Sample records for biopsy proven acute

  1. Biopsy-proven childhood glomerulonephritis in Johor. (United States)

    Khoo, J J; Pee, S; Thevarajah, B; Yap, Y C; Chin, C K


    There has been no published study of biopsy-proven childhood glomerulonephritis in Malaysia. To determine the pattern of childhood glomerulonephritis in Johor, Malaysia from a histopathological perspective and the various indications used for renal biopsy in children. Retrospective study was done of all renal biopsies from children under 16 years of age, received in Sultanah Aminah Hospital, Johor between 1994 and 2001. The histopathological findings were reviewed to determine the pattern of biopsy-proven glomerulonephritis. The indications for biopsy, mode of therapy given after biopsy and the clinical outcome were studied. 122 adequate biopsies were received, 9 children had repeat biopsies. Of the 113 biopsies, minimal change disease formed the most common histopathological diagnosis (40.7%) while lupus nephritis formed the most common secondary glomerulonephritis (23.0%). The main indications for biopsy were nephrotic syndrome (50.8%), lupus nephritis (25.4%) and renal impairment (13.1%). The mode of therapy was changed in 59.8% of the children. Of 106 patients followed-up, 84 children were found to have normal renal function in remission or on treatment. 4 patients developed chronic renal impairment and 16 reached end stage renal disease. Five of the 16 children with end stage disease had since died while 11 were on renal replacement therapy. Another 2 patients died of other complications. The pattern of childhood GN in our study tended to reflect the more severe renal parenchymal diseases in children and those requiring more aggressive treatment. This was because of our criteria of selection (indication) for renal biopsy. Renal biopsy where performed appropriately in selected children may not only be a useful investigative tool for histological diagnosis and prognosis but may help clinicians plan the optimal therapy for these children.

  2. Azithromycin-Induced, Biopsy-Proven Acute Interstitial Nephritis in an Adult Successfully Treated with Low-Dose Corticosteroids. (United States)

    Woodruff, Ashley E; Meaney, Calvin J; Hansen, Elizabeth A; Prescott, Gina M


    Acute interstitial nephritis (AIN) is a form of acute kidney injury (AKI) characterized by a rapid deterioration of renal function, inflammatory infiltration of interstitial tissues, and renal edema. Drug-induced AIN is the most common etiology of AIN, but AIN can also have infectious, autoimmune, or idiopathic causes. β-Lactam antibacterials, nonsteroidal antiinflammatory drugs, and proton pump inhibitors are recognized as leading causes of AIN; however, many other drugs have been identified as causes. We describe the case of a 59-year-old white male who developed AIN that required hemodialysis following azithromycin treatment. He presented to the hospital with complaints of nausea, vomiting, malaise, and fever over the past 3 days, along with no urine output in the preceding 24 hours. Two weeks earlier, he had completed a 5-day course of azithromycin 500 mg on day 1 followed by 250 mg/day on days 2-5 (total dose 1.5 g) for an upper respiratory tract infection. On admission, the patient's serum creatinine (S(cr)) concentration was 7.4 mg/dl (baseline = 1.3 mg/dl). He reported a similar episode of kidney failure 2 years earlier after taking azithromycin; however, at that time it was believed the AKI was likely due to benazepril use in the setting of acute infection, and a kidney biopsy was not performed. His S(cr) concentration peaked at 11.4 mg/dl, and three sessions of hemodialysis were required. A kidney biopsy was performed that revealed AIN. Low-dose prednisone 0.3 mg/kg (30 mg)/day, tapered over the next 3 months, was administered, and his renal function improved to near baseline prior to discharge; 6 months later, his Scr concentration was 1.4 mg/dl. Despite lower than recommended dosing, this patient responded well to prednisone and did not experience long-term sequelae from renal injury. Use of the Naranjo Adverse Drug Reaction Probability Scale indicated a definite relationship (score of 10) between azithromycin exposure and the manifestation of AIN. To

  3. Outcome of biopsy proven minimal change disease (MCD) in children

    African Journals Online (AJOL)

    Background and Objectives: MCD is the most common histological sub-type of nephrotic syndrome with variable clinical course in children. There are limited studies in literature on the outcome of biopsy proven MCD. The objective was to look at the treatment response and outcome of patients with MCD treated at a tertiary ...

  4. Biopsy-proven kidney diseases in the elderly: clinical characteristics, renal histopathological spectrum and prognostic factors. (United States)

    Chen, Yue; Li, Ping; Cui, Chunli; Yuan, Aihong; Zhang, Kun; Yu, Chen


    Objective To explore the clinical characteristics, renal histopathological spectrum and prognostic factors of biopsy-proven kidney diseases in the elderly. Methods A retrospective observational study was conducted in elderly patients who had received renal biopsies. Demographic, clinical and pathological data at the time of the biopsy were collected from the medical records. Follow-up records and prognostic factors were studied. Results The elderly (≥60 years) accounted for 74 of 434 (17.1%) native renal biopsies that were performed in a 9-year period. In the cohort of included elderly patients ( n = 72), the prevalence of nephrotic syndrome and acute kidney injury was 62.5% (45 of 72) and 40.3% (29 of 72), respectively. For elderly patients with primary glomerular diseases ( n = 44), membranous nephropathy was the most frequent pathological type (24 of 44; 54.5%). For elderly patients with secondary glomerular diseases ( n = 25), anti-neutrophil cytoplasmic antibody-associated vasculitis was the most frequent aetiology (nine of 25; 36.0%). Requirement for renal replacement therapy (RRT) was an independent risk factor for poor prognosis. Conclusions Kidney diseases in the elderly have distinctive characteristics. Requirement for RRT was associated with poor prognosis in the elderly with biopsy-proven kidney diseases.

  5. Spectrum of biopsy proven renal disease in South Asian children: Two decades at a tropical tertiary care centre. (United States)

    Mohapatra, Anjali; Kakde, Shailesh; Annapandian, Vellaichamy M; Valson, Anna T; Duhli, Neelaveni; Korula, Anila; Matthai, Smita Mary; Pulimood, Anna B; David, Vinoi G; Alexander, Suceena; Jacob, Shibu; Varughese, Santosh; Gopal, Basu; Veerasamy, Tamilarasi; John, George T


    We report findings from a large single centre paediatric renal biopsy cohort in South Asia. We analyzed all renal biopsies performed on children aged ≤18 years between 1996 and 2015 at our centre. The clinical characteristics and histological diagnosis pertaining to each case, distribution of renal diseases in children with various clinical presentations, and changes in the pattern of kidney disease during the study period were analyzed. A total of 1740 paediatric kidney biopsies were performed during the study period. The mean age was 12.8± 4.9 years (8 months to 18 years) and the male: female ratio was 1.5:1. The most common indication for renal biopsy was nephrotic syndrome (63.2%) followed by acute nephritic syndrome (13%). Minimal change disease was the most common cause of nephrotic syndrome while endocapillary proliferative glomerulonephritis (65.7% infection related), remained the commonest cause of acute nephritic syndrome. IgA nephropathy was the commonest cause of chronic kidney disease. Contrary to trends in European paediatric cohorts, the frequency of lupus nephritis increased over the two decades of the study, while that of endocapillary proliferative glomerulonephritis did not show any appreciable decline. This study provides the largest data on biopsy proven renal disease in children from South Asia published till date and highlights important differences in the spectrum and trends of kidney disease compared to data from other regions. This article is protected by copyright. All rights reserved.

  6. Flares in Biopsy-Proven Giant Cell Arteritis in Northern Italy (United States)

    Restuccia, Giovanna; Boiardi, Luigi; Cavazza, Alberto; Catanoso, Mariagrazia; Macchioni, Pierluigi; Muratore, Francesco; Cimino, Luca; Aldigeri, Raffaella; Crescentini, Filippo; Pipitone, Nicolò; Salvarani, Carlo


    Abstract This study evaluated the frequency, timing, and characteristics of flares in a large cohort of Italian patients with biopsy-proven giant cell arteritis (GCA) and to identify factors at diagnosis able to predict the occurrence of flares. We evaluated 157 patients with biopsy-proven transmural GCA diagnosed and followed at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 4 years of follow-up. Fifty-seven patients (36.5%) experienced ≥1 flares. Fifty-one (46.4%) of the 110 total flares (88 relapses and 22 recurrences) were experienced during the first 2 years after diagnosis. The majority of relapses occurred with doses of prednisone ≤ 10 mg/day (82.9%), whereas only 3.4% of relapses occurred for doses ≥ 25 mg/day. Polymyalgia rheumatica (46.5%) and cranial symptoms (41.9%) were the most frequent manifestations at the time of the first relapse. Cumulative prednisone dose during the first year and total cumulative prednisone dose were significantly higher in flaring patients compared with those without flares (7.8 ± 2.4 vs 6.7 ± 2.4 g, P = 0.02; 15.5 ± 8.9 vs 10.0 ± 9.2 g, P = 0.0001, respectively). The total duration of prednisone treatment was longer in flaring patients (58 ± 44 vs 30 ± 30 months, P = 0.0001). Patients with disease flares had at diagnosis more frequently systemic manifestations (P = 0.02) and fever ≥ 38°C (P = 0.02), significantly lower hemoglobin levels (P = 0.05), more frequent presence at temporal artery biopsy (TAB) specimens of giant cells (P = 0.04) and intraluminal acute thrombosis (P = 0.007), and more moderate/severe arterial inflammation (P = 0.009) compared with those without flares. In the multivariate model fever ≥ 38 °C (hazard ratio 2.14; 95% confidence interval, 1.06–4.32, P = 0.03) and the severity of inflammatory infiltrate

  7. Pathological discrepancy between colposcopic directed cervical biopsy and Loop Electrosurgical-Excision Procedures (LEEPs in patients with biopsies proven high grade cervical intraepithelial neoplasia

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    Sitchuphong Noothong


    Conclusion: The prevalence of patients with CIN1 or less from LEEP specimens who previously had colposcopic biopsies proven CIN2 or 3 was 16.3%. CIN2 from biopsy was the statistically significant risk factor of CIN1 or less in LEEP specimens.

  8. Biopsy-Proven Metastatic Merkel Cell Carcinoma to the Orbit: Case Report and Review of Literature. (United States)

    Cugley, Dean R; Roberts-Thomson, Samuel J; McNab, Alan A; Pick, Zelda


    Merkel cell carcinoma is a rare neuroendocrine tumor of subspecialized dermal mechanoreceptors, associated with immunosuppression. The usual ophthalmic presentation is an eyelid lesion. The authors present a case of biopsy-proven orbital metastatic Merkel cell carcinoma in the absence of any eyelid lesion, in an immunosuppressed patient with a history of multiple cancers. There are to the authors' knowledge only 2 other case reports of presumed metastatic Merkel cell carcinoma to the orbit, though neither were biopsied. Despite its rarity, metastatic Merkel cell carcinoma should be included in the differential of a metastatic orbital lesion, in the patient with a known or suspected cutaneous primary. The patient has had an excellent response to combined radiotherapy and programmed death-1 inhibitor pembrolizumab, and this case highlights the potential benefit of an exciting new biologic therapy.

  9. Clinical characteristics of biopsy-proven allergic bronchopulmonary mycosis: variety in causative fungi and laboratory findings. (United States)

    Ishiguro, Takashi; Takayanagi, Noboru; Kagiyama, Naho; Shimizu, Yoshihiko; Yanagisawa, Tsutomu; Sugita, Yutaka


    The diagnosis of allergic bronchopulmonary mycosis (ABPM) has traditionally relied widely on Rosenberg's criteria, which emphasize immunologic responses while overlooking the investigation of mucous plugs as a primary criterion. Therefore, the characteristics of biopsy-proven ABPM require further elucidation. The aim of this study was to analyze the clinical characteristics of biopsy-proven ABPM and address whether full compliance with clinical criteria, such as the presence of asthma, and certain laboratory findings is necessary to establish a diagnosis of ABPM. We retrospectively analyzed 17 patients with biopsy-proven ABPM focusing on causative fungi and laboratory findings. Causative fungi included Aspergillus sp. in seven patients, Schizophyllum commune in four patients, Penicillium sp. in two patients and unknown in five patients. Bronchial asthma was observed in 10 patients, eosinophilia was observed in 10 patients and an increased serum immunoglobulin (Ig) E level was observed in 14 of the 17 patients. IgG for Aspergillus sp. was positive in six of the seven patients with ABPM due to Aspergillus and turned positive in the remaining patient during follow-up. Technological limitations prevented the measurement of specific IgE for S. commune and IgG for S. commune and Penicillium sp. in most patients. Computed tomography revealed central bronchiectasis, pulmonary infiltration and mucous plugs in all patients. Causative fungi other than Aspergillus sp. are not uncommon, and immunological tests for other fungi should be popularized. Asthma and characteristic laboratory findings, such as peripheral blood eosinophilia, increased serum IgE and precipitating antibodies, may not always be required to diagnose ABPM. The importance of typical pathologic findings of mucous plugs for diagnosing ABPM requires reevaluation. Further studies are needed to establish more elaborate diagnostic criteria for ABPM.

  10. Frequency and outcomes of biopsy-proven fibroadenomas recommended for surgical excision. (United States)

    Lee, Shimwoo; Mercado, Cecilia L; Cangiarella, Joan F; Chhor, Chloe M


    Our aim was to investigate the outcomes of fibroadenomas recommended for surgical excision due to large size (>2cm) or interval growth. A retrospective review of our institutional radiology database from 2007 to 2015 was performed. We identified 167 biopsy-proven fibroadenomas recommended for surgical consultation. Of these, 75 (45%) cases actually underwent excision, 7 (9%, 95% CI: 4-18%) of which were upgraded to phyllodes tumors upon histopathological examination. Our results support the current recommendation to surgically excise breast lesions diagnosed as fibroadenomas with size >2cm or with interval growth due to the considerable risk of finding phyllodes tumors. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Biopsy-proven renal disease in Ile-Ife, Nigeria: A histopathologic review

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    I M Onwubuya


    Full Text Available Although various patterns of renal diseases have been reported from different renal biopsy registries worldwide, data from Nigeria remain scanty. A 10-year retrospective review of renal biopsies was conducted in our tertiary health care facility. All cases were reclassified based on their light microscopic features after the application of standard histochemical stains. A total of 165 cases were reviewed with a male:female ratio of 1.8:1 and a mean age of 15.4 ± 12.0 years. About 69.7% of the cases were below the age of 16 years, while only 2.4% were older than 50 years. The most common indications for biopsy were nephrotic syndrome (72.1% and acute renal failure of unknown etiology (11.5%. Overall, glomerulonephritis (80% was the most common histologic category and occurred only in individuals younger than 50 years old. Minimal change disease (22.9% and membranoproliferative glomerulonephritis (21.9% were the most common varieties in children, while membranous glomerulonephritis (30.6% and focal segmental glomerulosclerosis (27.8% were the commonest among the adult population. The initial histologic diagnosis was revised in 18 cases while a diagnosis was arrived at in seven cases initially adjudged as inadequate for assessment. This study showed that renal biopsy was predominantly performed in children and adolescents. Although glomerulonephritis was the predominant disease, the predominant histologic patterns varied with the patient age. Despite the scarcity of advanced diagnostic tools in resource-poor environments, routine use of histochemical stains is helpful in the evaluation of renal biopsies.

  12. Long-term remission in biopsy proven giant cell arteritis: A retrospective cohort study. (United States)

    Restuccia, Giovanna; Boiardi, Luigi; Cavazza, Alberto; Catanoso, Mariagrazia; Macchioni, Pierluigi; Muratore, Francesco; Soriano, Alessandra; Cimino, Luca; Aldigeri, Raffaella; Crescentini, Filippo; Pipitone, Nicolò; Salvarani, Carlo


    To evaluate the frequency of long-term remission after glucocorticoids (GCs) suspension in an Italian cohort of patients with biopsy-proven GCA and to identify factors that may predict long-term remission. We evaluated 131 patients with biopsy-proven transmural GCA diagnosed and followed up at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 18 months of follow-up. Long-term remission was defined as complete clinical remission without elevation of inflammatory markers for at least one year after the GC withdrawal. 73 patients (56%) experienced long-term remission. Disease flares were less frequently observed in patients with long-term remission compared to those without (p = 0.002). The cumulative doses of prednisone at 1 year and for the entire followup duration were significantly lower (p < 0.0001 for both parameters) in patients with long-term remission; similarly, the duration of prednisone treatment was also significantly lower (p < 0.0001). The presence of PMR at diagnosis (HR 0.46) was significantly negatively associated with long-term remission (p = 0.008), while hemoglobin levels (HR 1.48) were significantly positively associated (p < 0.0001). Patients with long-term remission were able to reach 10 mg/day and 5 mg/day of prednisone sooner than the patients without (p = 0.02 and p < 0.0001, respectively). In our cohort of GCA patients around half of the patients were able to attain long-term remission. Recognition of findings which predict disease course may aid decisions regarding therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Effect of Autoantibodies to Erythropoietin Receptor in Systemic Lupus Erythematosus with Biopsy-proven Lupus Nephritis. (United States)

    Hara, Akinori; Furuichi, Kengo; Yamahana, Junya; Yasuda, Haruka; Iwata, Yasunori; Sakai, Norihiko; Shimizu, Miho; Kaneko, Shuichi; Wada, Takashi


    We examined the clinical significance of autoantibodies to the erythropoietin receptor (EPOR) in patients with systemic lupus erythematosus (SLE) who had biopsy-proven lupus nephritis (LN). Forty-six Japanese patients with SLE with LN who had undergone renal biopsy during 1993-2014 were enrolled in this study and followed for a mean of 83 months. Sera from those patients were screened for anti-EPOR antibodies using ELISA. Anti-EPOR antibodies were detected in 18 (39%) of the 46 patients with SLE with anemia. Anti-EPOR antibodies were associated with low hemoglobin concentrations and reticulocytopenia. In addition, anti-EPOR antibodies were positively correlated with SLE disease activity, even though serum levels of the complement factors 3 and 4 did not differ between the 2 groups. In patients with International Society of Nephrology/Renal Pathology Society 2003 class IV LN, anti-EPOR antibodies were associated with active lesions including cellular crescents in glomeruli. Decrease in renal function was more frequently observed in patients without complete or partial renal response than in patients with it, and serum levels of the antibodies as well as renal response to treatment were significant risk factors for progression of renal dysfunction. The present study suggests that anti-EPOR antibodies might be involved in overall disease activity and active renal lesions, as well as in the impaired erythropoiesis in patients with SLE with LN. Further, the levels of anti-EPOR antibodies may be an additional predictor for renal injury.

  14. A clinical and biochemical profile of biopsy-proven non-alcoholic fatty liver disease subjects

    International Nuclear Information System (INIS)

    Khurram, M.; Mushraf, M.


    To describe clinical and biochemical features of patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD). Fifty patients of either and of all ages were included, who had ultrasound evidence of fatty liver, deranged liver enzymes, and negative history of alcohol uptake. Serological/biochemical tests/markers of other liver diseases were negative. Each subject underwent liver biopsy reported by a single histopathologist. Clinical (symptoms, hypertension, hepatomegaly, and obesity) and biochemical evaluation (for diabetes, lipid abnormalities, and aspartate to alanine aminotransferase ratio (AST/ALT)) of each subject was done. Chi-square and t-tests were used for p-value calculation for finding significant difference between fatty liver and non-alcoholic steato-hepatitis groups. Thirty three (66%) patients were female and 34% were male. Mean age was 45.50+-11.50 years. Histopathologically, 62% subjects had fatty liver alone, while 38% had nonalcoholic steatohepatitis (NASH). Fatigue (100%), hypertriglyceridemia (80%), hepatomegaly (72%), AST/ALT ratio <1 (72%), and obesity/overweight (54%) were common NAFLD-related features. Except for hypertriglycedemia (p-value 0.008), no statistically significant association was noted between these features and histopathological subtypes of NAFLD. NAFLD-related clinical and biochemical features included fatigue, obesity, hepatomegaly, AST/ALT ratio <1, and hypertriglycedemia. Significant relationship existed between hypertriglyceridemia and NASH. (author)

  15. Low level of circulating basophil counts in biopsy-proven active lupus nephritis. (United States)

    Liang, Peifen; Tang, Ying; Lin, Liu; Zhong, Haowen; Yang, Hui; Zeng, Yuchun; Lv, Jun; Li, Xiaomei; Lu, Yanying; Xu, Anping


    Basophils have been shown to be important players in promoting lupus nephritis (LN). However, the relationship between circulating basophil counts and renal pathology activity of LN remains unclear. In this retrospective study, 159 clinical and pathology samples from patients with biopsy-proven LN were analyzed. The renal activity and classification were evaluated according to renal pathology. The correlations between circulating basophil counts and renal pathology activity index were assessed. Overall, circulating basophil counts correlated with total systemic lupus erythematosus disease activity index (SLEDAI) score (r = - 0.31), renal SLEDAI score (r = - 0.35), activity index (AI) score(r = - 0.40), and renal histologic activity parameters (p counts (0.007 ± 0.007 vs. 0.011 ± 0.010 × 10 9 /L, p = 0.04). Subgroup analyses revealed that the circulating basophil counts in group B (AI > 8) were significantly lower than that in group A (AI ≤ 8) (0.004 ± 0.006 vs. 0.009 ± 0.009 × 10 9 /L, p counts among LN pathology classification groups (p counts when compared with group of class I/II (p counts as a convenient and helpful marker for renal activity of LN.

  16. Diffusion-weighted MR imaging in biopsy-proven Creutzfeldt-Jakob disease

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    Kim, Hyo Cheol; Chang, Kee Hyun; Song In Chan; Lee, Sang Hyun; Kwon, Bae Ju; Han, Moon Hee; Kim, Sang Yun [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    To compare conventional and diffusion-weighted MR imaging in terms of their depiction of the abnormalities occurring in Creutzfeldt-Jakob disease. We retrospectively analyzed the findings of conventional (T2-weighted and fluid-attenuated inversion recovery) and diffusion-weighted MR imaging in four patients with biopsy-proven Creutzfeldt-Jakob disease. The signal intensity of the lesion was classified by visual assessment as markedly high, slightly high, or isointense, relative to normal brain parenchyma. Both conventional and diffusion-weighted MR images demonstrated bilateral high signal intensity in the basal ganglia in all four patients. Cortical lesions were observed on diffusion-weighted MR images in all four, and on fluidattenuated inversion recovery MR images in one, but in no patient on T2-weighted images. Conventional MR images showed slightly high signal intensity in all lesions, while diffusion-weighted images showed markedly high signal intensity in most. Diffusion-weighted MR imaging is more sensitive than its conventional counterpart in the depiction of Creutzfeldt-Jakob disease, and permits better detection of the lesion in both the cerebral cortices and basal ganglia.

  17. Diffusion-weighted MR imaging in biopsy-proven Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Kim, Hyo Cheol; Chang, Kee Hyun; Song In Chan; Lee, Sang Hyun; Kwon, Bae Ju; Han, Moon Hee; Kim, Sang Yun


    To compare conventional and diffusion-weighted MR imaging in terms of their depiction of the abnormalities occurring in Creutzfeldt-Jakob disease. We retrospectively analyzed the findings of conventional (T2-weighted and fluid-attenuated inversion recovery) and diffusion-weighted MR imaging in four patients with biopsy-proven Creutzfeldt-Jakob disease. The signal intensity of the lesion was classified by visual assessment as markedly high, slightly high, or isointense, relative to normal brain parenchyma. Both conventional and diffusion-weighted MR images demonstrated bilateral high signal intensity in the basal ganglia in all four patients. Cortical lesions were observed on diffusion-weighted MR images in all four, and on fluidattenuated inversion recovery MR images in one, but in no patient on T2-weighted images. Conventional MR images showed slightly high signal intensity in all lesions, while diffusion-weighted images showed markedly high signal intensity in most. Diffusion-weighted MR imaging is more sensitive than its conventional counterpart in the depiction of Creutzfeldt-Jakob disease, and permits better detection of the lesion in both the cerebral cortices and basal ganglia

  18. Long-term outcome of biopsy-proven minimal change nephropathy in Chinese adults. (United States)

    Szeto, Cheuk-Chun; Lai, Fernand Mac-Moune; Chow, Kai-Ming; Kwan, Bonnie Ching-Ha; Kwong, Vickie Wai-Ki; Leung, Chi-Bon; Li, Philip Kam-Tao


    Minimal change nephropathy is a common cause of primary nephrotic syndrome in adults. However, there are few studies of its clinical course, response to treatment, and long-term outcome. Retrospective cohort study. 340 consecutive adult patients with nephrotic syndrome and biopsy-proven minimal change nephropathy treated in a university hospital from 1984 until 2004. Treatment response groups: primary steroid resistance, frequent relapse (≥4 relapses within 1 year), infrequent relapse (≥1 relapse but not frequent relapse), and no relapse (reference group); disease pattern. Medical problems after diagnosis; patient survival; renal survival. Median time to remission was 10 (IQR, 8-12) weeks; 179 (52.6%) had no relapse, 42 (12.4%) had infrequent relapses, 86 (25.3%) were frequent relapsers or steroid dependent, and 33 (9.7%) had primary steroid resistance. After a median follow-up of 174.7 (IQR, 119.7-235.0) months, 32 patients developed end-stage renal disease and 62 died (25 after progression to end-stage renal disease). Cox regression analysis showed that age and treatment response groups were the independent predictors of patient survival. Compared to the no-relapse group, the infrequent-relapse group had significantly better patient survival (adjusted HR, 0.19; 95% CI, 0.08-0.44; Presistance group had significantly worse patient survival (adjusted HR, 5.87; 95% CI, 1.83-18.85; Presistance group. Retrospective study. A substantial proportion of adult patients with minimal change nephropathy continue to have disease flares more than 10 years after the initial presentation, and medical problems after diagnosis are common. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  19. Biopsy-proven renal involvement and prognosis in 13 hispanic patients with primary Sjögren syndrome. (United States)

    Carrillo-Pérez, Diego Luis; Tejeda-Maldonado, Javier; Garza-García, Carlos; Soto-Abraham, Virgilia; Hernández-Molina, Gabriela; Molina-Paredes, Giovanni Arnoldo; Uribe-Uribe, Norma O; Morales-Buenrostro, Luis E


    The aim of this study was to describe a case series of 13 Hispanic patients with primary Sjögren syndrome (pSS) and biopsy-proven renal involvement. We describe the clinical, serological and histological characteristics as well as the prognosis in a group of patients with pSS and biopsy-proven renal involvement, treated in 2 referral nephrology units in Mexico City. Thirteen patients with pSS underwent kidney biopsy (KB) over a period of 27 years. The median duration from pSS diagnosis to KB was 13.9 months. Seven patients (54%) had glomerulonephritis and 6 patients (46%) had tubulointerstitial nephritis. All patients were treated with corticosteroids and/or immunosuppressants. Eight patients (62%) remained stable or their renal function improved after a median follow-up of 12 months. This case series reflects the broad spectrum of renal involvement in pSS. We observed that in our Hispanic population, glomerular involvement was the most frequent abnormality, mainly membranous glomerulopathy, followed by tubulointerstitial disease. Tubular atrophy and interstitial fibrosis were also common biopsy findings. Treatment with corticosteroids or other immunosuppressive agents appear to slow renal disease progression. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  20. Incidence, Prevalence, and Survival of Biopsy-Proven Giant Cell Arteritis in Northern Italy During a 26-Year Period. (United States)

    Catanoso, Mariagrazia; Macchioni, Pierluigi; Boiardi, Luigi; Muratore, Francesco; Restuccia, Giovanna; Cavazza, Alberto; Pipitone, Nicolò; Mancuso, Pamela; Luberto, Ferdinando; Salvarani, Carlo


    To investigate the epidemiology and mortality in patients with biopsy-proven giant cell arteritis (GCA) in northern Italy. All patients with incident temporal-artery biopsy-positive GCA, diagnosed between 1986 and 2012 and living in the Reggio Emilia area, were identified by using a pathology register and by reviewing all histopathologic specimens. For each patient, we identified 1 comparison subject from the same geographic area, matched for age and sex. Mortality rates and specific causes of death were reported. There were 285 incident cases of biopsy-proven GCA (210 women) during the 26-year study period. The overall age- and sex-adjusted incidence per 100,000 persons ages ≥50 years was 5.8 (95% confidence interval [95% CI] 5.1, 6.5). Incidence was significantly higher in women (7.8 [95% CI 6.7, 8.9]) than in men (3.3 [95% CI 2.6, 4.1]) (P < 0.0001). Annual age- and sex-adjusted incidence rates significantly increased by 15.9% per 3 years from 1986 to 2000, then significantly fell by -4.8% per 3 years from 2001-2012. The prevalence of GCA on December 31, 2012 was 87.9 (95% CI 75.8, 101.4). No significant differences in the mortality rates were observed between GCA patients (4.9 per 100 person-years [95% CI 4.1, 5.8]) and non-GCA subjects (5.6 [95% CI 4.7, 6.6]). No significant differences in causes of death were observed comparing GCA patients to non-GCA subjects. This large population-based study of biopsy-proven GCA confirmed the lower incidence of GCA in Mediterranean countries and did not observe any increased mortality risk. © 2016, American College of Rheumatology.

  1. Biopsies (United States)

    ... vs. risks? What are the limitations of biopsies? What are biopsies? A biopsy is the removal of tissue in order to examine it for disease. The ... lung parenchyma during renal biopsy top of page What are the limitations of ... some cases, the amount of tissue obtained from a needle biopsy may not be ...

  2. Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Overlap Syndrome in Patients With Biopsy-Proven Glomerulonephritis (United States)

    Jarrot, Pierre-Andre; Chiche, Laurent; Hervier, Baptiste; Daniel, Laurent; Vuiblet, Vincent; Bardin, Nathalie; Bertin, Daniel; Terrier, Benjamin; Amoura, Zahir; Andrés, Emmanuel; Rondeau, Eric; Hamidou, Mohamed; Pennaforte, Jean-Loup; Halfon, Philippe; Daugas, Eric; Dussol, Bertrand; Puéchal, Xavier; Kaplanski, Gilles; Jourde-Chiche, Noemie


    Abstract The aim of the study was to report the clinical, biological, and pathological characteristics of patients with glomerulonephritis (GN) secondary to systemic lupus erythematosus (SLE)/antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) overlap syndrome. A nationwide survey was conducted to identify cases of SLE/AAV overlap syndrome. Data were collected from SLE and AAV French research groups. Inclusion criteria were diagnosis of both SLE and AAV according to international classification criteria and biopsy-proven GN between 1995 and 2014. Additional cases were identified through a systematic literature review. A cohort of consecutive biopsy-proven GN was used to study the prevalence of overlapping antibodies and/or overlap syndrome. The national survey identified 8 cases of SLE/AAV overlap syndrome. All patients were female; median age was 40 years. AAV occurred before SLE (n = 3), after (n = 3), or concomitantly (n = 2). Six patients had rapidly progressive GN and 3/8 had alveolar hemorrhage. All patients had antinuclear antibodies (ANA); 7/8 had p-ANCA antimyeloperoxidase (MPO) antibodies. Renal biopsies showed lupus nephritis (LN) or pauci-immune GN. Remission was obtained in 4/8 patients. A literature review identified 31 additional cases with a similarly severe presentation. In the GN cohort, ANCA positivity was found in 30% of LN, ANA positivity in 52% of pauci-immune GN, with no correlation with pathological findings. The estimated prevalence for SLE/AAV overlap syndrome was 2/101 (2%). In patients with GN, SLE/AAV overlap syndrome may occur but with a low prevalence. Most patients have an aggressive renal presentation, with usually both ANA and anti-MPO antibodies. Further studies are needed to assess shared pathogenesis and therapeutic options. PMID:27258503

  3. Increased circulating zonulin in children with biopsy-proven nonalcoholic fatty liver disease. (United States)

    Pacifico, Lucia; Bonci, Enea; Marandola, Lidia; Romaggioli, Sara; Bascetta, Stefano; Chiesa, Claudio


    To investigate the potential association of circulating zonulin with the stage of liver disease in obese children with biopsy-confirmed nonalcoholic fatty liver disease (NAFLD). A case-control study was performed. Cases were 40 obese children with NAFLD. The diagnosis of NAFLD was based on magnetic resonance imaging (MRI) with high hepatic fat fraction (HFF ≥ 5%), and confirmed by liver biopsy with ≥ 5% of hepatocytes containing macrovesicular fat. Controls were selected from obese children with normal levels of aminotransferases, and without MRI evidence of fatty liver as well as of other causes of chronic liver diseases. Controls were matched (1-to 1) with the cases on age, gender, pubertal stage and as closely as possible on body mass index- standard deviation score. All participants underwent clinical examination, laboratory tests including zonulin, inflammatory and metabolic parameters, and MRI for measurement of HFF and visceral adipose tissue. Zonulin values were significantly greater in obese subjects with NAFLD than in those without NAFLD [median (interquartile range), 4.23 (3.18-5.89) vs 3.31 (2.05-4.63), P zonulin concentrations increased significantly with the severity of steatosis and the Spearman's coefficient revealed a positive correlation between zonulin values and steatosis (r = 0.372, P zonulin and lobular inflammation (P = 0.23), ballooning (P = 0.10), fibrosis score (P = 0.18), or presence of nonalcoholic steatohepatitis (P = 0.17). Within the entire study population, zonulin levels were positively associated with gamma-glutamyl transferase, 2-h insulin, HFF, and negatively associated with whole-body insulin sensitivity index (WBISI), after adjustment for age, gender and pubertal status. When the associations were restricted to the group of NAFLD patients, 2-h insulin, hepatic fat, and WBISI retained statistical significance. Circulating zonulin is increased in children and adolescents with NAFLD and correlates with the severity of

  4. Specimen Provenance Testing Identifies Contamination That Affects Molecular Prognostic Assay Results in Prostate Cancer Biopsy Specimens. (United States)

    Wojno, Lathem; Minutella, Caitlyn; Moylan, Donald; Bush, Arla; Wojno, Kirk


    To determine if tissue contamination in histologic specimens can significantly affect the results of prognostic molecular markers that are routinely used as confirmatory tests to safely assign appropriate candidates to prostate cancer active surveillance protocols. This study evaluates 2,134 cases from a single, large urology practice that were successfully tested for DNA specimen provenance verification using short tandem repeat analysis for the presence of a significant level of contaminating DNA. After removal of the contamination, five of the samples were retested, and the results of the molecular diagnostic test were compared. 49 of the 2,134 cases (2.3%) sent for DNA provenance analysis were found to possess significant levels of contamination. Of these 49 cases, seven of them were resent for a repeat molecular diagnostic test after being decontaminated. Five of these prostate cancer specimens had sufficient tissue and RNA to give a more accurate cell cycle progression (CCP) score. The average absolute change in these patient's CCP scores was 0.48, with a low of a 0.1-unit and a high of a 1.0-unit difference. These changes in CCP scores are significant enough to cause meaningful alterations in a patient's calculated 10-year mortality rate, as defined by their combined risk score (CRS). DNA contamination in unstained tissue sections sent for prognostic prostate cancer molecular diagnostic testing occurs on 2.3% of cases, and can be of a magnitude that affects the results and subsequent clinical decision of appropriateness for active surveillance. Copyright © 2018. Published by Elsevier Inc.

  5. Immunological aspects of biopsy-proven lupus nephritis in Bahraini patients with systemic lupus erythematosus

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    Eman M Farid


    Full Text Available Lupus nephritis (LN is a frequent and potentially serious complication of systemic lupus erythematosus (SLE that may influence morbidity and mortality. Immunological investigations are aiding tools to the kidney biopsy findings in early diagnosis, in addition to monitoring the effect of therapy. The aim of the present study is to highlight the role of these investigations in a group of Bahraini patients and to determine whether there is any positive association between these findings and the outcome of LN. The current study is a retrospective case-control study of randomly selected 88 SLE patients, 44 with biopsyproven LN and 44 without, acting as controls. All renal biopsies performed during the period from 1996 to 2012 were classified according to the World Health Organization classification. Immunological investigations analyzed are: Antinuclear antibodies (ANA, anti-ds DNA, anti-ENA, anti-cardiolipin antibodies (abs and complement components C3, C4. Human leukocyte antigen (HLA typing class II was performed on selected cases. All patients had positive ANA (100%. A significantly high frequency of anti-Smith abs among the non-LN group (43.18% compared with the LN group (18.18% was found (P <0.001. On the other hand, the anti-Ro/SSA abs in the non-LN group was also found at a statistically higher frequency (20.45% compared with that in the LN group (4.54% (P <0.01. Anti-ds-DNA abs were found to be higher in the LN group (84.09% compared with the non-LN group (70.45%, but the difference was not statistically significant (P = 0.082. There was a positive association of ANA positivity and low C3 and or C4 in the studied group. In our study, 88.2% of the HLA typed patients had HLADR2, DR3 or both. In conclusion, in our Arabic Bahraini SLE patients, the presence of anti-Smith, anti-Ro/SSA and anti-RNP antibodies and the absence of anti-dsDNA antibodies are independent predictive markers for renal involvement. However, more prospective studies with a

  6. Comparison of the diagnostic value of different lymphocyte subpopulations in bronchoalveolar lavage fluid in patients with biopsy proven sarcoidosis. (United States)

    Tanrıverdi, Hakan; Uygur, Fırat; Örnek, Tacettin; Erboy, Fatma; Altınsoy, Bülent; Atalay, Figen; Büyükuysal, Mustafa Çağatay; Tekin, İshak Özel; Araslı, Mehmet; Tor, Müge Meltem


    Bronchoalveolar lavage is considered a helpful tool in the diagnosis of diffuse parenchimal lung diseases such as sarcoidosis. CD4/CD8 ratio is higly specific but not sensitive to distinguish sarcoidosis and other intestitial lung diseases. We aimed to compare the diagnostic value of CD4/CD8 ratio and other lmphocyte subpopulations such as CD3+16+56, CD103+, CD4+CD103+, CD8+CD103+ in bronchoalveolar lavage to distinguish sarcoidosis and other nonsarcoidosis interstitial lung diseases. Using the bronchoscopy records from 2006 to 2013, we evaluated 68 patients with biopsy proven sarcoidosis and 72 patients with clinicoradiological and/or biopsy proven diffuse parenchimal lung diseases. Cut off values, sensitivity and specificity were given for aforementioned parameters. Bronchoalveolar lavage CD4/CD8 ratio, CD4+ T lymphocyte percentage, CD4+103+, CD3+CD103-, CD8+CD103+/CD103+ ratio were significantly higher in sarcoidosis than other diffuse parenchimal lung diseases whereas CD3+103+, CD3+16+56+, CD8+, CD8+CD103+, CD8+CD103+/CD8+ were significantly lower. Best cut off value of CD4/CD8 was 1.34 with sensitivity and specificity 76.4%, 79.4% respectively. The cut off values of CD4/CD8 of >3.5 and >2.5 had specificity 95.9% and 95.3%, respectively and sensitivity 52%, 41%, respectively. CD4/CD8 ratio is highly specific but not sensitive for sarcoidosis diagnosis. Thus, BAL flow cytometry is not diagnostic alone without appropriate clinicoradiological and/or histopathological findings.

  7. Biopsy-proven case of Epstein-Barr virus (EBV)-associated vasculitis of the central nervous system. (United States)

    Kano, Kohei; Katayama, Takayuki; Takeguchi, Shiori; Asanome, Asuka; Takahashi, Kae; Saito, Tsukasa; Sawada, Jun; Saito, Masato; Anei, Ryogo; Kamada, Kyousuke; Miyokawa, Naoyuki; Nishihara, Hiroshi; Hasebe, Naoyuki


    A 75-year-old woman was admitted to our hospital with rapidly deteriorating consciousness disturbance. She had a 7-year history of rheumatoid arthritis (RA), which had been treated with methotrexate (MTX) and prednisolone. Brain T2-weighted MRI showed diffuse high-intensity lesions in the cerebral subcortical and deep white matter, bilateral basal ganglia and thalamus. A cerebrospinal fluid examination revealed elevated protein levels and positive Epstein-Barr virus (EBV) DNA. Human immunodeficiency virus was negative. Brain biopsy showed perivascular lymphocytic infiltration in the parenchyma and meninx with EBV-encoded small RNA (EBER). Since this case did not fulfill the criteria for chronic active EBV infection (CAEBV), she was diagnosed with Epstein-Barr virus (EBV)-associated vasculitis of the central nervous system. High-dose methylprednisolone, acyclovir, ganciclovir and foscarnet were not effective. Although EBV is a causative agent of infectious mononucleosis (IM), lymphomas and nasopharyngeal carcinomas, vasculitic pathology of the central nervous system with EBV reactivation in the elderly is rare. Immunosuppressive drugs such as steroids and MTX are widely used to treat autoimmune disorders, but may exacerbate the reactivation of EBV. This is the first case of biopsy-proven EBV-positive/HIV-negative vasculitis during the treatment of RA with MTX and steroids. This case indicates that EBV-associated vasculitis needs to be considered as a differential diagnosis of CNS vasculitis. © 2016 Japanese Society of Neuropathology.

  8. Outcomes of rationing dialysis therapy in biopsy-proven end-stage renal disease in South Africa. (United States)

    Okpechi, Ikechi G; Swanepoel, Charles R; Rayner, Brian L


    Due to poverty, many countries of sub-Saharan Africa suffer a severe burden of end-stage renal disease (ESRD), the cause of which is often unidentified. We sought to identify biopsy-proven causes of ESRD in Cape Town, South Africa, and to determine the outcome of these patients. Records of biopsies reported as ESRD over a 10-year period were selected for analysis. The demographic, clinical and biochemical characteristics of the patients at the time of biopsy were documented. The decision of the committee that assesses the eligibility of patients for long-term renal replacement therapy (RRT) was documented, and if a patient was not accepted the reasons for the rejection were noted. Chronic glomerulonephritis (CGN) was the most frequent cause of ESRD (31.2%); human immunodeficiency virus-associated nephropathy (HIVAN) accounted for 12.5% of ESRD cases. Sixty-six patients (45.8%) were never reviewed by the assessment committee for placement in the dialysis program. Of the remaining 78 patients (54.2%) reviewed for RRT, only 48/78 (61.5%) were selected. A higher frequency of patients with HIVAN were not accepted for RRT (17.7%) than patients with HIVAN who were accepted (2.1%) (p=0.008). Social factors such as lack of housing, alcohol abuse, illicit drug abuse, lack of transportation and lack of family/social support accounted for 56.7% of patients not being accepted for RRT. There needs to be a development of programs amongst Africans to provide effective solutions that tackle the burden of ESRD, especially related to the increasing prevalence of HIVAN.

  9. Therapy of Acute Intestinal Infections in Children: Proven Efficiency

    Directory of Open Access Journals (Sweden)

    S. V. Khaliullina


    Full Text Available The paper focuses on questions of etiotropic, pathogenetic, and symptomatic treatment of acute infectious diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed such as the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.

  10. Biopsy (United States)

    ... to examine tissue for disease. Normal Results The tissue removed is normal. What Abnormal Results Mean An abnormal biopsy means that the tissue or cells have an unusual structure, shape, size, ...

  11. Patients with computed tomography-proven acute diverticulitis require follow-up to exclude colorectal cancer

    Directory of Open Access Journals (Sweden)

    Shafquat Zaman


    Full Text Available Background/Aims: Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer (CRC. However, its usefulness has been debated in this era of high-resolution computed tomography (CT diagnosis. We assessed the frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to the confidence in the CT diagnosis.Methods: Records of patients with CT-proven acute diverticulitis between October 2007 and March 2014 at Sandwell & West Birmingham Hospitals NHS Trust were retrieved. The National Cancer Registry confirmed the cases of CRC. Endoscopy quality indicators were compared between these patients and other patients undergoing the same endoscopic examination over the same period.Results: We identified 235 patients with CT-proven acute diverticulitis, of which, 187 were managed conservatively. The CT report was confident of the diagnosis of acute diverticulitis in 75% cases. Five of the 235 patients were subsequently diagnosed with CRC (2.1%. Three cases of CRC were detected in the 187 patients managed conservatively (1.6%. Forty-eight percent of the conservatively managed patients underwent follow-up endoscopy; one case of CRC was identified. Endoscopies were often incomplete and caused more discomfort for patients with diverticulitis compared with controls.Conclusions: CRC was diagnosed in patients with CT-proven diverticulitis at a higher rate than in screened asymptomatic populations, necessitating follow-up. CT reports contained statements regarding diagnostic uncertainty in 25% cases, associated with an increased risk of CRC. Follow-up endoscopy in patients with CT-proven diverticulitis is associated with increased discomfort and high rates of incompletion. The use of other follow-up modalities should be considered.

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


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


    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...

  13. Risk factors for acute prostatitis after transrectal biopsy of the prostate. (United States)

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


    To investigate the incidence, clinical features, pathogenic bacteria, and risk factors associated with acute prostatitis after transrectal prostate biopsy. 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 rectal examination, or both. All biopsies were performed with the patient hospitalized except for 10 patients who refused to be hospitalized, and ciprofloxacin was administered as an antibiotic prophylaxis. The incidence, clinical features, pathogenic bacteria, and potential risk factors associated with acute prostatitis after prostate biopsy were evaluated. Acute prostatitis developed in 18 (2.0%) cases after prostate biopsy. Among them, 9 (1.0%) had bacteremia and 2 (0.2%) showed clinical features of sepsis. Of the total 50 urine or blood specimens sent for culture study, 27 (54.0%) specimens showed positive cultures, including E. coli in 25. Among the 27 culture-positive specimens, 26 (96.3%) were resistant to ciprofloxacin. Among the potential risk factors for acute prostatitis after prostate biopsy, biopsy performed as an outpatient procedure without a cleansing enema (p=0.001) and past history of cerebrovascular accident (p=0.048) were statistically significant. Fluoroquinolone is effective as an antibiotic prophylaxis for transrectal prostate biopsy in most cases. The incidence of acute prostatitis after transrectal prostate biopsy was 2.0%, and almost all cases were caused by fluoroquinolone-resistant E. coli. A cleansing enema is recommended before transrectal prostate biopsy.

  14. Antiendomysial and antihuman recombinant tissue transglutaminase antibodies in the diagnosis of coeliac disease: a biopsy-proven European multicentre study. (United States)

    Collin, Pekka; Kaukinen, Katri; Vogelsang, Harald; Korponay-Szabó, Ilma; Sommer, Rudolf; Schreier, Elisabeth; Volta, Umberto; Granito, Alessandro; Veronesi, Lorenza; Mascart, Françoise; Ocmant, Annick; Ivarsson, Anneli; Lagerqvist, Carina; Bürgin-Wolff, Annemarie; Hadziselimovic, Faruk; Furlano, Raoul I; Sidler, Marc A; Mulder, Chris J J; Goerres, Marije S; Mearin, M Luisa; Ninaber, Maarten K; Gudmand-Høyer, Eivind; Fabiani, Elisabetta; Catassi, Carlo; Tidlund, Helena; Alainentalo, Lisbeth; Mäki, Markku


    To investigate the value of serum antitissue transglutaminase IgA antibodies (IgA-TTG) and IgA antiendomysial antibodies (IgA-EMA) in the diagnosis of coeliac disease in cohorts from different geographical areas in Europe. The setting allowed a further comparison between the antibody results and the conventional small-intestinal histology. A total of 144 cases with coeliac disease [median age 19.5 years (range 0.9-81.4)], and 127 disease controls [median age 29.2 years (range 0.5-79.0)], were recruited, on the basis of biopsy, from 13 centres in nine countries. All biopsy specimens were re-evaluated and classified blindly a second time by two investigators. IgA-TTG were determined by ELISA with human recombinant antigen and IgA-EMA by an immunofluorescence test with human umbilical cord as antigen. The quality of the biopsy specimens was not acceptable in 29 (10.7%) of 271 cases and a reliable judgement could not be made, mainly due to poor orientation of the samples. The primary clinical diagnosis and the second classification of the biopsy specimens were divergent in nine cases, and one patient was initially enrolled in the wrong group. Thus, 126 coeliac patients and 106 controls, verified by biopsy, remained for final analysis. The sensitivity of IgA-TTG was 94% and IgA-EMA 89%, the specificity was 99% and 98%, respectively. Serum IgA-TTG measurement is effective and at least as good as IgA-EMA in the identification of coeliac disease. Due to a high percentage of poor histological specimens, the diagnosis of coeliac disease should not depend only on biopsy, but in addition the clinical picture and serology should be considered.

  15. Serum pigment epithelium-derived factor levels are increased in patients with biopsy-proven nonalcoholic fatty liver disease and independently associated with liver steatosis. (United States)

    Yilmaz, Yusuf; Eren, Fatih; Ayyildiz, Talat; Colak, Yasar; Kurt, Ramazan; Senates, Ebubekir; Tuncer, Ilyas; Dolar, Enver; Imeryuz, Nese


    Increased serum concentrations of pigment epithelium-derived factor (PEDF) have been linked to the metabolic syndrome in the general population. However, the relationship between serum PEDF and nonalcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, remains unknown. We assayed serum PEDF levels in 156 patients with biopsy-proven NAFLD and 103 nonsteatotic control subjects who were matched for age and sex. The association between levels of PEDF and clinical, biochemical, and histological phenotypes was examined. NAFLD patients had significantly higher serum PEDF levels (1.97±0.50 μg/mL) than control subjects (1.51±0.49 μg/mL, Student's t test, P<0.001). Multivariable-adjusted stepwise regression analysis showed that PEDF ([beta]=0.32, t=3.13, P=0.002) and triglycerides ([beta]=0.22, t=2.23, P=0.02) were, in the order they entered into the model, the main independent predictors of steatosis scores in our patients with NAFLD. Serum PEDF levels are significantly increased in patients with biopsy-proven NAFLD and are associated with liver steatosis independently of traditional risk factors. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Biopsy-proven case of childhood primary angiitis of the central nervous system presenting with bilateral panuveitis and anisocoria

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    Saettele, Megan R. [University of Missouri-Kansas City School of Medicine, Department of Radiology, Kansas City, MO (United States); St. Luke' s Hospital, Department of Radiology, Kansas City, MO (United States); Loskutov, Anatoly; Sigley, Matthew J. [University of Missouri-Kansas City School of Medicine, Department of Radiology, Kansas City, MO (United States); Lowe, Lisa H. [St. Luke' s Hospital, Department of Radiology, Kansas City, MO (United States); University of Missouri-Kansas City School of Medicine, Department of Radiology, Kansas City, MO (United States); Children' s Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO (United States); Nielsen, David B. [University of Missouri-Kansas City School of Medicine, Department of Radiology, Kansas City, MO (United States); Children' s Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO (United States)


    Childhood primary angiitis of the central nervous system (cPACNS) is a rare and poorly understood immune-mediated vasculitis that preferentially affects blood vessels of the central nervous system (CNS). It must be distinguished from other disorders to initiate prompt treatment and improve the patient's prognosis. The presentation of cPACNS is highly variable, making a clinical diagnosis challenging. However, MRI may be helpful in showing typical findings including perivascular space inflammation and enhancement. Identification of these imaging features allows the radiologist to specifically suggest this rare diagnosis. The purpose of this manuscript is to present a biopsy-confirmed case of cPACNS in a 9-year-old girl who presented uniquely with panuveitis and anisocoria, and emphasize the MRI features that should prompt the radiologist to suggest this rare diagnosis. (orig.)

  17. Biopsy-proven case of childhood primary angiitis of the central nervous system presenting with bilateral panuveitis and anisocoria

    International Nuclear Information System (INIS)

    Saettele, Megan R.; Loskutov, Anatoly; Sigley, Matthew J.; Lowe, Lisa H.; Nielsen, David B.


    Childhood primary angiitis of the central nervous system (cPACNS) is a rare and poorly understood immune-mediated vasculitis that preferentially affects blood vessels of the central nervous system (CNS). It must be distinguished from other disorders to initiate prompt treatment and improve the patient's prognosis. The presentation of cPACNS is highly variable, making a clinical diagnosis challenging. However, MRI may be helpful in showing typical findings including perivascular space inflammation and enhancement. Identification of these imaging features allows the radiologist to specifically suggest this rare diagnosis. The purpose of this manuscript is to present a biopsy-confirmed case of cPACNS in a 9-year-old girl who presented uniquely with panuveitis and anisocoria, and emphasize the MRI features that should prompt the radiologist to suggest this rare diagnosis. (orig.)

  18. Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome. (United States)

    Qureshi, K; Abrams, G A


    Obesity is a major risk factor for non-alcoholic fatty liver disease (NAFLD). NAFLD encompasses simple fatty liver (FL) and non-alcoholic steatohepatitis (NASH) in its spectrum. NASH can progress to liver cirrhosis and is associated with liver cancer. Not all obese subjects have insulin resistance (IR) or develop metabolic syndrome (MS). This study evaluates the prevalence of NAFLD in severely obese subjects without MS. We retrospectively reviewed 445 charts from our database of severely obese subjects with clinical suspicion of NAFLD and who were selected for laparoscopic Roux-en-Y gastric bypass surgery. One hundred five subjects who did not have MS, as defined by the International Diabetes Foundation, based on comprehensive pre-operative metabolic evaluation were included. Liver biopsy specimens were evaluated for NAFLD. 24% of morbidly obese (mean body mass index [BMI] 48 kg m(-2) ) adult subjects (mean age 38 years) who underwent bariatric surgery did not have MS. NAFLD was identified in 77 (73%) on liver biopsy, out of which 59 (56%) were labelled as FL and 18 (17%) had histological diagnosis of NASH. Age, gender, race and BMI were the same among all groups. Among NAFLD subjects, 22% did not have any additional metabolic component of MS, while 36% had low high-density lipoprotein, 27% had hypertension, 8% had high triglycerides and 6% had hyperglycaemia. IR calculated by HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) and diagnosis of hyperglycaemia was statistically higher in NASH group compared to those who did not have NASH. NAFLD is highly prevalent in morbidly obese individuals who undergo bariatric surgery despite the absence of MS. Diagnosis of hyperglycaemia in such subjects suggests the presence of IR and may have underlying NASH, which is a progressive form of NAFLD. © 2016 World Obesity.

  19. The CNDP1 (CTG5 Polymorphism Is Associated with Biopsy-Proven Diabetic Nephropathy, Time on Hemodialysis, and Diabetes Duration

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    Thomas Albrecht


    Full Text Available Considering that the homozygous CNDP1 (CTG5 genotype affords protection against diabetic nephropathy (DN in female patients with type 2 diabetes, this study assessed if this association remains gender-specific when applying clinical inclusion criteria (CIC-DN or biopsy proof (BP-DN. Additionally, it assessed if the prevalence of the protective genotype changes with diabetes duration and time on hemodialysis and if this occurs in association with serum carnosinase (CN-1 activity. Whereas the distribution of the (CTG5 homozygous genotype in the no-DN and CIC-DN patients was comparable, a lower frequency was found in the BP-DN patients, particularly in females. We observed a significant trend towards high frequencies of the (CTG5 homozygous genotype with increased time on dialysis. This was also observed for diabetes duration but only reached significance when both (CTG5 homo- and heterozygous patients were included. CN-1 activity negatively correlated with time on hemodialysis and was lower in (CTG5 homozygous patients. The latter remained significant in female subjects after gender stratification. We confirm the association between the CNDP1 genotype and DN to be likely gender-specific. Although our data also suggest that (CTG5 homozygous patients may have a survival advantage on dialysis and in diabetes, this hypothesis needs to be confirmed in a prospective cohort study.

  20. Myocarditis mimicking acute myocardial infarction: role of endomyocardial biopsy in the differential diagnosis


    Angelini, A; Calzolari, V; Calabrese, F; Boffa, G; Maddalena, F; Chioin, R; Thiene, G


    OBJECTIVE—To test the hypothesis, using endomyocardial biopsies, that unexplained cases of apparent acute myocardial infarction were caused by myocarditis.
MATERIAL—Between 1992 and 1998, 12 patients were admitted to the coronary care unit with severe chest pain, ST segment elevation, increased serum creatine kinase and MB isoenzyme, and with wall motion abnormalities on echocardiogram highly suggestive of acute myocardial infarction. These patients were further investigated by endomyocardial...

  1. Multiparametric 3T MRI for the prediction of pathological downgrading after radical prostatectomy in patients with biopsy-proven Gleason score 3 + 4 prostate cancer

    International Nuclear Information System (INIS)

    Gondo, Tatsuo; Hricak, Hedvig; Sala, Evis; Vargas, Hebert Alberto; Zheng, Junting; Moskowitz, Chaya S.; Bernstein, Melanie; Eastham, James A.


    The aim of this study was to assess the diagnostic performance of pre-treatment 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) for predicting Gleason score (GS) downgrading after radical prostatectomy (RP) in patients with GS 3 + 4 prostate cancer (PCa) on biopsy. We retrospectively reviewed 304 patients with biopsy-proven GS 3 + 4 PCa who underwent mpMRI before RP. On T2-weighted imaging and three mpMRI combinations (T2-weighted imaging + diffusion-weighted imaging [DWI], T2-weighted imaging + dynamic contrast-enhanced-MRI [DCE-MRI], and T2-weighted imaging + DWI + DCE-MRI), two radiologists (R1/R2) scored the presence of a dominant tumour using a 5-point Likert scale (1 = definitely absent to 5 = definitely present). Diagnostic performance in identifying downgrading was evaluated via areas under the curves (AUCs). Predictive accuracies of multivariate models were calculated. In predicting downgrading, T2-weighted imaging + DWI (AUC = 0.89/0.85 for R1/R2) performed significantly better than T2-weighted imaging alone (AUC = 0.72/0.73; p 0.99 for R1/R2). On multivariate analysis, the clinical + mpMRI model incorporating T2-weighted imaging + DWI (AUC = 0.92/0.88 for R1/R2) predicted downgrading significantly better than the clinical model (AUC = 0.73; p < 0.001 for R1/R2). mpMRI improves the ability to identify a subgroup of patients with Gleason 3 + 4 PCa on biopsy who are candidates for active surveillance. DCE-MRI (compared to T2 + DWI) offered no additional benefit to the prediction of downgrading. (orig.)

  2. A neural network approach to the biopsy diagnosis of early acute renal transplant rejection. (United States)

    Furness, P N; Levesley, J; Luo, Z; Taub, N; Kazi, J I; Bates, W D; Nicholson, M L


    To develop and test a neural network to assist in the histological diagnosis of early acute renal allograft rejection. We used three sets of biopsies to train and test the network: 100 'routine' biopsies from Leicester; 21 selected difficult biopsies which had already been evaluated by most of the renal transplant pathologists in the UK, in a study of the Banff classification of allograft pathology and 25 cases which had been classified as 'borderline' according to the Banff classification in a review of transplant biopsies from Oxford. The correct diagnosis for each biopsy was defined by careful retrospective clinical review. Biopsies where this review did not provide a clear diagnosis were excluded. Each biopsy was graded for 12 histological features and the data was entered into a simple single layer perception network, designed using the MATLAB neural network toolbox. Results were compared with logistic regression using the same data, and with 'conventional' histological diagnosis. If the network was trained only with the 100 'routine' cases, its performance with either of the other sets was poor. However, if either of the 'difficult' sets was added to the training group, testing with the other 'difficult' group improved dramatically; 19 of the 21 'Banff' study cases were diagnosed correctly. This was achieved using observations made by a trainee pathologist. The result is better than was achieved by any of the many experienced pathologists who had previously seen these biopsies (maximum 18/21 correct), and is considerably better than that achieved by using logistic regression with the same data. A neural network can provide a considerable improvement in the diagnosis of early acute allograft rejection, though further development work will be needed before this becomes a routine diagnostic tool. The selection of cases used to train the network is crucial to the quality of its performance. There is scope to improve the system further by incorporating clinical

  3. Outcome of therapy in biopsy proven lupus nephritis with cyclophosphamide or mycophenolate: Registry data from a South Indian tertiary care center

    Directory of Open Access Journals (Sweden)

    Keerthi Talari


    Results: Eighty-three patients (75 females with the mean age of 25 ± 8.9 years were included. The median duration of follow-up was 18 months (range: 6–153. Forty-one patients had Class IV, 19 Class III, 11 Class V, 7 Class III/IV + V, and 5 Class II LN. Forty received high-dose cyclophosphamide (HD CyC, 14 Euro-Lupus Nephritis Trial cyclophosphamide (ELNT CyC, 20 mycophenolate mofetil (MMF for induction, while two received azathioprine, one cyclosporine, one modified ponticelli, and five with Class II nephritis received no induction. Baseline characteristics were comparable between three groups. The response rate was similar between the three groups: 30/40 in the HD CyC group, 12/14 in the ELNT CyC group, and 15/20 in the MMF group responded at the end of induction (P = 0.69. Complete response rate was higher in the individuals who received cyclophosphamide (HD CyC + ELNT CyC as compared to MMF (17/34 vs. 2/13, P = 0.05. Univariate analysis of factors predicting response revealed only class of nephritis as a significant factor predicting response (complete or partial at the end of induction therapy. Conclusion: In this South Indian lupus registry a complete response at 6 months in biopsy-proven LN was better with cyclophosphamide than mycophenolate.

  4. Association of recently described adipokines with liver histology in biopsy-proven non-alcoholic fatty liver disease: a systematic review. (United States)

    Bekaert, M; Verhelst, X; Geerts, A; Lapauw, B; Calders, P


    The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising, as is the prevalence of obesity and type 2 diabetes. It is increasingly recognized that an impaired pattern in adipokine secretion could play a pivotal role in the development of NAFLD. We performed a systematic review to evaluate the potential link between newly described adipokines and liver histology in biopsy-proven NAFLD patients. A computerized literature search was performed in PubMed, EMBASE and Web of Science electronic databases. Thirty-one cross-sectional studies were included, resulting in a total of seven different investigated adipokines. Studies included in this review mainly had a good methodological quality. Most adipokines were suggested to be involved in the inflammatory response that develops within the context of NAFLD, either at hepatic or systemic level, and/or hepatic insulin resistance. Based on literature, clinical studies suggest that chemerin, resistin and adipocyte-fatty-acid-binding protein potentially are involved in NAFLD pathogenesis and/or progression. However, major inconsistency still exists, and there is a high need for larger studies, together with the need of standardized assays to determine adipokine levels. © 2015 World Obesity.

  5. Aortography delays surgery of CT proven acute traumatic rupture of the thoracic aorta; Case report

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, A.; Moreno, R.; Martin, V.; Iniguez, A.; Alvarez, J. (Hospital Universitario de San Carlos, Madrid (Spain). Dept. de Radiodiagnostico, Servicio de Cirurgia Vascular, Servicio de Exploracion Cardiopulmonar, and Unidad de Cuidados Intensivos)


    A case of acute traumatic rupture of the thoracic aorta was diagnosed by dynamic CT. Angiographic confirmation was required, delaying surgical repair and contribution to the fatal outcome. If reliable findings of acute traumatic rupture of the thoracic aorta are shown by CT, we question the usefulness of angiographic confirmation in such cases. (orig.).

  6. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer. (United States)

    Woo, Sungmin; Kim, Sang Youn; Lee, Joongyub; Kim, Seung Hyup; Cho, Jeong Yeon


    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. • PI-RADSv2 was an independent predictor of downgrading in biopsy-proven GS 7(3+4) PC • PSA density was also an independent predictor of downgrading • MRI may assist in identifying AS candidates in biopsy-proven GS 7(3+4) PC patients.

  7. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sungmin; Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Joongyub [Seoul National University College of Medicine, Seoul National University Hospital, Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul (Korea, Republic of); Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)


    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. (orig.)


    Directory of Open Access Journals (Sweden)

    N. F. Puchinyan


    Full Text Available Aim. To evaluate risk of repeated atherothrombotic events in patients survived acute coronary syndrome (ACS and having poorly reduced platelet aggregation (proven by optical aggregometry in response to acetylsalicylic acid (ASA therapy.Material and methods. 200 patients with ACS (aged 56,6±9,2 y.o. were included in the study. Platelet functional activity during ASA therapy was evaluated with laser aggregometer. ASA resistance was defined if the summarizing index of platelet aggregation (induced with ADP, 5 mμml/l was 50% or higher during ASA therapy. Observation period was 18±6 months. Atherothrombotic events (unstable angina, myocardial infarction, stroke, cardiovascular death were considered.Results. Lack ASA response rate was about 12%. Totally 22 repeated atherothrombotic events were registered: 5,6% among ASA sensitive patients and 50% - among ASA resistant patients. Repeated atherothrombotic events were registered in ASA resistance patients during first 14 days. ASA sensitive patients showed repeated atherothrombotic events in some months after ACS. The relative risk of cardiovascular event in ASA resistance patients was 8,92 (CI 95% 4,39; 17,84 р=0,05.Conclusion. The high level of the induced platelet aggregation (proven by laser aggregometry points to high risk of repeated atherothrombotic events in patients with ACS.

  9. Prostate-Specific Antigen Mass and Free Prostate-Specific Antigen Mass for Predicting the Prostate Volume of Korean Men With Biopsy-Proven Benign Prostatic Hyperplasia


    Park, Tae Yong; Chae, Ji Yun; Kim, Jong Wook; Kim, Jin Wook; Oh, Mi Mi; Yoon, Cheol Yong; Moon, Du Geon


    Purpose It has been reported that prostate-specific antigen (PSA) correlates with prostate volume. Recently, some studies have reported that PSA mass (PSA adjusted for plasma volume) is more accurate than PSA at predicting prostate volume. In this study, we analyzed the accuracy of PSA and the related parameters of PSA mass, free PSA (fPSA), and fPSA mass in predicting prostate volume. Materials and Methods We retrospectively investigated 658 patients who underwent prostate biopsy from 2006 t...

  10. Evaluation of suspected local recurrence in head and neck cancer: A comparison between PET and PET/CT for biopsy proven lesions

    International Nuclear Information System (INIS)

    Halpern, Benjamin S.; Yeom, Kristen; Fueger, Barbara J.; Lufkin, Robert B.; Czernin, Johannes; Allen-Auerbach, Martin


    Background: 18 F-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT. Materials and methods: Forty-nine patients with a mean age of 59 ± 18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n = 27) or direct endoscopic biopsy (n = 16) or ultrasound guided biopsy (n = 6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images. Results: Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61%) were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p = 0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p = NS) and 95% (p = NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p = NS), 78% (p = NS) and 86% (p = 0.06) for PET/CT. Conclusion: The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p = 0.06)

  11. Biopsy-Proven Diffuse Mediastinal Prostate Cancer Metastases Negative on 18F-Fluorocholine, Diagnosed on 68Ga-PSMA and 18F-PSMA PET/CT. (United States)

    Chaussé, Guillaume; Niazi, Tamim; Abikhzer, Gad Solomon; Probst, Stephan Michael


    A 72-year-old man with prostate cancer (stage T3b, Gleason score 7) treated by radical prostatectomy was found to have biochemical failure (prostate-specific antigen 8.5 ng/mL) and a suspicious growing nodularity at the left prostate bed on MRI. F-fluorocholine PET/CT failed to demonstrate any site of uptake suggestive of malignancy. A bone scan did exclude bone metastases. Ga-PSMA PET/CT revealed various positive lymph nodes in the supraclavicular, mediastinal, and hilar regions. This was confirmed on F-DCFPyl PET/CT, with the addition of a suspicious right axillary lymph node. Mediastinal biopsy confirmed metastatic prostate cancer.

  12. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. (United States)

    Daniels, L; Ünlü, Ç; de Korte, N; van Dieren, S; Stockmann, H B; Vrouenraets, B C; Consten, E C; van der Hoeven, J A; Eijsbouts, Q A; Faneyte, I F; Bemelman, W A; Dijkgraaf, M G; Boermeester, M A


    Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. Patients with CT-proven, primary, left-sided, uncomplicated, acute diverticulitis were included at 22 clinical sites in the Netherlands, and assigned randomly to an observational or antibiotic treatment strategy. The primary endpoint was time to recovery during 6 months of follow-up. Main secondary endpoints were readmission rate, complicated, ongoing and recurrent diverticulitis, sigmoid resection and mortality. Intention-to-treat and per-protocol analyses were done. A total of 528 patients were included. Median time to recovery was 14 (i.q.r. 6-35) days for the observational and 12 (7-30) days for the antibiotic treatment strategy, with a hazard ratio for recovery of 0·91 (lower limit of 1-sided 95 per cent c.i. 0·78; P = 0·151). No significant differences between the observation and antibiotic treatment groups were found for secondary endpoints: complicated diverticulitis (3·8 versus 2·6 per cent respectively; P = 0·377), ongoing diverticulitis (7·3 versus 4·1 per cent; P = 0·183), recurrent diverticulitis (3·4 versus 3·0 per cent; P = 0·494), sigmoid resection (3·8 versus 2·3 per cent; P = 0·323), readmission (17·6 versus 12·0 per cent; P = 0·148), adverse events (48·5 versus 54·5 per cent; P = 0·221) and mortality (1·1 versus 0·4 per cent; P = 0·432). Hospital stay was significantly shorter in the observation group (2 versus 3 days; P = 0·006). Per-protocol analyses were concordant with the intention-to-treat analyses. Observational treatment without antibiotics did not prolong recovery and can be considered appropriate in patients with uncomplicated diverticulitis. Registration number: NCT01111253 ( © 2016 BJS Society Ltd Published by John

  13. Impact and safety of open lung biopsy in patients with acute respiratory distress syndrome (ARDS). (United States)

    Ortiz, G; Garay, M; Mendoza, D; Cardinal-Fernández, P


    Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014. Critically ill patients over 18 years of age, undergoing invasive mechanical ventilation, diagnosed with ARDS of unknown etiology, and with OLB performed at the bedside. ARDS was diagnosed according to the Berlin definition. DAD was defined by the presence of a hyaline membrane plus at least one of the following: intra-alveolar edema, alveolar type I cell necrosis, alveolar type II cell (cuboidal cells) proliferation progressively covering the denuded alveolar-capillary membrane, interstitial proliferation of fibroblasts and myofibroblasts, or organizing interstitial fibrosis. The rate of treatment change (RTC) was established according to whether the OLB pathology report resulted in: a) the prescription or discontinuation of an antimicrobial; b) the indication of new procedures; c) medical interconsultation; or d) limitation of therapeutic effort. Patients were followed-up until death or hospital discharge. This study was approved by the Ethics Committee. A total of 32 OLBs were performed during the study period; 17 were ruled out as they did not involve ARDS, and 15 were considered for further analysis. A histological diagnosis was reached in 14 of the 15 patients (12 DAD, one case of bronchiolitis obliterans organizing pneumonia and one case of Wegener's granulomatosis with alveolar hemorrhage). The RTC rate was 0.73. The most frequent intervention was discontinuation of

  14. Reno-invasive fungal infection presenting as acute renal failure: Importance of renal biopsy for early diagnosis

    Directory of Open Access Journals (Sweden)

    Priyadarshi Ranjan


    Full Text Available Renal zygomycosis, caused by invasive fungi, is a rare and potentially fatal infec-tion. The patient usually presents with non-specific symptoms and renal failure. A 34-year-old male non-diabetic and without any predisposing factors for systemic fungal infection presented to the emergency department with diffuse abdominal pain, high-grade fever and acute renal failure with a serum creatinine of 6.5. A computed tomography showed bilateral diffuse globular nephromegaly. A urine smear for fungal examination showed right angle branching hyphae and kidney biopsy showed fungal hyphae within the glomeruli, tubules and interstitium. Although radiological investigations can give us a clue, the definitive diagnosis can only be made by kidney biopsy. A high index of suspicion and timely diagnosis is important for a proper management.

  15. Effects of combined liver and udder biopsying on the acute phase response of dairy cows with experimentally induced E. coli mastitis

    DEFF Research Database (Denmark)

    Khatun, Momena; Sørensen, Peter; Ingvartsen, Klaus Lønne


    A minimally invasive biopsy technique was evaluated for udder tissue collection in dairy cows with Escherichia coli mastitis. Meanwhile, the effect of taking repeated liver and udder biopsies on the systemic and local acute phase response (APR) of the dairy cows was investigated during the disease....... The cows were divided into a biopsy group (B) (n = 16) and a no-biopsy group (NB) (n = 16) and were sampled in the acute disease stage and in the recovery stage. The cows’ pre-disease period served as a control period for establishing baseline values for the investigated parameters. A total of 32 Holstein...... of combined biopsying were investigated by recording production traits, clinical response, and measuring inflammatory milk and blood parameters: E. coli, somatic cell count, milk amyloid A (MAA) levels, white blood cell count, polymorphonuclear neutrophilic leukocyte numbers and serum amyloid A levels...

  16. Can anti-osteoporotic therapy reduce adjacent fracture in magnetic resonance imaging-proven acute osteoporotic vertebral fractures? (United States)

    Chen, Ying-Chou; Lin, Wei-Che


    Adjacent fracture of the cemented vertebrae result from crushed fragile trabeculae during follow-up, suggesting impaired bone marrow integrity. This study aimed to determine if anti-osteoporotic therapy can decrease the risk of adjacent fracture in patients after vertebroplasty. This retrospective study reviewed of cases of osteoporotic patients with magnetic resonance imaging (MRI)-proven acute vertebral fractures between 2001 and 2007. Osteoporotic patients were investigated as determined by pre-operative MRI with subsequent adjacent fracture of the cemented vertebrae and for the possibility of anti-osteoporotic therapy decreasing the progression of collapse after a minimum of 6 months follow-up. All associated co-morbidities were recorded, as well as the use of anti-osteoporotic drugs (i.e., bisphosphonate, raloxifen, calcitonin, and teriparatide). Cox regression analysis was also performed. The 192 vertebral fractured patients who underwent vertebroplasty and anti-osteoporotic therapy had a mean age of 74.40 ± 6.41. The basic characteristics of patients with and without adjacent fracture differed in age, body mass index, rheumatoid arthritis, and use of glucocorticoids and anti-osteoporotic drugs (Table 1). Using the Kaplan-Meier curve, anti-osteoporotic therapy after vertebroplasty had a significant effect on adjacent fracture (p = 0.037, by log rank text). After adjusting for potential confounders, patients with anti-osteoporotic therapy still had a lower adjacent fracture rate than patients without anti-osteoporotic therapy (p = 0.006; HR: 2.137, 95 % CI: 1.1238-3.690). The adjacent fracture rate also increased in old age (p = 0.019; HR: 1.049; 95 % CI:1.008-1.039) and among smokers (p = 0.026; HR: 3.891; 95 % CI: 1.175-12.890). In this study, adjacent fracture of cemented vertebrae is inevitable after vertebroplasty but can be mitigated by anti-osteoporotic therapy to increase bone mass.

  17. Cone biopsy (United States)

    ... biopsy; HSIL - cone biopsy; Low-grade cone biopsy; High-grade cone biopsy; Carcinoma in situ-cone biopsy; ... the cervix. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery . 4th ed. ...

  18. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis

    NARCIS (Netherlands)

    Daniels, L.; de Korte, N.; van Dieren, S.; Stockmann, H. B.; Vrouenraets, B. C.; Consten, E. C.; van der Hoeven, J. A.; Eijsbouts, Q. A.; Faneyte, I. F.; Bemelman, W. A.; Dijkgraaf, M. G.; Boermeester, M. A.; Glaap, C. E M; Croonen, A.; Cuesta, M. A.; Kuijvenhoven, J.; Buijsman, R.; Den Uil, S.; De Reuver, P. R.; Tuynman, J. B.; Van de Wall, B. J M; Stam, M. A W; Roumen, R. M H; Truin, W.; Wijn, R.; Gerhards, M. F.; Kuhlmann, K. F D; Van der Zaag, E. S.; Biemond, J. E.; Klicks, R. J.; Dhar, N.; Cense, H. A.; De Groot, G. H.; Pikoulin, Y.; Van Ramshorst, G. H.; Hoornweg, L. L.; Koet, L.; Van Geloven, A. A W; Emous, M.; Claassen, A. T P M; Mollink, S.; Sonneveld, D. J A; Bouvé, L.; Diepenhorst, G. M P; Vles, W. J.; Toorenvliet, B. R.; Lange, J. F.; Mannaerts, G. H H; Grotenhuis, B. A.; tot Nederveen Cappel, R. J De Vos; Deerenberg, E. B.; Depla, A. C T M; Bruin, S.; Vos, X.; Scheepers, J. J G; Boom, M. J.; Boerma, D.; Van Esser, S.; Pruim, J.; Reitsma, J. B.

    Background: Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. Methods: Patients with

  19. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis

    NARCIS (Netherlands)

    Daniels, L.; Unlu, C.; Korte, N. de; Dieren, S. van; Stockmann, H.B.; Vrouenraets, B.C.; Consten, E.C.; Hoeven, J.A. van der; Eijsbouts, Q.A.; Faneyte, I.F.; Bemelman, W.A.; Dijkgraaf, M.G.; Boermeester, M.A.; Reuver, P.R.; et al.,


    BACKGROUND: Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. METHODS: Patients with

  20. Two cases of acute rhabdomyolysis. Pathogenesis, muscle biopsy, EMG, X-CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Junichi; Maruyama, Hideharu; Yamamura, Yoshinori; Kurihara, Teruyuki; Matsukura, Shigeru


    Case 1 was a 25-year-old male who developed coma and the swelling of the left thigh after he was medicated with many kinds of major and minor tranquilizers. Serum CK and myoglobin levels were 26, 600 IU/l (normal value : less than 120 IU/l) and 196 ng/ml (normal value : less than 60 ng/ml), respectively. X-CT revealed low density area in the central portion of the adductor muscle of the left thigh. Case 2 was a 63-year-old male who developed paraplegia and the swelling of the right thigh. Serum CK and myoglobin levels were 39,960 IU/L and 406 ng/ml respectively. The biopsy of the right anterior tibialis muscle revealed non-specific ischemic myogenic changes. Electromyographic studies revealed two different changes. One was myogenic changes in the adductor muscle of the right thigh, which was not complicated by the compartment syndrome. The other was denervation changes in the right tibialis anterior, which was complicated by the compartment syndrome. MRI reflected the biopsy findings, such as the swelling of the myocytes and the interstitial tissues better than X-CT. ARML is one of emergency muscle disorders. Early diagnosis and adequate fluid therapy to prevent renal failure are indispensable and lifesaving. Both cases were treated successfully, and they became ambulatory upon discharge.

  1. Novel protocol including liver biopsy to identify and treat CD8+ T-cell predominant acute hepatitis and liver failure. (United States)

    McKenzie, Rebecca B; Berquist, William E; Nadeau, Kari C; Louie, Christine Y; Chen, Sharon F; Sibley, Richard K; Glader, Bertil E; Wong, Wendy B; Hofmann, Lawrence V; Esquivel, Carlos O; Cox, Kenneth L


    In the majority of children with ALF, the etiology is unknown and liver transplantation is often needed for survival. A patient case prompted us to consider that immune dysregulation may be the cause of indeterminate acute hepatitis and liver failure in children. Our study includes nine pediatric patients treated under a multidisciplinary clinical protocol to identify and treat immune-mediated acute liver injury. Patients with evidence of inflammation and no active infection on biopsy received treatment with intravenous immune globulin and methylprednisolone. Seven patients had at least one positive immune marker before or after treatment. All patients had a CD8+ T-cell predominant liver injury that completely or partially responded to immune therapy. Five of the nine patients recovered liver function and did not require liver transplantation. Three of these patients subsequently developed bone marrow failure and were treated with either immunosuppression or stem cell transplant. This series highlights the importance of this tissue-based approach to diagnosis and treatment that may improve transplant-free survival. Further research is necessary to better characterize the immune injury and to predict the subset of patients at risk for bone marrow failure who may benefit from earlier and stronger immunosuppressive therapy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Acute compartment syndrome in the pelvic limb of a cow following biopsy of a skeletal muscle-associated hemangiosarcoma. (United States)

    Vogel, Susan R; Desrochers, André; Lanthier, Isabelle; Strina, Marion; Babkine, Marie


    A 6-year-old Holstein cow was examined because of chronic lameness and swelling near the stifle joint of the left pelvic limb. A mass was palpated in the soft tissues lateral to the proximal aspect of the left tibia. Multiple attempts to obtain a biopsy specimen of the mass resulted in acute compartment syndrome of the femoral compartment (tensor fasciae latae and biceps femoris muscles) and lateral tibial compartment (cranial tibial and peroneus tertius muscles) with associated sciatic nerve paralysis. Surgical decompression via tensor fasciae latae and biceps femoris incision resolved the sciatic nerve paralysis. On the fifth day following surgery, the cow began to develop signs of increased respiratory effort. Thoracic radiography revealed a pulmonary metastatic micronodular pattern. The cow was euthanized because its condition deteriorated. Metastatic hemangiosarcoma was confirmed at necropsy, and the primary tumor was the mass that was lateral to the tibia and within the biceps femoris muscle. Hemangiosarcoma should be considered a differential diagnosis for lameness in cattle when no orthopedic cause can be identified. Close patient surveillance is strongly recommended in the event that a vascular tumor is present because catastrophic consequences are possible. To our knowledge, this is the first report of acute compartment syndrome in a pelvic limb of a bovine patient and the only report of hemangiosarcoma in the skeletal muscle of cattle.

  3. Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. (United States)

    Ornish, Dean; Lin, Jue; Chan, June M; Epel, Elissa; Kemp, Colleen; Weidner, Gerdi; Marlin, Ruth; Frenda, Steven J; Magbanua, Mark Jesus M; Daubenmier, Jennifer; Estay, Ivette; Hills, Nancy K; Chainani-Wu, Nita; Carroll, Peter R; Blackburn, Elizabeth H


    Telomere shortness in human beings is a prognostic marker of ageing, disease, and premature morbidity. We previously found an association between 3 months of comprehensive lifestyle changes and increased telomerase activity in human immune-system cells. We followed up participants to investigate long-term effects. This follow-up study compared ten men and 25 external controls who had biopsy-proven low-risk prostate cancer and had chosen to undergo active surveillance. Eligible participants were enrolled between 2003 and 2007 from previous studies and selected according to the same criteria. Men in the intervention group followed a programme of comprehensive lifestyle changes (diet, activity, stress management, and social support), and the men in the control group underwent active surveillance alone. We took blood samples at 5 years and compared relative telomere length and telomerase enzymatic activity per viable cell with those at baseline, and assessed their relation to the degree of lifestyle changes. Relative telomere length increased from baseline by a median of 0·06 telomere to single-copy gene ratio (T/S)units (IQR-0·05 to 0·11) in the lifestyle intervention group, but decreased in the control group (-0·03 T/S units, -0·05 to 0·03, difference p=0·03). When data from the two groups were combined, adherence to lifestyle changes was significantly associated with relative telomere length after adjustment for age and the length of follow-up (for each percentage point increase in lifestyle adherence score, T/S units increased by 0·07, 95% CI 0·02-0·12, p=0·005). At 5 years, telomerase activity had decreased from baseline by 0·25 (-2·25 to 2·23) units in the lifestyle intervention group, and by 1·08 (-3·25 to 1·86) units in the control group (p=0·64), and was not associated with adherence to lifestyle changes (relative risk 0·93, 95% CI 0·72-1·20, p=0·57). Our comprehensive lifestyle intervention was associated with increases in relative

  4. Liver biopsy (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

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

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


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

  6. Tongue biopsy (United States)

    Biopsy - tongue ... A tongue biopsy can be done using a needle. You will get numbing medicine at the place where the ... provider will gently stick the needle into the tongue and remove a tiny piece of tissue. Some ...

  7. Muscle biopsy. (United States)

    Meola, G; Bugiardini, E; Cardani, R


    Muscle biopsy is required to provide a definitive diagnosis in many neuromuscular disorders. It can be performed through an open or needle technique under local anesthesia. The major limitations of the needle biopsy technique are the sample size, which is smaller than that obtained with open biopsy, and the impossibility of direct visualization of the sampling site. However, needle biopsy is a less invasive procedure than open biopsy and is particularly indicated for diagnosis of neuromuscular disease in infancy and childhood. The biopsied muscle should be one affected by the disease but not be too weak or too atrophic. Usually, in case of proximal muscle involvement, the quadriceps and the biceps are biopsied, while under suspicion of mitochondrial disorder, the deltoid is preferred. The samples must be immediately frozen or fixed after excision to prevent loss of enzymatic reactivity, DNA depletion or RNA degradation. A battery of stainings is performed on muscle sections from every frozen muscle biopsy arriving in the pathology laboratory. Histological, histochemical, and histoenzymatic stainings are performed to evaluate fiber atrophy, morphological, and structural changes and metabolic disorders. Moreover, immunohistochemistry and Western blotting analysis may be used for expression analysis of muscle proteins to obtain a specific diagnosis. There are myopathies that do not need muscle biopsy since a genetic test performed on a blood sample is enough for definitive diagnosis. Muscle biopsy is a useful technique which can make an enormous contribution in the field of neuromuscular disorders but should be considered and interpreted together with the patient's family and clinical history.

  8. Contrast-enhanced ultrasonography could be a non-invasive method for differentiating none or mild from severe fibrosis in patients with biopsy proven non-alcoholic fatty liver disease. (United States)

    Nasr, Patrik; Hilliges, Annette; Thorelius, Lars; Kechagias, Stergios; Ekstedt, Mattias


    The gold standard for diagnosing fibrosis stage in non-alcoholic fatty liver disease (NAFLD) is liver biopsy. The aim of this study was to determine whether contrast-enhanced ultrasonography (CEUS) with transit time measurements could be a non-invasive alternative for differentiating none or mild from severe fibrosis in NAFLD patients. Various serum markers and clinical variables were also evaluated. Fifty-eight patients with NAFLD underwent CEUS prior to liver biopsy. All patients were also evaluated according to the Göteborg University Cirrhosis Index (GUCI), the AST-Platelet Ratio Index (APRI), the NAFLD fibrosis score, and the FIB-4 and BARD score. The hepatic vein arrival time (HV) was shorter in patients with severe fibrosis (25.9 ± 4.8 vs 29.5 ± 4.7 s, p = 0.023), and the difference between the hepatic and portal vein (ΔHV-PV) was shorter (2.3 ± 2.8 vs 6.4 ± 2.8 s, p < 0.0001) while the difference in arrival time between the portal vein and hepatic artery (ΔPV-HA) arrival time was significantly longer (6.0 ± 2.2 vs 3.6 ± 1.6 s, p < 0.0001). The area under receiver operating characteristics curve values for HV, ΔHV-PV and ΔPV-HA to separate none or mild from severe fibrosis was 0.71, 0.83 and 0.84, respectively. The corresponding figures for GUCI, APRI, NAFLD fibrosis score, FIB-4 and BARD score were 0.93, 0.92, 0.86, 0.90 and 0.77, respectively. CEUS and non-invasive scoring systems could exclude severe fibrosis in NAFLD patients.

  9. Endometrial biopsy (United States)

    ... due to changes in hormone levels ( anovulatory bleeding ) Risks Risks of endometrial biopsy include: Infection Causing a ... American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, ...

  10. Bone Biopsy (United States)

    ... bear denotes child-specific content. Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Bone Biopsy Sponsored by Please note ...

  11. Skin Biopsy (United States)

    ... tape it closed with small strips of clear, sticky tape. If you get stitches, your doctor will ... of Your Skin Melanoma Eczema Aspiration and Biopsy: Bone Marrow Impetigo Pityriasis Rosea View more Partner Message ...

  12. Cytokine and acute phase protein gene expression in liver biopsies from dairy cows with a lipopolysaccharide - induced mastitis

    DEFF Research Database (Denmark)

    Vels, J; Røntved, Christine M.; Bjerring, Martin


    .1 ± 0.1 vs. log10 2.8 ± 0.1 x 103 cells/mL), heart rate (76 ± 1 vs. 93 ± 1 beats/min), and respiratory rate (32 ± 2 vs. 36 ± 1 breaths/min) in the acute phase of the disease. The LPS treatment upregulated the hepatic expression of TNF- (103 ± 24 vs. 255 ± 18 units), IL-1β (37 ± 23 vs. 296 ± 18 units...

  13. Flow-Based Provenance

    Directory of Open Access Journals (Sweden)

    Sabah Al-Fedaghi


    Full Text Available Aim/Purpose: With information almost effortlessly created and spontaneously available, current progress in Information and Communication Technology (ICT has led to the complication that information must be scrutinized for trustworthiness and provenance. Information systems must become provenance-aware to be satisfactory in accountability, reproducibility, and trustworthiness of data. Background:\tMultiple models for abstract representation of provenance have been proposed to describe entities, people, and activities involved in producing a piece of data, including the Open Provenance Model (OPM and the World Wide Web Consortium. These models lack certain concepts necessary for specifying workflows and encoding the provenance of data products used and generated. Methodology: Without loss of generality, the focus of this paper is on OPM depiction of provenance in terms of a directed graph. We have redrawn several case studies in the framework of our proposed model in order to compare and evaluate it against OPM for representing these cases. Contribution: This paper offers an alternative flow-based diagrammatic language that can form a foundation for modeling of provenance. The model described here provides an (abstract machine-like representation of provenance. Findings: The results suggest a viable alternative in the area of diagrammatic representation for provenance applications. Future Research: Future work will seek to achieve more accurate comparisons with current models in the field.

  14. Liver Biopsy (United States)

    ... instrument called a cannula to remove the liver tissue sample. What is the liver and what does it do? ... who specializes in diagnosing diseases—looks at the tissue with a microscope and sends a report to the person's health care provider. What are the risks of liver biopsy? The risks ...

  15. Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure

    Directory of Open Access Journals (Sweden)

    Vera Luiza Capelozzi


    Full Text Available BACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co-infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open lung biopsy specimens from five patients with ARDS with confirmed H1N1. METHODS: Lung specimens underwent microbiologic analysis, and examination by optical and electron microscopy. Immunophenotyping was used to characterize macrophages, natural killer, T and B cells, and expression of cytokines and iNOS. RESULTS: The pathological features observed were necrotizing bronchiolitis, diffuse alveolar damage, alveolar hemorrhage and abnormal immune response. Ultrastructural analysis showed viral-like particles in all cases. CONCLUSIONS: Viral-like particles can be successfully demonstrated in lung tissue by ultrastructural examination, without confirmation of the virus by RT-PCR on nasopharyngeal aspirates. Bronchioles and epithelium, rather than endothelium, are probably the primary target of infection, and diffuse alveolar damage the consequence of the effect of airways obliteration and dysfunction on innate immunity, suggesting that treatment should be focused on epithelial repair.

  16. Proven Weight Loss Methods (United States)

    Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. ... limiting calories) usually isn’t enough to cause weight loss. But exercise plays an important part in helping ...

  17. Stereotactic biopsy

    International Nuclear Information System (INIS)

    Mwangi, M.N.; Handa, A.


    This technology is capable of locating lesions precise detected by the mammography examinations. This devise allows the surgeon to position automatically the needle to perform the cytological/histological biopsy with maximum position accuracy. This is under sterile procedure. to position the lesion in the beam, two radiographic procedures are carried out: the first with the X-ray beam at an inclination of -15 degrees with respect to the position 0 degrees and the second at the inclination +15 degrees. After processing the film the lesion will appear on both radiographs but on light are of the negatoscope. With the cursor information is fed from four points. On the display the length of the needle will appear immediately. The length of the needle to be used in suction is chosen on the basis of the two values on the display. This information fed on the control panel will move the needle unit position where the lesion is. the needle is then introduced under local anaesthesia at the preselected length until it clicks into position. An exposure is made with needle in situ in position at +15 degrees and -15 degrees to ensure the needle is in position. the suction is then carried out and the needle removed. The machine is then reset to return at the initial position

  18. Provenance Store Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Paulson, Patrick R.; Gibson, Tara D.; Schuchardt, Karen L.; Stephan, Eric G.


    Requirements for the provenance store and access API are developed. Existing RDF stores and APIs are evaluated against the requirements and performance benchmarks. The team’s conclusion is to use MySQL as a database backend, with a possible move to Oracle in the near-term future. Both Jena and Sesame’s APIs will be supported, but new code will use the Jena API

  19. Ultrasound-guided renal biopsy: experience using an automated core biopsy system. (United States)

    Chan, R; Common, A A; Marcuzzi, D


    To assess the safety and efficacy of ultrasound-guided percutaneous renal biopsy using an automated core biopsy system, and to determine radiologists' accuracy in predicting sample adequacy. Ninety-five biopsies were performed on 25 native kidneys and 70 renal allografts using a 16-gauge automated, spring-loaded core biopsy device under real-time sonographic guidance. Radiologists performing the biopsy estimated the number of core samples needed to obtain an adequate specimen, based on visual inspection of each core. The final determination of the number of samples was made by a pathology technologist who attended each biopsy, based on preliminary microscopic examination of tissue cores. After each biopsy, an ultrasonographic examination was performed to search for biopsy-related hemorrhage, and a questionnaire was given to the patient to determine biopsy-related complications, which were categorized as either minor or major. The main indication for biopsy was acute renal failure (in 43.2% of biopsies). An average of 3 tissue cores per biopsy were obtained. Of the 94 patients in whom a biopsy was conducted to exclude diffuse renal disease, a mean of 12.5 glomeruli were present in each specimen. Overall, adequate tissue for diagnosis was obtained in 98.9% of cases. The radiologists' estimate of the number of core samples needed concurred with the pathology technologists' determination of sample adequacy in 88.4% of cases. A total of 26 complications occurred (in 27.4% of biopsies), consisting of 23 minor (24.2%) and 3 major (3.2%) complications. Real-time sonographic guidance in conjunction with an automated core biopsy system is a safe and accurate method of performing percutaneous renal biopsy. Routine use of sonographic examinations to search for biopsy-related complications is not indicated. Radiologists are accurate in estimating sample adequacy in most cases; however, the presence of a pathology technologist at the biopsy procedure virtually eliminates the

  20. Bone lesion biopsy (United States)

    Bone biopsy; Biopsy - bone ... the cut, then pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  1. Biopsy system for CT-guided biopsies

    International Nuclear Information System (INIS)

    Onik, G.; Cosman, E.; Wells, T.; Goldberg, H.I.; Moss, A.; Costello, P.; Kane, R.


    CT stereotaxic brain biopsies have made brain biopsies safe and minimally invasive. CT-guided biopsies of the body, however, have traditionally used a hand-guidance method. CT biopsy guidance systems for the body have recently become available that have similar capabilities as those of brain biopsy systems. To compare the clinical utility of stereotaxically guided biopsies with hand-guided biopsies, the authors prospectively compared 40 biopsies performed with each method. In the stereotaxic method, a localizor grid was placed on the patient to define a reference point, and a frame was used to guide the needle along the intended path. Computer software programs calculated complex paths from one scan plane to another. Although the results disclosed no significant differences in lesion size or path length between the two groups, the stereotaxically guided biopsies required 75% fewer needle manipulations to hit the intended target. Consequently, the stereotaxically guided biopsies required 40% less time and 80% fewer localization scans to find the biopsy needle than did the hand-guided biopsies

  2. Cell line provenance. (United States)

    Freshney, R Ian


    Cultured cell lines have become an extremely valuable resource, both in academic research and in industrial biotechnology. However, their value is frequently compromised by misidentification and undetected microbial contamination. As detailed elsewhere in this volume, the technology, both simple and sophisticated, is available to remedy the problems of misidentification and contamination, given the will to apply it. Combined with proper records of the origin and history of the cell line, assays for authentication and contamination contribute to the provenance of the cell line. Detailed records should start from the initiation or receipt of the cell line, and should incorporate data on the donor as well as the tissue from which the cell line was derived, should continue with details of maintenance, and include any accidental as well as deliberate deviations from normal maintenance. Records should also contain details of authentication and regular checks for contamination. With this information, preferably stored in a database, and suitable backed up, the provenance of the cell line so created makes the cell line a much more valuable resource, fit for validation in industrial applications and more likely to provide reproducible experimental results when disseminated for research in other laboratories.

  3. From Provenance Standards and Tools to Queries and Actionable Provenance (United States)

    Ludaescher, B.


    The W3C PROV standard provides a minimal core for sharing retrospective provenance information for scientific workflows and scripts. PROV extensions such as DataONE's ProvONE model are necessary for linking runtime observables in retrospective provenance records with conceptual-level prospective provenance information, i.e., workflow (or dataflow) graphs. Runtime provenance recorders, such as DataONE's RunManager for R, or noWorkflow for Python capture retrospective provenance automatically. YesWorkflow (YW) is a toolkit that allows researchers to declare high-level prospective provenance models of scripts via simple inline comments (YW-annotations), revealing the computational modules and dataflow dependencies in the script. By combining and linking both forms of provenance, important queries and use cases can be supported that neither provenance model can afford on its own. We present existing and emerging provenance tools developed for the DataONE and SKOPE (Synthesizing Knowledge of Past Environments) projects. We show how the different tools can be used individually and in combination to model, capture, share, query, and visualize provenance information. We also present challenges and opportunities for making provenance information more immediately actionable for the researchers who create it in the first place. We argue that such a shift towards "provenance-for-self" is necessary to accelerate the creation, sharing, and use of provenance in support of transparent, reproducible computational and data science.

  4. Provenance through Time (United States)

    Chandler, C. L.; Groman, R. C.; Shepherd, A.; Allison, M. D.; Kinkade, D.; Rauch, S.; Wiebe, P. H.; Glover, D. M.


    The ability to reproduce scientific results is a cornerstone of the scientific method, and access to the data upon which the results are based is essential to reproducibility. Access to the data alone is not enough though, and research communities have recognized the importance of metadata (data documentation) to enable discovery and data access, and facilitate interpretation and accurate reuse. The Biological and Chemical Oceanography Data Management Office (BCO-DMO) was first funded in late 2006 by the National Science Foundation (NSF) Division of Ocean Sciences (OCE) Biology and Chemistry Sections to help ensure that data generated during NSF OCE funded research would be preserved and available for future use. The BCO-DMO was formed by combining the formerly independent data management offices of two marine research programs: the United States Joint Global Ocean Flux Study (US JGOFS) and the US GLOBal Ocean ECosystems Dynamics (US GLOBEC) program. Since the US JGOFS and US GLOBEC programs were both active (1990s) there have been significant changes in all aspects of the research data life cycle, and the staff at BCO-DMO has modified the way in which we manage data contributed to the office. The supporting documentation that describes each dataset was originally displayed as a human-readable text file retrievable via a Web browser. BCO-DMO still offers that form because our primary audience is marine researchers using Web browser clients; however we are seeing an increased demand to support machine client access. Metadata records from the BCO-DMO data system are now extracted and published out in a variety of formats. The system supports ISO 19115, FGDC, GCMD DIF, Dataset extension, formal publication with a DOI, and RDF with semantic markup including PROV-O, FOAF and more. In the 1990s, data documentation helped researchers locate data of interest and understand the provenance sufficiently to determine fitness for purpose. Today, providing data

  5. Biopsy - Multiple Languages (United States)

    ... 简体中文) Expand Section Biopsy - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Bone Marrow Biopsy - 简体中文 (Chinese, Simplified (Mandarin dialect)) ...

  6. Provenance Datasets Highlighting Capture Disparities (United States)


    academic use case that has corollaries in offices everywhere. We also describe two distinct possibilities for provenance capture methods within this domain...Figure 1: Sample provenance graph of the librarians preparing the requested report, from the “Complete” dataset. The tool, SpectorSoft,2 was

  7. Recording Process Documentation for Provenance

    NARCIS (Netherlands)

    Groth, P.T.; Moreau, L


    Scientific and business communities are adopting large-scale distributed systems as a means to solve a wide range of resource-intensive tasks. These communities also have requirements in terms of provenance. We define the provenance of a result produced by a distributed system as the process that

  8. Transjugular Liver Biopsy: Results of 97 Patients

    Directory of Open Access Journals (Sweden)

    Kemal Deniz


    Full Text Available Objective: To evaluate the feasibility and efficacy of transjugular liver biopsy in patients with contraindicated percutaneous biopsy.Materials and Methods: Between June 2005 and April 2010, 97 patients who were admitted for transjugular liver biopsy were enrolled in this retrospective study. All liver biopsies were obtained using an 18 gauge Quick-Core liver biopsy set through the right hepatic vein via the internal jugular vein. Clinical indication, histopathological diagnosis, and complications were noted.Results: Primary technical success was achieved in 93 (95.8% patients. Hepatic veins could not be catheterized and opacified in two patients and in the remaining two patients the veins could be opacified and catheterized but we were not able to pass the biopsy needle into the hepatic vein because of the acute angle between the inferior vena cava and hepatic veins. At least two specimens were obtained from each patient. The most frequent histopathological diagnosis was cirrhosis. A subcutaneous hematoma around the puncture side was encountered in one patient.Conclusion: Transjugular liver biopsy is a feasible and effective alternative in patients with contraindication for percutaneous biopsy.

  9. Colon Biopsy Findings of Renal Transplant Patients. (United States)

    Taştepe, Firdevs Zeynep; Özgün, Gonca; Özdemir, Binnaz Handan; Tepeoğlu, Merih; Haberal, Mehmet


    The purpose of this study was to evaluate colonic pathologies in renal transplant recipients. Patients with colon biopsies were selected from 1816 renal transplant recipients from January 1990 to December 2012 at Baskent University Hospital (Ankara, Turkey). Demographic and clinical findings with colon biopsies were examined. There were 84 patients who had colon biopsies after renal transplant. There were 57 male and 27 female patients (median age at renal transplant was 33 y). Chronic diarrhea was the most common clinical finding at the time of colon biopsy. The median interval from renal transplant to first colon biopsy was 48.1 ± 47.5 months. On microscopic evaluation, there were no pathologic changes in 17 patients. The remaining 67 patients had colitis (38 patients), polyps (17 patients), cytomegalovirus colitis (8 patients), and amyloidosis (4 patients). The mean interval between transplant and the diagnosis of colitis was 49.08 ± 42.6 months, amyloidosis was 47.5 ± 79.28 months, cytomegalovirus colitis was 5 ± 3.5 months, and polyps was 77.65 ± 58.8 months. There was a statistically significant difference between biopsy diagnosis and the time interval between transplant and colon biopsy (P colonic biopsies, 40 patients never had acute rejection episodes and 44 patients had at least 1 acute rejection episode. Seven of 8 patients with cytomegalovirus colitis, 19 of 38 with colitis, 3 of 4 with amyloidosis, and 5 of 17 with polyps had acute rejection episodes. In our report on colonic manifestations in renal transplant recipients, the most common colonic lesion was noninfectious colitis. Cytomegalovirus colitis is an important infection that affects immunosuppressed individuals, such as transplant recipients. Cytomegalovirus must be kept in mind, and thorough sectioning and immunohistochemical sta ining should be used if necessary in the presence of any clinical or histologic suspicion for infective colitis.

  10. Ultrasound-Guided Breast Biopsy (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses ... of Ultrasound-Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast ...

  11. Temno biopsy needle

    International Nuclear Information System (INIS)

    Quinn, S.F.; Demlow, T.; Dunkley, B.


    This paper reports on the Temno needle which is spring-activated biopsy needle that is being marketed to radiologists as a needle that can obtain histologic cores. One hundred fifteen biopsy procedures were performed; biopsy sites included liver; retroperitoneum; lung, mediastinum, and pleura; musculoskeletal structures; thyroid; abdominal and pelvic masses; and pancreas. The needle sizes included 21-gauge, 18-gauge, 16-gauge, and 14-gauge needles. The biopsy procedures were diagnostic in 87.8D% of cases, and the average biopsy specimen measured 1.0-40.0 mm. The biopsy diagnoses included both malignant and benign processes. The Temno needle has a lightweight, nonattenuating handle that makes it especially useful for CT-guided procedures

  12. Computer tomography guided lung biopsy using interactive breath-hold control

    DEFF Research Database (Denmark)

    Ashraf, Haseem; Krag-Andersen, Shella; Naqibullah, Matiullah


    BACKGROUND: Interactive breath-hold control (IBC) may improve the accuracy and decrease the complication rate of computed tomography (CT)-guided lung biopsy, but this presumption has not been proven in a randomized study. METHODS: Patients admitted for CT-guided lung biopsy were randomized....... CONCLUSIONS: The use of IBC for CT-guided lung biopsy was not an advantage for unselected patients in our care, since it did not improve the biopsy accuracy and the risk of pneumothorax was increased....

  13. Sentinel node biopsy in penile cancer

    DEFF Research Database (Denmark)

    Jakobsen, J. K.; Krarup, K. P.; Sommer, P.


    INTRODUCTION & OBJECTIVES: Nodal involvement is a strong prognosticator in penile cancer and lymph node staging is crucial. Sentinel node biopsy (SNB) has proven a useful staging tool with few complications, but evidence rely mostly on single institution publications with a short follow-up. In th......INTRODUCTION & OBJECTIVES: Nodal involvement is a strong prognosticator in penile cancer and lymph node staging is crucial. Sentinel node biopsy (SNB) has proven a useful staging tool with few complications, but evidence rely mostly on single institution publications with a short follow......-up. In this study we estimated the diagnostic accuracy of SNB in patients with squamous cell carcinoma of the penis and assessed procedure-related complications in a multicentre setting with long-term follow-up. MATERIAL & METHODS: Data was retrospectively collected from medical records by one medical doctor...... died from complications. CONCLUSIONS: To our knowledge, this is the first complete national study on sentinel node biopsy. Penile cancer sentinel node biopsy with a close follow-up is a reliable lymph node staging and has few complications in a national multicentre setting. Inguinal lymph node...

  14. Unusual presentation and inconclusive biopsy render fibroadenoma ...

    African Journals Online (AJOL)

    Two young, nonlactating, nulliparous women presented with acutely painful breast masses. Sonographic features showed mixed echogenic masses. Core biopsies were not diagnostic, and surgical excision revealed infarcted fibroadenomas in both cases. Although fibroadenomas are common, they do not commonly infarct, ...

  15. Provenance an introduction to PROV

    CERN Document Server

    Moreau, Luc


    The World Wide Web is now deeply intertwined with our lives, and has become a catalyst for a data deluge, making vast amounts of data available online, at a click of a button. With Web 2.0, users are no longer passive consumers, but active publishers and curators of data. Hence, from science to food manufacturing, from data journalism to personal well-being, from social media to art, there is a strong interest in provenance, a description of what influenced an artifact, a data set, a document, a blog, or any resource on the Web and beyond. Provenance is a crucial piece of information that can

  16. Improved transvenous liver biopsy needle

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Matzen, P; Christoffersen, P


    A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle...... should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver....

  17. A Noisy 10GB Provenance Database

    Energy Technology Data Exchange (ETDEWEB)

    Cheah, You-Wei; Plale, Beth; Kendall-Morwick, Joey; Leake, David; Ramakrishnan, Lavanya


    Provenance of scientific data is a key piece of the metadata record for the data's ongoing discovery and reuse. Provenance collection systems capture provenance on the fly, however, the protocol between application and provenance tool may not be reliable. Consequently, the provenance record can be partial, partitioned, and simply inaccurate. We use a workflow emulator that models faults to construct a large 10GB database of provenance that we know is noisy (that is, has errors). We discuss the process of generating the provenance database, and show early results on the kinds of provenance analysis enabled by the large provenance.

  18. MRI of pathology-proven peripheral nerve amyloidosis

    Energy Technology Data Exchange (ETDEWEB)

    McKenzie, Gavin A.; Broski, Stephen M.; Howe, Benjamin M.; Spinner, Robert J.; Amrami, Kimberly K.; Dispenzieri, Angela; Ringler, Michael D. [Mayo Clinic, Department of Musculoskeletal Radiology, Rochester, MN (United States)


    To highlight the MRI characteristics of pathologically proven amyloidosis involving the peripheral nervous system (PNS) and determine the utility of MRI in directing targeted biopsy for aiding diagnosis. A retrospective study was performed for patients with pathologically proven PNS amyloidosis who also underwent MRI of the biopsied or excised nerve. MRI signal characteristics, nerve morphology, associated muscular denervation changes, and the presence of multifocal involvement were detailed. Pathology reports were reviewed to determine subtypes of amyloid. Charts were reviewed to gather patient demographics, neurological symptoms and radiologist interpretation. Four men and three women with a mean age of 62 ± 11 years (range 46-76) were identified. All patients had abnormal findings on EMG with mixed sensorimotor neuropathy. All lesions demonstrated diffuse multifocal neural involvement with T1 hypointensity, T2 hyperintensity, and variable enhancement on MRI. One lesion exhibited superimposed T2 hypointensity. Six of seven patients demonstrated associated muscular denervation changes. Peripheral nerve amyloidosis is rare, and the diagnosis is difficult because of insidious symptom onset, mixed sensorimotor neurologic deficits, and the potential for a wide variety of nerves affected. On MRI, peripheral nerve involvement is most commonly characterized by T1 hypointensity, T2 hyperintensity, variable enhancement, maintenance of the fascicular architecture with fusiform enlargement, multifocal involvement and muscular denervation changes. While this appearance mimics other inflammatory neuropathies, MRI can readily detect neural changes and direct-targeted biopsy, thus facilitating early diagnosis and appropriate management. (orig.)

  19. Mediastinoscopy with biopsy (United States)

    ... This procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders . ... Biopsies of lymph node tissues are normal and do not show signs of cancer or infection.

  20. Salivary gland biopsy (United States)

    ... biopsy References Miloro M, Kolokythas A. Diagnosis and management of salivary gland disorders. In: Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery . 6th ed. St Louis, ...

  1. Colposcopy - directed biopsy (United States)

    ... squamous cells - colposcopy; Pap smear - colposcopy; HPV - colposcopy; Human papilloma virus - colposcopy; Cervix - colposcopy; Colposcopy ... also called cervical dysplasia) Cervical warts (infection with human papilloma virus , or HPV) If the biopsy does not determine ...

  2. Biopsy (For Parents) (United States)

    ... is taking or whether your child has any allergies. Be sure to report any bleeding tendencies in your child, and whether your daughter might be pregnant. Some biopsies require only local anesthesia. Others require sedation or general anesthesia. If that's ...

  3. Biopsy in Musculoskeletal Tumors

    Directory of Open Access Journals (Sweden)

    Mohammad Gharehdaghi


    Full Text Available Diagnosis of bone tumors is based on careful evaluation of clinical, imaging and a pathologic findings. So the biopsy of bone and soft tissue sarcomas is the final step in evaluation and a fundamental step in the diagnosis of the lesion. It should not be performed as a shortcut to diagnosis (1. The biopsy should be performed in order to confirm the diagnosis and differentiate among few diagnoses after careful staged studies. Real and artificial changes in imaging studies will be superimposed after performing biopsy, which may alter the interpretation if done after biopsy is taken (1. The correct management of a sarcoma depends on the accurate diagnosis. Inadequate, inapprppriate, or inaccurate non-representative biopsy leads to poorer outcome in terms of survivorship and limb salvage. An incorrect, unplanned incision and biopsy may unnecessarily contaminate uninvolved compartments which may convert a salvageable limb to amputation. Anatomic approach along with the proper biopsy techniques may lead to success or catastrophe. It is clear that in patients with inappropriate biopsy, the chance of the need to change the treatment to more radical than would originally be expected is significantly higher. Also it is more probable to need to  convert curative to palliative treatment and to require adjuvant radiotherapy in patients with inappropriate biopsies. Patients with sarcoma are best served by early referral to a specialized center where staged investigations and biopsy can be performed with minimal morbidity (3. Open biopsy is still considered the gold standard; however, recent studies suggest comparable results with percutaneous core needle biopsy. Our study on 103 consecutive CNB and open biopsy showed comparable results as well. Surgeons need to answer to two questions prior to performing a biopsy: 1-          Where is the best part of the lesion to be biopsied? 2-          What is the safest route without contaminating

  4. Corpus vitreum, retina og chorioidea biopsi

    DEFF Research Database (Denmark)

    Scherfig, Erik Christian Høegh


    oftalmology, biopsy, choroid, corpus vitreum, retina, malignant melanoma, biopsy technic, retinoblastoma......oftalmology, biopsy, choroid, corpus vitreum, retina, malignant melanoma, biopsy technic, retinoblastoma...

  5. Provenance Data in Social Media (United States)


    Bachelor of Arts -New York University, and unknown. With definitions for what we consider provenance data in social media to be, we can develop...adjustment allows the PROPATHS to use state of the art approximation solution for the minimum DIRECTED STEINER TREE problem. The algorithm greedily computes...Library of Congress/Electronic, June 2008. Contributors include and The Digital Ethnography Working Group at Kansas State University; Accessed on 22 Mar

  6. Provenance management in Swift with implementation details.

    Energy Technology Data Exchange (ETDEWEB)

    Gadelha, L. M. R; Clifford, B.; Mattoso, M.; Wilde, M.; Foster, I. (Mathematics and Computer Science); ( CLS-CI); (Federal Univ. of Rio de Janeiro); (National Lab. for Scientific Computing, Brazil); (Univ. of Chicago)


    The Swift parallel scripting language allows for the specification, execution and analysis of large-scale computations in parallel and distributed environments. It incorporates a data model for recording and querying provenance information. In this article we describe these capabilities and evaluate interoperability with other systems through the use of the Open Provenance Model. We describe Swift's provenance data model and compare it to the Open Provenance Model. We also describe and evaluate activities performed within the Third Provenance Challenge, which consisted of implementing a specific scientific workflow, capturing and recording provenance information of its execution, performing provenance queries, and exchanging provenance information with other systems. Finally, we propose improvements to both the Open Provenance Model and Swift's provenance system.

  7. Logical provenance in data-oriented workflows?

    KAUST Repository

    Ikeda, R.


    We consider the problem of defining, generating, and tracing provenance in data-oriented workflows, in which input data sets are processed by a graph of transformations to produce output results. We first give a new general definition of provenance for general transformations, introducing the notions of correctness, precision, and minimality. We then determine when properties such as correctness and minimality carry over from the individual transformations\\' provenance to the workflow provenance. We describe a simple logical-provenance specification language consisting of attribute mappings and filters. We provide an algorithm for provenance tracing in workflows where logical provenance for each transformation is specified using our language. We consider logical provenance in the relational setting, observing that for a class of Select-Project-Join (SPJ) transformations, logical provenance specifications encode minimal provenance. We have built a prototype system supporting the features and algorithms presented in the paper, and we report a few preliminary experimental results. © 2013 IEEE.

  8. Provenance data in social media

    CERN Document Server

    Barbier, Geoffrey; Gundecha, Pritam


    Social media shatters the barrier to communicate anytime anywhere for people of all walks of life. The publicly available, virtually free information in social media poses a new challenge to consumers who have to discern whether a piece of information published in social media is reliable. For example, it can be difficult to understand the motivations behind a statement passed from one user to another, without knowing the person who originated the message. Additionally, false information can be propagated through social media, resulting in embarrassment or irreversible damages. Provenance data

  9. No need for biopsies

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Skindersoe, Mette E; Christensen, Jens Jørgen


    The aim of the study was to compare three sampling techniques used in routine diagnostics to identify the microbiota in chronic venous leg ulcers. A total of 46 patients with persisting venous leg ulcers were included in the study. At inclusion, swab, biopsy and filter paper pad samples were...... collected. After 4 weeks, additional biopsy and filter paper pad samples were collected. Bacteria were isolated and identified at species level by standard methods. The most common bacterial species detected was Staphylococcus aureus found in 89% of the ulcers. No methicillin-resistant S. aureus isolates...

  10. Breast biopsy - stereotactic (United States)

    The provider will ask about your medical history. A breast exam may be done. If you take medicines (including aspirin, supplements, or herbs), ask your doctor whether you need to stop taking these before the biopsy. Tell your doctor if you may be ...

  11. Closed Pericardial Biopsy

    African Journals Online (AJOL)


    Sep 28, 1974 ... The instrument used is a hook biopsy needle (Fig. I). manufactured by Becton, Dickinson and Co., Rutherford,. New Jersey, USA. The instrument' and technique' will be reviewed. The instrument consists of an ll-gauge needle with a sharp cutting edge into which fits, interchangeably, a 13-gauge needle or a ...

  12. Lung needle biopsy (United States)

    ... if you have certain lung diseases such as emphysema. Usually, a collapsed lung after a biopsy does not need treatment. But ... any type Bullae (enlarged alveoli that occur with emphysema) Cor pulmonale (condition ... of the lung High blood pressure in the lung arteries Severe ...

  13. No need for biopsies

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Skindersoe, Mette E; Christensen, Jens Jørgen


    The aim of the study was to compare three sampling techniques used in routine diagnostics to identify the microbiota in chronic venous leg ulcers. A total of 46 patients with persisting venous leg ulcers were included in the study. At inclusion, swab, biopsy and filter paper pad samples were coll...

  14. Open pleural biopsy (United States)

    An open pleural biopsy is done in the hospital using general anesthesia . This means you will be asleep and pain-free. A tube will be placed through your mouth down your throat to help you breathe. The surgery is done in ...

  15. Leveraging Data Provenance to Enhance Cyber Resilience (United States)


    prerequisite to the use of data provenance to improve system resilience is its reliable capture and man- agement, which is made possible through provenance...Aware Operating Systems The Linux Provenance Modules (LPM) project is not only a provenance-aware operating system, but a generalized framework for the...controversy [31]. An overview of the LPM architecture is shown in Figure 1. LPM instruments the Linux kernel with a 178 dedicated user space kernel space

  16. Mammotome HH biopsy - the future of minimal invasive breast surgery?

    International Nuclear Information System (INIS)

    Pietrzyk, G.; Nowicki, J.; Bojarski, B.; Kedzierski, B.; Wysocki, A.; Prudlak, E.


    Vacuum-assisted breast biopsy / Mammotome HH '' R '' Breast Biopsy System/ is the milestone in the diagnosis of breast lesions. This system has proven to be as diagnostically reliable as open surgery, but without scarring, deformations and hospitalizations associated with an open procedure. The aim of our study was to assess the role and possibilities of using this biopsy in treatment of benign breast lesions like fibroadenoma. From 2001 to 2004, about 1118 Mammotome biopsies were performed in our Department. Among 445 Mammotome biopsies performed under US control there were 211 cases of fibroadenomas. Follow-up was performed in 156 patients with this result at 6 and 12 months after biopsy. In our study we took into considerations the size, localizations as well as performers. In 2002 there were 70.8% patients with total lesion excision, 16.7% with residual lesion and 12.5% women with hematomas or scars. In 2003-2004 there were more women with total lesion excision (84.3%), fewer residual tumors and other lesions. In future, Mammotome breast biopsy can replace scalpel, and will become an alternative method to open surgical excision of fibroadenomas. It is important especially in the cases of young women to prevent cosmetic deformations and scars. (author)

  17. Benefits of early biopsy on the outcome of kidney transplantation. (United States)

    Dominguez, J; Kompatzki, A; Norambuena, R; Arenas, J; Dell'Oro, A; Bustamante, A; Pinochet, R; Cabello, J M; Alvarez, S; Pais, E; Llanos, R; Cortes-Monroy, G


    Delayed graft function has been associated with worse long-term kidney allograft survival. Adequate diagnosis of the etiology of dysfunction is crucial, often requiring routine early biopsies. The aim of this article was to report the results and safety of early kidney allograft biopsies and how they influenced its management. Between September 1994 and July 2004, 134 renal transplant recipients were prescribed cyclosporine (CsA; Neoral, Novartis, Chile), steroids, and a third agent (azathioprine in 92% of the graft recipients). Thirty-four patients (26%) had a kidney biopsy performed within the first week because of allograft dysfunction. The main diagnosis was acute tubular necrosis (ATN) in 22 patients (65%), whereas 6 (18%) were diagnosed with an acute rejection episode (ARE), allowing prompt initiation of therapy with reversal of rejection in 4 of them. Two patients (6%) showed signs of thrombotic microangiopathy (TMA) induced by CsA, which subsided following a switch from CsA to tacrolimus (Prograf Pharmainvesti, Chile). In 2 patients, the biopsy specimen showed signs of CsA nephrotoxicity that reverted following dose reduction. Finally, in 2 patients, the biopsy specimen showed chronic nephropathy of donor origin, which had not been previously recognized, resulting in graft loss. There was only one major complication related to the biopsy, intraperitoneal bleeding that required surgical treatment. Early allograft biopsy is safe and, in a significant number of cases (30%), it detects important allograft pathology (ARE, TMA, and drug toxicity), which when adequately and promptly treated may rescue the graft.

  18. Provenance of the terrestrial planets. (United States)

    Wetherill, G W


    Earlier work on the simultaneous accumulation of the asteroid belt and the terrestrial planets is extended to investigate the relative contribution to the final planets made by material from different heliocentric distances. As before, stochastic variations intrinsic to the accumulation processes lead to a variety of final planetary configurations, but include systems having a number of features similar to our solar system. Fifty-nine new simulations are presented, from which thirteen are selected as more similar to our solar system than the others. It is found that the concept of "local feeding zones" for each final terrestrial planet has no validity for this model. Instead, the final terrestrial planets receive major contributions from bodies ranging from 0.5 to at least 2.5 AU, and often to greater distances. Nevertheless, there is a correlation between the final heliocentric distance of a planet and its average provenance. Together with the effect of stochastic fluctuations, this permits variation in the composition of the terrestrial planets, such as the difference in the decompressed density of Earth and Mars. Biologically important light elements, derived from the asteroidal region, are likely to have been significant constituents of the Earth during its formation.

  19. Oral Biopsy: A Dental Gawk

    African Journals Online (AJOL)

    Oral Biopsy: A Dental Gawk. Sir,. Dermatologists are often confronted with neoplasms ... the use of a needle, biopsy punch, biopsy forceps, laser, or electrocautery device. Needles may be appropriate in ... so widespread in dental practice––fundamentally because of a lack of awareness of the procedure among dental.

  20. Radiologically Guided Bone Biopsy: Results of 502 Biopsies

    International Nuclear Information System (INIS)

    Ng, Chaan S.; Salisbury, Jonathan R.; Darby, Alan J.; Gishen, Philip


    Purpose: To analyze the results of 502 biopsies over a 19-year period for the purpose of highlighting the results that can be expected from such a large study, with emphasis on needle choice and anesthetic methods. Methods: The histological, cytological, and microbiological results of 477 patients who had 502 bone biopsies carried out between July 1977 and March 1996 were studied. Less than 5% of patients required second biopsies. There were almost equal numbers of males and females in the group. The lesions were visible radiologically and most of the biopsies were carried out by a single operator. The lesions were classified on their histopathological, cytopathological, and microbiological findings. Results: Tumors accounted for 40% of the biopsies, and infection for 16%. Biopsies which did not yield a 'positive' diagnosis accounted for 31%; these included specimens reported as normal, or as showing reactive changes, repair, remodelling, non-specific features, inflammation (but not clearly infective), or no evidence of malignancy or inflammation. Less than 4% of biopsies were incorrect, and some of these were re-biopsied. Conclusion: Bone biopsy is a valuable technique for positive diagnosis of malignancy or infection, as it enables a definitive plan for treatment and management of patients to be established. Exclusion of serious pathology is almost equally important. In principle, any osseous site can be biopsied using fluoroscopic or computed tomographic guidance. Care in the biopsy technique and selection of the bone needle is required

  1. PROX: Approximated Summarization of Data Provenance. (United States)

    Ainy, Eleanor; Bourhis, Pierre; Davidson, Susan B; Deutch, Daniel; Milo, Tova


    Many modern applications involve collecting large amounts of data from multiple sources, and then aggregating and manipulating it in intricate ways. The complexity of such applications, combined with the size of the collected data, makes it difficult to understand the application logic and how information was derived. Data provenance has been proven helpful in this respect in different contexts; however, maintaining and presenting the full and exact provenance may be infeasible, due to its size and complex structure. For that reason, we introduce the notion of approximated summarized provenance, where we seek a compact representation of the provenance at the possible cost of information loss. Based on this notion, we have developed PROX, a system for the management, presentation and use of data provenance for complex applications. We propose to demonstrate PROX in the context of a movies rating crowd-sourcing system, letting participants view provenance summarization and use it to gain insights on the application and its underlying data.

  2. Nail biopsy: A user's manual

    Directory of Open Access Journals (Sweden)

    Chander Grover


    Full Text Available Nail biopsy is a procedure not routinely resorted to; but when indicated, it is often the only clue left for diagnosis. At such times, it pays to be conversant with it. It is an investigation that not only provides etiologic, diagnostic, and prognostic information but also aids in understanding the pathogenesis of nail diseases. It can be of therapeutic value, especially with respect to nail tumors. This article compiles the procedural techniques for nail biopsy of various types and attempts to summarize the evidence available in the literature. The objective of nail biopsy is to clinch a precise diagnosis of nail pathology with a simple and safe surgical procedure, avoiding pain or permanent nail damage. Patient selection is of utmost importance, wherein, the patient does not have typical skin lesions, yields inadequate information on routine nail investigations, and has no peripheral vascular compromise. The patient needs to be explained about the risks associated, the expected functional handicap, the time required for regrowth, a possibility of permanent nail dystrophy, and a possibility of not achieving a diagnosis even after the biopsy. Techniques and types of various nail biopsies are being discussed in this article. The specimen could be collected as an excision biopsy, punch biopsy, shave biopsy, or longitudinal biopsy. The trick lies in choosing the appropriate area for biopsy. Various biopsy types discussed in this article include nail plate biopsy (easiest and least scarring; nail bed biopsy (elliptical excision or punch; nail matrix biopsy (elliptical excision, punch excision (≤3 mm or tangential/shave excision; and nail fold biopsy. Complications reported along with means to minimize them are also discussed.

  3. Usefulness of automated biopsy guns in image-guided biopsy

    International Nuclear Information System (INIS)

    Lee, Jung Hyung; Rhee, Chang Soo; Lee, Sung Moon; Kim, Hong; Woo, Sung Ku; Suh, Soo Jhi


    To evaluate the usefulness of automated biopsy guns in image-guided biopsy of lung, liver, pancreas and other organs. Using automated biopsy devices, 160 biopsies of variable anatomic sites were performed: Biopsies were performed under ultrasonographic(US) guidance in 95 and computed tomographic (CT) guidance in 65. We retrospectively analyzed histologic results and complications. Specimens were adequate for histopathologic diagnosis in 143 of the 160 patients(89.4%)-Diagnostic tissue was obtained in 130 (81.3%), suggestive tissue obtained in 13(8.1%), and non-diagnostic tissue was obtained in 14(8.7%). Inadequate tissue was obtained in only 3(1.9%). There was no statistically significant difference between US-guided and CT-guided percutaneous biopsy. There was no occurrence of significant complication. We have experienced mild complications in only 5 patients-2 hematuria and 2 hematochezia in transrectal prostatic biopsy, and 1 minimal pneumothorax in CT-guided percutaneous lung biopsy. All of them were resolved spontaneously. The image-guided biopsy using the automated biopsy gun was a simple, safe and accurate method of obtaining adequate specimen for the histopathologic diagnosis

  4. Telepathology and Optical Biopsy

    Directory of Open Access Journals (Sweden)

    Olga Ferrer-Roca


    Full Text Available The ability to obtain information about the structure of tissue without taking a sample for pathology has opened the way for new diagnostic techniques. The present paper reviews all currently available techniques capable of producing an optical biopsy, with or without morphological images. Most of these techniques are carried out by physicians who are not specialized in pathology and therefore not trained to interpret the results as a pathologist would. In these cases, the use of telepathology or distant consultation techniques is essential.

  5. No need for biopsies

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Skindersoe, Mette E; Christensen, Jens Jørgen


    collected. After 4 weeks, additional biopsy and filter paper pad samples were collected. Bacteria were isolated and identified at species level by standard methods. The most common bacterial species detected was Staphylococcus aureus found in 89% of the ulcers. No methicillin-resistant S. aureus isolates...... were found. We did not find any significant differences regarding the bacterial species isolated between the three sampling techniques. However, using multiple techniques led to identification of more species. Our study suggests that it is sufficient to use swab specimens to identify the bacterial...

  6. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography

    DEFF Research Database (Denmark)

    Herrmann, Eva; de Lédinghen, Victor; Cassinotto, Christophe


    sites, as well as on successful transient elastography (TE) in 665 patients. Most patients had chronic hepatitis C (HCV, n = 379), hepatitis B (HBV, n = 400) or non-alcoholic fatty liver disease (NAFLD, n = 156). AUROCs of 2D-SWE in patients with HCV, HBV and NAFLD were 86.3%, 90.6% and 85...... was strongest in HBV patients. CONCLUSION: 2D-SWE has good to excellent performance for the non-invasive staging of liver fibrosis in patients with hepatitis B. Further prospective studies are needed for head to head comparison between 2D SWE and other imaging modalities to establish disease...

  7. Chronic hepatitis in Nigerian patients: a study of 70 biopsy-proven

    African Journals Online (AJOL)

    liver cell dysplasia (LCD) were seen in 4 cases (1 asymptomatic, 3 symptomatic). All the 4 cases (3 males and 1 female) with LCD were positive for HBsAg and had a histological grade of5 9. The female patient returned 3 years after the diagnosis of chronic hepatitis was made with evidence of neoplastic transformation as ...

  8. Evaluation of peritoneal fluid hemosiderin-laden macrophages in biopsy-proven endometriosis. (United States)

    Bedaiwy, Mohamed Ali; Noriega, Javier; Abdel Aleem, Mahmoud; Gupta, Sajal; AbulHassan, Ahmed M; Brainard, Jennifer; Ismail, Alaa M; Falcone, Tommaso


    To evaluate peritoneal fluid hemosiderin-laden macrophages (H-LMs) in patients with endometriosis compared to controls. Consecutive series of 46 patients during a year undergoing laparoscopy for benign gynecologic conditions were included. The presence of H-LMs in peritoneal fluid was evaluated. We compared clinical factors in patients with or without endometriosis in respect to H-LM status. To assess the potential of H-LMs to diagnose endometriosis, the sensitivity and specificity were calculated. Patients with endometriosis were significantly more likely to have positive H-LM test results than controls (p = 0.0013). The presence of H-LM has a low sensitivity of 52% but an acceptable specificity of 87% in diagnosing endometriosis. The presence of H-LMs was not related with any other of the clinical factors studied. The presence of specific findings of H-LMs related to endometriosis strongly suggests abnormalities in peritoneal iron metabolism.

  9. Cardiac Involvement is Underdiagnosed in Patients with Biopsy-Proven Systemic AL Amyloidosis

    Directory of Open Access Journals (Sweden)

    Haoyi Zheng


    Diagnosis of cardiac amyloidosis based on presence of heart failure symptoms led to underdiagnosis of cardiac involvement defined by the NCCN criteria. Guideline recommended assessment of cardiac involvement and cardiac response to treatment was not routinely implemented in our cohort.

  10. Cluster analysis of BI-RADS descriptions of biopsy-proven breast lesions (United States)

    Markey, Mia K.; Lo, Joseph Y.; Tourassi, Georgia D.; Floyd, Carey E., Jr.


    The purpose of this study was to identify and characterize clusters in a heterogeneous breast cancer computer-aided diagnosis database. Identification of subgroups within the database could help elucidate clinical trends and facilitate future model building. Agglomerative hierarchical clustering and k-means clustering were used to identify clusters in a large, heterogeneous computer-aided diagnosis database based on mammographic findings (BI-RADS) and patient age. The clusters were examined in terms of their feature distributions. The clusters showed logical separation of distinct clinical subtypes such as architectural distortions, masses, and calcifications. Moreover, the common subtypes of masses and calcifications were stratified into clusters based on age groupings. The percent of the cases that were malignant was notably different among the clusters. Cluster analysis can provide a powerful tool in discerning the subgroups present in a large, heterogeneous computer-aided diagnosis database.

  11. Ultrasonographic findings 6 months after 11-gauge vacuum-assisted large-core breast biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Docktor, B.J.L.; MacGregor, J.H.; Burrowes, P.W. [Foothills Medical Centre, Dept. of Diagnostic Imaging, Calgary, Alberta (Canada)]. E-mail:


    To assess the ultrasonographic features of post-biopsy change 6 months after 11-gauge vacuum-assisted large-core breast biopsy of pathologically proven benign lesions. Using the literature as a reference, we hypothesized that large-core breast biopsy would result in tissue changes that may mimic malignancy and may be more apparent on ultrasonography than on mammography. Two radiologists whose subspecialty is breast imaging retrospectively reviewed the pre-biopsy and 6-month follow-up sonograms of 24 patients with pathologically proven benign lesions. The images were assessed for the number and type of ultrasonographic features. A Breast Imaging Reporting and Data System (BI-RADS) category was assigned to each lesion before biopsy and at 6-month follow-up. The composition of breast tissue surrounding the lesion was assessed as fatty, mixed fibroglandular or dense. The frequency of ultrasonographic changes at 6 months after 11-gauge vacuum-assisted large-core breast biopsy was more frequent than the rate of post-biopsy change previously reported to occur mammographically. The nature of these changes may mimic malignancy in some cases. The ultrasonographic appearance of the breast after large-core breast biopsy may mimic malignancy and is, therefore, a potential pitfall when interpreting a post-biopsy sonogram. (author)

  12. Ultrasonographic findings 6 months after 11-gauge vacuum-assisted large-core breast biopsy. (United States)

    Docktor, Bobbie Jo L; MacGregor, John Henry; Burrowes, Paul W


    To assess the ultrasonographic features of post-biopsy change 6 months after 11-gauge vacuum-assisted large-core breast biopsy of pathologically proven benign lesions. Using the literature as a reference, we hypothesized that large-core breast biopsy would result in tissue changes that may mimic malignancy and may be more apparent on ultrasonography than on mammography. Two radiologists whose subspecialty is breast imaging retrospectively reviewed the pre-biopsy and 6-month follow-up sonograms of 24 patients with pathologically proven benign lesions. The images were assessed for the number and type of ultrasonographic features. A Breast Imaging Reporting and Data System (BI-RADS) category was assigned to each lesion before biopsy and at 6-month follow-up. The composition of breast tissue surrounding the lesion was assessed as fatty, mixed fibroglandular or dense. The frequency of ultrasonographic changes at 6 months after 11-gauge vacuum-assisted large-core breast biopsy was more frequent than the rate of post-biopsy change previously reported to occur mammographically. The nature of these changes may mimic malignancy in some cases. The ultrasonographic appearance of the breast after large-core breast biopsy may mimic malignancy and is, therefore, a potential pitfall when interpreting a post-biopsy sonogram.

  13. Ultrasonographic findings 6 months after 11-gauge vacuum-assisted large-core breast biopsy

    International Nuclear Information System (INIS)

    Docktor, B.J.L.; MacGregor, J.H.; Burrowes, P.W.


    To assess the ultrasonographic features of post-biopsy change 6 months after 11-gauge vacuum-assisted large-core breast biopsy of pathologically proven benign lesions. Using the literature as a reference, we hypothesized that large-core breast biopsy would result in tissue changes that may mimic malignancy and may be more apparent on ultrasonography than on mammography. Two radiologists whose subspecialty is breast imaging retrospectively reviewed the pre-biopsy and 6-month follow-up sonograms of 24 patients with pathologically proven benign lesions. The images were assessed for the number and type of ultrasonographic features. A Breast Imaging Reporting and Data System (BI-RADS) category was assigned to each lesion before biopsy and at 6-month follow-up. The composition of breast tissue surrounding the lesion was assessed as fatty, mixed fibroglandular or dense. The frequency of ultrasonographic changes at 6 months after 11-gauge vacuum-assisted large-core breast biopsy was more frequent than the rate of post-biopsy change previously reported to occur mammographically. The nature of these changes may mimic malignancy in some cases. The ultrasonographic appearance of the breast after large-core breast biopsy may mimic malignancy and is, therefore, a potential pitfall when interpreting a post-biopsy sonogram. (author)

  14. Percutaneous transbiliary biopsy. (United States)

    Andrade, Gustavo Vieira; Santos, Miguel Arcanjo; Meira, Marconi Roberto; Meira, Mateus Duarte


    Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct. RESUMO A drenagem percutânea das vias biliares é um procedimento estabelecido para obstruções malignas, nos quais, muitas vezes, não se consegue um diagnóstico histológico. Descrevemos a técnica de biópsia da lesão obstrutiva através do acesso de drenagem biliar, utilizando um fórcipe de biópsia endoscópica 7F, amplamente disponível e alguns reutilizáveis. Esta técnica aplica-se a lesões dos ductos hepáticos, do hepático comum e de toda extensão do colédoco.

  15. Prostate biopsy: indications and technique. (United States)

    Matlaga, Brian R; Eskew, L Andrew; McCullough, David L


    The last decade has seen numerous modifications in the way prostate cancer is diagnosed. We review the current indications for and methods of prostate biopsy. The English language literature was reviewed regarding major indications for and methods of prostate biopsy. Pertinent peer reviewed articles were collated and analyzed. The most widely accepted indication for prostate biopsy is a prostate specific antigen (PSA) value of greater than 4.0 ng./ml. However, some investigators advocate prostate biopsy for men with a PSA value in the 2.5 to 4.0 ng./ml. range, believing that use of this parameter results in detection of a greater number of cases of curable disease. Age specific PSA range, percent free PSA and presence of prostatic intraepithelial neoplasia or atypia are all considered to be relative indications for prostate biopsy. The current literature describes a trend toward increasing the number of cores obtained and the sites biopsied beyond those of the standard sextant technique. The additional cores in many series are obtained from more lateral regions of the gland. Although several criteria are used as indications for initial prostate biopsy, all are based on PSA level and/or abnormal digital rectal examination. Future improvements in currently used prostate cancer markers may result in better selection of cases to biopsy. There is no universally accepted technique of prostate gland biopsy. The current literature supports use of more extensive biopsy techniques to increase the likelihood of prostate cancer detection.

  16. Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

    International Nuclear Information System (INIS)

    Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon


    To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

  17. Special Issue: The First Provenance Challenge

    Energy Technology Data Exchange (ETDEWEB)

    Moreau, Luc; Ludaescher, Bertram T.; Altintas, Ilkay; Barga, Roger S.; Bowers, Shawn; Callahan, Steven P.; Chin, George; Clifford, Ben; Cohen, Shirley; Cohen-Boulakia, Sarah; Davidson, Susan; Deelman, Ewa; digiampietri, Luciano; Foster, Ian T.; Freire, Juliana; Frew, James; Futrelle, Joe; Gibson, Tara D.; Gil, Yolanda; Goble, Carole; Golbeck, Jennifer; Groth, Paul; Holland, David A.; Jiang, Sheng; Kim, Jihie; Koop, David; Krenek, Ales; McPhillips, Timothy; Mehta, Gaurang; Miles, Simon; Metzger, Dominic; Munroe, Steve; Myers, James D.; Plale, Beth A.; Podhorszki, norbert; Ratnakar, Varun; Emanuele , Santos; scheidegger, Carlos E.; Schuchardt, Karen L.; Seltzer, Margo I.; Simmhan, Yogesh L.; Claudio, Silva T.; Slaughter, Peter; Stephan, Eric G.; Stevens, Robert; Turi, Daniele; Vo, Huy T.; Wilde, Mike J.; Zhao, Jun; Zhao, Yong


    The first Provenance Challenge was set up in order to provide a forum for the community to help understand the capabilities of different provenance systems and the expressiveness of their provenance representations. To this end, a Functional Magnetic Resonance Imaging workflow was defined, which participants had to either simulate or run in order to produce some provenance representation, from which a set of identified queries had to be implemented and executed. Sixteen teams responded to the challenge, and submitted their inputs. In this paper, we present the challenge workflow and queries, and summarise the participants contributions.

  18. Ciprofloxacin-Ceftriaxone Combination Prophylaxis for Prostate Biopsy; Infective Complications

    Directory of Open Access Journals (Sweden)

    Alper Ozorak


    Full Text Available Aim: To present our clinical experience about infective complications due to ultrasound guided transrectal prostate biopsy under ciprofloxacin plus third-generation cephalosporin (Ceftriaxone combination prophylaxis. Material and Method: The 1193 patients that used combination of ceftriaxone 1 g intramuscular 1 hour before biopsy and ciprofloxacin 500 mg twice a day for 5 days after biopsy were included to study. Before biopsy, urine analysis and urinary cultures were not performed routinely. Serious infective complications such as acute prostatitis and urosepsis, causing microorganisms were evaluated. Results: Serious infective complications occurred in (1.3% 16 patients. Fifteen of them had acute prostatitis and urine culture results were positive in 10/15 patients for Escherichia coli. The strains were uniformly resistant to ciprofloxacin. Only 1 patient had urosepsis and his blood and urine cultures demonstrated extended- spectrum %u03B2-lactamase-producing (ESBL Escherichia coli also resistant to ciprofloxacin. Antibiotic treatment-related side effects were not observed in any patient. Discussion: Although there is not a certain procedure, ciprofloxacin is the most common used antibiotic for transrectal prostate biopsy prophylaxis. On the other hand, the incidence of ciprofloxacin resistant Escherichia coli strain is increasing. Thus, new prophylaxis strategies have to be discussed. Ceftriaxone plus ciprofloxacin prophylaxis is safe and can be useable option for prophylaxis of prostate biopsy.

  19. Discrepancies between biopsy-based and excision-based grading of cervical intraepithelial neoplasia: the important role of time between excision and biopsy. (United States)

    Zhang, Lu; Li, Qiang; Zhao, Mingyu; Jia, Lin; Zhang, Youzhong


    We sought to evaluate the rate of cervical intraepithelial neoplasia (CIN) ≤ 1 in loop electrosurgical excision procedure (LEEP) specimens after the treatment of biopsy-proven CIN 2-3, and to identify factors that are associated with the rate of CIN ≤ 1, especially focusing on the time interval between biopsy and LEEP. The goal of this research is to reduce the overtreatment of women with CIN 2-3. This was a retrospective study performed on women undergoing LEEP for biopsy-proven CIN 2-3 in Qilu hospital in Shandong, China. Patients were separated according to LEEP pathology (CIN ≤ 1 vs. CIN 2-3), and compared using the χ2 test and Student t test. The main outcome measures were pathologic discrepancy (defined as CIN 2-3 at biopsy, but CIN ≤ 1 at excision). Of the 391 women with biopsy-proven CIN 2-3, 26.9% had LEEP specimens with CIN ≤ 1 histologies. The likelihood of a CIN ≤ 1 LEEP specimen increases for greater biopsy-LEEP intervals (odds ratio, 1.374; 95% confidence interval, 1.089-1.735; P = 0.008). Cases in younger women and biopsy-assessed CIN 2 cases were both more likely to have CIN 1 or negative LEEP specimens. The rate of spontaneous histologic regression (defined as CIN ≤ 1 at resection) was 26.9%. These low-grade lesions were more common in LEEP specimens from young women with CIN 2 at biopsy, and who underwent LEEP later after the initial biopsy.

  20. The accuracy of colposcopic biopsy

    DEFF Research Database (Denmark)

    Stoler, Mark H; Vichnin, Michelle D; Ferenczy, Alex


    We evaluated the overall agreement between colposcopically directed biopsies and the definitive excisional specimens within the context of three clinical trials. A total of 737 women aged 16-45 who had a cervical biopsy taken within 6 months before their definitive therapy were included. Per......-protocol, colposcopists were to also obtain a representative cervical biopsy immediately before definitive therapy. Using adjudicated histological diagnoses, the initial biopsies and the same day biopsies were correlated with the surgically excised specimens. The overall agreement between the biopsies taken within 6...... months of definitive therapy, and the definitive therapy diagnoses was 42% (weighted kappa = 0.34) (95% CI: 0.29-0.39). The overall underestimation of cervical intraepithelial neoplasia grade 2/3 or adenocarcinoma in situ (CIN2-3/AIS) and CIN3/AIS was 26 and 42%, respectively. When allowing for one...

  1. Histological Value of Duodenal Biopsies

    Directory of Open Access Journals (Sweden)

    Limci Gupta


    Full Text Available This study was performed to see the value of histopathological diagnosis in management of patients with duodenal biopsies; to look for correlation of histology and serology in suspected cases of coeliac disease; the reasons for taking duodenal biopsies and whether proper adequate histories are provided on the forms sent with request for histopathological view on duodenal biopsies. Here are the observations of the study followed by the discussion.

  2. Launch Services, a Proven Model (United States)

    Trafton, W. C.; Simpson, J.


    From a commercial perspective, the ability to justify "leap frog" technology such as reusable systems has been difficult to justify because the estimated 5B to 10B investment is not supported in the current flat commercial market coupled with an oversupply of launch service suppliers. The market simply does not justify investment of that magnitude. Currently, next generation Expendable Launch Systems, including Boeing's Delta IV, Lockheed Martin's Atlas 5, Ariane V ESCA and RSC's H-IIA are being introduced into operations signifying that only upgrades to proven systems are planned to meet the changes in anticipated satellite demand (larger satellites, more lifetime, larger volumes, etc.) in the foreseeable future. We do not see a new fleet of ELVs emerging beyond that which is currently being introduced, only continuous upgrades of the fleet to meet the demands. To induce a radical change in the provision of launch services, a Multinational Government investment must be made and justified by World requirements. The commercial market alone cannot justify such an investment. And if an investment is made, we cannot afford to repeat previous mistakes by relying on one system such as shuttle for commercial deployment without having any back-up capability. Other issues that need to be considered are national science and security requirements, which to a large extent fuels the Japanese, Chinese, Indian, Former Soviet Union, European and United States space transportation entries. Additionally, this system must support or replace current Space Transportation Economies with across-the-board benefits. For the next 10 to 20 years, Multinational cooperation will be in the form of piecing together launch components and infrastructure to supplement existing launch systems and reducing the amount of non-recurring investment while meeting the future requirements of the End-User. Virtually all of the current systems have some form of multinational participation: Sea Launch

  3. Provenance studies through petrography and heavy mineral ...

    African Journals Online (AJOL)

    Provenance studies through petrography and heavy mineral analysis of part of Agbaja-Lokoja formation, Bida basin, NW Nigeria. ... Abundance of feldspathic grains is a reflection of its closeness to the provenance which is perhaps located in the north central basement domain on account of the paleocurrent azimuth trend ...

  4. Geographic characterisation of African provenances of Faidherbia ...

    African Journals Online (AJOL)

    African Crop Science Journal ... Abstract. Polymerase Chain Reaction (PCR) analysis based on Internal Franscribed Spacers (ITS) and Random Amplified Polymorphic DNA (RAPD) were carried out on sixteen provenances of Faidherbia albida currently growing in a provenance trial in semi-arid Baringo district in Kenya.

  5. Provenance, tectonics and palaeoclimate of Proterozoic Chandarpur ...

    Indian Academy of Sciences (India)

    climatic condition. The provenance analysis revealed that the Chandarpur clastics were derived from granites and granite–gneisses of a continental block tectonic provenance. Petrographic stud- ies further indicate that high grade metamorphic rocks did not make any perceptible contribution to the Chandarpur system.

  6. Therapy of Acute Intestinal Infections in Children: Proven Efficiency

    Directory of Open Access Journals (Sweden)

    S. V. Khaliullina


    Full Text Available The paper focuses on questions of etiotropic, pa diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed suchas the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.

  7. The Pattern of Histologically-Proven Acute Post-infectious ...

    African Journals Online (AJOL)

    The most common site of preceding infection was the respiratory tract (68.8%). At presentation, 89.2% had nephritic syndrome and 9.4% had rapidly progressive glomerulonephritis. Proteinuria was observed in 99.3%, hematuria in 95.3%, peripheral edema in 89.2% and hypertension in 81.8%. Most patients (60.7%) had ...

  8. Active Provenance in Data-intensive Research (United States)

    Spinuso, Alessandro; Mihajlovski, Andrej; Filgueira, Rosa; Atkinson, Malcolm


    Scientific communities are building platforms where the usage of data-intensive workflows is crucial to conduct their research campaigns. However managing and effectively support the understanding of the 'live' processes, fostering computational steering, sharing and re-use of data and methods, present several bottlenecks. These are often caused by the poor level of documentation on the methods and the data and how users interact with it. This work wants to explore how in such systems, flexibility in the management of the provenance and its adaptation to the different users and application contexts can lead to new opportunities for its exploitation, improving productivity. In particular, this work illustrates a conceptual and technical framework enabling tunable and actionable provenance in data-intensive workflow systems in support of reproducible science. It introduces the concept of Agile data-intensive systems to define the characteristic of our target platform. It shows a novel approach to the integration of provenance mechanisms, offering flexibility in the scale and in the precision of the provenance data collected, ensuring its relevance to the domain of the data-intensive task, fostering its rapid exploitation. The contributions address aspects of the scale of the provenance records, their usability and active role in the research life-cycle. We will discuss the use of dynamically generated provenance types as the approach for the integration of provenance mechanisms into a data-intensive workflow system. Enabling provenance can be transparent to the workflow user and developer, as well as fully controllable and customisable, depending from their expertise and the application's reproducibility, monitoring and validation requirements. The API that allows the realisation and adoption of a provenance type is presented, especially for what concerns the support of provenance profiling, contextualisation and precision. An actionable approach to provenance

  9. Provenance for Earth Science Data Systems (United States)

    Hua, H.; Tilmes, C.; Ramapriyan, H. K.; Duggan, B.; Wilson, B. D.; Manipon, G. J. M.


    Earth Science Data Systems across NASA play a critical role in data processing, management, and analysis of NASA observations. However, there is a growing need to provide the provenance of these datasets as scientists increasingly need more transparency of the data products to improve their understanding and trust of the science results. Lessons learned from Climategate show that there is public demand for more transparency and understanding in the science process. Science data systems are key to enabling the capture, management, and use of production provenance information. Science analysis now also may involve merging multi-sensor datasets where lineage can facilitate the understanding of the data. But there does not exist a formal recommendation for an interoperable standard for provenance representation for use in NASA's Earth Science Data Systems. The W3C Provenance Working Group has a specification for the representation of provenance information. The standard is very general and intended to support the breadth of any domain. To better serve the needs of specific domain communities, the standard has several built in points of extensibility. We will present efforts by NASA's Earth Science Data Systems Working Group (ESDSWG) on Provenance to develop an Earth Science extension to the PROV specification (PROV-ES) and how it can be used in science data system to capture, consume, and interpret provenance information.

  10. Kidney Biopsies May Help Predict Renal Function After Liver Transplantation. (United States)

    Pichler, Raimund H; Huskey, Janna; Kowalewska, Jolanta; Moiz, Abdul; Perkins, James; Davis, Connie L; Leca, Nicolae


    Renal biopsy has been proposed to determine the cause or reversibility of renal failure for patients with end-stage liver disease and may be useful in the kidney allocation. Nevertheless, little data exist to validate the usefulness of kidney biopsies in this patient population. We evaluated the utility of renal biopsies in a cohort of 59 consecutive liver transplant candidates with renal impairment of unclear etiology referred to determine the need for simultaneous liver kidney transplantation (SLK) versus liver alone transplantation (LAT). Pathological diagnoses, patient outcomes and the usefulness of biopsy results in predicting renal recovery were analyzed. Our biopsy complication rate was relatively low with only 2.9% and 4.2% serious complications occurring with transjugular and percutaneous renal biopsies, respectively. The most common pathological diagnoses on renal biopsies were membranoproliferative glomerulonephritis (23%) followed by IgA nephropathy (19%) and acute tubular injury (19%). Simultaneous liver kidney transplantation was recommended for patients with greater than 40% global glomerular sclerosis, or with interstitial fibrosis greater than 30% or for patients on hemodialysis for 2 months or longer. The best histological predictor for posttransplant glomerular filtration rate in the LAT group was the extent of global glomerulosclerosis (P = 0.0001). Based on biopsy criteria, we were able to avoid kidney allocation to 70% of our patients with renal dysfunction. Over the first year posttransplant, SLK and LAT patients had comparable estimated glomerular filtration rates. Kaplan-Meier survival analysis did not demonstrate a difference in patient survival between patients who underwent LAT versus SLK. Renal biopsy can be relatively safe in this population, may help elucidate the etiology of renal failure, may predict post-LAT kidney function, and may be helpful in kidney allocation for liver transplant candidates.

  11. Archives and societal provenance Australian essays

    CERN Document Server

    Piggott, Michael


    Records and archival arrangements in Australia are globally relevant because Australia's indigenous people represent the oldest living culture in the world, and because modern Australia is an ex-colonial society now heavily multicultural in outlook. Archives and Societal Provenance explores this distinctiveness using the theoretical concept of societal provenance as propounded by Canadian archival scholars led by Dr Tom Nesmith. The book's seventeen essays blend new writing and re-workings of earlier work, comprising the fi rst text to apply a societal provenance perspective to a national sett

  12. Provenance trials of larch in Siberia

    Energy Technology Data Exchange (ETDEWEB)

    Milyutin, L.I. [V.N. Sukachev Inst. of Forest SB RAS, Krasnoyarsk (Russian Federation)


    Some results of provenance trials of larch in Siberia are given. These provenance trials were established in the last thirty years by efforts of V.N. Sukaczev Inst. of Forest. Provenances and species of larch were tested in some field trials distributed over Siberia between Lat. N 52 deg and 66 deg, Long. E 88 deg and 113 deg: near Krasnoyarsk, in Republic Khakasia (an altitudes of 800 and 1200 metres), in the Lower Yenisei near Turukhansk, in the west and south regions of Krasnoyarsk territory, in the Upper Lena, near Chita. 2 refs

  13. Bone marrow trephine biopsies: A single centre experience in Eastern India

    Directory of Open Access Journals (Sweden)

    Sima Chauhan


    Full Text Available Introduction: Bone marrow aspiration (BMA and trephine biopsy are indispensable diagnostic tools for evaluating hematological and nonhematological disorders in the present era. However, trephine biopsy demands greater technical skills and expertise as compared to BMA alone. In this study, we have analyzed the advantages of carrying out trephine biopsy along with BMA in the same sitting. Materials and Methods: This is a prospective observational study carried out from June 2014 to May 2015. The patients attending hematology and medicine outdoors were screened by detailed clinical examination, laboratory investigations including complete blood counts, peripheral smear, and whenever indicated were subjected to BMA and trephine biopsy in the same sitting. Results: Out of total 570 aspirations and trephine biopsies done, 8% showed inadequate aspirates and diagnosis was based only on biopsy findings. Confirmatory diagnosis of aplastic anemia was done on trephine biopsy in 100% cases. Fifty percent cases of granulomas and 33.3% cases of metastasis were missed in aspiration smears. They were diagnosed on trephine biopsy. All cases of myelofibrosis required trephine biopsy for diagnosis, but aspiration alone was adequate for diagnosis in majority of acute leukemias. Conclusion: Trephine biopsy is mandatory for diagnosis of aplastic anemia, myelofibrosis, and for staging of lymphomas. It specially carries diagnostic value in cases of dry tap and bloody aspirates. Aspiration is simple, has high specificity, and is especially useful for nutritional anemia, immune thrombocytopenia, acute leukemia, and multiple myeloma.

  14. Role of pleural biopsy in etiological diagnosis of pleural effusion

    Directory of Open Access Journals (Sweden)

    Pandit Sudipta


    Full Text Available Background: Pleural effusion remains the most common manifestation of pleural pathology. Sometimes it is difficult to differentiate between tubercular and malignant pleural effusion in spite of routine biochemical and cytological examination of pleural fluid. Aims: This study aims to evaluate the role of pleural biopsy to determine the etiology of pleural effusion and to correlate it with the biochemical and cytological parameters of pleural fluid. Settings and Design: Seventy two consecutive patients of pleural effusion were selected from the out patient and indoor department of a tertiary hospital of Kolkata. It was a prospective and observational study conducted over a period of one year. Materials and Methods: Biochemical, cytological and microbiological evaluation of pleural fluid was done in all cases. Those with exudative pleural effusions underwent pleural biopsy by Abram′s needle. Subsequently, the etiology of effusion was determined. Results: Malignancy was the most common etiology, followed by tuberculosis. Pleural biopsy was done in 72 patients. Pleural tissue was obtained in 62 cases. Malignancy was diagnosed in 24, tuberculosis in 20 and non-specific inflammation in 18, on histopathological examination. Out of 20 histological proven tuberculosis cases adenosine de-aminase (ADA was more than 70 u/l in 11 cases. Conclusions: In our study, malignancy is more common than tuberculosis, particularly in elderly. When thoracoscope is not available, pleural fluid cytology and pleural biopsy can give definite diagnosis. Pleural fluid ADA ≥ 70 u/l is almost diagnostic of tuberculosis, where pleural biopsy is not recommended.

  15. A Provenance Tracking Model for Data Updates

    Directory of Open Access Journals (Sweden)

    Gabriel Ciobanu


    Full Text Available For data-centric systems, provenance tracking is particularly important when the system is open and decentralised, such as the Web of Linked Data. In this paper, a concise but expressive calculus which models data updates is presented. The calculus is used to provide an operational semantics for a system where data and updates interact concurrently. The operational semantics of the calculus also tracks the provenance of data with respect to updates. This provides a new formal semantics extending provenance diagrams which takes into account the execution of processes in a concurrent setting. Moreover, a sound and complete model for the calculus based on ideals of series-parallel DAGs is provided. The notion of provenance introduced can be used as a subjective indicator of the quality of data in concurrent interacting systems.

  16. PET-guided breast biopsy. (United States)

    Kalinyak, Judith E; Schilling, Kathy; Berg, Wendie A; Narayanan, Deepa; Mayberry, Jennifer P; Rai, Rajesh; Dupree, Elizabeth B; Shusterman, Denise K; Gittleman, Mark A; Luo, Weidong; Matthews, Chris G


    Molecular imaging, using positron emission tomography (PET), has become an integral step in the evaluation of many patients with malignancy. However, its use in patients with breast cancer has been limited by the lower levels of (18) F-fluorodeoxyglucose (FDG) uptake in some breast malignancies compared to other cancers, the small size of many breast cancers, and the need for biopsy under PET guidance. High-resolution breast PET, or positron emission mammography (PEM), with biopsy guidance software, now addresses these issues. We report a prospective, multicenter study designed to test the efficacy and safety of PEM biopsy guidance software in women with FDG-avid breast lesions worrisome for malignancy. The intervention chosen was vacuum-assisted core biopsy. Nineteen subjects underwent a total of 24 PEM-guided biopsies. All lesions were successfully targeted and sampled as determined by post-biopsy image scan evaluation, specimen imaging, and pathologic concordance. Invasive cancer was identified in 13 of 24 lesions (54%), while four (17%) were high-risk lesions and three of these were upgraded to malignancy at excision. No serious adverse events occurred and all patients found the procedure to cause only minimal to mild discomfort. High-resolution PEM-guided breast biopsy is both safe and effective for the sampling of PET-depicted breast lesions. © 2011 Wiley Periodicals, Inc.

  17. Ultrasonic Needles for Bone Biopsy. (United States)

    Mathieson, Andrew; Wallace, Robert; Cleary, Rebecca; Li Li; Simpson, Hamish; Lucas, Margaret


    Bone biopsy is an invasive clinical procedure, where a bone sample is recovered for analysis during the diagnosis of a medical condition. When the architecture of the bone tissue is required to be preserved, a core-needle biopsy is taken. Although this procedure is performed while the patient is under local anaesthesia, the patient can still experience significant discomfort. Additionally, large haematoma can be induced in the soft tissue surrounding the biopsy site due to the large axial and rotational forces, which are applied through the needle to penetrate bone. It is well documented that power ultrasonic surgical devices offer the advantages of low cutting force, high accuracy, and preservation of soft tissues. This paper reports a study of the design, analysis, and test of two novel power ultrasonic needles for bone biopsy that operate using different configurations to penetrate bone. The first utilizes micrometric vibrations generated at the distil tip of a full-wavelength resonant ultrasonic device, while the second utilizes an ultrasonic-sonic approach, where vibrational energy generated by a resonant ultrasonic horn is transferred to a needle via the chaotic motion of a free-mass. It is shown that the dynamic behavior of the devices identified through experimental techniques closely match the behavior calculated through numerical and finite-element analysis methods, demonstrating that they are effective design tools for these devices. Both devices were able to recover trabecular bone from the metaphysis of an ovine femur, and the biopsy samples were found to be comparable to a sample extracted using a conventional biopsy needle. Furthermore, the resonant needle device was also able to extract a cortical bone sample from the central diaphysis, which is the strongest part of the bone, and the biopsy was found to be superior to the sample recovered by a conventional bone biopsy needle.

  18. An R package for statistical provenance analysis (United States)

    Vermeesch, Pieter; Resentini, Alberto; Garzanti, Eduardo


    This paper introduces provenance, a software package within the statistical programming environment R, which aims to facilitate the visualisation and interpretation of large amounts of sedimentary provenance data, including mineralogical, petrographic, chemical and isotopic provenance proxies, or any combination of these. provenance comprises functions to: (a) calculate the sample size required to achieve a given detection limit; (b) plot distributional data such as detrital zircon U-Pb age spectra as Cumulative Age Distributions (CADs) or adaptive Kernel Density Estimates (KDEs); (c) plot compositional data as pie charts or ternary diagrams; (d) correct the effects of hydraulic sorting on sandstone petrography and heavy mineral composition; (e) assess the settling equivalence of detrital minerals and grain-size dependence of sediment composition; (f) quantify the dissimilarity between distributional data using the Kolmogorov-Smirnov and Sircombe-Hazelton distances, or between compositional data using the Aitchison and Bray-Curtis distances; (e) interpret multi-sample datasets by means of (classical and nonmetric) Multidimensional Scaling (MDS) and Principal Component Analysis (PCA); and (f) simplify the interpretation of multi-method datasets by means of Generalised Procrustes Analysis (GPA) and 3-way MDS. All these tools can be accessed through an intuitive query-based user interface, which does not require knowledge of the R programming language. provenance is free software released under the GPL-2 licence and will be further expanded based on user feedback.

  19. Churg-Strauss syndrome presenting with acute renal insufficiency accompanied by eosinophilic tubulointerstitial nephritis. (United States)

    Hirohama, Daigoro; Hoshino, Junichi; Sumida, Keiichi; Hasegawa, Eiko; Hiramatsu, Rikako; Yamanouchi, Masayuki; Hayami, Noriko; Suwabe, Tatsuya; Sawa, Naoki; Takemoto, Fumi; Ubara, Yoshifumi; Hara, Shigeko; Ohashi, Kenichi; Takaichi, Kenmei


    We encountered an unusual and rare case of 59-year-old woman with Churg-Strauss syndrome (CSS) showing myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA)-related acute renal insufficiency accompanied by eosinophilic tubulointerstitial nephritis. To date, reports in English of CSS presenting with rapidly progressive/acute renal insufficiency and biopsy-proven renal lesions have been uncommon. Here, we discuss this unusual case and review the previously reported CSS cases. The complication of eosinophilic tubulointerstitial nephritis in CSS cases with acute renal insufficiency might be higher than generally thought. Furthermore, the presence of eosinophilic infiltration and eosinophilic tubulointerstitial nephritis might be associated with the good renal outcome in CSS patients.

  20. Model-based Abstraction of Data Provenance

    DEFF Research Database (Denmark)

    Probst, Christian W.; Hansen, René Rydhof


    to bigger models, and the analyses adapt accordingly. Our approach extends provenance both with the origin of data, the actors and processes involved in the handling of data, and policies applied while doing so. The model and corresponding analyses are based on a formal model of spatial and organisational......Identifying provenance of data provides insights to the origin of data and intermediate results, and has recently gained increased interest due to data-centric applications. In this work we extend a data-centric system view with actors handling the data and policies restricting actions....... This extension is based on provenance analysis performed on system models. System models have been introduced to model and analyse spatial and organisational aspects of organisations, to identify, e.g., potential insider threats. Both the models and analyses are naturally modular; models can be combined...

  1. Analysis Traceability and Provenance for HEP (United States)

    Shamdasani, Jetendr; McClatchey, Richard; Branson, Andrew; Kovács, Zsolt


    This paper presents the use of the CRISTAL software in the N4U project. CRISTAL was used to create a set of provenance aware analysis tools for the Neuroscience domain. This paper advocates that the approach taken in N4U to build the analysis suite is sufficiently generic to be able to be applied to the HEP domain. A mapping to the PROV model for provenance interoperability is also presented and how this can be applied to the HEP domain for the interoperability of HEP analyses.

  2. Renal biopsy in the elderly

    Directory of Open Access Journals (Sweden)

    Javier Robaina


    Full Text Available Introduction: Kidney disease is very common among the elderly. Over the last decades, the number of renal biopsies performed on these patients has increased. Objective: This study was carried out to examine the frequency and the clinical-pathological correlation of kidney disease in elderly patients who have had a renal biopsy done. Methods: The clinical presentation of kidney disease and the main histological findings were retrospectively analyzed in patients over 65 who had undergone renal biopsy (n=109 for a period of 12 years. Results: The total number of renal biopsies performed during this period was 871, out of which 109 (12.5% corresponded to patients over 65. The main indications for renal biopsies were nephrotic syndrome (37.6% and kidney failure (34.9%. Microscopic hematuria was found in 59.6% of the patients and high blood pressure in 62.4% of them. The most frequent histological diagnosis was membranous glomerulonephritis (21.1%, followed by extracapillary glomerulonephritis (20.2%. When clinical syndromes and histological findings were compared, the nephrotic syndrome was found to be the main feature of membranous nephropathy (78.3%, of focal segmental glomerulosclerosis (55.6% and of diabetic nephropathy (66.7%. Kidney failure was present in 90% of the cases of extracapillary glomerulonephritis (95.5% pauciimmune or type 3. Microscopic hematuria was the main sign of mesangial prolifeative glomerulonephritis (83.3%. Conclusions: Nephrotic syndrome and kidney failure (especially rapidly progressive renal failure were the main renal biopsy results in this group of patients, bearing close relation to histological findings. The most common types of glomerulonephritis were membranous GN and pauciimmune extracapillary GN. Renal biopsy provides useful information for the diagnosis, prognosis and treatment of kidney disease in the elderly.

  3. The role of procurement biopsies in acceptance decisions for kidneys retrieved for transplant. (United States)

    Kasiske, Bertram L; Stewart, Darren E; Bista, Bipin R; Salkowski, Nicholas; Snyder, Jon J; Israni, Ajay K; Crary, Gretchen S; Rosendale, John D; Matas, Arthur J; Delmonico, Francis L


    There is a shortage of kidneys for transplant, and many patients on the deceased donor kidney transplant waiting list would likely benefit from kidneys that are currently being discarded. In the United States, the most common reason given for discarding kidneys retrieved for transplant is procurement biopsy results. This study aimed to compare biopsy results from discarded kidneys with discard attributed to biopsy findings, with biopsy results from comparable kidneys that were successfully transplanted. In this retrospective, observational, case-control study, biopsy reports were examined from 83 kidneys discarded in 2010 due to biopsy findings (cases), 83 contralateral transplanted kidneys from the same donor (contralateral controls), and 83 deceased donors randomly matched to cases by donor risk profile (randomly matched controls). A second procurement biopsy was obtained in 64 of 332 kidneys (19.3%). The quality of biopsy reports was low, with amounts of tubular atrophy, interstitial inflammation, arteriolar hyalinosis, and acute tubular necrosis often not indicated; 69% were wedge biopsies and 94% used frozen tissue. The correlation between first and second procurement biopsies was poor; only 25% of the variability (R(2)) in glomerulosclerosis was explained by biopsies being from the same kidney. The percentages of glomerulosclerosis overlapped substantially between cases, contralateral controls, and randomly matched controls: 17.1%±15.3%, 9.0%±6.6%, and 5.0%±5.9%, respectively. Of all biopsy findings, only glomerulosclerosis>20% was independently correlated with discard (cases versus contralateral controls; odds ratio, 15.09; 95% confidence interval, 2.47 to 92.41; P=0.003), suggesting that only this biopsy result was used in acceptance decisions. One-year graft survival was 79.5% and 90.7% in contralateral and randomly matched controls, respectively, versus 91.6% among all deceased donor transplants in the Scientific Registry of Transplant Recipients

  4. Thirty years old lady with nephrotic syndrome: a case of biopsy ...

    African Journals Online (AJOL)

    We describe a case of a 30 years old female patient who presented with nephrotic syndrome and impaired renal function which was diagnosed to have systemic lupus erythematosus (SLE) with lupus nephritis. This is the first biopsy proven lupus nephritis in Tanzania. SLE is common among females and is reported be more ...

  5. Sunitinib-Induced Acute Interstitial Nephritis in a Thrombocytopenic Renal Cell Cancer Patient

    Directory of Open Access Journals (Sweden)

    Ibrahim Azar


    Full Text Available Sunitinib, a multitargeted tyrosine Kkinase inhibitor (TKI, is currently the standard of care for patients with metastatic renal cell carcinoma. Renal adverse events associated with sunitinib include proteinuria, renal insufficiency secondary to focal segmental glomerulosclerosis (FSGS, and thrombotic microangiopathy. We describe the second reported instance of biopsy-proven sunitinib-induced acute interstitial nephritis (AIN, in a challenging case complicated by thrombocytopenia. The case illustrates the importance of early diagnosis and intervention in ensuring long-term recovery from renal complications. Four other cases of AIN reported along with inhibition of the vascular endothelial growth factor (VEGF by either TKI (sunitinib and sorafenib or antibodies (bevacizumab suggest a possible class effect. Given our experience, we recommend monitoring renal function with VEGF inhibition, and in the case of renal failure in the setting of an unclear diagnosis, we recommend prompt biopsy.

  6. Sunitinib-Induced Acute Interstitial Nephritis in a Thrombocytopenic Renal Cell Cancer Patient. (United States)

    Azar, Ibrahim; Esfandiarifard, Saghi; Sinai, Pedram; Wazir, Ali; Foulke, Llewellyn; Mehdi, Syed


    Sunitinib, a multitargeted tyrosine kinase inhibitor (TKI), is currently the standard of care for patients with metastatic renal cell carcinoma. Renal adverse events associated with sunitinib include proteinuria, renal insufficiency secondary to focal segmental glomerulosclerosis (FSGS), and thrombotic microangiopathy. We describe the second reported instance of biopsy-proven sunitinib-induced acute interstitial nephritis (AIN), in a challenging case complicated by thrombocytopenia. The case illustrates the importance of early diagnosis and intervention in ensuring long-term recovery from renal complications. Four other cases of AIN reported along with inhibition of the vascular endothelial growth factor (VEGF) by either TKI (sunitinib and sorafenib) or antibodies (bevacizumab) suggest a possible class effect. Given our experience, we recommend monitoring renal function with VEGF inhibition, and in the case of renal failure in the setting of an unclear diagnosis, we recommend prompt biopsy.

  7. New fiber-based approaches for optical biopsy (Conference Presentation) (United States)

    Weber, Jessie R.; Rivière, Christophe; Proulx, Antoine; Gallant, Pascal; Mermut, Ozzy


    Optical biopsy of tissue using fiber optic probes has proven to be a powerful tool for non-invasive and minimally invasive diagnostics. However, there are still many challenges to improving diagnostic value and commercial translation of these techniques. Many fiber-based methods are limited by background noise, which impairs sensitivity and specificity. Aspects of quality control, such as adequacy of the target of interest sampled and validation of optical measurements with histopathology can be problematic. Complexity, cost, and disposability or sterilizability are roadblocks to widespread clinical use. Here, we present new approaches to using fibers for optical biopsy aimed at solving these problems. Specifically, the new concepts are designed with the goals of being simple and disposable, to improve control of light delivery and collection from the sample, and to inherently enable better quality control of the biopsy process. A concept-of-operation aimed at nearly zero impact to the work flow of the biopsy and standard pathology procedures will be outlined. Several concepts for fiber implementations will be presented. A trade-off analysis of the concepts used to select a first implementation for testing will be presented. Preliminary experimental validation in phantoms and tissue samples will be presented for the selected configuration.

  8. Preserving cultural heritage objects: provenance formalization

    Directory of Open Access Journals (Sweden)

    Francesca Tomasi


    Full Text Available Preservation is a composite task, because digital objects are multilevel, stratified, and complex entities. In order to ensure conceptual preservation, the cultural object must be accompanied by the most accurate details about the provenance. With the provenance, in fact, it is possible to attribute paternity to the actions linked to that cultural object, in such a way as to guarantee its reliability. Given the amount of existing information on the Web, there is a need for mechanisms to determine the provenance of the data, in order to guarantee not just the reliability of the information but also the authoritativeness, so that the final user can use it. By translating these principles into ontology, the object is preserved in its conceptual dimension. Two ontologies aimed at the formalization of the provenance (PRoles and HiCO are then described, which have also been tested on two different projects: a structured collection (a catalog and a set of unstructured documents (a digital edition.

  9. Phenotypic variation among five provenances of Pterocarpus ...

    African Journals Online (AJOL)

    At 14 months of seedling growth after stem dieback the Nyazura and Kapirimposhi provenances were significantly shorter, whereas there were no significant differences in diameter growth and dry biomass from root, stem, leaf or root:shoot dry biomass ratio. Fourteen months after germination new shoots emerged from ...

  10. Paleoclimatic, paleovegetational and provenance change in the ...

    Indian Academy of Sciences (India)

    Paleoclimatic, paleovegetational and provenance change in the Ganga Plain during the late Quaternary. Shailesh Agrawal, Prasanta Sanyal, Melinda K Bera,. Jitendra K Dash and Srinivasan Balakrishnan. J. Earth Syst. Sci. 122(4), June 2013, 1141–1152, c@ Indian Academy of Sciences. Supplementary data ...

  11. Paleoclimatic, paleovegetational and provenance change in the ...

    Indian Academy of Sciences (India)

    Present study aims at reconstructing the paleomonsoonal rainfall, paleovegetation and provenance change during the late Quaternary. Towards this, Bhognipur core, collected from the southern Ganga Plain, have been sampled for soil carbonate (SC) and soil. The 18O values of SC (18OSC) range from −7.6 to −4.9‰.

  12. Provenance testing at Michigan Technological University (United States)

    Robert L. Sajdak


    The location of M.T.U. in the Keweenaw Peninsula of Upper Michigan provides some unique advantages and disadvantages in provenance testing and tree improvement research. Extremes in summer and winter temperatures are uncommon because of the moderating effect of Lake Superior. Near the Lake we have about 140 frost-free days while inland the frost-free season is only 80...

  13. Model-based Abstraction of Data Provenance

    NARCIS (Netherlands)

    Probst, Christian W.; Hansen, René Rydhof

    Identifying provenance of data provides insights to the origin of data and intermediate results, and has recently gained increased interest due to data-centric applications. In this work we extend a data-centric system view with actors handling the data and policies restricting actions. This

  14. Provenance, tectonics and palaeoclimate of Proterozoic Chandarpur ...

    Indian Academy of Sciences (India)

    . 1975 Re-evaluation of the use of undulatory extinction and polycrysrtallinity in detrital quartz for provenance interpretation; J. Sedim. Petrol. 45 873–882. Berner R A 1969 Goethite stability and the origin of red beds; Geochim. Et Cosm. Acta.

  15. Paleoclimatic, paleovegetational and provenance change in the ...

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Earth System Science; Volume 122; Issue 4. Paleoclimatic, paleovegetational and provenance change in the Ganga Plain during the late Quaternary. Shailesh Agrawal Prasanta Sanyal Melinda K Bera Jitendra K Dash Srinivasan Balakrishnan. Volume 122 Issue 4 August 2013 pp 1141-1152 ...

  16. Ultrasound-guided forceps for pleural biopsy

    Directory of Open Access Journals (Sweden)

    Gamal Agmy


    Clinical implications: Ultrasound-guided forceps for pleural biopsy can overcome many of the limitations of the conventional needle biopsy procedures, provides multiple biopsy specimens of the parietal pleura that are inaccessible to the biopsy needle, and can be carried out easily and safely even in sick and obese patients. The diagnostic yield is nearly similar to thoracoscopy.

  17. Renal biopsy in the elderly: a single-center experience. (United States)

    Harmankaya, Ozlem; Okuturlar, Yildiz; Kocoglu, Hakan; Kaptanogullari, Hakan; Yucel, Sibel Kocak; Ozkan, Hanise; Acarer, Didem; Erdogan, Ezgi; Yilmaz, Murvet; Hursitoglu, Mehmet


    Aging population has been increasing worldwide. So the number of elderly patients presenting with kidney disease has also been increasing. In this retrospective study, we assessed biopsy results of elderly patients and their clinical presentations. Native renal biopsy results of 98 elderly patients (≥65 years) were analyzed. These 98 patients consisted of 56 males (57.1 %) and 42 females (42.9 %) with a mean age of 70.59 ± 5.31 years (65-88 years). The clinical presentations of our elderly patients were nephritic syndrome (n = 45), acute kidney injury (n = 35), nephrotic syndrome (n = 33), chronic kidney disease (n = 32) and combined nephritic and nephrotic syndrome (n = 14). In patients with nephritic syndrome, the most common diagnosis was crescentic GN (17.8 % type 3 and 13.3 % types 1 and 2). Crescentic GN was also the most frequent among patients with acute kidney injury (37.1 %), while membranous nephropathy was the major histopathological diagnosis in chronic kidney disease patients. In nephrotic syndrome, the most common histopathological diagnosis was AA amyloidosis. None of the patients had a major life-threatening complication. Biopsies in the elderly are as safe as in the general population. Renal biopsy should be performed to provide an accurate diagnosis and initiate specific treatment in elderly patients.

  18. The PBase Scientific Workflow Provenance Repository

    Directory of Open Access Journals (Sweden)

    Víctor Cuevas-Vicenttín


    Full Text Available Scientific workflows and their supporting systems are becoming increasingly popular for compute-intensive and data-intensive scientific experiments. The advantages scientific workflows offer include rapid and easy workflow design, software and data reuse, scalable execution, sharing and collaboration, and other advantages that altogether facilitate “reproducible science”. In this context, provenance – information about the origin, context, derivation, ownership, or history of some artifact – plays a key role, since scientists are interested in examining and auditing the results of scientific experiments. However, in order to perform such analyses on scientific results as part of extended research collaborations, an adequate environment and tools are required. Concretely, the need arises for a repository that will facilitate the sharing of scientific workflows and their associated execution traces in an interoperable manner, also enabling querying and visualization. Furthermore, such functionality should be supported while taking performance and scalability into account. With this purpose in mind, we introduce PBase: a scientific workflow provenance repository implementing the ProvONE proposed standard, which extends the emerging W3C PROV standard for provenance data with workflow specific concepts. PBase is built on the Neo4j graph database, thus offering capabilities such as declarative and efficient querying. Our experiences demonstrate the power gained by supporting various types of queries for provenance data. In addition, PBase is equipped with a user friendly interface tailored for the visualization of scientific workflow provenance data, making the specification of queries and the interpretation of their results easier and more effective.

  19. Update on Myocarditis and Inflammatory Cardiomyopathy: Reemergence of Endomyocardial Biopsy. (United States)

    Dominguez, Fernando; Kühl, Uwe; Pieske, Burkert; Garcia-Pavia, Pablo; Tschöpe, Carsten


    Myocarditis is defined as an inflammatory disease of the heart muscle and is an important cause of acute heart failure, sudden death, and dilated cardiomyopathy. Viruses account for most cases of myocarditis or inflammatory cardiomyopathy, which could induce an immune response causing inflammation even when the pathogen has been cleared. Other etiologic agents responsible for myocarditis include drugs, toxic substances, or autoimmune conditions. In the last few years, advances in noninvasive techniques such as cardiac magnetic resonance have been very useful in supporting diagnosis of myocarditis, but toxic, infectious-inflammatory, infiltrative, or autoimmune processes occur at a cellular level and only endomyocardial biopsy can establish the nature of the etiological agent. Furthermore, after the generalization of immunohistochemical and viral genome detection techniques, endomyocardial biopsy provides a definitive etiological diagnosis that can lead to specific treatments such as antiviral or immunosuppressive therapy. Endomyocardial biopsy is not commonly performed for the diagnosis of myocarditis due to safety reasons, but both right- and left endomyocardial biopsies have very low complication rates when performed by experienced operators. This document provides a state-of-the-art review of myocarditis and inflammatory cardiomyopathy, with special focus on the role of endomyocardial biopsy to establish specific treatments. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Kidney Biopsy in Jordan: Complications and Histopathological Findings

    Directory of Open Access Journals (Sweden)

    Ghnaimat Mohamad


    Full Text Available In this retrospective study, we reviewed the medical records, and histopathology findings of 191 patients who underwent renal biopsies at King Hussein Medical Center (KHMC during a four-year period (1993-97. All were performed using Tru-Cut needles under ultrasound guidance. There were 119 males (62.3% and 72 females (37.7%; the mean age was 29.1 years (range 5-76 years. Side effects of the renal biopsies included pain at the site of he biopsy in 17 (8.9%, gross hematuria in six (3.1% and hematuria requiring blood transfusion in one (0.5% patient. Nephrotic syndrome was the most common indication for biopsy followed by acute renal failure of unknown etiology. Among the nephritic patients, minimal change disease and post-infectious glomerulonephritis (GN were the commonest findings in children below the age of 15 years, membrano-proliferative GN ranked first in adults whole membranous GN and amyloidosis were more common in the elderly. WE conclude that renal biopsy was associated with a n acceptably low rate of complications in our practice, and that the patterns of renal histology vary slightly from those reported from other countries.

  1. Cytology Preparations of Formalin Fixative Aid Detection of Giardia in Duodenal Biopsy Samples. (United States)

    Panarelli, Nicole C; Gobara, Nariman; Hoda, Rana S; Chaump, Michael; Jessurun, Jose; Yantiss, Rhonda K


    Giardiasis is the most common intestinal parasitic infection in the United States. The organism elicits no, or minimal, inflammatory changes in duodenal biopsy samples, so it can be easily overlooked. We performed this study to determine whether Giardia could be isolated from the formalin fixative of biopsy samples, and to evaluate the value of fluid analysis in the assessment for potential infection. We prospectively evaluated duodenal biopsy samples from 92 patients with a clinical suspicion of giardiasis or symptoms compatible with that diagnosis (ie, diarrhea, bloating, or abdominal pain) Biopsy samples were routinely processed and stained with hematoxylin and eosin. Histologic diagnoses included giardiasis (5 cases, 4%), normal findings (64 cases, 70%), peptic injury/active duodenitis (12 cases, 13%), and intraepithelial lymphocytosis with villous blunting (10 cases, 12%). Fifteen cases (13%) showed detached degenerated epithelial cells or mucus droplets in the intervillous space that resembled Giardia. Cytology slides were prepared from formalin in the biopsy container using the standard Cytospin protocol and reviewed by a cytopathologist blinded to the biopsy findings. Cytologic evaluation revealed Giardia spp. in all 5 biopsy-proven cases, and identified an additional case that was not detected by biopsy analysis. Organisms were significantly more numerous (mean: 400 trophozoites; range, 120 to 810) and showed better morphologic features in cytology preparations compared with tissue sections (mean: 129 trophozoites; range, 37 to 253 organisms; P=0.05). Our findings suggest that cytology preparations from formalin fixative can resolve diagnostically challenging cases and even enhance Giardia detection in some cases.

  2. PAV ontology: provenance, authoring and versioning. (United States)

    Ciccarese, Paolo; Soiland-Reyes, Stian; Belhajjame, Khalid; Gray, Alasdair Jg; Goble, Carole; Clark, Tim


    Provenance is a critical ingredient for establishing trust of published scientific content. This is true whether we are considering a data set, a computational workflow, a peer-reviewed publication or a simple scientific claim with supportive evidence. Existing vocabularies such as Dublin Core Terms (DC Terms) and the W3C Provenance Ontology (PROV-O) are domain-independent and general-purpose and they allow and encourage for extensions to cover more specific needs. In particular, to track authoring and versioning information of web resources, PROV-O provides a basic methodology but not any specific classes and properties for identifying or distinguishing between the various roles assumed by agents manipulating digital artifacts, such as author, contributor and curator. We present the Provenance, Authoring and Versioning ontology (PAV, namespace a lightweight ontology for capturing "just enough" descriptions essential for tracking the provenance, authoring and versioning of web resources. We argue that such descriptions are essential for digital scientific content. PAV distinguishes between contributors, authors and curators of content and creators of representations in addition to the provenance of originating resources that have been accessed, transformed and consumed. We explore five projects (and communities) that have adopted PAV illustrating their usage through concrete examples. Moreover, we present mappings that show how PAV extends the W3C PROV-O ontology to support broader interoperability. The initial design of the PAV ontology was driven by requirements from the AlzSWAN project with further requirements incorporated later from other projects detailed in this paper. The authors strived to keep PAV lightweight and compact by including only those terms that have demonstrated to be pragmatically useful in existing applications, and by recommending terms from existing ontologies when plausible. We analyze and compare PAV with related

  3. Predictors of prostate cancer in ultrasound-guided transperineal saturation biopsy in Turkish men with multiple prior negative biopsies. (United States)

    Yazici, Sertac; Kiziloz, Halil; Bozaci, Ali Cansu; Baydar, Dilek Ertoy; Del Biondo, Dario; Ozen, Haluk


    Transperineal prostate biopsy (STPB) is associated with an improved cancer detection rate and an increase in anterior and apical prostate cancers compared to standard transrectal biopsy. A total of 48 men with at least two sets of prior prostate biopsies underwent transrectal ultrasound-guided STPB. Prostate rebiopsy indications were serum prostate-specific antigen (PSA) levels greater than 2.5 ng/mL and/or abnormal digital rectal examination and/or presence of high-grade prostatic intraepithelial neoplasia (HGPIN; ≥2 cores) or atypical small acinar proliferation (ASAP) at previous biopsies. The procedure was performed at dorsal lithotomy position under general anesthesia using a perineal 0.5 cm brachytherapy template attached to the transrectal ultrasound probe. Specimens from each zone were sent separately for pathological examination. Mean PSA level at STPB was 15.9 ng/mL (range 4.03 to 59.57). An average of 54.5 cores was obtained. Prostate adenocarcinoma was detected in 15 of 48 (31%) patients. Mean percentage of malignant cores was 11.9%. Multivariate logistic regression analysis revealed that age and presence of ASAP or HGPIN at previous biopsies were independent predictors of prostate cancer (p<0.05). No major complications, including sepsis and severe urinary or rectal bleeding, were observed in any of the patients. Five patients (10%) developed acute urinary retention after the procedure requiring urethral catheterization. Considerable number of patients with negative multiple biopsies were diagnosed with prostate cancer. STPB is a well-tolerated procedure with minimal morbidity, which can be considered for the diagnosis of prostate cancer in patients with previous negative biopsies.

  4. Testicular biopsy in prepubertal boys

    DEFF Research Database (Denmark)

    Faure, Alice; Bouty, Aurore; O'Brien, Mike


    for the preservation of fertility after gonadotoxic chemotherapy - even for prepubertal boys - are emerging. Cryopreservation of testicular tissue samples for the preservation of fertility - although still an experimental method at present - is appealing in this context. In our opinion, testicular biopsy...

  5. Biopsy techniques for intraocular tumors

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi


    Full Text Available Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88-95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous, suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies.

  6. Gram stain of tissue biopsy (United States)

    ... suspected. Normal Results Whether there are bacteria, and what type there are, depends on the tissue being biopsied. Some tissues in the body are ... about the meaning of your specific test results. What Abnormal Results Mean ... results usually mean there is an infection in the tissue. More tests, such as culturing the tissue that ...

  7. Network Dimensions in the Getty Provenance Index


    Schich, Maximilian; Huemer, Christian; Adamczyk, Piotr; Manovich, Lev; Liu, Yang-Yu


    In this article we make a case for a systematic application of complex network science to study art market history and more general collection dynamics. We reveal social, temporal, spatial, and conceptual network dimensions, i.e. network node and link types, previously implicit in the Getty Provenance Index (GPI). As a pioneering art history database active since the 1980s, the GPI provides online access to source material relevant for research in the history of collecting and art markets. Ba...

  8. MCloud: Secure Provenance for Mobile Cloud Users (United States)


    policy or decision, unless so designated by other documentation. 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office ...P.O. Box 12211 Research Triangle Park, NC 27709-2211 fraud detection, data protection, provenance, mobile device, social network REPORT DOCUMENTATION...PHP. We used the Open Source Computer Vision (OpenCV) library [7] for the video motion analysis. The client allows users to capture movies and

  9. When to biopsy seminal vesicles. (United States)

    Panach-Navarrete, J; García-Morata, F; Hernández-Medina, J A; Martínez-Jabaloyas, J M


    The involvement of seminal vesicles in prostate cancer can affect the prognosis and determine the treatment. The objective of this study was to determine whether we could predict its infiltration at the time of the prostate biopsy to know when to indicate the biopsy of the seminal vesicles. observational retrospective study of 466 patients who underwent seminal vesicle biopsy. The indication for this biopsy was a prostate-specific antigen (PSA) level greater than 10 ng/ml or an asymmetric or obliterated prostatoseminal angle. The following variables were included in the analysis: PSA level, PSA density, prostate volume, number of cores biopsied, suspicious rectal examination, and preservation of the prostatoseminal angle, studying its relationship with the involvement of the seminal vesicles. Forty-one patients (8.8%) had infiltrated seminal vesicles and 425 (91.2%) had no involvement. In the univariate analysis, the cases with infiltration had a higher mean PSA level (P 19.60 ng/dL (P < .01) and 2.95 times higher if there is a suspicious rectal examination (P = .014). Furthermore, this probability increases by 1.04 times for each unit of prostate volume lower (P < .01). The ROC curves showed maximum sensitivity and specificity at 19.6 ng/mL for PSA and 0.39 for PSA density. In this series, greater involvement of seminal vesicles was associated with a PSA level ≥20 ng/ml, a suspicious rectal examination and a lack of prostatoseminal angle preservation. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Acute interstitial nephritis induced by Dioscorea quinqueloba (United States)


    Background The use of herbal medicine may be a risk factor for the development of kidney injury, as it has been reported to cause various renal syndromes. Dioscorea quinqueloba is a medicinal herb that is used as an alternative therapy for cardiovascular disease and various medical conditions. Case presentation A 52-year-old man was admitted with complaints of skin rash and burning sensation. He had ingested a raw extract of D. quinqueloba as a traditional remedy. Laboratory tests revealed the following values: absolute eosinophil count, 900/mm3; serum creatinine level, 2.7 mg/dL; and blood urea nitrogen, 33.0 mg/dL. The immunoglobulin E level was markedly increased at 1320.0 IU/mL. Urinalysis revealed a fractional excretion of sodium of 3.77%, protein 1+, and blood 3+. Histological examination of the renal biopsy specimen showed a diffusely edematous interstitium with infiltrates composed of eosinophils, lymphocytes, and neutrophils. Conclusion Here, we present the first reported case of biopsy-proven acute interstitial nephritis following ingestion of D. quinqueloba associated with skin rash, eosinophilia, and increased plasma immunoglobulin E level. PMID:25186588

  11. Proximal Tubular Injury in Medullary Rays Is an Early Sign of Acute Tacrolimus Nephrotoxicity

    Directory of Open Access Journals (Sweden)

    Diane Cosner


    Full Text Available Tacrolimus (FK506 is one of the principal immunosuppressive agents used after solid organ transplantations to prevent allograft rejection. Chronic renal injury induced by tacrolimus is characterized by linear fibrosis in the medullary rays; however, the early morphologic findings of acute tacrolimus nephrotoxicity are not well characterized. Kidney injury molecule-1 (KIM-1 is a specific injury biomarker that has been proven to be useful in the diagnosis of mild to severe acute tubular injury on renal biopsies. This study was motivated by a patient with acute kidney injury associated with elevated serum tacrolimus levels in whom KIM-1 staining was present only in proximal tubules located in the medullary rays in the setting of otherwise normal light, immunofluorescent, and electron microscopy. We subsequently evaluated KIM-1 expression in 45 protocol and 39 indicated renal transplant biopsies to determine whether higher serum levels of tacrolimus were associated with acute segment specific injury to the proximal tubule, as reflected by KIM-1 staining in the proximal tubules of the cortical medullary rays. The data suggest that tacrolimus toxicity preferentially affects proximal tubules in medullary rays and that this targeted injury is a precursor lesion for the linear fibrosis seen in chronic tacrolimus toxicity.

  12. Serum level of soluble fibrinogen-like protein 2 in renal allograft recipients with acute rejection: a preliminary study. (United States)

    Zhao, Z; Yang, C; Tang, Q; Zhao, T; Jia, Y; Ma, Z; Rong, R; Xu, M; Zhu, T


    Soluble fibrinogen-like protein 2 (sfgl2), which is mainly secreted by T cells, is a novel effector of regulatory T cells with immunosuppressive functions. The aim of this study was to investigate serum levels of sfgl2 among renal allograft recipients. From November 2010 to August 2011 we retrospectively divided 47 renal allograft recipients into an acute rejection (n = 19) versus a stable group (n = 28) according to allograft biopsy results, using the Banff 2007 classification. The acute rejection group was subdivided into grade I (n = 8) versus grade II T-cell-mediated (n = 6) or antibody-mediated rejection episodes (n = 5). Peripheral blood samples were collected at the time of biopsy. Fourteen healthy volunteers were included as normal group controls. Serum levels of sfgl2 were analyzed by enzyme-linked immunosorbent assay. Serum levels of sfgl2 were increased among renal allograft recipients suffering from biopsy-proven acute rejection episodes (61.91 ± 45.68 ng/mL), versus those with stable allografts (38.59 ± 19.92 ng/mL, P rejection episodes (41.71 ± 16.44 ng/mL, P rejection (34.10 ± 9.26 ng/mL, P rejection episodes to an extent dependent upon the pathological type and severity of the response. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  13. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

    Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann


    To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking.......To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

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

    Energy Technology Data Exchange (ETDEWEB)

    Qayyum, Aliya; Coakley, F.V.; Lu, Y.; Olpin, J.D.; Wu, L.; Yeh, B.M.; Carroll, P.R.; Kurhanewicz, J. [California Univ., San Francisco, CA (United States). Dept. of Radiology


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

  15. Biopsy (United States)

    ... What is the FOD? Foundation Levels of Giving Governance By-Laws Committees Committee Service Conflict of Interest ... These are often done to remove a small growth and confirm its nature at the same time. ...

  16. Secure Location Provenance for Mobile Devices (United States)


    BEEN REVIEWED AND IS APPROVED FOR PUBLICATION IN ACCORDANCE WITH ASSIGNED DISTRIBUTION STATEMENT. FOR THE DIRECTOR: / S / DAVID M. CLIMEK Work...UU 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON DAVID M. CLIMEK a. REPORT U b. ABSTRACT U c. THIS PAGE U 19b. TELEPHONE NUMBER (Include...Francalanza, and V. Sassone , “A formal model of provenance in distributed systems,” in Proc. of TaPP. USENIX Association, Feb 2009, pp. 1–11. [50] I

  17. Different types of power reactors and provenness

    International Nuclear Information System (INIS)

    Goodman, E.I.


    The lecture guides the potential buyer in the selection of a reactor type. Recommended criteria regarding provenness, licensability, and contractual arrangements are defined and discussed. Tabular data summarizing operating experience and commercial availability of units are presented and discussed. The status of small and medium power reactors which are of interest to many developing countries is presented. It is stressed that each prospective buyer will have to establish his own criteria based on specific conditions which will be applied to reactor selection. In all cases it will be found that selection, either pre-selection of bidders or final selection of supplier, will be a fairly complex evaluation. (orig.) [de

  18. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)


    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various ...

  19. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  20. Aortography following subdiaphragmal aortic biopsy

    International Nuclear Information System (INIS)

    Schimmler, J.


    A juxtaposition of the subdiaphragmal and infrarenal translumbar aortic biopsy sites showed decisive advantages in favour of the higher site: a more stable position because of better anatomic fixation and rarer incidence of vascular alterations, a wider vascular lumen. Disadvantages lie in the fact that the large visceral arteries (especially Tr. coeliacus) branch off nearly and in the close anatomic relationship to large abdominal organs and the thoracal region. Evaluation of the radiographical image of the vascular tree after subdiaphragmal aortic biopsy showed an average 82% of the vessels to the area of the Knees to be assessable (renal arteries approximately 93%, popliteal arteries approximately 70%). Beyong, the method proved unsatisfactory: 52% of the vessels could not, or not safety, be evaluated. A relatively broad spectrum of indications by comparison with transfemoral catheter aortography had no influence on the rate of complications with reference to either method. A comparison of the topographic conditions shows the need for even more scrupulons observation of the technique in subdiaphragmal biopsy than in the infrarenal one. To sum up the results obtained, subdiaphregmal translumbar aortography is to be preferred to the infrarenal one where transfemoral catheter aortography is contra-indicated, within the limits mentioned. (orig.) [de

  1. Unsuspected pheochromocytoma: Risk of blood-pressure alterations during percutaneous adrenal biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Casola, G.; Nicolet, V.; van Sonnenberg, E.; Withers, C.; Bretagnolle, M.; Saba, R.M.; Bret, P.M.


    Four unsuspected pheochromocytomas were discovered during percutaneous fine-needle biopsy of the adrenal gland under ultrasound (n = 1) and computed tomographic (n = 3) guidance. One patient suffered an acute episode of alternating hypertension and hypotension during the procedure. A second patient had no alterations in vital signs during the procedure but had a severe hypertensive crisis during induction of anesthesia at surgery. Neither biopsy nor surgery affected the vital signs in the other two patients. During biopsy study of adrenal lesions, the possibility of unsuspected pheo-chromocytoma should be considered, and the interventional radiologist must be familiar with the emergency treatment of hypotensive or hypertensive crises that may occur.

  2. A review of sentinel lymph node biopsy for thin melanoma. (United States)

    Joyce, K M; McInerney, N M; Joyce, C W; Jones, D M; Hussey, A J; Donnellan, P; Kerin, M J; Kelly, J L; Regan, P J


    Although there is a lack of established survival benefit of sentinel lymph node biopsy (SLNB), this technique has been increasingly applied in the staging of patients with thin (≤1.00 mm) melanoma (T1Nx), without clear supportive evidence. We review the guidelines and available literature on the indications and rationale for performing SLNB in thin melanoma. As a consequence of the paucity of evidence of SLNB in thin melanoma, there is considerable variability in the guidelines. It is difficult to define clinicopathologic factors that reliably predict the presence of nodal metastasis. SLNB does not yet inform management in thin melanoma to improve survival outcome. Based on available evidence, high risk patients with melanomas between 0.75 and 1.00 mm may be appropriate candidates to be considered for SLN biopsy after discussing the likelihood of finding evidence of nodal progression, the risks of sentinel node biopsy, and the lack of proven survival benefit from any form of surgical nodal staging.

  3. Ultrasound diagnosis of fibroadenoma - is biopsy always necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Smith, G.E.C. [Bradford Royal Infirmary, Bradford, West Yorkshire (United Kingdom)], E-mail:; Burrows, P. [Bradford Royal Infirmary, Bradford, West Yorkshire (United Kingdom)


    Aim: To review the ultrasound characteristics of fibroadenoma and the necessity to biopsy all fibroadenomas in the under 25 years age group. Materials and methods: The details of all patients under 25 years of age who attended a large district general hospital in the UK between 1995 and 2005 with a clinical diagnosis of fibroadenoma and subsequently, underwent a breast biopsy were obtained. The report of the targeted ultrasound for these patients was reviewed and this was correlated with the histopathology report (n = 447). If there was a significant discrepancy between the ultrasound and the pathology report, the ultrasound images were reviewed. Results: Out of 447 patients 357 had an ultrasound diagnosis of fibroadenoma. This was histologically proven in 281 (78.8%) cases. In 75 (21.5%) of these patients the final histology was either another benign pathology or normal. One patient (0.3%) had an invasive carcinoma. Conclusion: The majority of patients in the 25 years and under age group have benign breast pathology, most commonly fibroadenoma. Modern ultrasound is a reliable technique to diagnose fibroadenoma in the hands of experienced breast radiologists. Therefore, in this age group, it is proposed that a palpable lump that has the ultrasound characteristics entirely consistent with a fibroadenoma need not be biopsied unless there is overriding clinical concern. The patients should be reassured, discharged, and advised to return for further evaluation only if they detect a change in the palpable abnormality.

  4. Ultrasound diagnosis of fibroadenoma - is biopsy always necessary?

    International Nuclear Information System (INIS)

    Smith, G.E.C.; Burrows, P.


    Aim: To review the ultrasound characteristics of fibroadenoma and the necessity to biopsy all fibroadenomas in the under 25 years age group. Materials and methods: The details of all patients under 25 years of age who attended a large district general hospital in the UK between 1995 and 2005 with a clinical diagnosis of fibroadenoma and subsequently, underwent a breast biopsy were obtained. The report of the targeted ultrasound for these patients was reviewed and this was correlated with the histopathology report (n = 447). If there was a significant discrepancy between the ultrasound and the pathology report, the ultrasound images were reviewed. Results: Out of 447 patients 357 had an ultrasound diagnosis of fibroadenoma. This was histologically proven in 281 (78.8%) cases. In 75 (21.5%) of these patients the final histology was either another benign pathology or normal. One patient (0.3%) had an invasive carcinoma. Conclusion: The majority of patients in the 25 years and under age group have benign breast pathology, most commonly fibroadenoma. Modern ultrasound is a reliable technique to diagnose fibroadenoma in the hands of experienced breast radiologists. Therefore, in this age group, it is proposed that a palpable lump that has the ultrasound characteristics entirely consistent with a fibroadenoma need not be biopsied unless there is overriding clinical concern. The patients should be reassured, discharged, and advised to return for further evaluation only if they detect a change in the palpable abnormality

  5. Ultrasound diagnosis of fibroadenoma - is biopsy always necessary? (United States)

    Smith, G E C; Burrows, P


    To review the ultrasound characteristics of fibroadenoma and the necessity to biopsy all fibroadenomas in the under 25 years age group. The details of all patients under 25 years of age who attended a large district general hospital in the UK between 1995 and 2005 with a clinical diagnosis of fibroadenoma and subsequently, underwent a breast biopsy were obtained. The report of the targeted ultrasound for these patients was reviewed and this was correlated with the histopathology report (n=447). If there was a significant discrepancy between the ultrasound and the pathology report, the ultrasound images were reviewed. Out of 447 patients 357 had an ultrasound diagnosis of fibroadenoma. This was histologically proven in 281 (78.8%) cases. In 75 (21.5%) of these patients the final histology was either another benign pathology or normal. One patient (0.3%) had an invasive carcinoma. The majority of patients in the 25 years and under age group have benign breast pathology, most commonly fibroadenoma. Modern ultrasound is a reliable technique to diagnose fibroadenoma in the hands of experienced breast radiologists. Therefore, in this age group, it is proposed that a palpable lump that has the ultrasound characteristics entirely consistent with a fibroadenoma need not be biopsied unless there is overriding clinical concern. The patients should be reassured, discharged, and advised to return for further evaluation only if they detect a change in the palpable abnormality.

  6. 20 CFR 718.106 - Autopsy; biopsy. (United States)


    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Autopsy; biopsy. 718.106 Section 718.106... PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a) A report of an autopsy or biopsy submitted in connection with a claim shall include a detailed gross macroscopic and...

  7. Breast magnetic resonance imaging guided biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Bo La; Kim, Sun Mi; Jang, Mi Jung [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Cho, Nariya; Moon, Woo Kyung [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Hak Hee [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    Despite the high sensitivity of breast magnetic resonance imaging (MRI), pathologic confirmation by biopsy is essential because of limited specificity. MRI-guided biopsy is required in patients with lesions only seen on MRI. We review preprocedural considerations and the technique of MRI-guided biopsy, challenging situations and trouble-shooting, and correlation of radiologic and pathologic findings.

  8. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

    Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann


    To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

  9. Provenance of sediments from Sumatra, Indonesia (United States)

    Liebermann, Christof; Hall, Robert; Gough, Amy


    The island of Sumatra is situated at the south-western margin of the Indonesian archipelago. Sumatra is affected by active continental margin volcanism along the Sunda Trench, west of Sumatra as a result of active northeast subduction of the Indian plate under the Eurasian plate. Exposures of the Palaeozoic meta-sedimentary basement are mainly limited in extent to the northeast-southwest trending Barisan Mountain chain. The younger Cenozoic rocks are widespread across Sumatra, but can be grouped into structurally subdivided 'fore-arc', 'intramontane', and 'back-arc' basins. However, the formation of the basins pre-dates the current magmatic arc, thus a classical arc-related generation model can not be applied. The Cenozoic formations are well studied due to hydrocarbon enrichment, but little is known about their provenance history. A comprehensive sedimentary provenance study of the Cenozoic formations can aid in the wider understanding of Sumatran petroleum plays, can contribute to palaeographic reconstruction of western SE Asia, and might help to simplify the overall stratigraphy of Sumatra. This work represents a multi-proxy provenance study of sedimentary rocks from the main Cenozoic basins of Sumatra, alongside sediment from present-day river systems. The project refines the provenance in two ways: first, by studying the heavy mineral assemblages of the targeted formations, and secondly, by U-Pb detrital zircon dating using LA-ICP-MS to identify the age-range of the potential sediment sources. Preliminary U-Pb zircon age-data of >1500 concordant grains (10% discordant cut-off), heavy mineral compositions, and thin section analysis from two fieldwork seasons indicate a mixed provenance model, with a proximal igneous source, and mature basement rocks. An increase of the proximal signature in Lower-Miocene strata indicated by the occurrence of unstable heavy mineral phases such as apatite, and clinopyroxene suggests a major change of the source at the Oligocene

  10. Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis

    Directory of Open Access Journals (Sweden)

    Marilda Mazzali


    Full Text Available CONTEXT: Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years.1 Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made. OBJECTIVES: To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients. DESIGN: Accuracy study, retrospective analysis. SETTING: A university terciary referral center. SAMPLE: 339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy. MAIN MEASUREMENTS: Laboratory evaluation and hystological analysis (light microscopy, imunofluorescent eletronic microscopy. RESULTS: Most of the biopsies (58.9% were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection. CONCLUSIONS: Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.

  11. How harmful can herbal remedies be? a case of severe acute tubulointerstitial nephritis

    Directory of Open Access Journals (Sweden)

    P Beniwal


    Full Text Available Acute interstitial nephritis (AIN is a condition in which acute kidney injury (AKI is characterized by the histological finding of interstitial inflammation. Hyponidd is an ayurvedic drug containing Momordica charantia, Gymnema sylvestre, Swertia chirata, etc., used for the treatment of Type 2 diabetes mellitus (DM and polycystic ovarian disease as an insulin sensitizer. There are no case reports of AIN caused by this drug yet. We report a biopsy-proven case of AKI due to severe AIN associated with the use of hyponidd tablet in a 60-year-old male with DM and hypertension. As these types of various indigenous compounds are used as home remedies in our country, awareness about the possible adverse effects of these agents among physicians is very important in the early diagnosis and management.

  12. Transjugular Renal Biopsy: Our Experience and Technical Considerations

    International Nuclear Information System (INIS)

    See, Teik Choon; Thompson, Barbara C.; Howie, Alexander J.; Karamshi, M.; Papadopoulou, Anthie M.; Davies, Neil; Tibballs, Jonathan


    The purpose of this study was to describe the indications for and technique of transjugular renal biopsy (TJRB) and evaluate the efficacy and complications of this method. We performed a retrospective review of 59 patients who underwent TJRB using the Quick-core needle biopsy system (Cook, Letchworth, UK) over a 4-year period. The indications for obtaining renal biopsy included acute renal failure, chronic renal failure, nephrotic syndrome, and proteinuria with or without other associated disease. Indications for the transjugular approach included coagulopathy, biopsy of a solitary kidney or essentially single functioning kidney, simultaneous renal and hepatic biopsy, morbid obesity, and failed percutaneous biopsy. All but four cases were performed via the right internal jugular vein. The right, left, or both renal veins were cannulated in 41, 14, and 4 cases, respectively. Combined liver and renal biopsies were obtained in seven cases. Diagnostic biopsy specimens were obtained in 56 of 59 patients (95%). The number and size of tissue cores ranged from 1 to 9 mm and from 1 to 20 mm, respectively. The mean numbers of glomeruli per procedure on light microscopy and electron microscopy were 10.3 and 2.6, respectively. Specimens for immunohistology were acquired in 49 cases, of which 40 were adequate. Of the 56 successful TJRB procedures, 34 (61%) were associated with isolated capsular perforation (19), contained subcapsular leak (10), isolated collecting system puncture (1), and concurrent collecting system and capsular perforation (4). There was a significant increase in capsular perforation with six or more needle passes, although no significant correlation was seen between number of needle passes and complication. Six patients had minor complications defined as hematuria or loin pain. Seven patients developed major complications, of whom five received blood transfusion alone. Two required intervention: in one an arteriocalyceal fistula was embolized and the patient

  13. Provenance and recycling of Arabian desert sand (United States)

    Garzanti, Eduardo; Vermeesch, Pieter; Andò, Sergio; Vezzoli, Giovanni; Valagussa, Manuel; Allen, Kate; Kadi, Khalid A.; Al-Juboury, Ali I. A.


    This study seeks to determine the ultimate origin of aeolian sand in Arabian deserts by high-resolution petrographic and heavy-mineral techniques combined with zircon U-Pb geochronology. Point-counting is used here as the sole method by which unbiased volume percentages of heavy minerals can be obtained. A comprehensive analysis of river and wadi sands from the Red Sea to the Bitlis-Zagros orogen allowed us to characterize all potential sediment sources, and thus to quantitatively constrain provenance of Arabian dune fields. Two main types of aeolian sand can be distinguished. Quartzose sands with very poor heavy-mineral suites including zircon occupy most of the region comprising the Great Nafud and Rub' al-Khali Sand Seas, and are largely recycled from thick Lower Palaeozoic quartzarenites with very minor first-cycle contributions from Precambrian basement, Mesozoic carbonate rocks, or Neogene basalts. Instead, carbonaticlastic sands with richer lithic and heavy-mineral populations characterize coastal dunes bordering the Arabian Gulf from the Jafurah Sand Sea of Saudi Arabia to the United Arab Emirates. The similarity with detritus carried by the axial Tigris-Euphrates system and by transverse rivers draining carbonate rocks of the Zagros indicates that Arabian coastal dunes largely consist of far-travelled sand, deposited on the exposed floor of the Gulf during Pleistocene lowstands and blown inland by dominant Shamal northerly winds. A dataset of detrital zircon U-Pb ages measured on twelve dune samples and two Lower Palaeozoic sandstones yielded fourteen identical age spectra. The age distributions all show a major Neoproterozoic peak corresponding to the Pan-African magmatic and tectonic events by which the Arabian Shield was assembled, with minor late Palaeoproterozoic and Neoarchean peaks. A similar U-Pb signature characterizes also Jafurah dune sands, suggesting that zircons are dominantly derived from interior Arabia, possibly deflated from the Wadi al

  14. Provenance studies of amber by PIXE

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, L.; Ruvalcaba S, J.L. [Centro de Estudios Mayas, Instituto de Investigaciones Filologicas, UNAM C.P. 04510 Mexico D.F. (Mexico)


    Analyses by Infrared Spectroscopy and {sup 13} C Nuclear Magnetic Resonance are suitable to determine the paleobotanic source of amber, but cannot differentiate between beds of the same paleobotanic source. Particle Induced X-ray Emission (PIXE) using an external set-up is presented as a new and non-destructive semiquantitative method for provenance studies of amber. PIXE analysis is focused at inorganic contents of amber, considering that the composition of microscopic inclusions depends on the sedimentation environment and it can be used to determine similarities and differences between amber samples and correlate them with amber beds. Results of analyses on amber samples from several world regions and a group of archaeological samples from Chiapas, Mexico, are presented. Amber from different regions have specific inorganic elemental contents; archaeological samples can be associated with beds, even if they have the same paleobotanic origin. (Author)

  15. Usefulness of99mTc-dimercaptosuccinic acid renal scan in the diagnosis and follow-up of acute tubulointerstitial nephritis in children. (United States)

    Vidal, Enrico; Miorin, Elisabetta; Zucchetta, Pietro; Benetti, Elisa; Longo, Germana; Meneghesso, Davide; Parolin, Mattia; Murer, Luisa


    Symptoms and signs of acute tubulointerstitial nephritis (ATIN) are nonspecific; therefore, renal biopsy is often necessary to clarify the diagnosis. The aim of this study was to evaluate the use of 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy in the diagnosis and follow-up of ATIN. We retrospectively reviewed the charts of five patients (nine renal units) with a median age of 14 years who underwent DMSA scan after a clinical and/or biopsy-proven diagnosis of ATIN. The exam was performed within 1 month after disease onset and repeated at a median time of 12 months after the acute phase. DMSA renal scans performed during the acute phase allowed the discovery of suggestive findings, including diffuse reduction of the renal uptake of radionuclide and presence of multiple 'cold' focal lesions in a corticomedullary distribution. The follow-up scintigraphy resulted normal in two patients who were treated with steroids and in one patient who presented a mild renal dysfunction in the acute phase. By contrast, the control scan showed persistent renal damage in one patient who was further readmitted because of hypertension and in one renal transplanted patient who presented a Stage 3 acute kidney injury in the acute phase. DMSA renal scan might be a reliable tool for an early non-invasive diagnosis of ATIN in children and might be particularly useful in those patients who are not candidates for a kidney biopsy. Moreover, DMSA scan gives accurate follow-up evaluation, as it allows monitoring of the evolution of acute renal parenchymal inflammation with potential risk of renal scar formation. Due to the small sample size, our findings warrant further validation in a larger study.

  16. Oropharyngeal histoplasmosis: The diagnosis lies in the biopsy. (United States)

    Miranda, Claudia; Jaker, Michael A; Fitzhugh-Kull, Valerie A; Dever, Lisa L


    Histoplasma capsulatum , a dimorphic fungus found world-wide, is endemic to regions of the Mississippi and Ohio River valleys and portions of Central and South America. Initial infection can present with acute pulmonary symptoms or remain clinically asymptomatic, with disease course generally guided by degree of inoculum and underlying immunosuppression. A chronic, progressive course of weight loss, oral ulceration, and fatigue has been associated with elderly males. We present a 79-year-old man with a chronic, progressive course of oral lesions, odynophagia, and weight loss who was found to have histoplasmosis on oral biopsy performed for suspicions of oropharyngeal squamous cell carcinoma. Histoplasma urine antigen, serum complement fixation antibody titers, and fungal tissues were all negative despite validated sensitivities in the >90% range. Our case report highlights the critical role of tissue biopsy in establishing a diagnosis of oropharyngeal histoplasmosis.

  17. A unified framework for managing provenance information in translational research

    Directory of Open Access Journals (Sweden)

    Sahoo Satya S


    Full Text Available Abstract Background A critical aspect of the NIH Translational Research roadmap, which seeks to accelerate the delivery of "bench-side" discoveries to patient's "bedside," is the management of the provenance metadata that keeps track of the origin and history of data resources as they traverse the path from the bench to the bedside and back. A comprehensive provenance framework is essential for researchers to verify the quality of data, reproduce scientific results published in peer-reviewed literature, validate scientific process, and associate trust value with data and results. Traditional approaches to provenance management have focused on only partial sections of the translational research life cycle and they do not incorporate "domain semantics", which is essential to support domain-specific querying and analysis by scientists. Results We identify a common set of challenges in managing provenance information across the pre-publication and post-publication phases of data in the translational research lifecycle. We define the semantic provenance framework (SPF, underpinned by the Provenir upper-level provenance ontology, to address these challenges in the four stages of provenance metadata: (a Provenance collection - during data generation (b Provenance representation - to support interoperability, reasoning, and incorporate domain semantics (c Provenance storage and propagation - to allow efficient storage and seamless propagation of provenance as the data is transferred across applications (d Provenance query - to support queries with increasing complexity over large data size and also support knowledge discovery applications We apply the SPF to two exemplar translational research projects, namely the Semantic Problem Solving Environment for Trypanosoma cruzi (T.cruzi SPSE and the Biomedical Knowledge Repository (BKR project, to demonstrate its effectiveness. Conclusions The SPF provides a unified framework to effectively manage provenance

  18. Tissue Biopsies in Diabetes Research

    DEFF Research Database (Denmark)

    Højlund, Kurt; Gaster, Michael; Beck-Nielsen, Henning


    Type 2 diabetes is characterized by insulin resistance in major metabolic tissues such as skeletal muscle, liver and fat cells, and failure of the pancreatic ß-cells to compensate for this abnormality (1,2). Skeletal muscle is the major site of glucose disposal in response to insulin, and insulin....... Together with morphological studies, measurement of energy stores and metabolites, enzyme activity and phosphorylation, gene and protein expression in skeletal muscle biopsies have revealed a variety of cellular abnormalities in patients with type 2 diabetes and prediabetes. The possibility to establish...

  19. Tissue Biopsies in Diabetes Research

    DEFF Research Database (Denmark)

    Højlund, Kurt; Gaster, Michael; Beck-Nielsen, Henning


    Type 2 diabetes is characterized by insulin resistance in major metabolic tissues such as skeletal muscle, liver and fat cells, and failure of the pancreatic ß-cells to compensate for this abnormality (1,2). Skeletal muscle is the major site of glucose disposal in response to insulin, and insulin...... description of the technique of percutaneous needle biopsy of skeletal muscle and the establishment of human muscle cell cultures together with a discussion of advantages and limitations of the methods in diabetes research...

  20. Kidney biopsy in west of Iran: Complications and histopathological findings (United States)

    Rahbar, M.


    In this retrospective study, we reviewed the medical records and histopathology findings of 135 patients who underwent renal biopsies at two special hospitals affiliated to Kermanshah medical university during a six-year period (2003-2007). All were performed using Tru-Cut needle under ultrasound guidance. Twenty four specimens were unsatisfactory. There were 38 males (34.2%) and 73 females (65.7%) in 111 patients with adequate specimens (each specimen has more than 5 glomeruli); the mean age was 16.5 years (range 2-64 years). Side effects of the renal biopsies included pain at the site of biopsy in 2 (2.7%), gross hematuria in 1 (0.9%). Nephrotic syndrome was the most common indication for biopsy followed by acute renal failure of unknown etiology and nephritic syndrome. Primary glomerular disease was reported in 78 patients (70.2%) and also secondary glomerular disease in 33 patients (29.7%). Among the primary glomerulonephritis disease, minimal change disease and membranous glomerulonephritis were the commonest findings in children below the age of 16 years. Minimal change disease ranked first in adults whole membranous glomerular disease and focal segmental glomerulosclerosis were more common in the elderly. In all patients lupus glomerular disease was the commonest secondary glomerular disease. We conclude that study on renal biopsy makes final diagnosis which is associated with an acceptably low rate of complications in our practice, and in all, the patterns of renal histology in our study vary slightly from those reported from other countries. PMID:20368927


    Directory of Open Access Journals (Sweden)

    Sandhya Rani Sahoo


    Full Text Available BACKGROUND Bone Marrow Trephine Biopsy (BMTB and aspiration is critical for diagnosis, prognostic evaluation and monitoring therapeutic response. BMTB is of greater value in assessing cellularity, degree of fibrosis, marrow architecture and especially when aspiration is dry tap. At the same time, it provides sample for immunohistochemistry. MATERIALSAND METHODS It is a single centre observational study conducted from July 2014 to July 2016 in Department of Pathology, S.C.B. Medical College, Cuttack, which included both cell block and touch imprint along with trephine biopsy. Cases selected where lymphoma studied for pattern and extent of infiltration. Aspiration with dry tap and selected cases of myeloproliferative disorders, myelodysplastic syndrome, leukaemia (both acute and chronic, anaemia, multiple myeloma were studied. Jamshidi needle was used for biopsy. Samples obtained were formalin preserved, kept in decalcification solution (Hammersmith protocol and H and E slides prepared. Special stain-like reticulin and Masson’s trichrome were used for grading of fibrosis. Immunohistochemistry was done on selected cases of lymphoma. RESULTS Out of total 100 cases studied, 60 were of haematopoietic and lymphoid neoplasms, 12 anaemia, 20 secondary metastasis, 8 miscellaneous (1 haemophagocytic lymphohistiocytic disease, 1 storage disease, 1 granulomatous and 5 ITP. CONCLUSION The study was conducted to establish the advantage of bone marrow biopsy in inadequate and failed aspiration, but both are complementary to each other and together provide a comprehensive evaluation of the bone marrow. Bone marrow fibrosis are well accessed and increased detection of tumour cells in suspected secondary metastasis. Special stains, IHC, cytogenetic study can be done over biopsy block.

  2. Provenance research: investigation of genetic diversity associated with geography (United States)

    Robert Z. Callaham


    Provenance in forestry refers to the population of trees growing at n particular place of origin. Provenance research defines the genetic and environmental components of phenotypic variation associated with geographic source. Information on provenance is important in assuring sources of seed to give well-adapted, productive trees and in directing breeding of...

  3. Evaluation of 19 provenances of Calliandra calothyrsus at Gairo and ...

    African Journals Online (AJOL)

    Performance evaluation was conducted among nineteen provenances of Calliandra calothyrsus from meso-America, Indonesia and Tanzania. Two trials were established in February and March, 1996 at Gairo (8 provenances) and Sokoine University of Agriculture (SUA) Farm (17 provenances) in Morogoro, Tanzania.

  4. Irradiation sensibility of different provenances of Jatropha curcas L. seeds

    International Nuclear Information System (INIS)

    Yang Qing; Xu Congheng; Peng Daiping; Duan Zhubiao; Han Lei; Sun Qixiang; Peng Zhenhua


    The irradiation sensibility of 10 provenances of Jatropha curcas L. seeds to 60 Co γ-rays was studied. The results showed that the relationship between relative germination rate of the seeds and the doses of irradiation was negative correlation, and the difference of relative germination rate among different doses treatment was significant at 5% probability level or highly significant at 1% probability level. For seeds of different provenances, the correlation coefficient of linear regression was from -0.89--0.96, and the medial lethal doses (LD 50) of 10 provinces was from 127 Gy to 184 Gy. According to the LD 50, we could divided 10 provinces of J. curcas L. into sensitive provenance, transitional provenances and obtuse provenances. The provenances of Yuanjiang , Yunan (184 Gy) belonged to sensitive provenance; the provenances of Zhenfeng, Guizhou (127 Gy) and the provenances of Yuedong, Hainan (141 Gy) belonged to obtuse provenance; other 7 provenances belonged to transitional provenances. The results provided important experiment basis for germ plasma resources innovation of J. curcas L. (authors)

  5. BIOPSY PROVEN MEDULLARY SPONGE KIDNEY: Clinical findings, histopathology, and role of osteogenesis in stone and plaque formation (United States)

    Evan, Andrew P.; Worcester, Elaine M.; Williams, James C.; Sommer, Andre J.; Lingeman, James E.; Phillips, Carrie L.; Coe, Fredric L.


    Medullary sponge kidney (MSK) is associated with recurrent stone formation, but the clinical phenotype is unclear because patients with other disorders may be incorrectly labeled MSK. We studied 12 patients with histologic findings pathognomonic of MSK. All patients had an endoscopically recognizable pattern of papillary malformation, which may be segmental or diffuse. Affected papillae are enlarged and billowy, due to markedly enlarged inner medullary collecting ducts (IMCD), which contain small, mobile ductal stones. Patients had frequent dilation of Bellini ducts, with occasional mineral plugs. Stones may form over white (Randall’s) plaque, but most renal pelvic stones are not attached, and have a similar morphology as ductal stones, which are a mixture of calcium oxalate and apatite. Patients had no abnormalities of urinary acidification or acid excretion; the most frequent metabolic abnormality was idiopathic hypercalciuria. Although both Runx2 and Osterix are expressed in papillae of MSK patients, no mineral deposition was seen at the sites of gene expression, arguing against a role of these genes in this process. Similar studies in idiopathic calcium stone formers showed no expression of these genes at sites of Randall’s plaque. The most likely mechanism for stone formation in MSK appears to be crystallization due to urinary stasis in dilated IMCD with subsequent passage of ductal stones into the renal pelvis where they may serve as nuclei for stone formation. PMID:25615853

  6. Long-term outcome of biopsy-proven, frequently relapsing minimal-change nephrotic syndrome in children.

    NARCIS (Netherlands)

    Kyrieleis, H.A.; Lowik, M.M.; Pronk, I.; Cruysberg, J.R.M.; Kremer, J.A.M.; Oyen, W.J.G.; Heuvel, L.P.W.J. van den; Wetzels, J.F.M.; Levtchenko, E.N.


    BACKGROUND AND OBJECTIVES: Frequently relapsing and steroid-dependent minimal-change nephrotic syndrome (MCNS) that originates in childhood can persist after puberty in >20% of patients. These patients require immunosuppressive treatment during several decades of their life. We examined long-term

  7. Big Data Provenance: Challenges, State of the Art and Opportunities. (United States)

    Wang, Jianwu; Crawl, Daniel; Purawat, Shweta; Nguyen, Mai; Altintas, Ilkay


    Ability to track provenance is a key feature of scientific workflows to support data lineage and reproducibility. The challenges that are introduced by the volume, variety and velocity of Big Data, also pose related challenges for provenance and quality of Big Data, defined as veracity. The increasing size and variety of distributed Big Data provenance information bring new technical challenges and opportunities throughout the provenance lifecycle including recording, querying, sharing and utilization. This paper discusses the challenges and opportunities of Big Data provenance related to the veracity of the datasets themselves and the provenance of the analytical processes that analyze these datasets. It also explains our current efforts towards tracking and utilizing Big Data provenance using workflows as a programming model to analyze Big Data.

  8. Big Data Provenance: Challenges, State of the Art and Opportunities (United States)

    Wang, Jianwu; Crawl, Daniel; Purawat, Shweta; Nguyen, Mai; Altintas, Ilkay


    Ability to track provenance is a key feature of scientific workflows to support data lineage and reproducibility. The challenges that are introduced by the volume, variety and velocity of Big Data, also pose related challenges for provenance and quality of Big Data, defined as veracity. The increasing size and variety of distributed Big Data provenance information bring new technical challenges and opportunities throughout the provenance lifecycle including recording, querying, sharing and utilization. This paper discusses the challenges and opportunities of Big Data provenance related to the veracity of the datasets themselves and the provenance of the analytical processes that analyze these datasets. It also explains our current efforts towards tracking and utilizing Big Data provenance using workflows as a programming model to analyze Big Data. PMID:29399671

  9. Infective endocarditis with spondylodiscitis after prostate biopsy

    Directory of Open Access Journals (Sweden)

    Fernando Pivatto Júnior


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

  10. Can Sonovue targeted biopsy replace extended or saturation biopsy in prostate cancer diagnosis? Our experience at primary and repeat biopsy. (United States)

    Pepe, Pietro; Candiano, Giuseppe; Pennisi, Michele; Aragona, Francesco


    To evaluate the detection rate of prostate cancer (PCa) at initial and repeat biopsy in patients submitted to Sonovue targeted biopsy vs extended or saturation prostate biopsy (SPBx). From November 2007 to April 2008 60 patients aged 64 years (median) underwent extended TRUS-guided transperineal prostate biopsy. Indications to biopsy were: abnormal DRE, PSA > 10 ng/mL; PSA included between 2.6 and 4.0 and 4.1 and 10 ng/mL with %free/total PSA digital rectal examination was positive in 9 vs 3 patients, respectively. Before performing extended or SPBx scheme in case of primary (19 cores) and repeated (28 cores) procedure, prostate areas characterized by absence of enhancement after Sonovue (2.4 mg) administration on gray scale during continuous harmonic imaging (HI) contrast-enhanced ultrasound (CEUS) were considered suspicious for PCa and submitted to targeted biopsy. 3.5 (median) targeted biopsies were performed in the peripheral zone of 22 men. In patients who underwent primary and repeated biopsy PCa was detected in 20/45 (44.5%) and 3/15 (20%) cases, but Sonovue detected only 6/20 (30%) and 1/3 (33.4%) of cancers, respectively. Sensitivity and specificity of Sonovue in diagnosing PCa was equal to 30.0% and 61.5% (primary biopsy) vs 33.4% and 54.5% (repeated biopsy). Based on its low diagnostic accuracy, Sonovue CEUS HI targeted biopsy can not replace extended or SPBx in diagnosing PCa.

  11. Neonatal functional intestinal obstruction and the presence of severely immature ganglion cells on rectal biopsy: 6 year experience. (United States)

    Burki, Tariq; Kiho, Liina; Scheimberg, Irene; Phelps, Simon; Misra, Devesh; Ward, Harry; Colmenero, Isabel


    We report our experience of managing eight babies who presented with neonatal intestinal obstruction and whose rectal biopsies showed severely immature ganglion cells. Neonatal unit records were reviewed to detect patients with suspected Hirschsprung's disease or functional intestinal obstruction. Those with intestinal atresia, anorectal malformation, malrotation, cystic fibrosis and prematurity were excluded. We identified 73 patients born at term. Twenty-seven did not need a rectal biopsy. Twenty-one had biopsy proven Hirschsprung's disease, while 17 had a normal rectal biopsy. Eight patients, all of whom presented with severe abdominal distension, showed immature ganglion cells. Seven had failed to pass meconium after birth. X-rays in all patients showed distended loops of bowel. Two neonates underwent an emergency laparotomy and a stoma. A repeat biopsy at 3 months showed maturation of ganglion cells and the stoma was reversed. Rectal biopsy was repeated in two other patients 2-9 months after the first biopsy and showed mature ganglion cells. At follow-up, one patient still suffers from severe constipation. Seven are asymptomatic now, including the two patients who needed a stoma. Immature ganglion cells on rectal biopsy may be an indicator of transient functional immaturity of the intestine.

  12. Tracking Provenance in ORNL's Flexible Research Platforms

    Energy Technology Data Exchange (ETDEWEB)

    Hensley, Zachary P [ORNL; Sanyal, Jibonananda [ORNL; New, Joshua Ryan [ORNL


    Provenance is dened as information about the origin of objects, a concept that applies to both physical and digital objects and often overlaps both. The use of provenance in systems designed for research is an important but forgotten feature. Provenance allows for proper and exact tracking of information, its use, its lineage, its derivations and other metadata that are important for correctly adhering to the scien- tic method. In our project's prescribed use of provenance, researchers can determine detailed information about the use of sensor data in their experiments on ORNL's Flexible Research Platforms (FRPs). Our project's provenance system, Provenance Data Management System (ProvDMS), tracks information starting with the creation of information by an FRP sensor. The system determines station information, sensor information, and sensor channel information. The system allows researchers to derive generations of experiments from the sensor data and tracks their hierarchical flow. Key points can be seen in the history of the information as part of the information's workflow. The concept of provenance and its usage in science is relatively new and while used in other cases around the world, our project's provenance diers in a key area. To keep track of provenance, most systems must be designed or redesigned around the new provenance system. Our system is designed as a cohesive but sepa- rate entity and allows for researchers to continue using their own methods of analysis without being constrained in their ways in order to track the provenance. We have designed ProvDMS using a lightweight provenance library, Core Provenance Library (CPL) v.6 In addition to keeping track of sensor data experiments and its provenance, ProvDMS also provides a web-enabled visualization of the inheritance.

  13. Nerve Biopsy In The Diagnosis Of Leporsy

    Directory of Open Access Journals (Sweden)

    Hazra B


    Full Text Available Skin and nerve biopsies were done in 33 cases of different clinical types of leprosy selected from Dermatology OPD of Medical College and Hospitals, Calcutta during 1994-95. Histopathological results were compared with emphasis on the role of nerve biopsies in detection of patients with multibacillary leprosy. The evident possibility of having patients with multibacillary leprosy in peripheral leprosy with multiple drugs. It is found that skin and nerve biopsy are equally informative in borderline and lepromatour leprosy and is the only means to diagnose polyneuritic leprosy. Nerve biopsy appears to be more informative in the diagnosis of all clinical types of leprosy.

  14. The diagnostic value of liver biopsy

    Directory of Open Access Journals (Sweden)

    Zimmermann Arthur


    Full Text Available Abstract Background Since the introduction of molecular diagnostic tools such as markers for hepatitis C and different autoimmune diseases, liver biopsy is thought to be useful mainly for staging but not for diagnostic purposes. The aim was to review the liver biopsies for 5 years after introduction of testing for hepatitis C, in order to evaluate what diagnostic insights – if any – remain after serologic testing. Methods Retrospective review of all liver biopsies performed between 1.1.1995 and 31.12.1999 at an academic outpatient hepatology department. The diagnoses suspected in the biopsy note were compared with the final diagnosis arrived at during a joint meeting with the responsible clinicians and a hepatopathologist. Results In 365 patients, 411 diagnoses were carried out before biopsy. 84.4 % were confirmed by biopsy but in 8.8 %, 6.8 % and 10.5 % the diagnosis was specified, changed or a diagnosis added, respectively. Additional diagnoses of clinical relevance were unrecognized biliary obstruction and additional alcoholic liver disease in patients with chronic hepatitis C. Liver biopsy led to change in management for 12.1 % of patients. Conclusion Even in the era of advanced virological, immunological and molecular genetic testing, liver biopsy remains a useful diagnostic tool. The yield is particularly high in marker negative patients but also in patients with a clear-cut prebiopsy diagnosis, liver biopsy can lead to changes in patient management.

  15. Robotic Prostate Biopsy in Closed MRI Scanner

    National Research Council Canada - National Science Library

    Fischer, Gregory


    .... This work enables prostate brachytherapy and biopsy procedures in standard high-field diagnostic MRI scanners through the development of a robotic needle placement device specifically designed...

  16. Needle muscle biopsy and its application

    Directory of Open Access Journals (Sweden)

    Meng-long CHEN


    Full Text Available Needle muscle biopsy is a straightforward and reliable minimally-invasive technique. During the past century, the needle biopsy can provide adequate samples and the technique has gradually gained wider acceptance. Compared with open biopsy, needle biopsy is less traumatic, with low rate of complications, and is suitable for the identifications and evaluations of muscular dystrophy, inflammatory myopathies and systemic diseases involving muscles, specially for infants and young children. Domestic insiders should be encouraged to apply this technique. DOI: 10.3969/j.issn.1672-6731.2015.06.003 

  17. Data Provenance Architecture for the Geosciences (United States)

    Murphy, F.; Irving, D. H.


    The pace at which geoscientific insights inform societal development quickens with time and these insights drive decisions and actions of ever-increasing human and economic significance. Until recently academic, commercial and government bodies have maintained distinct bodies of knowledge to support scientific enquiry as well as societal development. However, it has become clear that the curation of the body of data is an activity of equal or higher social and commercial value. We address the community challenges in the curation of, access to, and analysis of scientific data including: the tensions between creators, providers and users; incentives and barriers to sharing; ownership and crediting. We also discuss the technical and financial challenges in maximising the return on the effort made in generating geoscientific data. To illustrate how these challenges might be addressed in the broader geoscientific domain, we describe the high-level data governance and analytical architecture in the upstream Oil Industry. This domain is heavily dependent on costly and highly diverse geodatasets collected and assimilated over timeframes varying from seconds to decades. These data must support both operational decisions at the minute-hour timefame and strategic and economic decisions of enterprise or national scale, and yet be sufficiently robust to last the life of a producing field. We develop three themes around data provenance, data ownership and business models for data curation. 1/ The overarching aspiration is to ensure that data provenance and quality is maintained along the analytical workflow. Hence if data on which a publication or report changes, the report and its publishers can be notified and we describe a mechanism by which dependent knowledge products can be flagged. 2/ From a cost and management point of view we look at who "owns" data especially in cases where the cost of curation and stewardship is significant compared to the cost of acquiring the data

  18. Hypoxia marker labeling in tumor biopsies: quantification of labeling variation and criteria for biopsy sectioning

    International Nuclear Information System (INIS)

    Thrall, Donald E.; Rosner, Gary L.; Azuma, Chieko; McEntee, Margaret C.; Raleigh, James A.


    Background and purpose: The error associated with using biopsy-based methods for assessing parameters reflective of the tumor microenvironment depends on the variability in distribution of the parameter throughout the tumor and the biopsy sample. Some attention has been given to intratumoral distribution of parameters, but little attention has been given to their intrabiopsy distribution. We evaluated the intrabiopsy distribution of CCI-103F, a 2-nitroimidazole hypoxia marker. Materials and methods: The hypoxia marker CCI-103F was studied in dogs bearing spontaneous solid tumors. Two biopsies were taken from each of seven tumors, for a total of 14 biopsies. Biopsies were serially sectioned and four to six contiguous slides from each 100-150 μm of the biopsy were used to formulate the best estimate of CCI-103F labeled area throughout the biopsy sample. One, two or four slides were then randomly selected from each biopsy and the labeled area, based on this limited sample, was compared to the estimate obtained from counting all available slides. Random sampling of slides was repeated 1000 times for each biopsy sample. Results: CCI-103F labeling variance throughout the biopsy decreased as the estimated overall labeled area in the biopsy decreased. The error associated with estimating the overall labeled area in a biopsy from a randomly selected subset of slides decreased as the number of slides increased, and as the overall labeled area in the biopsy decreased. No minimally labeled biopsy was classified as unlabeled based on limited sampling. Conclusion: With regard to CCI-103F labeling, quantification of the labeled area in four randomly selected slides from a biopsy can provide, in most biopsies, an estimate of the labeled area in the biopsy within an absolute range of ±0.05

  19. Serial superficial digital flexor tendon biopsies for diagnosing and monitoring collagenase-induced tendonitis in horses

    Directory of Open Access Journals (Sweden)

    José C. de Lacerda Neto


    Full Text Available The purpose of this investigation was to demonstrate the feasibility of a biopsy technique by performing serial evaluations of tissue samples of the forelimb superficial digital flexor tendon (SDFT in healthy horses and in horses subjected to superficial digital flexor tendonitis induction. Eight adult horses were evaluated in two different phases (P, control (P1 and tendonitis-induced (P2. At P1, the horses were subjected to five SDFT biopsies of the left forelimb, with 24 hours (h of interval. Clinical and ultrasonographic (US examinations were performed immediately before the tendonitis induction, 24 and 48 h after the procedure. The biopsied tendon tissues were analyzed through histology. P2 evaluations were carried out three months later, when the same horses were subjected to tendonitis induction by injection of bacterial collagenase into the right forelimb SDFT. P2 clinical and US evaluations, and SDFT biopsies were performed before, and after injury induction at the following time intervals: after 24, 48, 72 and 96 h, and after 15, 30, 60, 90, 120 and 150 days. The biopsy technique has proven to be easy and quick to perform and yielded good tendon samples for histological evaluation. At P1 the horses did not show signs of localised inflammation, pain or lameness, neither SDFT US alterations after biopsies, showing that the biopsy procedure per se did not risk tendon integrity. Therefore, this procedure is feasible for routine tendon histological evaluations. The P2 findings demonstrate a relation between the US and histology evaluations concerning induced tendonitis evolution. However, the clinical signs of tendonitis poorly reflected the microscopic tissue condition, indicating that clinical presentation is not a reliable parameter for monitoring injury development. The presented method of biopsying SDFT tissue in horses enables the serial collection of material for histological analysis causing no clinical signs and tendon damage seen

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

    Energy Technology Data Exchange (ETDEWEB)

    Meier-Schroers, Michael, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Homsi, Rami, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Kukuk, Guido, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Wolter, Karsten, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Decker, Georges, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Fischer, Stefan, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Marx, Christian, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Schmeel, Frederic Carsten, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Block, Wolfgang, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Sprinkart, Alois Martin, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Traeber, Frank, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Schild, Hans Heinz, E-mail: [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Willinek, Winfried, E-mail: [Department of Radiology, Neuroradiology, Sonography and Nuclear Medicine, Hospital of the Barmherzige Brüder Trier, Nordallee 1, 54292 Trier (Germany)


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

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

    International Nuclear Information System (INIS)

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


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

  2. Data provenance assurance in the cloud using blockchain (United States)

    Shetty, Sachin; Red, Val; Kamhoua, Charles; Kwiat, Kevin; Njilla, Laurent


    Ever increasing adoption of cloud technology scales up the activities like creation, exchange, and alteration of cloud data objects, which create challenges to track malicious activities and security violations. Addressing this issue requires implementation of data provenance framework so that each data object in the federated cloud environment can be tracked and recorded but cannot be modified. The blockchain technology gives a promising decentralized platform to build tamper-proof systems. Its incorruptible distributed ledger/blockchain complements the need of maintaining cloud data provenance. In this paper, we present a cloud based data provenance framework using block chain which traces data record operations and generates provenance data. We anchor provenance data records into block chain transactions, which provide validation on provenance data and preserve user privacy at the same time. Once the provenance data is uploaded to the global block chain network, it is extremely challenging to tamper the provenance data. Besides, the provenance data uses hashed user identifiers prior to uploading so the blockchain nodes cannot link the operations to a particular user. The framework ensures that the privacy is preserved. We implemented the architecture on ownCloud, uploaded records to blockchain network, stored records in a provenance database and developed a prototype in form of a web service.

  3. morphological pattern of endometrial biopsies in south

    African Journals Online (AJOL)

    INTRODUCTION. Endometrial biopsies are among the most common specimens submitted for histopathological analysis.1. Endometrial biopsy is a safe, efficient and cost-effective means of evaluating the uterine endometrium. The procedure is usually associated with minimal discomfort and is easily accomplished in the ...

  4. Testicular biopsy: Clinical practice and interpretation

    NARCIS (Netherlands)

    G.R. Dohle (Gert); S. Elzanaty (Saad); N.J. van Casteren (Niels)


    textabstractTesticular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia. Recent guidelines for male infertility have limited the indications for a diagnostic testicular biopsy to the confirmation of obstructive

  5. Ultrasound guided synovial biopsy of the wrist

    NARCIS (Netherlands)

    van Vugt, R. M.; van Dalen, A.; Bijlsma, J. W.


    Seven patients (4 female and 3 male, mean age 46) with arthritis of the wrist (n = 7) without known etiology were evaluated. High-definition ultrasound equipment was used for localization of synovial hypertrophy, suitable for ultrasound guided biopsy without risk. A 18-gauge diameter Tru-cut biopsy

  6. 'Microerosions' in rectal biopsies in Crohn's disease

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier


    Small (less than 1 mm), superficial erosions ('microerosions') have been observed stereo-microscopically in surface-stained rectal biopsies in Crohn's disease (CD). Biopsy specimens from 97 patients with CD, 225 with ulcerative colitis (UC), and a control material of 161 patients were investigated...

  7. Data Provenance and Data Management in eScience

    CERN Document Server

    Bai, Quan; Giugni, Stephen; Williamson, Darrell; Taylor, John


    eScience allows scientific research to be carried out in highly distributed environments. The complex nature of the interactions in an eScience infrastructure, which often involves a range of instruments, data, models, applications, people and computational facilities, suggests there is a need for data provenance and data management (DPDM). The W3C Provenance Working Group defines the provenance of a resource as a “record that describes entities and processes involved in producing and delivering or otherwise influencing that resource”. It has been widely recognised that provenance is a critical issue to enable sharing, trust, authentication and reproducibility of eScience process.   Data Provenance and Data Management in eScience identifies the gaps between DPDM foundations and their practice within eScience domains including clinical trials, bioinformatics and radio astronomy. The book covers important aspects of fundamental research in DPDM including provenance representation and querying. It also expl...

  8. Screening for Helicobacter pylori in Idiopathic Pulmonary Fibrosis Lung Biopsies. (United States)

    Kreuter, Michael; Kirsten, Detlef; Bahmer, Thomas; Penzel, Roland; Claussen, Martin; Ehlers-Tenenbaum, Svenja; Muley, Thomas; Palmowski, Karin; Eichinger, Monika; Leider, Marta; Herth, Felix J F; Rabe, Klaus F; Bittmann, Iris; Warth, Arne


    Increasing evidence suggests a role of gastro-oesophageal reflux (GER) in idiopathic pulmonary fibrosis (IPF) pathogenesis. Recently, an association between serum Helicobacter pylori (HP) antibody positivity and more severe disease was described, but HP has not been directly analysed in lung tissue so far. To investigate the presence of HP in the lung tissue of IPF patients. Two tertiary interstitial lung disease care centre databases were screened for available lung biopsy material from IPF patients. Clinical and radiological data, including presence of GER and antiacid medication, were evaluated. HP-specific PCR was carried out on the IPF lung biopsy specimens. A total of 39 IPF patients were included, of whom 85% were male. The patients' median age was 66 years, their vital capacity was 79% predicted, and their diffusing capacity for carbon monoxide was 53% predicted. In all, 82% of the lung biopsies were surgical and 18% transbronchial. Comorbidities were GER disease in 23% (n = 9), sleep apnoea in 13% (n = 5) and hiatal hernia in 38% of the cases (n = 15). Proton pump inhibitors were prescribed at the time of biopsy in 21% of the cases (n = 9). After a median follow-up of 25 months (range 6-69), there were 1 death, 1 lung transplantation and 8 acute exacerbations without relevant differences between the GER and non-GER subgroups. HP DNA was not detected in any of the lung tissue samples. The fact that no HP DNA was detected in the lung tissues calls into question the proposed relevance of HP to the direct pathogenesis of IPF. © 2015 S. Karger AG, Basel.

  9. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass. (United States)

    Mehta, Keyur Kamlesh; Ahmad, Sabina Qureshi; Shah, Vikas; Lee, Haesoon


    We describe a case of 17 year-old male with a nasopharyngeal rhabdomyosarcoma who developed postobstructive pulmonary edema (POPE) after removing the endotracheal tube following biopsy. He developed muffled voice, rhinorrhea, dysphagia, odynophagia, and difficulty breathing through nose and weight loss of 20 pounds in the preceding 2 months. A nasopharyngoscopy revealed a fleshy nasopharyngeal mass compressing the soft and hard palate. Head and neck MRI revealed a large mass in the nasopharynx extending into the bilateral choana and oropharynx. Biopsy of the mass was taken under general anesthesia with endotracheal intubation. Immediately after extubation he developed oxygen desaturation, which did not improve with bag mask ventilation with 100% of oxygen, but improved after a dose of succinylcholine. He was re-intubated and pink, frothy fluid was suctioned from the endotracheal tube. Chest radiograph (CXR) was suggestive of an acute pulmonary edema. He improved with mechanical ventilation and intravenous furosemide. His pulmonary edema resolved over the next 24 h. POPE is a rare but serious complication associated with upper airway obstruction. The pathophysiology of POPE involves hemodynamic changes occurring in the lung and the heart during forceful inspiration against a closed airway due to an acute or chronic airway obstruction. This case illustrates the importance of considering the development of POPE with general anesthesia, laryngospasm and removal of endotracheal tube to make prompt diagnosis and to initiate appropriate management.

  10. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass

    Directory of Open Access Journals (Sweden)

    Keyur Kamlesh Mehta


    Full Text Available We describe a case of 17 year-old male with a nasopharyngeal rhabdomyosarcoma who developed postobstructive pulmonary edema (POPE after removing the endotracheal tube following biopsy. He developed muffled voice, rhinorrhea, dysphagia, odynophagia, and difficulty breathing through nose and weight loss of 20 pounds in the preceding 2 months. A nasopharyngoscopy revealed a fleshy nasopharyngeal mass compressing the soft and hard palate. Head and neck MRI revealed a large mass in the nasopharynx extending into the bilateral choana and oropharynx. Biopsy of the mass was taken under general anesthesia with endotracheal intubation. Immediately after extubation he developed oxygen desaturation, which did not improve with bag mask ventilation with 100% of oxygen, but improved after a dose of succinylcholine. He was re-intubated and pink, frothy fluid was suctioned from the endotracheal tube. Chest radiograph (CXR was suggestive of an acute pulmonary edema. He improved with mechanical ventilation and intravenous furosemide. His pulmonary edema resolved over the next 24 h. POPE is a rare but serious complication associated with upper airway obstruction. The pathophysiology of POPE involves hemodynamic changes occurring in the lung and the heart during forceful inspiration against a closed airway due to an acute or chronic airway obstruction. This case illustrates the importance of considering the development of POPE with general anesthesia, laryngospasm and removal of endotracheal tube to make prompt diagnosis and to initiate appropriate management.

  11. Coeliac disease: to biopsy or not? (United States)

    Reilly, Norelle R; Husby, Steffen; Sanders, David S; Green, Peter H R


    Coeliac disease is increasingly recognized as a global problem in both children and adults. Traditionally, the findings of characteristic changes of villous atrophy and increased intraepithelial lymphocytosis identified in duodenal biopsy samples taken during upper gastrointestinal endoscopy have been required for diagnosis. Although biopsies remain advised as necessary for the diagnosis of coeliac disease in adults, European guidelines for children provide a biopsy-sparing diagnostic pathway. This approach has been enabled by the high specificity and sensitivity of serological testing. However, these guidelines are not universally accepted. In this Perspective, we discuss the pros and cons of a biopsy-avoiding pathway for the diagnosis of coeliac disease, especially in this current era of the call for more biopsies, even from the duodenal bulb, in the diagnosis of coeliac disease. In addition, a contrast between paediatric and adult guidelines is presented.

  12. Prostate cancer diagnostics with biopsy material

    Directory of Open Access Journals (Sweden)

    Fedorina Т.A.


    Full Text Available The aim of the article is to study the potential importance of specific location of biopsy of prostate cancer. Material and methods. Histological material from 700 patients has been examinated. 580 specimen of radical prostatectomy were examined. TRUS-guided 12-cores biopsy has been performed in all patients. Histological, computer morphomet-ric, immunohistochemal methods (PIN4-coctail, AR were used. Results. It has been established that undergrading of carcinoma in needle biopsy occurred in 26% of patients. Overgrading of carcinoma in needle biopsy may also occur, but it was only found in 3% of cases. Undergrading results have been explained by low amount of tumor elements taken from tiny areas of carcinoma, multicentric growth and heterogenous structure of tumor. Conclusions. An important task is to identify the minimal or limited adenocarcinoma in biopsies, as tumor of >1cc volume is often found in prostatectomy specimen.

  13. Delayed culture of Leishmania in skin biopsies. (United States)

    Dedet, J P; Pratlong, F; Pradinaud, R; Moreau, B


    Between January 1997 and October 1998, 16 skin biopsies collected from 13 patients with cutaneous leishmaniasis in French Guiana were inoculated in culture medium after travel for 3-17 days from the place of biopsy to the culture laboratory in France. Each biopsy fragment was introduced near the flame of a Bunsen burner into the transport medium (RPMI medium supplemented with 10% fetal calf serum) which was maintained at ambient temperature during postal delivery to France. In France the biopsies were ground in sterile saline before being inoculated into NNN culture tubes. The cultures were incubated at 25 degrees C and subcultured every week until the 5th week. The cultures were positive in 9 cases, remained negative in 4, and were contaminated in 3 cases. Positive results were obtained at all seasons and for 3 different Leishmania species. The study indicates that delayed culture can yield useful results from biopsies taken in field conditions.

  14. Breast carcinoma in radiosurgery biopsy

    International Nuclear Information System (INIS)

    Cohen, Leonard O.; Brito, Pablo E.; Coppolecchia, German L.; Giarmana, Maria J.; Delle Ville, Rodolfo E.; Cortese, Eduardo M.


    Purpose: To report our experience on the detection of breast cancer (BC) through guided radiosurgical biopsies (GRSB) in the Gynecology Department of the Hospital Aeronautico Central (SGHAC). Materials and method: We retrospectively analyzed 622 GRSBs performed at the SGHAC between 1 January 1995 and 31 December 2004. We took into account single or associated lesions found in mammograms, which we subdivided into four types: 1) Non-palpable mammographic nodules; 2) Microcalcifications; 3) Structural distortions; 4) Mammographic asymmetries. Results: We found 332 non-palpable nodules (53.4%), 214 microcalcifications (34.4%), 40 structural distortions (6.4%), and 36 mammographic asymmetries (5.8%). Out of the 622 GRSBs performed during the above period, 152 BCs were diagnosed, that is, an incidence of 24.4% detected through this method. Out of the 152 BCs, 110 (72.4%) were invasive and 42 (27.6%) were noninvasive. Conclusions: Although 24.4% of BCs were identified through GRSBs, our tea m considers this to be the standard method for early detection of breast cancer. (author) [es

  15. Expression of cytotoxic mediators (perforin, granzyme B, FAS, and FAS-l in renal allograft biopsies

    Directory of Open Access Journals (Sweden)

    Therezinha Gauri Leitão


    Full Text Available Objectives: To analyze the in situ expression of perforin, granzymeB, FAS-L and FAS in renal allograft biopsies by means ofimmunohistochemistry and correlate these findings with the degreeof histologic rejection and allograft outcome. Methods: Ninety-sixallograft biopsies were divided into three groups: acute rejection (n= 56, chronic rejection (n = 31, and cases with stable renal function(no rejection; n = 9. The expression of perforin, granzyme B, FAS-L,and FAS was evaluated by immunohistochemistry. Results: Asignificantly higher expression of perforin and granzyme B wasobserved in acute rejection biopsies (4.83 ± 0.65 and 30.05 ± 7.93cells/mm2 compared to chronic rejection biopsies (0.71 ± 0.13 and11.4 ± 3.84 cells/mm2; p < 0.001, and p <0.05, respectively, but thiswas not the case for FAS-L (24.44 ± 5.56 in acute rejection versus 18.87± 6.83 in chronic rejection. Perforin, granzyme B, and FAS-L expressionwas significantly higher in the acute rejection group compared to the norejection and control groups. FAS expression was similar in all groups. Amodest correlation between perforin expression and the severity of ARwas observed (r = 0.28, p = 0.05. Perforin was the most reliable markerfor acute rejection diagnosis, with 80% sensitivity and 84.3% specificity.Conclusion: The in situ expression of perforin, granzyme B, and FAS-Lin AR reflects the presence of an active cytotoxic process. Additionalallograft biopsies are necessary in order to evaluate the usefulness ofthese markers for allograft rejection monitoring.

  16. Collapsing Focal Segmental Glomerulosclerosis in a Patient with Acute Malaria

    Directory of Open Access Journals (Sweden)

    Najamus Sehar


    seen in association with HIV infection. Rare data is available about the association between collapsing FSGS and malaria. Case Description. A 72-year-old African male patient presented to the hospital for generalized body aches, fatigue, fever, and night sweats for three days. He had history of recent travel to Ghana. Patient looked in acute distress and was shivering. Laboratory tests showed elevated serum creatinine (Cr of 2.09 mg/dL (baseline was 1.5 mg/dL in 2012. Hospital course was significant for rapid elevation of Cr to 9.5 mg/dL and proteinuria of 7.9 grams. Autoimmune studies resulted negative. Blood smear resulted positive for Plasmodium falciparum and patient was treated with Artemether/Lumefantrine. Patient’s fever and pain improved, but kidney function continued to deteriorate and he became oliguric. On day seven, he was started on Hemodialysis. Tests for different causes of glomerular pathology were also negative. He underwent left kidney biopsy which resulted in findings consistent with severe collapsing glomerulopathy. Discussion. This case illustrates a biopsy proven collapsing FSGS likely secondary to malarial infection requiring renal replacement therapy. Literature review revealed only few case reports that suggested the possible association of malaria with secondary form of FSGS.

  17. Towards a common provenance model for research publications (United States)

    Fu, L.; Ma, X.; West, P.; Beaulieu, S. E.; Di Stefano, M.; Fox, P. A.


    Provenance is information about entities, activities, and people involved in producing a piece of data or thing, which can be used to form assessments about its quality, reliability or trustworthiness. In a research publication, provenance includes entities, activities and people involved in the process leading to the parts of the publication such as figures, tables, paragraphs etc. Such information is often desirable for the readers to correctly interpret publication content and enables them to evaluate the credibility of the reported results by digging into the software in use, source data and responsible agents or even reproducing the results themselves. In this presentation, we will describe our ontology designed to model the preparing process of research publications based on our experience from two projects, both focusing on provenance capturing for research publications. The first project is about capturing provenance information for a National Climate Assessment (NCA) report of the US Global Change Research Program (USGCRP), and the second about capturing provenance information for an Ecosystem Status Report (ESR) of the Northeast Fisheries Science Center (NEFSC). Both projects base their provenance modeling on the W3C Provenance ontology (PROV-O), which proves to be an effective way to create models for provenance capturing. We will illustrate the commonalities and differences between use cases of these two projects and how we derive a common model from models specifically designed to capture provenance information for each of the projects.

  18. Semantic Workflows and Provenance-Aware Software (Invited) (United States)

    Gil, Y.


    Workflows are increasingly used in science to manage complex computations and data processing at large scale. Intelligent workflow systems provide assistance in setting up parameters and data, validating workflows created by users, and automating the generation of workflows from high-level user guidance. These systems use semantic workflows that extend workflow representations with semantic constraints that express characteristics of the data and analytic models. Reasoning algorithms propagate these semantic constraints throughout the workflow structure, select executable components for underspecified steps, and suggest parameter values. Semantic workflows also enhance provenance records with abstract steps that reflect the overall data analysis method rather than just execution traces. Intelligent workflow systems are provenance-aware, since they both use and generate provenance and metadata as the data is being processed. Provenance-aware software enhances scientific analysis by propagating upstream metadata and provenance to new data products. Through the use of provenance standards, such as the recent W3C PROV recommendation for provenance on the Web, provenance-aware software can significantly enhance scientific data analysis, publication, and reuse. New capabilities are enabled when provenance is brought to the forefront in the design of software systems for science.

  19. A single-center retrospective clinicopathologic study of endomyocardial biopsies after heart transplant at Baskent University Hospital in Ankara, 1993-2014. (United States)

    Terzi, Ayşen; Sezgin, Atilla; Tunca, Zeynep; Deniz, Ebru; Ayva, Ebru Şebnem; Haberal Reyhan, Nihan; Müderrisoğlu, Haldun; Özdemir, Binnaz Handan


    The purpose of this study was to investigate the frequency and prognostic importance of acute cellular rejection after heart transplant. All 84 heart transplant patients at our center from January 1993 to January 2014, including all 576 endomyocardial biopsies, were evaluated with retrospective review of clinical records and endomyocardial biopsies. Routine and clinically indicated endomyocardial biopsies after heart transplant were graded for acute cellular rejection (2005 International Society for Heart and Lung Transplantation Working Formulation). Survival analysis was performed using Kaplan-Meier method. There were 61 male (73%) and 23 female recipients. Median age at heart transplant was 29 years (range, 1-62 y). Posttransplant early mortality rate was 17.9% (15 patients). In the other 69 patients, 23 patients died and 46 patients (66.7%) were alive at mean 69.3 ± 7.2 months after heart transplant. Mean follow-up was 35.4 ± 29.8 months (range, 0.07-117.5 mo). Mean 8.4 ± 4.2 endomyocardial biopsies (range, 1-19 biopsies) were performed per patient. Median first biopsy time was 7 days (range, 1-78 d). The frequency of posttransplant acute cellular rejection was 63.8% (44 of 69 patients) by histopathology; 86% patients experienced the first episode of acute cellular rejection within 6 months after transplant. There were 18 patients with acute cellular rejection ≥ grade 2R on ≥ 1 endomyocardial biopsy in 44 patients with acute cellular rejection. No significant difference was observed between survival rates of patients with grade 1R or ≥ grade 2R acute cellular rejection, or between survival rates of patients with or without diagnosis of any grade of acute cellular rejection. Acute cellular rejection was not related to any prognostic risk factor. Acute cellular rejection had no negative effect on heart recipient long-term survival, but it was a frequent complication after heart transplant, especially within the first 6 months.

  20. Review of renal biopsy database: a single centre south Indian study

    Directory of Open Access Journals (Sweden)

    : Clement Wilfred Devadass, Vijaya Mysorekar V, Gireesh MS, Mahesh E, Gurudev KC, Radhika K


    Full Text Available Background: The epidemiology of biopsy- proven renal disease (BPRD provides information that is useful for clinical practice and investigation. India lacks a national renal data registry system and there is a scarcity of information on the pattern of BPRD in South India. Objectives: To determine the occurrence and analyse the epidemiology of BPRD in our local (South Indian population. Material and Methods: A retrospective review of reports of native renal biopsies performed on patients at a tertiary care hospital in South India, from 2008 to 2013 was undertaken. All renal biopsies were studied by light and immunofluorescence microscopy and were classified into primary glomerulonephritis (PGN, secondary glomerulonephritis (SGN, tubulointerstitial nephritis, vascular nephropathy, hereditary nephritis, end stage renal disease and biopsies exhibiting no significant pathology. Results: A total of 661 cases were included in the study. The most common clinical syndrome as an indication for renal biopsy was NS (29%. PGN was the most common BPRD, accounting for 42.3 % of the cases. Minimal change disease (33.6% was the commonest PGN followed by membranous nephropathy (15.7% and focal segmental glomerulosclerosis (12.6%. Diabetic nephropathy (76.9% was the commonest SGN (14.7% followed by lupus nephritis. Conclusion: Our study represents an important contribution to understanding the epidemiology of renal disease in South India. The distribution pattern of PGN largely corresponds to the distribution pattern described in other South Indian studies. However, there is a wide variation of major histologic patterns of PGN across the world.

  1. Fluoroscopy-Guided Percutaneous Vertebral Body Biopsy Using a Novel Drill-Powered Device: Technical Case Series

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, Adam N., E-mail:; Pacheco, Rafael A., E-mail:; Tomasian, Anderanik, E-mail: [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Hsi, Andy C., E-mail: [Washington University School of Medicine, Division of Anatomic Pathology, Department of Pathology & Immunology (United States); Long, Jeremiah, E-mail: [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Chang, Randy O., E-mail: [Washington University School of Medicine (United States); Jennings, Jack W., E-mail: [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States)


    BackgroundA novel coaxial biopsy system powered by a handheld drill has recently been introduced for percutaneous bone biopsy. This technical note describes our initial experience performing fluoroscopy-guided vertebral body biopsies with this system, compares the yield of drill-assisted biopsy specimens with those obtained using a manual technique, and assesses the histologic adequacy of specimens obtained with drill assistance.MethodsMedical records of all single-level, fluoroscopy-guided vertebral body biopsies were reviewed. Procedural complications were documented according to the Society of Interventional Radiology classification. The total length of bone core obtained from drill-assisted biopsies was compared with that of matched manual biopsies. Pathology reports were reviewed to determine the histologic adequacy of specimens obtained with drill assistance.ResultsTwenty eight drill-assisted percutaneous vertebral body biopsies met study inclusion criteria. No acute complications were reported. Of the 86 % (24/28) of patients with clinical follow-up, no delayed complications were reported (median follow-up, 28 weeks; range 5–115 weeks). The median total length of bone core obtained from drill-assisted biopsies was 28 mm (range 8–120 mm). This was longer than that obtained from manual biopsies (median, 20 mm; range 5–45 mm; P = 0.03). Crush artifact was present in 11 % (3/28) of drill-assisted biopsy specimens, which in one case (3.6 %; 1/28) precluded definitive diagnosis.ConclusionsA drill-assisted, coaxial biopsy system can be used to safely obtain vertebral body core specimens under fluoroscopic guidance. The higher bone core yield obtained with drill assistance may be offset by the presence of crush artifact.

  2. Indications for kidney biopsy in idiopathic childhood nephrotic syndrome. (United States)

    Alshami, Alanoud; Roshan, Abishek; Catapang, Marisa; Jöbsis, Jasper J; Kwok, Trevor; Polderman, Nonnie; Sibley, Jennifer; Sibley, Matt; Mammen, Cherry; Matsell, Douglas G


    Most cases of childhood nephrotic syndrome (NS) are due to minimal change disease (MCD), while a minority of children have focal segmental glomerulosclerosis (FSGS) and an unfavorable clinical course, requiring a kidney biopsy to confirm diagnosis. We hypothesized that clinical characteristics at diagnosis and initial response to corticosteroid treatment accurately predict FSGS and can be used to guide consistent practice in the indications for kidney biopsy. This was a case control study (1990-2012). Inclusion criteria included age 1-17 years, meeting the diagnostic criteria for NS, and having biopsy-proven FSGS or MCD. Clinical characteristics at diagnosis included age, kidney function [estimated glomerular filtration rate (eGFR)], hypertension, hematuria, nephritis (reduced eGFR, hematuria, hypertension), and response to steroids. From a total of 169 children who underwent kidney biopsy for NS we included 65 children with MCD and 22 with FSGS for analysis. There were no significant between-group differences in age, sex, or eGFR at the time of diagnosis. The FSGS group had a higher proportion of hypertension (40 vs. 15%; p = 0.02), hematuria (80 vs. 47%; p = 0.01), and nephritis (22 vs. 2%; p = 0.004) and was more likely to be steroid resistant after 6 weeks of treatment than the MCD group (67 vs. 19%; p < 0.001). As predictors of FSGS, hematuria had a high sensitivity of 0.80 [95% confidence interval (CI) 0.56-0.93] and low specificity of 0.53 (95% CI 0.39-0.66), nephritis had a low sensitivity of 0.22 (95% CI 0.07-0.48) and high specificity of 0.98 (95% CI 0.88-0.99), and steroid resistance had a low sensitivity of 0.67 (95% CI 0.43-0.85) and high specificity of 0.81 (95% CI 0.68-0.90). The combination of steroid resistance after 6 weeks of therapy and/or nephritis at diagnosis yielded the optimal sensitivity and specificity at 0.80 (95% CI 0.56-0.93) and 0.75 (95% CI 0.60-0.86), respectively, confirmed by the highest receiver operator characteristic

  3. Transvenous liver biopsy via the femoral vein

    International Nuclear Information System (INIS)

    Khosa, F.; McNulty, J.G.; Hickey, N.; O'Brien, P.; Tobin, A.; Noonan, N.; Ryan, B.; Keeling, P.W.N.; Kelleher, D.P.; McDonald, G.S.A.


    AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

  4. Prevention of sepsis prior to prostate biopsy

    Directory of Open Access Journals (Sweden)

    Liam Toner


    Full Text Available Purpose: Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy. Materials and Methods: A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria. Results: Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel. Conclusions: The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice.

  5. [Multifocal histoplasmosis due to Histoplasma capsulatum var. duboisii in a 22 year-old Senegalese patient without proven immunodepression]. (United States)

    Diadie, S; Diatta, B; Ndiaye, M; Gaye, M; Sow, D; Ndiaye, M T; Seck, B; Diallo, S; Diop, A; Diallo, M; Ly, F; Niang, S O; Kane, A; Dieng, M T


    The authors report a case of multifocal African histoplasmosis with polymorphic skin involvement occuring in a patient without proven immunosuppression. He was a young 22-year-old patient from eastern Senegal - but born in Ouganda - who presented with polymorphic skin lesions: ombilicated papulo-nodules, gums and ulcerative and budding lesions. He showed lymphadenopathies without clinical inflammation and with a cheesy appearance of the biopsy but without tuberculosis and also hepatosplenic and bone involvement. Mycological samples of the skin and lymph nodes biopsies revealed yeasts of Histoplasma capsulatum var. duboisii with a positive culture on Sabouraud medium. HIV serology, HTLV1et 2, the serum proteins electrophoresis were unremarkable. Treatment with amphotericin B was irregular because of its inaccessibility in the national territory and its cost. The patient died of sepsis together with the aggravation of his disease. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Provenance, tectonic setting and source-area weathering of the ...

    Indian Academy of Sciences (India)

    The discriminant function plot indicates quartzose sedimentary provenance, and to some extent, the felsic igneous provenance, derived from weathered granite, gneissic terrain and/or from pre-existing sedimentary terrain. The CIA value indicates low to moderate degree of chemical weathering and the average ICV values ...

  7. Growth and provenance variation of Pinus caribaea var ...

    African Journals Online (AJOL)

    CAMCORE has visited 33 populations of Pinus caribaea var. hondurensis in Belize, Guatemala, Honduras, El Salvador, Nicaragua, and Quintana Roo, Mexico. Seed collections have been made in 29 provenances from 1, 325 mother trees. A total of 21 provenances and sources of Pinus caribaea var. hondurensis were ...

  8. Adaptation of eastern whitepine provenances to planting sites (United States)

    Maurice E., Jr. Demeritt; Peter W. Garrett


    Eastern white pine provenances from the extreme limits of the natural range of this species are changing from above- and below-average stability to average stability for height growth with increasing age. The regression method is useful for evaluating the stability of provenance to planting sites. The same general conclusions are reached for the performance at...

  9. Provenance variation in Eucalyptus camaldulensis Dehnh. in California (United States)

    B.M. Emery; F. Thomas Ledig


    In California, the Lake Albacutya provenance of river red gum was clearly superior in volume growth to 22 other provenances collected throughout the range of the species in Australia. It had at least 2.5 times the volume of the plantation mean at 5.5 years, consistent with its performance in other countries with Mediterranean climates like California's. Other...

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

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


    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. 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 technique. Patients with acute or chronic prostatitis, prostatic abscess, history of surgery on prostate within the previous three months and patients on 5α-reductase inhibitors or on urethral catheter were excluded. Of the 4702 patients evaluated, 70.9 per cent had PSA of less than 4 ng/ml and 29.1 per cent had PSA of more than 4 ng/ml. Of these, 875 men with a mean age of 65.72±7.4 (range 50-75 yr) had trans rectal ultrasonography (TRUS) guided biopsy. Twenty five men had biopsy at PSA level of 20 ng/ml. Positive predictive value of PSA in ranges of 4.1-10, 10.1-20, >20 ng/ml was 15.2, 24 and 62.6 per cent, respectively with negative DRE. PSA cut-off to do biopsy was derived by ROC curve as 5.82 ng/ml for all the men. When the subjects were further stratified on the basis of DRE findings, a cut-off of 5.4 ng/ml was derived in men with normal DRE. A cut-off for biopsy in symptomatic men with negative DRE could safely be raised to 5.4 ng/ml, which could avoid subjecting 10 per cent of men to undergo unnecessary biopsy.

  11. Research traceability using provenance services for biomedical analysis. (United States)

    Anjum, Ashiq; Bloodsworth, Peter; Branson, Andrew; Habib, Irfan; McClatchey, Richard; Solomonides, Tony; Soomro, Kamran; The Neugrid Consortium


    We outline the approach being developed in the neuGRID project to use provenance management techniques for the purposes of capturing and preserving the provenance data that emerges in the specification and execution of workflows in biomedical analyses. In the neuGRID project a provenance service has been designed and implemented that is intended to capture, store, retrieve and reconstruct the workflow information needed to facilitate users in conducting user analyses. We describe the architecture of the neuGRID provenance service and discuss how the CRISTAL system from CERN is being adapted to address the requirements of the project and then consider how a generalised approach for provenance management could emerge for more generic application to the (Health)Grid community.

  12. Ultrasound guided pleural biopsy in undiagnosed exudative pleural effusion patients

    Directory of Open Access Journals (Sweden)

    Adel S. Ahmed


    In conclusion: Thoracic ultrasound (TUS guided pleural biopsy had a diagnostic yield which was slightly lower but comparable to both CT guided pleural biopsy and medical thoracoscopic pleural biopsy (MT.

  13. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ... Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During ...

  14. Radial scars without atypia in percutaneous biopsy specimens: can they obviate surgical biopsy? (United States)

    Mesa-Quesada, J; Romero-Martín, S; Cara-García, M; Martínez-López, A; Medina-Pérez, M; Raya-Povedano, J L

    To evaluate the need for surgical biopsy in patients diagnosed with radial scars without atypia by percutaneous biopsy. In this retrospective observational study, we selected patients with a histological diagnosis of radial scar in specimens obtained by percutaneous biopsy during an 8-year period. The statistical analysis was centered on patients with radial scar without atypia (we assessed the radiologic presentation, the results of the percutaneous biopsy, and their correlation with the results of surgical biopsy and follow-up) and we added the patients with atypia and cancer in the elaboration of the diagnostic indices. We identified 96 patients with radial scar on percutaneous biopsy; 54 had no atypia, 18 had atypia, and 24 had cancer. Among patients with radial scar without atypia, there were no statistically significant differences between patients who underwent imaging follow-up and those who underwent surgical biopsy (p>0.05). The rate of underdiagnosis for percutaneous biopsy in patients without atypia was 1.9%. The rates of diagnosis obtained with percutaneous biopsy in relation to follow-up and surgical biopsy in the 96 cases were sensitivity 92.3%, specificity 100%, positive predictive value 100%, negative predictive value 97.2%, and accuracy 97.9%. The area under the ROC curve was 0.96 (p<0.001), and the kappa concordance index was 0.95 (p<0.001) CONCLUSIONS: We consider that it is not necessary to perform surgical biopsies in patients with radial scars without atypia on percutaneous biopsies because the rate of underestimation is very low and the concordance between the diagnosis reached by percutaneous biopsy and the definitive diagnosis is very high. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. GoM Coastal Biopsy Surveys - NRDA (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Small vessel surveys were conducted within estuarine and nearshore coastal waters of Barataria Bay, LA and Mississippi Sound, MS to collect tissue biopsy samples...

  16. Incision for pleural tissue biopsy (image) (United States)

    ... open pleural biopsy, a small piece of the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with ...

  17. Cryopreservation of biopsied cleavage stage human embryos. (United States)

    Stachecki, James J; Cohen, Jacques; Munné, Santiago


    The aim was to develop a method to optimize cryopreservation of biopsied multi-celled human embryos. Human day 3 embryos that were donated to research, along with those found to be chromosomally abnormal after blastomere biopsy and fluorescence in-situ hyridization (FISH), were cryopreserved using a slow-freezing protocol in either standard embryo cryopreservation solution [embryo transfer freezing medium (ETFM), a conventional sodium-based medium] or CJ3 (a choline-based, sodium-free medium). After thawing, the number of intact cells was recorded and the previously biopsied embryos were re-analysed using FISH. Biopsied embryos had a lower proportion of intact blastomeres after cryopreservation as compared with intact embryos. However, a significantly (P < 0.05) higher proportion of blastomeres from intact and biopsied embryos cryopreserved in CJ3 (84.1 and 80.1% respectively) survived after thaw than those in ETFM (73.6 and 50.5% respectively). The proportion of aneuploid and mosaic embryos was not statistically different between the two groups. In addition, the frequency of lost cells by aneuploid and mosaic embryos was similar. This study describes a new method that improves the survival of cryopreserved biopsied embryos, and shows that it may also be beneficial for the storage of intact human multi-celled embryos.

  18. Komadu: A Capture and Visualization System for Scientific Data Provenance

    Directory of Open Access Journals (Sweden)

    Isuru Suriarachchi


    Full Text Available Data provenance captured from scientific applications is a critical precursor to data sharing and reuse. For researchers wanting to repurpose data, it is a source of information about the lineage and attribution of the data and this is needed in order to establish trust in a data set. Komadu is a standalone provenance capture and visualization system for capturing, representing, and manipulating provenance coming from scientific tools, infrastructures, and repositories. It uses the W3C PROV standard [1] in representing data, and it is the successor of the Karma [2] provenance capture system which was based on Open Provenance Model (OPM [3]. Komadu comes with two different interfaces: a Web Services interface based on Apache Axis2 [4] and a messaging interface based on RabbitMQ [5]. Komadu is completely open source and the source code is publicly available on GitHub [6]. Even though Komadu has been used most extensively in relation to scientific research, its interfaces are designed to collect and visualize provenance of any kind of application needing provenance.

  19. SEIS-PROV: Practical Provenance for Seismological Data (United States)

    Krischer, L.; Smith, J. A.; Tromp, J.


    It is widely recognized that reproducibility is crucial to advance science, but at the same time it is very hard to actually achieve. This results in it being recognized but also mostly ignored by a large fraction of the community. A key ingredient towards full reproducibility is to capture and describe the history of data, an issue known as provenance. We present SEIS-PROV, a practical format and data model to store provenance information for seismological data. In a seismological context, provenance can be seen as information about the processes that generated and modified a particular piece of data. For synthetic waveforms the provenance information describes which solver and settings therein were used to generate it. When looking at processed seismograms, the provenance conveys information about the different time series analysis steps that led to it. Additional uses include the description of derived data types, such as cross-correlations and adjoint sources, enabling their proper storage and exchange. SEIS-PROV is based on W3C PROV (, a standard for generic provenance information. It then applies an additional set of constraints to make it suitable for seismology. We present a definition of the SEIS-PROV format, a way to check if any given file is a valid SEIS-PROV document, and two sample implementations: One in SPECFEM3D GLOBE ( to store the provenance information of synthetic seismograms and another one as part of the ObsPy ( framework enabling automatic tracking of provenance information during a series of analysis and transformation stages. This, along with tools to visualize and interpret provenance graphs, offers a description of data history that can be readily tracked, stored, and exchanged.

  20. Acute disseminated cutaneous candidiasis. (United States)

    Fong, P H; Chan, H L; Lee, Y S; Wong, H B


    Acute disseminated candidiasis is a serious and difficult problem often seen in immunocompromised states. Appearance of a characteristic skin eruption is helpful in the diagnostic. We report below a case report of an eight year old girl with aplastic anemia who had received multiple courses of antibiotics. A profuse monomorphic papular nodular eruption subsequently appeared on the face, palms and soles. Candida tropicalis was identified from the skin biopsy taken from one such lesion.

  1. A Rare Sequela of Acute Disseminated Encephalomyelitis


    Vijay Kodadhala; Saravana Devulapalli; Mohankumar Kurukumbi; Annapurni Jayam-Trouth


    Acute disseminated encephalomyelitis is a demyelinating disease, typically occurring in children following a febrile infection or a vaccination. Primary and secondary immune responses contribute to inflammation and subsequent demyelination, but the exact pathogenesis is still unknown. Diagnosis of acute disseminated encephalomyelitis is strongly suggested by temporal relationship between an infection or an immunization and the onset of neurological symptoms. Biopsy is definitive. In general, ...

  2. Liver Biopsies for Chronic Hepatitis C: Should Nonultrasound-Guided Biopsies Be Abandoned?

    Directory of Open Access Journals (Sweden)

    Jennifer A Flemming


    Full Text Available BACKGROUND/OBJECTIVE: Liver biopsy has been the gold standard for grading and staging chronic hepatitis C virus (HCV-mediated liver injury. Traditionally, this has been performed by trained practitioners using a nonimage-guided percutaneous technique at the bedside. Recent literature suggests an expanding role for radiologists in obtaining biopsies using an ultrasound (US-guided technique. The present study was undertaken study to determine if the two techniques produced liver biopsy specimens of similar quality and hypothesized that at our institution, non-US-guided percutaneous liver biopsies for HCV would be of higher quality than US-guided specimens.

  3. The technique of ultrasound guided prostate biopsy. (United States)

    Romics, Imre


    This article discusses the preparations for ultrasound guided prostate biopsy, the conditions used and the process of performing a biopsy. The first step in preparing the patient is a cleansing enema before biopsy. Every author proposes the use of a preoperative antibiotic based prophylaxis. Differences may be found in the type, dosage and the duration of this preoperative application, which can last from 2 h to 2 days. For anaesthesia, lidocaine has been proposed, which may be used as a gel applied in the rectum or in the form of a prostate infiltrate. Quite a few colleagues administer a brief intravenous narcosis. A major debate goes on in respect of defining the number of biopsy samples needed. Hodge proposed sextant biopsy in 1989, for which we had false negative findings in 20% of all cases. Because of this, it has recently been suggested that eight or rather ten samples be taken. There are some who question even this. Twelve biopsy samples do offer an advantage compared to six, although in the case of eight this is not the case. We shall present an in depth discussion of the various opinions on the different numbers of biopsies samples required. For the sample site, the apex, the base and the middle part are proposed, and (completing the process) two additional samples can also be taken from the transition zone (TZ), since 20% of all prostate cancers originate from TZ. In case of a palpable nodule or any lesion made visible by TRUS, an additional, targeted, biopsy has to be performed. Certain new techniques like the 3-D Doppler, contrast, intermittent and others shall also be presented. The control of the full length of samples taken by a gun, as well as the proper conservation of the samples, are parts of pathological processing and of the technical tasks. A repeated biopsy is necessary in the case of PIN atypia, beyond which the author also discusses other indications for a repeated biopsy. We may expect the occurrence of direct postoperative complications

  4. Transjugular liver core biopsy: indications, results, and complications

    International Nuclear Information System (INIS)

    Dinkel, H.P.; Wittchen, K.; Hoppe, H.; Triller, J.; Dufour, J.F.; Zimmermann, A.


    Purpose: To evaluate benefit, feasibility, and frequency of complications with transjugular liver biopsy using a semi-automatic Tru-cut system. Materials and Methods: Eighty-five consecutive patients (57 males, 28 females) with various liver disorders (cirrhosis [30], hepatitis [12], acute hepatopathy [34], orthotopic liver transplantation [8], hepatocellular carcinoma [1]), coagulopathies (n=71) and/or ascites (n = 46) were referred to our department for a transjugular liver biopsy. Mean age was 48 ± 16 years (range 17 to 75 years). Success and complications were retrospectively evaluated from the radiology reports, pathology reports, and patient files. Success was defined as procuring a tissue specimen that enabled a definite histological diagnosis. The complications included thrombosis at the puncture site, hematoma, cardiac arrhythmia, capsular perforation, hemorrhage, and cardiac damage. Mortality included all deaths within 30 days after the procedure. Procedure-related mortality included all deaths related to the procedure. Results: The procedure was technically successful in 80 patients (94%) and unsuccessful in 5 patients (6%) due to a failed hepatic vein cannulation (1 patient with Budd Chiari syndrome and total liver vein occlusion, 4 patients with unsuitable anatomy). One biopsy pass was made in 22 patients, and two passes were made in 45 and three or more passes in 14 patients, all in a single session. The sample quality was judged by the pathologist as good in 71 of 80 patients (89%) and poor in 8 patients (10%). A diagnosis was not possible in 1 patient. Eight procedure-related complications occurred, which were classified according to the criteria of the society of interventional radiology (SIR) as minor in 5 (3 type A, 2 type B) and major in 3 (1 pneumothorax, type C, 1 nonfatal bleeding, type D, and 1 fatal bleeding, type F). Procedure-related mortality was 1%, overall mortality 15% (mostly due to progressive liver failure). (orig.) [de

  5. provenance of sandstone on the western flank of anambra basin

    African Journals Online (AJOL)


    However, because the mineralogy of clastic rocks is considerably altered by weathering processes, transport and diagenesis constraining their provenance using mineralogy alone becomes difficult. This work therefore explores the integrative approach of textural characteristics, heavy mineral analysis and framework.

  6. The Symbiotic Relationship between Scientific Workflow and Provenance (Invited) (United States)

    Stephan, E.


    The purpose of this presentation is to describe the symbiotic nature of scientific workflows and provenance. We will also discuss the current trends and real world challenges facing these two distinct research areas. Although motivated differently, the needs of the international science communities are the glue that binds this relationship together. Understanding and articulating the science drivers to these communities is paramount as these technologies evolve and mature. Originally conceived for managing business processes, workflows are now becoming invaluable assets in both computational and experimental sciences. These reconfigurable, automated systems provide essential technology to perform complex analyses by coupling together geographically distributed disparate data sources and applications. As a result, workflows are capable of higher throughput in a shorter amount of time than performing the steps manually. Today many different workflow products exist; these could include Kepler and Taverna or similar products like MeDICI, developed at PNNL, that are standardized on the Business Process Execution Language (BPEL). Provenance, originating from the French term Provenir “to come from”, is used to describe the curation process of artwork as art is passed from owner to owner. The concept of provenance was adopted by digital libraries as a means to track the lineage of documents while standards such as the DublinCore began to emerge. In recent years the systems science community has increasingly expressed the need to expand the concept of provenance to formally articulate the history of scientific data. Communities such as the International Provenance and Annotation Workshop (IPAW) have formalized a provenance data model. The Open Provenance Model, and the W3C is hosting a provenance incubator group featuring the Proof Markup Language. Although both workflows and provenance have risen from different communities and operate independently, their mutual

  7. Provenance, tectonic setting and source-area weathering of the ...

    Indian Academy of Sciences (India)

    s12040-017-0803-5. Provenance, tectonic setting and source-area weathering of the lower Cambrian ... (2010) carried out detrital zircon studies in order to correlate ...... and tectonic evolution of the Central Asian Orogenic Belt;. Chinese Sci. Bull.

  8. Acute fatty liver in pregnancy.

    NARCIS (Netherlands)

    Tan, A.; Krieken, J.H.J.M. van; Peters, W.H.M.; Steegers, E.A.P.


    When confronted with liver abnormalities during the third trimester of pregnancy, one should consider acute fatty liver of pregnancy. The differential diagnosis with (pre-)eclampsia and HELLP syndrome is sometimes difficult. In these cases a liver biopsy is helpful though rarely performed during

  9. DataONE: A Data Federation with Provenance Support

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Yang [University of Illinois at Urbana-Champaign; Jones, Christopher [National Center for Ecological Analysis and Synthesis, Santa Barbara; Cuevas-Vicenttin, Victor [ Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico; Jones, Matthew B. [National Center for Ecological Analysis and Synthesis, Santa Barbara; Ludascher, Bertram [University of Illinois at Urbana-Champaign; McPhillips, Timothy [University of Illinois at Urbana-Champaign; Missier, Paolo [Newcastle University, UK; Schwalm, Christopher [Woods Hole Research Center (WHRC), Massachusetts; Slaughter, Peter [National Center for Ecological Analysis and Synthesis, Santa Barbara; Vieglais, Dave [University of Kansas; Walker, Lauren [National Center for Ecological Analysis and Synthesis, Santa Barbara


    DataONE is a federated data network focusing on earth and environmental science data. We present the provenance and search features of DataONE by means of an example involving three earth scientists who interact through a DataONE Member Node. DataONE provenance systems enable reproducible research and facilitate proper attribution of scientific results transitively across generations of derived data products.

  10. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach (United States)


    Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. Methods A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Results Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P guided diagnostic breast biopsy procedure. Significantly more (P guided diagnostic breast biopsy procedure. Conclusions In appropriately selected cases, the 8-gauge vacuum-assisted biopsy approach appears to be advantageous to the spring-loaded 14-gauge core biopsy approach for providing the most accurate and optimal diagnostic information. PMID:21835024

  11. Automatic run-time provenance capture for scientific dataset generation (United States)

    Frew, J.; Slaughter, P.


    Provenance---the directed graph of a dataset's processing history---is difficult to capture effectively. Human- generated provenance, as narrative metadata, is labor-intensive and thus often incorrect, incomplete, or simply not recorded. Workflow systems capture some provenance implicitly in workflow specifications, but these systems are not ubiquitous or standardized, and a workflow specification may not capture all of the factors involved in a dataset's production. System audit trails capture potentially all processing activities, but not the relationships between them. We describe a system that transparently (i.e., without any modification to science codes) and automatically (i.e. without any human intervention) captures the low-level interactions (files read/written, parameters accessed, etc.) between scientific processes, and then synthesizes these relationships into a provenance graph. This system---the Earth System Science Server (ES3)---is sufficiently general that it can accommodate any combination of stand-alone programs, interpreted codes (e.g. IDL), and command- language scripts. Provenance in ES3 can be published in well-defined XML formats (including formats suitable for graphical visualization), and queried to determine the ancestors or descendants of any specific data file or process invocation. We demonstrate how ES3 can be used to capture the provenance of a large operational ocean color dataset.

  12. Lightweight Provenance Service for High-Performance Computing

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Dong; Chen, Yong; Carns, Philip; Jenkins, John; Ross, Robert


    Provenance describes detailed information about the history of a piece of data, containing the relationships among elements such as users, processes, jobs, and workflows that contribute to the existence of data. Provenance is key to supporting many data management functionalities that are increasingly important in operations such as identifying data sources, parameters, or assumptions behind a given result; auditing data usage; or understanding details about how inputs are transformed into outputs. Despite its importance, however, provenance support is largely underdeveloped in highly parallel architectures and systems. One major challenge is the demanding requirements of providing provenance service in situ. The need to remain lightweight and to be always on often conflicts with the need to be transparent and offer an accurate catalog of details regarding the applications and systems. To tackle this challenge, we introduce a lightweight provenance service, called LPS, for high-performance computing (HPC) systems. LPS leverages a kernel instrument mechanism to achieve transparency and introduces representative execution and flexible granularity to capture comprehensive provenance with controllable overhead. Extensive evaluations and use cases have confirmed its efficiency and usability. We believe that LPS can be integrated into current and future HPC systems to support a variety of data management needs.

  13. Exsanguinating Hemorrhage during Open Biopsy in a Primary Breast Angiosarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Majid Akrami


    Full Text Available Angiosarcomas are endothelial cell neoplasms in the lining of the blood vessel wall and account for about 0.04% of all breast malignancies with a high rate of error in primary diagnosis. The breast angiosarcoma is a rare and uncommon pathology and has been described mostly as case reports. Indeed, only a limited number of cases have been published. Accordingly, the natural history of this tumor and its clinical course remain unclear, and as a consequence, no uniform treatment strategy exists. We present the clinical course and challenges in the diagnosis of a primary angiosarcoma of the breast in a young woman, presenting with a mass in her left breast. Fine-needle aspiration and core needle biopsy failed to confer a correct diagnosis. She suffered severe bleeding at the time of open biopsy and underwent total mastectomy, followed by adjuvant chemotherapy. Young women with solid breast tumors, especially those that are highly vascular, should be considered malignant until proven otherwise. Accurate diagnosis may be difficult. Open biopsy can be diagnostic, although exsanguinating bleeding may occur. Thus, performing open biopsy in locations other than equipped operating rooms may be hazardous and should be avoided.

  14. Breast biopsy prediction using a case-based reasoning classifier for masses versus calcifications (United States)

    Bilska-Wolak, Anna O.; Floyd, Carey E., Jr.


    We investigated how the subdivision of breast biopsy cases into masses and calcifications influences breast cancer prediction for a case-based reasoning (CBR) classifier system. Mammographers' BI-RADS (TM) descriptions of mammographic lesions were used as input to predict breast biopsy outcome. The CBR classifier compared the case to be examined to a reference collection of cases and identified similar cases. The decision variable for each case was formed as the ratio of malignant similar cases to all similar cases. The reference data collection consisted of 1433 biopsy-proven mammography cases, and was divided into 3 categories: mass cases, calcification cases, and other. Performance was evaluated using ROC analysis and Round Robin sampling, and variance was estimated using a bootstrap analysis. The best ROC area for masses was 0.92+/- 0.01. At 98% sensitivity, about 209 (51%) patients with benign mass lesions might have been spared biopsy, while missing 5 (2%) malignancies. The best ROC area for calcifications was only 0.64+/- 0.02. At 98% sensitivity, 50 (12%) benign calcification cases could have been spared, while missing 5 (2%) malignancies. The CBR system performed substantially better on the masses than on the calcifications.

  15. Prevalence of Concomitant Sacroiliac joint Dysfunction in Patients With Image Proven Herniated Lumbar Discs

    Directory of Open Access Journals (Sweden)

    Salah Alalawi


    Full Text Available Background:Sacroiliac joint (SIJ dysfunction is a widely known but poorly defined cause of low back pain. To our knowledge, few published studies have been conducted to evaluate systematically the prevalence and significance of concomitant sacroiliac joint dysfunction in patients with herniated lumbar discs. As concomitant SIJ dysfunction in low back pain patients is likely to respond to particular noninvasive interventions such as manipulation,improved understanding of the relationship between these two diagnoses would improve clinical decision making and research.Methods:This study was designated to estimate the prevalence of concomitant sacroiliac joint dysfunction in sub acute low back pain patients with image proven discopathy and evaluate the theory that sacroiliac joint dysfunction can be a source of pain and functional disability in discopathy. A total of 202 patients with sub acute radicular back pain and MRI proven herniated lumbar discs underwent standardized   physiatrist history and physical examination, specified for detection of concomitant sacroiliac joint dysfunction.Results: Sacroiliac joint dysfunction is a concomitant finding in 72.3% of evaluated patients.There was significantly higher SIJ dysfunction prevalence in female patients (p <0.0001. Conclusion: SIJ dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, in the presence of radicular and sacroiliac joint symptoms, SIJ dysfunction, regardless of intervertebral disc pathology, must be considered in clinical decisiomaking.

  16. Renal Biopsy in Type 2 Diabetic Patients. (United States)

    Espinel, Eugenia; Agraz, Irene; Ibernon, Meritxell; Ramos, Natalia; Fort, Joan; Serón, Daniel


    The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients.

  17. Comparative study of decomposable and indecomposable biopsy needle in lung puncture biopsy

    International Nuclear Information System (INIS)

    Wang Bo; Sheng Zhanxin; Wen Yamin; Zhang Liping; Wen Zongqiu


    Objective: To contrast the clinical practice characteristics with decomposable and indecomposable biopsy needle in the CT-guided lung puncture biopsy. Methods: 50 patients with lung tumour carried on puncture biopsy under the CT guidance were divided in two groups randomly: Group A (25 examples): using the indecomposable BioPinceTM biopsy needle; Group B(25 examples): using the decomposable Precisa or Vitesse biopsy needle. The puncture biopsy organization quantity, the first time puncture success rate, the pathological diagnosis result and the incidence of puncture complication were compared in two groups. Results: More striped structures were gained obviously in group A than in group B: 24/25 and 11/25 respectively (P>0.05), The pathological diagnosis 'serious extrusion amoebocyte and nature undetermined' only occurred in group B. But the first time puncture success rate was lower in group A than in B: 52%(13/25) and 80%(20/25) respectively (P>0.05), The incidence of hemorrhage and pneumothorax in group A was higher slightly: 84% and 72%, 16% and 4% respectively (P>0.05). Conclusion: The indecomposable needle (BioPinceTM) was better in lung puncture biopsy, but the lower first time puncture success rate also increases the risk of operation and complication in some degree because of the structure of the needle. On the contrary, decomposable needle (the Precisa or the Vitesse) was not the best choice in lung puncture biopsy. But it had the original superiority, especially regarding the special patient such as patient with small tumour, thin thoracic wall, bad physique for its nimble operation. It is essential for us to use the two different types of biopsy needle rationally to enhance the level of CT-guided lung puncture biopsy. (authors)

  18. Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors. (United States)

    Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young


    To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P guided-fine needle aspiration, gender, age, size, presence of vascularity, and suspicious US features were not associated with post-biopsy hematoma according to experience level. Post-biopsy hematoma occurred significantly more with ultrasound guided-core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P guided-core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P guided-core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

  19. Unusual presentation and inconlusive biopsy render fibroadenoma in two young females a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    D Meerkotter


    Full Text Available Two young non-lactating females presented with acutely painful breast masses. Sonographic features showed mixed echogenic masses. Core biopsy was non-diagnostic in both and surgical excision revealed infarcted fibroadenomas. Although fibroadenomas are common, they do not commonly infarct and only rarely in non-lactating and non-pregnant females. These two cases highlight the clinical and imaging characteristics of this important differential diagnosis.

  20. Treatment of a biliary-venous fistula following percutaneous biopsy in a pediatric living related liver transplant patient

    International Nuclear Information System (INIS)

    Weintraub, Joshua L.; Mobley, David; Hawari, Ashraf; English, Benjamin


    Liver biopsy is a common study performed after hepatic transplantation. Most centers routinely perform a biopsy 1 week after surgery to evaluate for the possibility of acute rejection. Subsequent biopsies are based on clinical symptoms and routine hepatic function laboratory testing. We report the clinical presentation and treatment of a biliary-venous fistula resulting in sepsis and bilhemia (elevated serum bilirubin levels caused by a biliary-venous fistula) in a 21/2-year-old patient 4 months after partial left lateral segment living related liver transplantation. This case is unusual in that the fistula is the reversal of the more common venous-biliary fistula. The fistula developed after a percutaneous liver biopsy was performed. (orig.)

  1. ISO TC211 standards on Provenance for Earth science (United States)

    Di, L.; Deng, M.


    Data provenance, also called lineage, records the derivation history of a data product. The history could include the algorithms used, the process steps taken, the computing environment run, data sources input to the processes, the organization/person responsible for the product, etc. Provenance provides important information to data users for them to determine the usability and reliability of the product. In the science domain, the data provenance is especially important since scientists need to use the information to determine the scientific validity of a data product and to decide if such a product can be used as the basis for further scientific analysis. Provenance is a kind of metadata. In Earth science domain, the International Organization for Standardization (ISO) Technical Committee 211 (ISO TC 211) have set geospatial metadata standards for geospatial data, including ISO 19115:2003-Metadata, ISO 19115-2:2009-Metadata-Part 2: Extensions for imagery and gridded data, and ISO 19115-1:2014 - Metadata -- Part 1: Fundamentals. ISO 19115 and ISO 19115-1 define the fundamental metadata for documenting geospatial data products, and ISO 19115-2 provides additional metadata classes for imagery and gridded data. ISO 19115-1:2014 is the revised version of ISO 19115:2003. ISO 19115 and ISO 19115-1 define fundamental lineage information classes and subclasses. They miss some key information classes needed for documenting the provenance in the Web service environment, such as the running environment, the algorithms, and software executables. However, ISO 19115-2 extends the lineage model in ISO 19115 and provides additional metadata classes needed for documenting provenance information. The combination of lineage models in ISO 19115 and ISO 19115-2 provides a comprehensive provenance information model needed for the web service environment. Currently the ISO Provence standard is not compatible with W3C Prov standard. The revision of ISO 19115-2 will be started in

  2. Improved Accuracy of Percutaneous Biopsy Using “Cross and Push” Technique for Patients Suspected with Malignant Biliary Strictures

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Prashant, E-mail: [University of Birmingham, School of Cancer Sciences, Vincent Drive (United Kingdom); Rangarajan, Balaji; Mangat, Kamarjit, E-mail:, E-mail: [University Hospital Birmingham NHS Trust, Department of Radiology (United Kingdom)


    PurposeVarious methods have been used to sample biliary strictures, including percutaneous fine-needle aspiration biopsy, intraluminal biliary washings, and cytological analysis of drained bile. However, none of these methods has proven to be particularly sensitive in the diagnosis of biliary tract malignancy. We report improved diagnostic accuracy using a modified technique for percutaneous transluminal biopsy in patients with this disease.Materials and MethodsFifty-two patients with obstructive jaundice due to a biliary stricture underwent transluminal forceps biopsy with a modified “cross and push” technique with the use of a flexible biopsy forceps kit commonly used for cardiac biopsies. The modification entailed crossing the stricture with a 0.038-in. wire leading all the way down into the duodenum. A standard or long sheath was subsequently advanced up to the stricture over the wire. A Cook 5.2-Fr biopsy forceps was introduced alongside the wire and the cup was opened upon exiting the sheath. With the biopsy forceps open, within the stricture the sheath was used to push and advance the biopsy cup into the stricture before the cup was closed and the sample obtained. The data were analysed retrospectively.ResultsWe report the outcomes of this modified technique used on 52 consecutive patients with obstructive jaundice secondary to a biliary stricture. The sensitivity and accuracy were 93.3 and 94.2 %, respectively. There was one procedure-related late complication.ConclusionWe propose that the modified “cross and push” technique is a feasible, safe, and more accurate option over the standard technique for sampling strictures of the biliary tree.

  3. Provenance-based refresh in data-oriented workflows

    KAUST Repository

    Ikeda, Robert


    We consider a general workflow setting in which input data sets are processed by a graph of transformations to produce output results. Our goal is to perform efficient selective refresh of elements in the output data, i.e., compute the latest values of specific output elements when the input data may have changed. We explore how data provenance can be used to enable efficient refresh. Our approach is based on capturing one-level data provenance at each transformation when the workflow is run initially. Then at refresh time provenance is used to determine (transitively) which input elements are responsible for given output elements, and the workflow is rerun only on that portion of the data needed for refresh. Our contributions are to formalize the problem setting and the problem itself, to specify properties of transformations and provenance that are required for efficient refresh, and to provide algorithms that apply to a wide class of transformations and workflows. We have built a prototype system supporting the features and algorithms presented in the paper. We report preliminary experimental results on the overhead of provenance capture, and on the crossover point between selective refresh and full workflow recomputation. © 2011 ACM.

  4. Sudetic larch in Germany - Results of provenance and progeny research

    Energy Technology Data Exchange (ETDEWEB)

    Weisgerber, H. [Forest Centre for Management Planning, Research and Ecology, Hann Muenden (Germany)


    There are only a few older sources of Sudetic larch in Germany. They distinguish themselves by outstanding growth and low susceptibility to canker. This impression was confirmed by results of provenance research. The Sudetic larch tested in comparison with numerous other provenances proved to be fast-growing, site-tolerant, to a large extent insusceptible to canker, with straight but also slightly to moderately curved stems. The Sudetic provenances behave remarkably uniformly as regards these characteristics. In addition to provenance research investigations have been going on for a long time in Germany into individual differences within the Sudetic larch populations. A report is given on the results of progeny tests from free and controlled pollination, using the example of a seed orchard consisting of 54 clones. We point also to possibilities for improving stem quality by selection steps. The results of provenance and progeny research on Sudetic larch are in the meantime being put to use to a large extent in practical forestry. The forest administrations of various federal lands recommend the use of reproductive material of Sudetic origin and from seed orchards. 20 refs, 3 figs

  5. The role of diagnostic imaging and liver biopsy in the diagnosis of focal nodular hyperplasia in children. (United States)

    Valentino, Pamela L; Ling, Simon C; Ng, Vicky L; John, Philip; Bonasoni, Paola; Castro, Denise A; Taylor, Glenn; Chavhan, Govind B; Kamath, Binita M


    Focal nodular hyperplasia (FNH), a benign liver tumour, has a characteristic appearance on diagnostic imaging (DI) and histology. The role of liver biopsy in children for the diagnosis of FNH is unclear. This study investigates the diagnostic accuracy of DI for FNH in children without comorbidities, compared to liver biopsy. A total of 304 consecutive patients (age liver mass were retrospectively ascertained (1990-2010). Individuals with a history of malignancy, liver disease or syndromes with increased malignancy risk were excluded. DI and biopsy data were reviewed. After excluding 205 cases, 99 liver masses were studied. Based on histology, the most common diagnosis was hepatoblastoma (46/99, 44%) followed by FNH (23/99, 23%). The mean age at FNH diagnosis was 11.1 ± 5.2 years, with female preponderance (78%), and a median follow-up of 1.35 years (interquartile range 0.54, 4.20 years). 19/23 biopsy-proven FNH met standard criteria for FNH on DI. In 4/23 cases of biopsy-proven FNH, imaging did not suggest FNH. Two false positive cases included adenoma and fibrolamellar hepatocellular carcinoma. On review of original reports, DI had 82.6% sensitivity and 97.4% specificity for the diagnosis of FNH. On blind review, the sensitivity of DI for FNH diagnosis was 81.3% for MRI (13/16), and 53.3% for CT (8/15). In this cohort of children with liver masses and no comorbidities, a diagnosis of FNH by imaging was highly specific, and MRI was the most sensitive study for its diagnosis. Liver biopsy may be deferred in selected children if the DI, particularly MRI, is indicative of FNH. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Transjugular liver biopsy : the efficacy of quick-core biopsy needle system

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Gyoo Sik; Ahn, Byung Kwon; Lee, Sang Ouk; Chang, Hee Kyong; Oh, Kyung Seung; Huh, Jin Do; Joh, Young Duk [Kosin Medical College, Pusan (Korea, Republic of)


    To evaluate the efficacy of the Quick-Core biopsy needle system in performing transjugular liver biopsy. Between December 1995 and June 1997, eight patients underwent transjugular liver biopsy involving use of the Quick-Core biopsy needle system; the conditions involved were coagulopathy (n=4), thrombocytopenia (n=3), and ascites (n=1). Via the right internal jugular vein, the right hepatic vein was selectively catheterized with a 7-F transjugular guiding catheter, and a14-guage stiffening cannula was then inserted through this catheter; to obtain core tissue, a Quick-Core needle was then advanced into the liver parenchyma through the catheter-cannula combination. Eighteen- and 19-guage needles were used in three and five patients, respectively; specimen size, adequacy of the biopsy specimen and histologic diagnosis were determined, and complications were recorded. Biopsy was successful in all patients. The mean length of the specimen was 1.4 cm (1.0 - 1.8 cm), and all were adequate for pathologic examinations ; specific diagnosis was determined in all patients. There were two malignant neoplasms, two cases of veno-occlusive disease, and one case each of cirrhosis, fulminant hepatitis, Banti syndrome and Budd-Chiari syndrome. One patient complained of neck pain after the procedure, but no serious procedural complications were noted. Our preliminary study shows that the Quick-Core biopsy needle system is safe and provides adequate core tissues with high diagnostic yields. (author). 23 refs., 1 tab., 3 figs.

  7. Transjugular liver biopsy : the efficacy of quick-core biopsy needle system

    International Nuclear Information System (INIS)

    Jung, Gyoo Sik; Ahn, Byung Kwon; Lee, Sang Ouk; Chang, Hee Kyong; Oh, Kyung Seung; Huh, Jin Do; Joh, Young Duk


    To evaluate the efficacy of the Quick-Core biopsy needle system in performing transjugular liver biopsy. Between December 1995 and June 1997, eight patients underwent transjugular liver biopsy involving use of the Quick-Core biopsy needle system; the conditions involved were coagulopathy (n=4), thrombocytopenia (n=3), and ascites (n=1). Via the right internal jugular vein, the right hepatic vein was selectively catheterized with a 7-F transjugular guiding catheter, and a14-guage stiffening cannula was then inserted through this catheter; to obtain core tissue, a Quick-Core needle was then advanced into the liver parenchyma through the catheter-cannula combination. Eighteen- and 19-guage needles were used in three and five patients, respectively; specimen size, adequacy of the biopsy specimen and histologic diagnosis were determined, and complications were recorded. Biopsy was successful in all patients. The mean length of the specimen was 1.4 cm (1.0 - 1.8 cm), and all were adequate for pathologic examinations ; specific diagnosis was determined in all patients. There were two malignant neoplasms, two cases of veno-occlusive disease, and one case each of cirrhosis, fulminant hepatitis, Banti syndrome and Budd-Chiari syndrome. One patient complained of neck pain after the procedure, but no serious procedural complications were noted. Our preliminary study shows that the Quick-Core biopsy needle system is safe and provides adequate core tissues with high diagnostic yields. (author). 23 refs., 1 tab., 3 figs

  8. Sentinel Lymph Node Biopsy in Nonmelanoma Skin Cancer Patients

    Directory of Open Access Journals (Sweden)

    Marie-Laure Matthey-Giè


    Full Text Available The management of lymph nodes in nonmelanoma skin cancer patients is currently still debated. Merkel cell carcinoma (MCC, squamous cell carcinoma (SCC, pigmented epithelioid melanocytoma (PEM, and other rare skin neoplasms have a well-known risk to spread to regional lymph nodes. The use of sentinel lymph node biopsy (SLNB could be a promising procedure to assess this risk in clinically N0 patients. Metastatic SNs have been observed in 4.5–28% SCC (according to risk factors, in 9–42% MCC, and in 14–57% PEM. We observed overall 30.8% positive SNs in 13 consecutive patients operated for high-risk nonmelanoma skin cancer between 2002 and 2011 in our institution. These high rates support recommendation to implement SLNB for nonmelanoma skin cancer especially for SCC patients. Completion lymph node dissection following positive SNs is also a matter of discussion especially in PEM. It must be remembered that a definitive survival benefit of SLNB in melanoma patients has not been proven yet. However, because of its low morbidity when compared to empiric elective lymph node dissection or radiation therapy of lymphatic basins, SLNB has allowed sparing a lot of morbidity and could therefore be used in nonmelanoma skin cancer patients, even though a significant impact on survival has not been demonstrated.

  9. Acute painful neuropathy in thallium poisoning. (United States)

    Kuo, H-C; Huang, C-C; Tsai, Y-T; Chu, C-C; Hsieh, S-T; Chu, N-S


    Dysesthesia, allodynia, distal muscle weakness, and sensory impairment were noted in two patients with acute thallium intoxication. Two months later, nerve conduction studies showed an axonal degeneration. Sural nerve biopsy disclosed a decreased fiber density in the large myelinated fibers. Quantitative sensory testing also revealed an impairment of pinprick, temperature, and touch sensations. Cutaneous nerve biopsy confirmed a loss of epidermal nerves indicating an involvement of the small sensory nerves.

  10. Visualizing the Provenance of Personal Data Using Comics

    Directory of Open Access Journals (Sweden)

    Andreas Schreiber


    Full Text Available Personal health data is acquired, processed, stored, and accessed using a variety of different devices, applications, and services. These are often complex and highly connected. Therefore, use or misuse of the data is hard to detect for people, if they are not capable to understand the trace (i.e., the provenance of that data. We present a visualization technique for personal health data provenance using comic strips. Each strip of the comic represents a certain activity, such as entering data using a smartphone application, storing or retrieving data on a cloud service, or generating a diagram from the data. The comic strips are generated automatically using recorded provenance graphs. The easy-to-understand comics enable all people to notice crucial points regarding their data such as, for example, privacy violations.

  11. Protective Capnothorax During Transthoracic Needle Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, John, E-mail:; Siemienowicz, Miranda L.; Lyen, Stephen; Kandel, Sonja; Rogalla, Patrik [University of Toronto, Division of Cardiothoracic Imaging, Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital (Canada)


    PurposeTransthoracic needle biopsy (TTNB) is an established procedure in the management of pulmonary nodules. The most common complications are directly related to crossing the lung or visceral pleura during the biopsy. In this study, we describe the use of carbon dioxide instead of room air to create a protective “capnothorax” during TTNB.Materials and MethodsFive patients underwent creation of a capnothorax during TTNB. Parameters recorded were location and size of target, distance from pleura, length of procedure, volume of carbon dioxide, periprocedural complications and biopsy result.ResultsInduction of capnothorax was successful in all cases. In two patients, a continuous infusion of carbon dioxide was required to maintain an adequate volume of intrapleural gas. In two patients, the carbon dioxide resolved spontaneously and in the remaining patients it was aspirated at the end of the procedure. All biopsies were diagnostic with no periprocedural or postprocedural complications.ConclusionThis study suggests that protective iatrogenic capnothorax is a safe and effective technique during TTNB. The intrinsic properties and availability of carbon dioxide make it an attractive alternative to room air.

  12. Core biopsies of the breast: Diagnostic pitfalls

    Directory of Open Access Journals (Sweden)

    Megha Joshi


    Full Text Available The incidence of breast cancer is increasing worldwide. In this review article, the authors compare and contrast the incidence of breast cancer, and the inherent differences in the United States (US and India in screening techniques used for diagnosing breast cancer. In spite of these differences, core biopsies of the breast are common for diagnosis of breast cancer in both countries. The authors describe "Best Practices" in the reporting and processing of core biopsies and in the analysis of estrogen receptor (ER, progesterone receptor (PR, and human epidermal growth factor Receptor 2 (Her2/neu. The pitfalls in the diagnosis of fibroepithelial lesions of the breast on core biopsy are discussed, as also the significance of pseudoangiomatous stromal hyperplasia of the breast (PASH is discussed in core biopsy. In this review, the management and diagnosis of flat epithelial atypia and radiation atypia are elaborated and the use of immunohistochemistry (IHC in papillary lesions, phyllodes tumor, and complex sclerosing lesions (radial scars is illustrated. Rarer lesions such as mucinous and histiocytoid carcinoma are also discussed.

  13. Liver biopsy — the current view?

    African Journals Online (AJOL)

    1). The term. 'Chiba needle', sometimes used interchangeably with fine-needle, is also confusing, being applied to needles as large as 18 gauge. At the same time improvements in the core biopsy needles and alternatives has added to the options. Stubs needle gauge. X. Fig. 1. Needle gauge versus outer diameter in mm.

  14. Liver biopsy in liver patients with coagulopathy

    DEFF Research Database (Denmark)

    Ott, P.; Gronbaek, H.; Clausen, M.R.


    The risk of severe bleeding after liver biopsy is estimated to be 1:12,000 in patients with near normal coagulation (INR 60 billion /l). Beyond these limits, the risk is higher, but still uncertain. The Danish guidelines require INR > 1.5, platelet count

  15. Ultrasound- and MRI-Guided Prostate Biopsy (United States)

    ... assistance of a nurse and an MR imaging technologist. As with the ultrasound procedure, you may receive antibiotics, sedatives and pain medication before the biopsy. The MRI-guided procedure may use contrast ... A nurse or technologist will insert an intravenous (IV) catheter into a ...

  16. Acute ischemic stroke prognostication, comparison between ...

    African Journals Online (AJOL)

    Ossama Y. Mansour


    Nov 20, 2014 ... or predict all dimensions of recovery and disability after acute stroke. Several scales have proven reliability and validity in stroke trials. Objectives: The aim of the work was to evaluate the FOUR score predictability for outcome of patients with acute ischemic stroke in comparison with the NIHSS and the GCS ...

  17. Positron emission mammography-guided breast biopsy. (United States)

    Raylman, R R; Majewski, S; Weisenberger, A G; Popov, V; Wojcik, R; Kross, B; Schreiman, J S; Bishop, H A


    Positron emission mammography (PEM) is a technique to obtain planar images of the breast for detection of potentially cancerous, radiotracer-avid tumors. To increase the diagnostic accuracy of this method, use of minimally invasive methods (e.g., core biopsy) may be desirable for obtaining tissue samples from lesions detected with PEM. The purpose of this study was to test the capabilities of a novel method for performing PEM-guided stereotactic breast biopsies. The PEM system consisted of 2 square (10 x 10 cm) arrays of discrete scintillator crystals. The detectors were mounted on a stereotactic biopsy table. The stereotactic technique used 2 PEM images acquired at +/-15 degrees and a new trigonometric algorithm. The accuracy and precision of the guidance method was tested by placement of small point sources of (18)F at known locations within the field of view of the imager. The calculated positions of the sources were compared with the known locations. In addition, simulated stereotactic biopsies of a breast phantom consisting of a 10-mm-diameter gelatin sphere containing a concentration of (18)F-FDG consistent with that reported for breast cancer were performed. The simulated lesion was embedded in a 4-cm-thick slab of gelatin containing a commonly reported concentration of FDG, simulating a compressed breast (target-to-background ratio, approximately 8.5:1). An anthropomorphic torso phantom was used to simulate tracer uptake in the organs of a patient 1 h after a 370-MBq injection of FDG. Five trials of the biopsy procedure were performed to assess repeatability. Finally, a method for verifying needle positioning was tested. The positions of the point sources were successfully calculated to within 0.6 mm of their true positions with a mean error of +/-0.4 mm. The biopsy procedures, including the method for verification of needle position, were successful in all 5 trials in acquiring samples from the simulated lesions. The success of this new technique shows its

  18. Automated Generation of Technical Documentation and Provenance for Reproducible Research (United States)

    Jolly, B.; Medyckyj-Scott, D.; Spiekermann, R.; Ausseil, A. G.


    Data provenance and detailed technical documentation are essential components of high-quality reproducible research, however are often only partially addressed during a research project. Recording and maintaining this information during the course of a project can be a difficult task to get right as it is a time consuming and often boring process for the researchers involved. As a result, provenance records and technical documentation provided alongside research results can be incomplete or may not be completely consistent with the actual processes followed. While providing access to the data and code used by the original researchers goes some way toward enabling reproducibility, this does not count as, or replace, data provenance. Additionally, this can be a poor substitute for good technical documentation and is often more difficult for a third-party to understand - particularly if they do not understand the programming language(s) used. We present and discuss a tool built from the ground up for the production of well-documented and reproducible spatial datasets that are created by applying a series of classification rules to a number of input layers. The internal model of the classification rules required by the tool to process the input data is exploited to also produce technical documentation and provenance records with minimal additional user input. Available provenance records that accompany input datasets are incorporated into those that describe the current process. As a result, each time a new iteration of the analysis is performed the documentation and provenance records are re-generated to provide an accurate description of the exact process followed. The generic nature of this tool, and the lessons learned during its creation, have wider application to other fields where the production of derivative datasets must be done in an open, defensible, and reproducible way.


    Directory of Open Access Journals (Sweden)

    Tameem Afroz


    Full Text Available BACKGROUND Prostate needle biopsies can pose a major diagnostic challenge when it comes to differentiating adenocarcinoma and its variants from its benign mimics. In needle biopsies, when the suspicious focus is small, morphological features may not suffice to differentiate it from its morphologic mimics like atrophy, basal cell hyperplasia, reactive inflammatory changes, seminal vesicles and adenosis. Immunohistochemical marker for basal cells, p63 and prostate cancer specific marker, Alpha-Methylacyl-CoA Racemase (AMACR help in overcoming such diagnostic dilemmas. MATERIALS AND METHODS We analysed 157 prostate core needle biopsies over a period of 2 years. Routine Hematoxylin and Eosin (H and E sections and immunohistochemical markers for basal cells (p63 and prostate cancer specific marker (AMACR were used. Prospective study was done on prostate needle core biopsies. Biopsy was done under ultrasound guidance with an 18-gauge needle. Biopsy was done in patients with raised serum PSA levels for exclusion of prostate carcinoma. RESULTS Over a period of two years, 157 prostate core needle biopsies were studied. 83 were benign lesions comprising 69 benign prostatic hyperplasias, five basal cell hyperplasias, four granulomatous lesions and three showed atrophic changes. Two biopsies morphologically resembled seminal vesicles. Prostate cancer specific marker, AMACR was negative in all, but two lesions. In these two lesions, it showed weak nonspecific staining. Basal cell marker p63 showed a continuous staining pattern highlighting the basal cells in all the 69 cases of benign prostatic hyperplasia, 5 cases of basal hyperplasia showed positivity in all the hyperplastic basal cells. In the two cases of seminal vesicles, it showed intense basal cell positivity. It showed a discontinuous pattern in two of the four granulomatous lesions and showed a weak, but a continuous staining pattern in the atrophic lesions. 74 were adenocarcinomas; the predominant

  20. Consistent and reproducible outcomes of blastocyst biopsy and aneuploidy screening across different biopsy practitioners: a multicentre study involving 2586 embryo biopsies. (United States)

    Capalbo, Antonio; Ubaldi, Filippo Maria; Cimadomo, Danilo; Maggiulli, Roberta; Patassini, Cristina; Dusi, Ludovica; Sanges, Federica; Buffo, Laura; Venturella, Roberta; Rienzi, Laura


    Is blastocyst biopsy and quantitative real-time PCR based comprehensive chromosome screening a consistent and reproducible approach across different biopsy practitioners? The blastocyst biopsy approach provides highly consistent and reproducible laboratory and clinical outcomes across multiple practitioners from different IVF centres when all of the embryologists received identical training and use similar equipment. Recently there has been a trend towards trophectoderm (TE) biopsy in preimplantation genetic screening (PGS)/preimplantation genetic diagnosis (PGD) programmes. However, there is still a lack of knowledge about the reproducibility that can be obtained from multiple biopsy practitioners in different IVF centres in relation also to blastocysts of different morphology. Although it has been demonstrated that biopsy at the blastocyst stage has no impact on embryo viability, it remains a possibility that less experienced individual biopsy practitioners or laboratories performing TE biopsy may affect certain outcomes. We investigated whether TE biopsy practitioners can have an impact on the quality of the genetic test and the subsequent clinical outcomes. This longitudinal cohort study, between April 2013 and December 2014, involved 2586 consecutive blastocyst biopsies performed at three different IVF centres and the analysis of 494 single frozen euploid embryo transfer cycles (FEET). Seven biopsy practitioners performed the blastocyst biopsies in the study period and quantitative PCR was used for comprehensive chromosome screening (CCS). The same practitioner performed both the biopsy and tubing procedures for each blastocyst they biopsied. To investigate the quality of the biopsied samples, the diagnostic rate, sample-specific concurrence and the cell number retrieved in the biopsy were evaluated for each biopsy operator. Clinical outcomes following FEET cycles were stratified by biopsy operator and compared. Cellularity of the biopsy sample was also

  1. Evaluation of polymerase chain reaction in nerve biopsy specimens of patients with Hansen's disease. (United States)

    Tiwari, Vandana; Malhotra, Kiranpreet; Khan, Kainat; Maurya, Pradeep K; Singh, Ajai Kumar; Thacker, Anup Kumar; Husain, Nuzhat; Kulshreshtha, Dinkar


    Pure neuritic variety of leprosy (PNL) presents as peripheral neuropathy with absent skin lesions and negative skin smears. Diagnosing PNL is an uphill task as most of these patients have nonspecific changes on nerve biopsy. In such circumstances, additional molecular diagnostic tools like polymerase chain reaction (PCR) has proven to be useful in diagnosing leprosy. The present study was planned to evaluate the role of PCR in nerve biopsy specimens of patients with PNL. Patients attending the neuromuscular clinic from January 2013 to June 2014 with mononeuropathy multiplex underwent detailed diagnostic evaluation to ascertain the cause of neuropathy. Patients where this evaluation failed to establish an etiology underwent a nerve biopsy. Nerve biopsy was done in 52 patients, of which 35 were diagnosed as pure neuritic leprosy. Definite leprosy with positive wade fite staining for lepra bacilli was seen in 13 patients and 22 biopsies revealed a probable leprosy without lepra bacilli being identified. PCR for M. leprae was positive in 22 patients (62%). 12 of the 13 cases with definite leprosy on histopathology were PCR positive while in the AFB negative group, PCR was positive in 10 cases. PCR had a sensitivity of 92.3%, specificity of 54.5%. The positive and negative predictive value of PCR was 54.5% and 92.3% respectively. PCR helps in diagnosing PNL in doubtful cases. A positive PCR increases the sensitivity of detection of M. leprae especially in cases of probable PNL group where AFB cannot be demonstrated on histopathology. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Safety and effectiveness of percutaneous biopsy of focal splenic lesions under ultrasonographic guidance

    Energy Technology Data Exchange (ETDEWEB)

    Han, Hyun Young; Kim, Joo Heon [Eulji University College of Medicine, Taejeon (Korea, Republic of); Shin, Kyung Sook [Chungnam National University College of Medicine, Taejeon (Korea, Republic of)


    To evaluate the diagnostic yield and safety of ultrasound (US)-guided percutaneous needle biopsy for the diagnosis of focal splenic lesions. US guided, automated needle biopsy using an 18-gauge cutting needle was performed in 11 patients, consisted of nine men and two women (mean age=49 years), with focal splenic lesions detected on the CT or US. Six patients (55%) had multiple lesions while five (45%) had a single lesion. Two of eleven patients had splenomegaly. None of 11 patients had the prior diagnosis of extrasplenic or hematopoietic malignancies. The biopsy was considered successful if a specific pathological diagnosis was possible. The diagnostic yield and frequency of complication were retrospectively analyzed. Tissue adequate for histological diagnosis was obtained in nine (82%) of 11 patients, and no complications other than mild, localized discomfort occurred. Multifocal splenic lesions without splenomegaly in five patients were confirmed as Hodgkin's disease (n=2), tuberculosis (n=1), infarction (n=1), and hemangioma (n=1). All single lesion in four patients were proven as benign conditions including hamartoma (n=2), lymphangioma (n=1) and chronic organizing abscess (n=1), and only of them with a large hamartoma received splenectomy while others did not receive further treatment. Although in two (18%) patients with multiple lesions and splenomegaly, no specific diagnosis was established by US-guided biopsy, malignant lymphoma and Hodgkin's disease were confirmed by surgery. US-guided automated needle biopsy is a safe and valuable procedure that can provides a specific diagnosis in patients with splenic lesions.

  3. Baseline Prostate Atrophy is Associated with Reduced Risk of Prostate Cancer in Men Undergoing Repeat Prostate Biopsy. (United States)

    Moreira, Daniel M; Bostwick, David G; Andriole, Gerald L; Peterson, Bercedis L; Cohen, Harvey J; Castro-Santamaria, Ramiro; Freedland, Stephen J


    We evaluated whether the presence and severity of baseline prostate atrophy in men with initial biopsy negative for prostate cancer was associated the risk of subsequent prostate cancer detection in a clinical trial with scheduled study mandated biopsies. We retrospectively analyzed the records of 3,084 men 50 to 75 years old with prostate specific antigen between 2.5 and 10 ng/ml, and a prior negative biopsy in the placebo arm of the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study who completed at least 1 per-protocol biopsy. Prostate cancer (defined as present or absent) and prostate atrophy (graded as absent, mild or moderate/marked) was assessed by central pathology review. The association of baseline atrophy with positive 2 and 4-year repeat biopsies was evaluated with logistic regression, controlling for baseline covariates. Baseline prostate atrophy was detected in 2,143 men (70%) and graded as mild and moderate/marked in 1,843 (60%) and 300 (10%) baseline biopsies, respectively. Patients with atrophy were older and had a larger prostate, and more acute and chronic prostate inflammation. At 2-year biopsy the prostate cancer incidence was 17% (508 cases). Baseline atrophy was significantly associated with lower prostate cancer risk (univariable and multivariable OR 0.60, 95% CI 0.50-0.74 and OR 0.67, 95% CI 0.54-0.83, p atrophy the prostate cancer risk at the 2-year repeat biopsy was lower for mild atrophy (OR 0.69, 95% CI 0.55-0.86) and moderate/marked atrophy (OR 0.51, 95% CI 0.34-0.76, each p atrophy in men with a prostate biopsy negative for prostate cancer was independently associated with subsequent lower prostate cancer detection. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Somatostatin receptor scintigraphy predicts impending cardiac allograft rejection before endomyocardial biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Aparici, C.M.; Martin, J.C.; Tembl, A.; Flotats, A.; Estorch, M.; Catafau, A.M.; Berna, L.; Carrio, I. [Nuclear Medicine Department, Hospital Sant Pau, Barcelona (Spain); Narula, J.; Puig, M.; Camprecios, M.; Ballester, M. [Cardiology Department, Sant Pau Hospital, Barcelona (Spain)


    The invasive nature of endomyocardial biopsy has led to a search for alternative diagnostic modalities for the detection of cardiac allograft rejection. To date, no non-invasive test meets all the requirements for the detection of acute and chronic rejection. The rejection process usually presents with lymphocyte infiltration with or without myocyte necrosis, which indicates the severity of cardiac allograft rejection and the necessity of treatment. Activated lymphocytes express somatostatin receptors; thus somatostatin receptor imaging could be used to target them. The aim of this study was to assess the feasibility of using somatostatin receptor imaging to target activated lymphocytes in the process of cardiac allograft rejection. Thirteen somatostatin receptor imaging studies were performed on ten cardiac allograft recipients 12-4745 days after transplantation, simultaneously with endomyocardial biopsy, to assess the imaging of activated lymphocytes in comparison with histological findings. Somatostatin receptor imaging was performed 4 h after the injection of 110 MBq of the somatostatin analogue indium-111 pentetreotide. {sup 111}In-pentetreotide uptake was visually scored and semi-quantitatively estimated by the calculation of a heart-to-lung ratio (HLR). The visual score correlated with the HLR. Intense/moderate uptake on visual assessment and an HLR >1.6 was observed in eight studies. In three of these studies there was significant rejection in the simultaneous endomyocardial biopsy [International Society of Heart and Lung Transplantation (ISHLT) rejection grade 3A/4]. Intense/moderate uptake was associated with mild or no rejection in the remaining five patients, and in four of them the next endomyocardial biopsy performed 1 week later demonstrated significant rejection requiring treatment. Two patients with low uptake and an HLR <1.6 had no evidence of rejection either in the simultaneous endomyocardial biopsy or in the endomyocardial biopsy performed the

  5. Outcomes of transperineal template-guided prostate biopsy in 409 patients. (United States)

    Symons, James L; Huo, Andrew; Yuen, Carlo L; Haynes, Anne-Maree; Matthews, Jayne; Sutherland, Robert L; Brenner, Phillip; Stricker, Phillip D


    To present the template-guided transperineal prostate biopsy (TPB) outcomes for patients of two urologists from a single institution. We conducted a prospective study of 409 consecutive men who underwent TPB between December 2006 and June 2008 in a tertiary referral centre using a standardized 14-region technique. The procedure was performed as day surgery under general anaesthesia with fluoroquinolone antibiotic cover. Follow-up took place within 2 weeks, during which time men were interviewed using a standardized template. Results were compared with those of the Australian national prostate biopsy audits performed by the Urological Society of Australia and New Zealand (USANZ). Indications for biopsy included elevated prostate-specific antigen (PSA) level (75%), with a median PSA level of 6.5 ng/mL, abnormal digital rectal examination (8%) and active surveillance (AS) re-staging (18%). The mean patient age was 63 years and two-thirds of patients were undergoing their first biopsy. A positive biopsy was found in 232 men, 74% of whom had a Gleason score of ≥7. The overall cancer detection rate was 56.7% (USANZ 2005 national audit = 56.5%). Stratified between those having their first TPB or a repeat procedure (after a previous negative biopsy), the detection rates were 64.4 and 35.6%, respectively. Significantly higher detection rates were found in prostates <50 mL in volume than in larger prostates (65.2 vs 38.3%, respectively, P < 0.001). Haematuria was the most common side effect (51.7%). Others included dysuria (16.4%), acute urinary retention (4.2%) and fever (3.2%). One patient (0.2%) had septicaemia requiring i.v. antibiotics. Repeat biopsy was not associated with increased complication rates. TPB is a safe and efficacious technique, with a cancer detection rate of 56.7% in the present series, and a low incidence of major side effects. Stratified by prostate volume, the detection rate of TPB was higher in smaller glands. Given the relatively low rate of

  6. Ultrasound guided closed pleural biopsy versus medical thoracoscopic pleural biopsy in diagnosis of pleural diseases

    Directory of Open Access Journals (Sweden)

    K. Sobhy


    Conclusion: Both TUS guided pleural biopsy and medical thoracoscopic pleural biopsy are available to diagnose different pleural lesions each of which has its advantages and disadvantages. The proper selection of the patients for each modality will result in raising the diagnostic yield of both modalities. TUS examination before medical thoracoscopy will allow proper selection of patients, reduce incidence of complications, guide for the best site of entry and raisethe diagnostic yield of medical thoracoscopy.

  7. Facilitating Fine Grained Data Provenance using Temporal Data Model

    NARCIS (Netherlands)

    Huq, M.R.; Wombacher, Andreas; Apers, Peter M.G.


    E-science applications use fine grained data provenance to maintain the reproducibility of scientific results, i.e., for each processed data tuple, the source data used to process the tuple as well as the used approach is documented. Since most of the e-science applications perform on-line

  8. Provenance of sandstone on the western flank of Anambra Basin ...

    African Journals Online (AJOL)

    Petrographic and heavy mineral studies were carried out on clastic deposits that crop out in Ikpeshi, Auchi and Fugar localities in order to determine the provenance of the ... The heavy mineral suites and the petrographic signatures of the sandstones suggest derivation mainly from acid igneous rocks, gneisses and older ...

  9. Growth and quality of Grevillea robusta provenances in Ruhande ...

    African Journals Online (AJOL)

    They are used as sawn timber for furniture industry, for construction and packaging. They are essential ... Although the outstanding provenances reported elsewhere are not represented in the Rwandan trial which is very small and with a design that is not very well designed, useful results were obtained. Significant ...

  10. Climate Data Provenance Tracking for Just-In-Time Computation (United States)

    Fries, S.; Nadeau, D.; Doutriaux, C.; Williams, D. N.


    The "Climate Data Management System" (CDMS) was created in 1996 as part of the Climate Data Analysis Tools suite of software. It provides a simple interface into a wide variety of climate data formats, and creates NetCDF CF-Compliant files. It leverages the NumPy framework for high performance computation, and is an all-in-one IO and computation package. CDMS has been extended to track manipulations of data, and trace that data all the way to the original raw data. This extension tracks provenance about data, and enables just-in-time (JIT) computation. The provenance for each variable is packaged as part of the variable's metadata, and can be used to validate data processing and computations (by repeating the analysis on the original data). It also allows for an alternate solution for sharing analyzed data; if the bandwidth for a transfer is prohibitively expensive, the provenance serialization can be passed in a much more compact format and the analysis rerun on the input data. Data provenance tracking in CDMS enables far-reaching and impactful functionalities, permitting implementation of many analytical paradigms.

  11. Performance of Provenances of Sesbania macrantha at Gairo ...

    African Journals Online (AJOL)

    Performance evaluation was conducted among 21 provenances of Sesbania macrantha from 9 regions of Tanzania and one region of Rwanda. The trial was established in February, 1996 at Gairo, Morogoro, Tanzania. Assessments were carried out at 6, 12 and 15 months for survival, root-collar diameter and height.

  12. Adoption of proven soil management practices by rural women in ...

    African Journals Online (AJOL)

    The adoption of proven soil management practices by rural women in Imo State was assessed. The objectives of the study included to determine the soil management practices adopted by the women and to analyse the relationship between the adoption and the rural women's socio-economic characteristics.

  13. Changing provenance of late Cenozoic sediments in the Jianghan Basin

    Directory of Open Access Journals (Sweden)

    Lei Shao


    Full Text Available The Yangtze River is one of the most important components of the East Asia river system. In this study, sediments in the Jianghan Basin, middle Yangtze River, were selected for trace element and rare earth element (REE measurements, in order to decipher information on the change of sediment provenance and evolution of the Yangtze River. According to the elemental variations, the late Cenozoic sediments of the Jianghan Basin could be divided into four parts. During 2.68–2.28 Ma and 1.25–0 Ma, provenance of the sediments was consistent, whereas sediments were derived from variable sources during 2.28–1.25 Ma. Comparison of the elemental compositions between the Pliocene and Quaternary sediments revealed a change in sediment source from a more felsic source area to a more basic source area around the Pliocene–Quaternary boundary. Input from the Emeishan LIP should account for this provenance change. Based on the provenance analysis of sediments in the Jianghan Basin, we infer that the Yangtze River developed into a large river with its drainage basin extended to the Emeishan LIP no later than the Pliocene–Quaternary boundary.

  14. From Observation to Impacts: Provenance for Earth Science Resources (United States)

    Hua, H.; Tilmes, C.; Fox, P. A.; Zednik, S.; Duggan, B.; Aulenbach, S.; Wilson, B. D.; Manipon, G. J. M.; Privette, A. P.


    NASA's Earth Science Data Systems Working Group (ESDSWG) on Provenance is working on a provenance specification for use in Earth science data systems to capture, consume, and interpret the end-to-end data life cycle information. Based on W3C PROV, this Earth Science extension can be used as an interoperable specification for representing Earth science resources that includes observations by instruments, data producers, data processing systems, data archive centers, data users, analysis findings, and societal impacts. NASA is participating in the Big Earth Data Initiative (BEDI) and also leading a related Climate Data Initiative (CDI) effort. Under CDI, NASA is also working with the U.S. Global Change Research Program (USGCRP) and the U.S. Group on Earth Observations (USGEO) to identify and make interoperable relevant data from multiple interagency sources. These interagency efforts will improve the discoverability, accessibility, and usability of Federal data and information products derived from civil Earth observations. We will present our progress to develop a provenance specification for representing Earth science resources from observation to impacts and how it can be used to support these initiatives. We will show how it can be used in earth science data systems to automatically capture, consume, and interpret provenance information using semantic technologies.

  15. Provenance, tectonic setting and source-area weathering of the ...

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Earth System Science; Volume 126; Issue 2. Provenance, tectonic setting and ... The chondrite normalized REE pattern of the samples is equivalent to uppercontinental crust, which reflects enriched LREE and flat HREE with negative Eu anomaly. The tectonic setting discriminant diagram log[K ...

  16. Combining User Reputation and Provenance Analysis for Trust Assessment

    NARCIS (Netherlands)

    Ceolin, D.; Groth, P.T.; Maccatrozzo, V.; Fokkink, W.J.; van Hage, W.R.; Nottamkandath, A.


    Trust is a broad concept that in many systems is often reduced to user reputation alone. However, user reputation is just one way to determine trust. The estimation of trust can be tackled from other perspectives as well, including by looking at provenance. Here, we present a complete pipeline for

  17. Provenance of the Late Neogene Siwalik sandstone, Kumaun ...

    Indian Academy of Sciences (India)

    Provenance of the Late Neogene Siwalik sandstone,. Kumaun Himalayan Foreland Basin: Constraints from the metamorphic rank and index of detrital rock fragments. Poonam Jalal1,∗ and Sumit K Ghosh2. 1Department of Geology, H.N.B. Garhwal University, Srinagar 246 174, India. 2Wadia Institute of Himalayan Geology ...

  18. Provenance analysis of the Oligocene turbidites (Andaman Flysch ...

    Indian Academy of Sciences (India)

    The Oligocene-aged sandstone-shale turbidites of the Andaman Flysch are best exposed along the east coast of the South Andaman Island. Previously undocumented sandstone-shale geochemistry, investigated here, provides important geochemical constraints on turbidite provenance. The average 70.75 wt% SiO2, ...

  19. Geochemistry evidence for depositional settings and provenance of ...

    Indian Academy of Sciences (India)

    This paper aims to discuss the depositional settings and provenances for the Jurassic in Jiyuan basin, North China, based on the rare earth element (REE) and trace element features of 16 Jurassic argillaceous rock samples from the Anyao, Yangshuzhuang and Ma'ao Formations, respectively. Generally, geochemical ...

  20. CT-guided adrenal biopsy: comparison of ipsilateral decubitus versus prone patient positioning for biopsy approach

    International Nuclear Information System (INIS)

    Odisio, Bruno C.; Tam, Alda L.; Avritscher, Rony; Gupta, Sanjay; Wallace, Michael J.


    To compare ipsilateral decubitus and prone patient positioning for performing computed tomography guided adrenal biopsy using the requirements for out-of-plane approach (OOP) and the needle insertion time (NIT) as a surrogate for procedure complexity. The study included 106 adrenal biopsies performed in 104 patients with lesions measuring ≤4 cm that were divided into two groups: Ipsilateral decubitus (Group I) and prone (Group II) positions. The frequency of use of an OOP biopsy path and the NIT were recorded as well as diagnostic yield, adverse events and transgression of organs to approach the target lesion. Groups I and II comprised 54 and 50 patients, respectively. The use of the OOP approach was significantly less frequent (P < 0.01) in Group I (n = 4) compared to Group II (n = 38). NIT was statistically shorter (P < 0.01) in Group I (9 min and 43 s) compared to Group II (19 min and 7 s). There were fewer organs traversed in Group I versus Group II. Diagnostic yield and post-biopsy complications were equal in both groups. Ipsilateral adrenal biopsy approach is a less complex, equally reliable and safe compared to the prone approach based on the less frequent use of the OOP approach and the shorter NIT. circle Ipsilateral adrenal biopsy decubitus positioning provides a direct, non-transpulmonary path for sampling circle Ipsilateral decubitus positioning reduces the need for potentially dangerous out-of-plane approaches (OOP) circle Ipsilateral decubitus and prone positioning are equally reliable and safe techniques. (orig.)

  1. Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy.

    Directory of Open Access Journals (Sweden)

    Suzanne C E Diepstraten

    Full Text Available BACKGROUND: We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. METHODS: From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic large core needle biopsy, drawn from the prospective COBRA (Core Biopsy after RAdiological localization and COBRA2000 cohort studies, were used to fit the multivariable model and assess its overall performance, discrimination, and calibration. RESULTS: 348 women with large core needle biopsy-proven ductal carcinoma in situ were available for analysis. In 100 (28.7% patients invasive carcinoma was found at subsequent surgery. Nine predictors were included in the model. In the multivariable analysis, the predictors with the strongest association were lesion size (OR 1.12 per cm, 95% CI 0.98-1.28, number of cores retrieved at biopsy (OR per core 0.87, 95% CI 0.75-1.01, presence of lobular cancerization (OR 5.29, 95% CI 1.25-26.77, and microinvasion (OR 3.75, 95% CI 1.42-9.87. The overall performance of the multivariable model was poor with an explained variation of 9% (Nagelkerke's R(2, mediocre discrimination with area under the receiver operating characteristic curve of 0.66 (95% confidence interval 0.58-0.73, and fairly good calibration. CONCLUSION: The evaluation of our multivariable prediction model in a large, clinically representative study population proves that routine clinical and pathological variables are not suitable to select patients with large core needle biopsy-proven ductal carcinoma in situ for sentinel node biopsy during primary surgery.


    Directory of Open Access Journals (Sweden)

    M. L. Arefjev


    Full Text Available There is well known fact that kidney transplants from Extended Criteria Donors may increase risk of De- layed Graft Function and Primary Non-Function of transplants. We have collected and tested 65 «zero» kidney biopsies from cadaver donors aged from 19 to 71 years old. In the pool of elderly donors who died from cerebrovascular accident the frequency of nephrosclerosis presentation was higher than in donors of yonger age who died from craniocephalic trauma. Nevertheless in the general donor pool the number of sclerosed glomeruli was no more than 12%. We did not meet at all in the whole volume of material any bi- opsy with the severe degree of arteriosclerosis. The «zero» biopsies of cadaver kidneys is quite usable and unexpensive tool to measure the degree of nephrosclerosis in order to exclude kidneys which are not fitable for transplantation. 

  3. Liver CT-guided aspirative biopsies

    International Nuclear Information System (INIS)

    Santos, Gilda da Cunha; Carvalho, Leda Viegas de; Chojniak, Rubens; Morini, Sandra Regina


    Sixty-eight CT-guided aspirative biopsies of hepatic nodules were performed at A.C. Camargo Hospital, Sao Paulo, Brazil, from 1992 to 1995. The cases were distributed as follow: 44(64.7%) with a positive diagnosis for neoplastic cells, 6(8.8%) with a negative diagnosis, and 14 (20.5%) with insufficient material. Of the positive cases (primary neoplasias and metastases), the cytological diagnosis was achieved in 39 cases. There were 36 cases of carcinoma (7 hepato carcinomas, 18 adenocarcinomas, 1 small cell carcinoma and 10 cases of unspecified differentiation), 2 cases of melanoma and 1 case of melanoma and 1 case of sarcoma. The correlation with histopathological exams showed no false positive cases and concordance between cytological and histopathological diagnosis. The results demonstrate that CT-guided aspirative biopsy of hepatic nodules permits a rapid diagnosis of neoplastic lesions, especially for the evaluation of metastases. (author)

  4. Acute arterial hemorrhage following radiotherapy of oropharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Greve, Jens; Schuler, Patrick; Hoffmann, Thomas K. [Dept. of Otorhinolaryngology, Univ. of Duisburg-Essen, Essen (Germany); Dept. of Otorhinolaryngology, Univ. of Duesseldorf (Germany); Bas, Murat; Bier, Henning [Dept. of Otorhinolaryngology, Technical Univ. of Munich (Germany); Turowski, Bernd [Dept. of Radiology, Univ. of Duesseldorf (Germany); Scheckenbach, Kathrin [Dept. of Otorhinolaryngology, Univ. of Duesseldorf (Germany); Budach, Wilfried; Boelke, Edwin [Dept. of Radiooncology, Univ. of Duesseldorf (Germany); Bergmann, Christoph; Lang, Stephan; Arweiler-Harbeck, Diana; Lehnerdt, Goetz; Mattheis, Stefan [Dept. of Otorhinolaryngology, Univ. of Duisburg-Essen, Essen (Germany)


    Background and purpose: vascular erosion is a rare but life-threatening complication after radiotherapy. The authors report on acute arterial bleeding and its therapy following radiotherapy of oropharyngeal tumors. Patients and methods: ten patients with oropharyngeal squamous cell carcinoma of any stage developed foudroyant acute arterial hemorrhage 3-46 months (14.4 {+-} 5.1 months) after primary (5/10) or adjuvant radio(chemo)therapy (R[C]T). Results: all patients had a history of recurrent minor bleeding episodes and showed deep mucosal ulcerations also outside the primary tumor region. A life-threatening arterial hemorrhage appeared in the area of these mucosal defects in the pharyngeal region. Affected vessels were the common carotid artery as well as the internal and the external portion with branches like the ascending pharyngeal and superior thyroid arteries. Treatment consisted of emergency intubation or tracheotomy followed by exposure and package of the pharynx and surgical ligature and/or embolization. 6/10 patients (all hospitalized) survived the episode, however, lethal outcome in 4/10 patients (outpatients) was related to asphyxia as a result of blood aspiration or exsanguination. None of the patients revealed evidence of persistent or recurrent tumor disease as proven by biopsy/autopsy and imaging technique. Conclusion: vascular erosion following primary or adjuvant R(C)T represents a rare and potentially life-threatening complication requiring immediate emergency treatment involving head and neck surgeons, anesthesiologists and neuroradiologists. For patients with oropharyngeal neoplasms treated by R(C)T and showing recurrent bleeding episodes and mucosal ulceration particularly after the acute treatment phase, hospitalization with prophylactic surgical ligature or embolization of affected arteries is recommended. (orig.)

  5. Correlation of Cervical Pap Smear with Biopsy in the Lesion of Cervix. (United States)

    Dhakal, R; Makaju, R; Sharma, S; Bhandari, S; Shrestha, S; Bastakoti, R

    Background Cervical cancer can be controlled to a greater extent by screening to improve morbidity and mortality. Pap smear is important screening method, which has proven to be highly effective in reducing the number of cases and the mortality from cervical carcinoma. Any abnormality detected in pap smear has to be confirmed with cervical biopsy, which remains the reference investigation. Objective To find the changes of cervical cytology by pap smear, to classify cervical lesions into malignant and benign groups on cytological and histopathological basis and to correlate the changes observed in cervical cytology with cervical biopsy. Method This is a prospective cross sectional study done in between July 2014 and July 2015 in Dhulikhel Hospital, Kathmandu University Hospital. During the period, all the samples requested for pap smear were studied. The cases who had undergone both pap smear and cervical biopsy were compared. Clinical data were obtained from requisition submitted along with the cytology and tissue specimens received in the department. Result During the study period, total 1922 pap smears were performed and out of them 75 patients were advised to do cervical biopsy. On cytology, out of total 1922 number of cases, 67.90% were normal, 27.90% were inflammatory smears, 3.80% were unsatisfactory (inadequate) and 0.40% were high grade intraepithelial lesions. Highest numbers of patients screened for pap smear ranged from 31 to 40 years. On histopathology, 78.70% had chronic cervicitis, 8% had normal findings, 1.30% had moderate and 6.70% had severe squamous intraepithelial lesions. The frank malignancy was found in 5.30%. The mean age ± SD for carcinoma was 52.75±6.29. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value of pap smear were 77.80%, 100%, 100% and 97% respectively considering cervical biopsy as the gold standard Conclusion This study revealed a good correlation of cervical cytology with cervical biopsy

  6. A position paper on standardizing the nonneoplastic kidney biopsy report

    NARCIS (Netherlands)

    A. Chang (Anthony); I.W. Gibson (Ian); A.H. Cohen (Arthur); J.J. Weening (Jan); J.C. Jennette (Charles); A.B. Fogo (Agnes)


    textabstractThe biopsy report for nonneoplastic kidney diseases represents a complex integration of clinical data with light, immunofluorescence, and electron microscopic findings. Practice guidelines for the handling and processing of the renal biopsy have previously been created. However, specific

  7. Timing embryo biopsy for PGD - before or after cryopreservation? (United States)

    Shinar, S; Kornecki, N; Schwartz, T; Mey-Raz, N; Amir, H; Almog, B; Shavit, T; Hasson, J


    Pre-implantation genetic diagnosis (PGD) is required in order to screen and diagnose embryos of patients at risk of having a genetically affected offspring. A biopsy to diagnose the genetic profile of the embryo may be performed either before or after cryopreservation. The aim of this study was to determine which biopsy timing yields higher embryo survival rates. Retrospective cohort study of all PGD patients in a public IVF unit between 2010 and 2013. Inclusion criteria were patients with good-quality embryos available for cryopreservation by the slow freezing method. Embryos were divided into two groups: biopsy before and biopsy after cryopreservation. The primary outcome was embryo survival rates post thawing. Sixty-five patients met inclusion criteria. 145 embryos were biopsied before cryopreservation and 228 embryos were cryopreserved and biopsied after thawing. Embryo survival was significantly greater in the latter group (77% vs. 68%, p Cryopreservation preceding biopsy results in better embryo survival compared to biopsy before cryopreservation.

  8. Systemic Air Embolism After CT-guided Lung Biopsy (United States)


    Patients Who Underwent Percutaneous Lung Biopsy Under CT Guidance; Patients Who Presented Systemic Air Embolism After Percutaneous Lung Biopsy Under CT Guidance Depicted at the Time of the Procedure on a Whole Thoracic CT

  9. Magnetic resonance imaging of breast cancer: does the time interval between biopsy and MRI influence MRI-pathology discordance in lesion sizing? (United States)

    Mennella, Simone; Paparo, Francesco; Revelli, Matteo; Baccini, Paola; Secondini, Lucia; Barbagallo, Stella; Friedman, Daniele; Garlaschi, Alessandro


    Background Breast magnetic resonance imaging (MRI) is more accurate than ultrasound and mammography in estimating local extension of both invasive breast cancer and ductal carcinoma in situ (DCIS) and it is part of a breast cancer patient's preoperative management. Purpose To verify if time interval between breast biopsy and preoperative MRI, lesion margins, and biopsy technique can influence tumor sizing on MRI. Material and Methods By a database search, we retrospectively identified all women with a newly diagnosed, biopsy-proven, primary breast cancer who underwent MRI before surgery. The time interval between biopsy and MRI, the type of biopsy procedure, and various pathological features of tumors were collected. We defined the concordance between MRI and pathology measurements as a difference of 30 days ( P < 0.05). By means of multivariate analysis, we found that DCIS subtype and the presence of poorly defined margins on MRI are the only two factors independently and strongly associated with MRI-pathology discordance in lesion sizing. Conclusion Size, histology, and margins of tumors may affect the accuracy of MRI measurements. The type of biopsy procedure and the time interval between biopsy and preoperative MRI are not independently associated to MRI-pathology discordance.

  10. Clinical heart transplantation without routine endomyocardial biopsy. (United States)

    Warnecke, H; Müller, J; Cohnert, T; Hummel, M; Spiegelsberger, S; Siniawski, H K; Lieback, E; Hetzer, R


    In a prospective clinical study, routine endomyocardial biopsy (EMB) for early detection of cardiac allograft rejection was replaced by two noninvasive diagnostic techniques. In 32 patients who underwent transplantation during a 6-month period, intramyocardial electrogram (IMEG) amplitude was recorded with the telemetry function of a dual-chamber pacemaker system. An amplitude decrease of more than 8% below the individual range of variability in overnight long-term recordings served as an indicator of rejection. A prolongation of the time interval Te--the time span between maximal posterior wall contraction and peak retraction velocity--of more than 20 msec was used as an additional indicator of rejection-related left ventricular dysfunction. For patient safety, routine EMBs were still performed but remained undisclosed to the transplantation team. The pathologist was asked to intervene in cases of discrepancies between biopsy results and medical decisions, but no such intervention was necessary. Twenty-seven rejection episodes were treated medically, of which 22 were diagnosed noninvasively. In four patients, EMB, ordered because noninvasive parameters remained inconclusive, led to medical treatment. No false negative IMEG results were observed. Retrospective correlation with rejection gave a 100% negative predictive value for IMEG and a 96.9% negative predictive value for echocardiographic diagnosis. We conclude that omission of a schedule of routine biopsies is justified, if the described techniques of IMEG and echocardiography are meticulously applied and indicate normal cardiac function. EMB remains indicated if noninvasive parameters are not conclusive or if false-positive IMEG results, which were observed in the presence of infection or arrhythmias, are suspected. The frequency of EMB can be reduced by 90%, compared to conventional routine biopsy schedules. Diagnostic safety is increased because the additional information gained from IMEG and

  11. Bridging the provenance gap: opportunities and challenges tracking in and ex silico provenance in sUAS workflows (United States)

    Thomer, A.


    Data provenance - the record of the varied processes that went into the creation of a dataset, as well as the relationships between resulting data objects - is necessary to support the reusability, reproducibility and reliability of earth science data. In sUAS-based research, capturing provenance can be particularly challenging because of the breadth and distributed nature of the many platforms used to collect, process and analyze data. In any given project, multiple drones, controllers, computers, software systems, sensors, cameras, imaging processing algorithms and data processing workflows are used over sometimes long periods of time. These platforms and processing result in dozens - if not hundreds - of data products in varying stages of readiness-for-analysis and sharing. Provenance tracking mechanisms are needed to make the relationships between these many data products explicit, and therefore more reusable and shareable. In this talk, I discuss opportunities and challenges in tracking provenance in sUAS-based research, and identify gaps in current workflow-capture technologies. I draw on prior work conducted as part of the IMLS-funded Site-Based Data Curation project in which we developed methods of documenting in and ex silico (that is, computational and non-computation) workflows, and demonstrate this approaches applicability to research with sUASes. I conclude with a discussion of ontologies and other semantic technologies that have potential application in sUAS research.

  12. Breast MR biopsy: Pathological and radiological correlation

    International Nuclear Information System (INIS)

    Dratwa, Chloe; Chopier, Jocelyne; Jalaguier-Coudray, Aurelie; Thomassin-Piana, Jeanne; Gonin, Julie; Antoine, Martine; Trop, Isabelle; Darai, Emile; Thomassin-Naggara, Isabelle


    To identify pathological features for sample analysis of magnetic resonance imaging-guided vaccum-assisted breast biopsy (MRIgVaBB) to optimize radio pathological correlation and identify discordant benign result. Databases of two centres were queried to identify MRIgVaBB performed between January 2009 and February 2013. A cohort of 197 women (mean age: 54.5 years (24-77)) with 208 lesions was identified. We retrospectively analyzed all prebiopsy MRI examinations according to the new BI-RADS lexicon, and all biopsy samples to describe the lesion of interest, its interface with the surrounding breast tissue and other associated features. The malignancy rate was 26.0 % (54/208) with an underestimation rate of 15.67 % (5/32). A visible interface at pathology between a biopsied lesion and the surrounding breast tissue was more frequently identified in mass enhancement compared to NME or focus (p = 0.0003). Regional NME was correlated with a high degree of fibrosis (p = 0.001) and the presence of PASH (p = 0.0007). Linear or segmental NME was correlated with the presence of periductal mastitis (p = 0.0003). The description of a visible interface between the target lesion and the surrounding tissue is crucial to confirm the correct targeting of an MR mass or a NME. (orig.)

  13. Analysis of bronchial biopsies in chronic cough. (United States)

    Macedo, Patricia; Zhang, Qingling; Saito, Junpei; Liang, Zhike; Ffolkes, Lorrette; Nicholson, Andrew G; Chung, Kian Fan


    Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated with chronic cough. 100 consecutive patients referred to a specialist cough clinic underwent a systematic assessment including a fiberoptic bronchoscopy for bronchial biopsies. In 38 patients, treatment of associated causes led to amelioration of cough ('explained') and in 62, there was no association or improvement ('idiopathic'). The latter group had a longer duration of cough, a lower FeNO levels and a more sensitive capsaicin cough response, with an increase in basement membrane thickness with no differences in goblet cell hyperplasia and seromucinous hyperplasia, and in lymphocyte, neutrophil and eosinophil counts. The duration of cough was inversely correlated with the degree of neutrophil infiltration. We conclude that pathological examination of bronchial biopsies is unlikely to be useful in the diagnosis of chronic cough in non-smokers. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. The diagnostic value of contrast-enhanced CT in Acute bilateral renal cortical necrosis: a case report

    International Nuclear Information System (INIS)

    Choi, Pil Youb; Lee, Su Han; Lee, Woo Dong


    Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renal medulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal cortical necrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is a useful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following an operation for abdominal trauma

  15. Provenance for Runtime Workflow Steering and Validation in Computational Seismology (United States)

    Spinuso, A.; Krischer, L.; Krause, A.; Filgueira, R.; Magnoni, F.; Muraleedharan, V.; David, M.


    Provenance systems may be offered by modern workflow engines to collect metadata about the data transformations at runtime. If combined with effective visualisation and monitoring interfaces, these provenance recordings can speed up the validation process of an experiment, suggesting interactive or automated interventions with immediate effects on the lifecycle of a workflow run. For instance, in the field of computational seismology, if we consider research applications performing long lasting cross correlation analysis and high resolution simulations, the immediate notification of logical errors and the rapid access to intermediate results, can produce reactions which foster a more efficient progress of the research. These applications are often executed in secured and sophisticated HPC and HTC infrastructures, highlighting the need for a comprehensive framework that facilitates the extraction of fine grained provenance and the development of provenance aware components, leveraging the scalability characteristics of the adopted workflow engines, whose enactment can be mapped to different technologies (MPI, Storm clusters, etc). This work looks at the adoption of W3C-PROV concepts and data model within a user driven processing and validation framework for seismic data, supporting also computational and data management steering. Validation needs to balance automation with user intervention, considering the scientist as part of the archiving process. Therefore, the provenance data is enriched with community-specific metadata vocabularies and control messages, making an experiment reproducible and its description consistent with the community understandings. Moreover, it can contain user defined terms and annotations. The current implementation of the system is supported by the EU-Funded VERCE ( It provides, as well as the provenance generation mechanisms, a prototypal browser-based user interface and a web API built on top of a NoSQL storage

  16. Acute pancreatitis (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... well it can be treated. Complications of acute pancreatitis may include: Acute kidney failure Long-term lung damage (ARDS) Buildup ...

  17. Nonfocal renal biopsies: adequacy and factors affecting a successful outcome. (United States)

    Goldstein, Mark A; Atri, Mostafa; O'Malley, Martin; Jacks, Lindsay; John, Rohan; Herzenberg, Andrew; Reich, Heather; Ghai, Sangeet


    The purpose of this study was to evaluate factors affecting the success of ultrasound-guided core biopsy of kidneys and determine the optimum number of passes. This retrospective study evaluated 484 nonfocal renal biopsies performed with 18-gauge side-notch biopsy needles. Number of biopsy passes, serum creatinine, body mass index, needle type, transplant age, kidney size, diabetic status, and operator were evaluated as predictors of the number of biopsy passes. Four hundred seventy-four biopsies (338 transplant, 136 native) were included with mean number of passes 2.87 (3.1 native vs 2.78 transplant; P = 0.002). Mean number of glomeruli yielded per pass was 6.9 (7.2 transplant vs 6.1 native; P = 0.0002) with 3 passes adequate for histological diagnosis in 84% of biopsies. Native kidney, increasing serum creatinine level, trainee biopsy operator, and use of a Temno needle were found to be independent predictors of having more than 3 biopsy passes on multivariate analysis. Age, sex, body mass index, diabetic status, and kidney size were not associated with the number of biopsy passes. The success of a nonfocal renal biopsy has many influencing variables, and in the absence of an on-site electron microscopy technologist to immediately evaluate biopsy samples, 3 passes with an 18-gauge needle would be adequate in 84% of kidneys to achieve a histological diagnosis, with 2 passes needed for transplant kidneys to meet the Banff 97 criteria.

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

    African Journals Online (AJOL)


    Jan 3, 2012 ... of both sextant and extended 10-core biopsy protocols at different PSA levels and digital rectal examination (DRE) ... Key words: Biopsy, detection rate, digital rectal examination, extended, prostate cancer, prostate-specific antigen, sextant .... Indications for prostate biopsy were elevated PSA alone in.

  19. The Natural History of Biopsy-Negative Rejection after Heart Transplantation

    Directory of Open Access Journals (Sweden)

    Zhaoyi Tang


    Full Text Available Purpose. The most recent International Society for Heart and Lung Transplantation (ISHLT biopsy scale classifies cellular and antibody-mediated rejections. However, there are cases with acute decline in left ventricular ejection fraction (LVEF ≤ 45% but no evidence of rejection on biopsy. Characteristics and treatment response of this biopsy negative rejection (BNR have yet to be elucidated. Methods. Between 2002 and 2012, we found 12 cases of BNR in 11 heart transplant patients as previously defined. One of the 11 patients was treated a second time for BNR. Characteristics and response to treatment were noted. Results. 12 cases (of 11 patients were reviewed and 11 occurred during the first year after transplant. 8 cases without heart failure symptoms were treated with an oral corticosteroids bolus and taper or intravenous immunoglobulin. Four cases with heart failure symptoms were treated with thymoglobulin, intravenous immunoglobulin, and intravenous methylprednisolone followed by an oral corticosteroids bolus and taper. Overall, 7 cases resulted in return to normal left ventricular function within a mean of 14 ± 10 days from the initial biopsy. Conclusion. BNR includes cardiac dysfunction and can be a severe form of rejection. Characteristics of these cases of rejection are described with most cases responding to appropriate therapy.

  20. Renal biopsy in childhood nephrotic syndrome

    International Nuclear Information System (INIS)

    Hafeez, F.; Rasool, F.; Hamid, T.


    Objective: To study the histopathological pattern in childhood nephrotic syndrome who underwent biopsy, and the safety of the procedure. Design: A prospective study. Patients and Duration of Study: Nephrology Department, The Children Hospital and the Institute of Child Health, Lahore form July 1999 to June 2001. Subjects and method: Ultrasound guided percutaneous renal biopsy was done in nephrotics, who were (a) steroid resistant (SR), (b) wit signs of steroid toxicity (c) deranged renal functions, hypocomplementemia, gross haematuria (d) signs of systemic disease. Patients with congenital nephrosis were not included. The biopsy material was examined under light microscope after staining with H and E and PAS. Results: Thirty-five patients with male to female ratio of 2.5:1 in the age range of 1-1/2 years 14 years (mean 6.9 years) underwent renal biopsy. Fifteen (42.9)% were SRNS (Steroid resistant nephritic syndrome), while 7 (20%) had signs of steroid toxicity and deranged renal functions each. Gross haematuria and signs suggestive of systemic disease were present in 3 (8.6%) Patients in each group. The most predominant histopathology was measangioproliferative in 12 (34.2%) followed by MPGN (Membranoproliferative glomerulonephritis) in 7 (20%), MCNS (Minimal change nephrotic syndrome) in 6 (17.1%), membranous nephropathy in 3 (8.85%), FSGS (Focal segmental glomeurlosclerosis) and focal proliferative GN (Glomerulonephritis) was seen in 1 (2.85%) each. Among the steroid resistant patients the most common histopathology was mesangioproliferative GN in 7 (46.6%) followed by MCNS and FSGS in 2 (13.2%) each. Overall complication rate was 17.2% in 6 with gross haematuria and flank pain seen in 2 (5.7%), while small perirenal haematoma and urinary retention occurred in 1 (2.85%) patients in each group. Conclusion: Percutaneous renal biopsy is a safe procedure with minimal risk of complications, it helps the nephrologist to find out the underlying histopathology for the

  1. Endometrial Histopathology in Patients with Laparoscopic Proven Salpingitis and HIV-1 Infection

    Directory of Open Access Journals (Sweden)

    Nelly R. Mugo


    Full Text Available Study Objective. To identify sensitive and specific histological criteria for endometritis in women with laparoscopically-confirmed acute salpingitis. Methods. Women, age 18–40 years of age presenting with complaints of lower abdominal pain ≤2 weeks and no antibiotics use in past two weeks, were enrolled. They underwent clinical examination, screening for HIV; other sexually transmitted infections plus endometrial biopsy sampling for histopathology. Diagnostic laparoscopy confirmed the diagnosis of acute salpingitis. Controls were women undergoing tubal ligation and HIV-1 infected women asymptomatic for genital tract infection. Results. Of 125 women with laparoscopically-confirmed salpingitis, 38% were HIV-1 seropositive. Nineteen HIV-1 negative controls were recruited. For the diagnosis of endometritis, ≥1 plasma cells (PC and ≥3 polymorphonuclear lymphocytes (PMN per HPF in the endometrium had a sensitivity of 74% for HIV-1-seropositive, 63% for HIV-1-seronegative women with a specificity of 75% and positive predictive value of 85% regardless of HIV-1-infection for predicting moderate to severe salpingitis. For HIV-1-seronegative women with mild salpingitis, ≥1 PC and ≥3 PMN had a sensitivity of 16% and a PPV of 57%. Conclusion. Endometrial histology, did not perform well as a surrogate marker for moderate to severe salpingitis, and failed as a surrogate marker for mild salpingitis.

  2. Frequency of kidney diseases and clinical indications of pediatric renal biopsy: A single center experience

    Directory of Open Access Journals (Sweden)

    S Imtiaz


    Full Text Available Kidney biopsy occupies a fundamental position in the management of kidney diseases. There are very few renal pathology studies available in the literature from developing world. This study scrutinized the frequency and clinicopathological relationship of kidney biopsies done at the kidney center from 1997 to 2013 amongst pediatric patients. Kidney allograft biopsy were excluded. The specimen was examined under light microscopy and immunofluorescence while electron microscopy was not done. The study includes 423 patients, mean age was 10.48 ± 4.58 years, males 245 (57.9% were more than females 178 (42.1%. Nephrotic syndrome 314 (74.2% was the most common clinical presentation followed by acute nephritic syndrome 35 (8.3% and acute renal failure 24 (5.7%. Primary glomerulonephritis (PGN was the most common group of diseases, seen in 360 (85.1% followed by secondary glomerulonephritis (SGN in 27 (6.4% and tubulointerstitial nephritis in 21 (5.0%. Among PGN, minimal change disease (MCD was the most dominant disease, with 128 (30.3% cases followed by focal segmental glomerulosclerosis FSGS in 109 (25.8% and membranous glomerulonephropathy in 27 (6.4%. Lupus nephritis (LN was the leading cause of glomerular disease in SGN followed by hemolytic uremic syndrome. In conclusion, MCD is the most common histological finding, especially in younger children and FSGS is second to it. SGN is rare, and the most common disease in this category is LN while tubulointerstitial and vascular diseases are infrequent.

  3. Towards Provenance and Traceability in CRISTAL for HEP (United States)

    Shamdasani, Jetendr; Branson, Andrew; McClatchey, Richard


    This paper discusses the CRISTAL object lifecycle management system and its use in provenance data management and the traceability of system events. This software was initially used to capture the construction and calibration of the CMS ECAL detector at CERN for later use by physicists in their data analysis. Some further uses of CRISTAL in different projects (CMS, neuGRID and N4U) are presented as examples of its flexible data model. From these examples, applications are drawn for the High Energy Physics domain and some initial ideas for its use in data preservation HEP are outlined in detail in this paper. Currently investigations are underway to gauge the feasibility of using the N4U Analysis Service or a derivative of it to address the requirements of data and analysis logging and provenance capture within the HEP long term data analysis environment.

  4. Towards Provenance and Traceability in CRISTAL for HEP

    CERN Document Server

    Shamdasani, Jetendr; McClatchey, Richard


    This paper discusses the CRISTAL object lifecycle management system and its use in provenance data management and the traceability of system events. This software was initially used to capture the construction and calibration of the CMS ECAL detector at CERN for later use by physicists in their data analysis. Some further uses of CRISTAL in different projects (CMS, neuGRID and N4U) are presented as examples of its flexible data model. From these examples, applications are drawn for the High Energy Physics domain and some initial ideas for its use in data preservation HEP are outlined in detail in this paper. Currently investigations are underway to gauge the feasibility of using the N4U Analysis Service or a derivative of it to address the requirements of data and analysis logging and provenance capture within the HEP long term data analysis environment.

  5. Making geological sense of 'Big Data' in sedimentary provenance


    Vermeesch, P.; Garzanti, E.


    Sedimentary provenance studies increasingly apply multiple chemical, mineralogical and isotopic proxies to many samples. The resulting datasets are often so large (containing thousands of numerical values) and complex (comprising multiple dimensions) that it is warranted to use the Internet-era term ‘Big Data’ to describe them. This paper introduces Multidimensional Scaling (MDS), Generalised Procrustes Analysis (GPA) and Individual Differences Scaling (INDSCAL, a type of ‘3-way MDS’ algorith...

  6. Integrating prediction, provenance, and optimization into high energy workflows

    Energy Technology Data Exchange (ETDEWEB)

    Schram, M.; Bansal, V.; Friese, R. D.; Tallent, N. R.; Yin, J.; Barker, K. J.; Stephan, E.; Halappanavar, M.; Kerbyson, D. J.


    We propose a novel approach for efficient execution of workflows on distributed resources. The key components of this framework include: performance modeling to quantitatively predict workflow component behavior; optimization-based scheduling such as choosing an optimal subset of resources to meet demand and assignment of tasks to resources; distributed I/O optimizations such as prefetching; and provenance methods for collecting performance data. In preliminary results, these techniques improve throughput on a small Belle II workflow by 20%.

  7. Implementing Provenance Collection in a Legacy Data Product Generation System (United States)

    Conover, H.; Ramachandran, R.; Kulkarni, A.; Beaumont, B.; McEniry, M.; Graves, S. J.; Goodman, H.


    NASA has been collecting, storing, archiving and distributing vast amounts of Earth science data derived from satellite observations for several decades now. The raw data collected from the different sensors undergoes many different transformations before it is distributed to the science community as climate-research-quality data products. These data transformations include calibration, geolocation, and conversion of the instrument counts into meaningful geophysical parameters, and may include reprojection and/or spatial and temporal averaging as well. In the case of many Earth science data systems, the science algorithms and any ancillary data files used for these transformations are delivered as a "black box" to be integrated into the data system's processing framework. In contrast to an experimental workflow that may vary with each iteration, such systems use consistent, well-engineered processes to apply the same science algorithm to each well-defined set of inputs in order to create standard data products. Even so, variability is inevitably introduced. There may be changes made to the algorithms, different ancillary datasets may be used, underlying hardware and software may get upgraded, etc. Furthermore, late-arriving input data, operator error, or other processing anomalies may necessitate regeneration and replacement of a particular set of data files and any downstream products. These variations need to be captured, documented and made accessible to the scientific community so they can be properly accounted for in analyses. This presentation describes an approach to provenance capture, storage and dissemination implemented at the NASA Science Investigator-led Processing System (SIPS) for the AMSR-E (Advanced Microwave Scanning Radiometer - Earth Observing System) instrument. Key considerations in adding provenance capabilities to this legacy data system include: (1) granularity of provenance information captured, (2) additional context information needed

  8. Statistical analysis of lead isotope data in provenance studies

    International Nuclear Information System (INIS)

    Reedy, C.L.


    This paper reports on tracing artifacts to ore sources which is different from assigning ore samples to time epochs. Until now, archaeometrists working with lead isotopes have used the ratio methods developed by geochronologists. For provenance studies, however, the use of composition data (the fraction of each of the four isotopes) leads to fewer arbitrary choices, two standard types of plots (labelled ternary and canonical variable, and a consistent method of discriminant analysis for separating groups of samples from different sources

  9. Examining the Prospective Scuba Diver: Which Exclusions are Proven?


    Beauprie, Ian


    Who can safely dive? All prospective divers in Canada must have a physician's approval to start training. Many review articles and typical check-list medical forms, however, imply exclusions that are not well proven. The author critically analyzes current diving and diving accident statistics and discusses the physiology of risk. He also discusses diving morbidity and mortality from pressure changes, illness caused by immersion only, hypothermia, and diving during pregnancy.

  10. Provenance of coastal dune sands along Red Sea, Egypt

    Indian Academy of Sciences (India)

    Samir M Zaid


    Jun 7, 2017 ... The average CIA values in SF and QS coastal dune sands are low relative to the range of the PAAS, suggesting an arid .... Skewness (Ski) values of QS vary from 0.04 (near symmetrical) to –0.3 ϕ (coarse ...... Alfredo-Morales E and Santa-Cruz R L 2009 Beach sand composition and provenance in a sector ...

  11. Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies

    DEFF Research Database (Denmark)

    Wallace, William Dean; Li, Ning; Andersen, Claus B


    a statistically significant difference vs NABs in the setting of acute lung injury, with or without diffuse alveolar damage (p = 0.0008), in the presence of capillary neutrophilic inflammation (p = 0.0014), and in samples with endotheliitis (p = 0.0155). In samples with complement 4d staining, there was a trend......-DSAs, and no antibodies (NABs) present. The significance of each histologic variable was reviewed. RESULTS: We found no statistically significant association with acute cellular rejection, airway inflammation, or bronchiolitis obliterans and the presence or absence of antibodies. However, biopsy specimens with DSAs had...... but no statistically significant difference between specimens associated with DSAs and specimens with NABs. CONCLUSIONS: Capillary inflammation, acute lung injury, and endotheliitis significantly correlated with DSAs. The infrequently observed diffuse staining for complement 4d limits the usefulness of this stain....

  12. Provenance Representation in the Global Change Information System (GCIS) (United States)

    Tilmes, Curt


    Global climate change is a topic that has become very controversial despite strong support within the scientific community. It is common for agencies releasing information about climate change to be served with Freedom of Information Act (FOIA) requests for everything that led to that conclusion. Capturing and presenting the provenance, linking to the research papers, data sets, models, analyses, observation instruments and satellites, etc. supporting key findings has the potential to mitigate skepticism in this domain. The U.S. Global Change Research Program (USGCRP) is now coordinating the production of a National Climate Assessment (NCA) that presents our best understanding of global change. We are now developing a Global Change Information System (GCIS) that will present the content of that report and its provenance, including the scientific support for the findings of the assessment. We are using an approach that will present this information both through a human accessible web site as well as a machine readable interface for automated mining of the provenance graph. We plan to use the developing W3C PROV Data Model and Ontology for this system.

  13. Neutron activation analysis: a powerful tool in provenance investigations

    International Nuclear Information System (INIS)

    Meloni, Sandro; Oddone, Massimo


    It is well known that neutron activation analysis (NAA), both instrumental and destructive, allows the simultaneous determination of a number of elements, mostly trace elements, with high levels of precision and accuracy. These peculiar properties of NAA are very useful when applied to provenance studies, i.e. to the identification of the origin of raw materials with which artifacts had been manufactured in ancient times. Data reduction by statistical procedures, especially multivariate analysis techniques, provides a statistical 'fingerprint' of investigated materials, both raw materials and archaeological artifacts, that, upon comparison, allows the identification of the provenance of prime matters used for artifact manufacturing. Thus information on quarries and flows exploitation in the antiquity, on technological raw materials processing, on trade routes and about the circulation of fakes, can be obtained. In the present paper two case studies are reported. The first one deals with the identification of the provenance of clay used to make ceramic materials, mostly bricks and tiles, recovered from the excavation of a Roman 'villa' in Lomello (Roman name Laumellum) and of Roman settlings in Casteggio (Roman name Clastidium). Both sites are located in the Province of Pavia in areas called Lomellina and Oltrepo respectively. The second one investigates the origin of the white marble used to build medieval arks, Carolingian age, located in the church of San Felice, now property of the University of Pavia. Experimental set-up, analytical results and data reduction procedures are presented and discussed. (author)

  14. Unguided bronchoscopic biopsy: Does yield increase with operator experience

    Directory of Open Access Journals (Sweden)

    Tyagi Rahul


    Full Text Available Background Bronchoscopic Forceps biopsy (Endobronchial Biopsy (EBB and Trans Bronchial Lung Biopsy (TBLB are commonly performed for diagnosis in patients with endobronchial abnormalities or diffuse parenchymal involvement. As the operator gains experience his yield of various diagnostic bronchoscopic biopsies is expected to increase, however, no studies on the subject are available in literature. Aims To determine the effect of on- job experience on the yield of unguided bronchoscopic biopsies. Methods A total of 244 bronchoscopies were performed between Oct 2013 and Oct 2016. A retrospective analysis of all these bronchoscopies was undertaken. All patients who underwent biopsy were included in the study. Patients were divided into two groups with first group (Group A comprising of biopsies done between Oct 2013 to Apr 2015 and second group comprising biopsies done between May 2015 to Oct 2016 (Group B. The diagnostic yield in two groups was compared. Results Total 71 bronchoscopic biopsies were performed during Oct 2013 to Oct 2016. 36 patients were included in group A and 35 patients were included in group B. The groups were matched in demographic profile, clinical diagnosis, bronchoscopic findings and type of biopsy undertaken. The biopsy was diagnostic in 31 patient (43.6 per cent and nondiagnostic in 33 patients (46.4 per cent. There were 15 diagnostic biopsies in group A and 16 diagnostic biopsies in group B. The difference in the diagnostic biopsies between the two groups was not significant. Conclusion There was no significant impact of on job experience on diagnostic yield of biopsies. This may be due to adequate exposure during training leading to a diagnostic plateau being reached.

  15. A Provenance Model for Real-Time Water Information Systems (United States)

    Liu, Q.; Bai, Q.; Zednik, S.; Taylor, P.; Fox, P. A.; Taylor, K.; Kloppers, C.; Peters, C.; Terhorst, A.; West, P.; Compton, M.; Shu, Y.; Provenance Management Team


    Generating hydrological data products, such as flow forecasts, involves complex interactions among instruments, data simulation models, computational facilities and data providers. Correct interpretation of the data produced at various stages requires good understanding of how data was generated or processed. Provenance describes the lineage of a data product. Making provenance information accessible to hydrologists and decision makers not only helps to determine the data’s value, accuracy and authorship, but also enables users to determine the trustworthiness of the data product. In the water domain, WaterML2 [1] is an emerging standard which describes an information model and format for the publication of water observations data in XML. The W3C semantic sensor network incubator group (SSN-XG) [3] is producing ontologies for the description of sensor configurations. By integrating domain knowledge of this kind into the provenance information model, the integrated information model will enable water domain researchers and water resource managers to better analyse how observations and derived data products were generated. We first introduce the Proof Mark Language (PML2) [2], WaterML2 and the SSN-XG sensor ontology as the proposed provenance representation formalism. Then we describe some initial implementations how these standards could be integrated to represent the lineage of water information products. Finally we will highlight how the provenance model for a distributed real-time water information system assists the interpretation of the data product and establishing trust. Reference [1] Taylor, P., Walker, G., Valentine, D., Cox, Simon: WaterML2.0: Harmonising standards for water observation data. Geophysical Research Abstracts. Vol. 12. [2] da Silva, P.P., McGuinness, D.L., Fikes, R.: A proof markup language for semantic web services. Inf. Syst. 31(4) (2006), 381-395. [3] W3C Semantic Sensor Network Incubator Group

  16. Provenance-Enabled Integration of Sensor Network Data (United States)

    Pinheiro da Silva, P.; McGuinness, D. L.


    Ontology design in support of sensor networks requires deep scientific and technical knowledge. For instance, sensor network ontologies may define concepts rich enough to describe the selection of sensor locations that are driven by both scientific use cases, such as proximity to a physical entity, and technical requirements, such as wireless coverage. Our work in collaboration with IBM and the FUND for Lake George is set within the context of the Jefferson Project that aims to monitor, analyze, and understand observation and simulation data in support of decision making concerning the ecosystem of Lake George, NY. We have designed a Human-Aware Sensor Network Ontology (HASNet-O) that we believe is broadly reusable. We will highlight its contributions, describe its relationships to well used ontologies, and demonstrate it in action in the Jefferson Project. The ontology leverages best in class foundational ontologies including OBOE, VSTO, and PROV. One of the reasons HASNet-O is reusable is because it uses a provenance perspective to generalize what initially looked like sensor-specific terms that can be more accurately viewed as provenance terms. For example, we observe that the Activity concept from the PROV language, a W3C provenance standard, can be used to explain complete sensor lifecycles by describing how a network operates including how human interventions may interfere with the quality of the sensor network data, even for highly automated networks. We further observe that Observation activities, which are at the core of most sensor network ontologies, are not described in terms of deployments. In fact, Deployment activities are rarely documented in sensor data/metadata although Observation instances can only occur during the lifetime of Deployment instances. Our analysis of network ontologies in light of provenance knowledge includes a discussion about relationships. For instance, relationships between sensors and data are well-established provenance

  17. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    International Nuclear Information System (INIS)

    Hoffer, F.A.; Gow, K.; Davidoff, A.; Flynn, P.M.


    Background. Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. Objective. We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. Materials and methods. We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the lungs of 24 children with suspected pulmonary aspergillosis. Twenty-two were being treated for malignancy and two for congenital immunodeficiency; 15 had received bone-marrow transplants. The accuracy of the percutaneous lung biopsy was determined by subsequent surgical resection, autopsy, or clinical course. Results. Histopathological studies showed ten biopsy specimens with septate hyphae, indicating a mold, and seven with Aspergillus flavus colonies in culture. The remaining 18 biopsies revealed no fungi. No patient had progressive aspergillosis after negative biopsy. Invasive pulmonary mold was detected by percutaneous biopsy with 100 % (10/10) sensitivity and 100 % (18/18) specificity. Percutaneous biopsy results influenced the surgical decision in 86 % (24 of 28) of the cases. Bleeding complicated the biopsy in 46 % (13/28) and hastened one death. Conclusion. Percutaneous biopsy of the lung is an accurate technique for the diagnosis of invasive pulmonary aspergillosis and correctly determines which immunosuppressed pediatric patients would benefit from therapeutic pulmonary resection. (orig.)

  18. Diagnosis of prostate cancer with needle biopsy: should all cases be biopsied before treatment? (United States)

    Oranusi, C K; Ugezu, A I; Nwofor, Ame


    The triad of digital rectal examination (DRE), serum prostate specific antigen, and transrectal ultrasound-guided prostate biopsy is used in the detection of prostate cancer (PCa). It is recommended that all cases of PCa should be diagnosed with needle biopsy before treatment. The exclusion criteria for those that may not be suitable have not yet been defined. We reviewed all the patients diagnosed with PCa at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Southeast, Nigeria, from January 2007 to December 2010. Relevant biodata and method of diagnosis of PCa before treatment were reviewed. A total of 133 patients had bilateral orchidectomy over the period. 120 (90.2%) had their diagnosis confirmed by needle biopsy before bilateral orchidectomy (category 1), while 13 (9.8%) had bilateral orchidectomy before diagnosis was confirmed. The method of diagnosis for category 1 patients was with lower urinary tract symptoms (LUTS), abnormal DRE findings, elevated prostate-specific antigen (PSA), and transrectal needle biopsy. For category 11 patients, diagnosis of PCa was suspected based on LUTS, abnormal DRE findings, and elevated PSA. Of this number, 11 (84.6%) had, in addition, sudden onset paraplegia at presentation, while 2 (15.4%) had severe uncontrolled hematuria at presentation. All the patients in both categories had needle biopsy confirmation of their disease. The sensitivity of PSA was 99.2%. Needle biopsy of the prostate is the preferred method for the diagnosis of PCa in most cases before treatment is undertaken. There are valid reasons why all PCas will not be diagnosed in this fashion. Elevated PSA when combined with an abnormal DRE finding increases the predictive value for cancer. In areas where pathologists are lacking, abnormal DRE and elevated PSA results can be a guide to proceed to treatment especially, where there is severe compromise of patients' quality of life due to symptoms of advanced PCa while awaiting confirmation.

  19. Steroid-Refractory Acute GVHD: Predictors and Outcomes

    Directory of Open Access Journals (Sweden)

    Jason R. Westin


    Full Text Available Patients with steroid-resistant acute graft versus host disease (aGVHD have a dismal prognosis, with mortality rates in excess of 90%. We sought to identify a subgroup of patients less likely to benefit from initial therapy with corticosteroids as well as the impact of response on day 14 on outcome. Retrospective evaluation was performed of patients with biopsy-proven aGVHD treated with corticosteroids after allogeneic HSCT at M.D. Anderson Cancer Center from 1998 through 2002 (=287. Overall response to first-line therapy on day 14 was 56%. Grade III-IV aGVHD and hyperacute GVHD were the most significant factors predicting failure. Patients who fail to respond to steroids by day 14 should be considered for clinical trials. Severity of aGVHD, hyperacute GVHD, and sex mismatch could be integrated into prognostic scoring systems which may allow for pretreatment identification of patients unlikely to benefit from standard therapy with corticosteroids.

  20. CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: Accuracy, complications and radiation dose

    International Nuclear Information System (INIS)

    Prosch, Helmut; Stadler, Alfred; Schilling, Matthias; Bürklin, Sandra; Eisenhuber, Edith; Schober, Ewald; Mostbeck, Gerhard


    Background: The aim of this retrospective study was to compare the diagnostic accuracy, the frequency of complications, the duration of the interventions and the radiation doses of CT fluoroscopy (CTF) guided biopsies of lung lesions with those of multislice CT (MS-CT) biopsy mode-guided biopsies. Methods: Data and images from 124 consecutive patients undergoing CTF-guided lung biopsy (group A) and 132 MS-CT-biopsy mode-guided lung biopsy (group B) were reviewed. CTF-guided biopsies were performed on a Siemens Emotion 6 CT scanner with intermittent or continuous CT-fluoroscopy, MS-CT biopsy mode-guided biopsies were performed on a Siemens Emotion 16 CT scanner. All biopsies were performed with a coaxial needle technique. Results: The two groups (A vs. B) did not differ significantly regarding sensitivity (95.5% vs. 95.9%), specificity (96.7% vs. 95.5%), negative predictive value (87.9% vs. 84%) or positive predictive value (98.8% vs. 98.9%). Pneumothorax was observed in 30.0% and 32.5% of the patients, respectively. Chest tube placement was necessary in 4% (group A) and 13% (group B) of the patients. The duration of the intervention was significantly longer in group A (median 37 min vs. 32 min, p = 0.04). The mean CT dose index (CTDI) was 422 in group A and 36.3 in group B (p < 0.001). Conclusion: Compared to CTF-guided biopsies, chest biopsies using the MS-CT biopsy mode show dramatically lower CTDI levels. Although the diagnostic yield of the procedures do not differ significantly, biopsies using the MS-CT-biopsy mode have a three-fold higher rate of chest tube placement.

  1. The biopsy of the boar testes using ultrasonographic examination

    Directory of Open Access Journals (Sweden)

    Laima Liepa


    Full Text Available The biopsy of live animal testes is an important clinical manipulation to control spermatogenesis and reproductive system pathologies. The aim was to develop a method of boar testes biopsy using a biopsy gun with ultrasound guidance and to investigate the influence of this procedure on the boar testes parenchyma and quality of ejaculate. The biopsy was carried out in six 8-month-old boars. Fourteen days prior to and 21 days after biopsy, the quality of ejaculate was examined (weight of ejaculate; concentration and motility of spermatozoa with a seven-day intervals. Ultrasound images of the testes parenchyma were recorded three times: directly before and 15 minutes after the biopsy, then 21 days after the procedure. The testes biopsies of generally anesthetized boars were performed with the biopsy gun for needle biopsy with a 12cm long, disposable 16-gauge needle 1.8mm in diameter (Vitesse through 1cm skin incision in the depth of 1.2-1.6cm of parenchyma. Fifteen minutes after the biopsy, macroscopic injures of the parenchyma of all the boar testes were not detected in the ultrasound image. Twenty one days after biopsy, the hyperechogenic line 0.1-0.2cm in diameter was seen in the testes parenchyma of six boars in the depth of 1.2-1.6cm. The biopsy of boar testes did not influence the quality of boars ejaculate. The ultrasonographic examination of boar testicles before the biopsy reduced possibilities to traumatize large blood vessels of the testes. A perfect boar testicular biopsy was easy to perform using ultrasonographic examination in the pigsty conditions.

  2. Percutaneous CT-guided needle biopsies of musculoskeletal tumors: a 5-year analysis of non-diagnostic biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Torriani, Martin; Rosenthal, Daniel I. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute for Technology Assessment, Department of Radiology, Boston, MA (United States); Springfield, Dempsey S. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)


    To study non-diagnostic CT-guided musculoskeletal biopsies and take steps to minimize them. Specifically we asked: (1) What malignant diagnoses have a higher non-diagnostic rate? (2) What factors of a non-diagnostic biopsy may warrant more aggressive pursuit? (3) Do intra-procedural frozen pathology (FP) or point-of-care (POC) cytology reduce the non-diagnostic biopsy rate ?This study was IRB-approved and HIPAA-compliant. We retrospectively reviewed 963 consecutive CT-guided musculoskeletal biopsies. We categorized pathology results as malignant, benign, or non-diagnostic and recorded use of FP or POC cytology. Initial biopsy indication, final diagnosis, method of obtaining the final diagnosis of non-diagnostic biopsies, age of the patient, and years of biopsy attending experience were recorded. Groups were compared using Pearson's χ{sup 2} test or Fisher's exact test. In all, 140 of 963 (15 %) biopsies were non-diagnostic. Lymphoma resulted in more non-diagnostic biopsies (P < 0.0001). While 67% of non-diagnostic biopsies yielded benign diagnoses, 33% yielded malignant diagnoses. Patients whose percutaneous biopsy was indicated due to the clinical context without malignancy history almost always generated benign results (96 %). Whereas 56% of biopsies whose indication was an imaging finding of a treatable lesion were malignant, 20% of biopsies whose indication was a history of malignancy were malignant. There was no statistically significant difference in the nondiagnostic biopsy rates of pediatric versus adult patients (P = 0.8) and of biopsy attendings with fewer versus more years of experience (P = 0.5). The non-diagnostic rates of biopsies with FP (8 %), POC cytology (25 %), or neither (24 %) were significantly different (P < 0.0001). Lymphoma is the malignant diagnosis most likely to result in a non-diagnostic biopsy. If the clinical and radiologic suspicion for malignancy is high, repeat biopsy is warranted. If the clinical context suggests a

  3. Acute renal failure caused by Klebsiella pneumoniae pyelonephritis

    NARCIS (Netherlands)

    Creyghton, W. M.; Lobatto, S.; Weening, J. J.


    We report a 34-year-old male patient without prior medical history who presented with acute renal failure due to acute bacterial pyelonephritis. Both blood and urine cultures grew Klebsiella pneumoniae. Although a kidney biopsy revealed extensive necrosis and no viable glomeruli, renal function

  4. Transperineal prostate biopsy with ECHO-MRI fusion. Biopsee system. Initial experience. (United States)

    Romero-Selas, E; Cuadros, V; Montáns, J; Sánchez, E; López-Alcorocho, J M; Gómez-Sancha, F


    The aim of this study is to present our initial experience with the stereotactic echo-MRI fusion system for diagnosing prostate cancer. Between September 2014 and January 2015, we performed 50 prostate biopsies using the stereotactic echo-MRI fusion system. The 3-Tesla multiparameter MR images were superimposed using this image fusion system on 3D echo images obtained with the Biopsee system for the exact locating of areas suspected of prostate cancer. The lesions were classified using the Prostate Imaging Report and Date System. We assessed a total of 50 patients, with a mean age of 63 years (range, 45-79), a mean prostate-specific antigen level of 8 ng/mL (range, 1.9-20) and a mean prostate volume of 52mL (range, 12-118). Prostate cancer was diagnosed in 69% of the patients and intraepithelial neoplasia in 6%. The results of the biopsy were negative for 24% of the patients. The results of the biopsy and MRI were in agreement for 62% of the patients; however, 46% also had a tumour outside of the suspicious lesion. We diagnosed 46% anterior tumours and 33% apical tumours. One patient had a haematuria, another had a haematoma and a third had acute urine retention. Multiparametric prostatic MRI helps identify prostate lesions suggestive of cancer. The Biopsee echo-MRI fusion system provides for guided biopsy and increases the diagnostic performance, reducing the false negatives of classical biopsies and increasing the diagnosis of anterior tumours. Transperineal access minimises the risk of prostatic infection and sepsis. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Delphinella Shoot Blight on Abies lasiocarpa Provenances in Norway

    Directory of Open Access Journals (Sweden)

    Venche Talgø


    Full Text Available Delphinella shoot blight (Delphinella abietis attacks true firs (Abies spp. in Europe and North America. Especially subalpine fir (A. lasiocarpa, one of the main Christmas tree species in Norway, is prone to the disease. The fungus kills current year needles, and in severe cases entire shoots. Dead needles become covered with black fruiting bodies, both pycnidia and pseudothecia. Delphinella shoot blight has mainly been a problem in humid, coastal regions in the northwestern part of Southern Norway, but, probably due to higher precipitation in inland regions during recent years, heavy attacks were found in 2011 in a field trial with 76 provenances of subalpine fir in Southeastern Norway. However, the amount of precipitation seemed less important once the disease had established in the field. Significant differences in susceptibility between provenances were observed. In general, the more bluish the foliage was, the healthier the trees appeared. The analysis of provenance means indicated that, at least for the southern range, the disease ratings were correlated with foliage color. This study also includes isolation, identification, a pathogenicity test, a seed test and electron microscopy of the wax layer on the needles. The fungus was identified based on the morphology of spores and by sequencing the Internal Transcribed Spacer (ITS regions of the ribosomal DNA. Koch’s postulates were fulfilled. The fungus was found present on newly harvested seeds and may therefore spread via international seed trade. When comparing the wax layers on green and blue needles, those of the latter were significantly thicker, a factor that may be involved in disease resistance.

  6. Dengue: muscle biopsy findings in 15 patients

    Directory of Open Access Journals (Sweden)

    S.M.F. Malheiros


    Full Text Available Dengue is known to produce a syndrome involving muscles, tendons and joints. The hallmark of this syndrome is severe myalgia but includes fever, cutaneous rash, and headache. The neuromuscular aspects of this infection are outlined only in isolated reports, and the muscle histopathological features during myalgia have not been described. In order to ascertain the actual neuromuscular involvement in dengue and better comprehend the histological nature of myalgia, we performed a clinical and neurological evaluation, a serum CPK level and a muscle biopsy (with histochemistry in 15 patients (4 males, median age 23 years (range 14-47 with classic dengue fever, serologically confirmed, during the bra-zilian dengue epidemics from September 1986 to March 1987. All patients had a history of fever, headache and severe myalgia. Upon examination 4 had a cutaneous rash, 3 had fever, and 3 a small hepatomegaly. The neurological examination was unremarkable in all and included a manual muscle test. CPK was mildly elevated in only 3 patients. Muscle biopsy revealed a light to moderate perivascular mononuclear infiltrate in 12 patients and lipid accumulation in 11. Mild mitochondrial proliferation was seen in 3, few central nuclei in 3, rare foci of myonecrosis in 3, and 2 patients had type grouping. Dengue in our patients, produced myalgia but no detectable muscle weakness or other neuromuscular involvement. The main histopathological correlation with myalgia seems to be a perivascular mononuclear infiltrate and lipid accumulation.

  7. Post biopsy pneumothorax: Risk factors and course

    International Nuclear Information System (INIS)

    Sanchez, J.A.; Retamar, J.A.; Blazquez, J.; Castano, J.C.


    The was to study the natural course of pneumothorax produced after aspiration biopsy in the attempt to differentiate those cases that will resolve spontaneously from those that will require drainage, and to assess the possible risk factors associated with the development of this entity. Eighty-nine CT-guided aspiration biopsies were performed in 80 patients. Control CT was done immediately after the procedure and 24 hours later. When pneumothorax persisted, CT was repeated at 48 h, 72 h, day 5 and day 7 or until a drainage tube was introduced. The cases of pneumothorax were classified as minimal, anterior or anterolateral. Seven variables were assessed as possible risk factors for its occurrence. Pneumothorax developed on 29 occasions (32.5%), requiring drainage in 12 cases (13.5%). In 20 patients (22%), pneumothorax occurred immediately, while in the remaining 9 (10%) it was detected in the 24 h CT scan. When studied according to type, drainage was required in 3 of the 19 cases of minimal or anterior pneumothorax (15%) and in 9 or the 10 cases of anterolateral location (90%) (p<0.0005). The mean thickness of the parenchyma punctured was 3.4 cm +- 2.2. cm when pneumothorax developed and 1.3 cm+- 2 cm when it did not (p<0.0001). There is a statistically significant association between the development of anterolateral pneumothorax and the need for chest drainage. The thickness of the punctured parenchyma is associated with the production of pneumothorax. 16 refs

  8. Endometrial biopsy findings in postmenopausal bleeding

    International Nuclear Information System (INIS)

    Sarfraz, T.; Tariq, H.


    To study endometrial histopathology in women presenting with postmenopausal bleeding. A two-year study from January 2003 to December 2004 of 100 cases of postmenopausal bleeding was conducted at Combined Military Hospital, Sialkot. The histopathology of endometrial biopsy specimens was done to find out the causes of postmenopausal bleeding in these ladies. All these 100 patients had confirmed menopause and the average age was 55 years and above. The most common histopathological diagnosis was senile endometrial atrophy (27%), followed by simple cystic hyperplasia in (17%). Three cases of simple cystic hyperplasia had coexistent ovarian tumors. Glandular hyperplasia without atypia was seen in 6% and with atypia in 4%. Other causes were endometritis (13%), endometrial polyps (8%), proliferative phase endometrium (6%) and secretary phase endometrium (5%). Endometrial carcinoma was seen in (6%) cases, (8%) biopsy specimens were non-representative. Although senile endometrial atrophy was most commonly found in these ladies but a significant percentage of endometrial hyperplasia and endometrial cancer implies the need for investigating all cases of postmenopausal bleeding. Bimanual examination and pelvic ultrasonography should be combined with endometrial sampling so that rare pelvic pathologies may not be missed. (author)

  9. Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Gang; Chamroonrat, Wichana; Torigian, Drew A.; Alavi, Abass [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Chen, Wengen [University of Maryland Medical Center, Department of Diagnostic Radiology and Nuclear Medicine, Baltimore, MD (United States); Zhuang, Hongming [Children' s Hospital of Philadelphia, Philadelphia, PA (United States)


    The objective is to assess the role of {sup 18}F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT versus bone marrow biopsy (BMB) in the initial evaluation of bone marrow (BM) involvement in pediatric lymphoma patients. Fifty-four pediatric patients with pathologically proven lymphoma [31 Hodgkin's disease (HD), 23 non-Hodgkin's lymphoma (NHL)] were included in this study. All patients had soft tissue biopsy and BMB and had FDG PET/CT scans within 2 weeks of biopsy. Among the 31 HD patients, FDG PET/CT revealed positive BM involvement in 4 patients, while BMB revealed BM involvement in 2 patients who were also positive on FDG PET/CT imaging. Among the 23 NHL patients, FDG PET/CT revealed positive BM involvement in 8 patients, while biopsy revealed BM involvement in 5 patients on initial studies (4 of them were also positive on FDG PET/CT, and 1 was BMB positive but was negative on FDG PET/CT), plus 1 false-negative BMB study initially but positive on repeat biopsy after FDG PET/CT. The overall sensitivity of detecting BM involvement by lymphoma was 92 and 54% (p < 0.05) for FDG PET/CT and BMB, respectively. It is noted that there were more positive BMB findings in patients with abnormal FDG activities seen in the biopsy sites on PET/CT. Our study demonstrates that FDG PET/CT has high sensitivity and accuracy and a substantial complementary value to BMB in the initial diagnosis of pediatric lymphoma, and should be employed as a first-line study. (orig.)

  10. Quantification and localization of M2 macrophages in human kidneys with acute tubular injury

    Directory of Open Access Journals (Sweden)

    Palmer MB


    Full Text Available Matthew B Palmer,1 Alfred A Vichot,2 Lloyd G Cantley,2 Gilbert W Moeckel1 1Department of Pathology, Yale University School of Medicine, New Haven, CT, USA; 2Department of Medicine, Yale University School of Medicine, New Haven, CT, USA Abstract: This study addresses for the first time the question whether there is significant macrophage population in human kidney sections from patients with acute tubular injury (ATI. We examined therefore the interstitial macrophage population in human kidney tissue with biopsy-proven diagnosis of ATI, minimal change disease (MCD, and MCD with ATI. Kidney biopsies from patients with the above diagnoses were stained with antibodies directed against CD68 (general macrophage marker, CD163 (M2 marker, and HLA-DR (M1 marker and their respective electron microscopy samples were evaluated for the presence of interstitial macrophages. Our study shows that patients with ATI have significantly increased numbers of interstitial CD68+ macrophages, with an increase in both HLA-DR+ M1 macrophages and CD163+ M2 macrophages as compared to patients with MCD alone. Approximately 75% of macrophages were M2 (CD163+ whereas only 25% were M1 (HLA-DR+. M2 macrophages, which are believed to be critical for wound healing, were found to localize close to the tubular basement membrane of injured proximal tubule cells. Ultra structural examination showed close adherence of macrophages to the basement membrane of injured tubular epithelial cells. We conclude that macrophages accumulate around injured tubules following ATI and exhibit predominantly an M2 phenotype. We further speculate that macrophage-mediated repair may involve physical contact between the M2 macrophage and the injured tubular epithelial cell. Keywords: macrophages, acute kidney injury, CD163, HLA-DR, CD68, electron microscopy

  11. Rapidly aggravated Creutzfeldt-Jacob disease: autopsy-proven case

    International Nuclear Information System (INIS)

    Park, Seung Hyun; Kang, Hyun Koo; Yu, Hyeon; Lee, Sang Chun


    Creutzfeldt-Jakob disease (DJD) is one of the transmissible spongiform encephalopathies, which is mediated by what has been known as 'prion'. It is a rare and fatal progressive neurodegenerative disease that affects the middle and old aged. There are a number of subtypes of CJD, one of which is the sporadic type characterized by rapidly progressing clinical symptoms, including progressive dementia, myoclonic jerk, and pyramidal or extrapyramidal syndrome. Patients usually end up dying within 1 to 2 years of contacting the disease. We report an autopsy-proven case of sporadic CJD with clinical symptoms that progressed within several days, along with dramatic changes on diffusion weighted magnetic resonance images

  12. Provenance metadata gathering and cataloguing of EFIT++ code execution

    International Nuclear Information System (INIS)

    Lupelli, I.; Muir, D.G.; Appel, L.; Akers, R.; Carr, M.; Abreu, P.


    Highlights: • An approach for automatic gathering of provenance metadata has been presented. • A provenance metadata catalogue has been created. • The overhead in the code runtime is less than 10%. • The metadata/data size ratio is about ∼20%. • A visualization interface based on Gephi, has been presented. - Abstract: Journal publications, as the final product of research activity, are the result of an extensive complex modeling and data analysis effort. It is of paramount importance, therefore, to capture the origins and derivation of the published data in order to achieve high levels of scientific reproducibility, transparency, internal and external data reuse and dissemination. The consequence of the modern research paradigm is that high performance computing and data management systems, together with metadata cataloguing, have become crucial elements within the nuclear fusion scientific data lifecycle. This paper describes an approach to the task of automatically gathering and cataloguing provenance metadata, currently under development and testing at Culham Center for Fusion Energy. The approach is being applied to a machine-agnostic code that calculates the axisymmetric equilibrium force balance in tokamaks, EFIT++, as a proof of principle test. The proposed approach avoids any code instrumentation or modification. It is based on the observation and monitoring of input preparation, workflow and code execution, system calls, log file data collection and interaction with the version control system. Pre-processing, post-processing, and data export and storage are monitored during the code runtime. Input data signals are captured using a data distribution platform called IDAM. The final objective of the catalogue is to create a complete description of the modeling activity, including user comments, and the relationship between data output, the main experimental database and the execution environment. For an intershot or post-pulse analysis (∼1000

  13. Provenance of coals recovered from the wreck of HMAV Bounty

    Energy Technology Data Exchange (ETDEWEB)

    Erskine, N.; Smith, A.H.V.; Crosdale, P.J. [Australian National Maritime Museum, Sydney, NSW (Australia)


    Coal samples from HMAV Bounty were analysed using standard techniques to shed light on their provenance. Petrographic analysis indicated they were Carboniferous, with high vitrinite and liptinite content and a mean random reflectance of vitrinite of 0.99%. Palynological analysis indicated the samples were derived from the Middle Coal Measures, Westphalian B. Combining coal rank (vitrinite reflectance), age, knowledge of seam distributions and coalfield history indicates the most like source to be the Durham Coalfield, possibly the Hutton or Low Main Seams. These coals were mined along the valley of the Wear in the latter part of the 18th century.

  14. Capturing, Harmonizing and Delivering Data and Quality Provenance (United States)

    Leptoukh, Gregory; Lynnes, Christopher


    Satellite remote sensing data have proven to be vital for various scientific and applications needs. However, the usability of these data depends not only on the data values but also on the ability of data users to assess and understand the quality of these data for various applications and for comparison or inter-usage of data from different sensors and models. In this paper, we describe some aspects of capturing, harmonizing and delivering this information to users in the framework of distributed web-based data tools.

  15. Nd and Sr isotopes: implications of provenance and geological mapping

    International Nuclear Information System (INIS)

    Albuquerque, Marcio Fernando dos Santos; Horbe, Adriana Maria Coimbra; Dantas, Elton Luiz


    XRD, Nd and Sr isotopes, major, minor and traces elements quantification were applied to rocks, lateritic crusts and soils from Sumauma Supergroup and Alto Tapajos Group, in order to indicate provenance of the rocks and using lateritic products as geologic mapping tool. For the rocks, the results showed sources related to provinces Tapajos Parima, Rondonia Juruena, Sunsas, Carajas and Amazonia Central. However, the incision of Cachimbo graben allowed which the Sumauma Supergroup erosion also were source for the Alto Tapajos Group, allied to contribution of volcanics from Colider Group. Lateritic crusts and soils are correlates to bedrocks, allowing the use as geologic mapping tool. (author)

  16. [Stereotactic vacuum-assisted breast biopsy (Mammotome biopsy) for non-palpable microcalcification on mammography]. (United States)

    Matsuzaki, Saeko; Shiba, Eiichi; Kobayashi, Yasushi; Kawai, Mieko; Kitamura, Kaeko; Nishita, Toshiyuki; Nishio, Hiroshi; Kobayashi, Nobuyuki


    The purpose of this study was to assess the benefits of stereotactic vacuum-assisted breast biopsy in patients with non-palpable microcalcification detected on mammography. Between October 2001 and November 2003, stereotactic Mammotome biopsies were performed for 150 microcalcified lesions on mammography using the prone-type stereotactic vacuum-assisted breast biopsy system (Mammotest and Mammovision, Fischer, Denver, USA) . The mammography findings were classified according to the guidelines of The Japan Radiological Society/The Japan Association of Radiological Technologists. Ninety-eight cases were category 3, 38 were category 4, and 14 were category 5. All cases were determined to be cases of microcalcification by specimen radiography or histology. Complications were negligible. One hundred twenty of the cases were mastopathy, and 30 of them were breast cancer (14 were ductal carcinoma in situ, 7 were ductal carcinoma in situ with microinvasion, and 9 were invasive ductal carcinoma). Twenty-seven breast cancers were diagnosed as category 4 or 5 (51.9%) on mammography. The operative stages of 27 cases were as follows: 7 were stage 0, 17 were stage 1, and 3 were stage 2A. Twenty-four of 27 (88.9%) were early breast cancers. Mammotome biopsy is a safe and useful modality for the histological diagnosis of non-palpable microcalcifications.

  17. Systematic extended and saturation prostate biopsy: when and how. (United States)

    Scattoni, V; Maccagnano, C; Zanni, G; Angiolilli, D; Raber, M; Rigatti, P; Montorsi, F


    The increasing incidence of prostate cancer is manly due to the improvement of systematic transrectal ultrasound-guided prostate biopsy techniques. The objective of this review is to analyze the different approaches and the most common schemes used to perform prostate biopsy, the role of the anesthetic procedures, of the complementary imaging methods and the histological evaluation of the biopsy results. The actual indications to perform prostate biopsy have been also critically reviewed. We performed a review of the literature by searching Medline Database with the following key words: prostate cancer, diagnosis, trans-rectal ultrasound (TRUS), prostate biopsy, anaesthesia and prognosis. Prostate biopsy is always performed under transrectal ultrasound guidance with both transrectal and transperineal approach, with a minimal core number of 10. The extended protocols include lateral peripheral zone cores and cores from lesions found on palpation or imaging. Saturation biopsies should be performed only in case of repeat biopsies. The refinement of effective local anesthesia has allowed to increase the number of biopsies without important side effects. Complementary imaging methods might be adopted in order to reduce the number of unnecessary procedures .The histological issues related to the number and the location of cores are still matter of debate as important prognostic factors. According to international guidelines, the factors most involved in performing prostate biopsy still include suspicious digital rectal examination and PSA. Both the transrectal and the transperineal approach in prostatic biopsy are valid in term of detection rate and low incidence of side effects. The initial biopsy scheme in mainly extended, saturation biopsy has to be considered only in the repeat setting, with the eventual help of the complementary imaging methods. The histological issues has to be considered about patient's prognosis.

  18. [Non-Hodgkin's primary intestinal lymphoma - a cause of acute abdominal manifestation in children]. (United States)

    Brankov, O; Dumanov, K; Stoilov, S; Doĭnova, P; Drebov, R; Khristozova, I


    Lymphomas of the gastrointestinal tract are the most common type of primary extranodal lymphomas, accounting for 5 to 10% of all non-Hodgkin's lymphomas (NHL). From January 1996 to November 2005, 10 patients with primary intestinal lymphomas were submitted with clinical signs of acute abdomen to the Pediatric surgical department in Sofia. The children presented with radiologically proven intussusception, ileal obstruction or peritonitis due to bowel perforation. At exploration the tumor was located in the ileum in 4 cases, in the terminal ileum and coecum in 3 cases, appendix in one and multiple sites were found in 2 cases. Children with localized disease underwent radical resection of the tumor mass with ileo - transverso anastomosis (3), partial bowel resection (4), and appendectomy (1) whereas in 2 children with advanced disease diagnostic biopsy alone with temporary ileostomy in one were accomplished. According to histology, 5 patients had Burkitt lymphoma and 5 lymphoblast NHL. The children were treated according CHOP. Over five - years relapse - free survival for localized disease accounts 6 children. Primary NHL in children often presents with acute abdominal condition requiring surgical exploration. Prognosis depends of adequacy of surgical resection and the adjuvant chemotherapy.

  19. PI-RADS Version 2: Detection of Clinically Significant Cancer in Patients With Biopsy Gleason Score 6 Prostate Cancer. (United States)

    Seo, Ji Won; Shin, Su-Jin; Taik Oh, Young; Jung, Dae Chul; Cho, Nam Hoon; Choi, Young Deuk; Park, Sung Yoon


    The purpose of this study was to analyze the utility of the Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) in the detection of a clinically significant cancers in patients with prostate cancers with a biopsy Gleason score of 6. A group of 182 consecutively registered patients with biopsy-proven prostate cancer with a Gleason score of 6 underwent MRI and radical prostatectomy. Clinically significant cancer was surgically defined as Gleason score of 7 or greater, tumor volume of 0.5 cm 3 or greater, or tumor category T3 or greater. Clinical parameters (prostate-specific antigen level, greatest percentage of biopsy core, and percentage of positive cores) and the PI-RADSv2 ratings by three independent readers (experienced readers 1 and 2, inexperienced reader 3) were investigated. Cutoffs and the diagnostic performance of PI-RADSv2 for clinically significant cancer were analyzed. Clinically significant cancer was found in 87.4% (159/182) of patients. The cutoff PI-RADSv2 score for clinically significant cancer was 4 for readers 1 and 2 and 5 for reader 3. The AUCs were 0.829 and 0.853 for readers 1 and 2 (p PI-RADSv2 may help experienced readers identify clinically significant prostate cancers in patients with a biopsy Gleason score of 6. However, some small (PI-RADSv2 is used.

  20. A Case Report of Dramatically Increased Thyroglobulin after Lymph Node Biopsy in Thyroid Carcinoma after Total Thyroidectomy and Radioiodine

    Directory of Open Access Journals (Sweden)

    Mandana Moosavi


    Full Text Available Thyroglobulin (Tg is an important modality for monitoring patients with thyroid cancers, especially after thyroidectomy followed by radioiodine (RAI. It is also used as a marker for burden of thyroid tissue whether malignant or benign. Although there have been several reports of rising serum Tg transiently after thyroid biopsy in intact glands and following palpation or trauma, there are no reports in the literature of elevation in Tg after biopsy of suspicious lesions in thyroidectomized patients. In this paper we report a fascinating case of a considerable and initially worrying, although ultimately transient, rise in Tg in a patient 2 years after total thyroidectomy and RAI ablation after fine needle aspiration (FNA of a suspicious thyroid bed nodule that was proven positive.

  1. A proven knowledge-based approach to prioritizing process information (United States)

    Corsberg, Daniel R.


    Many space-related processes are highly complex systems subject to sudden, major transients. In any complex process control system, a critical aspect is rapid analysis of the changing process information. During a disturbance, this task can overwhelm humans as well as computers. Humans deal with this by applying heuristics in determining significant information. A simple, knowledge-based approach to prioritizing information is described. The approach models those heuristics that humans would use in similar circumstances. The approach described has received two patents and was implemented in the Alarm Filtering System (AFS) at the Idaho National Engineering Laboratory (INEL). AFS was first developed for application in a nuclear reactor control room. It has since been used in chemical processing applications, where it has had a significant impact on control room environments. The approach uses knowledge-based heuristics to analyze data from process instrumentation and respond to that data according to knowledge encapsulated in objects and rules. While AFS cannot perform the complete diagnosis and control task, it has proven to be extremely effective at filtering and prioritizing information. AFS was used for over two years as a first level of analysis for human diagnosticians. Given the approach's proven track record in a wide variety of practical applications, it should be useful in both ground- and space-based systems.

  2. Diagnostic Value of Guided Biopsies: Fusion and Cognitive-registration Magnetic Resonance Imaging Versus Conventional Ultrasound Biopsy of the Prostate (United States)

    Oberlin, Daniel T.; Casalino, David D.; Miller, Frank H.; Matulewicz, Richard S.; Perry, Kent T.; Nadler, Robert B.; Kundu, Shilajit; Catalona, William J.; Meeks, Joshua J.


    Objective To better assess the increased utilization of multiparametric magnetic resonance imaging (mpMRI) and fusion biopsy of the prostate, we compared prostate cancer detection rates among (a) men undergoing MR-ultrasound (US) fusion biopsy, (b) mpMRI cognitive-registration biopsy, and (c) conventional transrectal US-guided biopsy for the detection of prostate cancer. Materials and Methods We present a retrospective review of consecutive patients undergoing mpMRI of the prostate with subsequent prostate biopsy from October 2013 to September 2015. Lesions concerning for prostate cancer visualized on mpMRI were targeted with cognitive-registration or MR-US fusion biopsies. A cohort of men undergoing conventional prostate biopsy was utilized for comparison. Rates of cancer detection were compared among the 3 cohorts. Results A total of 231 patients underwent mpMRI-targeted biopsy (81 fusion, 150 cognitive). There was no difference in prostate specific antigen, mpMRI-defined Prostate Imaging Reporting and Data System score or number of lesions, or history of prostate cancer among the cohorts. The overall detection rate of cancer was significantly higher in the fusion cohort (48.1%) compared with both the cognitive (34.6% P = .04) and conventional (32.0%, P = .03) cohorts. Cancer detection rates were comparable in the MRI-cognitive and transrectal prostate US biopsy groups (34.6% vs 32%). MR fusion detected significantly more Gleason ≥7 cancer (61.5 vs 37.5%, P = .04) and significantly less Gleason 6 cancer (38.5 vs 62.5%, P = .04) compared with conventional biopsy. Conclusion Targeted biopsy of the prostate using MR-US fusion increased the cancer detection rate compared with both cognitive registration and conventional biopsy and was associated with detection of higher-grade cancer compared with conventional biopsy. PMID:26966043

  3. Terror management theory in dermatology: skin biopsy influences patient compliance. (United States)

    Kim, Jae Hwan; Kim, Joonhwan; Jung, You-Hee; Yi, Youjae; Ahn, Hyo Hyun


    A skin biopsy is one of the most frequently performed procedures in the dermatology outpatient clinic, but doctors often do not consider the cognitive impact of the biopsy procedure. Based on "terror management theory," we reasoned that a skin biopsy increases patient compliance by unconsciously stimulating mortality salience. To study this hypothesis, trust toward doctors, authoritarian personality, mood, attitude toward recommendations, and intention to accept recommendations were compared be-tween skin biopsy and non-skin biopsy groups of patients. Eighty-three patients participated in the study, and 78 responses were used for the analysis. The results showed that patients who had a skin biopsy had a more positive attitude toward doctors' recommendations and a higher intention to follow the recommendations. These effects were not moderated by the patient's own personality (patient trust and authoritarian personality). The outcome of this study implies that performing a procedure itself can subliminally influence a patient's attitude toward a doctor's recommendations.

  4. Utility of skin biopsy in management of small fiber neuropathy. (United States)

    Boruchow, Scott A; Gibbons, Christopher H


    We examined the role of skin biopsy in the evaluation and management of patients with suspected small fiber neuropathy (SFN). A retrospective chart review was performed among all patients who underwent skin biopsy for evaluation of SFN at our institution between March 2008 and March 2011. Change in management was defined as a new diagnosis or change in treatment in response to both positive and negative skin biopsies. Among 69 patients who underwent skin biopsy, 25 had pathological evidence of an SFN, and 9 had evidence of borderline SFN. Change in management or diagnosis occurred in 14 of 25 patients with definite SFN, 6 of 9 patients with borderline SFN, and 16 of 35 biopsy negative patients. Skin biopsy changed management or diagnosis in 52% of patients evaluated for a possible SFN and appears to play a valuable role in the workup of these patients. Copyright © 2013 Wiley Periodicals, Inc.

  5. Clinical predictors of non-diabetic renal disease and role of renal biopsy in diabetic patients with renal involvement: a single centre review. (United States)

    Chong, Yip-Boon; Keng, Tee-Chau; Tan, Li-Ping; Ng, Kok-Peng; Kong, Wai-Yew; Wong, Chew-Ming; Cheah, Phaik-Leng; Looi, Lai-Meng; Tan, Si-Yen


    Type 2 diabetes mellitus (T2DM) is reportedly the leading cause of end-stage renal disease (ESRD) worldwide. However, non-diabetic renal diseases (NDRD) are not uncommon among T2DM patients with renal involvement. Our study aimed to examine the prevalence of NDRD in T2DM and clinical markers for diabetic nephropathy (DN) and NDRD and to determine the role of renal biopsy in T2DM patients and its impact on clinical practice. We conducted a retrospective analysis of T2DM patients in whom renal biopsies were performed from January 2004 to March 2008 (n = 110). Biopsy results were divided into three groups: group I/pure DN (62.7%), group II/isolated NDRD (18.2%), and group III/mixed lesions (19.1%). The causes of NDRD in decreasing order of frequency were acute interstitial nephritis, glomerulonephritides, hypertensive renal disease, and acute tubular necrosis. Significant clinical markers for DN are presence of diabetic retinopathy and longer duration of diabetes. For NDRD, useful clinical markers include the presence of acute renal failure and microscopic hematuria. In the DN subgroup, Indians had significantly shorter duration of diabetes on biopsy compared with Malays and Chinese. NDRD is prevalent in T2DM patients, and given its potentially treatable nature, renal biopsy should be considered in T2DM patients with nephropathy, especially in those with atypical features.

  6. Image-guided pleural biopsy: diagnostic yield and complications

    Energy Technology Data Exchange (ETDEWEB)

    Benamore, R.E. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom)]. E-mail:; Scott, K. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom); Richards, C.J. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom); Entwisle, J.J. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom)


    Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of pleura in the biopsy, and adequacy of tissue for histological diagnosis. Results: A total of 82 patients underwent 85 image-guided pleural biopsies over a 4-year period. 80 cases were performed under CT and five under US guidance. The rate of new pneumothorax detected by chest radiography was 4.7%. No patient required a chest drain or blood transfusion to treat complications. In 10 (12%) cases, there was inadequate tissue to reach a confident histological diagnosis and in eight (9%) of these, no pleura was present. Assuming all suspicious and inadequate biopsies are treated as benign, which is the worst case scenario, image-guided pleural biopsy has a sensitivity and specificity of 76% and 100%, respectively, for the diagnosis of malignant disease. Conclusions: Image-guided pleural biopsy is a safe procedure with few associated complications and has a higher sensitivity than previously published series for reverse cutting needle biopsy in the diagnosis of malignant pleural disease.

  7. Microfabricated instrument for tissue biopsy and analysis (United States)

    Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.


    A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate.

  8. Targeted cryotherapy using disposable biopsy punches

    Directory of Open Access Journals (Sweden)

    Avitus John Raakesh Prasad


    Full Text Available Cryotherapy is a commonly used office procedure that causes destruction of tissue by cryonecrosis due to rapid freezing and thawing of cells. The limitation in treating plantar warts and deeper dermal lesions is that the freeze time should be longer to penetrate deeper, which results in collateral damage to normal skin surrounding the lesion. This results in unwanted side effects of prolonged pain, blistering and haemorrhage and increased healing time. The cone spray technique was used to reduce collateral damage, but deeper penetration is difficult to achieve. An innovative technique using disposable biopsy punches is described that ensures deeper freezing as compared to the plastic cone. The metal cutting edge of the punch enters deeper into the lesions as the liquid nitrogen is passed, sparing damage to surrounding skin.

  9. Towards the mid-infrared optical biopsy

    DEFF Research Database (Denmark)

    Seddon, Angela B.; Benson, Trevor M.; Sujecki, Slawomir


    of external cancers, mid-infrared detection of cancer-margins during external surgery for precise removal of diseased tissue, in one go during the surgery, and mid-infrared endoscopy for early diagnosis of internal cancers and their precision removal. The mid-infrared spectral region has previously lacked......, agriculture and in manufacturing and chemical processing. This work is in part supported by the European Commission: Framework Seven (FP7) Large-Scale Integrated Project MINERVA: MId-to-NEaR-infrared spectroscopy for improVed medical diAgnostics (317803; are establishing a new paradigm in mid-infrared molecular sensing, mapping and imaging to open up the mid-infrared spectral region for in vivo (i.e. in person) medical diagnostics and surgery. Thus, we are working towards the mid-infrared optical biopsy ('opsy' look at, bio the biology) in situ...

  10. Provenance Capture in Data Access and Data Manipulation Software (United States)

    West, P.; Fox, P. A.; McGuinness, D. L.; Gallagher, J. H.; Holloway, D.; Potter, N.


    There is increasing need to trace back the origins of data products, whether images or charts in a report, data obtained from a sensor on an instrument, a generated dataset referenced in a research paper, in government reports on the environment, or in a publication or poster presentation. Yet, most software applications that perform data access and manipulation keep only limited history of the data, i.e. the provenance. Imagine the following scenario: There is a figure in a report showing multiple graphs and plots related to global climate, the report is being drafted for a government agency. The graphs and plots are generated using an algorithm from an iPython Notebook, developed by a researcher who is using a particular data portal, where the algorithm pulls data from four data sets from that portal. That data is aggregated together over the time dimension, constrained to a few parameters, accessed using a particular piece of data access software, and converted from one datatype to another datatype; All the processing on the data sets was conducted by three different researchers from a public university, on a project funded by the same government agency requesting the report, with one Principal Investigator and two Co-Investigators. In this scenario, today we're lucky to get a blob of text under the figure that might say a couple things about the figure with a reference to a publication that was written a few years ago. Data citation, data publishing information, licensing information, and provenance are all lacking in the derived data products. What we really want is to be able to trace the figure all the way back to the original datasets, including what was done to those datasets; and to see information about the researchers, the project, the agency funding, the award, and the organizations collaborating on the project. In this paper we discuss the need for such information and traceback features, as well as new technologies and standards that can help us

  11. Complications of transrectal ultrasound-guided 12-core prostate biopsy: a single center experience with 2049 patients. (United States)

    Efesoy, Ozan; Bozlu, Murat; Çayan, Selahittin; Akbay, Erdem


    Currently, transrectal ultrasound-guided (TRUS) systematic prostate biopsy is the standard procedure in the diagnosis of prostate cancer. Although TRUS-guided prostate biopsy is a safe method, it is an invasive procedure that is not free from complications. In this prospective study we evaluated the complications of a TRUS-guided 12-core prostate biopsy. The study included 2049 patients undergoing transrectal ultrasound-guided 12-core prostate biopsy used in the diagnosis of prostate cancer. The indications for the prostate biopsy were abnormal digital rectal examination findings and/or an elevated serum total prostate specific antigen (PSA) level (greater than 4 ng/mL). The participants received prophylactic oral ciprofloxacin (500 mg) the night before and the morning of the biopsy, followed by 500 mg orally twice daily for 2 days. To prevent development of voiding disorders, the patients also received oral alpha blockers for 30 days starting the day before the procedure. A Fleet enema was self-administered the night before the procedure for rectal cleansing. The complications were assessed both 10 days and 1 month after the biopsy. The mean age, serum total PSA level and prostate volume of the patients were 65.4±9.6 years, 18.6±22.4 ng/mL and 51.3±22.4 cc, respectively. From these 2.042 biopsies, 596 cases (29.1%) were histopathologically diagnosed as prostate adenocarcinoma. Minor complications, such as hematuria (66.3%), hematospermia (38.8%), rectal bleeding (28.4%), mild to moderate degrees of vasovagal episodes (7.7%), and genitourinary tract infection (6.1%) were noted frequently. Major complications were rare and included urosepsis (0.5%), rectal bleeding requiring intervention (0.3%), acute urinary retention (0.3%), hematuria necessitating transfusion (0.05%), Fournier's gangrene (0.05%), and myocardial infarction (0.05%). TRUS-guided prostate biopsy is safe for diagnosing prostate cancer with few major but frequent minor complications. However

  12. Evaluation of an endoscopic liver biopsy technique in green iguanas. (United States)

    Hernandez-Divers, Stephen J; Stahl, Scott J; McBride, Michael; Stedman, Nancy L


    To establish a safe and effective endoscopic technique for collection of liver biopsy specimens from lizards by use of a 2.7-mm rigid endoscope system that is commonly available in zoologic veterinary practice. Prospective study. 11 subadult male green iguanas (Iguana iguana). Each lizard was anesthetized, and right-sided coelioscopic examination of the right liver lobe and gallbladder was performed. Three liver biopsy specimens were collected from each lizard by use of a 2.7-mm rigid endoscope and 1.7-mm (5-F) biopsy forceps. Biopsy samples were evaluated histologically for quality and crush artifact. Ten days following surgery, all iguanas were euthanatized and underwent full necropsy examination. For all 11 iguanas, the right liver lobe and gallbladder were successfully examined endoscopically, and 3 biopsy specimens of the liver were collected without complications. Mean +/- SD durations of anesthesia and surgery were 24 +/- 7 minutes and 6.8 +/- 1.0 minutes, respectively. At necropsy, there was no evidence of trauma or disease associated with the skin or muscle entry sites, liver, or any visceral structures in any iguana. All 33 biopsy specimens were considered acceptable for histologic interpretation; in most samples, the extent of crush artifact was considered minimal. By use of a 2.7-mm rigid endoscope, liver biopsy procedures can be performed safely, swiftly, and easily in green iguanas. Biopsy specimens obtained by this technique are suitable for histologic examination. For evaluation of the liver and biopsy specimen collection in lizards, endoscopy is recommended.

  13. Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

    International Nuclear Information System (INIS)

    Cakmakci, Emin; Caliskan, Kosti Can; Tabakci, Omer Naci; Tahtabasi, Mehmet; Karpat, Zeki


    Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications may occur. To evaluate the efficiency, complications, safety and clinicopathological utility of ultrasonographic-guided percutaneous liver biopsy in diffuse liver disease. In our retrospective study, we evaluated ultrasound-assisted needle biopsies that were performed in outpatients from October 2006 to July 2010. The liver biopsies were performed following one-night fasting using the tru-cut biopsy gun (18-20 gauge) after marking the best seen and hypovascular part of the liver, distant enough from the adjacent organs. A total of 1018 patients were referred to our radiology department. Most of the patients had hepatitis B (60.6%). The biopsy specimens were recorded and sent to our pathology department for histopathological examination. According to the results of our series, percutaneous liver biopsy using the tru-cut biopsy gun guided by ultrasonography can be performed safely. We resolve that routine ultrasound of the puncture site is a quick, effective and safe procedure. The complication rate is very low. The US-assisted percutaneous liver biopsy should be used for all cases

  14. Effects of percutaneous needle liver biopsy on dairy cow behaviour

    DEFF Research Database (Denmark)

    Mølgaard, Lene; Damgaard, Birthe Marie; Bjerre-Harpøth, Vibeke


    . Percutaneous needle liver biopsies (after administration of local anaesthesia (2% Procaine)) and blood samples were taken during restraining. During the control treatment, animals were restrained and blood sampled. During the biopsy procedure, cows showed increased restlessness (P = 0.008), frequency of head...... shaking (P = 0.016), and decreased rumination (P = 0.064). After biopsies, tail pressing (P = 0.016) and time spent perching (P = 0.058) increased. Time spent upright (P = 0.10) and number of leg movements (P = 0.033) increased during the night as compared to controls. Thus, liver biopsy induced...

  15. CT guided percutaneous biopsy of the cervical spine

    International Nuclear Information System (INIS)

    Yuan Huishu; Li Xuan; Liang Kunru


    To evaluate the effects of CT guided biopsy of cervical spine in clinical treatment, and discuss the technique involved, ten patients underwent percutaneous biopsy of cervical lesions under CT guidance. Anterior approach with the patient sitting and the needle passing through the mouth was done in one case; latero posterior approach with patient in lateral decubitus position in 5 cases; and lateral approach with 3 patients supine and 1 in lateral decubitus. Nine of ten patients had definitive histological diagnosis, the accuracy of biopsy was 90%, no complications were found. CT guided biopsy of cervical spine is safe and effective, with rare complications, providing important information for clinical treatment

  16. Prostate biopsy techniques and indications: when, where, and how? (United States)

    Scherr, Douglas S; Eastham, James; Ohori, Makoto; Scardino, Peter T


    Transrectal ultrasound (TRUS) and prostate biopsy have become one of the most common office-based procedures for the practicing urologist. During the past 50 years, the techniques, indications, and pathologic interpretation of prostate biopsies have evolved. The abandonment of blind finger-guided needle biopsies in favor of systematic TRUS-guided biopsies epitomizes much of this change. Similarly, the indications for prostate biopsy have become more refined. In the past, the presence of a prostatic nodule on digital rectal examination (DRE) was the primary indication for biopsy until the introduction of prostatic-specific antigen (PSA) in the 1980s and its widespread use for prostate cancer screening. Abnormalities of PSA or its derivatives now represent the most common indication for prostate biopsy. Although TRUS initially began as a tool to direct needles into various locations within the prostate, today a great deal of information can be obtained from prostate ultrasound for the discerning clinician. As such, TRUS-guided biopsy of the prostate has become an important staging and diagnostic tool for the practicing urologist. Here we review the current techniques and indications as well as pertinent pathologic and staging data obtained through TRUS and prostate biopsy. Copyright 2002 by W.B. Saunders Company

  17. A new instrument for rectal suction biopsy in the diagnosis of Hirschsprung′s disease: Triple rectal suction biopsy

    Directory of Open Access Journals (Sweden)

    Barlas Meral


    Full Text Available A new instrument for suction rectal biopsy in infants suspected of having Hirschsprung′s disease is described that can be completely dismantled, physically cleaned, lubricated, and heat sterilised. Triple rectal suction biopsy instrument with the patent application, which involves (0.5 cm diameter suction of mucosa and sub-mucosa and provides taking three different biopsies within a 2 cm distant from each other with a single shot, instead of only one or taking a full layer biopsy under general anesthesia for the diagnosis of Hirschsprung disease. As a preliminary study, in the 36 and 12 biopsy materials taken from the rabbits and children, respectively, it was found that mucosa and sub-mucosa were sufficient and in all of the cross sections, parasympathetic nerve fibers, and ganglion cells were existed. A successful biopsy was usually achieved and no complications occurred.

  18. Clinical utility of bronchoalveolar lavage and respiratory tract biopsies in diagnosis and management of suspected invasive respiratory fungal infections in children. (United States)

    Batra, Surabhi; Li, Betty; Underhill, Nicole; Maloney, Rebekah; Katz, Ben Z; Hijiya, Nobuko


    Bronchoscopy with bronchoalveolar lavage (BAL) and respiratory tract biopsies are important tools for diagnosing fungal infections in children with cancer and hematopoietic stem cell transplant (HSCT) recipients. Our objective was to evaluate the impact of BAL and respiratory tract biopsies on the management of suspected fungal infections in oncology and HSCT patients. We retrospectively reviewed the medical records of oncology and HSCT patients with possible, probable, or proven fungal infection of the respiratory tract and determined whether BAL or biopsy following computed tomography (CT) prompted a change in management. Among 101 patients (0.5-29 years of age), 24 underwent a BAL and 31 had biopsies (27 lung and 4 sinus). The remaining 46 patients had CT scans only. Of these, there were radiographic findings suggestive of a fungal infection in 38 patients (83%). Thirty of these 38 patients (79%) had a change in management. BAL provided a diagnosis in 6 of 24 patients (25%). There was a change in management in 2 of the 6 (33%). Respiratory tract biopsy provided a diagnosis in 12 of 31 patients (39%). Biopsy results led to a change in management in 4 of the 12 patients (33%). Significant postoperative morbidity attributed to biopsy occurred in 3 of 31 patients (10%); 2 patients had pneumothorax requiring chest tube and intubation and a patient had prolonged intubation. BAL and biopsy in children with an oncological diagnosis or those undergoing HSCT only infrequently lead to changes in management in the era of empiric therapy with broad-spectrum anti-fungal agents. © 2015 Wiley Periodicals, Inc.

  19. Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

    Directory of Open Access Journals (Sweden)

    Ewa Łukasiewicz


    Full Text Available Aim: The aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy. Material and methods: Fifty-five articles (original papers and reviews, half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account. Results: Pre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index. Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs. Conclusions: Microscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more

  20. Acute eosinophilic pneumonia: a case report

    International Nuclear Information System (INIS)

    Jung, Gyoo; Sik; Oh, Kyung Seung; Kim, Jong Min; Huh, Jin Do; Joh, Young Duk; Jang, Tae Won; Jung, Man Hong


    Acute eosinophilic pneumonia is one of a recently described idiopathic eosinophilic lung disease, which differs from chronic eosinophilic pneumonia. Patients with acute eosinophilic pneumonia develop acute onset of dyspnea, hypoxemia, diffuse pulmonary infiltrates and pleural effusion on chest radiograph, and show an increase in number of eosinophils in bronchoalveolar lavage fluid or lung biopsy specimen. Prompt and complete response to corticosteroid therapy without any recurrence is characteristically seen in patient with this disease. Although the etiology of acute eosinophilic pneumonia is not known, it has been suggested to be related to a hypersensitivity phenomenon to an unidentified inhaled antigen. We report four cases of acute eosinophilic pneumonia presented with acute onset of dyspnea, diffuse pulmonary infiltrates on chest radiograph, and eosinophilia in bronchoalveolar lavage fluid in previously healthy adults

  1. The provenance investigation on ancient chinese Ru porcelains by NAA

    International Nuclear Information System (INIS)

    Gao Zhengyao; Wang Jie; Chen Songhua


    The 28 samples of glazes and bodies of ancient Chinese Ru porcelains are analyzed by neutron activation. The 36 element contents in each sample are determined. The neutron activation analysis (NAA) data are analyzed by fuzzy cluster. The trend cluster diagram is obtained. The result shows that the ancient Chinese Ru porcelains were most probably from the same raw material source though they were from different time, fired in different kilns and in different colors. The near provenance relation between ancient Jun porcelain and ancient Ru porcelain is preliminarily analyzed. The two modern Ru porcelains approximate to ancient Ru porcelains, one becomes estranged from ancient Ru porcelains. Jingdezhen porcelain is unconcerned with Ru porcelains

  2. Rapidly aggravated Creutzfeldt-Jacob disease: autopsy-proven case

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seung Hyun; Kang, Hyun Koo; Yu, Hyeon; Lee, Sang Chun [Seoul Veterans Hospital, Seoul (Korea, Republic of)


    Creutzfeldt-Jakob disease (DJD) is one of the transmissible spongiform encephalopathies, which is mediated by what has been known as 'prion'. It is a rare and fatal progressive neurodegenerative disease that affects the middle and old aged. There are a number of subtypes of CJD, one of which is the sporadic type characterized by rapidly progressing clinical symptoms, including progressive dementia, myoclonic jerk, and pyramidal or extrapyramidal syndrome. Patients usually end up dying within 1 to 2 years of contacting the disease. We report an autopsy-proven case of sporadic CJD with clinical symptoms that progressed within several days, along with dramatic changes on diffusion weighted magnetic resonance images.

  3. EPR spectroscopy can help with paint pigment provenance

    International Nuclear Information System (INIS)

    Troup, G.J.; Hutton, D.R.


    Full text: The microwave magnetic spectroscopic technique EPR can be used to determine the presence of paramagnetic impurities in paint pigments, and the purity of composition regarding the main colourant. Hence EPR can help determine provenance of pigments, just as it can for gemstones. Specimens of Lapis Lazuli (synthetic, Afghanistan, Chile, Greenland) showed quite recognisably different spectra, at room temperature, in a Varian E-12 X-band spectrometer (9.1 GHz frequency). Similarly, specimens of yellow ochre, two imported into Australia, one North Australian, another 95% pure Goethite, showed recognisably different spectra. The North Australian one uniquely gave a known radiation damage signal from quartz, perhaps to be expected, given the abundance of radioactive ores in the region. Further samples have been obtained and the results from these will be reported

  4. Modelling climate change effects with provenance test data

    Energy Technology Data Exchange (ETDEWEB)

    Matyas, C. (Sopron Univ., Sopron (Hungary))


    Provenance tests of forest trees, which were originally intended to identify suitable seed sources for planting at different locations, provide valuable data for assessing the response of populations to environmental change. Environmental differences between the location of origin and the planting (test) site have been calculated by principal component analysis and termed ecological distance. Based on ecological distance values, the growth response of tree populations can be modeled as a function of the test site macroclimate. These models can then be used to predict the effects of climatic change on growth and survival. The growth response model predicts that increasing annual mean temperatures will result in accelerated growth if precipitation is sufficient, but only within the limits characteristic of the species. At the southern limits of distribution, growth and competitive ability of the species will decline, leading to successional changes. 20 refs., 4 figs., 3 tabs.

  5. Federated provenance of oceanographic research cruises: from metadata to data (United States)

    Thomas, Rob; Leadbetter, Adam; Shepherd, Adam


    The World Wide Web Consortium's Provenance Data Model and associated Semantic Web ontology (PROV-O) have created much interest in the Earth and Space Science Informatics community (Ma et al., 2014). Indeed, PROV-O has recently been posited as an upper ontology for the alignment of various data models (Cox, 2015). Similarly, PROV-O has been used as the building blocks of a data release lifecycle ontology (Leadbetter & Buck, 2015). In this presentation we show that the alignment between different local data descriptions of an oceanographic research cruise can be achieved through alignment with PROV-O and that descriptions of the funding bodies, organisations and researchers involved in a cruise and its associated data release lifecycle can be modelled within a PROV-O based environment. We show that, at a first-order, this approach is scalable by presenting results from three endpoints (the Biological and Chemical Oceanography Data Management Office at Woods Hole Oceanographic Institution, USA; the British Oceanographic Data Centre at the National Oceanography Centre, UK; and the Marine Institute, Ireland). Current advances in ontology engineering, provide pathways to resolving reasoning issues from varying perspectives on implementing PROV-O. This includes the use of the Information Object design pattern where such edge cases as research cruise scheduling efforts are considered. PROV-O describes only things which have happened, but the Information Object design pattern allows for the description of planned research cruises through its statement that the local data description is not the the entity itself (in this case the planned research cruise) and therefore the local data description itself can be described using the PROV-O model. In particular, we present the use of the data lifecycle ontology to show the connection between research cruise activities and their associated datasets, and the publication of those data sets online with Digital Object Identifiers and

  6. Functional Requirements for Information Resource Provenance on the Web

    Energy Technology Data Exchange (ETDEWEB)

    McCusker, James P.; Lebo, Timothy; Graves, Alvaro; Difranzo, Dominic; Pinheiro da Silva, Paulo; McGuinness, Deborah L.


    We provide a means to formally explain the relationship between HTTP URLs and the representations returned when they are requested. According to existing World Wide Web architecture, the URL serves as an identier for a semiotic referent while the document returned via HTTP serves as a representation of the same referent. This begins with two sides of a semiotic triangle; the third side is the relationship between the URL and the representation received. We complete this description by extending the library science resource model Functional Requirements for Bibliographic Resources (FRBR) with cryptographic message and content digests to create a Functional Requirements for Information Resources (FRIR). We show how applying the FRIR model to HTTP GET and POST transactions disambiguates the many relationships between a given URL and all representations received from its request, provides fine-grained explanations that are complementary to existing explanations of web resources, and integrates easily into the emerging W3C provenance standard.

  7. A global renewable mix with proven technologies and common materials

    International Nuclear Information System (INIS)

    García-Olivares, Antonio; Ballabrera-Poy, Joaquim; García-Ladona, Emili; Turiel, Antonio


    A global alternative mix to fossil fuels is proposed, based on proven renewable energy technologies that do not use scarce materials. The mix consists of a combination of onshore and offshore wind turbines, concentrating solar power stations, hydroelectricity and wave power devices attached to the offshore turbines. Solar photovoltaic power could contribute to the mix if its dependence on scarce materials is solved. The most adequate deployment areas for the power stations are studied, as well as the required space. Material requirements are studied for the generation, power transport and for some future transport systems. The order of magnitude of copper, aluminium, neodymium, lithium, nickel, zinc and platinum that may be required for the proposed solution is obtained and compared with available reserves. Overall, the proposed global alternative to fossil fuels seems technically feasible. However, lithium, nickel and platinum could become limiting materials for future vehicles fleet if no global recycling systems were implemented and rechargeable zinc–air batteries would not be developed; 60% of the current copper reserves would have to be employed in the implementation of the proposed solution. Altogether, they may become a long-term physical constraint, preventing the continuation of the usual exponential growth of energy consumption. - Highlights: ▶ A global renewable mix with proven energy technologies and common materials. ▶ Wind turbines, concentrating solar power, hydroelectricity and wave attenuators. ▶ Mix technically feasible. Lithium, nickel and platinum may limit vehicles fleet. ▶ Sixty per cent of copper reserves used in the mix and in societal electrification. ▶ Power cannot growth exponentially. Future “spaceship economy” scenario expected.

  8. Evolving provenance in the Proterozoic Pranhita-Godavari Basin, India

    Directory of Open Access Journals (Sweden)

    Udeni Amarasinghe


    Full Text Available The Pranhita-Godavari Basin in central eastern India is one of the Proterozoic “Purāna” basins of cratonic India. New geochronology demonstrates that it has a vast depositional history of repeated basin reactivation from the Palaeoproterozoic to the Mesozoic. U-Pb laser ablation inductively coupled plasma mass spectrometry dating of detrital zircons from two samples of the Somanpalli Group—a member of the oldest sedimentary cycle in the valley—constrains its depositional age to ∼1620 Ma and demonstrates a tripartite age provenance with peaks at ∼3500 Ma, ∼2480 Ma and ∼1620 Ma, with minor age peaks in the Eoarchaean (∼3.8 Ga and at ∼2750 Ma. These ages are consistent with palaeocurrent data suggesting a southerly source from the Krishna Province and Enderby Land in East Antarctica. The similarity in the maximum depositional age with previously published authigenic glauconite ages suggest that the origin of the Pranhita-Godvari Graben originated as a rift that formed at a high angle to the coeval evolving late Meosproterozoic Krishna Province as Enderby Land collided with the Dharwar craton of India. In contrast, detrital zircons from the Cycle III Sullavai Group red sandstones yielded a maximum depositional age of 970 ± 20 Ma and had age peaks of ∼2550 Ma, ∼1600 Ma and then a number of Mesoproterozoic detrital zircons terminating in three analyses at ∼970 Ma. The provenance of these is again consistent with a southerly source from the Eastern Ghats Orogen and Antarctica. Later cycles of deposition include the overlying Albaka/Usur Formations and finally the late Palaeozoic to Mesozoic Gondwana Supergroup.

  9. ASDF: An Adaptable Seismic Data Format with Full Provenance (United States)

    Smith, J. A.; Krischer, L.; Tromp, J.; Lefebvre, M. P.


    In order for seismologists to maximize their knowledge of how the Earth works, they must extract the maximum amount of useful information from all recorded seismic data available for their research. This requires assimilating large sets of waveform data, keeping track of vast amounts of metadata, using validated standards for quality control, and automating the workflow in a careful and efficient manner. In addition, there is a growing gap between CPU/GPU speeds and disk access speeds that leads to an I/O bottleneck in seismic workflows. This is made even worse by existing seismic data formats that were not designed for performance and are limited to a few fixed headers for storing metadata.The Adaptable Seismic Data Format (ASDF) is a new data format for seismology that solves the problems with existing seismic data formats and integrates full provenance into the definition. ASDF is a self-describing format that features parallel I/O using the parallel HDF5 library. This makes it a great choice for use on HPC clusters. The format integrates the standards QuakeML for seismic sources and StationXML for receivers. ASDF is suitable for storing earthquake data sets, where all waveforms for a single earthquake are stored in a one file, ambient noise cross-correlations, and adjoint sources. The format comes with a user-friendly Python reader and writer that gives seismologists access to a full set of Python tools for seismology. There is also a faster C/Fortran library for integrating ASDF into performance-focused numerical wave solvers, such as SPECFEM3D_GLOBE. Finally, a GUI tool designed for visually exploring the format exists that provides a flexible interface for both research and educational applications. ASDF is a new seismic data format that offers seismologists high-performance parallel processing, organized and validated contents, and full provenance tracking for automated seismological workflows.

  10. Species choice, provenance and species trials among native Brazilian species

    Energy Technology Data Exchange (ETDEWEB)

    Drumond, M.A.


    Six papers from the conference are presented. Drumond, M.A., Potential of species native to the semi-arid tropics, 766-781, (Refs. 18), reports on Anadenanthera macrocarpa, Mimosa species, Schinopsis brasiliensis, Spondias tuberosa, Ziziphus joazeiro, Cnidoscolus phyllacanthus, Bursera leptophleos (leptophloeos), Tabebuia impetiginosa, Astronium urundeuva, and Mimosa caesalpinia. Monteiro, R.F.R., Speltz, R.M., Gurgel, J.T. do A.; Silvicultural performance of 24 provenances of Araucaria angustifolia in Parana, 814-824, (Refs. 8). Pires, C.L. da S., Kalil Filho, A.N., Rosa, P.R.F. da, Parente, P.R., Zanatto, A.C.S.; Provenance trials of Cordia alliodora in the State of Sao Paulo, 988-995, (Refs. 9). Nogueira, J.C.B., Siqueira, A.C.M.F., Garrido, M.A.O., Gurgel Garrido, L.M. do A., Rosa, P.R.F., Moraes, J.L. de, Zandarin, M.A., Gurgel Filho, O.A., Trials of some native species in various regions of the State of Sao Paulo, 1051-1063, (Refs. 9) describes Centrolobium tomentosum, Peltophorum dubium, Tabebuia vellosoi, Cariniana legalis, and Balfourodendron riedelianum. Batista, M.P., Borges, J.F., Franco, M.A.B.; Early growth of a native species in comparison with exotics in northeastern Para, Brazil, 1105-1110, (Refs. 3). Jacaranda copaia is compared with Gmelina arborea, Pinus caribaea various hondurensis, Eucalyptus deglupta, and E. urophylla. Lima, P.C.F., Souza, S.M. de, Drumond, M.A.; Trials of native forest species at Petrolina, Pernambuco, 1139-1148, (Refs. 8), deals with Anadenanthera macrocarpa, Piptadenia obliqua, Pithecellobium foliolosum, Astronium urundeuva, Schinopsis brasiliensis, Cassia excelsa, Caesalpinia pyramidalis, Parkia platycephala, Pseudobombax simplicifolium, Tabebuia impetiginosa, Caesalpinia ferrea, and Aspidosperma pyrifolium. 18 references.

  11. Prediction of acute cardiac rejection using radionuclide techniques

    International Nuclear Information System (INIS)

    Novitzky, D.; Bonioszczuk, J.; Cooper, D.K.C.; Isaacs, S.; Rose, A.G.; Smith, J.A.; Uys, C.J.; Barnard, C.N.; Fraser, R.


    Radionuclide scanning of the donor left ventricle using technetium-99m-labelled red cells was used to monitor acute rejection after heterotopic heart transplantation and compared with histopathological evidence of rejection obtained at examination of an endomyocardial biopsy specimen. The ejection fraction and end-diastolic, end-systolic and stroke volumes were calculated at each examination; an equation was derived from these data to predict the degree of acute rejection, using histopathological examination of endomyocardial biopsy specimens as criteria of the presence and severity of rejection. A highly significant multiple correlation between radionuclide scanning parameters and endomyocardial biopsy was found. The advantages of non-invasive radionuclide scanning over the invasive procedure of endomyocardial biopsy are discussed

  12. A methodology for automated CPA extraction using liver biopsy image analysis and machine learning techniques. (United States)

    Tsipouras, Markos G; Giannakeas, Nikolaos; Tzallas, Alexandros T; Tsianou, Zoe E; Manousou, Pinelopi; Hall, Andrew; Tsoulos, Ioannis; Tsianos, Epameinondas


    Collagen proportional area (CPA) extraction in liver biopsy images provides the degree of fibrosis expansion in liver tissue, which is the most characteristic histological alteration in hepatitis C virus (HCV). Assessment of the fibrotic tissue is currently based on semiquantitative staging scores such as Ishak and Metavir. Since its introduction as a fibrotic tissue assessment technique, CPA calculation based on image analysis techniques has proven to be more accurate than semiquantitative scores. However, CPA has yet to reach everyday clinical practice, since the lack of standardized and robust methods for computerized image analysis for CPA assessment have proven to be a major limitation. The current work introduces a three-stage fully automated methodology for CPA extraction based on machine learning techniques. Specifically, clustering algorithms have been employed for background-tissue separation, as well as for fibrosis detection in liver tissue regions, in the first and the third stage of the methodology, respectively. Due to the existence of several types of tissue regions in the image (such as blood clots, muscle tissue, structural collagen, etc.), classification algorithms have been employed to identify liver tissue regions and exclude all other non-liver tissue regions from CPA computation. For the evaluation of the methodology, 79 liver biopsy images have been employed, obtaining 1.31% mean absolute CPA error, with 0.923 concordance correlation coefficient. The proposed methodology is designed to (i) avoid manual threshold-based and region selection processes, widely used in similar approaches presented in the literature, and (ii) minimize CPA calculation time. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Renal biopsy in paroxysmal nocturnal hemoglobinuria: An insight into the spectrum of morphologic changes

    Directory of Open Access Journals (Sweden)

    V Puri


    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, acquired, potentially life-threatening disease of blood, characterized by complement-induced intravascular hemolytic anemia and thrombosis. PNH can sometimes present directly with renal manifestations, without showing any hematological manifestation. It, therefore, becomes essential for clinicians and pathologists to be aware of the spectrum of renal changes in PNH. The aim of this study was to document the morphologic changes observed in renal biopsies in patients with PNH. This is an observational study. We report three cases that presented with acute or chronic renal insufficiency and were suspected as PNH on viewing their renal biopsy in light of their clinical and laboratory details. All the three cases were confirmed as PNH on the basis of flow cytometric analysis of CD55 and CD59. Renal biopsy in these patients showed a variety of morphologic changes, however the most consistent finding was moderate-to-heavy siderosis in their kidneys. PNH per se may be difficult to diagnose clinically and sometimes present directly with renal manifestations. It is, therefore, prudent for nephrologists and nephropathologists to be aware of the spectrum of renal changes in PNH.

  14. An evaluation of patient experience during percutaneous breast biopsy. (United States)

    Seely, Jean M; Hill, Fraser; Peddle, Susan; Lau, Jackie


    Percutaneous breast biopsy in a tertiary referral high volume breast centre: can we improve the patient experience? The study was performed to evaluate patient experience during ultrasound-guided (UGB) and vacuum-assisted stereotactic breast biopsy (SBB) and determine what factors could improve the patient experience. Consecutive patients who underwent image guided breast biopsy from 01- 05/30, 2015 were approached in a structured telephone interview to evaluate pain and bruising from the procedure. Three hundred and fifty-one patients were interviewed (116 SBB and 235 UGB). Information about the radiologist performing the biopsy, biopsy type, needle gauge, and number of cores was collected from the biopsy reports. Correlation was done using Spearman rank test. Average patient scores of pain with UGB and SBB were 2.3 and 3.1 (out of 10). There was a significant correlation between pain during SBB and physician experience (p = 0.013), and no correlation with pain during UGB (p > 0.05). No correlation was found between needle gauge and pain experienced during breast biopsy or between numbers of cores and pain (p > 0.05). Body position during SBB was mentioned to cause discomfort and pain in 28% of patients while during UGB was mentioned by 0.4% of patients. SBB was inferior to UGB for patient experience, but years of radiologists' experience correlated with improved patient scores of pain for SBB. • To achieve high quality, an institution must emphasise patient-centred care. • Increased radiologist training with stereotactic biopsy may contribute to improved patient experience. • Stereotactic breast biopsy was inferior to ultrasound biopsy for patient experience. • Radiologists' experience correlated with improved patient scores of pain for stereotactic biopsy.


    Directory of Open Access Journals (Sweden)

    Aljosa Mandic


    Full Text Available Introduction: A definitive diagnosis of cervical intraepithelial neoplasia (CIN is confirmed after histopathological (HP examination of the tissue obtained through the biopsy. The aim of this study was to compare histopathological results obtained with punch biopsy and results obtained through one of the excisional techniques. Material and methods: We analysed histology results of 130 patients referred to our institution with abnormal smear. Punch biopsy was performed after colposcopic examination in all patients before one of the excision methods. Excision methods performed were: large loop excision of transformation zone (LLETZ, radio-frequency knife conisation or cold knife conisation. Based on the histopathological examination of the punch biopsy specimen or excisional specimen diagnosis of CIN was established. Results: CIN and invasive cancer were the most common diagnoses in the 31–40 age group at 45.4% (59/130. Discrepancies in the histological diagnosis between punch biopsy and excisional biopsy was identified in 58.5% (76/130 of the patients. In 6% of the of the cases the biopsy did not detect an invasive carcinoma. Conclusion: The most frequent discrepancies between punch biopsy and excisional biopsy were in the group of patients with a higher grade cervical dysplasia. Mild dysplastic changes diagnosed through punch biopsy, require a more conservative approach, as the majority of this group had negative specimens on the cone after excision, especially in the younger population. It is advisable that the patients above 30 years of age and a higher grade dysplasia in the biopsy specimen, should undergo one of the excisional techniques as a diagnostic/therapeutic method of treatment.

  16. Prostate atypia: does repeat biopsy detect clinically significant prostate cancer? (United States)

    Dorin, Ryan P; Wiener, Scott; Harris, Cory D; Wagner, Joseph R


    While the treatment pathway in response to benign or malignant prostate biopsies is well established, there is uncertainty regarding the risk of subsequently diagnosing prostate cancer when an initial diagnosis of prostate atypia is made. As such, we investigated the likelihood of a repeat biopsy diagnosing prostate cancer (PCa) in patients in which an initial biopsy diagnosed prostate atypia. We reviewed our prospectively maintained prostate biopsy database to identify patients who underwent a repeat prostate biopsy within one year of atypia (atypical small acinar proliferation; ASAP) diagnosis between November 1987 and March 2011. Patients with a history of PCa were excluded. Chart review identified patients who underwent radical prostatectomy (RP), radiotherapy (RT), or active surveillance (AS). For some analyses, patients were divided into two subgroups based on their date of service. Ten thousand seven hundred and twenty patients underwent 13,595 biopsies during November 1987-March 2011. Five hundred and sixty seven patients (5.3%) had ASAP on initial biopsy, and 287 (50.1%) of these patients underwent a repeat biopsy within one year. Of these, 122 (42.5%) were negative, 44 (15.3%) had atypia, 19 (6.6%) had prostatic intraepithelial neoplasia, and 102 (35.6%) contained PCa. Using modified Epstein's criteria, 27/53 (51%) patients with PCa on repeat biopsy were determined to have clinically significant tumors. 37 (36.3%) proceeded to RP, 25 (24.5%) underwent RT, and 40 (39.2%) received no immediate treatment. In patients who underwent surgery, Gleason grade on final pathology was upgraded in 11 (35.5%), and downgraded 1 (3.2%) patient. ASAP on initial biopsy was associated with a significant risk of PCa on repeat biopsy in patients who subsequently underwent definitive local therapy. Patients with ASAP should be counseled on the probability of harboring both clinically significant and insignificant prostate cancer. © 2015 Wiley Periodicals, Inc.

  17. Analysis of histopathological pattern of kidney biopsy specimens in Kuwait: A single-center, five-year prospective study

    Directory of Open Access Journals (Sweden)

    Emad Abdallah


    Full Text Available Glomerulonephritis (GN varies in incidence in different geographical areas due to different socioeconomic conditions and ethnicity, genetic variability and environmental factors. Our study is aimed to determine the histopathological pattern of kidney biopsies in Kuwait over the preceding five years. In a prospective study, we analyzed the clinical and pathological data of 214 kidney biopsies that were performed during the period from November 2009 to November 2014 at the Al-Khezam Dialysis Center, Al-Adan Hospital, Kuwait. Kidney biopsies were performed percutaneously using an automated gun guided by ultrasound. The biopsy samples were processed for light microscopy and immunofluorescence. Electron microscopy was performed only in selected cases. Age, gender, serum creatinine, 24-h urinary protein, virology, immunology profiles, indication for renal biopsy and histopathological findings were recorded for analysis. Primary GN was reported in 46.7%, secondary GN was reported in 42.9% and tubulointerstitial disease was reported in 10.3% of the 214 kidney biopsies studied. Among primary GN, membranous GN (MGN was the most common lesion (12.1%, followed by immunoglobulin A nephropathy (IgAN, 11.7%, minimal change disease (9.8%, focal and segmental glomerulosclerosis (9.3%, membranoproliferative GN (1.9%, Alport′s syndrome (1.4% and fibrillary GN (0.46%. Among biopsies that showed secondary GN, lupus nephritis was the most common (11.7%, followed by hypertensive glomerulosclerosis (10.3%, crescentic GN (7.1%, diabetic nephropathy (3.3%, thrombotic microangiopathy (2.3%, amyloidosis (2.3%, post-infectious GN (1.4% and myeloma kidney (0.9%. Among biopsies that showed tubulointerstitial disease, acute interstitial nephritis was the most common lesion (6.1%, followed by chronic interstitial nephritis (2.8% and acute tubular necrosis (1.4%. Our study indicates that MGN was the most common primary GN, followed by IgAN, while lupus nephritis was the most

  18. Acute Bronchitis (United States)

    ... Table of Contents1. Overview2. Symptoms3. Diagnosis4. Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is acute bronchitis? Acute ... heartburn, you can get acute bronchitis when stomach acid gets into the bronchial tree. How is acute ...

  19. Case Report: Acute disseminated encephalomyelitis in two Nigerian ...

    African Journals Online (AJOL)

    We report two children from the South-western part of Nigeria with blood culture proven typhoid fever who developed encephalopathy and acute cerebellar syndrome due to acute disseminated encephalomyelitis (ADEM). In this report, we discussed the symptomatology and management of post-Salmonella disseminated ...

  20. Morphological pattern of endometrial biopsies in southwestern Nigeria

    African Journals Online (AJOL)

    Background: Endometrium remains the most sensitive indicator of ovarian function and endometrial biopsy is one of the diagnostic procedures in endometrial pathology. The current study was carried out to examine the morphological pattern of endometrial biopsies in Ibadan, South-western Nigeria and compare the results ...

  1. Biopsying southern right whales : Their reactions and effects on reproduction

    NARCIS (Netherlands)

    Best, PB; Reeb, D; Rew, MB; Palsboll, PJ; Schaeff, C; Brandao, A

    Collecting skin biopsies from large whales for genetic analysis is often subject to national permit, and in the case of cow-calf pairs, it may be prohibited. We present results of 906 biopsy attempts on southern fight whales (Eubalaena australis) in South African waters between 1995 and 1997,

  2. Histopathological of lymph node biopsies in Lagos, South West ...

    African Journals Online (AJOL)

    The demographic data regarding age, sex, provisional diagnosis and site of biopsy were obtained from request forms. The data were analysed using the Statistical Package for Social Science version 21. There were 123 lymph node biopsies seen during the study period with age range of 1- 78 years and male to female ...

  3. Testicular Biopsies of Azoospermic Men at The Lagos State ...

    African Journals Online (AJOL)

    Patients and Methods: A retrospective study of testicular biopsies of azoospermic men who presented to our institution from 2005 to 2006 was performed. The patient's age, type of infertility and histopathological diagnosis were evaluted. All biopsies were preserved in 10% formaldehyde solution. Results: Of the 51 ...

  4. Morphological Pattern of Testicular Biopsies in Zaria, Nigeria ...

    African Journals Online (AJOL)

    Result: Testicular biopsies of eighty eight infertile men were examined and most biopsies were from the 35 – 39 years age group in 65.9% of cases. Hypospermatogenesis accounted for 68.2% of patients, while 11.4% had normal morphology. Granulomatous and non-specific orchitis were not uncommon. Conclusion: This ...

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

    African Journals Online (AJOL)

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

  6. Sentinel lymph node biopsy in breast cancer and melanoma

    NARCIS (Netherlands)

    Doting, Meintje Hylkje Edwina


    Summary and conclusions In the introduction, a short overview of the development of the sentinel lymph node biopsy concept is presented. In addition to melanoma and breast cancer, the usefulness of sentinel lymph node biopsy as a surgical assessment method for squamous cell carcinoma of penis and

  7. Magnetic resonance imaging guided biopsy of musculoskeletal lesions

    Directory of Open Access Journals (Sweden)

    Hung-Ta H. Wu


    Conclusion: Biopsy under MRI guidance is especially valuable for the localization of bone marrow lesions, viable tumors (after chemotherapy or radiation, and lesions that cannot be visualized using CT. It is both accurate and safe, is a good alternative biopsy method, and may be a good adjunctive technique for the localization of bone lesions for radiofrequency ablation or other interventional procedures.

  8. Results of prostatic biopsies in Algerian patients with an elevated ...

    African Journals Online (AJOL)

    Objective: to report on prostatic biopsy results in Algerian patients presenting with a suspicious Digital Rectal Examination (DRE) and\\or an elevated total PSA. Methods: data collected on prepared index cards were age, result of DRE, rate of PSA and number of cores, as well as the histological result. The biopsies were ...

  9. Role of Ultrasound Guided Biopsy of Thoracic Lesions | Elameen ...

    African Journals Online (AJOL)

    Objective: This prospective study is to evaluate and enhance the role of ultrasound in biopsy guidance of thoracic lesions. Methods: 55 patients were subjected for fine needle aspiration (FNA) and/or core needle biopsy (CNB) from peripheral chest lesions in Ribat University Hospital during the period from April 2011 and ...

  10. Sensitivity of Computed Tomography‑guided Transthoracic Biopsies ...

    African Journals Online (AJOL)


    Mar 5, 2018 ... Introduction: The indications for open biopsies for intrathoracic lesions have become almost negligible. This development was made possible by less invasive maneuvers such as computed tomography‑guided (CT‑guided) biopsy, thoracoscopy or video‑assisted thoracoscopy, and bronchoscopy.

  11. CT guided percutaneous needle biopsy of the chest: initial experience

    African Journals Online (AJOL)

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

  12. CT‑guided percutaneous transthoracic lung biopsy: First experience ...

    African Journals Online (AJOL)

    Percutaneous lung biopsy had been described in the nineteenth century by Leyden, but image- guided needle chest biopsy only gained widespread acceptance in the 1970s. Currently, tissue sampling of a thoracic lesion is indicated when the diagnosis cannot be obtained by the non-invasive techniques and cytological ...

  13. Sensitivity of Computed Tomography‑guided Transthoracic Biopsies ...

    African Journals Online (AJOL)

    Introduction: The indications for open biopsies for intrathoracic lesions have become almost negligible. This development was made possible by less invasive maneuvers such as computed tomography‑guided (CT‑guided) biopsy, thoracoscopy or video‑assisted thoracoscopy, and bronchoscopy. CT‑guided percutaneous ...

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

    African Journals Online (AJOL)

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

  15. Percutaneous core needle biopsies: The yield in spinal tuberculosis ...

    African Journals Online (AJOL)

    Background. Current recommendations for spinal tuberculosis (TB) not requiring open surgery include core needle biopsy to confirm TB and determine drug sensitivity. International figures show the positive culture yield from core needle biopsies is 50 - 83%. Objectives. To (i) assess the yield of percutaneous needle ...

  16. Duodenal versus jejunal biopsies in suspected celiac disease

    NARCIS (Netherlands)

    Thijs, WJ; van Baarlen, J; Kleibeuker, JH; Kolkman, JJ


    Background and Study Aims: In the past, small-bowel biopsies for diagnosis of celiac disease were taken from the jejunum with a suction capsule, but nowadays most physicians take endoscopic biopsies from the distal duodenum. To validate that practice we compared the diagnostic yield of endoscopic

  17. Provenance and sediment fluxes in the Irrawaddy (Ayeyarwadi) River (United States)

    Garzanti, Eduardo; Wang, Jiangang; Vezzoli, Giovanni; Limonta, Mara


    The Irrawaddy (Ayeyarwadi) River, still a natural system scarcely affected by human activities, ranks among the five major rivers in the world for its annual suspended load, estimated as 364±60 million tons (Robinson et al., 2007). Sourced in Himalayan glaciers southeast of the eastern Himalayan syntaxis at ca. 28°N, the Irrawaddy originates from the confluence of the Nmai and Mali Rivers, flows southward to receive its major Chindwin tributary in the middle of the central Myanmar Basin, and eventually empties through a nine-armed delta into the Andaman Sea. The compositional fingerprint of bedload sand in the upper Irrawaddy is characterized by common feldspars, medium/high rank of metamorphic rock fragments and high heavy-mineral concentration, reflecting provenance from mid-crustal granitoids, amphibolite-facies and subordinately greenschist-facies rocks widely exposed in the Mogok Belt and Lohit Plutonic Complex. Minor volcanic/metavolcanic and serpentinite grains indicate additional supply from volcanic-arc remnants and the Neotethyan ophiolitic suture. Sand of the Chindwin River has much higher quartz/feldspar ratio and much lower metamorphic indices and heavy-mineral concentration, reflecting provenance mainly from upper crustal sedimentary and very low-grade metasedimentary rocks exposed in the Indo-Burman Ranges (Garzanti et al., 2013). Feldspatho-litho-quartzose to litho-feldspatho-quartzose composition in the lower Irrawaddy is intermediate between that of Chindwin and upper Irrawaddy sand. The slight progressive downstream increase in volcanic rock fragments and chert, and decrease in metamorphic indices, point to additional local supply from volcanic and sedimentary cover rocks. U-Pb age spectra of detrital zircons are characterized by a major cluster between 30 and 150 Ma, corresponding to the long-lasting magmatic activity of the Western Myanmar Arc (Wang et al., 2014), with other clusters at 500-600 Ma and 800-1200 Ma, and a few ages between 1

  18. Spice-y Kidney Failure: A Case Report and Systematic Review of Acute Kidney Injury Attributable to the Use of Synthetic Cannabis. (United States)

    Zarifi, Ceyda; Vyas, Shuchi


    Spice is a synthetic cannabinoid that is readily available for purchase in smoke shops at relatively low cost. Spice is not detectable upon routine drug screening, making it an increasingly popular new street drug. A 21-year-old man presented with new-onset seizures. During the next 2 days, he developed uncontrollable hypertension, agitation, respiratory failure requiring intubation, pulmonary hypertension, and acute kidney injury (AKI) with a maximum blood urea nitrogen/creatinine level of 54/7.90 mg/dL. A complete renal workup was negative, but his urine sediment revealed granular casts. A discussion with family and friends revealed that this patient had smoked Spice during the last month. His renal function started to improve with supportive therapy, and his AKI resolved by the time of discharge without renal replacement therapy. Spice differs from marijuana because it is a cannabinoid receptor type 1 and 2 agonist. The pathologic mechanism of AKI remains unclear, but the condition likely is attributable to acute tubular necrosis or acute interstitial nephritis, as proven by biopsies performed in previous case series. It is important to raise awareness that a new Spice strain that may be circulating in the Southern California Inland Empire can endanger young users who may develop seizures, respiratory failure, and AKI.

  19. Aspiration biopsy of testis: another method for histologic examination

    International Nuclear Information System (INIS)

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.


    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective

  20. Painful percutaneous transthoracic needle biopsy of Schwannoma: a case report

    International Nuclear Information System (INIS)

    Kim, Sung Hoon; Chun, Kyung Ah; Kim, Young Joo; Park, Seog Hee; Shin, Kyung Sub; Lee, Eun Jung


    Percutaneous aspiration needle biopsy of the intrathoracic disease is a safe, easy, and accurate diagnostic method. It usually causes mild pain or discomfort during the procedure. We had a patient who complained of severe sharp pain, well localized at the biopsy site of the target mass during CT-guided transthoracic aspiration biopsy. It was pathologically confirmed as an intrathoracic schwannoma after special staining. To our knowledge, there has been no published report of such a painful percutaneous needle biopsy in a patient with schwannoma in Korea. Two cases were reported in other radiologic journals. The severe sharp pain developed during the transthoracic aspiration needle biopsy is a reliable sign of neurogenic tumor, therefore the participating radiologist should recommend specific immumochemical stain for neurogenic tumor to pathologist

  1. Sampling variability of percutaneous liver biopsy in primary sclerosing cholangitis. (United States)

    Olsson, R; Hägerstrand, I; Broomé, U; Danielsson, A; Järnerot, G; Lööf, L; Prytz, H; Rydén, B O; Wallerstedt, S


    AIMS--To study sampling variability of percutaneous liver biopsy in primary sclerosing cholangitis (PSC). METHODS--One hundred and twelve biopsy specimens (that is, 56 pairs) from 44 patients with PSC, confirmed by cholangiography, were evaluated blindly. Six different features, qualitative grading of four other features and staging according to Ludwig were assessed. RESULTS--Quantitative sampling variability was confined mainly to just one grade or stage, although 11% (six of 56) of the biopsy specimen pairs differed by more than one stage (7% (one of 15) in pairs > 2 cm in length). Qualitative sampling variabilities were between 18 and 71%. Advanced disease (stages 3 or 4) was missed in 40% (two of five) of the biopsy specimens while cirrhosis was missed in 37%. CONCLUSION--Paired liver biopsy specimens should be taken in clinical studies of PSC using liver histology for evaluation or prognosis. PMID:8537493

  2. Isotopic evidences for provenances of east asian dust

    International Nuclear Information System (INIS)

    Yang Jiedong; Chen Jun; Li Gaojun; Ji Junfeng; Rao Wenbo


    Based on systematical investigations on Nd-Sr isotopes of both the <75μm and <5μm silicate fractions of loess, sand, river and lacustrine sediment samples for ten major deserts, gobi, the Loess Plateau, and the northeast part of the Tibetan-Qinghai Plateau, the following results are obtained. (1) Three isotopic regions of Chinese deserts are identified. Region A (Aland A2), which is the deserts on the northern boundary of China with the highest ε Nd (0)>-7.0. Region B, which is the deserts on the northern margin of Tibetan Plateau with ε Nd (0) ranges form -11.9 to -7.4. Region C, which is the deserts on the Ordos Plateau with the lowest ε nd (0)<-11.5. The distribution of the three isotopic regions is controlled by the tectonic setting in North China. (2) The reliable isotope ranges of the Loess Plateau are 87 Sr/ 86 Sr from 0.71784 to 0.71944, ε Nd (0) from -9.2 to -11.3, which fall in Region B of the Qaiham Desert, Badain Jaran Desert and Tengger Desert. This indicates that the possibility of the Gurbantunggut Desert, Hunlun Buir sandy land, Onqin Daga sandy land, Horqin sandy land, the Hobq Desert and Mu Us Desert, as provenances for the loess are excluded. The isotopic range of the northeast part of the Tibetan-Qinghai Plateau coincides with those of the Badain Jaran Desert and Tengger Desert, and loess in the Loess Plateau, suggesting that the predominant source area of the Loess Plateau is most likely to be the northeast part of the Tibetan-Qinghai Plateau, and the Qaidam Desert, Badain Jaran Desert and Tengger Desert are middle transport stations of loess materials. (3) The comparison with isotopic data of dust extracted from snow deposits at Greenland and sediments of North Pacific confirms the Badain Jaran Desert, Tengger Desert and the Tibetan-Qinghai Plateau to be main source. (4) The analyzed results for dust samples in Beijing region demonstrate that aeolian dust in normal time in 2006 is mostly derived from mixing of Region B and bed rock soil

  3. Geochemical Signatures as a Tool for Vermiculite Provenance Determination

    Energy Technology Data Exchange (ETDEWEB)

    Karen E. Wright; Carl D. Palmer


    Thirty-eight samples of known origin (China, Libby MT, South Africa, South Carolina) and 6 vermiculite product samples of unknown origin were analyzed for major and trace elements, including rare earth elements to determine the feasibility of distinguishing the provenance of the samples based upon a geochemical signature. Probability plots suggest that two of the four groups (Libby, South Carolina) were comprised of two subgroups. Results of hierarchical cluster analysis are highly sensitive to the linkage method chosen. Ward’s method is the most useful for this data and suggests that there are five groups within the data set (South African samples, two subsets of the Libby samples, a subset of the South Carolina samples, and a second subset of the South Carolina samples combined with the China samples). Similar results were obtained using k-cluster analysis. Neither clustering method was able to distinguish samples from China from the South Carolina samples. Discriminant analysis was used on a four-category model comprised of the original four groups and on a six-category model comprised of the five categories identified from the cluster analysis but with the China samples grouped into a sixth category. The discriminant/classification model was able to distinguish all of the groups including the China samples from one another for both the four- and six-category models with 100% of the samples properly classified. The 6 unknown product samples were classified with a probability of consistency of 99%. Both discriminant models were also run with a subset of our analyte set to be consistent with the smaller Gunter et al., (2005) analyte set. Twenty vermiculite samples (nine of known origin and eleven of unknown origin) from their study were classified based on our discriminant models with the reduced set of analytes. Of the twenty samples, Gunter et al. (2005) was able to classify 16 with cluster analysis while our 4-category discriminant analysis model allowed us

  4. Renal graft survival according to Banff 2013 classification in indication biopsies. (United States)

    Arias-Cabrales, Carlos; Redondo-Pachón, Dolores; Pérez-Sáez, María José; Gimeno, Javier; Sánchez-Güerri, Ignacio; Bermejo, Sheila; Sierra, Adriana; Burballa, Carla; Mir, Marisa; Crespo, Marta; Pascual, Julio

    The impact of acute rejection in kidney graft survival is well known, but the prognosis of other diagnoses is uncertain. We evaluated the frequency and impact on graft survival of different diagnostic categories according to the Banff 2013 classification in a cohort of renal transplant recipients. Retrospective study of 495 renal biopsies by indication in 322 patients from 1990-2014. Two independent observers reviewed the histological reports, reclassifying according to the Banff 2013 classification. Of 495 biopsies, 28 (5.7%) were not diagnostic. Of the remaining 467, 10.3% were «normal» (category 1), 19.6% antibody-mediated changes (category 2), 5.9% «borderline» changes (category 3), 8.7% T-cell-mediated rejection (category 4), 23.4% interstitial fibrosis/tubular atrophy (IFTA) (category 5) and 26.5% with other diagnoses (category 6). As time after transplantation increases, diagnoses of categories 1, 3 and 4 decrease, while categories 5 and 2 increase. Worse graft survival with category 2 diagnosis was observed (45% at 7.5 years, HR 4.29 graft loss [95% CI, 2.39-7.73]; P≤.001, compared to category 1). Grafts with «unfavourable histology» (chronic antibody-mediated rejection, moderate-severe IFTA) presented worse survival that grafts with «favourable histology» (normal, acute tubular necrosis, mild IFTA). The Banff 2013 classification facilitates a histological diagnosis in 95% of indication biopsies. While diagnostic category 6 is the most common, a change in the predominant histopathology was observed according to time elapsed since transplantation. Antibody-mediated changes are associated with worse graft survival. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Interventional radiology virtual simulator for liver biopsy. (United States)

    Villard, P F; Vidal, F P; ap Cenydd, L; Holbrey, R; Pisharody, S; Johnson, S; Bulpitt, A; John, N W; Bello, F; Gould, D


    Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.

  6. Automated direct immunofluorescence analyses of skin biopsies. (United States)

    Lemcke, Susanne; Sokolowski, Siegmar; Rieckhoff, Nicole; Buschtez, Michael; Kaffka, Christian; Winter-Keil, Antje; Schaller, Christine; Rottmann, Norbert; Sadik, Christian D; Stöcker, Winfried; Zillikens, Detlef; Schmidt, Enno


    Diagnosis of autoantibody- and immune complex-induced skin diseases is primarily based on direct immunofluorescence (DIF) microscopy. DIF staining is usually performed manually and, therefore, is labor intensive. The quality of immunohistochemical results considerably depends on the experience of the person conducting the tests. The novel EUROTide(™) technique in combination with the biochip-based system EUROPath represents a new technology for automation of DIF staining. Frozen sections of previously characterized skin biopsies from bullous pemphigoid and pemphigus vulgaris patients were incubated with fluorescein-labelled anti-human IgG and complement C3c following the standard manual procedure and, for comparison, applying EUROTide/EUROPath in an automated version. Both, the manual and the automated procedure, detected IgG and C3c deposits in all samples. However, DIF stainings performed with EUROTide/EUROPath displayed more intense specific IF signals and distinctly less background staining. The detecting antibody could be used at a ×4 higher dilution. EUROTide/EUROPath applied in an automated system improves diagnostic accuracy and saves reagents. Larger studies in other routine laboratories may further explore the value of the EUROTide/EUROPath technology and may include comparison with other automated stainers. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Optical Systems of Biopsy: The Invisible Eye

    Directory of Open Access Journals (Sweden)

    Kriti Bagri-Manjrekar


    Full Text Available The exploration of new methods and techniques for the diagnosis of malignant tumours has always attracted the attention of scientists. The development of adjunct tools to facilitate the non invasive screening of high risk lesions in real time has the potential to significantly improve our ability to reduce the dismal morbidity and mortality of oral cancer. Despite easy accessibility of the oral cavity to examination, there is no satisfactory method to adequately screen and detect precancers non-invasively. The current method of oral cancer diagnosis clinically relies heavily on visual examination of the oral cavity. However, discerning potentially malignant and early malignant lesions from common benign inflammatory conditions can be difficult at times. There is a need for an objective method that could provide real- time results and be routinely applied to a large population. Though science is yet to present such a perfect technique, Optical Biopsy Systems developed using knowledge of light and tissue interaction, can provide a plausible option.

  8. CT-guided core-needle biopsy in omental pathology

    International Nuclear Information System (INIS)

    Pombo, F.; Rodriguez, E.; Martin, R.; Lago, M.


    Purpose: To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology. Material and Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscopic biopsy (n=1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n=6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0=1.8-mm Surecut core-needles. Results: In 16 patients, the final diagnosis was metastatic adenocarcinoma - with the primary tumor sites in the ovary (n=3), stomach (n=1), appendix (n=2), and unknown (n=10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n=16) or cytological (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications. Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology. (orig.)

  9. Morphologic Features Suggestive of Endometriosis in Nondiagnostic Peritoneal Biopsies. (United States)

    Harrison, Beth T; Mittal, Khush


    Endometriosis is a common disorder that causes significant morbidity from dysmenorrhea, pelvic pain, and subfertility. Establishment of a definitive diagnosis has important therapeutic implications; however, only approximately 50% of biopsies of laparoscopically suspicious areas provide a diagnosis of endometriosis. Histologic criteria for diagnosis require the presence of endometrial glands or endometrial-type stroma. We hypothesize that other frequently present, but nondiagnostic, histologic features of endometriosis suggest its presence in patients with nondiagnostic peritoneal biopsies. We performed a retrospective clinicopathologic study of morphologic and immunohistochemical features that may improve the histologic diagnosis of endometriosis on laparoscopic peritoneal biopsies. We compared diagnostic (n=88) and nondiagnostic (n=54) peritoneal biopsies from pathologically confirmed endometriosis cases with negative peritoneal biopsies (n=84) from early-stage gynecologic cancer cases. Statistical analysis utilized the Fisher exact test. Multiple morphologic features were significantly increased in nondiagnostic biopsies from patients with endometriosis in comparison with those from negative controls, including foamy macrophages (P=0.0001) and submesothelial stromal clusters (SSCs) (P=0.0008). SSCs ranged from subtle aggregates of spindle cells to nodules of whorled spindle cells with small vessels and extravasated red blood cells resembling stromal endometriosis. Immunohistochemical studies confirmed that ER and CD10-positive SSCs were present in a greater proportion of both nondiagnostic and diagnostic peritoneal biopsies and at a greater number of lesions per biopsy. The overall histologic detection rate of peritoneal biopsies for endometriosis was 62.0%, and inclusion of SSCs with or without foamy macrophages in the diagnostic criteria appreciably increased this rate to between 72.5% and 76.8%. We describe SSCs, which appear to be an early or less developed

  10. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

    Energy Technology Data Exchange (ETDEWEB)

    Hemmer, Judith M.; Heesewijk, Hans P.M. van [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Kelder, Johannes C. [St. Antonius Hospital, Department of Statistics, Nieuwegein (Netherlands)


    The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy. (orig.)

  11. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

    International Nuclear Information System (INIS)

    Hemmer, Judith M.; Heesewijk, Hans P.M. van; Kelder, Johannes C.


    The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy. (orig.)

  12. Antimicrobial stewardship initiatives throughout Europe: proven value for money

    Directory of Open Access Journals (Sweden)

    Edwin J.M. Oberjé


    Full Text Available Antimicrobial stewardship is recognized as a key component to stop the current European spread of antimicrobial resistance. It has also become evident that antimicrobial resistance is a problem that cannot be tackled by single institutions or physicians. Prevention of antimicrobial resistance needs rigorous actions at ward level, institution level, national level and at supra-national levels. Countries can learn from each other and possibly transplant best practices across borders to prevent antimicrobial resistance. The aim of this study is to highlight some of the success stories of proven cost-effective interventions, and to describe the actions that have been taken, the outcomes that have been found, and the difficulties that have been met. In some cases we came across substantial scope for real-life cost savings. Although the best approach to effectively hinder the spread of antimicrobial resistance remains unclear and may vary significantly among settings, several EU-wide examples demonstrate that cost-effective antimicrobial stewardship is possible. Such examples can encourage others to implement (the most cost-effective elements in their system.

  13. Provenance-aware optimization of workload for distributed data production (United States)

    Makatun, Dzmitry; Lauret, Jérôme; Rudová, Hana; Šumbera, Michal


    Distributed data processing in High Energy and Nuclear Physics (HENP) is a prominent example of big data analysis. Having petabytes of data being processed at tens of computational sites with thousands of CPUs, standard job scheduling approaches either do not address well the problem complexity or are dedicated to one specific aspect of the problem only (CPU, network or storage). Previously we have developed a new job scheduling approach dedicated to distributed data production – an essential part of data processing in HENP (preprocessing in big data terminology). In this contribution, we discuss the load balancing with multiple data sources and data replication, present recent improvements made to our planner and provide results of simulations which demonstrate the advantage against standard scheduling policies for the new use case. Multi-source or provenance is common in computing models of many applications whereas the data may be copied to several destinations. The initial input data set would hence be already partially replicated to multiple locations and the task of the scheduler is to maximize overall computational throughput considering possible data movements and CPU allocation. The studies have shown that our approach can provide a significant gain in overall computational performance in a wide scope of simulations considering realistic size of computational Grid and various input data distribution.

  14. Culture-proven bacterial keratitis in a Malaysian general hospital. (United States)

    Hooi, S H; Hooi, S T


    One hundred patients (101 eyes) with culture-proven bacterial keratitis were treated in the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, over a 4-year period. The majority of patients was male (63%), Malay (60%), from the Johor Bahru district (62%) and aged between 41 to 50 years (20%). The ocular predisposing factors were ocular trauma (41 eyes), ocular surface disease (28 eyes) and contact lens wear (26 eyes). The corneal ulcers were mainly large (50.5%), central (59.4%) and colonized by Gram-negative bacteria (78.1%). The most frequently isolated microorganisms were Pseudomonas aeruginosa (67 eyes), Staphylococcus aureus (12 eyes), Acinetobacter baumanii (6 eyes), Klebsiella pneumoniae (5 eyes), Corynebacterium sp. (3 eyes:) and Streptococcus pneumonliae (3 eyes). Twelve eyes (11.8%) had polymicrobial infection. A good visual outcome occurred in 52.5% of eyes analysed. Prognostic factors for visual outcome include presenting Snellen visual acuity, time to presentation after onset of ocular symptoms, ocular predisposing factor, corneal ulcer location and corneal ulcer size.

  15. Provenance of the K/T boundary layers

    International Nuclear Information System (INIS)

    Hildebrand, A.R.; Boynton, W.V.


    An array of chemical, physical and isotopic evidence indicates that an impact into oceanic crust terminated the Cretaceous Period. Approximately 1500 cu km of debris, dispersed by the impact fireball, fell out globally in marine and nonmarine environments producing a 2 to 4 mm thick layer (fireball layer). In North American locales, the fireball layer overlies a 15 to 25 mm thick layer of similar but distinct composition. This 15 to 25 mm layer (ejecta layer) may represent approximately 1000 cu km of lower energy ejecta from a nearby impact site. Isotopic and chemical evidence supports a mantle provenance for the bulk of the layers. The extraordinary REE pattern of the boundary clays was modelled as a mixture of oceanic crust, mantle, and approximately 10 percent continental material. The results are presented. If the siderophiles of the ejecta layer were derived solely from the mantle, a test may be available to see if the siderophile element anomaly of the fireball layer had an extraterrestrial origin. Radiogenic Os-187 is depleted in the mantle relative to an undifferentiated chondritic source. Os-187/Os-186 ratios of 1.049 and 1.108 were calculated for the ejecta and fireball layers, respectively

  16. LQCD workflow execution framework: Models, provenance and fault-tolerance

    International Nuclear Information System (INIS)

    Piccoli, Luciano; Simone, James N; Kowalkowlski, James B; Dubey, Abhishek


    Large computing clusters used for scientific processing suffer from systemic failures when operated over long continuous periods for executing workflows. Diagnosing job problems and faults leading to eventual failures in this complex environment is difficult, specifically when the success of an entire workflow might be affected by a single job failure. In this paper, we introduce a model-based, hierarchical, reliable execution framework that encompass workflow specification, data provenance, execution tracking and online monitoring of each workflow task, also referred to as participants. The sequence of participants is described in an abstract parameterized view, which is translated into a concrete data dependency based sequence of participants with defined arguments. As participants belonging to a workflow are mapped onto machines and executed, periodic and on-demand monitoring of vital health parameters on allocated nodes is enabled according to pre-specified rules. These rules specify conditions that must be true pre-execution, during execution and post-execution. Monitoring information for each participant is propagated upwards through the reflex and healing architecture, which consists of a hierarchical network of decentralized fault management entities, called reflex engines. They are instantiated as state machines or timed automatons that change state and initiate reflexive mitigation action(s) upon occurrence of certain faults. We describe how this cluster reliability framework is combined with the workflow execution framework using formal rules and actions specified within a structure of first order predicate logic that enables a dynamic management design that reduces manual administrative workload, and increases cluster-productivity.

  17. A global renewable mix with proven technologies and common materials (United States)

    Ballabrera, J.; Garcia-Olivares, A.; Garcia-Ladona, E.; Turiel, A.


    A global alternative mix to fossil fuels is proposed, based on proven renewable energy technologies that do not use scarce materials. Taking into account the availability of materials, the resulting mix consists of a combination of onshore and offshore wind turbines, concentrating solar power stations, hydroelectricity and wave power devices attached to the offshore turbines. Solar photovoltaic power could contribute to the mix if its dependence on scarce materials is solved. Material requirements are studied for the generation, power transport and for some future transport systems. The order of magnitude of copper, aluminium, neodymium, lithium, nickel, zinc and platinum that might be required for the proposed solution is obtained and compared with available reserves. While the proposed global alternative to fossil fuels seems technically feasible, lithium, nickel and platinum could become limiting materials for future vehicles fleet if no global recycling system were implemented and rechargeable zinc-air batteries could not be developed. As much as 60% of the current copper reserves would have to be employed in the implementation of the proposed solution. Altogether, the availability of materials may become a long-term physical constraint, preventing the continuation of the usual exponential growth of energy consumption.

  18. Descartes Mountains and Cayley Plains - Composition and provenance (United States)

    Drake, M. J.; Taylor, G. J.; Goles, G. G.


    Trace element compositions of petrographically characterized 2-4 mm lithic fragments from Apollo 16 soil samples are used to calculate initial REE concentrations in liquids in equilibrium with lunar anorthosites and to discuss the provenance of the Cayley Formation. Lithic fragments may be subdivided into four groups: (1) ANT rocks, (2) K- and SiO2-rich mesostasis-bearing rocks, (3) poikiloblastic rocks, and (4) (spinel) troctolites. Model liquids in equilibrium with essentially monominerallic anorthosites have initial REE concentrations 5-8 times those of chondrites. The REE contents of K- and SiO2-rich mesostasis-bearing rocks and poikiloblastic rocks are dominated by the mesostasis phases. ANT rocks appear to be more abundant in the Descartes Mountains, while poikiloblastic rocks appear to be more abundant in the Cayley Plains. Poikiloblastic rocks have intermediate to high LIL-element concentrations yet the low gamma-ray activity of Mare Orientale implies low LIL-element concentrations. Consequently, it is unlikely that the Cayley Formation is Orientale ejecta. A local origin as ejecta from smaller impacts is a more plausible model for the deposition of the Cayley Formation.

  19. Acute graft versus host disease

    Directory of Open Access Journals (Sweden)

    Vogelsang Georgia B


    Full Text Available Abstract Acute graft-versus-host disease (GVHD occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen. About 35%–50% of hematopoietic stem cell transplant (HSCT recipients will develop acute GVHD. The exact risk is dependent on the stem cell source, age of the patient, conditioning, and GVHD prophylaxis used. Given the number of transplants performed, we can expect about 5500 patients/year to develop acute GVHD. Patients can have involvement of three organs: skin (rash/dermatitis, liver (hepatitis/jaundice, and gastrointestinal tract (abdominal pain/diarrhea. One or more organs may be involved. GVHD is a clinical diagnosis that may be supported with appropriate biopsies. The reason to pursue a tissue biopsy is to help differentiate from other diagnoses which may mimic GVHD, such as viral infection (hepatitis, colitis or drug reaction (causing skin rash. Acute GVHD is staged and graded (grade 0-IV by the number and extent of organ involvement. Patients with grade III/IV acute GVHD tend to have a poor outcome. Generally the patient is treated by optimizing their immunosuppression and adding methylprednisolone. About 50% of patients will have a solid response to methylprednisolone. If patients progress after 3 days or are not improved after 7 days, they will get salvage (second-line immunosuppressive therapy for which there is currently no standard-of-care. Well-organized clinical trials are imperative to better define second-line therapies for this disease. Additional management issues are attention to wound infections in skin GVHD and fluid/nutrition management in gastrointestinal GVHD. About 50% of patients with acute GVHD will eventually have manifestations of chronic GVHD.

  20. Results of Short-Term Follow-Up in BI-RADS 3 and 4a Breast Lesions with a Histological Diagnosis of Fibroadenoma at Percutaneous Needle Biopsy. (United States)

    Clauser, Paola; Bazzocchi, Massimo; Marcon, Magda; Londero, Viviana; Zuiani, Chiara


    To evaluate the usefulness of short-term (6 months) follow-up in patients with Breast Imaging Report and Data System (BI-RADS) 3 and 4a lesions, after a diagnosis of fibroadenoma at an image-guided biopsy. The data of 318 women with 349 biopsy-proven fibroadenomas, a 6-month follow-up, and a follow-up of ≥ 24 months were retrospectively reviewed. Information on clinical history, lesion characteristics on ultrasound (US), mammography, and magnetic resonance imaging (MRI), BI-RADS classification, and follow-up was collected. The false-negative (FN) rate and the negative predictive value (NPV) for the biopsy were calculated. 43 patients (13.5%) presented with a palpable nodule; 18 (5.7%) had a history of breast cancer. There were 334 lesions visible on US (95.7%), 57 on US and mammography (16.3%), and 15 on mammography only (4.3%); 37 lesions were first detected on MRI. All lesions were stable at 6 months. After an at least 1-year follow-up, 4 lesions changed their features and were excised. Histology showed 1 invasive lobular cancer, 1 ductal carcinoma in situ, 1 phyllodes tumor, and 1 papilloma. The FN rate of the needle biopsy was 1.1% and the NPV was 98.9%. For lesions initially described as BI-RADS 3 and 4a with a histological diagnosis of fibroadenoma after biopsy, short-term follow-up can be avoided.

  1. Multicentre evaluation of targeted and systematic biopsies using magnetic resonance and ultrasound image-fusion guided transperineal prostate biopsy in patients with a previous negative biopsy. (United States)

    Hansen, Nienke L; Kesch, Claudia; Barrett, Tristan; Koo, Brendan; Radtke, Jan P; Bonekamp, David; Schlemmer, Heinz-Peter; Warren, Anne Y; Wieczorek, Kathrin; Hohenfellner, Markus; Kastner, Christof; Hadaschik, Boris


    To evaluate the detection rates of targeted and systematic biopsies in magnetic resonance imaging (MRI) and ultrasound (US) image-fusion transperineal prostate biopsy for patients with previous benign transrectal biopsies in two high-volume centres. A two centre prospective outcome study of 487 patients with previous benign biopsies that underwent transperineal MRI/US fusion-guided targeted and systematic saturation biopsy from 2012 to 2015. Multiparametric MRI (mpMRI) was reported according to Prostate Imaging Reporting and Data System (PI-RADS) Version 1. Detection of Gleason score 7-10 prostate cancer on biopsy was the primary outcome. Positive (PPV) and negative (NPV) predictive values including 95% confidence intervals (95% CIs) were calculated. Detection rates of targeted and systematic biopsies were compared using McNemar's test. The median (interquartile range) PSA level was 9.0 (6.7-13.4) ng/mL. PI-RADS 3-5 mpMRI lesions were reported in 343 (70%) patients and Gleason score 7-10 prostate cancer was detected in 149 (31%). The PPV (95% CI) for detecting Gleason score 7-10 prostate cancer was 0.20 (±0.07) for PI-RADS 3, 0.32 (±0.09) for PI-RADS 4, and 0.70 (±0.08) for PI-RADS 5. The NPV (95% CI) of PI-RADS 1-2 was 0.92 (±0.04) for Gleason score 7-10 and 0.99 (±0.02) for Gleason score ≥4 + 3 cancer. Systematic biopsies alone found 125/138 (91%) Gleason score 7-10 cancers. In patients with suspicious lesions (PI-RADS 4-5) on mpMRI, systematic biopsies would not have detected 12/113 significant prostate cancers (11%), while targeted biopsies alone would have failed to diagnose 10/113 (9%). In equivocal lesions (PI-RADS 3), targeted biopsy alone would not have diagnosed 14/25 (56%) of Gleason score 7-10 cancers, whereas systematic biopsies alone would have missed 1/25 (4%). Combination with PSA density improved the area under the curve of PI-RADS from 0.822 to 0.846. In patients with high probability mpMRI lesions, the highest detection rates of Gleason

  2. The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Mariko; Yuen, Sachiko; Akazawa, Kentaro; Nishida, Kaori; Yamada, Kei [Kyoto Prefectural University of Medicine, Departments of Radiology, Graduate School of Medical Science, Kyoto (Japan); Konishi, Eiichi [Kyoto Prefectural University of Medicine, Departments of Pathology, Graduate School of Medical Science, Kyoto (Japan); Kajihara, Mariko [Kyoto Breast Center Sawai Memorial Clinic, Departments of Radiology, Kyoto (Japan); Shinkura, Nobuhiko [Kyoto Breast Center Sawai Memorial Clinic, Departments of Surgery, Kyoto (Japan)


    To evaluate whether magnetic resonance (MR) imaging features can predict the presence of occult invasion in cases of biopsy-proven pure ductal carcinoma in situ (DCIS). We retrospectively reviewed 92 biopsy-proven pure DCIS in 92 women who underwent MR imaging. The following MR imaging findings were compared between confirmed DCIS and invasive breast cancer (IBC): lesion size, type, morphological and kinetic assessments by ACR BI-RADS MRI, and findings of fat-suppressed T2-weighted (FS-T2W) imaging. Sixty-eight of 92 (74%) were non-mass-like enhancements (NMLE) and 24 were mass lesions on MR imaging. Twenty-one of 68 (31%) NMLE and 13 of 24 (54%) mass lesions were confirmed as IBC. In NMLE lesions, large lesions (P = 0.007) and higher signal intensities (SI) on FS-T2W images (P = 0.032) were significantly associated with IBC. Lesion size remained a significant independent predictor of invasion in multivariate analysis (P = 0.032), and combined with FS-T2W SIs showed slightly higher observer performances (area under the curve, AUC, 0.71) than lesion size alone (AUC 0.68). There were no useful findings that enabled the differentiation of mass-type lesions. Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE. MR mammography permits more precise lesion assessment including ductal carcinoma in situ A correct diagnosis of occult invasion before treatment is important for clinicians This study showed the potential of MR mammography to diagnose occult invasion Treatment and/or aggressive biopsy can be given with greater confidence MR mammography can lead to more appropriate management of patients. (orig.)

  3. Provenance-Based Debugging and Drill-Down in Data-Oriented Workflows

    KAUST Repository

    Ikeda, Robert


    Panda (for Provenance and Data) is a system that supports the creation and execution of data-oriented workflows, with automatic provenance generation and built-in provenance tracing operations. Workflows in Panda are arbitrary a cyclic graphs containing both relational (SQL) processing nodes and opaque processing nodes programmed in Python. For both types of nodes, Panda generates logical provenance - provenance information stored at the processing-node level - and uses the generated provenance to support record-level backward tracing and forward tracing operations. In our demonstration we use Panda to integrate, process, and analyze actual education data from multiple sources. We specifically demonstrate how Panda\\'s provenance generation and tracing capabilities can be very useful for workflow debugging, and for drilling down on specific results of interest. © 2012 IEEE.

  4. Diagnostic management of patients with SAPHO syndrome: use of MR imaging to guide bone biopsy at CT for microbiological and histological work-up

    International Nuclear Information System (INIS)

    Kirchhoff, Timm; Rosenthal, Herbert; Prokop, Mathias; Chavan, Ajay; Galanski, Michael; Merkesdal, Sonja; Wagner, Annette; Zeidler, Henning; Mai, Uwe; Hammer, Michael


    Propionibacterium acnes (P. acnes) is suspected to be involved in the pathophysiology of SAPHO syndrome, since it has been isolated repeatedly through open surgical bone biopsy. This study demonstrates the role of MRI in identifying inflamed bone areas in patients with SAPHO syndrome and the role of CT-guided bone biopsies in obtaining samples from these areas for microbiological and histopathological investigations, thus obviating open surgery. Fourteen consecutive patients with SAPHO syndrome were investigated by MRI to identify acute inflammatory changes in hyperostotic periarticular bone. The CT-guided biopsies for microbiological investigations were taken from the areas identified. Patients positive for P. acnes were started on long-term antibiotic therapy according to antibiotic susceptibility. On MRI the inflammatory changes appeared as hyperintense areas on fat-saturated T2 fast-spin-echo (FSE) images and showed signal increase on fat-saturated T1 SE images after Gd-DTPA. With MR localization CT-guided bone biopsies yielded P. acnes in 8 patients. No bacteria could be isolated from the remaining 6 patients. Acute inflammatory bone changes in SAPHO syndrome are well localized by MRI. With MR localization, CT-guided bone biopsies offer a minimally invasive alternative to open surgery in the detection of. P. acnes leading to the institution of a specific antibiotic therapy. (orig.)

  5. Sentinel lymph node biopsy: clinical relevance

    International Nuclear Information System (INIS)

    Howman-Giles, R.


    Sentinel lymph node biopsy (SLNB) has become an important technique in the management of patients with intermediate level melanoma, clinical operable breast cancer and some other cancers. The technique relies on lymphatic mapping to define the lymph drainage from a primary tumour with the premise that the lymph nodes, which directly drain from that area, will reflect the tumour status of the remainder of the node field. Current techniques use lymphoscintigraphy where a radioactive labelled particle and / or blue dye are injected intradermally or intraparenchymally to map the lymph drainage, often in conjunction with a radioactive gamma probe at surgery. In patients with melanoma the SLNB has improved the staging and prognostic information by more accurate determination of whether regional lymph nodes have metastatic spread. This has a major impact on patient management as those patients with negative nodes do not require regional lymph node dissection and have a significantly better prognosis. In our experience of over 3000 patients the combined sentinel node biopsy technique localised accurately 98% of sentinel lymph nodes. Lymphoscintigraphy in patients with melanoma to locate the sentinel lymph nodes involves the intradermal injection of a radiocolloid around the melanoma site or the excision biopsy site. Injections of 5 -10 MBq in 0.05-0.1ml/inj are used and typically 4 injections are usually required. Following tracer injection dynamic imaging is performed to follow the lymphatic collecting vessels until they reach the draining sentinel nodes. An image should be acquired as the vessels reach the node field so that the sentinel nodes directly receiving the channels can be identified and distinguished from any second tier nodes which may sometimes be seen. Delayed scans are performed 2 hours later at which time all regions which can possible drain the primary melanoma site are examined with 5-10 minute static images. The surface location of all sentinel nodes is

  6. Renal biopsy with 16G needle: a safety study. (United States)

    Guerrero-Ramos, F; Villacampa-Aubá, F; Jiménez-Alcaide, E; García-González, L; Ospina-Galeano, I A; de la Rosa-Kehrmann, F; Rodríguez-Antolín, A; Passas-Martínez, J; Díaz-González, R


    The development of percutaneous renal biopsy as a routinary diagnostic procedure for renal masses is topic of discussion for the last few years. However, this technique has been associated with some complications, although infrequent, and morbidity. Our objective is to carry out a descriptive study about complications and outcomes of orthotopic kidney biopsies with 16 G needle. A retrospective review of 180 orthotopic ultrasound-guided renal biopsies performed in our service among January 2008 to May 2010 was carried out. The procedure was developed using an automated biopsy gun (16G needle). Multiple clinical variables, early post-procedure complications and its management were collected. Complication rates as well as the relationship between risk factors and occurrence of complications were studied. Mean age was 55.8 years. The average number of biopsy cylinders per intervention was 2.49. The overall complication rate was 5.6%. An interventionist attitude derived from complication of the procedure was necessary in only 3 patients (1.67%). No surgical interventions were required and no death as consequence of procedure was registered. No relationship between hypertension (P=.09) previous anticoagulation (P=.099) or previous antiaggregation (P=.603) and complications were demonstrated. In 2.8% of biopsies the material obtained was insufficient for diagnosing. Percutaneous ultrasound-guided renal biopsy with 16G needle is a safe technique with high diagnostic performance. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  7. Acute tubulo-interstitial nephritis leading to acute renal failure following multiple hornet stings

    Directory of Open Access Journals (Sweden)

    Bambery Pradeep


    Full Text Available Abstract Background Hornet stings are generally associated with local and occasionally anaphylactic reactions. Rarely systemic complications like acute renal failure can occur following multiple stings. Renal failure is usually due to development of acute tubular necrosis as a result of intravascular haemolysis, rhabdomyolysis or shock. Rarely it can be following development of acute tubulo-interstitial nephritis. Case presentation We describe a young male, who was stung on face, head, shoulders and upper limbs by multiple hornets (Vespa orientalis. He developed acute renal failure as a result of acute tubulo-interstitial nephritis and responded to steroids. Conclusion Rare causes of acute renal failure like tubulo-interstitial nephritis should be considered in a patient with persistent oliguria and azotemia following multiple hornet stings. Renal biopsy should be undertaken early, as institution of steroid therapy may help in recovery of renal function

  8. Acute bile nephropathy secondary to anabolic steroids. (United States)

    Alkhunaizi, Ahmed M; ElTigani, Mohamed A; Rabah, Rola S; Nasr, Samih H


    Renal dysfunction in cholestatic liver disease is multifactorial. Acute kidney injury may develop secondary to renal vasoconstriction in the setting of peripheral vasodilation and relative hypovolemia, tubular obstruction by bile casts, and direct tubular toxicity from bile. Anabolic steroids are frequently used by athletes to boost endurance and increase muscle mass. These agents are a recently recognized cause of hepatotoxicity and jaundice and may lead to acute kidney injury. To increase awareness about this growing problem and to characterize the pathology of acute kidney injury in this setting, we report on a young male who developed acute kidney injury in the setting of severe cholestatic jaundice related to ingestion of anabolic steroids used for bodybuilding. Kidney biopsy showed bile casts within distal tubular lumina, filamentous bile inclusions within tubular cells, and signs of acute tubular injury. This report supports the recently re-emerged concept of bile nephropathy cholemic nephrosis.

  9. Ultrasound-guided core needle biopsy for breast cancer

    International Nuclear Information System (INIS)

    Naqvi, S.Q.H.; Solangi, R.A.; Memon, M.; Solangi, R.A.


    To evaluate the efficacy of ultrasound-guided core needle biopsy (US-CNB) as a preoperative diagnostic modality for breast cancer. Females with solid and/or intermediate breast lesions visualized on ultrasonography. Apart from clinical work-up, all the above mentioned patients underwent ultrasound-guided core needle biopsy and excisional biopsy of their breast lesions. The histopathological diagnosis on ultrasound-guided core needle biopsy was then compared with the findings of the excisional biopsy. Out of the total 93 cases, 47(50.5%) had benign lesions on ultrasound; US-CNB showed 24 as fibroadenomata, four with chronic non-specific mastitis, five chronic suppurative mastitis, one tuberculosis, four fat necrosis, two lactational adenoma and seven cases with benign ductal hyperplasia without atypia. Nine (9.7%) cases showed suspicious abnormality on ultrasound; US-CNB revealed five cases with atypical ductal hyperplasia, one ductal carcinoma in situ and three invasive ductal carcinoma. Thirty seven (39.8%) cases were highly suggestive of malignancy on ultrasound; US-CNB showed 34 as invasive ductal carcinoma, two invasive lobular and one medullary carcinoma. Excisional biopsy confirmed the diagnosis of ultrasound-guided core needle biopsy in all cases except four; one case of chronic suppurative mastitis was diagnosed as that of tuberculosis and three cases of atypial ductal hyperplasia as invasive ductal carcinoma. Hence there was no false positive case, but four (4.3%) false negative cases. The sensitivity of the US-CNB was thus 100% and specificity 91.1%. Ultrasound guided core needle biopsy is a satisfactory procedure for the histopathological diagnosis of breast lesions. Any unsatisfactory, suspicious or atypical change on US-CNB should be followed by an open biopsy. (author)

  10. Does Prebiopsy, Nonsterile Ultrasonography Gel Affect Biopsy-Site Asepsis?

    International Nuclear Information System (INIS)

    Gurel, Kamil; Karabay, Oguz; Gurel, Safiye; Hildebolt, Charles


    Purpose. The purpose of this study was to determine the extent to which the use of nonsterile gel, prior to antiseptic procedures in ultrasonography (US)-guided percutaneous biopsies, results in contamination of the biopsy site. Materials and Methods. Patients referred for US-guided percutaneous biopsies were included in this study. Transmission material used for US evaluation before biopsy-site antiseptic procedures were performed was either nonsterile gel or sterile saline. Patients were randomly assigned to two groups: nonsterile gel (n = 30) and sterile saline (n = 30). Before the transmission material was used and after antiseptic procedures were performed, microbial swabs of a 10-cm 2 -diameter area were obtained at the biopsy site. Swabs were also obtained from the gel, saline, and povidine-iodine. Inoculated specimen plates were incubated at 37 o C under aerobic conditions, and the numbers of colony-forming units recorded. Nominal logistic regression analysis was used to calculate the odds of postantisepsis bacterial growth (after antiseptic procedures were performed) based on group, gender, coincidental disease (diabetes, chronic renal failure, and malignancy), biopsy-site location (head and neck or breast and abdomen), and local factors (skin fold, skin tag, and hair). Results. The following odds ratios (adjusted for the other variables) and their 95% confidence intervals were calculated: (1) group (2.9 [0.8-11.1]; p = 0.10); (2) gender (1.2 [0.3-5.2]; p = 0.78); (3) coincidental disease (7.6 [0.9-166.7]; p = 0.09); (4) biopsy site location (6.2 [1.4-31.3]; p = 0.02); and (5) local factors (7.0 [1.6-36.0]; p = 0.01). No bacterial growth occurred with swabs obtained from gel, povidine-iodine, or saline. Conclusion. We conclude that nonsterile gel used prior to percutaneous biopsy does not affect biopsy-site asepsis

  11. Holocene Evolution and Sediment Provenance of Horn Island, Mississippi, USA (United States)

    Schulze, N.; Wallace, D. J.; Miner, M. D.


    As one of the most stable islands in the Mississippi-Alabama barrier island chain, Horn Island provides critical habitat, plays an important role in regulating estuarine conditions in the Mississippi Sound, and helps to attenuate wave energy and storm surge for the mainland. The provenance of sediments comprising Horn Island is largely unknown and has implications for mode of island genesis and evolution. The existing literature proposes that island chain formation was initiated by bar emergence from a subaqueous spit that grew laterally westward from Dauphin Island in the east. Decelerating sea level rise 4,000 to 5,000 years ago facilitated island formation. This proposed mode of formation is supported by a lone radiocarbon date from lagoonal sediments below Horn Island, suggesting the system formed after 4,615 ± 215 years BP. Rivers supplying suspended sediment include the Mississippi, Pascagoula, Mobile and Apalachicola, but the variable nature of their paths and sediment supply means that Horn Island has received differing amounts of sediment from these proximal rivers throughout the Holocene. To analyze the stratigraphy and sediment characteristics of Horn Island, we will utilize 24 vibracores (up to 6 meters in length) from offshore Horn Island that were obtained by the United States Geological Survey (USGS) and 9 onshore drill cores (up to 28 meters in length) from the Mississippi Department of Environmental Quality. High-resolution LiDAR data collected by the National Oceanic and Atmospheric Administration in 2010 will be used to describe modern geomorphic barrier environments. We will employ down-core x-ray diffraction and x-ray fluorescence analyses to identify mineralogical and chemical signatures that potentially correspond to unique signatures of the fluvial sources of proximal rivers. New radiocarbon ages will be used to constrain the timing of island formation and alterations in sediment supply. High-resolution shallow geophysical data will provide

  12. Provenance based data integrity checking and verification in cloud environments. (United States)

    Imran, Muhammad; Hlavacs, Helmut; Haq, Inam Ul; Jan, Bilal; Khan, Fakhri Alam; Ahmad, Awais


    Cloud computing is a recent tendency in IT that moves computing and data away from desktop and hand-held devices into large scale processing hubs and data centers respectively. It has been proposed as an effective solution for data outsourcing and on demand computing to control the rising cost of IT setups and management in enterprises. However, with Cloud platforms user's data is moved into remotely located storages such that users lose control over their data. This unique feature of the Cloud is facing many security and privacy challenges which need to be clearly understood and resolved. One of the important concerns that needs to be addressed is to provide the proof of data integrity, i.e., correctness of the user's data stored in the Cloud storage. The data in Clouds is physically not accessible to the users. Therefore, a mechanism is required where users can check if the integrity of their valuable data is maintained or compromised. For this purpose some methods are proposed like mirroring, checksumming and using third party auditors amongst others. However, these methods use extra storage space by maintaining multiple copies of data or the presence of a third party verifier is required. In this paper, we address the problem of proving data integrity in Cloud computing by proposing a scheme through which users are able to check the integrity of their data stored in Clouds. In addition, users can track the violation of data integrity if occurred. For this purpose, we utilize a relatively new concept in the Cloud computing called "Data Provenance". Our scheme is capable to reduce the need of any third party services, additional hardware support and the replication of data items on client side for integrity checking.

  13. Provenance based data integrity checking and verification in cloud environments.

    Directory of Open Access Journals (Sweden)

    Muhammad Imran

    Full Text Available Cloud computing is a recent tendency in IT that moves computing and data away from desktop and hand-held devices into large scale processing hubs and data centers respectively. It has been proposed as an effective solution for data outsourcing and on demand computing to control the rising cost of IT setups and management in enterprises. However, with Cloud platforms user's data is moved into remotely located storages such that users lose control over their data. This unique feature of the Cloud is facing many security and privacy challenges which need to be clearly understood and resolved. One of the important concerns that needs to be addressed is to provide the proof of data integrity, i.e., correctness of the user's data stored in the Cloud storage. The data in Clouds is physically not accessible to the users. Therefore, a mechanism is required where users can check if the integrity of their valuable data is maintained or compromised. For this purpose some methods are proposed like mirroring, checksumming and using third party auditors amongst others. However, these methods use extra storage space by maintaining multiple copies of data or the presence of a third party verifier is required. In this paper, we address the problem of proving data integrity in Cloud computing by proposing a scheme through which users are able to check the integrity of their data stored in Clouds. In addition, users can track the violation of data integrity if occurred. For this purpose, we utilize a relatively new concept in the Cloud computing called "Data Provenance". Our scheme is capable to reduce the need of any third party services, additional hardware support and the replication of data items on client side for integrity checking.

  14. Infrared reflectance spectra: effects of particle size, provenance and preparation (United States)

    Su, Yin-Fong; Myers, Tanya L.; Brauer, Carolyn S.; Blake, Thomas A.; Forland, Brenda M.; Szecsody, J. E.; Johnson, Timothy J.


    We have recently developed methods for making more accurate infrared total and diffuse directional - hemispherical reflectance measurements using an integrating sphere. We have found that reflectance spectra of solids, especially powders, are influenced by a number of factors including the sample preparation method, the particle size and morphology, as well as the sample origin. On a quantitative basis we have investigated some of these parameters and the effects they have on reflectance spectra, particularly in the longwave infrared. In the IR the spectral features may be observed as either maxima or minima: In general, upward-going peaks in the reflectance spectrum result from strong surface scattering, i.e. rays that are reflected from the surface without bulk penetration, whereas downward-going peaks are due to either absorption or volume scattering, i.e. rays that have penetrated or refracted into the sample interior and are not reflected. The light signals reflected from solids usually encompass all such effects, but with strong dependencies on particle size and preparation. This paper measures the reflectance spectra in the 1.3 - 16 micron range for various bulk materials that have a combination of strong and weak absorption bands in order to observe the effects on the spectral features: Bulk materials were ground with a mortar and pestle and sieved to separate the samples into various size fractions between 5 and 500 microns. The median particle size is demonstrated to have large effects on the reflectance spectra. For certain minerals we also observe significant spectral change depending on the geologic origin of the sample. All three such effects (particle size, preparation and provenance) result in substantial change in the reflectance spectra for solid materials; successful identification algorithms will require sufficient flexibility to account for these parameters.

  15. Acute Pancreatitis and Pregnancy (United States)

    ... Information Acute Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  16. Acute interstitial nephritis in T-cell leukemia in a pediatric patient. (United States)

    Biro, Erika; Szikszay, Edit; Pethő-Orosz, Petronella; Bigida, László; Balla, György; Szabó, Tamás


    Acute lymphoid leukemia is the most frequently occurring malignancy in childhood, but acute tubulointerstitial nephritis with associated acute renal failure as the leading manifestation of leukemia is extremely rare. Only a few pediatric cases have been described in the literature. We present a surprising case in which physical examination and initial investigation were not typical for leukemia. Ultrasound showed only modest kidney enlargement while laboratory results indicated acute renal failure. Renal biopsy indicated tubulointerstitial nephritis, and subsequent steroid treatment led to sudden clinical improvement. One month later, however, the patient returned with typical clinical features of leukemia. Re-evaluation of the original kidney biopsy block indicated T-cell acute lymphoid leukemia. The present case highlights the importance of renal biopsy. © 2016 Japan Pediatric Society.

  17. Percutaneous biopsy of the synovial membrane of large joints

    International Nuclear Information System (INIS)

    Begule, V.


    Using flouroscopy, the authors have developed new techniques of percutaneous synovial biopsy (PSB) of large joints of limbs (other than the knee). PSB was performed on outpatients under local anesthesia. They have performed 84 biopsies (hips: 57), shoulders: 10, elbows: six, wrists: five, ankles: six). The PSB technique was gradually improved. Main technical refinements were use of a Tru-Cut needle introduced through a Jamshidi trephine needle, placement of the cutting window parallel to the anterior aspect of the joint, and selection of an optimal approach and biopsy site. With these improvements, the success rate of attaining synovial membrane was raised from 49% to 81%. No complications were encountered

  18. Magnetic-resonance-guided biopsy of focal liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Ethan A. [University of Michigan Health System, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Grove, Jason J. [University of Michigan Health System, Division of Interventional Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Der Spek, Abraham F.L.V. [University of Michigan Health System, Department of Anesthesiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Jarboe, Marcus D. [University of Michigan Health System, Division of Interventional Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); University of Michigan Health System, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Department of Surgery, Ann Arbor, MI (United States)


    Image-guided biopsy techniques are widely used in clinical practice. Commonly used methods employ either ultrasound (US) or computed tomography (CT) for image guidance. In certain patients, US or CT guidance may be suboptimal, or even impossible, because of artifacts, suboptimal lesion visualization, or both. We recently began performing magnetic resonance (MR)-guided biopsy of focal liver lesions in select pediatric patients with lesions that are not well visualized by US or CT. This report describes our experience performing MR-guided biopsy of focal liver lesions, with case examples to illustrate innovative techniques and novel aspects of these procedures. (orig.)

  19. Fine-needle aspiration biopsy of synovial sarcoma. A cytomorphologic analysis of primary, recurrent, and metastatic tumors. (United States)

    Kilpatrick, S E; Teot, L A; Stanley, M W; Ward, W G; Savage, P D; Geisinger, K R


    Thirteen fine-needle aspiration specimens from 10 patients with histologically proven synovial sarcoma are described. The aspiration biopsy specimens were obtained from the primary tumor in five cases, locally recurrent tumors in four cases, pulmonary metastases in three cases, and mediastinal metastasis in one case. Patient's ages ranged from 22 years to 65 years; there were four women and six men. All cases had a confirmation biopsy and/or resection specimen that were reviewed. Histologic subtypes included monophasic fibrous (5 cases), monophasic epithelial (1 case), biphasic (3 cases), and poorly differentiated (1 case). The majority of the aspiration biopsy specimens were similar with moderate to marked smear cellularity dominated by cohesive clusters of spindle-shaped cells with ovoid, hyperchromatic nuclei and scanty tapering cytoplasm. Nucleoli were not prominent. Epithelial tumor cells with ovoid to round, mostly regular, centrally to eccentrically located nuclei, surrounded by scant to abundant cytoplasm predominated in one case (monophasic epithelial) and were admixed with spindle cells in a second (classical biphasic). Multi-nucleated tumor giant cells were not observed in any of the tumors. In biphasic synovial sarcoma, the neoplastic spindle cells are generally more numerous and frequent than the epithelial cells, making distinction from monophasic synovial sarcoma or other spindle cell soft tissue tumors difficult. Although synovial sarcoma may be diagnosed by fine-needle aspiration cytology, clinical correlation, especially in monophasic types, is necessary to minimize errors in sarcoma classification.

  20. The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

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    Agata Stanek-Widera


    Full Text Available Fine needle aspiration biopsy (FNA is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE. We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100% cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100% provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100% specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment indicates that repeat FNA in order to confirm the diagnosis is unnecessary.