15. Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix Efectividad del abordaje "ver y tratar" en lesiones pre-invasivas en el colon uterino Efetividade da abordagem "ver e tratar" em lesões pré-invasivas no colo uterino

    Directory of Open Access Journals (Sweden)

    Aparecida Cristina Sampaio Monteiro

    2009-10-01

    &T con el abordaje tradicional (biopsia previa de las lesiones escamosas intraepiteliales del colon uterino. MÉTODOS: Estudio transversal realizado en la ciudad de Rio de Janeiro, Sureste de Brasil, de 1998 a 2004, con 900 pacientes no gestantes que presentaban citología sugestiva de lesión intraepitelial escamosa de alto grado. El método V&T incluye la excisión amplia de la zona de transformación que es indicada cuanto la citología es sugestiva de lesión intraepitelial escamosa de alto grado, la colposcopia es satisfactoria y compatible con la alteración citológica y la alteración colposcópica debe estar limita a la ectocervix y la primer centímetro del canal cervical. Fue analizado el subgrupo de 336 pacientes con colposcopias consideradas satisfactorias, comprendiendo dos grupos para comparación: pacientes tratadas sin biopsia previa (n=288 versus pacientes tratadas posterior a la biopsia mostrando lesión intraepitelial escamosa de alto grado (n=48. Fueron consideradas pérdidas las pacientes no tratadas o tratadas sólo un año o más posterior al reclutamiento por la clínica de colposcopia, en el grupo V&T. RESULTADOS: De las pacientes reclutadas durante el período de estudio, 71 no fueron tratadas o fueron tratadas sólo un año más tarde, suministrando una tasa global de abandonos de 7,9% (IC 95%: 6,1;9,7. El tiempo promedio entre la captación de la paciente y el tratamiento fue de 17,5 días en el V&T y 102,5 días en el grupo biopsia previa. Las tasas de pérdidas fueron de 1,4% (IC 95%: 0,04;2,7 en el grupo V&T y de 5,9% (IC 95%: 0;12,3 en el de biopsia previa (p=0,07. La proporción de tratamientos innecesarios (histología negativa en el grupo V&T fue 2,0% (IC 95%:0,4;3,6. CONCLUSIONES: La diferencia de tiempo promedio entre la captación de la paciente y el tratamiento indicó que el V&T es un método que ahorra tiempo. La proporción de casos negativos cuando el método V&T fue utilizado puede ser considerada baja.OBJETIVO: Comparar a

  16. The influence of endoscopic procedures upon the contamination of Helicobacter pylori cultures A influência dos procedimentos endoscópicos na contaminação de culturas de Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Marcelo L. Ribeiro

    2004-06-01

    Full Text Available BACKGROUND: Among the various diagnostic methods for the detection of Helicobacter pylori infection, histological examination and microbiological processing of gastric biopsy samples are assumed to be the gold standard techniques. AIMS: Since H. pylori culture can be affected by the presence of non-H. pylori bacteria, we evaluated the efficacy of endoscope disinfection and the influence of endoscopic procedures on culture contamination. PATIENTS AND METHODS: The procedures used during the first two routine endoscopies were evaluated during 28 consecutive days. Endoscopy room, forceps and endoscopic channel were analyzed before and after the beginning of normal procedures. After disinfection, a biopsy simulation was performed to verify the gastric bacteria. RESULTS: Endoscope disinfection removed all organisms from forceps and endoscopic channel with 100% efficacy. The most frequent non-H. pylori bacteria detected were Streptococcus bovis, Enterobacter hormaechei, and Staphylococcus aureus. The sensibility of the H. pylori culture was affected by the presence of non-H. pylori bacteria. CONCLUSION:The risk of transmission of microorganisms was not detectable when sterilized biopsy forceps and stringent disinfection standards were employed. Whilst S. bovis and E. hormaechei may be common in gastric microbial flora, the presence of P. aeruginosa and S. aureus indicated that the manipulation of biopsies could be responsible for culture contamination with these bacteria.RACIONAL E OBJETIVOS: Dentre os vários métodos diagnósticos empregados na detecção da infecção por Helicobacter pylori, o diagnóstico histológico e a análise microbiológica de biopsia gástrica são consideradas as técnicas mais sensíveis. Entretanto, a sensibilidade da cultura de H. pylori pode ser reduzida pela presença de outras bactérias. Desse modo, avaliou-se a eficácia da desinfecção do endoscópio e a influência dos procedimentos endoscópicos na contamina

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. 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

  19. Transanal Evisceration Caused by Rectal Laceration

    Science.gov (United States)

    Torres Sánchez, María Teresa; Richart Aznar, Jose Manuel; Martí Martínez, Eva María; Martínez-Abad, Manuel

    2014-01-01

    Transrectal evisceration caused by colorectal injury is an unusual entity. This pathology is more frequent in elderly patients and it is usually produced spontaneously. Rectal prolapse is the principal predisposing factor. An 81-year-old woman was taken to the hospital presenting exit of intestinal loops through the anus. After first reanimation measures, an urgent surgery was indicated. We observed the absence of almost every small intestine loop in the abdominal cavity; these had been moved to the pelvis. After doing the reduction, a 3 to 4 cm linear craniocaudal perforation in upper rectum was objectified, and Hartmann's procedure was performed. We investigated and knew that she frequently manipulate herself to extract her faeces. The fast preoperative management avoided a fatal conclusion or an extensive intestinal resection. Reasons that make us consider rectal self-injury as the etiologic factor are explained. PMID:24639971

  20. Management of Zinner’s Syndrome Associated with Contralateral Seminal Vesicle Hypoplasia: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehdi Kardoust Parizi

    2013-01-01

    Full Text Available A 27-year-old man presented with chronic hematospermia, painful ejaculation, and primary infertility. Physical examination, transrectal ultrasonography, and pelvic magnetic resonance imaging (MRI demonstrated left seminal vesicle cyst, left renal agenesia, and contralateral seminal vesicle hypoplasia. Hormone workup (LH, FSH, prolactin, and testosterone was normal. Sperm analysis showed oligoasthenozoospermia and low ejaculate volume. We performed transurethral resection of the ejaculatory duct (TUR-ED using methylene blue vasography guidance without surgical-related complications. Hematospermia and painful ejaculation completely improved at 2-month followup, and the patient’s wife experienced a missed abortion thereafter. This patient was considered as a rare variant of Zinner’s syndrome and was managed effectively with a less invasive treatment modality (TUR-ED.

  1. Beyond Histologic Staging: Emerging Imaging Strategies in Colorectal Cancer with Special Focus on Magnetic Resonance Imaging.

    Science.gov (United States)

    Fraum, Tyler J; Owen, Joseph W; Fowler, Kathryn J

    2016-09-01

    Imaging plays an increasingly important role in the staging and management of colorectal cancer. In recent years, magnetic resonance imaging (MRI) has supplanted transrectal ultrasound as the preferred modality for the locoregional staging of rectal cancer. Furthermore, the advent of both diffusion-weighted imaging and hepatobiliary contrast agents has significantly enhanced the ability of MRI to detect colorectal liver metastases. In clinical practice, MRI routinely provides prognostic information, helps to guide surgical strategy, and determines the need for neoadjuvant therapies related to both the primary tumor and metastatic disease. Expanding on these roles for MRI, positron emission tomography (PET)/MRI is the newest clinical hybrid imaging modality and combines the metabolic information of PET with the high soft tissue contrast of MRI. The addition of PET/MRI to the clinical staging armamentarium has the potential to provide comprehensive state-of-the-art colorectal cancer staging in a single examination. PMID:27582645

  2. Optimization of prostate cancer treatment plans using the adjoint transport method and discrete ordinates codes

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, S.; Henderson, D.L. [Dept. of Medical Physics, Madison, WI (United States); Thomadsen, B.R. [Dept. of Medical Physics and Dept. of Human Oncology, Madison (United States)

    2001-07-01

    Interstitial brachytherapy is a type of radiation in which radioactive sources are implanted directly into cancerous tissue. Determination of dose delivered to tissue by photons emitted from implanted seeds is an important step in the treatment plan process. In this paper we will investigate the use of the discrete ordinates method and the adjoint method to calculate absorbed dose in the regions of interest. MIP (mixed-integer programming) is used to determine the optimal seed distribution that conforms the prescribed dose to the tumor and delivers minimal dose to the sensitive structures. The patient treatment procedure consists of three steps: (1) image acquisition with the transrectal ultrasound (TRUS) and assessing the region of interest, (2) adjoint flux computation with discrete ordinate code for inverse dose calculation, and (3) optimization with the MIP branch-and-bound method.

  3. Managing locally advanced prostate cancer: a urologist's and a patient's perspective.

    Science.gov (United States)

    Kirby, Roger; Offen, Nigel

    2006-03-01

    A 60-year-old man presented to his general practitioner with prostatic symptoms and high blood pressure. Based upon a prostate-specific antigen level of 44 ng/ml and further investigations (digital rectal examination, transrectal ultrasound-guided needle biopsy, and magnetic resonance imaging, ultrasound and bone scans), the patient was diagnosed with locally advanced (cT3, N0, M0) prostate cancer. Here, the urologist and the patient describe treatment from their respective viewpoints. Following discussion of the advantages and disadvantages of the various therapeutic options, radiotherapy plus hormonal therapy (bicalutamide 150 mg) was chosen as the approach that best suited the patient's lifestyle. In this review, the patient and the urologist consider the impact of the chosen treatment in terms of efficacy, tolerability and quality of life. PMID:16520652

  4. Diagnostic Ultrasound in Colorectal Cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael

    2014-01-01

    in the liver metastases. In addition, we prospectively compared contrast-enhanced ultrasound with CT scan in the detection of liver metastases.Results By transrectal ultrasound of polyps using the new AWS technique, a sensitivity of 96% and a specificity of 88% was found for cancer, whereas digital exploration...... to neoadjuvant chemoradiation of advanced rectal cancer.IOUS is a safe method with a significantly higher sensitivity in the detection of liver metastases than preoperative ultrasound and surgical palpation. Patients with liver metastases, which harboured power Doppler signal centrally, more often had advanced...... of rectal cancer, especially in early tumours. Screening for colorectal cancer will give rise to the detection of a number of early tumours. Contrast-enhanced liver ultrasound and intraoperative ultrasound has additional space in the detection of liver metastases from colorectal cancer....

  5. MRI Findings of Rectal Submucosal Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hon Soul; Kim, Joo Hee; Lim, Joon Seok; Choi, Jin Young; Chung, Yong Eun; Park, Mi Suk; Kim, Myeong Jin; Kim, Ki Whang; Kim, Sang Kyum [Yonsei University Health System, Seoul (Korea, Republic of)

    2011-08-15

    Rectal submucosal lesions encompass a wide variety of benign and malignant tumors involving the rectum. With optical colonoscopy, any mass-like protrusion covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. Whereas the assessment of submucosal lesions may be limited with performing optical colonoscopy, cross-sectional imaging such as CT, transrectal ultrasonography and MRI allows the evaluation of perirectal tissues and pelvic organs in addition to the entire thickness of the rectum, and so this is advantageous for the assessment of rectal submucosal tumors. Among these, MRI is the best investigative modality for soft tissue characterization. Therefore, knowledge of the MRI features of rectal submucosal tumors can help achieve accurate preoperative diagnoses and facilitate the appropriate management.

  6. Trans-urethral ultrasound (TUUS) imaging for visualization and analysis of the prostate and associated tissues

    Science.gov (United States)

    Holmes, David R., III; Robb, Richard A.

    2000-04-01

    Accurate assessment of pathological conditions in the prostate is difficult. Screening methods include palpation if the prostate gland, blood chemical testing, and diagnostic imaging. Trans-rectal Ultrasound (TRUS) is commonly used for the assessment of pathological conditions, however, TRUS is severely constrained by the relative distal location of the imaging probe. Trans-urethral Ultrasound (TUUS) may overcome some limitations of TRUS. A TUUS catheter was used to image the prostate, rectum, bladder, ureter, neuro-vascular bundles, arteries, and surrounding tissue. In addition, 360 degrees rotational scans were recorded for reconstruction into 3D volumes. Segmentation was challenging, however, new techniques such as active contour methods show potential. 3D visualizations, including both volume and surface rendering, were provided to clinicians off-line. On-line 3D visualization techniques are currently being developed. Potential applications of TUUS include: prostate cancer diagnosis and staging as well as image guided biopsy and therapy.

  7. Endoclipping treatment of life-threatening rectal bleeding after prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos,; Jannis Kountouras,; Georgios Dimitriadis,; Grigoris Chatzimavroudis,; Christos Zavos,; Ioannis Pilpilidis,; George Paroutoglou,; George Germanidis,; Kostas Mimidis

    2009-01-01

    Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound (TRUS)-guided multiple biopsy of the prostate, but is usually mild and stops spontaneously. We report what is believed to be the first case of life-threatening rectal bleeding following this procedure, which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding. This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective method to achieve hemostasis in massive rectal bleeding after prostate biopsy. Additionally, current data on the complications of the TRUS-guided multiple biopsy of the prostate and the options for treating fulminant rectal bleeding, a consequence of this procedure, are described.

  8. An unusual case of prostate tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Abdulsalam AJ

    2015-05-01

    Full Text Available Ahmad Jasem Abdulsalam,1 Mohammad Adel Abdulsalam2 1Faculty of Medicine, Health Science Center, Jabriya, Kuwait; 2Mubarak Al Kabeer Hospital, Jabriya, Kuwait Introduction: Tuberculosis of the prostate is a rare complication of miliary tuberculosis. Case presentation: We report a 32-year-old Iranian male diagnosed with a case of miliary tuberculosis affecting the prostate. The patient was admitted to the hospital with convulsions. Computerized tomography increased the clinical suspicion of miliary tuberculosis extending to the prostate where a trans-rectal urethral biopsy was obtained. The biopsy revealed multiple necrotizing granulomata suggestive of tuberculosis. Conclusion: A strong clinical suspicion and availability of sophisticated tests with confirmation by biopsy, polymerase chain reaction, and culture are needed in order to avoid misdiagnosis of complicated miliary tuberculosis cases. Keywords: miliary, tuberculosis, prostate, disseminated, complication

  9. [Ultrasonographic findings and treatment in a cow with a haemangiosarcoma of the urinary bladder].

    Science.gov (United States)

    Braun, Ueli; Tschuor, A C; Hilbe, M; Lange, C E; Schwarzwald, C

    2009-10-01

    A 4.5-year-old Swiss Braunvieh cow was presented to the Department of Farm Animals, University of Zurich, because of severe haematuria. All other clinical findings were within normal ranges. Transrectal ultrasonography revealed a 1 cm x 1 cm echogenic, irregularly-shaped, raised mass in the wall of the urinary bladder. Endoscopy identified the mass as a proliferation, approximately 0.5 cm in diameter, which was bleeding continuously. Thermocautery of the bleeding site was carried out twice five days apart via endoscopy. Clinical signs resolved for the remainder of the cow's life; she was slaughtered 15 months later because of infertility. Histological examination of the mass revealed a haemangiosarcoma.

  10. Prostate Biopsy Assistance System with Gland Deformation Estimation for Enhanced Precision

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2009-01-01

    Computer-assisted prostate biopsies became a very active research area during the last years. Prostate tracking makes it possi- ble to overcome several drawbacks of the current standard transrectal ultrasound (TRUS) biopsy procedure, namely the insufficient targeting accuracy which may lead to a biopsy distribution of poor quality, the very approximate knowledge about the actual location of the sampled tissues which makes it difficult to implement focal therapy strategies based on biopsy results, and finally the difficulty to precisely reach non-ultrasound (US) targets stemming from different modalities, statistical atlases or previous biopsy series. The prostate tracking systems presented so far are limited to rigid transformation tracking. However, the gland can get considerably deformed during the intervention because of US probe pres- sure and patient movements. We propose to use 3D US combined with image-based elastic registration to estimate these deformations. A fast elastic registration algorithm that...

  11. Urethral pressure reflectometry, a novel technique for simultaneous recording of pressure and cross-sectional area in the prostatic urethra

    DEFF Research Database (Denmark)

    Aagaard, Mikael; Klarskov, Niels; Sønksen, Jens;

    2014-01-01

    parameters. The hysteresis in the sphincter region was significantly lower in the obstructed group (p = 0.005). Discomfort was significantly lower with PQ compared to UPR (p = 0.04). Nine men had slight bleeding from the urethra during measurement with UPR. CONCLUSIONS: The increase in all parameters from...... version of Prostate Symptom Score, flow rate, residual urine measurements, transrectal ultrasound, urethral pressure profilometry and visual analogue scale (Discomfort). UPR parameters measured were opening and closing pressure, opening and closing elastance and hysteresis, from the bladder neck...... the bladder neck to the sphincter region is consistent with previous studies measuring the same parameters. The hysteresis may explain why seven men were obstructed according to PQ....

  12. Giant congenital malformation of the perirectal plexus in computed tomography imaging – case report

    International Nuclear Information System (INIS)

    Congenital arteriovenous malformation (AVM) in the pelvic area is uncommon in males. The described case is of a giant lesion of this type that caused recurrent hemorrhaging in the lower part of the gastrointestinal tract. Preliminary diagnosis of vascular pathology was made on the basis of an endoscopic examination that revealed numerous pulsating protuberances of the rectal wall, in which blood flow was identified by means of transrectal ultrasonography. Complementing the diagnostics with a CT revealed a considerable extent of malformation, as well as its morphology and anatomical relations with the surrounding tissues. Following a two-year follow-up period, the malformation did not progress or demonstrate any intensification of clinical symptoms, therefore the patient continues to undergo conservative treatment

  13. Ultrasonographic appearance of early embryonic mortality in buffalo (Bubalus bubalis

    Directory of Open Access Journals (Sweden)

    Giuseppe Catone

    2010-01-01

    Full Text Available Embryonic mortality is one of the main causes responsible of the decline in fertility that occurs in buffaloes during periods of increasing daylight length (out sexual breeding season. Transrectal ultrasonography for pregnancy diagnosis offers some advantages over palpation per rectum: earlier diagnosis of pregnancy/non-pregnancy, determination of embryo/fetus viability, reduction of misdiagnosis, and reduction of .potential. iatrogenic embryo/fetal attrition. Non pregnant buffaloes on Day 25 after AI showed higher Resistive Index (RI (P<0.05 and Pulsatility Index (P=0.07 values, registered on CL on Days 10 after AI, compared to pregnant buffaloes. RI values were significantly higher (P=0.02 in non pregnant buffaloes also on Day 45 after AI. Colour Doppler sonography could be used to gain specific information relating to the ovarian blood flow in predicting early embryonic loss and to describe the ultrasonographic features of early embryonic death in buffaloes.

  14. Unusual presentation of seminal vesiculitis in an infertile man.

    Science.gov (United States)

    Andrade-Rocha, Fernando Tadeu

    2007-12-01

    Seminal vesiculitis is generally not investigated in infertile men, since it is uncommon and often nonspecific in signs and symptoms. In this article, the author reports an unusual presentation of seminal vesiculitis, incidentally diagnosed in a man referred for semen analysis to investigate infertility. Analyses of physical properties of the ejaculate (coagulation, liquefaction, volume, viscosity and pH) and of biochemical markers of the prostate (total calcium and zinc) and seminal vesicle (fructose and inorganic phosphorus) detected a dysfunction of the seminal vesicles that was subsequently diagnosed as vesiculitis using transrectal ultrasound. After treatment with a single 500-mg dose of oral ciprofloxacin, the patient was referred again for semen analysis. The analysis showed considerable improvement of the seminal vesicle function. The clinical significance of these findings is discussed. PMID:18163927

  15. Prostate Cancer: Multi-Parametric Magnetic Resonance Imaging of the Prostate re- classifies patients eligible for Active Surveillance

    DEFF Research Database (Denmark)

    Elkjær, Maria; Pedersen, Bodil Ginnerup; Høyer, Søren;

    2015-01-01

    Introduction and Objectives: Pathological examination of the extracted prostate after radical prostatectomy often reveals that trans-rectal ultrasound (TRUS) and TRUS-guided biopsy (TRUS-bx) underestimated the tumor’s true size and aggressiveness. This clinical problem seems to defy a satisfactory...... to the Prostate Imaging Reporting and Data System (PI-RADS) classification. MRI-guided in-bore biopsies (MRGB) were performed on lesions with a score of 4 or 5. Results: Up until now, 12 patients have been scanned. One patient was excluded due to severe claustrophobia. Of the 11 patients with sufficient quality...... up-grade (Gleason score 7 (3+4) and 7 (4+3), respectively). In the other two cases, MRGB pathology revealed foci of Gleason score 6 (3+3) with 13.7 mm and 7.6 mm cancer core length, respectively. Conclusion: Additional mpMRI in AS patients seems to re-classify a substantial number of patients...

  16. [Transvesical Removal of Seminal Vesicle Cystadenoma].

    Science.gov (United States)

    Takayasu, Kenta; Harada, Jiro; Kawa, Gen; Ota, Syuichi; Sakurai, Takanori

    2015-07-01

    Primary tumors of the seminal vesicles are extremely rare. There have been 25 reports of this tumor from overseas and most cases are cystadenoma. We report a case of seminal vesicle cystadenoma in a 70-year-old man who presented with lower abdominal pain and urinary frequency. A digital rectal examination detected a projecting and hard mass in the right side of the prostate. Magnetic resonance imaging (MRI) showed a 15 cm multiple cystic mass continuous with the right seminal vesicle. A transrectal needle biopsy revealed benign tissue. The tumor was resected using an open transvesical approach that enabled full exposure of the seminal vesicle without damaging the nerves and blood supply of the bladder. Pathology was consistent with a benign seminal vesicle cystadenoma. We describe the natural history, pathology,and surgical approach in this case.

  17. Primary yolk sac tumor of seminal vesicle: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Yao Xu-Dong

    2012-09-01

    Full Text Available Abstract Background Yolk sac tumor (endodermal sinus tumor is a rare malignant germ cell tumor arising in the testis or ovary. Extragonadal yolk sac tumor is even rarer and has only been described in case reports. Due to the rarity of the tumors, the appropriately optimal treatment remains unclear. We report a case of yolk sac tumor in the seminal vesicle. Case A 38-year-old Asian male presented with gross hematuria and hemospermia. Transrectal ultrasound scan showed a solid mass in the left seminal vesicle and the scrotal sonography showed no abnormalities. Bilateral seminal vesicles were resected, and histopathological examination showed a typical pattern of yolk sac tumor (YST. The patient responded poorly to comprehensive treatment of radiotherapy, chemotherapy and surgeries, developed systemic multiple metastases, and died of cachexia one and half years after diagnosis.

  18. 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 BCS (p cattle with an excitable temperament.

  19. TRUS Findings of Prostate Tumor or Tumor Like Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Jong; Jang, Jung Min; Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2006-03-15

    Tumors or tumor-like lesions in the prostate raise questions concerning their histogenesis and they may have prognoses dissimilar to those of prostatic adenocarcinoma. Several neoplasms involving the prostate have been described and characterized in recent years. In addition to adenocarcinoma, they include mucinous cyst adenocarcinoma, neuroendocrine cancer, lymphoma, spindle cell neoplasm, squamous cell carcinoma, transitional cell carcinoma, and benign prostatic hyperplasia (BPH) mimicking malignancy. In addition, infectious conditions such as tuberculosis and some stages of prostatic abscess can also mimic prostate tumors. Radiologic findings overlap and have limited roles in the diagnoses of these entities. However, knowledge of these variable tumors and tumor-like conditions is helpful when making accurate radiologic diagnoses, which have important clinical implications for treatment and prognosis. Transrectal ultrasound (TRUS) and available pathologic images of unusual tumors and tumor- like lesions are demonstrated in this article

  20. Lymphoma Presenting as Cancer of the Glans Penis: A Case Report

    Directory of Open Access Journals (Sweden)

    Konstantinos Stamatiou

    2012-01-01

    Full Text Available Penile lymphoma is a very rare neoplasm. We report the case of an 82-year-old man who presented with phimosis. The patient also complained of frequent and painful urination. Upon examination a painless penile ulcer and multiple enlarged inguinal lymph nodes were found. The shaft of the penis and the prostate were hard on palpation. Abdominal and transrectal ultrasound examination confirmed the involvement of the penis shaft and the prostate and also revealed involvement of the urinary bladder. Biopsy showed diffuse, large B-cell lymphoma. The patient was treated with systemic chemotherapy with full remission of the disease. We review the literature relevant to penile lymphoma and discuss this uncommon condition.

  1. Laser Illumination Modality of Photoacoustic Imaging Technique for Prostate Cancer

    Science.gov (United States)

    Peng, Dong-qing; Peng, Yuan-yuan; Guo, Jian; Li, Hui

    2016-02-01

    Photoacoustic imaging (PAI) has recently emerged as a promising imaging technique for prostate cancer. But there was still a lot of challenge in the PAI for prostate cancer detection, such as laser illumination modality. Knowledge of absorbed light distribution in prostate tissue was essential since the distribution characteristic of absorbed light energy would influence the imaging depth and range of PAI. In order to make a comparison of different laser illumination modality of photoacoustic imaging technique for prostate cancer, optical model of human prostate was established and combined with Monte Carlo simulation method to calculate the light absorption distribution in the prostate tissue. Characteristic of light absorption distribution of transurethral and trans-rectal illumination case, and of tumor at different location was compared with each other.The relevant conclusions would be significant for optimizing the light illumination in a PAI system for prostate cancer detection.

  2. Prostate cancer: 1.5 T endo-coil dynamic contrast-enhanced MRI and MR spectroscopy-correlation with prostate biopsy and prostatectomy histopathological data

    DEFF Research Database (Denmark)

    Chabanova, E.; Balslev, I.; Løgager, Vibeke Berg;

    2010-01-01

    prostatectomy, underwent prostate MR examination. Prostate cancer was identified by transrectal ultrasonographically (TRUS) guided sextant biopsy. MR examination was performed at 1.5T with an endorectal MR coil. Cancer localisation was performed on sextant-basis - for comparison between TRUS biopsy, MR...... techniques and histopathological findings on prostatectomy specimens. RESULTS: Prostate cancer was identified in all 43 patients by combination of the three MR techniques. The detection of prostate cancer on sextant-basis showed sensitivity and specificity: 50% and 91% for TRUS, 72% and 55% for T2WI, 49% and...... 69% for DCEMRI, and 46% and 78% for CSI. CONCLUSION: T2WI, DCEMRI and CSI in combination can identify prostate cancer. Further development of MR technologies for these MR methods is necessary to improve the detection of the prostate cancer...

  3. MR-guided prostate interventions.

    Science.gov (United States)

    Tempany, Clare; Straus, Sarah; Hata, Nobuhiko; Haker, Steven

    2008-02-01

    In this article the current issues of diagnosis and detection of prostate cancer are reviewed. The limitations for current techniques are highlighted and some possible solutions with MR imaging and MR-guided biopsy approaches are reviewed. There are several different biopsy approaches under investigation. These include transperineal open magnet approaches to closed-bore 1.5T transrectal biopsies. The imaging, image processing, and tracking methods are also discussed. In the arena of therapy, MR guidance has been used in conjunction with radiation methods, either brachytherapy or external delivery. The principles of the radiation treatment, the toxicities, and use of images are outlined. The future role of imaging and image-guided interventions lie with providing a noninvasive surrogate for cancer surveillance or monitoring treatment response. The shift to minimally invasive focal therapies has already begun and will be very exciting when MR-guided focused ultrasound surgery reaches its full potential. PMID:18219689

  4. Prostate biopsy tracking with deformation estimation

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2011-01-01

    Transrectal biopsies under 2D ultrasound (US) control are the current clinical standard for prostate cancer diagnosis. The isoechogenic nature of prostate carcinoma makes it necessary to sample the gland systematically, resulting in a low sensitivity. Also, it is difficult for the clinician to follow the sampling protocol accurately under 2D US control and the exact anatomical location of the biopsy cores is unknown after the intervention. Tracking systems for prostate biopsies make it possible to generate biopsy distribution maps for intra- and post-interventional quality control and 3D visualisation of histological results for diagnosis and treatment planning. They can also guide the clinician toward non-ultrasound targets. In this paper, a volume-swept 3D US based tracking system for fast and accurate estimation of prostate tissue motion is proposed. The entirely image-based system solves the patient motion problem with an a priori model of rectal probe kinematics. Prostate deformations are estimated with ...

  5. Ultrasound and hydroultrasound diagnosis of colonic and rectal tumours diseases

    International Nuclear Information System (INIS)

    A method of ultrasound (US) hydrocolonoscopy with the use of multicomponent contrast medium has been applied to examine 76 patients with tumors of the straight intestine and segmented one. Cancer has been diagnosed in 56 patients, benign tumors in 19 patients, lymphosarcoma of the blind gut has been revealed in one case. It is stated that a complex US examination of the straight and segmented intestines has a number of additional diagnostic potential in a visualization of the wall thickness, structure, tumor size and in a determination of the lesion length as compared with other radiation methods of observation. The use of survey US examination of the abdomen, US imaging with liquid echocontrast diagnostic medium and transrectal observation enable to solve in most cases severe problems in diagnosis and differential diagnosis of cancer of the straight intestine and segmented one

  6. Reproductive endocrine profiles and follicular growth after estrus induction in the riverine water buffalo (Bubalus bubalis, 2n=50 and riverine-swamp hybrid buffalo (2n = 49

    Directory of Open Access Journals (Sweden)

    R.H. BonDurant

    2010-02-01

    Full Text Available Ten adult female water buffalo were used in the present study (5 x [2n = 50] and 5 x [2n= 49] hybrids. Ovarian activity was monitored daily by transrectal ultrasonography between two consecutive ovulations. Observed follicular wave numbers were: 1 (n=1, 2 (n=4, and 3 (n=5. The interovulatory interval ranged 17 to 23 days. Differences in mean follicular diameter between follicles of the normal karyotype (2n=50 and buffalo hybrids (2n=49 were found on the second subordinate group of follicles (P0.05, whereas inhibin profiles were significantly higher in the hybrid group (P<0.05. Understanding the biological meaning of the difference in inhibin concentrations in B. bubalis female reproductive performance will require further investigation.

  7. Development of a Novel Robot for Transperineal Needle Based Interventions: Focal Therapy, Brachytherapy and Prostate Biopsies

    CERN Document Server

    Long, Jean-Alexandre; Baumann, Michael; Descotes, Jean-Luc; Bolla, Michel; Giraud, Jean-Yves; Rambeaud, Jean-Jacques; Troccaz, Jocelyne; 10.1016/j.juro.2012.06.003

    2012-01-01

    Purpose: We report what is to our knowledge the initial experience with a new 3-dimensional ultrasound robotic system for prostate brachytherapy assistance, focal therapy and prostate biopsies. Its ability to track prostate motion intraoperatively allows it to manage motions and guide needles to predefined targets. Materials and Methods: A robotic system was created for transrectal ultrasound guided needle implantation combined with intraoperative prostate tracking. Experiments were done on 90 targets embedded in a total of 9 mobile, deformable, synthetic prostate phantoms. Experiments involved trying to insert glass beads as close as possible to targets in multimodal anthropomorphic imaging phantoms. Results were measured by segmenting the inserted beads in computerized tomography volumes of the phantoms. Results: The robot reached the chosen targets in phantoms with a median accuracy of 2.73 mm and a median prostate motion of 5.46 mm. Accuracy was better at the apex than at the base (2.28 vs 3.83 mm, p <...

  8. A study of radionuclide noninvasive method for the evaluation of portal circulation

    International Nuclear Information System (INIS)

    A new method for evaluating portal systemic circulation was presented. Following transrectal administration of 99mTc-MIBI it was feasible to detect the presence of portasystemic shunting in both animal and patient studies. The heart-liver ratio (H/L ratio) and the portosystemic shunt index (SI) in normal controls were 0.21 +- 0.08 and 0.17 +- 0.06. Whereas in patients of liver cirrhosis with portal hypertension were 1.12 +- 0.18 and 0.54 +- 0.07 respectively. And showed a significant difference (p<0.01) between normal and cirrhosis group. A good correlation between the H/L, SI and the portal pressure measurement during operation (r = 0.93) was also found. Thereby it seems that portasystemic shunting can be quantified with this radionuclide noninvasive method

  9. 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)

    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.)

  10. Short communication: Development of the first follicular wave dominant follicle on the ovary ipsilateral to the corpus luteum is associated with decreased conception rate in dairy cattle.

    Science.gov (United States)

    Miura, R; Haneda, S; Kayano, M; Matsui, M

    2015-01-01

    In this study, we examined the effect of the locations of the first-wave dominant follicle (DF) and corpus luteum (CL) on fertility. In total, 350 artificial insemination (AI) procedures were conducted (lactating dairy cows: n=238, dairy heifers: n=112). Ovulation was confirmed 24 h after AI. The locations of the first-wave DF and CL were examined 5 to 9d after AI using rectal palpation or transrectal ultrasonography. Lactating dairy cows and dairy heifers were divided into 2 groups: (1) the ipsilateral group (IG), in which the DF was ipsilateral to the CL; and (2) the contralateral group (CG), in which the DF was contralateral to the CL. Pregnancy was diagnosed using transrectal ultrasonography 40d after AI. Conception rates were 54.0% in all cattle: 48.9% in lactating dairy cows, and 58.9% in dairy heifers. The incidence of the first-wave DF location did not differ between IG and CG (all cattle: 184 vs. 166; lactating cows: 129 vs. 109; heifers: 55 vs. 57 for IG vs. CG). Conception rates were lower in IG than in CG (all cattle: 40.2 vs. 69.3%; lactating dairy cows: 38.0 vs. 67.0%; dairy heifers: 45.5 vs. 73.7%, for IG vs. CG). Conception rate was not affected by season or live weight in heifers and lactating cows. In addition, days in milk at AI, milk production, body condition score, and parity did not affect conception in lactating cows. In summary, development of the first-wave DF in the ovary ipsilateral to the CL was associated with reduced conception rates in both lactating cows and heifers. PMID:25465564

  11. Effects of prostaglandin administration 10 days apart on reproductive parameters of cyclic dairy nulliparous goats

    Directory of Open Access Journals (Sweden)

    J.F. Fonseca

    2012-04-01

    Full Text Available This study reported the effects of prostaglandin (PGF2a administration 10 days apart on reproductive parameters of cyclic artificial inseminated (AI nulliparous Alpine (n=9 and Saanen (n=9 goats. Animals received two doses of 22.5mg PGF2a 10 days apart. After 1st and 2nd PGF2a administrations, estrus was monitored at 12 h intervals, with a buck teaser. Plasma progesterone concentration (ng/mL was determined from blood sampled on day 0 (1st PGF2a and the following 5, 10 (2nd PGF2a, 15, 20, 25 and 30 days. After the onset of the second estrus, females were transrectally (5 MHz probe scanned at 4 hour intervals until at least 8h after ovulation. Pregnancy was checked through transrectal ultrasound on days 20, 25, 30, 35 and 90 after insemination. All parameters studied did not differ between breeds (P>0.05. Estrous response and interval to estrus, respectively, after 1st (78.9% and 50.6±17.2h and 2nd PGF2a (88.9% and 50.0±14.8h administration did not differ (P>0.05. Overall animals ovulating (100.0%, interval to ovulation after 2nd PGF2a (64.5±19.5h and after estrous onset (18.0±9.1h, ovulation rate (1.3±0.5, diameter of ovulatory follicle (8.1±1.1mm were recorded. Embryo loss occurred before day 30 of pregnancy. Estrus can be efficiently synchronized in nulliparous Alpine and Saanen goats with two doses of prostaglandin 10 days apart.

  12. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  13. Biopsy follow-up in patients with isolated atypical small acinar proliferation (ASAP in prostate biopsy

    Directory of Open Access Journals (Sweden)

    Luca Leone

    2014-12-01

    Full Text Available The incidence of prostate cancer (PCA was evaluated in 155 patients with isolated Atypical Small Acinar Proliferation (ASAP found on initial prostate biopsy, after a medium-term follow-up (40 months with at least one re-biopsy. Clinical and histological data were analysed. Cancer was detected in 81 of 155 (52.3%. The cancer detection rate was 71.6%, 91.3%, 97.5%, 100% at the 1st re-biopsy, 2nd, 3rd, and 4th rebiopsy respectively. At the uni- and multivariate analyses, prostate volume (≤ 30 cc, transition zone volume (≤ 10 cc, small core length at the initial biopsy (≤ 10 mm and few number of cores at initial biopsy (≤ 8 are predictive of cancer. Furthermore, tumour characteristics on the whole surgical specimens was assessed in 30 men: 13 of 30 (43 % had clinically relevant cancer (volume > 0.5 ml or/and Gleason score ≥ 7, or pT3. Most of relevant cancers were detected in the distal apex, anterior gland and midline. These anatomical sites could be under-sampled at the initial biopsy using the transrectal approach. Our data suggest that follow-up biopsy is recommended in all cases of isolated ASAP detected after biopsy using endfire transrectal probe. The re-biopsy strategy should increase the number of cores (or a saturation biopsy, focusing on area of ASAP in the initial biopsy, but also including the under-sampled areas (anterior gland, distal apex and midline to detect clinically relevant cancers.

  14. 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 <2 ng/ml, respectively) had the highest PPL (76.3%; p < 0.0001). Furthermore, PPL was higher in cows with advanced parity and with high milk 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. PMID:27198072

  15. Assessment of prostatic fiducial marker introduction: patient morbidity, staff satisfaction and improved treatment field placement

    International Nuclear Information System (INIS)

    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.

  16. In vivo cryoablation of prostate tissue with temperature monitoring by optoacoustic imaging

    Science.gov (United States)

    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.

  17. Sperm parameter abnormalities, low seminal fructose and reactive oxygen species overproduction do not discriminate patients with unilateral or bilateral post-infectious inflammatory prostato-vesiculo-epididymitis.

    Science.gov (United States)

    Vicari, E; La Vignera, S; Castiglione, R; Calogero, A E

    2006-01-01

    We have shown that patients with prostato-vesiculo-epididymitis (PVE) have the worst sperm output compared to patients with prostato-vesiculitis or prostatitis alone. The present study was undertaken to closely examine whether unilateral or bilateral PVE had a different impact on sperm parameters, seminal fructose levels and reactive oxygen species (ROS) overproduction. To accomplish this, 78 patients with persistent post-infectious inflammatory PVE, clearly identified by scrotal and transrectal ultrasonography, and 30 patients with asymptomatic post-infectious inflammatory prostatitis (control group) underwent semen analysis (including seminal leukocyte concentration and number of spermiophagies), seminal fructose measurement and sperm ROS production from 45 and 90% Percoll fractions. Fifty patients turned out to have PVE bilaterally, whereas the remaining 28 had unilateral PVE. Patients with bilateral PVE had sperm concentration and total sperm number significantly lower than those found in patients with unilateral PVE. The other sperm parameters, the physicochemical properties (hyperviscosity, the presence of nonspecific agglutination, delayed liquefaction), seminal fructose levels and ROS production in both 45 and 90% Percoll fractions turned out similar between the two groups. Patients with bilateral or unilateral PVE had sperm parameters, seminal fructose levels and ROS production significantly worst than those found in patients with prostatitis alone. In conclusion, although patients with bilateral PVE had a decreased number of spermatozoa, the other sperm parameters and seminal fructose levels did not reflect the extension of PVE. Therefore, the diagnosis of unilateral or bilateral involvement of this complicated form of male accessory gland infection relies on scrotal and transrectal ultrasonography. PMID:16553029

  18. Successful artificial insemination in the Asian elephant (Elephas maximus using chilled and frozen-thawed semen

    Directory of Open Access Journals (Sweden)

    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.

  19. The feasibility of MRI-guided whole prostate ablation with a linear aperiodic intracavitary ultrasound phased array

    Energy Technology Data Exchange (ETDEWEB)

    Sokka, S.D. [MIT Harvard Division of Health Sciences and Technology, Boston, MA 02115 (United States); Brigham and Women' s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 (United States); Hynynen, K.H. [Brigham and Women' s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 (United States)

    2000-11-01

    Over the past decade, numerous minimally invasive thermal procedures have been investigated to treat benign prostate hyperplasia and prostate cancer. Of these methods, ultrasound has shown considerable promise due to its ability to produce more precise and deeper thermal foci. In this study, a linear, transrectal ultrasound phased array capable of ablating large tissue volumes was fabricated and evaluated. The device was designed to be compatible for use with MRI guidance and thermometry. The intracavitary applicator increases treatable tissue volume by using an ultrasonic motor to provide a mechanical rotation angle of up to 100 deg. to a 62-element 1D ultrasound array. An aperiodic array geometry was used to reduce grating lobes. In addition, a specially designed Kapton interconnect was used to reduce cable crosstalk and hence also improve the acoustic efficiency of the array. MRI-guided in vivo and ex vivo experiments were performed to verify the array's large-volume ablative capabilities. Ex vivo bovine experiments were performed to assess the focusing range of the applicator. The array generated foci in a 3 cm (2 to 5 cm from the array surface along the axis normal to the array) by 5.5 cm (along the long axis of the array) by 6 cm (along the transverse axis of the array at a depth of 4 cm) volume. In vivo rabbit thigh experiments were performed to evaluate the lesion-producing capabilities in perfused tissue. The array generated 3 cm x 2 cm x 2 cm lesions with 8 to 12 half-minute sonications equally spaced in the volume. The results indicate that transrectal ultrasound coagulation of the whole prostate is feasible with the developed device. (author)

  20. Effect of using different U/S probe Standoff materials in image geometry for interventional procedures: the example of prostate

    Science.gov (United States)

    Diamantopoulos, Stefanos; Butt, Saeed; Katsilieri, Zaira; Kefala, Vasiliki; Zogal, Pawel; Sakas, George; Baltas, Dimos

    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 MHz and 7 MHz. The U/S probe was covered by EA 4015 Silicone Standoff kit, or UA0059 Endocavity balloon filled either with water or one of the following: 40 ml of Endosgel®, Instillagel®, Ultraschall gel or Space OAR™ gel. The differences between images were recorded. Consequently, the dosimetric impact of the observed image distortion was investigated, using a tissue equivalent 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 needle shift was observed. The expansion of objects appeared in radial direction. The shift deforms also the PTV (prostate in our case) and other organs at risk (OARs) in the same way leading to overestimation of volume and underestimation of the dose. On the other hand, Instillagel® and Space OAR™ “shrinks” objects in an ultrasound image for 0.65 mm and 0.40 mm, respectively. Conclusions The use of EA 4015 Silicone Standoff kit for image acquisition, leads to erroneous contouring of PTV and OARs and reconstruction and placement of catheters, which results to incorrect dose calculation during prostate brachytherapy. Moreover, the reliability of QA procedures lies mostly in the right temperature of the water used for accurate simulation of real conditions of transrectal ultrasound imaging. PMID:23346130

  1. Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

    Science.gov (United States)

    Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

    2016-04-01

    High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

  2. A feasibility study of magnetic resonance electrical impedance tomography for prostate cancer detection

    International Nuclear Information System (INIS)

    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 Bz 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 Bz 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 Bz 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 feasibility

  3. The effect of puerperal uterine disease on histopathologic findings and mRNA expression of proinflammatory cytokines of the endometrium in dairy cows.

    Science.gov (United States)

    Heppelmann, M; Weinert, M; Ulbrich, S E; Brömmling, A; Piechotta, M; Merbach, S; Schoon, H-A; Hoedemaker, M; Bollwein, H

    2016-04-15

    The aim of this study was to investigate the effect of puerperal uterine disease on histopathologic findings and gene expression of proinflammatory cytokines in the endometrium of postpuerperal dairy cows; 49 lactating Holstein-Friesian cows were divided into two groups, one without (UD-; n = 29) and one with uterine disease (UD+; n = 21), defined as retained fetal membranes and/or clinical metritis. General clinical examination, vaginoscopy, transrectal palpation, and transrectal B-mode sonography were conducted on days 8, 11, 18, and 25 and then every 10 days until Day 65 (Day 0 = day of calving). The first endometrial sampling (ES1; swab and biopsy) was done during estrus around Day 42 and the second endometrial sampling (ES2) during the estrus after synchronization (cloprostenol between days 55 and 60 and GnRH 2 days later). The prevalence of histopathologic evidence of endometritis, according to the categories used here, and positive bacteriologic cultures was not affected by group (P > 0.05), but cows with uterine disease had a higher prevalence of chronic purulent endometritis (ES1; P = 0.07) and angiosclerosis (ES2; P ≤ 0.05) than healthy cows. Endometrial gene expression of IL1α (ES2), IL1β (ES2), and TNFα (ES1 and ES2) was higher (P ≤ 0.05) in the UD+ group than in the UD- group. In conclusion, puerperal uterine disease had an effect on histopathologic parameters and on gene expression of proinflammatory cytokines in the endometrium of postpuerperal cows, indicating impaired clearance of uterine inflammation in cows with puerperal uterine disease. PMID:26810831

  4. 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.

  5. Caracterización de las fibras del músculo gluteus medius en equinos por métodos histoquímicos e inmunohistoquímicos Characterization of fibers from gluteus medius muscle in horses by histochemical and immunohistochemical methods

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    A. ISLAS

    2001-01-01

    Full Text Available Se tomó una biopsia a cuatro centímetros de profundidad en el músculo Gluteus medius de 16 equinos. Los animales tenían una edad promedio de 6 años y durante 3 meses previo a la toma de la biopsia no habían realizado entrenamiento. Las muestras fueron analizadas por medio de la técnica mATPasa miofibrilar, NADH-TR e inmuno-histoquímica. Los porcentajes de fibras tipo I, IIA, IIB oxidativas y no oxidativas fueron de un 14, 39, 30 y 17%, respectivamente, para la técnica histoquímica y un 16, 35, 29 y 20% para las fibras tipo I , IIA, IIX y IIA+IIX para la técnica inmuno-histoquímica. El análisis estadístico demostró que no existen diferencias signifi-cativas entre ambas técnicas para la determinación de las fibras. Los resultados obtenidos permiten concluir que la inmunohistoquímica es una técnica que permite realizar una clasificación adecuada de la población fibrilar del músculo Gluteus medius en equinos adultos.Biopsies were taken at a depth of 4cm from the Gluteus medius muscle of 16 horses. The animals were 6 years old and had not been trained during 3 months before the study. The samples were analized by mATPase miofibrillar technique to determine the fibrillar composition by NADH-TR technique to determine the oxidative capacity of the fibres and immunohistochemistry to determine the fibre type. The histochemical study revealed an average fibrillar composition of 14, 39, 30 and 17 % for fibres typed I, IIA, IIX oxidative and IIX no oxidative and the inmunohistochemistry study showed 16, 35, 29 y 20% for fibres type I, IIA, IIX and IIA-IIX. The statistical analyses showed a good relationship between the histochemical and inmunohistochemical method in the determination of fiber types. The immunohistochemical method allows a good identification of the fiber in adult horses.

  6. 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

  7. Diagnóstico del liquen plano oral Diagnosis of the oral lichen planus

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    A. Blanco Carrión

    2008-02-01

    Full Text Available El objetivo de este trabajo es presentar los aspectos clínicos y patológicos necesarios para conocer mejor el liquen plano oral y poder diagnosticarlo correctamente. El diagnóstico se obtiene en primer lugar por el aspecto clínico de las lesiones. Se debe realizar siempre biopsia y estudio anatomopatológico para confirmar la sospecha clínica y realizar diagnóstico diferencial con otras entidades de apariencia clínica similar. Los pasos que debemos seguir para realizar un diagnóstico de certeza son: estudio de la clínica (anamnesis y exploración clínica, biopsia para estudio histopatológico y analítica sanguínea y determinación de la tensión arterial, buscando una posible relación con determinados procesos sistémicos. Se hará una inmunofluorescencia directa cuando haya que diferenciarlo de dermatopatías similares (lupus, penfigoide o pénfigo. En ocasiones podremos realizar un análisis estructural y otras pruebas diagnósticas.The aim of this work is to present the clinical and pathological necessary aspects to know better the oral lichen planus and to be able to diagnose it correctly. The diagnosis is obtained first by the clinical aspect of the injuries. It is necessary to realize always biopsy and histopathologyc evaluation to confirm the clinical suspicion and realize differential diagnosis with other entities of clinical similar appearance. The steps that we must follow to realize a diagnosis of certainty are: study of the clinic (anamnesis and clinical exploration, biopsy for histopathological study and analytical blood and determination of the blood pressure, looking for a possible relation with certain systemic processes. It will become a direct inmunofluorescence when it is necessary to differentiate it of similar disease (lupus, pemphigoid or pemphigus. In occasions we will be able to realize a ultraestructural analysis and other diagnostic tests.

  8. Cervical squamous and glandular intraepithelial neoplasia: identification and current management approaches Neoplasia intraepitelial cervical escamosa y glandular: identificación y estrategias de manejo

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    V Cecil Wright

    2003-01-01

    Full Text Available Certain types of human papillomaviruses (HPV are associated with squamous intraepithelial lesions and cancer and these are termed high-risk. HPV type 16 is detected in approximately half of the high-grade squamous intraepithelial lesions and cancer. Because of the high rate of spontaneous regression of low-grade squamous lesions, follow-up by cytology, colposcopy and possible biopsy appears preferable. Due to the higher rate of progression to malignancy of the high-grade lesions conservative treatment is recommended. One of the most common reasons for persistence relates to the human immunodeficiency virus. Adenocarcinoma in situ is an uncommon disorder and not well identified by cytologic sampling or colposcopic inspection. The diagnosis is made by cone biopsy, the specimen having negative margins for disease. Hysterectomy is the treatment procedure of choice unless fertility is an issue. Excisional methods (particularly electrosurgical loop can interfere with accurate histological interpretation in some cases of both squamous disease and adenocarcinoma in situ.Ciertos tipos de virus del papiloma humano (VPH, denominados de alto riesgo, están asociados con lesiones escamosas intraepiteliales y cáncer invasor. El VPH tipo 16 es detectado en aproximadamente la mitad de las lesiones escamosas intraepiteliales de alto grado y cáncer. Sin embargo, existe una elevada proporción de regresión espontánea en lesiones escamosas de bajo grado, por lo que para su monitoreo es preferible la utilización de citología, colposcopía y biopsia. Asimismo, debido a la elevada tasa de progresión a malignidad de lesiones de alto grado se recomienda un tratamiento conservador. Una de las razones comunes relacionadas con la persistencia de infección por el VPH es el virus de inmunodeficiencia humana. Por otra parte, el adenocarcinoma in situ es un trastorno raro, no bien identificado en muestras citológicas o de inspección colposcópica; el diagnóstico se

  9. Módulo pleuroscopía Toracoscopía Thoracoscopy

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    MAITE OYONARTE W

    2008-03-01

    Full Text Available la toracoscopía fue descrita el año 1910. Desde entonces se ha utilizado para el estudio y tratamiento de la patología pleural. las indicaciones hoy en día se centran en el estudio diagnóstico de exudados pleurales de etiología desconocida y para realizar pleurodesis mediante la insuflación de talco. la toracoscopía permite visualizar la cavidad pleural y tomar biopsias dirigidas sobre las lesiones sospechosas. Puede efectuarse en sala de endoscopía o en pabellón. El procedimiento se efectúa con el paciente ventilando en forma espontánea, con anestesia local, analgesia y sedación endovenosa. En el derrame pleural maligno, el rendimiento diagnóstico es sobre el 95%, y la efectividad de la pleurodesis es mayor al 90%. la toracoscopía es un procedimiento simple y bien tolerado. Es una técnica muy superior a la biopsia pleural percutánea por su capacidad de realizar diagnóstico y tratamiento en el mismo acto quirúrgico. En pacientes con un mal pronóstico permite evitar procedimientos más complejos como la videotoracoscopíaThoracoscopy was first described in 1910. Since then it has been used for the study and treatment of pleural diseases. Its main indications today are the study of exudative pleural effusions of unknown etiology and the pleurodesis procedure via talc poudrage. Thoracoscopy allows exploring the pleural cavity and taking biopsies of pleural lesions. It can be performed in the endoscopy room or in the operating room. It is usually done under local anesthesia with spontaneous breathing and intravenous mild sedation. The diagnostic yield in malignant pleural effusions is over 95%, and its efficacy in getting pleurodesis is over 90%. Thoracoscopy is a simple and well tolerated procedure. In neoplastic disease it is a much better technique than the percutaneous pleural biopsy because of its high diagnostic yield and because it allows to carry out pleurodesis at the same time. In patients who have poor prognosis it may

  10. Neoplasia Intraepitelial Cervical em Pacientes do Centro de Saúde-Escola Murialdo: Prevalência e Seguimento

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    Rafaela Aprato Menezes

    2011-04-01

    Full Text Available Introdução: o câncer de colo uterino é passível de prevenção e cura, apesar disso mantém uma alta taxa de mortalidade no mundo. A citologia realizada de rotina e associada à colposcopia e à biópsia cervical compõem o seguimento capaz de identificar lesões precursoras do câncer e de diminuir a incidência dessa patologia. Objetivos: identificar pacientes com Neoplasia Intra-epitelial Cervical, a prevalência dessas alterações conforme a faixa etária e definir qual o acompanhamento realizado por elas no Centro de Saúde-Escola Murialdo. Materiais e Métodos: estudo coorte retrospectivo de dados secundários das pacientes com lesão intraepitelial de baixo e alto grau, identificando a realização de colposcopia, biopsia e repetição da citologia após a primeira alteração citológica. Resultados: 372 mulheres entre 13 e 82 anos tiveram seus exames avaliados entre 1997 e 2008, resultando em prevalência de 70,2% de lesões de baixo grau e 29,8% de lesões de alto grau e câncer invasor. Delas, 68,2% passaram por colposcopia, 48,1% chegaram à biopsia e 8,8% das orientadas a repetir o CP, o fizeram em menos de um ano. No seguimento, 20,7% chegaram à conização, 1,9% sofreram histerectomia e 78,2% das alterações de baixo grau tiveram citologia normal à re-coleta. Conclusões: há baixa cobertura do rastreamento do câncer cervical nessa população com alta prevalência de HPV e infecções que vulnerabilizam o epitélio cervical. Porém, com a facilidade da colposcopia há super-avaliação das alterações e provavelmente tem-se diminuído a mortalidade pelo câncer. É urgente ampliar a vigilância em saúde da mulher até que as unidades de saúde estejam organizadas e ativas diante do tema.

  11. A 56-year-old woman with ampullary adenocarcinoma and acute pancreatitis Mujer de 56 años con adenocarcinoma de la ampolla de Vater y pancreatitis aguda

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    V. M. Santos

    2012-12-01

    Full Text Available A 56-year-old woman was admitted with jaundice, and laboratory data were indicative of pancreatitis, which recurred in spite of adequate clinical and nutritional management. The patient was an overweight diabetic using metformin, who had antecedents of cholelithiasis and recent cholecystectomy. Clinical and laboratory features were not conclusive about the cause of this acute pancreatitis. However, imaging data contributed to diagnosis suspicion, and the histopathology study of the transpapillary biopsy confirmed the ampullary adenocarcinoma. Whipple´s surgery was the procedure of choice, associated with radical lymphadenectomy, followed by an uneventful outcome. Recrudescence of signs and symptoms of acute pancreatitis, with elevated serum levels of bilirrubins and of hepatic canalicular enzymes, should enhance the suspicion index about periampullary tumors. High levels of CA 19-9 can constitute a useful marker of this condition. Transpapillary biopsy can characterize the diagnosis of ampullary malignancies.Se presenta el caso de una mujer de 56 años, que presentaba ictericia y cuyos exámenes de laboratorio fueran indicativos de pancreatitis. Presentó recurrencia a pesar de las medidas clínicas y nutricionales adecuadas. La paciente era diabética, con sobrepeso, tomaba metformina y con antecedentes de colelitiasis y reciente colecistectomía. Los datos clínicos y del laboratorio no fueron concluyentes acerca del origen de esta pancreatitis aguda. Sin embargo, los estudios de imagen contribuyeron a la sospecha del diagnóstico; los estudios de citologia exfoliativa y de biopsia transpapilar confirmaron un adenocarcinoma ampular. La cirugía de Whipple fue el procedimiento de opción, asociado con linfadenectomía radical, con resultado favorable. El recrudecimiento de señales y síntomas de pancreatitis aguda, con niveles séricos elevados de bilirrubina y de enzimas hepáticos debe reforzar el índice de sospecha acerca de tumores

  12. Granulomatosis sarcoidea necrosante con compromiso sistémico Necrotizing sarcoid granulomatosis with systemic involvement

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    María Elena Ceballos

    2006-09-01

    Full Text Available Mujer mapuche de 70 años quien en el curso de 1 año presentó baja de peso, ojo rojo bilateral y úlcera corneal que evolucionó hacia la perforación con herniación uveal y pérdida de la visión. Posteriormente se agregaron lesiones nodulares, violáceas, sensibles, algunas ulceradas en las zonas distales de ambas extremidades inferiores. La TAC de tórax demostró múltiples nódulos pulmonares. Tras un estudio exhaustivo se descartaron la tuberculosis y otras infecciones. Tanto la biopsia de las lesiones cutáneas como la biopsia pulmonar obtenida mediante toracotomía confirmaron la presencia de granulomas necrotizantes no caseificantes y arteritis granulomatosa. Se trató con esteroides y ciclofosfamida con mejoría de su condición general y regresión de las lesiones cutáneas y pulmonares en menos de 1 mes. Se realizó un trasplante de cornea. A los seis meses de seguimiento continúa en tratamiento, no ha presentado recaídas y tiene recuperación parcial de la visiónA 70-year-old mapuche female presented with a 1 year history of weight loss, bilateral red painful eyes and corneal ulcer that evolved into perforation and uveal herniation with complete visual loss. Reddish and painful nodules appeared on the distal aspect of both lower extremities, that ulcerated after months. A thoracic CT scan showed multiple pulmonary nodules. Infectious diseases were ruled out. An open lung biopsy and a skin biopsy were performed and both showed non-caseating necrotizing granulomas and granulomatous arteritis. Steroids and cyclophosphamide were started with complete regression of skin and pulmonary lesions within a month. Corneal transplantation was done. After 6 months follow-up, the patient is on low-dose of steroids, free of disease with partial vision recovery

  13. Oligodendroglioma in a patient with AIDS: case report and review of the literature Oligodendroglioma en un paciente con sida: reporte de caso y revisión de la literatura

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    Marcelo E. Corti

    2004-08-01

    Full Text Available In the last years, new techniques of neuroimages and histopathological methods have been added to the management of cerebral mass lesions in patients with AIDS. Stereotactic biopsy is necessary when after 14 days of empirical treatment for Toxoplasma gondii encephalitis there is no clinical or neuroradiologic improvement. We report a woman with AIDS who developed a single focal brain lesion on the right frontal lobe. She presented a long history of headache and seizures. After two weeks of empirical treatment for toxoplasma encephalitis without response, a magnetic resonance image with spectroscopy was performed and showed a tumoral pattern with a choline peak, diminished of N-acetyl-aspartate and presence of lactate. A stereotactic biopsy was performed. Histopathological diagnosis was a diffuse oligodendroglioma type A. A microsurgical resection of the tumor was carried out and antiretroviral treatment was started. To date she is in good clinical condition, with undetectable plasma viral load and CD4 T cell count > 200 cell/uL.En los últimos años, las nuevas técnicas de neuroimágenes y diversos métodos de diagnóstico histopatológico se han agregado al manejo clínico de las lesiones de masa cerebral ocupante en los pacientes con sida. La biopsia estereotáxica es necesaria cuando, luego de dos semanas de tratamiento empírico para toxoplasmosis cerebral, no se comprueba mejoría clínica ni neurorradiológica. Presentamos una paciente con sida que desarrolló una lesión cerebral a nivel del lóbulo frontal derecho. Como antecedente refirió una larga historia de cefalea y convulsiones. La resonancia nuclear magnética con espectroscopia de voxel único ubicado a nivel de la lesión mostró un patrón de lesión tumoral con pico de colina, déficit de N-acetil-aspartato y presencia de ácido láctico. La biopsia estereotáxica y el estudio histopatológico permitieron arribar al diagnóstico de oligodendroglioma difuso de tipo A. Se le

  14. Prevalencia de tumores odontogénicos en el Hospital Base Valdivia: periodo 1989-2008

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    L.C. Thiers

    2013-12-01

    Full Text Available Objetivo: Este artículo corresponde a un estudio observacional de tipo descriptivo de corte transversal, tiene como objetivo determinar la prevalencia de tumores odontogénicos en la población atendida en el Hospital Base Valdivia, en un periodo de 20 años (1989-2008, según la nueva clasificación de lesiones tumorales de la WHO, 2005. Metodología: Se revisaron 2.078 informes de biopsias correspondientes a lesiones de la cavidad oral de los archivos de informes del servicio de Anatomía Patológica, Hospital Base Valdivia entre enero del año 1989 y diciembre del año 2008. Como criterios de inclusión están la presencia de un diagnóstico histopatológico en la ficha y legibilidad de ésta. Las variables a analizar incluyen: edad, género, diagnóstico histopatológico, tipo de tumor y área de localización. Los datos recolectados fueron tabulados en planilla de base de datos, para su posterior análisis estadístico. Resultados: De las 2.078 biopsias del territorio bucal, 31 corresponden a tumores odontogénicos, lo que representa un 1,5% de todas las lesiones biopsiadas del territorio oral. Una lesión maligna fue encontrada y corresponde a carcinoma ameloblástico infiltrante. La lesión más frecuente correspondió a tumor odontogénico queratoquístico (41,9%, seguido por el ameloblastoma (22,6% y, por último, odontoma (16,1%. El promedio de edad de 35,7 años. El área más frecuente de presentación es el área molar mandibular (54,8%. Conclusión: Los tumores odontogénicos son de baja prevalencia en la población valdiviana atendida en el Hosptial Base Valdivia entre los años 1989-2008. No tiene predilección por género. La lesión más prevalente es el tumor odontogénico queratoqísitico.

  15. Selección de embriones humanos. Diagnóstico genético preimplantación

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    Natalia López Moratalla

    2011-01-01

    Full Text Available La posibilidad de detectar defectos cromosómicos o genéticos en embriones in vitro, asociada a las técnicas de Reproducción Humana Asistida antes de su posible transferencia a útero para completar su desarrollo, se presentó como una alternativa al aborto eugenésico. Y una opción para mujeres de edad avanzada para procrear, de evitar embarazos de embriones con defectos cromosómicos. El diagnóstico genético previo a la implantación (DGP y el cribado de los embriones in vitro (por las siglas en inglés, PSC, ofrecen la imagen de la persona con discapacidad como un individuo a excluir de la sociedad. Supone una experimentación humana directa, sin fines terapéuticos ni para el embrión que se manipula, se elige o descarta según el diagnóstico, ni para avance de la medicina perinatal. Dado que estas técnicas permiten disponer de varios embriones, se ha generado además una eugenesia «positiva», que busca seleccionar unos embriones en función de terceros, por tener unas determinadas características, sexo, o carecer de posibles predisposiciones a enfermedades. Varios aspectos exigen el deber ético ineludible de informar sobre esta forma de eugenesia que, además de serlo y destruir directa e intencionadamente la vida de seres humanos en sus primeras etapas, no cumple los requisitos mínimos de rigor de una investigación científica o biotecnológica. No se han realizado las pruebas previas en animales para validar las técnicas por lo que existen serios errores en el diagnostico con falsos positivos y falsos negativos. Recientemente se ha podido constatar que algunos embriones desechados pueden eliminar sus defectos con el desarrollo dos días después de la biopsia. Por otra parte, todo el estudio acerca de qué puede o no diagnosticarse es retrospectivo y los daños irrecuperables. Y, de especial importancia, es el hecho de que no se conoce con seguridad los efectos que la biopsia a un embrión de pocos días lleva consigo para

  16. Endoscopic evaluation and histological findings in graft-versus-host disease Evaluación endoscópica y hallazgos histológicos en la enfermedad de injerto contra huésped

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    Antonio Velasco-Guardado

    2012-06-01

    Full Text Available Background: the gastrointestinal (GI tract is the major target site of the graft-versus-host disease (GVHD. Diagnosis is based on endoscopic and histological findings. Material and methods: we performed a retrospective study from January 1st, 1990 to December 31st, 2008 on 338 upper gastrointestinal endoscopies (gastroscopies performed to 197 patients that underwent an allogeneic transplant with clinical suspicion of GI-GVHD. Results: endoscopic findings to the diagnosis of GVHD have a sensitivity (S of 34%, specificity levels (SP of 65%, a positive predictive value (PPV of 73% and a negative predictive value (NPV of 48%. The histological study of the endoscopic biopsies has a global sensibility of 85.6% SP = 34.6% PPV = 64.2% and NPV = 63.7%. Histological grade was correlated with the clinical grade of acute GVHD (p = 0.018. Conclusion: upper gastrointestinal endoscopy is useful for the diagnosis of GVHD, as it allows biopsies that can ultimately lead to the diagnosis, but with limited accuracy because the histological findings have low sensitivity and specificity, while the endoscopic findings are generally nonspecific.Introducción: el tracto gastrointestinal es la diana principal de afectación en la enfermedad de injerto contra huésped (EICH. Su diagnóstico se basa en los hallazgos endoscópicos e histológicos. Material y métodos: hemos realizado un estudio retrospectivo, desde el 1 de enero de 1990 hasta el 30 de diciembre de 2008, de 338 endoscopias digestivas altas realizadas a 197 pacientes sometidos a trasplante alogénico de células hematopoyéticas con sospecha de EICH gastrointestinal. Resultados: los hallazgos endoscópicos tienen una sensibilidad (S del 34%, especificidad (E del 65%, valor predictivo positivo (VPP del 73% y valor predictivo negativo (VPN del 48% para el diagnóstico de EICH. El estudio histológico de las biopsias tiene una S del 85,6%, E del 34,6%, VPP del 64,2% y VPN del 63,7%. El grado histológico se

  17. Morfología dual de células de mieloma: inusual presentación de un caso

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    María Virginia Bürgesser

    2012-06-01

    Full Text Available Una mujer de 41 años consultó por dolor facial. En una resonancia magnética nuclear se observó una masa en el ápex del peñasco derecho. La biopsia mostró una infiltración difusa por células grandes atípicas con morfología plasmablástica, positivas para CD138, BCL6, CD56 y p53, con expresión monoclonal de cadena liviana kappa y factor de proliferación del 80%, planteando el diagnóstico diferencial entre linfoma plasmablástico versus plasmocitoma plasmablástico. Un mapeo óseo evidenció múltiples lesiones osteolíticas en cráneo; el proteinograma reveló hipogamaglobulinemia y la inmunofijación en suero y orina fueron negativas. Se realizó biopsia de médula ósea donde se observó infiltración en un 30% del cilindro óseo por células plasmáticas maduras monoclonales para kappa, con expresión focal de p53 y negativas para CD56. Estos hallazgos confirmaron el diagnóstico de mieloma múltiple. Este caso pone de manifiesto la existencia de un espectro morfológico de las neoplasias de células plasmáticas, mostrando una evolución clonal continua con una plasticidad adquirida para desdiferenciarse, volverse inmaduras e infiltrar tejidos extramedulares, posiblemente debido a acumulación de alteraciones moleculares. Por lo tanto, se evidencia la dificultad del diagnóstico diferencial histopatológico entre linfoma plasmablástico y transformación plasmablástica de mieloma múltiple, debido a sus perfiles inmunohistoquímicos casi idénticos.

  18. 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.

  19. CALCINOSIS CUTIS METASTÁSICA: CALCIFILAXIS (ARTERIOLOPATÍA URÉMICA CALCIFICADA. A PROPÓSITO DE UN CASO. [METASTATIC CALCINOSIS CUTIS: CALCIPHYLAXIS (CALCIFIED UREMIC ARTERIOLOPATHY. A CASE REPORT

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    Lourdes Bolla de Lezcano

    2013-07-01

    Full Text Available Resumen La calcifilaxis es un síndrome clínico caracterizado por una calcificación vascular progresiva que ocasiona la aparición de lesiones violáceas, frecuentemente dolorosas, en la piel de pacientes con insuficiencia renal crónica, diálisis o trasplante renal, asociado usualmente a niveles elevados de hormona paratiroidea. Se presenta el caso clínico de una mujer de 44 años, diabética con insuficiencia renal crónica, en hemodiálisis desde hace 2 años, que fue diagnosticada de calcifilaxis tras sospecha clínica y biopsia de lesiones cutáneas. Abstract Calciphylaxis is a clinical syndrome characterized by progressive vascular calcification that causes the appearance of purplish lesions, often painful, in the skin of patients with chronic renal failure, dialysis or kidney transplantation, usually associated with elevated levels of parathyroid hormone. We report a case of a 44-year-old diabetic woman with chronic renal failure on hemodialysis for 2 years. She was diagnosed with calciphylaxis after clinical suspicion and biopsy of skin lesions.

  20. Prevalência de infecção por Helicobacter pylori em crianças avaliadas no Hospital de Clínicas de Porto Alegre, RS, Brasil

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    SOUSA Marcelo Basso

    2001-01-01

    Full Text Available Objetivos - Determinar a prevalência de infecção pelo Helicobacter pylori em pacientes de 2 a 18 anos submetidos a biopsias gástricas por endoscopia esôfago-gástrica-duodenal no Hospital de Clínicas de Porto Alegre, RS, durante o período de 1990 a 1997, correlacionando-a com os achados clínicos, endoscópicos e anatomopatológicos. Métodos - Estudo transversal embasado na revisão de arquivos médicos e de laudos anatomopatológicos, sendo estes últimos revistos por médico patologista que desconhecia as informações clínicas e laudos anatomopatológicos prévios. Resultados - Foram avaliados 181 pacientes e obteve-se uma prevalência de infecção pelo Helicobacter pylori de 24,86% (45 casos. Na histologia, gastrite foi encontrada em 38 pacientes dos 45 com Helicobacter pylori positivo e em 45 do 136 Helicobacter pylori negativo. Úlcera péptica foi encontrada em 6 dos 45 Helicobacter pylori positivo e em 3 dos 136 Helicobacter pylori negativo. Conclusão - O estudo demonstrou relação significativa da infecção do Helicobacter pylori com alterações principalmente histológicas nas crianças avaliadas.

  1. Avaliação da prevalência de lesões periapicais examinadas no laboratório de patologia bucal da FO-PUCRS nos anos de 1973, 1983, 1993 e 2003 = Evaluation of the prevalence of periapical pathology examined at the bucal patholology lab of the puc-rs in the years of 1973, 1983, 1993 and 2003

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    Bacaltchuk, Marcelo

    2005-01-01

    Full Text Available A ocorrência das lesões inflamatórias periapicais é uma questão discutida na literatura. O objetivo deste trabalho foi realizar um levantamento da prevalência de cistos, granulomas e abscessos nos anos de 1973, 1983, 1993 e 2003 na Faculdade de Odontologia da PUCRS, analisando a ocorrência dessas patologias de acordo com a idade, sexo e localização anatômica. Para isto, foram coletados dados nas fichas de biópsia dos casos registrados no Laboratório de Patologia Bucal da Faculdade de Odontologia da PUCRS. Posteriormente os mesmos foram inseridos na programa Access e analisados estatisticamente. Verificou-se que entre as lesões periapicais, a prevalência do cisto foi de 55. 5%, num total de 119 biopsias. O ano com maior número de diagnósticos foi 1993 (61 lesões. O sexo feminino foi acomentido por 68. 1% dos casos, e a segunda década de vida foi acometida com 26%. A região da maxila anterior mostrou-se a mais atingida (32% e há uma associação significativa entre a ocorrência de abscessos na maxila e de granulomas na mandíbula

  2. Cromomicosis: reporte de un caso incapacitante Chromomycosis: report of a disabling case

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    Sendy Solórzano

    2011-09-01

    Full Text Available La cromomicosis es una micosis profunda subcutánea producida por hongos dimórficos que de forma habitual habitan en restos vegetales. Se presenta el caso de un paciente de 51 años que seis años antes del ingreso se dedicaba a la fabricación de tejas en Madre de Dios, Perú; donde sufrió una lesión inicial papular en una pierna la cual se extendió hasta comprometer los cuatro miembros, con lesiones verrucosas que lo llevaron a la discapacidad. Se observaron cuerpos fumagoides en la biopsia de piel. El paciente fue hospitalizado y recibió curaciones tópicas, antibioticoterapia y terbinafina. Fue dado de alta al cabo de dos meses con mejoría clínica.Chromomycosis is a deep subcutaneous mycosis caused by different dymorphic fungi species that normally live in vegetal debris. We report the case of a 51 year-old patient that six years previous to the evaluation worked making roof tiles in Madre de Dios, Peru; where he presented an initial papular lesion in a leg, which continued expanding until the 4 limbs were affected with disabling verrucous lesions. Fumagoid cells were found in the skin biopsy. The patient was hospitalized and received topical cleaning, antibiotics and terbinafine. He was discharged two months later with clinical improvement.

  3. Descripción clinico-radiológica y patológica de las lesiones palpables de mama, Clínica León XIII, Seguro Social, Medellín, enero 2001-abril 2002

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    Gloria Marín

    2001-04-01

    Full Text Available

    El médico, frente a un paciente con enfermedad mamaria, debe realizar una historia clínica completa en donde se tengan en cuenta los factores de riesgo, los antecedentes personales y familiares de lesión mamaria (menarca precoz, y menopausia tardía, entre otros; el examen físico debe hacerse detenidamente, teniendo en cuenta la inspección, localización, signos y síntomas. No se puede restar importancia
    al estudio de las lesiones de mama, ya que con él se puede
    descartar y prevenir una posible lesión maligna.
    Para el estudio se tendrá en cuenta la «tríada diagnóstica» de las
    lesiones mamarias: clínica, mamografía o ecografía y biopsia en las
    lesiones palpables. Se desea observar la relación que existe entre la
    clínica y las ayudas diagnósticas para el establecimiento de una determinada enfermedad (1.

     

  4. Tumores carcinoides del apéndice. Presentación de caso.

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    Zaymar Haber Ané

    2015-09-01

    Full Text Available Se realizó un estudio descriptivo para caracterizar la evolución de seis pacientes con impresión diagnóstica de apendicitis y diagnóstico definitivo de tumor carcinoide, asistidos en el Hospital General Docente de Guantánamo “Dr. Agostinho Neto”, enero -marzo 2013. Se informa el caso de los pacientes: 3 femeninas y 3 masculinos con edades promedio entre 20 y 50 años, antecedentes de salud aparente y cuadro clínico de dolor abdominal intenso asociado o no a otro síntoma general, al examen físico se constata abdomen doloroso en fosa iliaca derecha, reacción peritoneal, signo de Blumberg positivo, ligero tinte ictérico y taquicardia. Los estudios de ultrasonido revelan la asociación en uno de los casos con quiste de ovario. Son admitidos en el hospital evolucionando favorablemente. Se identifican y describen en biopsia por parafina los componentes morfológicos de esta entidad y se realiza revisión de la literatura concerniente.

  5. [Variability in the clinical presentation of Pompe disease: development following enzyme replacement therapy].

    Science.gov (United States)

    Ley-Martos, Myriam; Salado-Reyes, María J; Espinosa-Rosso, Raúl; Solera-García, Jesús; Jiménez-Jiménez, Luis

    2015-11-01

    Introduccion. La enfermedad de Pompe es un trastorno generalizado progresivo producido por el deficit de la enzima alfa-glucosidasa acida (AGA) de los lisosomas. Se presentan tres casos manifestados de forma muy diferente y tratados con terapia enzimatica sustitutiva (TES), con evolucion favorable. Casos clinicos. Caso 1: varon de 3 meses, con debilidad y rechazo de la alimentacion, hepatomegalia leve, ligera macroglosia e hipotonia, y aumento de las enzimas musculares. Caso 2: varon de 5 meses, con retraso del desarrollo motor, sordera neurosensorial grave, trastornos respiratorios de repeticion de evolucion torpida, hipotonia y leve elevacion de la creatincinasa. Caso 3: varon de 22 años con disnea progresiva, con antecedentes de elevacion de la creatincinasa y las transaminasas, e hipercolesterolemia. Sufrio insuficiencia respiratoria grave que preciso intubacion endotraqueal. La biopsia muscular presento depositos de glucogeno sugestivos de la enfermedad. En los tres casos, el estudio electromiografico dio un patron caracteristico, con descargas pseudomiotonicas, y se confirmo el deficit de AGA en los linfocitos. Se encontro una mutacion en un caso y dos mutaciones en los otros dos. Todos recibieron TES con evolucion favorable: desaparicion de las alteraciones cardiacas en el caso 1, mejoria en los hitos motores en los dos casos infantiles y retirada del respirador en el caso 3. Conclusion. La enfermedad de Pompe tiene una amplia variabilidad en la expresion clinica. La TES consigue una buena respuesta, especialmente en las formas infantiles. La supervivencia a largo plazo de las formas infantiles tratadas permitira conocer mas aspectos del curso de la enfermedad.

  6. Hepatite aguda colestática pelo propiltiouracil: relato de caso Acute cholestatic hepatitis induced by propylthiouracil: case report

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    Mônica Beatriz PAROLIN

    2000-04-01

    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.Propylthiouracil is widely used to treat patients with hyperthyroidism. However, propylthiouracil-induced hepatitis is an uncommon entity. The case of a 15-year-old boy treated with propylthiouracil for hyperthyroidism who developed a cholestatic acute hepatitis is reported. Viral, metabolic and autoimmune liver diseases were excluded and liver biopsy showed a pattern suggestive of drug-induced cholestatic hepatitis. After discontinuating the drug, there was a progressive resolution of symptoms and normalization of liver biochemical tests. Despite its rarity, patients receiving propylthiouracil are exposed to develop severe hepatotoxicity.

  7. 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.

  8. Clonación y Transcripción del Gen EBER-1 del Virus Epatein-Barr: estudio de su expresión genética en linfomas por hibridación in situ

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    I Guerrero

    1999-01-01

    Full Text Available La capacidad del virus de Epstein Barr (VEB de inducir transformación e inmortalización de linfocitos y su alta prevalencia en algunas neoplasias linfoides ha motivado intensa investigación de su biología y comportamiento. Describimos la hibridación in situ (HIS, para la identificación de transcriptos del virus de Epstein-Barr, desarrollado en la Unidad de Biología Molecular del Centro de Investigación en Cáncer Maes - Heller, en biopsias de linfoma incluidas en parafina. El gen EBER-1(Epstein Barr-encoded RNA fue clonado y transcrito, el ARN transcrito fue evaluado con óptimos resultados en las líneas celulares Raji y Daudi que expresan EBER. Este transcrito marcado fue usado como sonda para determinar la expresión genética del virus en 159 especímenes biológicos en estudio y en controles positivos y negativos conocidos empleando la HIS. La actividad transcripcional del virus fue observada en 44% de los casos estudiados. Concluimos que la HIS en tejido incluido en parafina es una buena alternativa para detectar actividad del VEB y la presencia o ausencia de EBER puede ser considerada como marcador biológico en la etiopatología de estos linfomas.

  9. Osteosarcoma de huesos del pie con alto grado de malignidad

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    Alain Martínez Milián

    2015-05-01

    Full Text Available El osteosarcoma es la neoplasia primaria del hueso más frecuente, los hombres son los más afectados en una relación 1,2 - 1,5 por cada mujer y con una tasa de mortalidad cercana a 0,15/100.000 habitantes/año. Se reporta el caso de una paciente femenina de 57 años de edad, con dolor, aumento de volumen e impotencia funcional de aproximadamente seis meses de evolución, los exámenes diagnósticos utilizados fueron radiografía de pie, tomografía axial computarizada de miembro inferior y biopsia de hueso. Se tuvo la confirmación diagnóstica de osteosarcoma de alto grado de malignidad por anatomía patológica. El tratamiento realizado fue quirúrgico, practicándose la amputación del miembro inferior, pudiendo así mejorar la supervivencia y extendiéndole la vida a la paciente. El motivo de la presentación del caso está dado por la poca frecuencia de este tipo de tumor óseo en los huesos del pie en pacientes femeninas

  10. Carcinoma verrugoso

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    Esteban Quesada Jiménez

    2004-09-01

    Full Text Available Se presenta el caso de un paciente masculino de 76 años, vecino de Turrialba, agricultor, que consultó por una lesión de 3 años de evolución, localizada en la palma de la mano derecha a nivel palmar y compromiso de los dedos de la misma mano, caracterizada como una neoformación exofítica verrugosa de 5 por 11 cm. aproximadamente, con material caseoso entre sus crestas. La lesión ha estado creciendo de forma acelerada en los últimos 3 meses, causándole dolor y que le imposibilita ellaborar. Se le realizaron exámenes y se descartaron varias causas infecciosas, y concluyendo luego de varias biopsias con el diagnóstico de un carcinoma verrugoso. El paciente fue tratado mediante una amputación parcial de la mano. Este tumor es una variante del carcinoma epidermoide y presentamos su clasificación, patogénesis, histopatología, manifestaciones clínicas más frecuentes y diagnóstico diferencial.

  11. [Structural congenital myopathies].

    Science.gov (United States)

    Erazo-Torricelli, Ricardo

    2013-09-01

    Introduccion. Las miopatias congenitas son un grupo heterogeneo de enfermedades que comparten clinica de inicio precoz y alteraciones histopatologicas musculares especificas. El estudio genetico permite determinar la mutacion causal en la mayoria de los casos. Existe heterogeneidad fenotipica y genotipica, lo que se ilustra al observar que un genotipo puede expresarse en mas de una forma clinicopatologica y un fenotipo puede estar causado por diferentes mutaciones geneticas. Desarrollo. En esta revision, se detallan las caracteristicas de las principales miopatias congenitas que permiten su identificacion clinica, patologica y genetica. Se describen los hallazgos de la biopsia muscular que constituyen el principal pilar diagnostico. Se enfatiza y se detalla la importancia del diagnostico diferencial, descartando otras patologias que se presentan con hipotonia en la lactancia o el periodo neonatal. Se destacan las formas neonatales graves (nemalinica, miotubular ligada al X) que se deben identificar precozmente para establecer el pronostico y brindar un consejo genetico adecuado. Se subrayan las mutaciones del gen rianodina (RYR1) por su asociacion a la hipertermia maligna y las mutaciones de la selenoproteina 1 (SEPN1) y la miopatia nemalinica por su asociacion a hipoventilacion nocturna. Conclusiones. El conocimiento profundo de las miopatias estructurales congenitas facilita la confirmacion diagnostica de la miopatia congenita, lo que permite la aplicacion oportuna de medidas relacionadas con la respiracion y la alimentacion de los casos mas graves y con la optimizacion de la funcion motora en todos los pacientes con miopatia congenita.

  12. Carcinoma vulvar

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    Yamit Peñas Zayas

    2015-11-01

    Full Text Available El carcinoma de la vulva tiene una incidencia de aproximadamente un 3-5% dentro de todas las enfermedades ginecológicas malignas. El 90% de los tumores malignos de la vulva está constituido por carcinoma epidermoide, el resto son adenocarcinomas, carcinomas de células basales y melanomas. Se realiza la presentación de un caso de una paciente femenina de 25 años de edad con antecedentes  de Diabetes Mellitus tipo II y trombopatia, que ingresa en el servicio de ginecología con un cuadro cutáneo polimorfo, localizado en labios mayores y menores, dado por lesiones eritematoerosivas y vegetante, sospechándose clínicamente el diagnóstico  de un carcinoma epidermoide, corroborándose el mismo histológicamente al realizarse biopsia de piel. Se indicó tratamiento con quimioterapia. Por la edad de la paciente y ser menos frecuente en mucosa que en la piel,  motivo la presentación del caso.

  13. Manifestaciones digestivas y extradigestivas de la enfermedad celíaca.

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    Luis Ortigosa

    2009-11-01

    Full Text Available La enfermedad celíaca (EC es una enteropatía de base autoinmune que se manifiesta en sujetos genéticamente susceptibles, asociada con genes que codifican para las moléculas HLA DQ2 (DQ A1*0501/DQB1*0201 y DQ8 (DQA1*0301/ DQB1*0302. Se caracteriza por una respuesta inmunológica a la ingesta del gluten de trigo y otras prolaminas relacionadas del centeno y la cebada. Las manifestaciones clínicas son diversas, puede haber formas sintomáticas digestivas “clásicas” en niños, y formas extradigestivas en personas de todas las edades. Las manifestaciones atípicas y extradigestivas contribuyen cada vez más a dificultar y demorar el diagnóstico de EC. El uso de marcadores serológicos, especialmente los anticuerpos contra la transglutaminasa tisular, facilita el proceso diagnóstico inicial, que se debe confirmar con una biopsia intestinal para poner de manifiesto unas lesiones histológicas características, con grados variables de atrofia vellositaria, hiperplasia de las criptas e infiltrado linfocitario.

  14. Linfoma primario del sistema nervioso central en una paciente con lupus eritematoso sistémico

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    C. N. Pisoni

    2003-06-01

    Full Text Available Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difuso. Se inició radioterapia, no completó el tratamiento por complicaciones y falleció. Son muy pocos los casos publicados de linfoma primario del sistema nervioso central asociado a lupus eritematoso sistémico.A 36 year-old woman with systemic lupus erythematosus was admitted to our hospital with headache, brachiocrural hemiparesis and hemianesthesia. She had been treated with prednisone and cyclophosphamide. CT scan and MRI revealed a 15 mm nodular mass enhanced with gadolinium in left frontal convexity. CNS biopsy was performed and a diffuse large B-cell lymphoma was diagnosed. She was treated with radiation therapy without response and died. There are few reports of erythematosus systemic lupus associated with primary central nervous system lymphoma.

  15. Hipertrofia mamaria virginal: caso clínico Virginal breast hypertrophy: case report

    Directory of Open Access Journals (Sweden)

    F. J. Gabilondo Zubizarreta

    2007-12-01

    Full Text Available Presentamos un caso de hipertrofia virginal mamaria cuya aparición, controlada desde los 11 años, se estudió y diagnosticó mediante biopsia - aspiración como hipertrofia tipo filoides, siendo tratada quirúrgicamente mediante mamoplastia de reducción con patrón de Wise tradicional y colgajo horizontal bipediculado para el traslado del complejo areolar, que ha conservado la sensibilidad y la vascularización. La intervención única se realizó a los 12 años de edad de la paciente y, tras 5 años de seguimiento postoperatorio, conserva la sensibilidad en las areolas y un aspecto de volumen y forma satisfactorio para la paciente, sin prótesis ni retoques de ningún tipo y con cicatrices aceptables.We present a case of 12 years old patient, with a juvenile or virginal mammary hypertrophy and the postoperative result 5 years later without further recurrence and without any other treatment. We decided to perform a breast reduction like Wise´s style, with bipedicle horizontal flap to transport nipple-areola complex to the new location, and to keep sensibility. Five years later, the outcome is satisfactory to the patient, with very pleasant breast volume and shape, discret scars, good sensibility and without recurrence nor other surgical treatment.

  16. Identification of Paracoccidioides brasiliensis in adrenal glands biopsies of two patients with paracoccidioidomycosis and adrenal insufficiency Identificação do Paracoccidioides brasiliensis nas amostras de glândulas adrenais de dois doentes com paracoccidioidomicose e insuficiência adrenal

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Agudelo

    2009-02-01

    Full Text Available The authors report two cases of adrenal insufficiency secondary to infiltration of the adrenal glands by Paracoccidioides brasiliensis. The first patient had been treated for a chronic multifocal form of paracoccidiodomycosis 11 years ago. The diagnosis of the mycosis was done simultaneous with that of the adrenal insufficiency in the second patient. In both patients the diagnosis was done by direct visualization of fungus in adrenal biopsies. They were treated with hormonal supplements and itraconazol by 12 and six months, without relapses during the follow-up period.Os autores apresentam dois casos de insuficiência supra-renal secundária à infiltração das adrenais pelo Paracoccidioides brasiliensis. O primeiro paciente tinha sido tratado de paracoccidioidomicose crônica multifocal 11 anos atrás. No segundo paciente, o diagnóstico da micose foi feito de forma simultânea com o da insuficiência adrenal. Em ambos os pacientes, o diagnóstico foi feito pela visualização direta do fungo nas biopsias adrenais. Eles foram tratados com suplementos hormonais com itraconazol por seis a 12 meses, sem recaídas durante o período de acompanhamento.

  17. Diagnóstico del carcinoma escamoso de la mucosa bucal: reporte de 5 casos Diagnosis of the squamous carcinoma of the buccal mucous: report of 5 cases

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    JE Baudo

    2005-08-01

    Full Text Available Es indudable que el cáncer bucal causa un importante número de muertes a nivel mundial. El cáncer invasivo puede permanecer largo tiempo bajo cambios macroscópicos inespecíficos, sólo la biopsia permite su diagnóstico. La técnica más utilizada es la rutina con hematoxilina - eosina, actualmente se agrega a la misma otras que contribuyen a clarificar el diagnóstico, por ejemplo la inmunohistoquímica, que en muchos casos determinará la estirpe de una neoplasia.It is certain that the cancer buccal cause an important number of deaths at world level. The cancer invasivo can remain long time low changes macroscopic unspecific, the biopsy only allows its diagnosis. The more used technique is the routine with hematoxylin - eosin, at the moment is added to the same others that contribute to clarify the diagnosis, for example the inmunohistoquímica that will determine the stock of a neoplasia in many cases.

  18. [Description of a series of hospital patients with a spinal fistula].

    Science.gov (United States)

    Garcia-Cabo, C; Morales-Deza, E S; Martinez-Rodriguez, L; Murias-Quintana, E; Perez-Alvarez, A; Martinez-Ramos, J; Vega-Valdes, P; Suarez-Santos, P; Garcia-Rua, A; Moris, G

    2016-10-01

    Introduccion. Aunque las fistulas espinales suponen el 70% de las malformaciones arteriovenosas espinales, son una entidad infradiagnosticada. El shunt arteriovenoso produce una congestion vascular que da lugar a una mielopatia progresiva, en ocasiones irreversible si no se trata de forma precoz. Objetivo. Describir las caracteristicas clinicorradiologicas de una serie de pacientes con fistula espinal. Pacientes y metodos. Se realizo una busqueda retrospectiva de pacientes con diagnostico de fistula espinal ingresados en el area de neurociencias de un hospital de tercer nivel asistencial. Resultados. Se identificaron 19 pacientes (7 mujeres y 12 varones) con una edad media de 56 años. La fistula espinal fue de tipo I en un 79% de los pacientes y la localizacion dorsal fue la mas frecuente. La mayoria de los casos presento un curso progresivo (90%). Un 74% de los pacientes se diagnostico mediante resonancia magnetica. En cuatro casos fue necesaria la realizacion de una angiografia para llegar al diagnostico, y en uno de ellos se preciso una biopsia intraoperatoria. Se realizaron tres punciones lumbares, en dos de las cuales se objetivo pleocitosis linfocitaria e hiperproteinorraquia. El retraso diagnostico medio fue de nueve meses. Se trato a un 79% de los pacientes, y de ellos solo mejoro el 10%. Conclusiones. Ante una clinica sugestiva de fistula espinal, debe realizarse una angiografia espinal diagnostica aunque el paciente estudiado pueda presentar caracteristicas licuorales atipicas y normalidad en la resonancia magnetica medular.

  19. 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.

  20. Navegation system for tubular upper digestive tract Sistema de navegación tubular para vías digestivas altas

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    Camilo Andrés Rojas Cifuentes

    2013-03-01

    Full Text Available The present endoscopy is an uncomfortable experience because these instruments are great size and magnitude, generating feelings of discomfort to the patient during the operation. It’s designed a device to scale, allowing counteract this effect improving the mechanism of endoscopy, being this a more effective and flexible, compared with capsule endoscopy and endoscopy equipment present because will include a biopsy system for analyzing gastroenterological diseases or gastric cancers, with bluetooth communication for visualization of real-time space tract.La endoscopia actual es una experiencia incómoda ya que su instrumental es de gran tamaño y magnitud, generando sensación de molestia al paciente durante el manejo que realiza el especialista de los dispositivos que se operan en el proceso. Se diseña un dispositivo a escala, que permita contrarrestar tal efecto mejorando el mecanismo de endoscopia; siendo éste un sistema más efectivo y ágil, comparado con la cápsula endoscópica y el equipo actual, por lo cual incluirá un sistema de toma de biopsias para analizar enfermedades gastroenterológicas o cánceres, con comunicación Bluetooth para la visualización del espacio digestivo en tiempo real.