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Sample records for lns us-guided fnab

  1. EUS – Fine- Needle Aspiration Biopsy (FNAB in the Diagnosis of Pancreatic Adenocarcinoma: A Review

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-03-01

    Full Text Available Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS is a relatively new technology that employs endoscopy and high-frequency ultrasound (US. EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP brushing, CT-guided biopsies, and transabdominal ultrasound (US have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities

  2. lns physics, knowledge and problems

    International Nuclear Information System (INIS)

    Jacob, M.

    1976-01-01

    Reference is made to recent experimentation at the CERN intersecting storage ring (ISR) and experimentation at Fermilab. This is stated to have opened up a wide new domain as regards energy considerations. The ISR spans the 250 to 2000 GeV domain, whereas the Fermilab facilities reach 500 GeV. The many processes already studied are stated to show strikingly different energy behaviour. These commands do not attempt any systematic review of lns physics, but emphasise only a few important facts and questions. Three topics considered are (i) rising cross sections and related phenomena, (ii) scaling and short range order; and (iii) inelastic diffractive phenomena. Regarding (i) it is stated that all phenomena directly related to rising cross sections are amenable to simple logarithmic parametrisations that fit well with what is expected for very high energy behaviour. The very slow pace at which this occurs, however, remains a puzzle. With regard to (ii) the impressive stability of the phase space configuration of multiparticle events is stressed, which is translated in practice by scaling and short range order. Regarding (iii) diffractive excitation is an important topic in high energy hadron physics, and double diffractive excitation is an interesting study. It is stated that the stability of all large cross section hadronic processes with increasing energy is remarkable, and it is not understood why so many things change so slowly with increasing energy. What can be referred to as lns physics still carries many challenging questions. (U.K.)

  3. The rational use of fine needle aspiration biopsy (FNAB) in diagnosing thyroid nodules.

    Science.gov (United States)

    Sidoti, M; Marino, G; Resmini, E; Augeri, C; Cappi, C; Cavallero, D; Lagasio, C; Ceppa, P; Minuto, F; Giusti, M

    2006-06-01

    Fine needle aspiration biopsy (FNAB) plays a crucial role in the diagnosis of thyroid nodules and enables the number of surgical operations to be reduced. Theoretically, FNAB should be carried out on all nodules, though currently only those displaying certain characteristics are biopsied. Indeed, to perform FNAB on all nodules may be regarded as an excess of zeal. Therefore, it seems advisable that the endocrinologist should be able to confirm on the spot the necessity and utility of FNAB. We evaluated on a sample of 263 consecutive requests (209 female, 57 male; age 56.7+/-13.7 years) for FNAB in 2004: 1) the appropriateness of the investigation, 2) expected efficacy, 3) practical efficacy, 4) efficiency. FNAB was performed under echo-guidance in accordance with the standard technique. In 50%, 36%, 6%, 3%, 2% and 1% of cases, the echographic diagnosis was of MNG, UNG, pseudo-nodular lesion in ATD, lymph-node, neck cyst, suspected parathyroid lesion and tumefaction of the salivary glands, respectively. A pre-FNAB clinical risk score was assigned to each case on the basis of clinical and echographic data, with a maximum possible score of 11. The results of FNAB were subdivided into 5 categories according to the criteria of the BTA (Thy1-Thy5). After FNAB, a decisional category was assigned, ranging from ''observation'' to ''surgery''; this was subsequently (7-18 months) compared with the management strategy adopted by the attending physician. Information was gathered by means of telephone enquiry. 1) Appropriateness: on the basis of clinical and echographic findings, FNAB was not judged appropriate in 24% of cases because of either the lack of confirmation of a significant target (34%) or a low pre-FNAB risk score (range 0-2) (66%). The decisional category was ''observation'' in 87% of cases and ''further investigation'' in 13%. 2) Expected efficacy: FNAB was performed in 76% of cases. The biopsies (3%) performed on swollen lymph-nodes and extra-thyroid neck

  4. The EXCYT RIB facility at LNS

    Energy Technology Data Exchange (ETDEWEB)

    Ciavola, G. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Alba, R. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Calabretta, L. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Cuttone, G. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Di Bartolo, G. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Gammino, S. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Migneco, E. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Raia, G. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Rifuggiato, D. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Rovelli, A. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Sura, J. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Vinciguerra, D. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud; Wollnik, H. [Inst. Nazionale di Fisica Nucleare, Catania (Italy). Lab. Nazionale del Sud

    1996-11-11

    EXCYT, a project for a low energy ISOL facility at LNS, has been funded. It is based on two already existing particle accelerators. A K=800 superconducting cyclotron will deliver the primary beam of ions A{<=}48; E=50-80 MeV/amu. After its interaction in a thick target, the negatively ionized radioactive products (A<80) will be post-accelerated to 0.2-8 MeV/amu by a 15 MV SMP tandem. A description of the facility, including the fully redesigned ion optics, an overview of the design problems and the expected secondary beam intensities are presented. (orig.).

  5. The EXCYT RIB facility at LNS

    International Nuclear Information System (INIS)

    Ciavola, G.; Alba, R.; Calabretta, L.; Cuttone, G.; Di Bartolo, G.; Gammino, S.; Migneco, E.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Sura, J.; Vinciguerra, D.; Wollnik, H.

    1996-01-01

    EXCYT, a project for a low energy ISOL facility at LNS, has been funded. It is based on two already existing particle accelerators. A K=800 superconducting cyclotron will deliver the primary beam of ions A≤48; E=50-80 MeV/amu. After its interaction in a thick target, the negatively ionized radioactive products (A<80) will be post-accelerated to 0.2-8 MeV/amu by a 15 MV SMP tandem. A description of the facility, including the fully redesigned ion optics, an overview of the design problems and the expected secondary beam intensities are presented. (orig.)

  6. Radioactive ion beam facilities at INFN LNS

    International Nuclear Information System (INIS)

    Rifuggiato, D; Calabretta, L; Celona, L; Chines, F; Cosentino, L; Cuttone, G; Finocchiaro, P; Pappalardo, A; Re, M; Rovelli, A

    2011-01-01

    Radioactive ion beams are produced at INFN- Laboratori Nazionali del Sud (LNS) by means of the two operating accelerators, the Tandem and the Superconducting Cyclotron (CS), originally designed to accelerate stable beams. Both the ISOL (Isotope Separation On Line) and the IFF (In-Flight Fragmentation) methods are exploited to produce RIBs in two different ways at different energies: in the first case, the Cyclotron is the primary accelerator and the Tandem accelerates the secondary beams, while in the second case radioactive fragments are produced by the Cyclotron beam in a thin target with energies comparable to the primary beam energy. The ISOL facility is named EXCYT (Exotics at the Cyclotron and Tandem) and was commissioned in 2006, when the first radioactive beam ( 8 Li) has been produced. The IFF installation is named FRIBs (in Flight Radioactive Ion Beams), and it has started to produce radioactive beams in 2001, placing a thin target in the extraction beam line of the Cyclotron. The development of both facilities to produce and accelerate radioactive ion beams at LNS, is briefly described, with some details on the future prospects that are presently under consideration or realization.

  7. Molecular genetic markers for thyroid FNAB. Established assays and future perspective.

    Science.gov (United States)

    Musholt, Thomas J; Musholt, P B

    2015-01-01

    Thyroid nodules > 1 cm are observed in about 12% of unselected adult employees aged 18-65 years screened by ultrasound scan (40). While intensive ultrasound screening leads to early detection of thyroid diseases, the determination of benign or malignant behaviour remains uncertain and may trigger anxieties in many patients and their physicians. A considerable number of thyroid resections are consecutively performed due to suspicion of malignancy in the detected nodes. Fine needle aspiration biopsy (FNAB) has been recommended for the assessment of thyroid nodules to facilitate detection of thyroid carcinomas but also to rule out malignancy and thereby avoid unnecessary thyroid resections. However, cytology results are dependent on experience of the respective cytologist and unfortunately inconclusive in many cases. Molecular genetic markers are already used nowadays to enhance sensitivity and specificity of FNAB cytology in some centers in Germany. The most clinically relevant molecular genetic markers as pre-operative diagnostic tools and the clinical implications for the intraoperative and postoperative management were reviewed. Molecular genetic markers predominantly focus on the preoperative detection of thyroid malignancies rather than the exclusion of thyroid carcinomas. While some centers routinely assess FNABs, other centers concentrate on FNABs with cytology results of follicular neoplasia or suspicion of thyroid carcinoma. Predominantly mutations of BRAF, RET/PTC, RAS, and PAX8/PPARγ or expression of miRNAs are analyzed. However, only the detection of BRAF mutations predicts the presence of (papillary) thyroid malignancy with almost 98% probability, indicating necessity of oncologic thyroid resections irrespective of the cytology result. Other genetic alterations are associated with thyroid malignancy with varying frequency and achieve less impact on the clinical management. Molecular genetic analysis of FNABs is increasingly performed in Germany

  8. Recent improvements of the tandem facility at LNS

    International Nuclear Information System (INIS)

    Ciavola, G.; Calabretta, L.; Cuttone, G.; Gammino, S.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Scuderi, V.

    1993-01-01

    The Laboratorio Nazionale del Sud (LNS) of Catania is equipped with an upgraded 15 MV SMP tandem that is going to be coupled to a k=800 superconducting cyclotron. The status of the facility and the performances of the upgraded tandem are presented. (orig.)

  9. Use of fragmentation beams at LNS with CHIMERA detector

    Directory of Open Access Journals (Sweden)

    Gianí R.

    2012-07-01

    Full Text Available The recent intensity upgrade of the LNS fragmentation beam is discussed. The available beams, the tagging procedures and details on the beam quality are reported. The experimental program started with the CHIMERA detector using such beams is also discussed with preliminary results and future perspectives.

  10. Status of the EXCYT facility at INFN-LNS

    Energy Technology Data Exchange (ETDEWEB)

    Ciavola, G. E-mail: ciavola@lns.infn.it; Alba, R.; Calabretta, L.; Celona, L.; Cosentino, G.; Cuttone, G.; Finocchiaro, P.; Gammino, S.; Menna, M.; Papaleo, R.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Silvestri, M.; Vinciguerra, D.; Winkler, M

    2002-04-22

    The EXCYT facility at the INFN-LNS aims to the production of radioactive ion beams to be post-accelerated by a 15 MV Tandem. The primary stable heavy-ion beam (up to 80 MeV/amu, 1 p{mu}A) is supplied by a K-800 Superconducting Cyclotron, which has been operating in a stand-alone mode, by means of the new axial injection beam line, since December, 1999. The magnets of the primary beam line have been aligned and most of the components of the mass separator have been purchased. Different types of Heavy Ion Target-Source (HITS) systems have been built and are here described; in particular, a microwave ion source fully designed and manufactured at LNS has been assembled and successfully tested. Finally, low-intensity beam diagnostics is also ready and reliability tests are under way.

  11. Status of the EXCYT facility at INFN-LNS

    International Nuclear Information System (INIS)

    Ciavola, G.; Alba, R.; Calabretta, L.; Celona, L.; Cosentino, G.; Cuttone, G.; Finocchiaro, P.; Gammino, S.; Menna, M.; Papaleo, R.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Silvestri, M.; Vinciguerra, D.; Winkler, M.

    2002-01-01

    The EXCYT facility at the INFN-LNS aims to the production of radioactive ion beams to be post-accelerated by a 15 MV Tandem. The primary stable heavy-ion beam (up to 80 MeV/amu, 1 pμA) is supplied by a K-800 Superconducting Cyclotron, which has been operating in a stand-alone mode, by means of the new axial injection beam line, since December, 1999. The magnets of the primary beam line have been aligned and most of the components of the mass separator have been purchased. Different types of Heavy Ion Target-Source (HITS) systems have been built and are here described; in particular, a microwave ion source fully designed and manufactured at LNS has been assembled and successfully tested. Finally, low-intensity beam diagnostics is also ready and reliability tests are under way

  12. Using CHIMERA detector at LNS for gamma-particle coincidences

    Directory of Open Access Journals (Sweden)

    Cardella G.

    2016-01-01

    Full Text Available We have recently evaluated the quality of γ-ray angular distributions that can be extracted in particle-gamma coincidence measurements using the CHIMERA detector at LNS. γ-rays have been detected using the CsI(Tl detectors of the spherical part of the CHIMERA array. Very clean γ-rays angular distributions were extracted in reactions induced by different stable beams impinging on 12C thin targets. The results evidenced an effect of projectile spin flip on the γ-rays angular distributions. γ-particle coincidence measurements were also performed in reactions induced by neutron rich exotic beams produced through in-flight fragmentation at LNS. In recent experiments also the Farcos array was used to improve energy and angular resolution measurements of the detected charged particles. Results obtained with both stable and radioactive beams are reported.

  13. First operations of the LNS heavy ions facility

    International Nuclear Information System (INIS)

    Calabretta, L.; Ciavola, G.; Cuttone, G.; Gammino, S.; Gmaj, P.; Migneco, E.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Sura, J.; Scuderi, V.; Acerbi, E.; Alessandria, F.; Bellomo, G.; Bosotti, A.; Martinis, C. de; Giove, D.; Michelato, P.; Pagani, C.; Rossi, L.

    1996-01-01

    A heavy ion facility is now available at laboratorio nazionale del Sud (LNS) of Catania. It can deliver beams with an energy up to 100 MeV/amu. The facility is based on a 15 MV HVEC tandem and a K=800 superconducting cyclotron as booster. During the last year, the facility came into operation. A 58 Ni beam delivered by the tandem has been radially injected in the SC and then has been accelerated and extracted at 30 MeV/amu. In this paper the status of the facility together with the experience gained during the commissioning will be extensively reported. (orig.)

  14. First operations of the LNS heavy ions facility

    Energy Technology Data Exchange (ETDEWEB)

    Calabretta, L. [INFN-LNS, Catania (Italy); Ciavola, G. [INFN-LNS, Catania (Italy); Cuttone, G. [INFN-LNS, Catania (Italy); Gammino, S. [INFN-LNS, Catania (Italy); Gmaj, P. [INFN-LNS, Catania (Italy); Migneco, E. [INFN-LNS, Catania (Italy); Raia, G. [INFN-LNS, Catania (Italy); Rifuggiato, D. [INFN-LNS, Catania (Italy); Rovelli, A. [INFN-LNS, Catania (Italy); Sura, J. [INFN-LNS, Catania (Italy); Scuderi, V. [INFN-LNS, Catania (Italy); Acerbi, E. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Alessandria, F. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Bellomo, G. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Bosotti, A. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Martinis, C. de [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Giove, D. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Michelato, P. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Pagani, C. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy); Rossi, L. [INFN-sezione di Milano (Italy)]|[Univ. degli studi di Milano, Lab. LASA (Italy)

    1996-11-11

    A heavy ion facility is now available at laboratorio nazionale del Sud (LNS) of Catania. It can deliver beams with an energy up to 100 MeV/amu. The facility is based on a 15 MV HVEC tandem and a K=800 superconducting cyclotron as booster. During the last year, the facility came into operation. A {sup 58}Ni beam delivered by the tandem has been radially injected in the SC and then has been accelerated and extracted at 30 MeV/amu. In this paper the status of the facility together with the experience gained during the commissioning will be extensively reported. (orig.).

  15. US-guided percutaneous biopsies with a biopsy gun

    International Nuclear Information System (INIS)

    Ahn, In Oak; Kim, Hyung Jin; Kim, Jae Hyung; Lee, Goo; Jung, Sung Hoon

    1993-01-01

    Core tissue for histologic study is believed by many pathologist to be more diagnostic than material from needle aspiration. Recently introduced automatched biopsy gun simplifies core biopsies with increased quantity and quality of samples. Authors performed 38 percutaneous biopsies from 38 patients with 18G automated biopsy guns under US guide. Diagnostic target tissues were obtained in 33 biopsies(87%), inadequate tissues in 4(11%), and adequate but not of target tissue in 1(3%). There was no major complication requiring treatment, but pain needing analgesics and pain with nausea/vomiting were experienced in 2 and 1 biopsies respectively. Average number of needle passes was 1.5. We concluded that US guided gun biopsy was a easy and safe way to obtain tissue samples of good quantity and quality, especially useful in hospitals without constant availability of specialist in cytopathology

  16. Status Of The EXCYT Facility at INFN-LNS

    International Nuclear Information System (INIS)

    Cuttone, G.; Alba, R.; Calabretta, L.; Celona, L.; Chines, F.; Cosentino, L.; Finocchiaro, P.; Grmek, A.; Gammino, S.; Menna, M.; Messina, G.E.; Raia, G.; Passarello, S.; Re, M.; Rifuggiato, D.; Rovelli, A.; Russo, S.; Schillaci, G.; Scuderi, V.; Zappala, E.

    2004-01-01

    The EXCYT facility (EXotics with CYclotron and Tandem) at the INFN-LNS is based on a K-800 Superconducting Cyclotron injecting stable heavy-ion beams (up to 80 MeV/amu, 1 eμA) into a target-ion source assembly to produce the required nuclear species, and on a 15 MV Tandem for post-accelerating the radioactive beams. Since December 1999 the Superconducting Cyclotron operates in a stand-alone mode by means of the new axial injection beam line. The primary beam line has been already mounted and tested. The part of mass separator on the two high-voltage platforms together with low intensity diagnostics is already installed while the ancillary items along with the part of mass separator at ground potential will be installed during the next stop of accelerator operations. The target-ion source unit has been successfully tested on-line at GANIL. The goal of such efforts will be represented by the test of the mass separator with stable beams planned at LNS by the end of the year. The commissioning of the EXCYT facility is foreseen in 2004 together with the start of nuclear experiments program

  17. FNAB cytology of extra-cranial metastasis of glioblastoma multiforme may resemble a lung primary: A diagnostic pitfall

    Directory of Open Access Journals (Sweden)

    Dincer HE

    2005-01-01

    Full Text Available Abstract Background As extra-cranial metastasis of glioblastoma multiforme (GBM is rare, it may create a diagnostic dilemma especially during interpretation of fine needle aspiration biopsy (FNAB cytology. Case presentation We present transbronchial FNAB findings in a 62-year-old smoker with lung mass clinically suspicious for a lung primary. The smears of transbronchial FNAB showed groups of cells with ill-defined cell margins and cytological features overlapping with poorly differentiated non-small cell carcinoma. The tumor cells demonstrated lack of immunoreactivity for cytokeratin, thyroid transcription factor-1, and usual neuroendocrine markers, synaptophysin and chromogranin in formalin-fixed cellblock sections. However, they were immunoreactive for the other neuroendocrine immunomarker, CD56, suggesting neural nature of the cells. Further scrutiny of clinical details revealed a history of GBM, 13 months status-post surgical excision with radiation therapy and systemic chemotherapy. The tumor recurred 7 months earlier and was debulked surgically and with intra-cranial chemotherapy. Additional evaluation of tumor cells for glial fibrillary acidic protein (GFAP immunoreactivity with clinical details resulted in final interpretation of metastatic GBM. Conclusion Lack of clinical history and immunophenotyping may lead to a diagnostic pitfall with possible misinterpretation of metastatic GBM as poorly differentiated non-small cell carcinoma of lung in a smoker.

  18. Status and Perspectives of the INFN-LNS In-Flight Fragment Separator

    Science.gov (United States)

    Russotto, P.; Calabretta, L.; Cardella, G.; Cosentino, G.; De Filippo, E.; Gnoffo, B.; La Cognata, M.; Martorana, N. S.; Pagano, E. V.; Pizzone, R. G.; Quattrocchi, L.; Romano, S.; Russo, A. D.; Santonocito, D.

    2018-05-01

    In the last 15 years the FRIBs@LNS facility has successfully produced Radioactive Ion Beams using the In-Flight technique. We report on the current status and future perspectives opened by FRAISE, a new fragment separator that will be build in connection with the upgrade of Superconducting Cyclotron of the INFN-LNS laboratories.

  19. US-guided percutaneous ethanol injection in Plummer's adenoma

    International Nuclear Information System (INIS)

    Lagalla, R.; Iovane, A.; Caruso, G.; Midiri, N.; Oliveri, D.; Brancato, G.; Cardinale, A.

    1991-01-01

    The authors report their experience in the study of 8 patients showing sympoms of thyroid hyperfunction (Plummer's adenoma) and treated with US-guided percutaneous ethanol injection. The treatment consisted in injecting sterile ethanol in varying amounts (2 to 5 ml) according to nodule size, using a fine needle under US guidance. The patients underwent 3 to 6 injections, according to biochemical (T3-T4-TSH) and scintigraphic findings. Follow-up ay 12 months showed regression of clinical symptoms, a trend of hormone levels toward normalization and recovery of previously suppressed parenchymal function. No significant complications were observed, except for a transient thyrotoxic crisis in the patient bearing the largest nodule. The treatment of Plummer's adenoma by means of percutaneous ethanol injection under us guidance appears to provide specific clinical and technical advantages over other conventional treatments

  20. Recent progress in plasma modelling at INFN-LNS

    Science.gov (United States)

    Neri, L.; Castro, G.; Torrisi, G.; Galatà, A.; Mascali, D.; Celona, L.; Gammino, S.

    2016-02-01

    At Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS), the development of intense ion and proton sources has been supported by a great deal of work on the modelling of microwave generated plasmas for many years. First, a stationary version of the particle-in-cell code was developed for plasma modelling starting from an iterative strategy adopted for the space charge dominated beam transport simulations. Electromagnetic properties of the plasma and full-waves simulations are now affordable for non-homogenous and non-isotropic magnetized plasma via "cold" approximation. The effects of Coulomb collisions on plasma particles dynamics was implemented with the Langevin formalism, instead of simply applying the Spitzer 90° collisions through a Monte Carlo technique. A wide database of different cross sections related to reactions occurring in a hydrogen plasma was implemented. The next step consists of merging such a variety of approaches for retrieving an "as-a-whole" picture of plasma dynamics in ion sources. The preliminary results will be summarized in the paper for a microwave discharge ion source designed for intense and high quality proton beams production, proton source for European Spallation Source project. Even if the realization of a predictive software including the complete processes involved in plasma formation is still rather far, a better comprehension of the source behavior is possible and so the simulations may support the optimization phase.

  1. Recent progress in plasma modelling at INFN-LNS

    Energy Technology Data Exchange (ETDEWEB)

    Neri, L., E-mail: neri@lns.infn.it; Castro, G.; Mascali, D.; Celona, L.; Gammino, S. [INFN-Laboratori Nazionali del Sud, Via S. Sofia 62, 95125 Catania (Italy); Torrisi, G. [INFN-Laboratori Nazionali del Sud, Via S. Sofia 62, 95125 Catania (Italy); Università Mediterranea di Reggio Calabria, Via Graziella, 89100 Reggio Calabria (Italy); Galatà, A. [INFN-Laboratori Nazionali di Legnaro, Viale dell’Università 2, 35020 Legnaro, Padova (Italy)

    2016-02-15

    At Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS), the development of intense ion and proton sources has been supported by a great deal of work on the modelling of microwave generated plasmas for many years. First, a stationary version of the particle-in-cell code was developed for plasma modelling starting from an iterative strategy adopted for the space charge dominated beam transport simulations. Electromagnetic properties of the plasma and full-waves simulations are now affordable for non-homogenous and non-isotropic magnetized plasma via “cold” approximation. The effects of Coulomb collisions on plasma particles dynamics was implemented with the Langevin formalism, instead of simply applying the Spitzer 90° collisions through a Monte Carlo technique. A wide database of different cross sections related to reactions occurring in a hydrogen plasma was implemented. The next step consists of merging such a variety of approaches for retrieving an “as-a-whole” picture of plasma dynamics in ion sources. The preliminary results will be summarized in the paper for a microwave discharge ion source designed for intense and high quality proton beams production, proton source for European Spallation Source project. Even if the realization of a predictive software including the complete processes involved in plasma formation is still rather far, a better comprehension of the source behavior is possible and so the simulations may support the optimization phase.

  2. Influence of Sampling Practices on the Appearance of DNA Image Histograms of Prostate Cells in FNAB Samples

    Directory of Open Access Journals (Sweden)

    Abdelbaset Buhmeida

    1999-01-01

    Full Text Available Twenty‐one fine needle aspiration biopsies (FNAB of the prostate, diagnostically classified as definitely malignant, were studied. The Papanicolaou or H&E stained samples were destained and then stained for DNA with the Feulgen reaction. DNA cytometry was applied after different sampling rules. The histograms varied according to the sampling rule applied. Because free cells between cell groups were easier to measure than cells in the cell groups, two sampling rules were tested in all samples: (i cells in the cell groups were measured, and (ii free cells between cell groups were measured. Abnormal histograms were more common after the sampling rule based on free cells, suggesting that abnormal patterns are best revealed through the free cells in these samples. The conclusions were independent of the applied histogram interpretation method.

  3. Nodular fasciitis of the face diagnosed by US-guided core needle biopsy: a case report

    International Nuclear Information System (INIS)

    Lee, Sang Kwon; Kwon, Sun Young

    2006-01-01

    We report here on a case of nodular fasciitis (NF) that was diagnosed by ultrasonography (US)-guided core needle biopsy in a 31-year-old man, and we include the US and computed tomographic (CT) findings and the histopathologic findings at US-guided core needle biopsy (CNB). We suggest that high-resolution US is useful for the detailed evaluation of NF in the superficial regions, such as the face, and US-guided CNB is useful for the definitive histologic diagnosis of NF without causing scarring

  4. Physicochemical characterization of epigallocatechin gallate lipid nanoparticles (EGCG-LNs) for ocular instillation.

    Science.gov (United States)

    Fangueiro, Joana F; Andreani, Tatiana; Fernandes, Lisete; Garcia, Maria L; Egea, Maria A; Silva, Amélia M; Souto, Eliana B

    2014-11-01

    The encapsulation of epigallocatechin gallate (EGCG) in lipid nanoparticles (LNs) could be a suitable approach to avoid drug oxidation and epimerization, which are common processes that lead to low bioavailability of the drug limiting its therapeutic efficacy. The human health benefits of EGCG gained much interest in the pharmaceutical field, and so far there are no studies reporting its encapsulation in LNs. The purpose of this study has been the development of an innovative system for the ocular delivery of EGCG using LNs as carrier for the future treatment of several diseases, such as dry eye, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy and macular oedema. LNs dispersions have been produced by multiple emulsion technique and previously optimized by a factorial design. In order to increase ocular retention time and mucoadhesion by electrostatic attraction, two distinct cationic lipids were used, namely, cetyltrimethylammonium bromide (CTAB) and dimethyldioctadecylammonium bromide (DDAB). EGCG has been successfully loaded in the LNs dispersions and the nanoparticles analysis over 30 days of storage time predicted a good physicochemical stability. The particles were found to be in the nanometer range (<300 nm) and all the evaluated parameters, namely pH, osmolarity and viscosity, were compatible to the ocular administration. The evaluation of the cationic lipid used was compared regarding physical and chemical parameters, lipid crystallization and polymorphism, and stability of dispersion during storage. The results show that different lipids lead to different characteristics mainly associated with the acyl chain composition, i.e. double lipid shows to have influence in the crystallization and stability. Despite the recorded differences between DTAB and DDAB, both cationic LNs seem to fit the parameters for ocular drug delivery. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Preventative lipid-based nutrient supplements (LNS) and young child feeding practices: findings from qualitative research in Haiti.

    Science.gov (United States)

    Lesorogol, Carolyn; Jean-Louis, Sherlie; Green, Jamie; Iannotti, Lora

    2015-12-01

    To prevent undernutrition in an urban slum in Haiti, a lipid-based nutrient supplement (LNS) was introduced through a randomised control trial. Food supplementation for young child nutrition has a long history in Haiti, but there is little empirical information regarding the effects of supplementation on young child feeding practices. One of the concerns raised by supplementation is that it may disrupt other positive feeding practices such as breastfeeding and use of other complementary foods, with negative consequences for child nutrition. We conducted 29 in-depth interviews with mother-baby pairs from the three comparison groups: control, 3-month LNS supplementation and 6-month LNS supplementation. Findings from those in the LNS groups indicated high acceptance and satisfaction with LNS and perceptions that it positively affects child health and development. LNS was integrated into and enhanced ongoing complementary feeding practices. The effects of LNS use on duration and perceived quantity of breastfeeding were variable, but generally, breastfeeding was maintained during and after the intervention. Interviews generated insights into beliefs regarding infant and young child feeding practices such as introduction and use of complementary foods, and breastfeeding duration, exclusivity and cessation. Implications for the use of LNS in public health nutrition programmes are discussed. © 2014 John Wiley & Sons Ltd.

  6. Need to plan for a full-scale lns-physics program at the SSC

    International Nuclear Information System (INIS)

    White, A.R.

    1984-03-01

    Arguments for a full lns physics program at the SSC are enumerated and elaborated on. They are: first - the inadequacy of data from a minimal program, second - the potential fundamental significance of a high-energy soft physics collective phenomenon and third - the possible diffractive production of much of the interesting new physics that will be searched for

  7. An LNS Approach for Container Stowage Multi-port Master Planning

    DEFF Research Database (Denmark)

    Pacino, Dario

    2013-01-01

    The generation of competitive stowage plans have become a priority for the shipping industry. Stowage planning is NP-hard and is a challenging optimization problem in practice. Two-phase decomposition approaches have proved to give viable solutions. We propose a large neighborhood search (LNS) to...

  8. US-guided preoperative hook-wire localization of nonpalpable breast lesions

    International Nuclear Information System (INIS)

    Shin, Tae Beom; Lee, Sang Kwon; Kim, Hye Jung; Ryeom, Hun Kyu; Kim, Tae Hun; Kim, Yong Ju; Kang, Duk Sik; Lee, Young Ha; Park, Ho Yong

    2000-01-01

    To evaluate the feasibility and efficacy of US-guided preoperative wire localization of nonpalpable breast lesions. US-guided preoperative wire localization was performed upon 45 nonpalpable breast lesions including 14 nonpalpable masses, 11 nonpalpable masses with microcalcifications, 11 ductal lesions, 9 with microcalcifications. No local anesthesia was performed during the localization procedure. Under the US-guidance, the needle with the hook-wire was inserted into the lesion until the hook of the wire reached 1 cm beyond the posterior margin of the lesion. Precise wire positioning was confirmed by mammography. Specimen radiography or specimen ultrasonography was performed in all cases. US-guided preoperative wire localization was successfully achieved in all cases. The time required for US-guided wire localization was less than five minutes. All lesions were successfully removed by surgical excision. Successful removal was confirmed by specimen radiography or specimen ultrasonography, gross findings of the specimen and consistency between radiographic and pathologic findings. The histologic diagnosis of 45 lesions were 7 ductal carcinoma in situ, 8 invasive ductal carcinoma, 6 fibroadenoma, 8 intraductal papilloma, 2 atypical ductal hyperplasia, and 14 fibrocystic changes. No complications were occurred during and after the procedure. US-guided preoperative wire localization for excisional biopsy is simple, safe, and accurate method in the histologic diagnosis of nonpalpable breast lesions detectable with ultrasonography.

  9. US-guided preoperative hook-wire localization of nonpalpable breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Beom; Lee, Sang Kwon; Kim, Hye Jung; Ryeom, Hun Kyu; Kim, Tae Hun; Kim, Yong Ju; Kang, Duk Sik; Lee, Young Ha; Park, Ho Yong [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)

    2000-12-15

    To evaluate the feasibility and efficacy of US-guided preoperative wire localization of nonpalpable breast lesions. US-guided preoperative wire localization was performed upon 45 nonpalpable breast lesions including 14 nonpalpable masses, 11 nonpalpable masses with microcalcifications, 11 ductal lesions, 9 with microcalcifications. No local anesthesia was performed during the localization procedure. Under the US-guidance, the needle with the hook-wire was inserted into the lesion until the hook of the wire reached 1 cm beyond the posterior margin of the lesion. Precise wire positioning was confirmed by mammography. Specimen radiography or specimen ultrasonography was performed in all cases. US-guided preoperative wire localization was successfully achieved in all cases. The time required for US-guided wire localization was less than five minutes. All lesions were successfully removed by surgical excision. Successful removal was confirmed by specimen radiography or specimen ultrasonography, gross findings of the specimen and consistency between radiographic and pathologic findings. The histologic diagnosis of 45 lesions were 7 ductal carcinoma in situ, 8 invasive ductal carcinoma, 6 fibroadenoma, 8 intraductal papilloma, 2 atypical ductal hyperplasia, and 14 fibrocystic changes. No complications were occurred during and after the procedure. US-guided preoperative wire localization for excisional biopsy is simple, safe, and accurate method in the histologic diagnosis of nonpalpable breast lesions detectable with ultrasonography.

  10. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  11. Superior Thyroid Artery Lesion After US-Guided Chemical Parathyroidectomy: Angiographic Diagnosis and Treatment by Embolization

    International Nuclear Information System (INIS)

    Perona, Franco; Barile, Antonio; Oliveri, Michele; Quadri, Piergiorgio; Ferro, Carlo

    1999-01-01

    A 71-year-old woman presented with a life-threatening thyroid hemorrhage after US-guided chemical parathyroidectomy. The diagnosis was made by angiography followed by immediate embolization of a pseudoaneurysm of the left superior thyroid artery. Embolization controlled the hemorrhage, obviating the need for surgery. The patient made a full recovery with no evidence of further hemorrhage. Pseudoaneurysm of the superior thyroid artery is a rare cause of hemorrhage and percutaneous embolization is an effective method of treatment

  12. Usefulness of US-guided automated gun biopsy of nonpalpable breast lesions

    International Nuclear Information System (INIS)

    Kwak, Min Sook; Kim, Hak Soo; Lee, Han Kyung; Koh, Sung Hye; O, Eun Young; Yoon, Myung Hwan; Yang, Dal Mo; Kim, Hyung Sik

    1997-01-01

    To evaluate the clinical usefulness of ultrasonography(US)-guided automated gun biopsy of nonpalpable breast lesions. In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. In 29 of 30 lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows : one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibrodenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and in these four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US

  13. Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy.

    Science.gov (United States)

    Gedikoglu, Murat; Oguzkurt, Levent

    2017-01-01

    We aimed to describe ultrasonography (US)-guided percutaneous aspiration thrombectomy in pregnant women with iliofemoral deep vein thrombosis. This study included nine pregnant women with acute and subacute iliofemoral deep vein thrombosis, who were severe symptomatic cases with massive swelling and pain of the leg. Patients were excluded from the study if they had only femoropopliteal deep vein thrombosis or mild symptoms of deep vein thrombosis. US-guided percutaneous aspiration thrombectomy was applied to achieve thrombus removal and uninterrupted venous flow. The treatment was considered successful if there was adequate venous patency and symptomatic relief. Complete or significant thrombus removal and uninterrupted venous flow from the puncture site up to the iliac veins were achieved in all patients at first intervention. Complete relief of leg pain was achieved immediately in seven patients (77.8%). Two patients (22.2%) had a recurrence of thrombosis in the first week postintervention. One of them underwent a second intervention, where percutaneous aspiration thrombectomy was performed again with successful removal of thrombus and establishment of in line flow. Two patients were lost to follow-up after birth. None of the remaining seven patients had rethrombosis throughout the postpartum period. Symptomatic relief was detected clinically in these patients. Endovascular treatment with US-guided percutaneous aspiration thrombectomy can be considered as a safe and effective way to remove thrombus from the deep veins in pregnant women with acute and subacute iliofemoral deep vein thrombosis.

  14. Usefulness of US-guided automated gun biopsy of nonpalpable breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Sook; Kim, Hak Soo; Lee, Han Kyung; Koh, Sung Hye; O, Eun Young; Yoon, Myung Hwan; Yang, Dal Mo; Kim, Hyung Sik [Chungang Gil Hospital, Incheon (Korea, Republic of)

    1997-11-01

    To evaluate the clinical usefulness of ultrasonography(US)-guided automated gun biopsy of nonpalpable breast lesions. In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. In 29 of 30 lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows : one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibrodenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and in these four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US.

  15. Fragmentation studies with the CHIMERA detector at LNS in Catania: recent progress

    Energy Technology Data Exchange (ETDEWEB)

    Pagano, A.; Alderighi, M.; Amorini, F.; Anzalone, A.; Arena, L.; Auditore, L.; Baran, V.; Bartolucci, M.; Berceanu, I.; Blicharska, J.; Brzychczyk, J.; Bonasera, A.; Borderie, B.; Bougault, R.; Bruno, M.; Cardella, G.; Cavallaro, S.; Chatterjee, M.B.; Chbihi, A.; Cibor, J.; Colonna, M.; D' Agostino, M.; Dayras, R.; De Filippo, E.; Di Toro, M.; Gawlikowicz, W.; Geraci, E.; Giustolisi, F.; Grzeszczuk, A.; Guazzoni, P.; Guinet, D.; Iacono-Manno, M.; Kowalski, S.; La Guidara, E.; Lanzano, G.; Lanzalone, G.; Le Neindre, N.; Li, S.; Lo Nigro, S.; Maiolino, C.; Majka, Z.; Manfredi, G.; Paduszynski, T.; Papa, M.; Petrovici, M.; Piasecki, E.; Pirrone, S.; Planeta, R.; Politi, G.; Pop, A.; Porto, F.; Rivet, M.F.; Rosato, E.; Rizzo, F.; Russo, S.; Russotto, P.; Sassi, M.; Sechi, G.; Simion, V.; Siwek-Wilczynska, K.; Skwira, I.; Sperduto, M.L.; Steckmeyer, J.C.; Swiderski, L.; Trifiro, A.; Trimarchi, M.; Vannini, G.; Vigilante, M.; Wieleczko, J.P.; Wilczynski, J.; Wu, H.; Xiao, Z.; Zetta, L.; Zipper, W

    2004-04-05

    The new detector CHIMERA, in its final 4{pi} configuration, has been installed at Laboratori Nazionali del Sud (LNS) in Catania in January 2003. Beams of different energies ranging from protons to Au ions were delivered by the Tandem and the Super Conducting Cyclotron for nuclear reaction studies, in agreement with the approval of the Scientific Advisory Committee of LNS. Recent experimental results confirm very low energy thresholds of the trigger (below 0.5 MeV/nucleon), ensured within a wide dynamical range. Good characteristics of identification of light charged particles and heavy fragments have been obtained by using three detection techniques: {delta}E-E, {delta}E-time of flight, and the Pulse-Shape discrimination method. We present results of recent analysis concerning the production of intermediate mass fragments (IMF) in semi-peripheral collisions. Our results combined with theoretical Boltzmann-Nordheim-Vlasov simulations clearly demonstrate the presence of very fast processes of IMF production in the overlapping region of the target and projectile nuclei during re-separation, i.e. in the time scale comparable with the collision time. Evidence for slower, sequential-like production of IMF's is also shown.

  16. Fragmentation studies with the CHIMERA detector at LNS in Catania: recent progress

    International Nuclear Information System (INIS)

    Pagano, A.; Alderighi, M.; Amorini, F.; Anzalone, A.; Arena, L.; Auditore, L.; Baran, V.; Bartolucci, M.; Berceanu, I.; Blicharska, J.; Brzychczyk, J.; Bonasera, A.; Borderie, B.; Bougault, R.; Bruno, M.; Cardella, G.; Cavallaro, S.; Chatterjee, M.B.; Chbihi, A.; Cibor, J.; Colonna, M.; D'Agostino, M.; Dayras, R.; De Filippo, E.; Di Toro, M.; Gawlikowicz, W.; Geraci, E.; Giustolisi, F.; Grzeszczuk, A.; Guazzoni, P.; Guinet, D.; Iacono-Manno, M.; Kowalski, S.; La Guidara, E.; Lanzano, G.; Lanzalone, G.; Le Neindre, N.; Li, S.; Lo Nigro, S.; Maiolino, C.; Majka, Z.; Manfredi, G.; Paduszynski, T.; Papa, M.; Petrovici, M.; Piasecki, E.; Pirrone, S.; Planeta, R.; Politi, G.; Pop, A.; Porto, F.; Rivet, M.F.; Rosato, E.; Rizzo, F.; Russo, S.; Russotto, P.; Sassi, M.; Sechi, G.; Simion, V.; Siwek-Wilczynska, K.; Skwira, I.; Sperduto, M.L.; Steckmeyer, J.C.; Swiderski, L.; Trifiro, A.; Trimarchi, M.; Vannini, G.; Vigilante, M.; Wieleczko, J.P.; Wilczynski, J.; Wu, H.; Xiao, Z.; Zetta, L.; Zipper, W.

    2004-01-01

    The new detector CHIMERA, in its final 4π configuration, has been installed at Laboratori Nazionali del Sud (LNS) in Catania in January 2003. Beams of different energies ranging from protons to Au ions were delivered by the Tandem and the Super Conducting Cyclotron for nuclear reaction studies, in agreement with the approval of the Scientific Advisory Committee of LNS. Recent experimental results confirm very low energy thresholds of the trigger (below 0.5 MeV/nucleon), ensured within a wide dynamical range. Good characteristics of identification of light charged particles and heavy fragments have been obtained by using three detection techniques: ΔE-E, ΔE-time of flight, and the Pulse-Shape discrimination method. We present results of recent analysis concerning the production of intermediate mass fragments (IMF) in semi-peripheral collisions. Our results combined with theoretical Boltzmann-Nordheim-Vlasov simulations clearly demonstrate the presence of very fast processes of IMF production in the overlapping region of the target and projectile nuclei during re-separation, i.e. in the time scale comparable with the collision time. Evidence for slower, sequential-like production of IMF's is also shown

  17. Reduction of lns-1 gene expression and tissue insulin levels in n5-STZ rats

    Directory of Open Access Journals (Sweden)

    Belinda Vargas Guerrero

    2013-01-01

    Full Text Available Objective: The high global incidence of type 2 diabetes has challenged researchers to establish animal models that resemble the chronic stage observed in type 2 diabetes patients. One such model is induced by neonatal streptozotocin (n-STZ administration to rat pups at 0, 2, or 5 days after birth. In this study, we assessed lns-1 gene expression and tissue insulin levels as well as serum concentration of glucose and insulin, insulin resistance, and histological changes of the islets of Langerhans in n5-STZ rats after 20-weeks post-induction. Methods: Wistar rat pups were randomly distributed into a control group and a streptozotocin-induced group. Experimental induction involved a single intraperitoneal injection of streptozotocin (150 mg/kg into neonates at five days after birth. Results: At 20 weeks post-induction, streptozotocin-induced rats exhibited increased serum glucose levels, reduced serum insulin levels, impaired glucose metabolism and insulin resistance compared to control rats. Histologically, streptozotocin-induced rats exhibited atrophic islets, vacuolization, and significantly fewer insulin-positive cells. lns-1 gene expression was significantly decreased in n5-STZ rats in comparison to the control group. Conclusion: Our findings support that the n5-STZ model 20 weeks post-induction represents an appropriate experimental tool to study T2D and to evaluate novel therapeutic agents and targets that involve insulin gene expression and secretion, as well as complications caused by chronic diabetes.

  18. Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: A minimum of 2-year follow-up retrospective comparative study.

    Science.gov (United States)

    Alessio-Mazzola, Mattia; Repetto, Ilaria; Biti, Besmir; Trentini, Roberto; Formica, Matteo; Felli, Lamberto

    2018-01-01

    To compare the efficacy of two independent groups of patients treated with ultrasound (US)-guided extracorporeal shock wave (ESW) therapy and with US-guided injection of platelet-rich plasma (PRP) for chronic lateral epicondylitis (LE) with a minimum of 2-year follow-up. We retrospectively evaluated 63 patients treated for chronic LE (31 patients with autologous US-guided PRP injection and 32 patients with US-guided focal ESW therapy) from 2009 to 2014. All the patients were evaluated by means of Roles-Maudsley (RM) score, quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) score, visual analogic scale (VAS) and patient-rated tennis elbow evaluation (PRTEE) to retrospectively assess the pain relief, level of activity, the self-reported function and subjective satisfaction at minimum of 2-year follow-up. Both US-guided autologous PRP injection and US-guided focal ESW administration proved effective in chronic LE with significant improvement in the QuickDASH, VAS, RM and PRTEE scores ( p 0.05). The mean time between treatment and symptom resolution was significantly shorter for the PRP treatment ( p = 0.0212); furthermore, the mean time to return to the normal activities was quicker for PRP group ( p = 0.0119). Both PRP injection and ESW therapy are feasible and safe options for the treatment of chronic LE with low risk of complications and with good long-term follow-up results. US-guided PRP injection has quick efficacy when compared with US-guided focal ESW therapy.

  19. US-guided diffuse optical tomography for breast lesions: the reliability of clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Jung; Kim, Ji Youn; Youn, Jung Hyun; Kim, Myung Hyun; Koo, Hye Ryoung; Kim, Soo Jin; Sohn, Yu-Mee; Moon, Hee Jung; Kim, Eun-Kyung [Yonsei University College of Medicine, Institute of Radiological Science, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2011-07-15

    To prospectively assess the reliability of US-guided diffuse optical tomography (US-DOT) using interobserver agreement for the diagnosis of breast lesions with individual real-time imaging and to assess the interobserver agreement of conventional sonography (US) combined with US-DOT for differentiation between benignity and malignancy breast lesions. An Institutional Review Board approved this study, and all subjects provided written informed consent. 122 breast lesions in 111 patients evaluated with US-guided core biopsy were included. Assessments with US and US-DOT for cases subjected to biopsy were obtained by two radiologists using individual real-time imaging prior to biopsy and were prospectively recorded by each performer. With DOT, the total haemoglobin concentration (THC) for each breast lesion was measured. Histopathological results from US-guided biopsies were used as a reference standard. To assess measurement interobserver agreement, the intraclass correlation coefficient (ICC) and the Bland-Altman plot were used for THC in US-DOT and the kappa values and ROC analysis were used to evaluate the diagnostic performances of the US BI-RADS final assessment in US and combined US and US-DOT. Of 122 US-guided core biopsied lesions, 83 (68.0%) were diagnosed as benign, and 39 (32.0%) as malignant. Excellent correlation was seen in the THC in US-DOT (ICC score 0.796; 95% confidence interval, 0.708-0.857). The interobserver agreement in BI-RADS final assessment with US and US-DOT (almost perfect; {kappa} = 0.8618) was improved compared with that of US (substantial agreement, {kappa} = 0.6574). However, the overall areas under the ROC curve did not show significant differences between US and combined US and US-DOT, 0.8894 and 0.8975, respectively (P = 0.981). The reliability of THC in US-DOT showed excellent correlation in overall real-time performance. Although the inter-observer agreement for BI-RADS final assessment of US was improved by using US-DOT, the

  20. US-guided biopsy of renal allografts using 18G biopsy gun: analysis of 200 cases

    International Nuclear Information System (INIS)

    Kim, Eun Kyung; Lee, Jong Tae; Kim, Myeong Jin; Yoo, Hyung Sik; Kim, Ki Whang; Park, Ki Ill; Chung, Hyun Joo

    1995-01-01

    We evaluated the effectiveness and safety of 18G biopsy gun with US guidance in the transplanted kidneys. We performed 200 US-guided percutaneous biopsies using 18G biopsy gun. Diagnostic efficacy and complication of the biopsy in these patients were analyzed. Biopsy specimens were adequate for histologic diagnoses in 193 patients(96.5%). The mean of the biopsy frequency was 3, the mean of total glomerular number was 21.64 and the mean glomerular number per one biopsy was 6.93. Major complications occurred in 3 (1.5%) of the 200 biopsies; hematuria developed in two patients, AV fistula in one. These complications were successfully controlled either by only transfusion or by coil embolization. There were no statistical differences in blood pressure, hemoglobin, BUN/Cr between pre-and post-renal biopsies. US-guided percutaneous biopsy of renal allograft with 18G biopsy gun is simple, safe, and accurate method in evaluating the renal allograft dysfunction

  1. Treatment of benign cold thyroid nodule: efficacy and safety of US-guided percutaneous ethanol injection

    International Nuclear Information System (INIS)

    Kim, Jeong Kon; Lee, Ho Kyu; Lee, Myung Joon; Choi, Choong Gon; Suh, Dae Chul; Ahn, Il Min

    1998-01-01

    The purpose of this study was to evaluate the efficacy and safety of US-guided percutaneous ethanol injection for the treatent of benign cold thyroid nodules. Twenty-five patients with benign cold thyroid nodules (volume of each at least 2ml proven by PCNA to be adenomatous hyperplasia, and cold nodule by thyroid scan) underwent a total of one to three percutaneous ethanol injections (PEI) at intervals of one or two months. The mean amount of ethanol used was 6.2(range, 1.5-8)ml, depending on the volume of the nodule. Follow up ultrasonography was performed one to four months after the final session. The initial volume of nodules was 11.4±4.1(range, 2.5-41.4)ml, and in all cases this fell by 56.1±22.3%(range, 10.9-92.1%);in all cases, follow-up ultrasonography showed that echogeneity was lower and its pattern was heterogeneous. There were no important longstanding complications;the most common side effect was acute pain at the injection site(n=3D9), and in one case, transient vocal cord palsy occurred. Our results show that US-guided percutaneous injection of ethanol is an effective and a safe procedure for the treatment of benign cold thyroid nodules, and is thus an alternative to surgery or hormone therapy.=20

  2. Usefulness of the coaxial technique in US-guided breast core biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Jeong Hwa; Ha, Jeon Ju; Lee, Keon; Kim, Won Ho; Kwon, Jung Hyeok [Dongkang general hospital, Seoul (Korea, Republic of); Ham, Soo Youn [Ulsan Univ. Hospital, Ulsan (Korea, Republic of)

    1999-05-01

    To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40 patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion. Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We used an 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens were obtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and their rate were evaluated. For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, and the findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 of fibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12 lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. The procedure time was about 15 minutes and no significant complications were noted. In breast core biopsy, the coaxial technique is simple and time-saving, and compared with standard breast core biopsy, may also be less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells.

  3. Usefulness of the coaxial technique in US-guided breast core biopsy

    International Nuclear Information System (INIS)

    Kim, Dong Hyun; Lee, Jeong Hwa; Ha, Jeon Ju; Lee, Keon; Kim, Won Ho; Kwon, Jung Hyeok; Ham, Soo Youn

    1999-01-01

    To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40 patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion. Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We used an 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens were obtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and their rate were evaluated. For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, and the findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 of fibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12 lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. The procedure time was about 15 minutes and no significant complications were noted. In breast core biopsy, the coaxial technique is simple and time-saving, and compared with standard breast core biopsy, may also be less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells

  4. Risk of disseminated intravascular coagulation in patients undergoing US-guided transperineal prostatic biopsy

    International Nuclear Information System (INIS)

    Stella, M.S.; Comparato, D.; Camici, M.; Evangelisti, L.; Gaudio, V.; De Negri, F.; Talarico, L.; Giusti, C.; Morelli, G.

    1991-01-01

    Disseminated intravascular coagulation (DIC) is a severe life-threatening acute bleeding disorder. Traumatized tissues, tumors, necrotic tissues, or bacterial endotoxines release similar material in the blood to the tissutal factors activating the coagulation cascade. This preliminary study was aimed at verifying the risk of DIV in patients undergoing US-guided transperineal prostatic biopsy with Chiba and Tru-Cut needles. To evaluate the activation degree of coagulation factors in the circulation, the authors measured the concentrations of urinary fibrin degradation products in 10 patients undergoing US-guided transperineal prostatic biopsy, both before and after biopsy, every second hour, for 24 hours. Every tube of urine sample contained soya bean trypsin inhibitor and bovine thrombin to prevent any further fibrin degradation during incubation period for the possible presence of blood in urine samples. The results showed that 7/10 patients had marked increase in urinary fibrin degradation product levels (up to 800 XXXX%), with a 3-phase trend: early peak after 2-6 hours, middle peak after 6-14 hours, and late peak after 18-24 hours, which proved the activation of the coagulation cascade

  5. Overview of the future upgrade of the INFN-LNS superconducting cyclotron

    Science.gov (United States)

    Calabretta, Luciano; Calanna, Alessandra; Cuttone, Giacomo; D'Agostino, Grazia; Rifuggiato, Danilo; Domenico Russo, Antonio

    2017-06-01

    The LNS Superconducting Cyclotron, named “Ciclotrone Superconduttore” (CS), has been in operation for more than 20 years. A wide range of ion species from hydrogen to lead, with energy in the range 10 to 80 AMeV, have been delivered to users. The maximum beam power is limited to 100 W due to the beam dissipation on the electrostatic deflectors. To fulfil the demand of users aiming at studying rare processes in nuclear physics, an upgrade of the cyclotron is necessarily intended to increase the intensity of ion beams with mass lower than 40 a.m.u. up to a power 10 kW. This will be achieved by means of extraction by stripping. This solution needs to replace the cryostat including the superconducting coils. The present capability of the cyclotron will be maintained, i.e. all the ion species allowed by the operating diagram will be available, being extracted by electrostatic extraction. In addition to the high power beams for nuclear physics, it will be possible to produce medical radioisotopes like 211At using an internal target.

  6. DDS-based control loops for the RF system at INFN-LNS

    International Nuclear Information System (INIS)

    Caruso, A.; Calabretta, L.; Cosentino, G.; Sparta, A.; Speziale, F.

    2005-01-01

    In the last two years a new radio-frequency source generator has been working to synthesize the driving sinusoidal signals of the RF systems at LNS. This device is based on Direct Digital Synthesis (DDS) technique. Every time you need a constant relation of phase between several RF signals, our DDS-based multiple frequencies generator produces these high frequency waveforms. The good results of this DDS synthesizer technique, make us feel confident that we can develop a new DDS control system for the various RF equipment. The AD9852/54 a commercial DDS microchip, will be the core of this new control system. The component allows, through digital ports, the manipulation of the frequency, amplitude and phase of the developed RF-carrier without any interruption to the latter. In this way we would have a complete DDS control system capable of stabilizing amplitude, phase and tuning ensuring the present stability of the analog control loops. The remaining operations, such as turning on/off and protection of the system will be performed at the same time. The prototype of this new DDS control, its technical performances and the experimental results will be presented in this paper. (author)

  7. Correlation of cytological report obtained on FNAB with the sonographic features of thyroid nodular disease, experience for 4 months, Mexico Hospital

    International Nuclear Information System (INIS)

    Aragon Arrieta, Nazira

    2007-01-01

    The introduction in the market for ultrasound equipment with high resolution has opened the eyes of the radiologist and has made multiple pathologies that previously only were described by the pathologist, they are being recognized when performing a sonographic rating. The isotopic test has been the most used to assess the thyroid gland for many years. Other techniques are disposed at present for the evaluation of the same; ultrasound has been one of the most popular because it provides information of glandular pathology, determines behavior diagnosis, therapeutic or both. Besides, the low cost of doing the studies is another important factor to add. The realization of fine-needle biopsy of the thyroid gland is safe, inexpensive and minimally invasive; factors that influence plays an important role in the management of nodular thyroid disease. A correlation is established between sonographic findings and cytological reports obtained by FNAB, for 4 months (february to may 2006), in the population of Hospital Mexico, in order to set parameters that fit the environmental conditions. An observational study, retrospective and cross was performed. (author) [es

  8. Use of 70 MeV proton beam for medical applications at INFN-LNS: CATANA project

    International Nuclear Information System (INIS)

    Sabini, M.G.; Cirrone, G.A.P.; Barone Tonghi, L.; Cuttone, G.; Romeo, N.; Rovelli, A.; Bartolotta, A.; Brai, M.; Teri, G.; Nigro, S. Lo; Marano, F.; Nicoletti, G. A.; Reibaldi, A.; Privitera, G.; Salamone, V.; Raffaele, L.

    2000-01-01

    The project CATANA (Centro di Adro Terapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of protontherapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations

  9. Use of 70 MeV Proton Beam for Medical Applications at INFN-LNS: CATANA Project

    International Nuclear Information System (INIS)

    Sabini, M.G.; Cirrone, G.A.P.; Barone Tonghi, L.; Bartolotta, A.; Brai, M.; Cuttone, G.; Lo Nigro, S.; Marano, F.; Nicoletti, G.A.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Romeo, N.; Rovelli, A.; Salamone, V.; Teri, G.

    2000-01-01

    The project CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of proton therapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations

  10. Use of 70 MeV proton beam for medical applications at INFN-LNS: CATANA project

    Science.gov (United States)

    Sabini, M. G.; Cirrone, G. A. P.; Tonghi, L. Barone; Bartolotta, A.; Brai, M.; Cuttone, G.; Nigro, S. Lo; Marano, F.; Nicoletti, G. A.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Romeo, N.; Rovelli, A.; Salamone, V.; Teri, G.

    2000-04-01

    The project CATANA (Centro di Adro Terapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of protontherapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations.

  11. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Cha, Soon Joo

    2002-01-01

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 ±3.8 min. in the right approach and 9.6 ±3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9±2.4 min. in the right approach and 3.8±2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD

  12. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Cha, Soon Joo [College of Medicine, Inje Univ., Kimhae (Korea, Republic of)

    2002-02-01

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 {+-}3.8 min. in the right approach and 9.6 {+-}3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9{+-}2.4 min. in the right approach and 3.8{+-}2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD.

  13. Complete removal of a breast mass by US-guided mammotome biopsy: histologic assessment by marginal sampling

    International Nuclear Information System (INIS)

    Kim, Youn Jeong; Choi, Hye Young; Moon, Byung In; Lee, Shi Nae

    2005-01-01

    The aim of this study was to assess whether the complete removal of a breast mass using ultrasound (US) guided mammotome biopsy was successful using a marginal biopsy after insuring the total visual excision of the breast mass on US images. The relationship of complete breast mass removal, and the hematoma, mass size and shape were also evaluated. A US guided mammotome biopsy was performed in a total of 136 cases in 133 patients, with marginal biopsies also added when the complete removal of breast mass had been identified by sonography. The results of the marginal biopsies were serially dividing into three groups, as follows: group I were the cases in the initial 6 months, group II after the initial 6 months and group III having undergone two marginal biopsies. The marginal biopsies were performed in four directions around the probe, with 'marginal positivity' defined as the same histopathological findings to that of the main mass in at least one direction. A statistical analysis was also used to evaluate between the marginal positivity and the hematoma, mass size and shape. The marginal positivities of groups I, II and III were 48.8, 29.4 and 45.5%, respectively. The marginal positivity of those with a lobular shaped mass was significantly higher (ρ = 0.0121) than those with round or oval shaped masses (61.5 vs 33.7 vs 50%), but showed no statistical relationship with hematoma size of the lesions. Although the lesions were removed by US using a US-guided mammotome biopsy, many residual lesions were still histologically present in the marginal samplings, especially in the lobular shaped masse

  14. Beam commission of the high intensity proton source developed at INFN-LNS for the European Spallation Source

    Science.gov (United States)

    Neri, L.; Celona, L.; Gammino, S.; Miraglia, A.; Leonardi, O.; Castro, G.; Torrisi, G.; Mascali, D.; Mazzaglia, M.; Allegra, L.; Amato, A.; Calabrese, G.; Caruso, A.; Chines, F.; Gallo, G.; Longhitano, A.; Manno, G.; Marletta, S.; Maugeri, A.; Passarello, S.; Pastore, G.; Seminara, A.; Spartà, A.; Vinciguerra, S.

    2017-07-01

    At the Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS) the beam commissioning of the high intensity Proton Source for the European Spallation Source (PS-ESS) started in November 2016. Beam stability at high current intensity is one of the most important parameter for the first steps of the ongoing commissioning. Promising results were obtained since the first source start with a 6 mm diameter extraction hole. The increase of the extraction hole to 8 mm allowed improving PS-ESS performances and obtaining the values required by the ESS accelerator. In this work, extracted beam current characteristics together with Doppler shift and emittance measurements are presented, as well as the description of the next phases before the installation at ESS in Lund.

  15. Effectiveness of Fluoroscopic and US - Guided Percutaneous Catheter Drainage for Iliopsoas Abscess through the Anterolateral Transabdominal Approach

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ho Cheol; Shin, Tae Beom; Park, Mee Jung; Kim, Ji Eun; Choi, Hye Young; Bae, Kyung Soo; Choi, Dae Seob; Na, Jae Boem; Jeong, Seong Hoon [Gyeongsang National University Hospital, College of Medicine, Jinju (Korea, Republic of)

    2011-02-15

    We evaluated the effectiveness of performing fluoroscopic and ultrasonography guided percutaneous catheter drainage (PCD) through the anterolateral transabdominal approach for treating iliopsoas abscess. From January 2008 to December 2009, fluoroscopic and US-guided PCD through the anterolateral transabdominal approach was performed on sixteen iliopsoas abscesses of fourteen patients (7 males and 7 females; mean age: 63 years; age range: 30-87 years). Six abscesses were on the right side and ten abscesses were on the left side. The location of the abscesses were the psoas muscle (n=7), the iliacus muscle (n=7) and the iliopsoas muscle (n=2). All the procedures were performed under fluoroscopy and US guidance in the angiography room. The clinical findings before and after the procedure, the duration of catheter insertion and the procedure-related complications were evaluated. 15 out of the 16 iliopsoas abscesses were effectively treated. The duration of catheter insertion was 5- 27 days (mean: 14.6) days. No patient had significant complications during or after drainage. One patient died of uncontrolled diabetes complications and shock on the 9th day after percutaneous catheter drainage. One recurrence was noted 5 months after removal of the catheter. This patient underwent aspiration and antibiotic treatment for this lesion and the patient improved. Fluoroscopic and US-guided PCD for iliopsoas abscess through the anterolateral transabdominal approach is an effective and safe procedure

  16. Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI.

    Science.gov (United States)

    Song, Sung Eun; Cho, Nariya; Han, Wonshik

    2017-12-01

    To evaluate whether the post-clip placement MRI following second-look ultrasound (US)-guided core biopsy is useful to confirm the adequate sampling of suspicious lesions identified on breast MRI. Between 2014 and 2016, 31 consecutive women with 34 suspicious lesions that had not been identified on previous mammography or US were detected using MRI. Among them, 26 women with 29 lesions (mean size 1.5 cm, range 0.5-5.8 cm) found by second-look US underwent US-guided biopsy, subsequent clip insertion and post-clip placement MRI. Five women with five lesions that were not found by second-look US underwent MRI-guided biopsy. The technical success rate and lesion characteristics were described. The technical success rate was 96.6% (28/29). One failure case was a benign, 1.1-cm non-mass enhancement. Of the 28 success cases, 23 (82.1%) were masses and 5 (17.9%) were non-mass enhancements; 17 (60.7%) were benign, 4 (14.3%) were high-risk and 7 (25.0%) were malignant lesions. The technical success rate was 100% (28/28) for masses and 83.3% (5/6) for non-mass enhancements. Post-clip placement MRI following US-guided biopsy is useful in confirming the adequate sampling of lesions identified on MRI. This method could be an alternative to MRI-guided biopsy for lesions visible on US. • Post-clip MRI is useful for confirming adequate sampling of US-guided biopsy. • Post-clip MRI following US-guided biopsy revealed a 96.6 % technical success rate. • One technical failure case was a benign, 1.1-cm non-mass enhancement. • The technical success rate of US-guided biopsy for non-mass enhancements was 83.3 %.

  17. Lesion stiffness measured by shear-wave elastography: Preoperative predictor of the histologic underestimation of US-guided core needle breast biopsy.

    Science.gov (United States)

    Park, Ah Young; Son, Eun Ju; Kim, Jeong-Ah; Han, Kyunghwa; Youk, Ji Hyun

    2015-12-01

    To determine whether lesion stiffness measured by shear-wave elastography (SWE) can be used to predict the histologic underestimation of ultrasound (US)-guided 14-gauge core needle biopsy (CNB) for breast masses. This retrospective study enrolled 99 breast masses from 93 patients, including 40 high-risk lesions and 59 ductal carcinoma in situ (DCIS), which were diagnosed by US-guided 14-gauge CNB. SWE was performed for all breast masses to measure quantitative elasticity values before US-guided CNB. To identify the preoperative factors associated with histologic underestimation, patients' age, symptoms, lesion size, B-mode US findings, and quantitative SWE parameters were compared according to the histologic upgrade after surgery using the chi-square test, Fisher's exact test, or independent t-test. The independent factors for predicting histologic upgrade were evaluated using multivariate logistic regression analysis. The underestimation rate was 28.3% (28/99) in total, 25.0% (10/40) in high-risk lesions, and 30.5% (18/59) in DCIS. All elasticity values of the upgrade group were significantly higher than those of the non-upgrade group (PBreast lesion stiffness quantitatively measured by SWE could be helpful to predict the underestimation of malignancy in US-guided 14-gauge CNB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, B., E-mail: belarmino.goncalves@gmail.com [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Ambrosio, C.; Serra, S. [Department of Rheumatology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F. [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal)

    2011-09-15

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  19. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    International Nuclear Information System (INIS)

    Goncalves, B.; Ambrosio, C.; Serra, S.; Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F.

    2011-01-01

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  20. Anti-tumoral effect of recombinant vaccinia virus through US guided injection in a rabbit model of hepatic VX2 carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jong Young; Park, Byeong Ho; Kang, Myong Jin; Cho, Jin Han; Choi, Jong Cheol; Choi, Sun Seob; Nam, Kyung Jin; Hwang, Tae Ho; Jeong, Jin Sook [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2006-02-15

    The purpose of this study was to evaluate the anti-tumoral effect of recombinant vaccinia virus (rVV) (Thymidine kinase (-)/GM-CSF (+)) that was administered as a US guided intratumoral injection in a rabbit model of hepatic VX2 carcinoma. VX2 carcinoma was implanted in the livers of 12 rabbits. US was performed at every week interval to detect hepatic mass after the implantation of VX2 carcinoma. The accurate tumor size and volume was evaluated with CT when the tumor was detected on US. US guided injection of rVV (10{sup 9} pfu/ml) was preformed in three rabbits, intravenous injection of the same dose of rVV was done in two rabbits and another seven rabbits that were without any treatment were selected as a control group. We evaluated the change of the hepatic tumor size and extrahepatic metastasis on serial CT. Tumor specimens were harvested from rabbits that were killed at 8 weeks after VX2 implantation. These tissues were histoimmuopathologically compared to each other (the virus injection group and the control group). The differences between these groups were statistically assessed with student t-tests. Tumor growth was significantly suppressed in the US guided injection group compared with the intravenous injection group or the control group ({rho} < 0.01). The intravenous injection group showed statistically significant tumor suppression compared to the control group ({rho} < 0.01) until 2 weeks after virus injection. Quantification of the pulmonary metastatic nodules was performed in view of both the number and volume. The average number or volume of the pulmonary metastatic nodules in the US injection group was much smaller than these in the control group. Histopathologically, the tumors of the US guided injection group showed less extensive necrosis than those of the control group. Immunohistochemically, the tumor of the US guided injection group showed more prominent infiltration of CD4 (+) and CD8 (+) lymphocytes than did the tumors of the other group

  1. Acceleration of tendon healing using US guided intratendinous injection of bevacizumab: First pre-clinical study on a murine model

    International Nuclear Information System (INIS)

    Dallaudière, Benjamin; Lempicki, Marta; Pesquer, Lionel; Louedec, Liliane; Preux, Pierre Marie; Meyer, Philippe; Hess, Agathe; Durieux, Marie Hèlène Moreau; Hummel, Vincent; Larbi, Ahmed; Deschamps, Lydia

    2013-01-01

    Purpose: Tendinopathy shows early disorganized collagen fibers with neo-angiogenesis on histology. Peri-tendinous injection of corticosteroid is the commonly accepted strategy despite the abscence of inflammation in tendinosis. The aim of our study was to assess the potential of intratendinous injection of an anti-angiogenic drug (bevacizumab, AA) to treat tendinopathy in a murine model of patellar and Achilles tendinopathy, and to evaluate its local toxicity. Materials and method: Forty rats (160 patellar and Achilles tendons) were used for this study. We induced tendinosis (T+) in 80 tendons by injecting under ultrasonography (US) guidance Collagenase 1 ® (day 0 = D0, patellar = 40 and Achilles = 40). Clinical examination and tendon US were performed at D3, immediately followed by either AA (AAT+, n = 40) or physiological serum (PST+, n = 40, control) US-guided intratendinous injection. Follow-up at D6 and D13 using clinical, US and histology, and comparison between the 2 groups were performed. To study AA toxicity we compared the 80 remaining normal tendons (T−) after injecting AA in 40 (AAT−). Results: All AAT+ showed a better joint mobilization compared to PST+ at D6 (p = 0.004) with thinner US tendon diameters (p < 0.004), and less disorganized collagen fibers and neovessels on histology (p < 0.05). There was no difference at D13 regarding clinical status, US tendon diameter and histology (p > 0.05). Comparison between AAT− and T− showed no AA toxicity on tendon (p = 0.18). Conclusion: Our study suggests that high dose mono-injection of AA in tendinosis, early after the beginning of the disease, accelerates tendon's healing, with no local toxicity

  2. Acceleration of tendon healing using US guided intratendinous injection of bevacizumab: First pre-clinical study on a murine model

    Energy Technology Data Exchange (ETDEWEB)

    Dallaudière, Benjamin, E-mail: bendallau64@hotmail.fr [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Inserm U698, Hôpital universitaire Bichat, Paris (France); Université de Médecine Paris Diderot (France); Lempicki, Marta [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Université de Médecine Paris Diderot (France); Pesquer, Lionel [Centre d’Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac (France); Louedec, Liliane [Inserm U698, Hôpital universitaire Bichat, Paris (France); Preux, Pierre Marie [Laboratoire de Biostatistiques, Faculté de médecine, Limoges (France); Meyer, Philippe [Centre d’Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac (France); Hess, Agathe [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Université de Médecine Paris Diderot (France); Durieux, Marie Hèlène Moreau [Centre d’Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac (France); Hummel, Vincent; Larbi, Ahmed [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Deschamps, Lydia [Service d’ Anatomopathologie, Hôpital universitaire Bichat, Paris (France); and others

    2013-12-01

    Purpose: Tendinopathy shows early disorganized collagen fibers with neo-angiogenesis on histology. Peri-tendinous injection of corticosteroid is the commonly accepted strategy despite the abscence of inflammation in tendinosis. The aim of our study was to assess the potential of intratendinous injection of an anti-angiogenic drug (bevacizumab, AA) to treat tendinopathy in a murine model of patellar and Achilles tendinopathy, and to evaluate its local toxicity. Materials and method: Forty rats (160 patellar and Achilles tendons) were used for this study. We induced tendinosis (T+) in 80 tendons by injecting under ultrasonography (US) guidance Collagenase 1{sup ®} (day 0 = D0, patellar = 40 and Achilles = 40). Clinical examination and tendon US were performed at D3, immediately followed by either AA (AAT+, n = 40) or physiological serum (PST+, n = 40, control) US-guided intratendinous injection. Follow-up at D6 and D13 using clinical, US and histology, and comparison between the 2 groups were performed. To study AA toxicity we compared the 80 remaining normal tendons (T−) after injecting AA in 40 (AAT−). Results: All AAT+ showed a better joint mobilization compared to PST+ at D6 (p = 0.004) with thinner US tendon diameters (p < 0.004), and less disorganized collagen fibers and neovessels on histology (p < 0.05). There was no difference at D13 regarding clinical status, US tendon diameter and histology (p > 0.05). Comparison between AAT− and T− showed no AA toxicity on tendon (p = 0.18). Conclusion: Our study suggests that high dose mono-injection of AA in tendinosis, early after the beginning of the disease, accelerates tendon's healing, with no local toxicity.

  3. Lipid based nutrient supplements (LNS) for treatment of children (6 months to 59 months) with moderate acute malnutrition (MAM): A systematic review

    Science.gov (United States)

    Pena-Rosas, Juan Pablo; Boy-Mena, Evelyn; Sachdev, Harshpal S.

    2017-01-01

    Background Moderate acute malnutrition is a major public health problem affecting children from low- and middle-income countries. Lipid nutrient supplements have been proposed as a nutritional intervention for its treatment. Objectives To evaluate the effectiveness and safety of LNS for the treatment of MAM in infants and children 6 to 59 months of age. Study design Systematic review of randomized-controlled trials and controlled before-after studies. Results Data from nine trials showed that use of LNS, in comparison to specially formulated foods, improved the recovery rate (RR 1.08; 95% CI 1.02–1.14, 8 RCTs, 8934 participants, low quality evidence); decreased the chances of no recovery (RR 0.70; 95% CI 0.58–0.85, 7 RCTs, 8364 participants, low quality evidence) and the risk of deterioration into severe acute malnutrition (RR 0.87; 95% CI 0.73–1.03, 6 RCTs, 6788 participants, low quality evidence). There was little impact on mortality (RR 0.94, 95% CI 0.54–1.52, 8 RCTs, 8364 participants, very-low- quality evidence) or default rate (RR 1.32; 95% CI 0.73–2.4, 7 studies, 7570 participants, low quality evidence). There was improvement in weight gain, weight-for-height z-scores, height-for-age z-scores and mid-upper arm circumference. Subset analyses suggested higher recovery rates with greater amount of calories provided and with ready-to-use therapeutic foods, in comparison to ready-to-use supplementary foods. One study comparing LNS with nutritional counselling (very low quality evidence) showed higher chance of recovery, lower risk of deteriorating into severe acute malnutrition and lower default rate, with no impact on mortality, and no recovery. Conclusions Evidence restricted to the African regions suggests that LNS may be slightly more effective than specially formulated fortified foods or nutritional counselling in recovery from MAM, lowering the risk of deterioration into SAM, and improving weight gain with little impact on mortality or default

  4. Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI

    International Nuclear Information System (INIS)

    Song, Sung Eun; Cho, Nariya; Han, Wonshik

    2017-01-01

    To evaluate whether the post-clip placement MRI following second-look ultrasound (US)-guided core biopsy is useful to confirm the adequate sampling of suspicious lesions identified on breast MRI. Between 2014 and 2016, 31 consecutive women with 34 suspicious lesions that had not been identified on previous mammography or US were detected using MRI. Among them, 26 women with 29 lesions (mean size 1.5 cm, range 0.5-5.8 cm) found by second-look US underwent US-guided biopsy, subsequent clip insertion and post-clip placement MRI. Five women with five lesions that were not found by second-look US underwent MRI-guided biopsy. The technical success rate and lesion characteristics were described. The technical success rate was 96.6% (28/29). One failure case was a benign, 1.1-cm non-mass enhancement. Of the 28 success cases, 23 (82.1%) were masses and 5 (17.9%) were non-mass enhancements; 17 (60.7%) were benign, 4 (14.3%) were high-risk and 7 (25.0%) were malignant lesions. The technical success rate was 100% (28/28) for masses and 83.3% (5/6) for non-mass enhancements. Post-clip placement MRI following US-guided biopsy is useful in confirming the adequate sampling of lesions identified on MRI. This method could be an alternative to MRI-guided biopsy for lesions visible on US. (orig.)

  5. Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sung Eun [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Cho, Nariya [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Centre, Institute of Radiation Medicine, Seoul (Korea, Republic of); Han, Wonshik [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of)

    2017-12-15

    To evaluate whether the post-clip placement MRI following second-look ultrasound (US)-guided core biopsy is useful to confirm the adequate sampling of suspicious lesions identified on breast MRI. Between 2014 and 2016, 31 consecutive women with 34 suspicious lesions that had not been identified on previous mammography or US were detected using MRI. Among them, 26 women with 29 lesions (mean size 1.5 cm, range 0.5-5.8 cm) found by second-look US underwent US-guided biopsy, subsequent clip insertion and post-clip placement MRI. Five women with five lesions that were not found by second-look US underwent MRI-guided biopsy. The technical success rate and lesion characteristics were described. The technical success rate was 96.6% (28/29). One failure case was a benign, 1.1-cm non-mass enhancement. Of the 28 success cases, 23 (82.1%) were masses and 5 (17.9%) were non-mass enhancements; 17 (60.7%) were benign, 4 (14.3%) were high-risk and 7 (25.0%) were malignant lesions. The technical success rate was 100% (28/28) for masses and 83.3% (5/6) for non-mass enhancements. Post-clip placement MRI following US-guided biopsy is useful in confirming the adequate sampling of lesions identified on MRI. This method could be an alternative to MRI-guided biopsy for lesions visible on US. (orig.)

  6. LNS users primer for accessing government sites on the ARPA network. [MIT. -->. ANL, BNL, LBL, and New York Univ. Courant Inst

    Energy Technology Data Exchange (ETDEWEB)

    Kannel, M.

    1979-06-01

    This primer was developed as part of the study conducted by the Laboratory for Nuclear Science (LNS) on the feasibility of networks for computer resource sharing. The primer is an instructinal guide for the LNS user who would like to access and use computers at other government sites on the ARPA network. The format is a series of scenarios of actual recorded on-line terminal sessions' showing the novice user how to access the foreign site, obtain help documentation, run a simple program, and transfer files to and from the foreign site. Access to the ARPA network in these scenarios is via Multics or the Massachusetts Institute of Technology Terminal Interface Processor. The foreign government sites accessed are the computing facilities at Argonne National Laboratory, Brookhaven National Laboratory, Lawrence Livermore Laboratory, and New York University Courant Institute. This technique of auditing actual terminal sessions as a teaching aid can be extended to include other computing facilities as well as other networks.

  7. US-guided percutaneous treatment and physical therapy in rotator cuff calcific tendinopathy of the shoulder: outcome at 3 and 12 months.

    Science.gov (United States)

    Pasquotti, Giulio; Faccinetto, Alex; Marchioro, Umberto; Todisco, Matteo; Baldo, Vincenzo; Cocchio, Silvia; De Conti, Giorgio

    2016-08-01

    To monitor the results of ultrasound (US)-guided percutaneous treatment of calcific tendinopathy of the shoulder at 12 months (T12) after treatment (T0). To verify the possible relations between some pre- and post-procedural variables with the clinical outcome at T12. Forty-seven patients (26 female and 21 male) were enrolled in the study. Patients' approval and written informed consent were obtained. Symptoms were assessed by Constant Shoulder Score (CSS) at T0 and T12. Thirty of these also underwent a CSS control at 3 months (T3). The treatment efficacy was statistically tested for relation with location and type of calcification, characteristics of the tendon and subdeltoid bursa, impingement, and rehabilitation treatments. There was a significant increase in the average CSS value between T0 and T12 (40.7 vs. 75.3). The variables analysed did not show a statistically significant effect on the outcome at T12. A link was noticed only between patients' increasing age and score improvement, particularly among female subjects. US-guided treatment of calcific tendonitis is a viable therapeutic option. No pre- or intra-procedural parameters emerged which might help in predicting the outcome, apart from patients' needs in everyday life. • US-guided tcreatment of shoulder calcific tendinopathy is an excellent therapeutic option • Long-term results seem greatly affected by patients' features and needs in everyday life • No proven pre- or intra-procedural parameters emerged that might predict the outcome.

  8. Clinical and Research Activities at the CATANA Facility of INFN-LNS: From the Conventional Hadrontherapy to the Laser-Driven Approach.

    Science.gov (United States)

    Cirrone, Giuseppe A P; Cuttone, Giacomo; Raffaele, Luigi; Salamone, Vincenzo; Avitabile, Teresio; Privitera, Giuseppe; Spatola, Corrado; Margarone, Daniele; Patti, Valeria; Petringa, Giada; Romano, Francesco; Russo, Andrea; Russo, Antonio; Sabini, Maria G; Scuderi, Valentina; Schillaci, Francesco; Valastro, Lucia M

    2017-01-01

    The CATANA proton therapy center was the first Italian clinical facility making use of energetic (62 MeV) proton beams for the radioactive treatment of solid tumors. Since the date of the first patient treatment in 2002, 294 patients have been successful treated whose majority was affected by choroidal and iris melanomas. In this paper, we report on the current clinical and physical status of the CATANA facility describing the last dosimetric studies and reporting on the last patient follow-up results. The last part of the paper is dedicated to the description of the INFN-LNS ongoing activities on the realization of a beamline for the transport of laser-accelerated ion beams for future applications. The ELIMED (ELI-Beamlines MEDical and multidisciplinary applications) project is introduced and the main scientific aspects will be described.

  9. Clinical and Research Activities at the CATANA Facility of INFN-LNS: From the Conventional Hadrontherapy to the Laser-Driven Approach

    Science.gov (United States)

    Cirrone, Giuseppe A. P.; Cuttone, Giacomo; Raffaele, Luigi; Salamone, Vincenzo; Avitabile, Teresio; Privitera, Giuseppe; Spatola, Corrado; Amico, Antonio G.; Larosa, Giuseppina; Leanza, Renata; Margarone, Daniele; Milluzzo, Giuliana; Patti, Valeria; Petringa, Giada; Romano, Francesco; Russo, Andrea; Russo, Antonio; Sabini, Maria G.; Schillaci, Francesco; Scuderi, Valentina; Valastro, Lucia M.

    2017-01-01

    The CATANA proton therapy center was the first Italian clinical facility making use of energetic (62 MeV) proton beams for the radioactive treatment of solid tumors. Since the date of the first patient treatment in 2002, 294 patients have been successful treated whose majority was affected by choroidal and iris melanomas. In this paper, we report on the current clinical and physical status of the CATANA facility describing the last dosimetric studies and reporting on the last patient follow-up results. The last part of the paper is dedicated to the description of the INFN-LNS ongoing activities on the realization of a beamline for the transport of laser-accelerated ion beams for future applications. The ELIMED (ELI-Beamlines MEDical and multidisciplinary applications) project is introduced and the main scientific aspects will be described. PMID:28971066

  10. Clinical and Research Activities at the CATANA Facility of INFN-LNS: From the Conventional Hadrontherapy to the Laser-Driven Approach

    Directory of Open Access Journals (Sweden)

    Giuseppe A. P. Cirrone

    2017-09-01

    Full Text Available The CATANA proton therapy center was the first Italian clinical facility making use of energetic (62 MeV proton beams for the radioactive treatment of solid tumors. Since the date of the first patient treatment in 2002, 294 patients have been successful treated whose majority was affected by choroidal and iris melanomas. In this paper, we report on the current clinical and physical status of the CATANA facility describing the last dosimetric studies and reporting on the last patient follow-up results. The last part of the paper is dedicated to the description of the INFN-LNS ongoing activities on the realization of a beamline for the transport of laser-accelerated ion beams for future applications. The ELIMED (ELI-Beamlines MEDical and multidisciplinary applications project is introduced and the main scientific aspects will be described.

  11. Value of prostate specific antigen and prostatic volume ratio (PSA/V) as the selection criterion for US-guided prostatic biopsy

    International Nuclear Information System (INIS)

    Veneziano, S.; Paulica, P.; Querze', R.; Viglietta, G.; Trenta, A.

    1991-01-01

    US-guided biopsy was performed in 94 patients with suspected lesions at transerectal US. Histology demonstrated carcinoma in 43 cases, benign hyperplasia in 44, and prostatis in 7. In all cases the prostate specific antigen (PSA) was calculated, by means of US, together with prostatic volume (v). PSA was related to the corresponding gland volume, which resulted in PSA/V ratio. Our study showed PSA/V ration to have higher sensitivity and specificity than absolulute PSA value in the diagnosis of prostatic carcinoma. The authors believe prostate US-guided biopsy to be: a) necessary when the suspected area has PSA/V ratio >0.15, and especially when PSA/V >0.30; b) not indicated when echo-structural alterations are associated with PSA/V <0.15, because they are most frequently due to benign lesions. The combined use of PSA/V ratio and US is therefore suggested to select the patients in whom biopsy is to be performed

  12. Papillary lesions of the breast: comparison of the US-guided 14-gauge automated gun method and the 11-gauge directional vacuum-assisted biopsy method

    International Nuclear Information System (INIS)

    Ko, Eun Sook; Cho, Nariya; Yang, Sang Kyu; Kim, Do Youn; Moon, Woo Kyung

    2006-01-01

    The compare the outcomes of US-guided 14-gauge automated biopsy and 11-gauge vacuum-assisted biopsy for the papillary lesions of the breast. We retrospectively reviewed the US-guided core biopsies of 1,723 consecutive breast lesions that were treated from January 2003 to April 2005. Ninety-eight lesions (5.7%) were pathologically reported as papillary lesions. The biopsies were performed with using a 14-gauge automated gun on 65 lesions or with using an 11-gauge vacuum-assisted device on 33 lesions. Thirty-five lesions (54%, 35/65) of 14-gauge automated gun biopsies and 5 lesions (15%, 5/33) of 11-gauge vacuum-assisted biopsies underwent surgery. The histologic findings were compared with the surgical, imaging and follow-up findings. The histologic underestimation rate, the repeat biopsy rate and the false negative rate were compared between the two groups. The repeat biopsy rate was determined by dividing the total number of core biopsies into the number of repeat biopsies. 'ADH underestimation' was defined as a lesion yielding atypical ductal hyperplasia on percutaneous biopsy and carcinoma at surgery, and 'DCIS underestimation' was defined as a lesion yielding ductal carcinoma in situ on percutaneous biopsy and invasive carcinoma at surgery. The repeat biopsy rate was 42% (27/65) for the 14-gauge automated gun biopsies and 9.1% (3/33) for the 11-gauge vacuum-assisted biopsies. The ADH underestimation rate was 50% (7/14) for the 14-gauge automated gun biopsies and 0% (0/4) for the 11-gauge vacuum-assisted biopsies. The DCIS underestimation was 14% (1/7) for the 14-gauge automated gun biopsies and 0% (0/2) for the 11-gauge vacuum-assisted biopsies. The false negative rate was 0% for these two groups. For the papillary lesions of the breast, the outcomes of the US-guided core biopsies performed with the 11-gauge vacuum-assisted device were better than those of the biopsies performed with the 14-gauge automated gun, in terms of underestimation and repeat biopsy

  13. Breast lesions with imaging-histologic discordance during US-guided 14G automated core biopsy: can the directional vacuum-assisted removal replace the surgical excision? Initial findings

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Lee, Ji Young; Youk, Ji Hyun; Oh, Ki Keun; Park, Byeong-Woo; Kim, Seung-Il; Kim, Haeryoung

    2007-01-01

    The purpose of this study was to determine the frequency of carcinoma at percutaneous directional vacuum-assisted removal (DVAR) in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy, and to determine the role of DVAR in breast lesions with imaging-histologic discordance. A US-guided 14-gauge automated core needle biopsy was performed on 837 consecutive lesions. Imaging-histologic discordance was prospectively considered in 33 of 634 benign biopsies. DVAR was recommended in those lesions. Among the 33 lesions, 26 lesions that underwent subsequent DVAR or surgical excision made up our study population. Medical records, imaging studies, and histologic findings were reviewed. Among the 26 lesions, 18 lesions underwent subsequent US-guided DVAR, with 8-gauge probes for 15 of the lesions, and 11-gauge for three of the lesions. Two lesions were diagnosed as having carcinoma (2/18, 11.1% of upgrade rate; 3.1-32.8% CI). The remaining eight lesions underwent subsequent surgical excision, and carcinoma was diagnosed in one case (12.5% of upgrade rate; 2.2-47.1% CI). A US-guided DVAR of the breast mass with imaging-histologic discordance during US-guided 14-gauge automated core needle biopsy is a valuable alternative to surgery as a means of obtaining a definitive histological diagnosis. (orig.)

  14. Crossover trial to test the acceptability of a locally produced lipid-based nutrient supplement (LNS) for children under 2 years in Cambodia: a study protocol.

    Science.gov (United States)

    Borg, Bindi; Mihrshahi, Seema; Griffin, Mark; Chamnan, Chhoun; Laillou, Arnaud; Wieringa, Frank T

    2017-09-06

    The acceptability and efficacy of existing ready-to-use supplementary and therapeutic foods has been low in Cambodia, thus limiting success in preventing and treating malnutrition among Cambodian children. In that context, UNICEF and IRD have developed a locally produced, multiple micronutrient fortified lipid-based nutrient supplement. This food is innovative, in that it uses fish instead of milk as the animal source food. Very few supplementary foods have non-milk animal source foods, and in addition they have not been widely tested. This trial will assess the novel food's acceptability to children and caregivers. This is a cluster-randomised, incomplete block, 4×4 crossover design with no blinding. It will take place in four sites in a community setting in periurban Phnom Penh. Healthy children aged 9-23 months (n=100) will eat each of four foods for 3 days at a time. The amount they consume will be measured, and at the end of each 3-day set, caregivers will assess how well their child liked the food. After 12 days, caregivers themselves will do a sensory test of the 4 foods and will rank them in terms of preference. Ethical clearance was received from the University of Queensland Medical Research Ethics Committee (2014001070) and from Cambodia's National Ethics Committee for Health Research (03/8 NECHR). ClinicalTrials.gov, identifier: LNS-CAMB-INFANTS; NCT02257437. Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Fine-needle aspirates CYFRA 21-1 is a useful tumor marker for detecting axillary lymph node metastasis in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Jung Hyun Yoon

    Full Text Available INTRODUCTION: To assess whether the value of CYFRA21-1 in the aspirates of ultrasonography-guided fine-needle aspiration biopsy (US-FNAB can contribute to improving the performances of US-FNAB in the diagnosis of axillary lymph node (LN metastasis in breast cancer patients. METHODS: US-FNAB was performed in 156 axillary LNs in 152 breast cancer patients (mean age: 51.4 years, range: 17-92 years. Concentrations of CYFRA21-1 were measured from washouts of the syringe used during US-FNAB. Tumor marker concentrations, US-FNAB, intraoperative sentinel node biopsy (SNB, and surgical pathology results were reviewed and analyzed. For comparison, the values of CEA and CA15-3 were also measured from washouts. RESULTS: Among the 156 LNs, 75 (48.1% were benign, and 81 (51.9% were metastases. Mean concentrations of CYFRA21-1 were significantly higher in metastasis compared to benign LNs (P<0.001. US-FNAB combined to CYFRA21-1 showed significantly higher sensitivity, NPV, and accuracy compared to US-FNAB alone (all values P<0.05. All diagnostic indices of US-FNAB combined to CYFRA21-1 were significantly higher compared to US-FNAB combined with CEA or CA15-3 (all P<0.001. Of the 28 metastatic LNs which showed metastasis on SNB, CYFRA21-1 showed higher positive rate of 75.0% (CEA or CA15-3∶60.7%, P = 0.076. CONCLUSION: Measuring CYFRA 21-1 concentrations from US-FNAB aspirates improves sensitivity, NPV, and accuracy of US-FNAB alone, and may contribute to reducing up to 75.0% of unnecessary intraoperative SNB. Compared to CEA or CA15-3, CYFRA21-1 shows significantly higher performances when combined to US-FNAB in the preoperative diagnosis of LN metastasis in breast cancer patients.

  16. Some new machine projects studied at LNS

    International Nuclear Information System (INIS)

    Tkatchenko, A.

    1983-01-01

    In front of the increasing interest for the synchrotron radiation uses, the electron storage rings have been gradually transformed in light sources. Yet, those machines had not been optimized for this use. So, in the last 10 years, numerous optimized machines have been defined and destinated to sole synchrotron light production up to the X domain. In the French domain, several projects have been elaborated, to satisfy the national needs in far UV and X radiation. - SUPER-ACO project (0,8 GeV) from Orsay. Its realisation is in progress. - SIREM project (1,2 GeV) from Grenoble CEN. - European ESRF project (5 GeV) optimized for X radiation, and for which a work group has been installed at CERN. - A X radiation national machine project (3 or 4 GeV) derived from the ESRF one. - At last, the Mars project, concerning a X radiation source storage ring aimed to a industrial use: the microlithographie [fr

  17. NEUTRAL KAON PHOTOPRODUCTION AT LNS, TOHOKU UNIVERSITY

    Czech Academy of Sciences Publication Activity Database

    Kaneta, M.; Chiga, N.; Beckford, B.; Ejima, M.; Fujii, T.; Fujii, Y.; Fujibayashi, T.; Gogami, T.; Futatsukawa, K.; Hashimoto, O.; Hosomi, K.; Hirose, K.; Iguchi, A.; Kameoka, S.; Kanda, H.; Kato, H.; Kawama, D.; Kawasaki, T.; Kimura, C.; Kiyokawa, S.; Koike, T.; Kon, T.; Ma, Y.; Maeda, K.; Maruyama, N.; Matsumura, A.; Miyagi, Y.; Miura, Y.; Miwa, K.; Nakamura, S. N.; Nomura, H.; Okuyama, A.; Ohtani, A.; Otani, T.; Sato, M.; Shichijo, A.; Shirotori, K.; Takahashi, T.; Tamura, H.; Taniya, N.; Tsubota, H.; Tsukada, K.; Terada, N.; Ukai, M.; Uchida, D.; Watanabe, T.; Yamamoto, T.; Yamauchi, H.; Yokota, K.; Ishikawa, T.; Kinoshita, T.; Miyahara, H.; Nakabayashi, T.; Shimizu, H.; Suzuki, K.; Tamae, T.; Terasawa, T.; Yamazaki, H.; Han, Y. C.; Wang, T. S.; Sasaki, A.; Konno, O.; Bydžovský, Petr; Sotona, Miloslav

    2010-01-01

    Roč. 19, č. 12 (2010), s. 2355-2362 ISSN 0218-3013. [Sendai International Conference on Strangeness in Nuclear and Hadronic Systems. Sendai, 15.12.2008-18.12.2008] R&D Projects: GA ČR GA202/05/2142; GA ČR GA202/08/0984 Institutional research plan: CEZ:AV0Z10480505 Keywords : Strangeness * photoproduction Subject RIV: BE - Theoretical Physics Impact factor: 0.695, year: 2010

  18. O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF: relato de caso The diagnosis of metastatic carcinoma of the choroid using fine-needle aspiration biopsy (FNAB: case report

    Directory of Open Access Journals (Sweden)

    Zélia Maria da Silva Corrêa

    2003-01-01

    male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3 positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.

  19. The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

    International Nuclear Information System (INIS)

    Solivetti, Francesco Maria; Elia, Fulvia; Santaguida, Maria Giulia; Guerrisi, Antonino; Visca, Paolo; Cercato, Maria Cecilia; Di Carlo, Aldo

    2014-01-01

    The primary aim of this study was to evaluate the diagnostic accuracy of ultrasound (US) in the study of superficial lymph nodes during the follow-up of patients surgically treated for skin tumours. The secondary objective was to compare positive cytological results with histological reports. From 2004 to 2011, 480 patients (male/female: 285/195; median age 57 years; prevalent skin tumour: melanoma) underwent US-guided fine-needle aspiration biopsy (FNAB) of suspicious recurrent lymph nodes. An expert radiologist first performed US testing of the lymph nodes, expressing either a negative or positive outcome of the test. Subsequently, US-guided FNAB was performed. FNAB positive patients were subjected to lymphadenectomy; the patients who tested negative underwent the follow-up. The size of lymph nodes was ≤ 2 cm in 90% of cases. Out of the 336 (70%) US “positive” patients, 231 (68.8%) were FNAB positives. Out of the 144 (30%) US “negatives”, 132 (91.7%) were FNAB negatives. The sensitivity and specificity of the US were 95% and 55.7%, respectively; the negative predictive value was 91.7% and the positive predictive value was 68.8%. Definitive histological results confirmed FNAB positivity in 97.5% of lymphadenectomies. US is a sensitive method in the evaluation of superficial lymph nodes during the follow-up of patients with skin tumours. High positive predictive value of cytology was confirmed

  20. Value of prostate specific antigen and prostatic volume ratio (PSA/V) as the selection criterion for US-guided prostatic biopsy. Importanza del rapporto tra antigene prostatico specifico e volume prostatico nella selezione dei pazienti da sottoporre a biopsia ecoguidata della prostata

    Energy Technology Data Exchange (ETDEWEB)

    Veneziano, S; Paulica, P; Querze' , R; Viglietta, G; Trenta, A [Ospedale Melpighi, Bologna (Italy). Serv. di Radiologia

    1991-01-01

    US-guided biopsy was performed in 94 patients with suspected lesions at transerectal US. Histology demonstrated carcinoma in 43 cases, benign hyperplasia in 44, and prostatis in 7. In all cases the prostate specific antigen (PSA) was calculated, by means of US, together with prostatic volume (v). PSA was related to the corresponding gland volume, which resulted in PSA/V ratio. Our study showed PSA/V ration to have higher sensitivity and specificity than absolulute PSA value in the diagnosis of prostatic carcinoma. The authors believe prostate US-guided biopsy to be: a) necessary when the suspected area has PSA/V ratio >0.15, and especially when PSA/V >0.30; b) not indicated when echo-structural alterations are associated with PSA/V <0.15, because they are most frequently due to benign lesions. The combined use of PSA/V ratio and US is therefore suggested to select the patients in whom biopsy is to be performed. 20 refs.

  1. Detection of suspicious malignant cervical lymph nodes of unknown origin: diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy with nodal size and central necrosis correlate

    International Nuclear Information System (INIS)

    Lo, C.-P.; Chen, C.-Y.; Chin, S-.C.; Lee, K.-W.; Hsueh, C.-J.; Juan, C.-J.; Kao, H.-W.; Huang, G.-S.

    2007-01-01

    To assess the role of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) in the diagnostic workup of suspicious malignant cervical lymph nodes in patients with palpable neck masses and without known primary cancer. The diagnostic accuracy of imaging morphologic criteria, including sizes and central necrosis for assessing suspicious malignant nodes, were also examined. This is a retrospective study of 426 patients with palpable neck masses from an outpatient department evaluated with computed tomography, magnetic resonance imaging, or US. US-guided FNABs were performed in 102 patients with suspicious malignant cervical lymph nodes at a single institution. Cytologically positive lymph nodes (n = 12) were further validated with excisional biopsy. Negative lymph nodes (n = 90) were either excised (n = 10) or followed up by imaging studies for at least one year (n = 80). The diagnostic accuracy of the FNABs along with the imaging findings of nodal sizes and presence of central necrosis, which were classified by a consensus of 2 radiologists, were assessed. Twelve malignant nodes were detected with US-guided FNAB with one false-positive and one false-negative result. The overall sensitivity, specificity, and accuracy for FNAB were 91.7%, 98.9%, and 98.0%. respectively. The sensitivity, specificity, and accuracy were 66.7%, 30.0%, and 34.3% for size criterion and 75.0%, 83.3%, and 82.3% for central necrosis criterion. The size of cervical lymph node does not appear to be an important imaging criterion for assessing suspicious malignant lymph nodes, compared with the criterion of central necrosis. US-guided FNAB is highly specific and sensitive in the diagnostic workup of suspicious malignant cervical lymph nodes in patients without known primary cancers. (author)

  2. The combined application of radiology, nuclear medicine and fine needle aspiration biopsy cytology (FNAB)

    International Nuclear Information System (INIS)

    Cardozo, P.L.; Ruis, I.A.M.

    1980-01-01

    The combination of diagnostic cytology and diagnostic radiology, including intervention radiology, is a logical one. Radiology can visualize lesions which cannot be found otherwise and under its guidance cytology can obtain a direct and usually diagnostic proof of the true nature of the process with minimal inconvenience and risk for the patient. A survey of the combination of cytology and radiological procedures in the diagnosis work-up is outlined. (Auth.)

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

    Directory of Open Access Journals (Sweden)

    V. V. Kapustin

    2014-08-01

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

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

    Directory of Open Access Journals (Sweden)

    V. V. Kapustin

    2012-01-01

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

  5. Design of the radioactive ion beam facility at the LNS

    International Nuclear Information System (INIS)

    Migneco, E.; Alba, R.; Calabretta, L.; Ciavola, G.; Cuttone, G.; Di Giacomo, M.; Gammino, S.; Gmaj, P.; Moscatello, M.H.; Raia, G.

    1992-01-01

    At the Laboratorio Nazionale del Sud the existing 15 MV Tandem will be coupled to the Superconducting Cyclotron booster, which will provide light and heavy ion beams in the energy range 100-20 MeV/n. Using these beams, secondary radioactive beams can be produced by projectile fragmentation. A fragment separator will collect the secondary beam produced at energies near that of the projectile and deliver it into the experimental areas. The possibility of using an ECRIS source for the axial injection into the Cyclotron and producing radioactive ions on a thick source placed inside the Tandem preinjector is also discussed. (author) 7 refs.; 2 figs.; 1 tab

  6. Beam-chopping system for LNS superconducting cyclotron

    International Nuclear Information System (INIS)

    Calabretta, L.; Caruso, A.; Raia, G.; Sparta, A.; Zappala, E.; Zingale, A.; Khemka, P.; Wei, C.Y.

    1999-01-01

    Several experiments which foresee the measurement of time of flight require a bunched beam with a FWHM smaller that 1 ns and a temporal separation from 100 to 200 ns. An H.E. Chopper that achieves this temporal separation between the impulses has been installed along the beam extraction line of the cyclotron. The two electrodes, which deflect the beam and the inductance coil are both under vacuum. The operating frequency range of the LC resonant circuit is from 4.5 to 9 MHz and the maximum design voltage is 70 kV. The chopper selects only the beam bunches which cross the device at peak voltage, one bunch for cycle. A steerer magnet to recover the selected bunches on the beam axis is used. All the tests, measurements and chopper's performance, will be presented. (authors)

  7. Beam-chopping system for LNS superconducting cyclotron

    Energy Technology Data Exchange (ETDEWEB)

    Calabretta, L.; Caruso, A.; Raia, G.; Sparta, A.; Zappala, E.; Zingale, A. [INFN-LNS, Catania (Italy); Khemka, P. [VEEC, Calcutta (India); Wei, C.Y. [Institute of Modern Physics, Lanzhou (China)

    1999-07-01

    Several experiments which foresee the measurement of time of flight require a bunched beam with a FWHM smaller that 1 ns and a temporal separation from 100 to 200 ns. An H.E. Chopper that achieves this temporal separation between the impulses has been installed along the beam extraction line of the cyclotron. The two electrodes, which deflect the beam and the inductance coil are both under vacuum. The operating frequency range of the LC resonant circuit is from 4.5 to 9 MHz and the maximum design voltage is 70 kV. The chopper selects only the beam bunches which cross the device at peak voltage, one bunch for cycle. A steerer magnet to recover the selected bunches on the beam axis is used. All the tests, measurements and chopper's performance, will be presented. (authors)

  8. First years of operation of the LNS superconducting cyclotron

    Energy Technology Data Exchange (ETDEWEB)

    Rifuggiato, D.; Calabretta, L.; Cuttone, G.; Gammino, S.; Raia, G.; Rovelli, A. [Instituto Nazionale di Fisica Nucleare, Lab. Nazionali del Sud, Catania (Italy)

    1999-07-01

    The K800 Superconducting Cyclotron was commissioned in 1994 and has been in continuous operation since then. In 1996 many efforts were made to reach a condition of reliable operation. Several ion types have been accelerated and delivered to experimental halls. The demand for different beams has given the opportunity to explore several regions of the operating diagram of the machine: different magnetic field values have been set, as well as several RF frequencies have been used. The results demonstrate that the Cyclotron allows to accomplish a large variety of nuclear physics experiments, even if the maximum performance has not yet been achieved. A few sub-systems are being upgraded in view of the 'high intensity' operation (which is required for radioactive beam production) and in order to reach the maximum performance: upgrading is planned on the RF system and on the electrostatic deflectors. A new axial injection system has been designed to operate the machine in stand-alone mode. (authors)

  9. The ISOL exotic beam facility at LNS: the EXCYT project

    International Nuclear Information System (INIS)

    Ciavola, G.; Calabretta, L.; Cuttone, G.; Di Bartolo, G.; Finocchiaro, P.; Gammino, S.; Gu, M.; Migneco, E.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Vinciguerra, D.; Qin, J.; Wollnik, H.

    1997-01-01

    The aim of the EXCYT project (exotics with cyclotron and tandem) is the development of a facility for producing and accelerating exotic beams from 0.2 up to 8 MeV/amu. EXCYT is based on the ''two accelerators'' method. A K=800 superconducting cyclotron, axially injected by the ECR ion source SERSE, will deliver the primary beam. Such a beam will produce the required nuclear species in a modified ISOLDE type target-source complex. When required, a 15 MV tandem Van der Graaff will accelerate the secondary beams. Both accelerators are existing and operational at Laboratorio Nazionale del Sud. Concerning the status of the project, progress has been made in most of the key issues of the project, like the construction of SERSE, cyclotron upgrading, modification of the existing building, high resolution mass separator, and diagnostic equipment for low energy, low intensity beams. (orig.)

  10. First years of operation of the LNS superconducting cyclotron

    International Nuclear Information System (INIS)

    Rifuggiato, D.; Calabretta, L.; Cuttone, G.; Gammino, S.; Raia, G.; Rovelli, A.

    1999-01-01

    The K800 Superconducting Cyclotron was commissioned in 1994 and has been in continuous operation since then. In 1996 many efforts were made to reach a condition of reliable operation. Several ion types have been accelerated and delivered to experimental halls. The demand for different beams has given the opportunity to explore several regions of the operating diagram of the machine: different magnetic field values have been set, as well as several RF frequencies have been used. The results demonstrate that the Cyclotron allows to accomplish a large variety of nuclear physics experiments, even if the maximum performance has not yet been achieved. A few sub-systems are being upgraded in view of the 'high intensity' operation (which is required for radioactive beam production) and in order to reach the maximum performance: upgrading is planned on the RF system and on the electrostatic deflectors. A new axial injection system has been designed to operate the machine in stand-alone mode. (authors)

  11. The ISOL exotic beam facility at LNS: the EXCYT project

    Energy Technology Data Exchange (ETDEWEB)

    Ciavola, G.; Calabretta, L.; Cuttone, G.; Di Bartolo, G.; Finocchiaro, P.; Gammino, S.; Gu, M.; Migneco, E.; Raia, G.; Rifuggiato, D.; Rovelli, A.; Vinciguerra, D. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Qin, J. [Institute of Atomic Energy, Beijing (China); Wollnik, H. [Giessen Univ. (Germany)

    1997-04-01

    The aim of the EXCYT project (exotics with cyclotron and tandem) is the development of a facility for producing and accelerating exotic beams from 0.2 up to 8 MeV/amu. EXCYT is based on the ``two accelerators`` method. A K=800 superconducting cyclotron, axially injected by the ECR ion source SERSE, will deliver the primary beam. Such a beam will produce the required nuclear species in a modified ISOLDE type target-source complex. When required, a 15 MV tandem Van der Graaff will accelerate the secondary beams. Both accelerators are existing and operational at Laboratorio Nazionale del Sud. Concerning the status of the project, progress has been made in most of the key issues of the project, like the construction of SERSE, cyclotron upgrading, modification of the existing building, high resolution mass separator, and diagnostic equipment for low energy, low intensity beams. (orig.). 8 refs.

  12. The operator view of the Superconducting Cyclotron at LNS Catania

    International Nuclear Information System (INIS)

    Giove, D.; Cuttone, G.; Rovelli, A.

    1992-01-01

    The upper level of a distributed control system designed for the Superconducting Cyclotron (SC), will be discussed. In particular, we will present a detailed description of the operator view of this accelerator along with the tools for I/O points management, data representations, data archiving and retrieval. A dedicated program, developed by us, working under X-Window will be described as a starting point for a new man-machine interface approach in small laboratories opposed to the first industrial available packages. (author)

  13. Thyroid tissue: US-guided percutaneous laser thermal ablation.

    Science.gov (United States)

    Pacella, Claudio Maurizio; Bizzarri, Giancarlo; Spiezia, Stefano; Bianchini, Antonio; Guglielmi, Rinaldo; Crescenzi, Anna; Pacella, Sara; Toscano, Vincenzo; Papini, Enrico

    2004-07-01

    To evaluate in vivo the safety and effectiveness of percutaneous laser thermal ablation (LTA) in the debulking of thyroid lesions. Twenty-five adult patients at poor surgical risk with cold nodules (n = 8), autonomously hyperfunctioning thyroid nodules (n = 16), or anaplastic carcinoma (n = 1) underwent LTA. One to four 21-gauge spinal needles were inserted with ultrasonographic (US) guidance into the thyroid lesions. A 300-microm-diameter quartz optical fiber was advanced through the sheath of the needle. Nd:YAG laser was used with output power of 3-5 W. Side effects, complications, and clinical and hormonal changes were evaluated at the end of LTA and during follow-up. Linear regression analysis was used to investigate the correlation between energy delivered and reduction in nodule volume. Volume of induced necrosis and reduction in nodule volume were assessed with US or computed tomography. LTA was performed without difficulties in 76 LTA sessions. After treatment with 5 W, two patients experienced mild dysphonia, which resolved after 48 hours and 2 months. Improvement of local compression symptoms was experienced by 12 of 14 (86%) patients. Thyroid-stimulating hormone (TSH) was detectable in five of 16 (31%) patients with hyperfunctioning nodules at 6 months after LTA. Volume of induced necrosis ranged from 0.8 to 3.9 mL per session. Anaplastic carcinoma treated with four fibers yielded 32.0 mL of necrosis. Echo structure and baseline volume did not influence response. Energy load and reduction in nodule volume were significantly correlated (r(2) =.75, P nodule volume reduction at 6 months in hyperfunctioning nodules was 3.3 mL +/- 2.8 (62% +/- 21.4 [SD]) and in cold nodules was 7.7 mL +/- 7.5 (63% +/- 13.8). LTA may be a therapeutic tool for highly selected problems in the treatment of thyroid lesions. Copyright RSNA, 2004

  14. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: is it Necessary to Use Local Anesthesia for the Application of One Needle Puncture?

    International Nuclear Information System (INIS)

    Kim, Dong Wook; Rho, Myung Ho; Kim, Ki Nam

    2009-01-01

    This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was

  15. Test and calibration of the magnetic measurement system for the Superconducting Cyclotron at LNS, Catania

    International Nuclear Information System (INIS)

    Giove, D.; Rossi, L.; Gmaj, P.; LoMonaco, L.; Raia, G.

    1992-01-01

    The apparatus for magnetic measurements before commissioning of the Superconducting Cyclotron is presented. This is a fast system designed for the systematic mapping of cyclotron fields. A search coil measures the field variation by scanning the median plane radially. The absolute value of the field is measured by NMR probes placed at the cyclotron centre and at the RF cavity holes. Accounting for dead times (coil return, drift measurement); the conservative estimate was made of measuring one full map per hour, with an azimuthal step of 1 o . A brief description of the software used and probe calibration data are included. (author) 4 refs.; 1 fig.; 1 tab

  16. Dosimetric and clinical experience in eye proton treatment at INFN-LNS

    International Nuclear Information System (INIS)

    Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Lojacono, P.; Mongelli, V.; Patti, I. V.; Pittera, S.; Russo, G.; Valastro, L. M.; Lo Nigro, S.; Ott, J.; Reibaldi, A.; Privitera, G.; Raffaele, L.; Salamone, V.; Spatola, C.; Sabini, M. G.

    2009-01-01

    After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged us in our activity in the battle against cancer

  17. Dosimetric and clinical experience in eye proton treatment at INFN-LNS

    Science.gov (United States)

    Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Lojacono, P.; Mongelli, V.; Lo Nigro, S.; Ott, J.; Patti, I. V.; Pittera, S.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Russo, G.; Salamone, V.; Sabini, M. G.; Spatola, C.; Valastro, L. M.

    2009-05-01

    After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged us in our activity in the battle against cancer

  18. Evaluation of the effectiveness of the means of radioprotection Central Hospital LNS National Police of Peru

    International Nuclear Information System (INIS)

    Yovera Alvarez, J.; Basilio Chiappe, M.

    2011-01-01

    From observations of the damage caused by radiation, the need for protection and are the first recommendations in 1931. Based on this knowledge of both the damage and the protective measures already tested, it is desirable that institutions that use ionizing radiation, to establish the epidemiological surveillance system to control this risk .

  19. US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Preda, Lorenzo; De Fiori, Elvio; Rampinelli, Cristiano; Petralia, Giuseppe; Bonello, Luke [European Institute of Oncology, Department of Radiology, Milan (Italy); Ansarin, Mohssen; Chiesa, Fausto [European Institute of Oncology, Department of Head and Neck Surgery, Milan (Italy); Maffini, Fausto [European Institute of Oncology, Patology Division, Laboratory of Anatomy, Milan (Italy); Alterio, Daniela [European Institute of Oncology, Radiotherapy Division, Milan (Italy); Bellomi, Massimo [European Institute of Oncology, Department of Radiology, Milan (Italy); University of Milan, School of Medicine, Milan (Italy)

    2010-06-15

    To evaluate the feasibility and performance of ultrasound-guided transcutaneous tru-cut biopsy (USGTCB) in selected patients (with stenosis of airways or difficult intubation or contraindication to general anaesthesia) with untreated or previously treated suspicious laryngo-hypopharyngeal masses. Biopsies were performed with a free-hand technique by a single radiologist. Thirty-six USGTCBs were scheduled in 34 patients (24 males, 10 females; age range 47-95 years). Two USGTCBs were not performed, as lesions were not detectable: therefore, 16 USGTCBs were performed for an untreated mass suspicious for malignancy and 18 were performed for a mass suspicious for recurrence after radiotherapy alone, or associated with endoscopic laser surgery or chemotherapy. USGTCB diagnosed 25 squamous cell carcinomas (73.5%) and nine benign lesions (26.5%); no false positives and two false negatives were reported, both in patients previously treated with radiotherapy. The sensitivity, specificity, positive and negative predictive value of the technique was 92.5%, 100%, 100% and 77.7% respectively, with no major complications. Although biopsy under microlaryngoscopy remains the ''gold-standard'' technique, USGTCB is feasible, carries the advantages of avoiding general anaesthesia, is suitable for outpatients and is cost-effective. If applied to selected patients, it could be considered for the histological diagnosis of both primary and recurrent laryngo-hypopharyngeal masses. (orig.)

  20. On the significance of density-induced speed of sound variations on US-guided radiotherapy

    International Nuclear Information System (INIS)

    Fontanarosa, Davide; Meer, Skadi van der; Verhaegen, Frank

    2012-01-01

    Purpose: To show the effect of speed of sound (SOS) aberration on ultrasound guided radiotherapy (US-gRT) as a function of implemented workflow. US systems assume that SOS is constant in human soft tissues (at a value of 1540 m/s), while its actual nonuniform distribution produces small but systematic errors of up to a few millimeters in the positions of scanned structures. When a coregistered computerized tomography (CT) scan is available, the US image can be corrected for SOS aberration. Typically, image guided radiotherapy workflows implementing US systems only provide a CT scan at the simulation (SIM) stage. If changes occur in geometry or density distribution between SIM and treatment (TX) stage, SOS aberration can change accordingly, with a final impact on the measured position of structures which is dependent on the workflow adopted. Methods: Four basic scenarios were considered of possible changes between SIM and TX: (1) No changes, (2) only patient position changes (rigid rotation-translation), (3) only US transducer position changes (constrained on patient's surface), and (4) patient tissues thickness changes. Different SOS aberrations may arise from the different scenarios, according to the specific US-gRT workflow used: intermodality (INTER) where TX US scans are compared to SIM CT scans; intramodality (INTRA) where TX US scans are compared to SIM US scans; and INTERc and INTRAc where all US images are corrected for SOS aberration (using density information provided by SIM CT). For an experimental proof of principle, the effect of tissues thickness change was simulated in the different workflows: a dual layered phantom was filled with layers of sunflower oil (SOS 1478 m/s), water (SOS 1482 m/s), and 20% saline solution (SOS 1700 m/s). The phantom was US scanned, the layer thicknesses were increased and the US scans were repeated. The errors resulting from the different workflows were compared. Results: Theoretical considerations show that workflows implementing SOS correction based on SIM-CT scan (INTERc, INTRAc) give null errors in all scenarios except when tissues thickness changes, where an error proportional to the degree of change in SOS maps between SIM and TX (ΔSOS) occurs. An uncorrected workflow such as INTER produces in all scenarios a pure SOS error, while uncorrected INTRA produces a null error for rotation-translation of the patient, a ΔSOS error for changing tissues thickness and an error proportional to the degree of SOS distribution change along the different lines of view when shifting the transducer. The dual layered phantom demonstrated experimentally that the effect of SOS change between SIM and TX is clinically nonrelevant, being less than the intrinsic resolution of imaging systems, even when a substantial change in thicknesses is applied, provided that a SIM-CT-based SOS aberration correction is applied. Noncorrected workflows produce errors up to 4 mm for INTER and to 3 mm for INTRA in the phantom test. Conclusions: A SOS correction is advantageous for all US-gRT workflows and clinical cases, where the effect of SOS change can be considered a second order effect.

  1. Bowel lesions: percutaneous US-guided 18-gauge needle biopsy--preliminary experience.

    Science.gov (United States)

    Tudor, G R; Rodgers, P M; West, K P

    1999-08-01

    Ultrasonography-guided percutaneous biopsy was performed with local anesthesia and an 18-gauge needle in 10 patients with bowel-wall lesions. All patients underwent clinical review within 1 month. Biopsy was diagnostic in all patients. There were no complications, and all patients tolerated the procedure well. The technique appears to be safe and had an excellent diagnostic yield in our series.

  2. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    International Nuclear Information System (INIS)

    Yilmaz, Saim; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur

    2013-01-01

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1–10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  3. FNAB of metastatic lesions with special reference to clinicopathological analysis of primary site in cases of epithelial and non-epithelial tumors

    Directory of Open Access Journals (Sweden)

    Shamshad Ahmad

    2011-01-01

    Conclusion: The most critical aspect of the evaluation of metastatic cases is the accurate pathologic assessment of the malignant tissues in conjunction with pertinent clinical data. Such close collaboration between the clinician and the pathologist may maximize the diagnostic potential in treatable primary tumors.

  4. Evaluation of the effectiveness of the means of radioprotection Central Hospital LNS National Police of Peru; Evaluacion de la efectividad de los medios de radioproteccion en hospital central LNS de la policia nacional del Peru

    Energy Technology Data Exchange (ETDEWEB)

    Yovera Alvarez, J.; Basilio Chiappe, M.

    2011-07-01

    From observations of the damage caused by radiation, the need for protection and are the first recommendations in 1931. Based on this knowledge of both the damage and the protective measures already tested, it is desirable that institutions that use ionizing radiation, to establish the epidemiological surveillance system to control this risk .

  5. New developments at INFN-LNS on TOF–DOI PET based on SiPM detectors

    International Nuclear Information System (INIS)

    Cosentino, L.; Cusanno, F.; De Leo, R.; Di Venti, G.; Finocchiaro, P.; Garibaldi, F.; Loddo, F.; Meddi, F.; Musico, P.; Pappalardo, A.; Perrino, R.; Ranieri, A.

    2013-01-01

    The development of an endorectal PET Time Of Flight (TOF) probe prototype compatible with MRI, is going to be carried out within the INFN project TOPEM. Time resolution and depth of interaction (DOI) will allow to significantly improve the image quality, by rejecting those events coming from the surrounding tissues and correcting the parallax error. The activity described in this paper is focused on the characterization of the single pixel detector of the probe, consisting of a LYSO finger scintillator read out at both ends by means of a pair of Silicon Photomultipliers (SiPM). Energy, timing and DOI resolutions have been measured with a proper surface treatment and wrapping, finding very competitive results for DOI and timing

  6. MEDEA: A multi element detector array for gamma ray and light charged particle detection at the LNS-Catania

    International Nuclear Information System (INIS)

    Migneco, E.; Agodi, C.; Alba, R.; Coniglione, R.; Del Zoppo, A.; Finocchiaro, P.; Maiolino, C.; Piattelli, P.; Raia, G.; Sapienza, P.; Bellia, G.

    1992-01-01

    A 4π highly granular Multi Element Detector Array (MEDEA) for γ-rays and light charged particles is described. Its basic configuration consists of 180 barium fluoride scintillator crystals, arranged in the shape of a ball, plus a forward angle wall of 120 phoswich detectors. The inner radius of the ball (22 cm) and the distance of the wall from the target (55 cm) allow the placement of other detectors in the inner volume. The whole detection system operates under vacuum inside a large scattering chamber. Dedicated electronics has been designed and realized. It includes a powerful hardware second level trigger and preanalysis system, which allows on-line event selection, and a modular VME-bus based data acquisition system. In-beam performances of the system are also described. (orig.)

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  8. US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules.

    Science.gov (United States)

    Deandrea, Maurilio; Limone, Paolo; Basso, Edoardo; Mormile, Alberto; Ragazzoni, Federico; Gamarra, Elena; Spiezia, Stefano; Faggiano, Antongiulio; Colao, Annamaria; Molinari, Filippo; Garberoglio, Roberto

    2008-05-01

    The aim of the study was to define the effectiveness and safety of ultrasound-guided percutaneous radiofrequency (RF) thermal ablation in the treatment of compressive solid benign thyroid nodules. Thirty-one patients not eligible for surgery or radioiodine (131I) treatment underwent RF ablation for benign nodules; a total of 33 nodules were treated (2 patients had 2 nodules treated in the same session): 10 cold nodules and 23 hyperfunctioning. Fourteen patients complained of compressive symptoms. Nodule volume, thyroid function and compressive symptoms were evaluated before treatment and at 1, 3 and 6 mo. Ultrasound-guided RF ablation was performed using a Starbust RITA needle, with nine expandable prongs; total exposure time was 6 to 10 min at 95 degrees C in one area or more of the nodule. Baseline volume (measured at the time of RF ablation) was 27.7 +/- 21.5 mL (mean +/- SD), but significantly decreased during follow-up: 19.2 +/- 16.2 at 1 mo (-32.7%; p nodules remained euthyroid: five patients with hot nodules normalized thyroid function, and the remaining sixteen showed a partial remission of hyperthyroidism. Besides a sensation of heat and mild swelling of the neck, no major complications were observed. Improvement in compressive symptoms was reported by 13 patients, with a reduction on severity scale from 6.1 +/- 1.4 to 2.2 +/- 1.9 (p nodules. Hyperfunction was fully controlled in 24% of patients and partially reduced in the others.

  9. Neglected Papillary Thyroid Carcinoma Seven Years after Initial Diagnosis

    Directory of Open Access Journals (Sweden)

    Eleftherios D. Spartalis

    2013-01-01

    Full Text Available Papillary thyroid carcinoma (PTC is the most common epithelial thyroid tumor, accounting for more than 80% of all thyroid tumors. Recent advances in ultrasonographic screening and US-guided fine-needle aspiration biopsy (FNAB have facilitated the early detection and diagnosis of papillary thyroid carcinomas. In exceptionally rare cases, papillary thyroid tumors may assume enormous dimensions due to recurrent disease or the patient's negligence of the problem. We report an extremely rare case of a 72-year-old woman presented with a neglected giant exophytic papillary thyroid carcinoma with hemorrhagic ulcers. Computed tomography showed a mass measured 17×12 cm that caused a displacement of the trachea to the right side and reached the mediastinum. After bleeding management, patient was discharged. The patient was fully aware of her situation, but she denied any further therapeutic management.

  10. Real-time ultrasound elastography: an assessment of enlarged cervical lymph nodes.

    Science.gov (United States)

    Lo, Wu-Chia; Cheng, Po-Wen; Wang, Chi-Te; Liao, Li-Jen

    2013-09-01

    To determine the efficacy of real-time elastography (RTE), compared with our previously proposed prediction model, in the detection of malignancy in cervical lymph nodes (LNs). One hundred and thirty-one patients underwent ultrasound-guided fine needle aspiration biopsy (ultrasound FNAB) after ultrasound and RTE evaluation. The formula of the RTE scoring system was a four-point visual scale, based on a previously determined model. The formula of the prediction model was: [Formula: see text]. An extended model was constructed with four previous predictors and elasticity scores, using a logistic regression model. Final histology revealed 77 benign and 54 malignant LNs. In the elasticity score system, sensitivity was 66.7 %, specificity was 57.1 %, the positive predictive value (PPV) was 52.2 % and the negative predictive value (NPV) was 71.0 %. In the prediction model system, sensitivity was 79.6 %, specificity was 92.2 %, the PPV was 87.8 % and the NPV was 86.6 %. When the extended and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) was 0.94 and 0.95, respectively (P > 0.05). Qualitative RTE offers no additional value over conventional ultrasound in predicting malignancy in cervical LNs. • An ultrasound system can help in the assessment of cervical lymph nodes. • Grey-scale and power Doppler ultrasound remain fundamental for neck nodal evaluation. • Qualitative real-time elastography provided no additional value compared with current prediction models.

  11. Cytological and sonographic correlation of the biopsies by fine needle aspiration (FNAB) of thyroid nodules in the Hospital San Rafael de Alajuela of July 1, 2006 to February 28, 2007

    International Nuclear Information System (INIS)

    Barrantes Vega, Jesus

    2007-01-01

    The importance of the use of aspiration biopsy with ultrasonic-guided fine needle is recognized as screening method for diagnosis of thyroid nodules. Thyroid nodules are very common, the prevalence of palpitation has been estimated by 4% and 6% by ultrasound. The prevalence in autopsy data of patients with no history of thyroid pathology has been up to 50%. The use set of advanced imaging techniques and modified techniques of biopsy is implemented in order to increase the diagnostic security of thyroid lesions. The incidental finding of thyroid nodules or incidentalomas has soared dizzily, since the advent of ultrasound as an element in the valuation of thyroid disease and thyroid in the neck. Incidence has been reported even up to 40%. A growing number of endocrinologists are using aspiration biopsy with ultrasound guided fine needle of thyroid nodules as initial diagnostic procedure to identify discrete nodules with a direct location. The percentage of malignant nodules or that require surgery by size or symptomatology, generally, is very low, had to be established a systematic approach to reducing morbidity and mortality associated with major surgery of the neck and reduce costs. The biopsy by fine needle aspiration has been a well established diagnostic technique for preoperative evaluation of thyroid nodules, which has led a significant reduction in the number of unnecessary surgeries in most centers has been between 35-75%. This biopsy has been a specific method, sensitive and inexpensive. The sonographic guidance for biopsy by fine needle aspiration offers the following benefits: is safe and inexpensive, able to reduce costs in 25%, minimally invasive and highly effective, this guidance has increased the detection of malignancy of 14 to 39%. Among the complications that can occur is the formation of hematoma and pain, which are rare. On the other hand, the sonographic guidance is essential for biopsy nonpalpable nodules helping to ensure proper placement of the needle for a more accurate sampling. The nodule with the most striking characteristics or suggestive of malignancy can be biopsied, in patients with multiple nodules, instead of taking the largest size, namely irregular or microlobulated, marked hypoechogenicity, presence of microcalcifications and shape taller high than wide. (author) [es

  12. Diagnostic Benefit of Thyroglobulin Measurement in Fine-Needle Aspiration for Diagnosing Metastatic Cervical Lymph Nodes from Papillary Thyroid Cancer: Correlations with US Features

    International Nuclear Information System (INIS)

    Jeon, Se Jeong; Kim, Eun Hee; Son, Kyu Ri; Park, Do Joon; Cho, Bo Youn; Na, Dong Gyu; Park, Jeong Seon; Baek, Jung Hwan; Kim, Yoon Suk

    2009-01-01

    Our goals were to determine the added value of fine-needle aspiration biopsy (FNAB)-thyroglobulin (Tg) measurements over FNAB-cytology alone for diagnosing metastatic nodes, and to determine whether the ultrasound features of lymph nodes can be used to identify lymph nodes that may benefit from FNAB-Tg measurement in patients with papillary thyroid cancer. We retrospectively evaluated 76 surgically proven cervical lymph nodes. Twenty-nine patients were awaiting surgery and 18 patients had undergone thyroid surgery for papillary thyroid cancer. Ultrasound-guided FNAB and Tg measurements were performed and the ultrasound features were evaluated. The accuracies, sensitivities, and specificities of FNAB-cytology, FNAB-Tg, and combined FNAB-Tg/cytology were 90%, 80%, and 100%; 92%, 95%, and 90%; and 93%, 96%, and 90%, respectively. The diagnostic sensitivity of FNAB-Tg for metastatic nodes was significantly higher than that of FNAB-cytology (p = 0.011). Furthermore, combined FNAB-Tg/cytology significantly increased sensitivity (p = 0.002) and accuracy (p = 0.03) as compared with FNAB-cytology. Combined FNAB-Tg/cytology is significantly more sensitive and accurate at detecting metastatic nodes than FNAB-cytology alone. FNAB-Tg was better at diagnosing metastases in small lymph nodes

  13. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

    Directory of Open Access Journals (Sweden)

    Baldini Enke

    2013-02-01

    Full Text Available Abstract Background Measurement of thyroglobulin (Tg protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN metastasis from well-differentiated thyroid cancer (TC. In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp, Tg mRNA (FNAB-Tgm and calcitonin (CT mRNA (FNAB-CTm in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC in 26 CLN, metastatic medullary TC (MTC in 3 CLN, metastatic anaplastic TC (ATC in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

  14. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

    Science.gov (United States)

    2013-01-01

    Background Measurement of thyroglobulin (Tg) protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C) has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN) metastasis from well-differentiated thyroid cancer (TC). In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp), Tg mRNA (FNAB-Tgm) and calcitonin (CT) mRNA (FNAB-CTm) in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC) in 26 CLN, metastatic medullary TC (MTC) in 3 CLN, metastatic anaplastic TC (ATC) in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters. PMID:23421519

  15. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    Energy Technology Data Exchange (ETDEWEB)

    Eun, Na Lae; Chang, Hang Seok; Gweon, Hye Mi; Kim, Jeong Ah; Youk, Ji Hyun; Son, Eun Jun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoo, Mi Ri [Dept. of Radiology, Dongjak Kyunghee Hospital, Seoul (Korea, Republic of); Park, Ah Young [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Moon, Hee Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.

  16. Bell-shaped calcium-response curves of lns(l,4,5)P3- and calcium-gated channels from endoplasmic reticulum of cerebellum

    Science.gov (United States)

    Bezprozvanny, Llya; Watras, James; Ehrlich, Barbara E.

    1991-06-01

    RELEASE of calcium from intracellular stores occurs by two pathways, an inositol 1,4,5-trisphosphate (InsP3)-gated channel1-3 and a calcium-gated channel (ryanodine receptor)4-6. Using specific antibodies, both receptors were found in Purkinje cells of cerebellum7,8. We have now compared the functional properties of the channels corresponding to the two receptors by incorporating endoplasmic reticulum vesicles from canine cerebellum into planar bilayers. InsP3-gated channels were observed most frequently. Another channel type was activated by adenine nucleotides or caffeine, inhibited by ruthenium red, and modified by ryanodine, characteristics of the ryanodine receptor/channel6. The open probability of both channel types displayed a bell-shaped curve for dependence on calcium. For the InsP3-gated channel, the maximum probability of opening occurred at 0.2 µM free calcium, with sharp decreases on either side of the maximum. Maximum activity for the ryanodine receptor/channel was maintained between 1 and 100 µM calcium. Thus, within the physiological range of cytoplasmic calcium, the InsP3-gated channel itself allows positive feed-back and then negative feedback for calcium release, whereas the ryanodine receptor/channel behaves solely as a calcium-activated channel. The existence in the same cell of two channels with different responses to calcium and different ligand sensitivities provides a basis for complex patterns of intracellular calcium regulation.

  17. Clinical and research activities at the CATANA facility of INFN-LNS: fom the conventional hadrontherapy to the laser-driven approach

    Czech Academy of Sciences Publication Activity Database

    Cirrone, G.A.P.; Cuttone, G.; Raffaele, L.; Salamone, S.; Avitabile, T.; Privitera, G.; Spatola, C.; Margarone, Daniele; Patti, V.; Petringa, G.; Romano, F.; Russo, A.; Russo, An.; Sabini, M.G.; Scuderi, Valentina; Schillaci, F.; Valastro, L.

    2017-01-01

    Roč. 7, Sep (2017), 1-13, č. článku 223. ISSN 2234-943X R&D Projects: GA MŠk EF15_008/0000162 Grant - others:ELI Beamlines(XE) CZ.02.1.01/0.0/0.0/15_008/0000162 Institutional support: RVO:68378271 Keywords : proton therapy * dosimetry * clinical follow-up * Monte Carlo * laser -driven * ELIMED Subject RIV: BL - Plasma and Gas Discharge Physics OBOR OECD: Fluids and plasma physics (including surface physics)

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  19. Contrast-Enhanced Ultrasound Improves the Pathological Outcomes of US-Guided Core Needle Biopsy That Targets the Viable Area of Anterior Mediastinal Masses

    Directory of Open Access Journals (Sweden)

    Jian-hua Zhou

    2018-01-01

    Full Text Available Based on the option that ultrasound-guided core needle biopsy (US-CNB of the enhanced portion of anterior mediastinal masses (AMMs identified by contrast-enhanced ultrasound (CEUS would harvest viable tissue and benefit the histological diagnoses, a retrospective study was performed to elucidate the correlation between the prebiopsy CEUS and diagnostic yield of AMMs and found that CEUS potentially improved the diagnostic yield of AMMs compared with conventional US with a significant increase in the cellularity of samples. Furthermore, the marginal blood flow signals and absence of necrosis can predict the diagnostic yield of AMM. It was concluded that US-CNB of the viable part of AMMs, as verified by CEUS, was able to harvest sufficient tissue with more cellularity that could be used for ancillary studies and improve the diagnostic yield. And CEUS was recommended to those patients with AMMs undergoing repeated US-CNB, with the absence of marginal blood signals or presence of necrosis.

  20. Preoperative US-guided hook-needle insertion in recurrent lymph nodes of papillary thyroid cancer: A help for the surgeon

    International Nuclear Information System (INIS)

    Duprez, Raphaelle; Lebas, Patrick; Marc, Olivier Saint; Mongeois, Elise; Emy, Philippe; Michenet, Patrick

    2010-01-01

    Objective: The objective of this study is to investigate whether preoperative ultrasound guided insertion of a hook-needle is useful in reoperations for cervical recurrent lymph node metastases of papillary thyroid cancer. Patients and methods: 8 patients with operated papillary thyroid cancer were included in this study. They all had suspicious nonpalpable cervical lymph nodes discovered during follow-up. These lymph nodes were identified by ultrasound imaging and their metastatic nature was confirmed by fine needle aspiration cytology and measurement of in situ thyroglobulin. In all cases, surgical excision of these lymph nodes was decided. All 8 patients had a hook-needle inserted in the suspicious lymph node(s) preoperatively and under ultrasound guidance. Results and conclusion: In all 8 patients, the suspicious lymph nodes were removed and their metastatic nature was confirmed by the final pathological examination. This localization technique is very helpful for the surgeon during the excision of small and nonpalpable lymph nodes, especially in previously operated area.

  1. Short- to mid-term follow-up effectiveness of US-guided focal extracorporeal shock wave therapy in the treatment of elbow lateral epicondylitis.

    Science.gov (United States)

    Trentini, R; Mangano, T; Repetto, I; Cerruti, P; Kuqi, E; Trompetto, C; Franchin, F

    2015-09-01

    Lateral epicondylitis of the elbow is a common and disabling overuse syndrome. Several treatment modalities are currently available for this condition, but the optimal treatment method remains undefined. Extracorporeal shock wave therapy (ESWT) has been widely used in the last 10 years, although conflicting results are present in the literature. In this study, we evaluated 36 patients (37 elbows), with a mean follow-up time of 24.8 months. Focal ESWT was administered by means of an electromagnetic generator equipped with in-line ultrasound guidance, during one or more cycles of 3-4 weekly sessions. In the setting of the study, patients were clinically evaluated and subjective satisfaction and rate of relapse were investigated. A positive response was described in 75.7 % of the patients after treatment. Mean quickDASH score and VAS attested at 5.5 and 1.1, respectively. Roles and Maudsley score was rated as I or II in 33 cases. Four patients resulted not responders to the therapy, while 5 patients complained one or more episodes of symptoms relapse. No influence on the final outcome was evident with respect to demographic features and previous therapies as well. Response rate to further ESWT cycles in patients refractory to the first cycle of ESWT was 33.3 %. Focal ESWT represents a valuable and safe solution in case of elbow lateral epicondylitis, both in newly diagnosed and previously treated cases, representing a definitive treatment in the majority of patients. Patients refractory to a 3- to 4-session ESWT cycle have lower chances of positive response after further ESWT cycles.

  2. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Kara, Gulcan; Torun, Dilek; Kizilkilic, Osman; Yildirim, Tulin

    2005-01-01

    Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein

  3. Risk of malignancy in fine-needle aspiration biopsy in patients with thyroid nodules

    DEFF Research Database (Denmark)

    Egset, Alice Viktoria; Holm, Camilla; Larsen, Stine Rosenkilde

    2017-01-01

    Introduction: Fine-needle aspiration biopsy (FNAB) is the cornerstone of thyroid nodule evaluation. In most cases, FNAB can discriminate between benign and malignant disease. In other cases, it is only indicative of malignancy and the results are considered “suspicious”. In Denmark, thyroid FNAB...

  4. Percutaneous fine needle aspiration biopsy for the intrathoracic lesions: What is the meaning of non-diagnostic results?

    International Nuclear Information System (INIS)

    Kim, Min Ju; Lee, Jin Seong; Do, Kyung Hyun; Seo, Joon Beom; Song, Koun Sik; Lim, Tae Hwan

    2003-01-01

    To know what is the meaning of non-diagnostic results of fine needle aspiration biopsy (FNAB) and whether repeated aspiration is needed or not in those situations. We reviewed 1845 patients who underwent FNAB from 1997 to 2001. Non-diagnostic results of the first FNAB were divided into four groups: insufficient number of cells, inflammatory cells, necrotic debris and atypical cells. We analyzed final diagnosis of 531 patients who had non-diagnostic results from the first FNAB. Among them, 207 lesions were re-biopsied because of clinical and radiologic suspicion of malignancy. The diagnostic yield of repeated FNAB was analyzed and compared with the results of the first FNAB. Among 255 cases with 'inflammatory cells only' results, 120 cases were confirmed benignancy on follow-up. Twenty nine of 50 stypical cells (58%) were malignant of follow-up. One hundred one of 207 repeated FNAB resulted in the non-diagnostic reports, and 106 of 207 repeated FNAB were diagnosed as specific diagnosis. Among thirty lesions showing atypical cells on the repeated FNAB, 22 (73%) were identified as malignant neoplasms. When the specimen of FNAB shows atypical cells, the possibility of malignancy is very high. When the results of FNAB is non-diagnostic in the cases with clinical and radiological suspicion of malignancy, repeated FNAB procedures should be seriously considered and will be helpful for accurate specific diagnosis

  5. Endoscopic ultrasound with fine needle aspiration and biopsy in lung cancer and isolated mediastinal lymphadenopathy.

    LENUS (Irish Health Repository)

    Nadarajan, P

    2010-03-01

    Endoscopic ultrasound with fine-needle aspiration and biopsy (EUS-FNAB) is well established in diagnosing and staging lung cancer in patients with mediastinal adenopathy. EUS-FNAB is highly sensitive, less invasive and has lower complication rates when compared to surgical staging of mediastinal nodes. In this study we describe our experience of EUS-FNAB in lung cancer and other causes of mediastinal lymphadenopathy. EUS-FNAB was performed for assessment of PET positive mediastinal lymph nodes between January 2007 and March 2009 in AMNCH. The endpoints of our study were sensitivity and specificity of EUS-FNAB, morbidity and length of hospital stay. Thirty four patients underwent EUS-FNAB during the study period for both diagnosis and staging. Thirty patients had positive lymph node invasion and 4 had no evidence of malignant invasion. In these 4 patients negative cytology was confirmed on mediastinoscopy giving EUS-FNAB a sensitivity and specificity of 100%. EUS-FNAB upstaged the disease in 12 patients. EUS-FNAB is a reliable tool for mediastinal staging in lung cancer, significantly reducing the need for surgical staging procedures in patients with suspected mediastinal involvement.

  6. Ultrasound-guided fine-needle aspiration biopsy of the thyroid.

    Science.gov (United States)

    Tambouret, R; Szyfelbein, W M; Pitman, M B

    1999-10-25

    We reviewed the Massachusetts General Hospital experience with ultrasound-guided fine-needle aspiration biopsies (FNABs) of the thyroid to determine the indications, rate of unsatisfactory smears, correlation with excisional biopsy results, and verification of efficient use of personnel time. All radiologically guided FNABs of the thyroid from January 1993 through June 1997 were reviewed. As a measure of efficient use of technologist time, a sample of times spent by the technologist during the procedure for 20 cases in 1993 and 1997 was compared with that of an equal number of random nonthyroid image guided FNABs. Two hundred-ninety FNABs were identified in 251 patients, representing 12% of all thyroid FNABs and 11% of all radiologically guided FNABs. Indications in the 251 patients included multiple nodules (78), solitary nodules (61), complex nodules (39), prior failed FNAB (39), thyroid bed abnormalities post-thyroidectomy (21), difficult access (7), and investigation of recurrent tumor in residual thyroid lobe (6). Available records indicated 118 lesions were palpable and 45 were nonpalpable; the physical examination characteristics of the remainder (88) were not stated. Diagnoses included 44 unsatisfactory cases (15%), 103 macrofollicular lesions, 20 microfollicular lesions, 26 mixed macro/microfollicular lesions, 5 oxyphilic lesions, 1 trabecular pattern, 15 nonspecific follicular cell pattern, 9 follicular cell atypia, 30 cysts, 11 thyroiditis, 23 malignant tumors, and 3 other (1 parathyroid, 2 lymph node). Eighty-nine FNABs from 76 patients had subsequent surgical biopsy. Excisional biopsies in 14 unsatisfactory FNABs were benign. In the remaining 75 FNABs from 67 patients, 18 malignancies on FNAB were correctly diagnosed, but 3 other papillary carcinomas were only qualified as atypical follicular cells on cytology. No false-positive cases occurred. Of 15 macrofollicular lesions on cytology, 10 were adenomas on excision, only 2 of which were microfollicular

  7. Role of axillary lymph node ultra-sound and large core biopsy in the preoperative assessment of patients selected for sentinel node biopsy

    International Nuclear Information System (INIS)

    Nori, Jacopo; Boeri, Cecilia; Vanzi, Ermanno; Nori Bufalini, Filippo; Masi, Andrea; Bazzocchi, Massimo; Londero, Viviana; Mangialavori, Giuseppe; Distante, Vito; Simoncini, Roberta

    2005-01-01

    Purpose: To aim of this study was to evaluate the diagnostic accuracy of axillary lymph node sonography, if necessary in collaboration with US-guided large core biopsy, in the preoperative evaluation of breast cancer patients scheduled for quadrantectomy and sentinel lymph node excision. Materials and methods: From July 2001 to December 2002, we evaluated 117 breast cancer patients with ultrasound and, where indicated, FNAB. Breast lesions has diameters between 4 and 26 mm (mean diameter 11 mm). Fifteen (13%) of the 117 patients were excluded from the series as they did not found fulfil the criteria for preliminary sonography of the axilla: in 9 patients fewer than 4 nodes were detected and in 6 patients the breast lesions were intraoperatively found to be benign. Eleven patients (10.7%) with sonographically suspicious axillary nodes were sampled by US-guided core biopsy using a 14 or 16 Gauge Tru-Cut needle. Results: The ultrasound study aims to evaluate the dimensions and morphology of the breast lesion as well as detect and assess at least 4 axillary nodes. These were evaluated for hilar and cortical thickening and radio between the sinus diameter and the total longitudinal diameter. Lymph nodes with hilar diameters equal to or greater than 50% of the longitudinal diameter were considered normal. Of the 102 patients evaluated, 77 (75.7%) had normal axillary nodes according to the US criteria adopted. Negativity was confirmed by histology in 56 cases (72.7%, true negative); 21 (27.3%, false negative) were found to be positive, in contrast with the sonographic appearance. The false negative cases were due to lymph node micrometastasis which probably did not cause morphologic alterations perceptible at ultrasound. The remaining 25 patients (24.5%) had axillary lymph nodes classified as suspicious. In 13 cases of (52%, true positive) there was agreement with histology, whereas in 12 cases (48%, false positive) the US suspicion was not confirmed at surgery. The most

  8. Thyroid Fine Needle Aspiration Biopsies in Children: Study of Cytological-Histological Correlation and Immunostaining with Thyroid Peroxidase Monoclonal Antibodies

    Directory of Open Access Journals (Sweden)

    Bauer Andrew

    2010-05-01

    Full Text Available Context. There is limited data comparing results of fine needle aspiration biopsies (FNABs to histological diagnosis in children. Design. FNABs were performed in 707 children and cytological results were compared to histology in 165 cases. The usefulness of immunostaining with anti-TPO monoclonal antibodies (MoAb47 on FNAB samples was examined in 54 operated patients. Results. Among unsatisfactory, benign, suspicious, and malignant FNAB, the histological diagnoses were benign in 12/12 (100%, 69/70 (98.5%, 40/50 (80.0%, and 0/33 (0%, respectively. After surgery, malignancy was established in 44/165 (26.6% cases. The sensitivity, specificity, and positive and negative predictive values were 95.4%, 55.8%, 61.7%, and 95% with standard FNAB; and 100%, 75%, 73.3, and 100% with MoAb47. Among suspicious FNAB, positive MoAb47 staining was a reliable marker for exclusion of malignancy. Conclusion. Benign and malignant FNAB accurately predict histological diagnosis. In suspicious FNAB, MoAb47 immunostaining may be a useful adjunct to standard cytology.

  9. Clinical impact of endoscopic ultrasound-guided fine needle aspiration biopsy in patients with upper gastrointestinal tract malignancies. A prospective study

    DEFF Research Database (Denmark)

    Mortensen, M B; Pless, T; Durup, J

    2001-01-01

    BACKGROUND AND STUDY AIMS: Several studies have evaluated the accuracy of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) in the upper gastrointestinal tract, but so far no studies have specifically evaluated the clinical impact of EUS-FNAB in upper gastrointestinal tract......% in esophageal, gastric, and pancreatic cancer, respectively. The staging-related clinical impact was similar for all three types of cancer (11-12.5%), whereas the diagnosis-related impact was highest in pancreatic cancer patients (86%). EUS-FNAB was inadequate in 13% and gave false-negative results in 5......%. The overall sensitivity, specificity and accuracy for EUS-FNAB were 80%, 78% and 80%, respectively. No complications related to the biopsy procedure were seen. CONCLUSIONS: If EUS-FNAB was performed only in cases where a positive malignant result would change patient management, then approximately one out...

  10. Sonographic appearance of cervical lymphadenopathy due to infectious mononucleosis in children and young adults

    International Nuclear Information System (INIS)

    Fu, X.S.; Guo, L.M.; Lv, K.; Wang, L.; Ran, W.Q.; Tan, Q.T.; Wang, J.R.; Liu, X.

    2014-01-01

    Aim: To depict the grey-scale and Doppler features of cervical lymphadenopathy due to infectious mononucleosis (IM) and to compare the findings with other benign conditions and lymphoma. Materials and methods: One hundred and four patients <30 years old with 138 enlarged lymph nodes (LNs) were enrolled for sonographic analysis. These LNs were grouped as: IM LNs (59 LNs in 30 patients), lymphoma (30 LNs in 30 patients), bacterial lymphadenitis (24 LNs in 20 patients), tuberculosis (TB; 14 LNs in 13 patients), and reactive hyperplasia (11 LNs in 11 patients). Sonographic assessments included shape, echotexture, hilum, border, matting, cystic necrosis, calcification, and vascular pattern. For each sonographic feature, Fisher's exact test was performed to determine whether the difference between IM LNs and any another aetiology were statistically significant. Results: IM LNs tended to be round in shape (69%), heterogeneous in echotexture (61%), absent of echogenic hilum (66%), indistinct margins (80%), bilateral distribution (91%), and matting (83%) [even bilateral matting (66%)], and central hilar vascularity (89.8%). On analysis, bilateral matting had the highest specificity to IM LNs; however, its sensitivity was relatively low. In contrast to IM LNs, TB LNs were more likely to have unilateral matting, cystic necrosis, and calcification. Indistinct margins and decreased echogenicity of the hilum were more frequently seen in IM LNs than in bacterial LNs. Furthermore, central hilar vascularity was a common feature of IM LNs and other benignity, which can distinguish these from lymphoma and TB LNs. Conclusion: Although an individual sonographic feature had considerable overlaps between IM LNs and other aetiologies, the combination of several features may be helpful in the diagnosis of IM

  11. Calcitonin assay in wash-out fluid after fine-needle aspiration biopsy in patients with a thyroid nodule and border-line value of the hormone.

    Science.gov (United States)

    Massaro, F; Dolcino, M; Degrandi, R; Ferone, D; Mussap, M; Minuto, F; Giusti, M

    2009-04-01

    Assaying calcitonin (CT) in the wash-out fluid from fine-needle aspiration biopsies (CT-FNAB) could be useful in the diagnosis of medullary thyroid carcinoma (MTC). The aim of this study was to correlate serum CT with cytology and CT-FNAB. Twenty-seven subjects (age range 27-75 yr) were studied. FNAB was performed in a thyroid nodule (no.=16) or lymph-node (no.=1 previously operated on for MTC) or in the prevalent nodule of multinodular goiters (no.=10). CT-FNAB values obtained in 37 subjects with normal serum CT (thyroid nodules served as a negative control. In these subjects, CTFNAB values were 8.2+/-6.4 ng/l (range 2-30 ng/l). In patients with a thyroid nodule under evaluation for MTC, serum CT and CT-FNAB values were 14.5+/-3.9 ng/l (range 10-24 ng/l) and 16.4+/-29.8 ng/l (range 2-144 ng/l), respectively. In 4 patients, CT-FNAB values were higher than the highest values found in our negative controls (30 ng/l), but cytology results were compatible with a benign thyroid lesion and pentagastrin testing was negative. In 3 cases with CT-FNAB 100 ng/l. Our data do not show any correlation between CT-FNAB and serum CT. In conclusion, borderline CT values in patients with thyroid nodules are not rare. Our experience suggests that CT-FNAB does not have the same importance as that reported in the literature for thyroglobulin and PTH assay in wash-out fluid after FNAB in malignant thyroid and hyperfunctioning parathyroid lesions.

  12. ADM3, TFF3 and LGALS3 are discriminative molecular markers in fine-needle aspiration biopsies of benign and malignant thyroid tumours

    Science.gov (United States)

    Karger, S; Krause, K; Gutknecht, M; Schierle, K; Graf, D; Steinert, F; Dralle, H; Führer, D

    2012-01-01

    Background: Previously, we reported a six-marker gene set, which allowed a molecular discrimination of benign and malignant thyroid tumours. Now, we evaluated these markers in fine-needle aspiration biopsies (FNAB) in a prospective, independent series of thyroid tumours with proven histological outcome. Methods: Quantitative RT–PCR was performed (ADM3, HGD1, LGALS3, PLAB, TFF3, TG) in the needle wash-out of 156 FNAB of follicular adenoma (FA), adenomatous nodules, follicular and papillary thyroid cancers (TC) and normal thyroid tissues (NT). Results: Significant expression differences were found for TFF3, HGD1, ADM3 and LGALS3 in FNAB of TC compared with benign thyroid nodules and NT. Using two-marker gene sets, a specific FNAB distinction of benign and malignant tumours was achieved with negative predictive values (NPV) up to 0.78 and positive predictive values (PPV) up to 0.84. Two FNAB marker gene combinations (ADM3/TFF3; ADM3/ACTB) allowed the distinction of FA and malignant follicular neoplasia with NPV up to 0.94 and PPV up to 0.86. Conclusion: We demonstrate that molecular FNAB diagnosis of benign and malignant thyroid tumours including follicular neoplasia is possible with recently identified marker gene combinations. We propose multi-centre FNAB studies on these markers to bring this promising diagnostic tool closer to clinical practice. PMID:22223087

  13. X-ray guided biopsy

    International Nuclear Information System (INIS)

    Casanova, R.; Lezana, A.H.; Pedrosa, C.S.

    1980-01-01

    Fine needle aspiration biopsy (FNAB) is now a routine procedure in many X-ray Departments. This paper presents the authors' experience with this technique in chest, abdominal and skeletal lesions. (Auth.)

  14. A retrospective analysis of ultrasound-guided large core needle ...

    African Journals Online (AJOL)

    2016-07-27

    Jul 27, 2016 ... The different types of non-surgical breast biopsy procedures include: fine needle aspiration biopsy. (FNAB), core needle ... needle biopsies of breast lesions at a regional public hospital in ..... NCR_2009_FINAL.pdf. 2. Parikh J ...

  15. Study on diagnosis of HD

    International Nuclear Information System (INIS)

    Chen Shuran; Yang Yumei; Zhang Guangli

    1994-01-01

    The study suggests a three-step diagnostic method for diagnosing HD. The first step is to make TgA, TmA examination; the second step is to make differential diagnosis for the cases of negative TgA, TmA through FNAB examination; the third step is to make TgA, TmA and FNAB examination for dynamic observation of controversial cases left over in the former two steps to achieve accurate diagnosis. Differential diagnosis has been made with the method in 87 cases of HD (clinical diagnosis only). The result shows that 7 cases have been diagnosed as thyropathy through comprehensive evaluation; definite diagnosis of HD has been made in 62 cases through TgA, TmA and in 77 cases through FNAB; 3 cases of negative TgA and TmA failed to accept FNAB examination, and were later diagnosed as HD through operation pathology or clinical treatment

  16. Metastatic and non-metastatic lymph nodes. Quantification and different distribution of iodine uptake assessed by dual-energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Rizzo, Stefania [European Institute of Oncology, Department of Radiology, Milan (Italy); Radice, Davide [Department of Epidemiology and Biostatistics, Milan (Italy); Femia, Marco; Vigorito, Raffaella [Universita di Milano, Department of Health Sciences, Milan (Italy); De Marco, Paolo; Origgi, Daniela [Medical Physics, European Institute of Oncology, Milan (Italy); Preda, Lorenzo [Division of Radiology, National Centre of Oncological Hadrontherapy (CNAO Foundation), Pavia (Italy); University of Pavia, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, Pavia (Italy); Barberis, Massimo [European Institute of Oncology, Department of Pathology, Milan (Italy); Mauri, Giovanni [European Institute of Oncology, Division of Interventional Radiology, Milan (Italy); Mauro, Alberto [GE Medical Systems Italia SpA, Milan (Italy); Bellomi, Massimo [European Institute of Oncology, Department of Radiology, Milan (Italy); Universita di Milano, Department of Oncology, Milan (Italy)

    2018-02-15

    To evaluate quantification of iodine uptake in metastatic and non-metastatic lymph nodes (LNs) by dual-energy CT (DECT) and to assess if the distribution of iodine within LNs at DECT correlates with the pathological structure. Ninety LNs from 37 patients (23 with lung and 14 with gynaecological malignancies) were retrospectively selected. Information of LNs sent for statistical analysis included Hounsfield units (HU) at different energy levels; decomposition material densities fat-iodine, iodine-fat, iodine-water, water-iodine. Statistical analysis included evaluation of interobserver variability, material decomposition densities and spatial HU distribution within LNs. Interobserver agreement was excellent. There was a significant difference in iodine-fat and iodine-water decompositions comparing metastatic and non-metastatic LNs (p < 0.001); fat-iodine and water-iodine did not show significant differences. HU distribution showed a significant gradient from centre to periphery within non-metastatic LNs that was significant up to 20-30% from the centre, whereas metastatic LNs showed a more homogeneous distribution of HU, with no significant gradient. DECT demonstrated a lower iodine uptake in metastatic compared to non-metastatic LNs. Moreover, the internal iodine distribution showed an evident gradient of iodine distribution from centre to periphery in non-metastatic LNs, and a more homogeneous distribution within metastatic LNs, which corresponded to the pathological structure. (orig.)

  17. Fine Needle Aspiration Biopsy in a Rural Family Practice

    African Journals Online (AJOL)

    ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10-mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and ...

  18. Topical topic: value of fine needle aspiration biopsy in childhood rhabdomyosarcoma: twenty-six years of experience in Slovenia.

    Science.gov (United States)

    Pohar-Marinsek, Ziva; Anzic, Jozica; Jereb, Berta

    2002-06-01

    Chemotherapy (Cht) for rhabdomyosarcoma (RMS) given before local treatment can prevent mutilating surgery and high-dose irradiation (RT). Fine needle aspiration biopsy (FNAB) can confirm the diagnosis and neoadjuvant treatment can start without delay. The purpose of our study was to assess the role of FNAB in the management of childhood RMS in Slovenia. A total of 78 children and young adults were included. FNAB provided the pre-treatment diagnosis in 37 and surgical biopsy in 41 patients. In 61 cases recurrent/metastatic disease was aspirated. Cytological diagnoses were compared to the original histological diagnoses. All case histories, cytological and histological material were reviewed and immunocytochemical staining performed when necessary. FNAB provided a correct diagnosis of malignancy in all 37 primary tumours, a specific diagnosis of RMS was given in 29 (78%). With the use of immunocytochemistry during the last 15 years, the accuracy has risen to 87%. FNAB provided the diagnosis of recurrence/metastasis in 57/61 cases. No complications of FNAB were noted. Review of histology reclassified five original diagnoses of RMS into one malignant rhabdoid tumour and four sarcomas NOS. In review of cytology we were able to sub classify 80% of RMS. FNAB is a safe method, which enables us to establish the pre-treatment diagnosis of RMS, and to some extent even its type, without delay. In our study, FNAB successfully replaced surgical biopsy in 87% of RMS patients during the last 15 years. Neoadjuvant Cht was started immediately, surgery was delayed and more conservative. Consequently, the risk for treatment sequelae was considerably reduced. Copyright 2002 Wiley-Liss, Inc.

  19. Accuracy of frozen-section combined with imprint and fine needle aspiration biopsy in thyroid nodules

    Directory of Open Access Journals (Sweden)

    Benyamin Makes

    2007-06-01

    Full Text Available Thyroid malignancy can be found on 5% of thyroid nodules. In order to better managed of thyroid nodules, skills to differentiate benign from malignant cases were needed. Fine needle aspiration biopsy (FNAB was done preoperatively while frozen section (FS and imprint cytology (IC should be done intra-operatively. The objective of this research paper is to evaluate the diagnostic accuracy of FNAB versus frozen section combined with imprint cytology (FS+IC in thyroid nodules at the Anatomic-Pathology Department FMUI-CM Hospital, Jakarta. This diagnostic test, used data from clinico-pathological records in Anatomic Pathology Department, Faculty of Medicine University of Indonesia / Dr.Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during 1999-2003. Specimens with complete data of FNAB results, data of FS and slides of IC. All formalin fixed`specimens were reevaluated and used as the golden standard. Sensitivity, spesificity and accuracy of FS+IC were higher than FNAB (86.8% vs 73.7% ; 99.0% vs 83.9% ; 94.8% vs 80.5% respectively. If the results of FNAB were concordant with the result of FS+IC, the combined examination yields accuracy of 95.1%. The evaluation of frozen section combined with imprint cytology is very useful, because this examination significantly showed high accuracy in diagnosing thyroid malignancy. (Med J Indones 2007; 16:89-93Keywords: thyroid nodules, FNAB, frozen section, imprint cytology, accuracy

  20. Learning curve of thyroid fine-needle aspiration biopsy.

    Science.gov (United States)

    Penín, Manuel; Martín, M Ángeles; San Millán, Beatriz; García, Juana

    2017-12-01

    Fine-needle aspiration biopsy (FNAB) is the reference procedure for thyroid nodule evaluation. Its main limitation are inadequate samples, which should be less than 20%. To analyze the learning curve of the procedure by comparing the results of a non-experienced endocrinologist (endocrinologist 2) to those of an experienced one (endocrinologist 1). Sixty FNABs were analyzed from February to June 2016. Each endocrinologist made 2punctures of every nodule in a random order. This order and the professional making every puncture were unknown to the pathologist who examined the samples. Endocrinologist 1 had a higher percentage of diagnoses than endocrinologist 2 (82% vs. 72%, P=.015). In the first 20 FNABs, the difference between both physicians was remarkable and statistically significant (80% vs. 50%, P=.047). In the following 20 FNABs, the difference narrowed and was not statistically significant (90% vs. 65%, P=.058). In the final 20 FNABs, the difference was minimal and not statistically significant (75% vs. 70%, P=.723). The learning curve of ultrasound-guided FNAB may be completed in a suitable environment by performing it at least 60 times. Although the guidelines recommend at least 3punctures per nodule, 2are enough to achieve an accurate percentage of diagnoses. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Core-needle biopsy of breast cancer is associated with a higher rate of distant metastases 5 to 15 years after diagnosis than FNA biopsy.

    Science.gov (United States)

    Sennerstam, Roland B; Franzén, Bo S H; Wiksell, Hans O T; Auer, Gert U

    2017-10-01

    The literature offers discordant results regarding whether diagnostic biopsy is associated with the dissemination of cancer cells, resulting in local and/or distant metastasis. The long-term outcomes of patients with breast cancer were compared between those who were diagnosed using either fine-needle aspiration biopsy (FNAB) or core-needle biopsy (CNB) during 2 decades: the 1970s and 1990s. In the 1970s, the only diagnostic needle biopsy method used for breast cancer in Sweden was FNAB. CNB was introduced 1989 and became established in Stockholm Gotland County in the early 1990s. The authors compared the clinical outcomes of patients diagnosed using FNAB from 1971 to 1976 (n = 354) versus those of patients diagnosed using CNB from 1991 to 1995 (n = 1729). Adjusting for differences in various treatment modalities, mammography screening, tumor size, DNA ploidy, and patient age between the 2 decades, 2 strictly matched samples representing FNAB (n = 181) and CNB (n = 203) were selected for a 15-year follow-up study. In a comparison of the rates of distant metastasis in the strictly matched patient groups from the FNAB and CNB cohorts, significantly higher rates of late-appearing (5-15 years after diagnosis) distant metastasis were observed among the patients who were diagnosed on CNB compared with those who were diagnosed on FNAB. No significant difference in local metastasis was observed between the 2 groups. At 5 to 15 years after diagnosis of the primary tumor, CNB-diagnosed patients had significantly higher rates of distant metastases than FNAB-diagnosed patients. Cancer Cytopathol 2017;125:748-56. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. Histopathologic Findings Related to the Indeterminate or Inadequate Results of Fine-Needle Aspiration Biopsy and Correlation with Ultrasonographic Findings in Papillary Thyroid Carcinomas

    International Nuclear Information System (INIS)

    Jung, So Lyung; Jung, Chan Kwon; Kim, Sung Hun; Kang, Bong Joo; Ahn, Kook Jin; Kim, Bum Soo; Ahn, Myeong Im; Im, Dong Jun; Bae, Ja Sung; Chung, Soo Kyo

    2010-01-01

    To determine histopathologic findings related to the indeterminate or inadequate result of fine-needle aspiration biopsy (FNAB) in papillary thyroid carcinomas (PTCs) and to correlate histopathological findings with ultrasonographic features of tumors. We retrospectively reviewed the medical records of FNAB, histopathologic characteristics, and sonographic findings of the solid portion of 95 PTCs in 95 patients. All cases were pathologically confirmed by surgery. Histopathologic characteristics were analyzed for tumor distribution, microcystic changes, fibrosis, and tumor component. We assumed several histopathologic conditions to be the cause of indeterminate or inadequate results of FNAB, including: 1) an uneven tumor distribution, 2) > 30% microcystic changes, 3) > 30% fibrosis, and 4) < 30% tumor component. Ultrasonographic findings of each PTC were evaluated for echotexture (homogeneous or heterogeneous), echogenicity (markedly hypoechoic, hypoechoic, isoechoic, or hyperechoic), and volume of the nodule. We correlated histopathologic characteristics of the PTC with results of the FNAB and ultrasonographic findings. From 95 FNABs, 71 cases (74%) were confirmed with malignancy or suspicious malignancy (PTCs), 21 (22%) had indeterminate results (atypical cells), and three (4%) were negative for malignancy. None of the assumed variables influenced the diagnostic accuracy of FNAB. Tumor distribution and fibrosis were statistically correlated with ultrasonographic findings of the PTCs (p < 0.05). Uneven tumor distribution was related with small tumor volume, and fibrosis over 30% was correlated with homogeneous echotexture, markedly hypoechoic and hypoechoic echogenicity, and small tumor volume (p < 0.05). No histopathologic component was found to correlate with improper results of FNAB in PTCs. In contrast, two histopathologic characteristics, uneven distribution and fibrosis, were correlated with ultrasonographic findings

  3. Exploring the flexible chemistry of 4-fluoro-3-nitrophenyl azide for biomolecule immobilization and bioconjugation.

    Science.gov (United States)

    Kumar, Saroj; Kumar, Dileep; Ahirwar, Rajesh; Nahar, Pradip

    2016-10-01

    Bioconjugation and functionalization of polymer surfaces are two major tasks in materials chemistry which are accomplished using a variety of coupling agents. Immobilization of biomolecules onto polymer surfaces and the construction of bioconjugates are essential requirements of many biochemical assays and chemical syntheses. Different linkers with a variety of functional groups are used for these purposes. Among them, the benzophenones, aryldiazirines, and arylazides represent the most commonly used photolinker to produce the desired chemical linkage upon their photo-irradiation. In this review, we describe the versatile applications of 4-fluoro-3-nitrophenyl azide, one of the oldest photolinkers used for photoaffinity labeling in the late 1960s. Surprisingly, this photolinker, historically known as 1-fluoro-2-nitro-4-azidobenzene (FNAB), has remained unexplored for a long time because of apprehension that FNAB forms ring-expanded dehydroazepine as a major product and hence cannot activate an inert polymer. The first evidence of photochemical activation of an inert surface by FNAB through nitrene insertion reaction was reported in 2001, and the FNAB-activated surface was found to conjugate a biomolecule without any catalyst, reagent, or modification. FNAB has distinct advantages over perfluorophenyl azide derivatives, which are contemporary nitrene-generating photolinkers, because of its simple, single-step preparation and ease of thermochemical and photochemical reactions with versatile polymers and biomolecules. Covering these aspects, the present review highlights the flexible chemistry of FNAB and its applications in the field of surface engineering, immobilization of biomolecules such as antibodies, enzymes, cells, carbohydrates, oligonucleotides, and DNA aptamers, and rapid diagnostics. Graphical Abstract An overview of the FNAB-engineered activated polymer surfaces for covalent ligation of versatile biomolecules.

  4. Prognostic Significance of the Number of Positive Lymph Nodes in Women With T1-2N1 Breast Cancer Treated With Mastectomy: Should Patients With 1, 2, and 3 Positive Lymph Nodes Be Grouped Together?

    Energy Technology Data Exchange (ETDEWEB)

    Dai Kubicky, Charlotte, E-mail: charlottedai@gmail.com [Department of Radiation Medicine and Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States); Mongoue-Tchokote, Solange [Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States)

    2013-04-01

    Purpose: To determine whether patients with 1, 2, or 3 positive lymph nodes (LNs) have similar survival outcomes. Methods and Materials: We analyzed the Surveillance, Epidemiology, and End Results registry of breast cancer patients diagnosed between 1990 and 2003. We identified 10,415 women with T1-2N1M0 breast cancer who were treated with mastectomy with no adjuvant radiation, with at least 10 LNs examined and 6 months of follow-up. The Kaplan-Meier method and log–rank test were used for survival analysis. Multivariate analysis was performed using the Cox proportional hazard model. Results: Median follow-up was 92 months. Ten-year overall survival (OS) and cause-specific survival (CSS) were progressively worse with increasing number of positive LNs. Survival rates were 70%, 64%, and 60% (OS), and 82%, 76%, and 72% (CSS) for 1, 2, and 3 positive LNs, respectively. Pairwise log–rank test P values were <.001 (1 vs 2 positive LNs), <.001 (1 vs 3 positive LNs), and .002 (2 vs 3 positive LNs). Multivariate analysis showed that number of positive LNs was a significant predictor of OS and CSS. Hazard ratios increased with the number of positive LNs. In addition, age, primary tumor size, grade, estrogen receptor and progesterone receptor status, race, and year of diagnosis were significant prognostic factors. Conclusions: Our study suggests that patients with 1, 2, and 3 positive LNs have distinct survival outcomes, with increasing number of positive LNs associated with worse OS and CSS. The conventional grouping of 1-3 positive LNs needs to be reconsidered.

  5. Evaluation of 18F-FDG PET/CT Parameters for Detection of Lymph Node Metastasis in Cutaneous Melanoma.

    Science.gov (United States)

    Cha, Jongtae; Kim, Soyoung; Wang, Jiyoung; Yun, Mijin; Cho, Arthur

    2018-02-01

    The purpose of this study was to investigate the value of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in the detection of regional lymph node (LN) metastasis in patients with cutaneous melanoma. We evaluated patients with cutaneous melanoma who underwent FDG PET/CT for initial staging or recurrence evaluation. A total of 103 patients were enrolled, and 165 LNs were evaluated. LNs that were confirmed pathologically or by follow-up imaging were included in this study. PET parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis and tumour-to-liver ratio, were used to determine the presence of metastases, and the results were compared with CT-determined LN metastasis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values of the FDG PET parameters. A total of 93 LNs were malignant, and 84 LNs were smaller than 10 mm. In all 165 LNs, an SUVmax of >2.51 showed a sensitivity of 73.1%, a specificity of 88.9%, and an accuracy of 80.0% in detecting metastatic LNs. CT showed a higher specificity (87.3%) and lower accuracy (65.5%). For non-enlarged regional LNs (2.4 showed a high sensitivity (91%) and accuracy (89%) in detecting metastasis in LNs ≥1 cm, and LNs <1 cm with an SUVmax <1.4 were likely to be benign.

  6. Lesch-Nyhan Syndrome

    Science.gov (United States)

    ... National Organization for Rare Disorders (NORD) Purine Research Society See all related organizations Publications Order NINDS Publications Definition Lesch-Nyhan syndrome (LNS) is a rare, inherited ...

  7. Comparative cost-effectiveness of fine needle aspiration biopsy versus image-guided biopsy, and open surgical biopsy in the evaluation of breast cancer in the era of Affordable Care Act: a changing landscape.

    Science.gov (United States)

    Masood, Shahla; Rosa, Marilin; Kraemer, Dale F; Smotherman, Carmen; Mohammadi, Amir

    2015-08-01

    Proven as a time challenged and cost-effective sampling procedure, the use of FNAB has still remained controversial among the scientific community. Currently, other minimally invasive sampling procedures such as ultrasound guided fine needle aspiration biopsy (US-FNAB) and image guided core needle biopsy (IG-CNB) have become the preferred sampling procedures for evaluation of breast lesions. However, changes in the medical economy and the current growing emphasis on cost containment in the era of the Affordable Care Act make it necessary to stimulate a renewed interest in the use of FNAB as the initial diagnostic sampling procedure. This study was designed to define the changing trend in the practice of tissue sampling during the last several years, and to assess the comparative effectiveness and appropriateness of the procedure of choice for breast cancer diagnosis. After Institutional Review Board (IRB) approval, the computer database of the Pathology Department, University of Florida, College of Medicine-Jacksonville at UF Health was retrospectively searched to identify all breast biopsy pathology reports issued during the period of January 2004 to December 2011. The inclusion criteria were all women that underwent any of the following biopsy types: FNAB, US-FNAB, IG-CNB, and surgical biopsy (SB). Diagnostic procedures were identified using current procedural terminology (CPT) codes recorded on claims from the UF Health Jacksonville patient accounting application files. The data obtained was used to determine which technique has the best cost-effectiveness in the diagnosis of breast cancer. The outcome variable for this project was a positive breast cancer diagnosis resulting from these methodologies. The predictor variable was the biopsy type used for sampling. The rate of cancer detection for each procedure was also determined. Among the four groups of procedures compared, the lower cost was attributed to FNAB, followed by US-FNAB, and SB. IG-CNB was the most

  8. Quantitative analysis of fine needle aspiration biopsy samples

    International Nuclear Information System (INIS)

    Rajer, M.; Kmet, M.

    2005-01-01

    Background. The fine needle aspiration biopsy (FNAB) is one of the methods used in tumour evaluation. Since a certain number of tumour cells are needed for a complete diagnostic algorithm, we wanted to test how many cells remain in the needle and syringe after routine stains have been made and which factors influence this number. The remaining cells are used in ancillary diagnostic procedures. Materials and methods. One hundred fifty two FNAB samples of tumours of the breast, thyroid and lymph nodes were included in our study. We counted the cells which were left in the needle and the syringe after the standard smears had been made. Buerker-Tuerk's chamber was used for this purpose. Results. The number of cells depended on the organ from which the cells had been aspirated, on the type of tumour and, in the case of breast cancer, also on the level of experience of the FNAB performer. The percentage of samples with too few cells for all modern diagnostic methods (<5x105 ) is lowest in FNAB of lymph nodes (4.9%), followed by breast (16.7%) and thyroid (18%). Conclusions. We concluded that FNAB in the majority of cases grants a sufficient number of cells for the standard microscopic evaluation and also ancillary diagnostic procedures. (author)

  9. Can concurrent core biopsy and fine needle aspiration biopsy improve the false negative rate of sonographically detectable breast lesions?

    Directory of Open Access Journals (Sweden)

    Chang Tsai-Wang

    2010-07-01

    Full Text Available Abstract Background The aims of this study were to determine the accuracy of concurrent core needle biopsy (CNB and fine needle aspiration biopsy (FNAB for breast lesions and to estimate the false-negative rate using the two methods combined. Methods Over a seven-year period, 2053 patients with sonographically detectable breast lesions underwent concurrent ultrasound-guided CNB and FNAB. The sonographic and histopathological findings were classified into four categories: benign, indeterminate, suspicious, and malignant. The histopathological findings were compared with the definitive excision pathology results. Patients with benign core biopsies underwent a detailed review to determine the false-negative rate. The correlations between the ultrasonography, FNAB, and CNB were determined. Results Eight hundred eighty patients were diagnosed with malignant disease, and of these, 23 (2.5% diagnoses were found to be false-negative after core biopsy. After an intensive review of discordant FNAB results, the final false-negative rate was reduced to 1.1% (p-value = 0.025. The kappa coefficients for correlations between methods were 0.304 (p-value p-value p-value Conclusions Concurrent CNB and FNAB under ultrasound guidance can provide accurate preoperative diagnosis of breast lesions and provide important information for appropriate treatment. Identification of discordant results using careful radiological-histopathological correlation can reduce the false-negative rate.

  10. Comparison of specimen adequacy in fine-needle aspiration biopsies performed by surgeons and pathologists

    International Nuclear Information System (INIS)

    Al-Marzooq, Yusef M.; Chopra, Rajan; Al-Bahrani, Ahmed T.; Younis, Mohammad; Al-Mulhim, Abdulrahman S.; Al-Mommatten, Mohammed I.

    2004-01-01

    Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons. In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared. Of 692 FNAB's, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6% of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic. The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnstic accuracy of FNAB technique. (author)

  11. The reliability of fine-needle aspiration biopsy in terms of malignancy in patients with Hashimoto thyroiditis.

    Science.gov (United States)

    Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, Abdullah

    2015-02-01

    The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.

  12. Delivery of Flightless I Neutralizing Antibody from Porous Silicon Nanoparticles Improves Wound Healing in Diabetic Mice.

    Science.gov (United States)

    Turner, Christopher T; McInnes, Steven J P; Melville, Elizabeth; Cowin, Allison J; Voelcker, Nicolas H

    2017-01-01

    Flightless I (Flii) is elevated in human chronic wounds and is a negative regulator of wound repair. Decreasing its activity improves healing responses. Flii neutralizing antibodies (FnAbs) decrease Flii activity in vivo and hold significant promise as healing agents. However, to avoid the need for repeated application in a clinical setting and to protect the therapeutic antibody from the hostile environment of the wound, suitable delivery vehicles are required. In this study, the use of porous silicon nanoparticles (pSi NPs) is demonstrated for the controlled release of FnAb to diabetic wounds. We achieve FnAb loading regimens exceeding 250 µg antibody per mg of vehicle. FnAb-loaded pSi NPs increase keratinocyte proliferation and enhance migration in scratch wound assays. Release studies confirm the functionality of the FnAb in terms of Flii binding. Using a streptozotocin-induced model of diabetic wound healing, a significant improvement in healing is observed for mice treated with FnAb-loaded pSi NPs compared to controls, including FnAb alone. FnAb-loaded pSi NPs treated with proteases show intact and functional antibody for up to 7 d post-treatment, suggesting protection of the antibodies from proteolytic degradation in wound fluid. pSi NPs may therefore enable new therapeutic approaches for the treatment of diabetic ulcers. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Free thyroxine in needle washout after fine needle aspiration biopsy of toxic thyroid nodules.

    Science.gov (United States)

    Raikov, Nikolai; Nonchev, Boyan; Chaushev, Borislav; Vjagova, Diyana; Todorov, Svetoslav; Bocheva, Yana; Malceva, Daniela; Vicheva, Snejinka; Raikova, Asyia; Argatska, Antoaneta; Raikov, Miroslav

    2016-01-01

    The main diagnostic tool for toxic adenomas (TA) is radionuclide imaging indicated in patients with evidence of thyroid nodules in combination with thyrotoxic syndrome. Thyroid ultrasound and fine-needle aspiration biopsy (FNAB) are widely used for the valuation of thyroid masses. There is no literature data concerning the utility of FNAB and related tests for the diagnosis of hyperfunctioning thyroid nodules. The purpose of this study is to determine the levels of free thyroxine (FT4) in the needle washout after FNAB of hot thyroid nodules. The results of our study show that the FT4 levels in needle washout from TA were significantly higher than the surrounding parenchyma and correlated with the hormonal changes in patients with thyroid hyperfunctioning nodules. Further studies on a large number of patients are needed to refine the diagnostic value of this method and evaluate its importance in quantitative risk assessment of thyroid autonomy.

  14. MIBI scintigraphy in hypofunctioning thyroid nodules. Can it predict the dignity of the lesion?

    Energy Technology Data Exchange (ETDEWEB)

    Theissen, P.; Schmidt, M.; Ivanova, T.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2009-07-01

    Aim: Several authors have investigated the value of technetium-MIBI scanning to predict the dignity of hypofunctioning, cold thyroid nodules (HTN) in regions with differing levels of iodine supply. They concluded that an MIBI scan can exclude thyroid malignancy, although comparisons between the studies are of limited value owing to differences in methodology and wide variations in patient selection criteria. The present study investigates whether the above claim is also valid in Germany, a country with a long-standing and persistent, mild iodine deficiency and a high incidence of nodules in large goiters with a low prevalence of malignancy. Patients, methods: The study compares the results of {sup 99m}Tc-MIBI scintigraphy (incl. SPECT and planar images) in HTN (MIBI) with those of fine-needle aspiration biopsy (FNAB) and histology. Of 154 consecutive patients (121 women, 33 men; mean age 56 {+-} 12 years), 73 underwent thyroid surgery from which the results of FNAB and MIBI were assessed. Selection criteria were risk estimation or conditions limiting the feasibility of FNAB. The mean thyroid volume was 42 {+-} 25 ml, with 2.1 {+-} 1.4 nodules per patient. Results: Histology revealed thyroid malignancies in 8 out of 73 patients (11.0%). The negative predictive value for MIBI was 97%, which is comparable to FNAB (94%). However, in 19.5% of patients FNAB was indeterminate. Lower specificity (54%) and low positive predictive value (19%) showed that MIBI accumulation cannot differentiate between malignant and benign thyroid nodules. However, comparison with cytological and/or histological findings indicated that it could distinguish between lesions with differing rates of mitochondrial metabolism. Conclusion: Even in areas of former or mild iodine deficiency MIBI forms a basis for choosing between wait-and-see and surgical strategies if FNAB is unfeasible or not representative. However, even for pathological MIBI results, the prevalence of malignancy is not very high

  15. Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Yi-Ping, E-mail: yipingzhuang2010@sina.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Wang, Hai-Yan, E-mail: mycherishgirl@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Jin, E-mail: yari_zj@hotmail.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Feng, Yong, E-mail: fengyong119@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Lei, E-mail: motozl163@163.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China)

    2013-01-15

    Objective: CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions. Materials and methods: 102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness. Results: The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05). Conclusion: CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.

  16. The Structure of Neurexin 1[alpha] Reveals Features Promoting a Role as Synaptic Organizer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Fang; Venugopal, Vandavasi; Murray, Beverly; Rudenko, Gabby (Michigan)

    2014-10-02

    {alpha}-Neurexins are essential synaptic adhesion molecules implicated in autism spectrum disorder and schizophrenia. The {alpha}-neurexin extracellular domain consists of six LNS domains interspersed by three EGF-like repeats and interacts with many different proteins in the synaptic cleft. To understand how {alpha}-neurexins might function as synaptic organizers, we solved the structure of the neurexin 1{alpha} extracellular domain (n1{alpha}) to 2.65 {angstrom}. The L-shaped molecule can be divided into a flexible repeat I (LNS1-EGF-A-LNS2), a rigid horseshoe-shaped repeat II (LNS3-EGF-B-LNS4) with structural similarity to so-called reelin repeats, and an extended repeat III (LNS5-EGF-B-LNS6) with controlled flexibility. A 2.95 {angstrom} structure of n1{alpha} carrying splice insert SS3 in LNS4 reveals that SS3 protrudes as a loop and does not alter the rigid arrangement of repeat II. The global architecture imposed by conserved structural features enables {alpha}-neurexins to recruit and organize proteins in distinct and variable ways, influenced by splicing, thereby promoting synaptic function.

  17. Status of the Catania tandem as injector of the superconducting cyclotron

    International Nuclear Information System (INIS)

    Ciavola, G.; Cuttone, G.; Raia, G.

    1990-01-01

    The Catania LNS tandem facility is operating since 1984. The status and the main modifications of the accelerator during these years are described and the performance obtained is reported. A superconducting cyclotron will be installed at the LNS facility as tandem booster; the main progress is presented. (orig.)

  18. Willingness to pay for small-quantity lipid-based nutrient supplements for women and children: Evidence from Ghana and Malawi.

    Science.gov (United States)

    Adams, Katherine P; Vosti, Stephen A; Ayifah, Emmanuel; Phiri, Thokozani E; Adu-Afarwuah, Seth; Maleta, Kenneth; Ashorn, Ulla; Arimond, Mary; Dewey, Kathryn G

    2018-04-01

    Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000 days. Scaling up the delivery of supplements such as SQ-LNS hinges on understanding private demand and creatively leveraging policy-relevant factors that might influence demand. We used longitudinal stated willingness-to-pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ-LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ-LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ-LNS (and by extension, the options for effective delivery of SQ-LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ-LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ-LNS was not associated with WTP in either site. © 2017 The Authors. Maternal and Child Nutrition published by John Wiley & Sons, Ltd.

  19. Esophageal motion characteristics in thoracic esophageal cancer: Impact of clinical stage T4 versus stages T1-T3

    Directory of Open Access Journals (Sweden)

    Yuta Kobayashi, MS

    2016-10-01

    Conclusions: The EM and the ITV margins in cT4 were significantly smaller than those in cT1-T3. The NM and the ITV margins of abdominal LNs were much larger than those of cervicothoracic LNs and the esophagus. In clinical radiation therapy planning for esophageal cancer, we should take cT stage into consideration.

  20. 7254 ACCEPTABILITY OF DIFFERENT LIPID-BASED NUTRIENT ...

    African Journals Online (AJOL)

    Marlène Hébié

    2013-01-01

    Jan 1, 2013 ... acceptability tests with one of four sets of LNS products: LNS-30 g sweet, .... data and analyzed using non-parametric tests: Kruskal–Wallis test, Wilcoxon signed- rank test or Wilcoxon sum rank test to compare 2 groups and ...

  1. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6–18 months living in the rural region of Intibucá, Honduras

    Science.gov (United States)

    Background: Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. Methods: A 12-month randomised controlled trial was conducted among chil...

  2. Histopathologic correlation of parotid tumors

    International Nuclear Information System (INIS)

    Ramirez Valverde, Jose Miguel

    2014-01-01

    Malignization percentage of parotid pleomorphic adenoma is defined with fine needle aspiration biopsy (FNAB), prior negative in patients operated by parotid tumor in the Hospital San Juan de Dios between 2008-2012. Patients diagnosed with pleomorphic adenoma by FNAB are described in time, place and person. The histological type of parotid tumors diagnosed are defined. Management offered to patients diagnosed with parotid tumors is understood in the Hospital San Juan de Dios. Complications associated with surgical procedure in patients are specified. A quarter part the of parotid tumors from the series analyzed have been malignant, a similar percentage described in the literature [es

  3. Value of fine-needle aspiration biopsy of salivary gland lesions

    DEFF Research Database (Denmark)

    Christensen, Rikke Kølby; Bjørndal, Kristine; Godballe, Christian

    2010-01-01

    BACKGROUND: The aim of this study was to assess the utility of fine-needle aspiration biopsy (FNAB) in the diagnosis and treatment planning of the lesions of the salivary gland. METHODS: Eight hundred seventy-nine aspiration biopsies of the lesion of the salivary gland over a 10-year period, from...... was 98%, and the negative predictive value was 97%. The overall accuracy was 93%. The correct subtyping of the benign lesions was 97%, and the exact type-specific concordance of the malignant lesions was 71%. CONCLUSION: Considerable benefit to the patient may result from the cautious use of FNAB...

  4. Incidental irradiation of mediastinal and hilar lymph node stations during 3D-conformal radiotherapy for non-small cell lung cancer

    International Nuclear Information System (INIS)

    Kepka, Lucyna; Bujko, Krzysztof; Zolciak-Siwinska, Agnieszka; Garmol, Dariusz

    2008-01-01

    Purpose. To estimate the doses of incidental irradiation in particular lymph node stations (LNS) in different extents of elective nodal irradiation (ENI) in 3D-conformal radiotherapy (3D-CRT) for non-small cell lung cancer (NSCLC). Methods. Doses of radiotherapy were estimated for particular LNS delineated according to the recommendations of the Univ. of Michigan in 220 patients treated using 3D-CRT with different (extended, limited and omitted) extents of ENI. Minimum doses and volumes of LNS receiving 40 Gy or more (V40) were compared for omitted vs. limited+extended ENI and limited vs. extended ENI. Results. For omission of the ENI the minimum doses and V40 for particular LNS were significantly lower than for patients treated with ENI. For the limited ENI group, the minimum doses for LNS 5, 6 lower parts of 3A and 3P (not included in the elective area) did not differ significantly from doses given to respective LNS for extended ENI group. When the V40 values for extended and limited ENI were compared, no significant differences were seen for any LNS, except for group 1/2R, 1/2L. Conclusions. Incidental irradiation of untreated LNS seems play a part in case of limited ENI, but not in cases without ENI. For subclinical disease the delineation of uninvolved LNS 5, 6, and lower parts of 3A, 3P may be not necessary, because these stations receive the substantial part of irradiation incidentally, if LNS 4R, 4L, 7, and ipsilateral hilum are included in the elective area while this is not case for stations 1 and 2

  5. Are Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies—Assessment of Nodal Distribution in Gynecological Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kabolizadeh, Peyman; Fulay, Suyash; Beriwal, Sushil, E-mail: beriwals@upmc.edu

    2013-09-01

    Purpose: Intensity modulated radiation therapy is used to reduce dose to adjacent critical structures while maintaining adequate target coverage, but it requires precise target localization. We report the 3-dimensional distribution of para-aortic (PA) lymph nodes (LN) in pelvic malignancies. We propose a guideline to accurately define the PA LN by anatomic landmarks and compare our data with published guidelines for pancreatic cancer. Methods and Materials: A retrospective analysis was performed on 46 patients with pelvic malignancies and positive PA LNs. Positive LNs were defined based on size and morphology or fluorodeoxyglucose avidity. All PA LNs were characterized into 3 groups based on location: left PA (between aorta and left psoas muscle), aortocaval (between aorta and inferior vena cava), and right paracaval (between inferior vena cava and right psoas muscle). Patients with retrocrural LNs were also analyzed. Results: One hundred thirty-three positive PA LNs were evaluated. The majority of the PA LNs were in the left PA (59%) and aortocaval (35) regions, and only 8% were in the right paracaval region. All patients with positive right paracaval LNs also had involved left PA LNs, with only 1 exception. The highest PA LN involvement was at the level of the renal vessels and was seen in 28% of patients. Of these patients with disease extending to renal vessels, 38% had retrocrural LN involvement. Conclusions: The nodal contouring for the PA region should not be defined by a fixed circumferential margin around the vessels. The left PA and aortocaval spaces should be covered adequately because these are common locations of PA LNs. For microscopic disease superiorly, contouring should extend up to renal vessels rather than a fixed bony landmark. For patients who have nodal involvement at renal vessels, one can consider including retrocrural LNs. Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm are not applicable to

  6. Enhanced oral bioavailability of docetaxel by lecithin nanoparticles: preparation, in vitro, and in vivo evaluation

    Science.gov (United States)

    Hu, Kaili; Cao, Shan; Hu, Fuqiang; Feng, Jianfang

    2012-01-01

    The aim of this research work was to investigate the potential of lecithin nanoparticles (LNs) in improving the oral bioavailability of docetaxel. Docetaxel-loaded LNs (DTX-LNs) were prepared from oil-in-water emulsions and characterized in terms of morphology, size, zeta potential, and encapsulation efficiency. The in vitro release of docetaxel from the nanoparticles was studied by using dialysis bag method. Caco-2 cell monolayer was used for the in vitro permeation study of DTX-LNs. Bioavailability studies were conducted in rats and different pharmacokinetic parameters were evaluated after oral administration of DTX-LNs. The results showed that DTX-LNs had a mean diameter of 360 ± 8 nm and exhibited spherical shape with smooth surface under transmission electron microscopy. The DTX-LNs showed a sustained-release profile, with about 80% of docetaxel released within 72 hours. The apical to basolateral transport of docetaxel across the Caco-2 cell monolayer from the DTX-LNs was 2.14 times compared to that of the docetaxel solution (0.15 × 10−5 ± 0.016 × 10−5 cm/second versus 0.07 × 10−5 ± 0.003 × 10−5 cm/second). The oral bioavailability of the DTX-LNs was 3.65 times that of docetaxel solution (8.75% versus 2.40%). These results indicate that DTX-LNs were valuable as an oral drug delivery system to enhance the absorption of docetaxel. PMID:22848177

  7. Are Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies—Assessment of Nodal Distribution in Gynecological Malignancies

    International Nuclear Information System (INIS)

    Kabolizadeh, Peyman; Fulay, Suyash; Beriwal, Sushil

    2013-01-01

    Purpose: Intensity modulated radiation therapy is used to reduce dose to adjacent critical structures while maintaining adequate target coverage, but it requires precise target localization. We report the 3-dimensional distribution of para-aortic (PA) lymph nodes (LN) in pelvic malignancies. We propose a guideline to accurately define the PA LN by anatomic landmarks and compare our data with published guidelines for pancreatic cancer. Methods and Materials: A retrospective analysis was performed on 46 patients with pelvic malignancies and positive PA LNs. Positive LNs were defined based on size and morphology or fluorodeoxyglucose avidity. All PA LNs were characterized into 3 groups based on location: left PA (between aorta and left psoas muscle), aortocaval (between aorta and inferior vena cava), and right paracaval (between inferior vena cava and right psoas muscle). Patients with retrocrural LNs were also analyzed. Results: One hundred thirty-three positive PA LNs were evaluated. The majority of the PA LNs were in the left PA (59%) and aortocaval (35) regions, and only 8% were in the right paracaval region. All patients with positive right paracaval LNs also had involved left PA LNs, with only 1 exception. The highest PA LN involvement was at the level of the renal vessels and was seen in 28% of patients. Of these patients with disease extending to renal vessels, 38% had retrocrural LN involvement. Conclusions: The nodal contouring for the PA region should not be defined by a fixed circumferential margin around the vessels. The left PA and aortocaval spaces should be covered adequately because these are common locations of PA LNs. For microscopic disease superiorly, contouring should extend up to renal vessels rather than a fixed bony landmark. For patients who have nodal involvement at renal vessels, one can consider including retrocrural LNs. Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm are not applicable to

  8. Preparation and evaluation of enteric coated tablets of hot-melt extruded lansoprazole.

    Science.gov (United States)

    Alsulays, Bader B; Kulkarni, Vijay; Alshehri, Sultan M; Almutairy, Bjad K; Ashour, Eman A; Morott, Joseph T; Alshetaili, Abdullah S; Park, Jun-Bom; Tiwari, Roshan V; Repka, Michael A

    2017-05-01

    The objective of this work was to use hot-melt extrusion (HME) technology to improve the physiochemical properties of lansoprazole (LNS) to prepare stable enteric coated LNS tablets. For the extrusion process, we chose Kollidon ® 12 PF (K12) polymeric matrix. Lutrol ® F 68 was selected as the plasticizer and magnesium oxide (MgO) as the alkalizer. With or without the alkalizer, LNS at 10% drug load was extruded with K12 and F68. LNS changed to the amorphous phase and showed better release compared to that of the pure crystalline drug. Inclusion of MgO improved LNS extrudability and release and resulted in over 80% drug release in the buffer stage. Hot-melt extruded LNS was physically and chemically stable after 12 months of storage. Both formulations were studied for compatibility with Eudragit ® L100-55. The optimized formulation was compressed into a tablet followed by coating process utilizing a pan coater using L100-55 as an enteric coating polymer. In a two-step dissolution study, the release profile of the enteric coated LNS tablets in the acidic stage was less than 10% of the LNS, while that in the buffer stage was more than 80%. Drug content analysis revealed the LNS content to be 97%, indicating the chemical stability of the enteric coated tablet after storage for six months. HME, which has not been previously used for LNS, is a valuable technique to reduce processing time in the manufacture of enteric coated formulations of an acid-sensitive active pharmaceutical ingredient as compared to the existing methods.

  9. The quality of specimens obtained by fine-needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-10-27

    Oct 27, 2011 ... from a suspicious mass for diagnostic purposes.1 The first description of the use of ... breast, thyroid, lymph node, and salivary gland lesions, .... Ljung et al7 reviewed 1 043 consecutive FNABs of palpable breast lesions ...

  10. [Hepatic fine needle aspiration biopsy. Experience in the study of hepatic masses at the Salvador Zubiran National Institute of Nutrition].

    Science.gov (United States)

    Angeles-Angeles, A; Gamboa-Domínguez, A; Velázquez Fernández, D; Muñoz-Fernández, L

    1994-01-01

    The results of 114 fine-needle aspiration biopsies (FNAB) of the liver performed during six years (1987-1992) at the Departament of Pathology of the Instituto Nacional de la Nutrición Salvador Zubirán are presented. All were done by radiologists under ultrasonographic (three cases) or computerized tomographic guidance (111 cases). In order to determine the diagnostic accuracy, diagnoses made by FNAB were compared with those made by histological examination (coarse biopsies or surgical specimens) and/or by other diagnostic procedures including the clinical follow-up. Six cases were excluded because clinical information was not available. In 92 cases (85.2%) a correct diagnosis was made, in six (5.5%) the sample was inadequate and in 10 (9.3%) the diagnosis made by FNAB was incorrect. The diagnoses made were as follows: hepatocarcinoma 44, metastatic carcinoma 27, inflammatory lesions 12, regeneration 10, normal eight, unclassified carcinoma five, and lymphoma two. The sensitivity was 96.2, specificity 93.1, positive predictive value 97.4, negative predictive value 90.0, accuracy 95.3 and prevalence 73.1. There were three false negative and two false positive for carcinoma. These figures are similar to those found by other authors. No relevant complications were observed. It is concluded that FNAB of the liver is a safe, inexpensive and reliable method in the diagnoses of liver masses.

  11. Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Yi-Ping; Wang, Hai-Yan; Zhang, Jin; Feng, Yong (Dept. of Radiology, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China)), email: yipingzhuang2010@sina.com; Shi, Mei-Qi (Dept. of Chemotherapy, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China))

    2011-12-15

    Background. The safety of using a cutting needle when performing a core-needle biopsy is of major concern, in particular for small lung tumors or tumors near the hilum. Purpose. To investigate the usefulness of CT-guided fine needle aspiration biopsy (FNAB) of the lung in obtaining tumor tissue for epidermal growth factor receptor (EGFR) mutation analysis in advanced lung cancer patients. Material and Methods. Forty-three patients with stage IIIB-IV lung cancer were enrolled. In all patients, CT-guided FNAB was performed using an 18-gauge or 20-gauge Chiba aspiration needle for histology diagnosis and EGFR mutation analysis. Complications associated with CT-guided FNAB were observed, and the specimen mutational assessments were recorded. Results. The obtained tumor samples ranged from 0.5-1.5 cm in length and were adequate for histological and DNA analyses in all patients. No patient had a pneumothorax or hemoptysis. Minor needle tract bleeding appeared in eight patients. Mutation analysis was satisfactorily demonstrated in 23 mutations and 20 non-mutations. Ten and 13 mutations were identified by 18-gauge and 20-gauge needle biopsies, respectively. EFGR mutations, including 12 cases of EGFR exon 19 deletion and 11 cases of exon 21 point mutation, were present in 21 patients with adenocarcinomas, one with squamous cell carcinoma, and one with undifferentiated carcinoma. Conclusion. CT-guided FNAB is a feasible and safe technique for obtaining lung tumor tissues for EGFR gene mutation analysis

  12. Differentiating metastatic from nonmetastatic lymph nodes in cervical cancer patients using monoexponential, biexponential, and stretched exponential diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Qingxia; Wang, Meiyun; Shi, Dapeng [Radiological Department of Henan Provincial People' s Hospital, Zhengzhou, Henan (China); Zheng, Dandan [GE Healthcare, MR Research China, Beijing (China); Shi, Ligang [Pathological Department of Henan Provincial People' s Hospital, Zhengzhou, Henan (China); Liu, Mingbo [Radiotherapeutical Department of Henan Provincial People' s Hospital, Zhengzhou, Henan (China)

    2017-12-15

    To determine the diagnostic value of monoexponential, biexponential and stretched exponential models for identifying lymph nodes (LNs) in patients with cervical cancer. Fifty female patients with cervical cancer underwent preoperative magnetic resonance imaging. The diffusion parameters of the LNs were calculated by fitting the values to monoexponential, biexponential and stretched exponential models and were compared between the metastatic and non-metastatic LN groups. A total of 157 LNs with high signal intensity on multi-b-value DWI were detected, 41 of which were pathologically shown to be metastatic. Metastatic LNs presented with higher pure water diffusion (D) values, lower perfusion fraction (f) values, higher diffusion heterogeneity (α) values, higher short diameter (Size-S), long diameter (Size-L) and short long diameter ratio (S/L Ratio) than non-metastatic LNs (P<0.05). The Size-S of LNs exhibited the highest diagnostic value, with an area under the curve of 0.844. Compared with the size parameters, the diffusion parameters derived from multi-b-value diffusion-weighted imaging cannot reliably discriminate metastatic from non-metastatic LNs in daily clinical routine due to limited sensitivity and specificity. (orig.)

  13. Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the 18F-FDG Positron Emission Tomography CT Correlation

    International Nuclear Information System (INIS)

    Yoom, Soo Kyung; Jung, Jung Im; Ahn, Myeong Im; Park, Jae Gil; Yoo, Ie Ryung; Park, Seog Hee; Park, Mi Jung; Park, Hyun Jin

    2010-01-01

    To investigate the size criteria of multidetector computed tomography (MDCT) for the evaluation metastatic lymph nodes (LNs) for potentially operable squamous esophageal cancer, and to compare this information with the results of positron emission tomography-CT (PET-CT). Twenty-four patients who underwent radical esophagectomy for esophageal cancer were studied. All patients had preoperative MDCT and PET-CT. The MDCT findings were compared with those of PET-CT and were correlated with the surgical records. The receiver operating characteristic (ROC) curve method was used to determine the appropriate cut-off value to distinguish benign from metastatic LNs. The size of metastatic LNs (9.35 ± 3.41 mm) was significantly larger than that of benign LNs (5.74 ± 1.64 mm) (p<0.001). The best cut-off value was 7 mm (81.8% sensitivity, 80.8% specificity). PET-CT detected all metastatic LNs except for four in the peritumoral region. The sensitivity and specificity of metastatic LN evaluation on PET-CT were 82.6% and 99.4%, respectively. Only one LN without metastasis showed increased fluoro-2-deoxy-D-glucose uptake on PET-CT. Size of metastatic LNs can typically be < 10 mm. For MDCT, the short diameter of 7 mm may be the optimal criterion. PET-CT is very accurate for the assessment of metastatic LNs except for those in the peritumoral region

  14. The diagnostic ability of {sup 18}F-FDG PET/CT for mediastinal lymph node staging using {sup 18}F-FDG uptake and volumetric CT histogram analysis in non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Kim, Eun Young [Yonsei University College of Medicine, Division of Pulmonology, Department of Internal Medicine, Seoul (Korea, Republic of); Kim, Dae Joon [Yonsei University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Lee, Jae-Hoon [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kang, Won Jun; Yun, Mijin [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Jong Doo [Catholic Kwandong University College of Medicine, Department of Radiology, International St. Mary' s Hospital, Incheon (Korea, Republic of)

    2016-12-15

    To evaluate the clinical implications of lymph node (LN) density on {sup 18}F-FDG PET/CT for mediastinal LN characterization in non-small cell lung cancer (NSCLC). One hundred and fifty-two patients with 271 mediastinal LNs who underwent PET/CT and endobronchial ultrasound-guided transbronchial needle aspiration for staging were enrolled. Maximum standardized uptake value (SUVmax), short axis diameter, LN-to-primary cancer ratio of SUVmax, and median Hounsfield unit (HU) based on CT histogram were correlated to histopathology. Of 271 nodes, 162 (59.8 %) were malignant. SUVmax, short axis diameter, and LPR of malignant LNs were higher than those of benign nodes. Among malignant LNs, 71.0 % had median HU between 25 and 45, while 78.9 % of benign LNs had values <25 HU or >45 HU. Using a cutoff value of 4.0, SUVmax showed the highest diagnostic ability for detecting malignant LNs with a specificity of 94.5 %, but showing a sensitivity of 70.4 %. Using additional density criteria (median HU 25-45) in LNs with 2.0< SUVmax ≤4.0, the sensitivity increased to 88.3 % with the specificity of 82.6 %. LN density is useful for the characterization of LNs with mild {sup 18}F-FDG uptake. The risk of mediastinal LN metastasis in NSCLC patients could be further stratified using both {sup 18}F-FDG uptake and LN density. (orig.)

  15. Ultrasonic detection of lymph nodes in stomach cancer: Around celiac axis

    International Nuclear Information System (INIS)

    Lim, An Lee; Yang, Gyu Seob; Yoon, Chong Hyun

    1990-01-01

    From January 1987 to December 1989, we did ultrasound examination for lymph nodes(LNs) around the celiac axis in 159 patients of stomach cancer. And surgically removed LNs were correlated with sonographic result and pathologic confirmation for metastasis. The celiac axis as a landmark for location of LN was identified in 87%(138/159). On ultrasonic examination. 77 LNs were detected around the celiac axis from 62 patients, however no LNs was detected from the remaining 97 patients. In detail, the outputs of pathologic correlation are; sensitivity=80%(35/44), specificity=77%(88/115), overall accuracy=77%. When the size criteria was designated as diameters of 10, 15 and 20 mm, sensitivity was 89%, 68% and 39%, whereas the specificity was 55%, 79%, and 97% respectively. On the analysis of LNs according to their sizes, LNs with diameter of above 15 mm were significant for diagnosis of LN metastasis(P value<0.0005). On the analysis of LNs according to their shapes, LN with notched or lobulated margin was more significant than LN with discrete margin, especially when diameter of LN was below 15 mm. However the shape of LN played not so big role, when diameter of LN was above 15 mm

  16. Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

    Directory of Open Access Journals (Sweden)

    Bumpers Harvey L

    2011-05-01

    Full Text Available Abstract Background Although evaluation of at least 12 lymph nodes (LNs is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. Methods To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. Results For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91, but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64, examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87 and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26 decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p Conclusions Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

  17. Mapping the distinctive populations of lymphatic endothelial cells in different zones of human lymph nodes.

    Directory of Open Access Journals (Sweden)

    Saem Mul Park

    Full Text Available The lymphatic sinuses in human lymph nodes (LNs are crucial to LN function yet their structure remains poorly defined. Much of our current knowledge of lymphatic sinuses derives from rodent models, however human LNs differ substantially in their sinus structure, most notably due to the presence of trabeculae and trabecular lymphatic sinuses that rodent LNs lack. Lymphatic sinuses are bounded and traversed by lymphatic endothelial cells (LECs. A better understanding of LECs in human LNs is likely to improve our understanding of the regulation of cell trafficking within LNs, now an important therapeutic target, as well as disease processes that involve lymphatic sinuses. We therefore sought to map all the LECs within human LNs using multicolor immunofluorescence microscopy to visualize the distribution of a range of putative markers. PROX1 was the only marker that uniquely identified the LECs lining and traversing all the sinuses in human LNs. In contrast, LYVE1 and STAB2 were only expressed by LECs in the paracortical and medullary sinuses in the vast majority of LNs studied, whilst the subcapsular and trabecular sinuses lacked these molecules. These data highlight the existence of at least two distinctive populations of LECs within human LNs. Of the other LEC markers, we confirmed VEGFR3 was not specific for LECs, and CD144 and CD31 stained both LECs and blood vascular endothelial cells (BECs; in contrast, CD59 and CD105 stained BECs but not LECs. We also showed that antigen-presenting cells (APCs in the sinuses could be clearly distinguished from LECs by their expression of CD169, and their lack of expression of PROX1 and STAB2, or endothelial markers such as CD144. However, both LECs and sinus APCs were stained with DCN46, an antibody commonly used to detect CD209.

  18. FDG uptake and glut-1 expression in primary tumors and loco-regional lymph nodes in non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Lee, Won Woo; Nguyen, Xuan Canh; Chung, Jin Haeng; Park, So Yeon; Kim, Sang Eun

    2007-01-01

    FDG uptake level by primary tumors in NSCLC may affect the likelihood of malignant involvement in loco-regional lymph nodes (LNs). FDG uptake in tumors has been reported to be mediated by glucose transporter type 1 (Glut-I). Here, we investigated the correlations between primary tumors and loco-regional LNs in NSCLC regarding FDG uptake and Glut-1 expression. 126 NSCLC patients (M: F=103: 23, age=659.7y) who underwent curative resection and loco-regional LN dissection within 4 week period after FDG-PET study were enrolled. Maximum standardized uptake value (maxSUV) by PET and %Glut-1 expression by immunostaining were compared between primary tumors and FDG uptake positive loco-regional LNs. Significant correlations were found between 52 malignant LNs and 37 primary tumors in terms of maxSUV (r=0.6451, p<0.0001) and %Glut-1 expression (r=0.8341, p<0.0001). Linear regression of the relation between maxSUVs of malignant LNs (Y) and maxSUVs of primary tumors (X) yielded the expression Y = 0.5938 + 0.4808 X with an r2 value of 0.4162. On the other hand, no significant correlation was observed between 144 benign LNs and 75 primary tumors in terms of maxSUVs (r= -0.0125, p 0.8831). Moreover, %Glut-1 expressions of pathologically proven benign LNs and primary tumors were found to be correlated (r=0.3863, p=0.0004), but r2 value was low at 0.1492. High correlations were found between primary tumors and loco-regional metastatic LNs in NSCLC regarding FDG uptake and Glut-1 expression. Mediastinal LN staging of NSCLC by FDG-PET may be improved by considering the linear correlation between FDG uptakes of metastatic LNs and primary tumors

  19. Analysis of the BRAFV600E Mutation in Thyroid Nodules: the Preoperative Diagnostic Role of Fine-needle Aspiration Biopsy for Patients with Papillary Thyroid Cancer and Its Impact on Patient Care

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ji Yeon; Hong, Hyun Sook; Lee, Eun Hye; Kim, Chul Hee; Kwak, Jeong Ja; Lee, Seung Won; Kim, Jae Wook [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2011-06-15

    We wanted to evaluate the frequency of BRAFV600E mutations on the preoperative fine-needle aspiration biopsies (FNAB) of thyroid nodules and the effect of this on the accuracy of diagnosing papillary thyroid cancer (PTC). We also wanted to evaluate the influence of BRAFV600E analysis on patient care. The results of cytology and BRAFV600E mutation analysis of 190 thyroid nodules were retrospectively reviewed. The results of the cytology and BRAFV600E analysis were compared with the histopathological diagnosis for the surgically confirmed cases, and we calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy of FNAB and combining the modalities of FNAB and BRAFV600E mutation. The frequency of BRAFV600E mutation according to age and the influence of BRAFV600E analysis on patient care were studied. The nodule size was compared between the malignant and other categories of BRAFV600E positive nodules. Seventy four percent of the PTC were BRAFV600E positive. BRAFV600E analysis increased the sensitivity, NPP and diagnostic accuracy of FNAB. Fifty percent of the BRAFV600E positive nodules with other than malignant cytology received surgery and these were confirmed to be PTC. The frequency of BRAFV600E mutation increased with age, which was statistically significant. There was a statistically significant difference in the nodule size between the cytologically malignant nodules and the other nodules. BRAFV600E analysis increased the diagnostic accuracy of FNAB and it should be considered as being complementary to cytological analysis. The frequency of the BRAFV600E mutation increased with age. The size of the malignant nodules was larger than that of the benign nodules

  20. Analysis of the BRAFV600E Mutation in Thyroid Nodules: the Preoperative Diagnostic Role of Fine-needle Aspiration Biopsy for Patients with Papillary Thyroid Cancer and Its Impact on Patient Care

    International Nuclear Information System (INIS)

    Yang, Ji Yeon; Hong, Hyun Sook; Lee, Eun Hye; Kim, Chul Hee; Kwak, Jeong Ja; Lee, Seung Won; Kim, Jae Wook

    2011-01-01

    We wanted to evaluate the frequency of BRAFV600E mutations on the preoperative fine-needle aspiration biopsies (FNAB) of thyroid nodules and the effect of this on the accuracy of diagnosing papillary thyroid cancer (PTC). We also wanted to evaluate the influence of BRAFV600E analysis on patient care. The results of cytology and BRAFV600E mutation analysis of 190 thyroid nodules were retrospectively reviewed. The results of the cytology and BRAFV600E analysis were compared with the histopathological diagnosis for the surgically confirmed cases, and we calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy of FNAB and combining the modalities of FNAB and BRAFV600E mutation. The frequency of BRAFV600E mutation according to age and the influence of BRAFV600E analysis on patient care were studied. The nodule size was compared between the malignant and other categories of BRAFV600E positive nodules. Seventy four percent of the PTC were BRAFV600E positive. BRAFV600E analysis increased the sensitivity, NPP and diagnostic accuracy of FNAB. Fifty percent of the BRAFV600E positive nodules with other than malignant cytology received surgery and these were confirmed to be PTC. The frequency of BRAFV600E mutation increased with age, which was statistically significant. There was a statistically significant difference in the nodule size between the cytologically malignant nodules and the other nodules. BRAFV600E analysis increased the diagnostic accuracy of FNAB and it should be considered as being complementary to cytological analysis. The frequency of the BRAFV600E mutation increased with age. The size of the malignant nodules was larger than that of the benign nodules

  1. The diagnostic utility of CK5/6 and p63 in fine-needle aspiration of the breast lesions diagnosed as proliferative fibrocystic lesion.

    Science.gov (United States)

    Al-Maghraby, Hatem; Ghorab, Zeina; Khalbuss, Walid; Wong, John; Silverman, Jan F; Saad, Reda S

    2012-02-01

    Fine-needle aspiration (FNA) biopsy (FNAB) in the preoperative assessment of breast lesions has shown diagnostic limitations with false-positive and false-negative diagnoses. We investigated the diagnostic value of cytokeratin 5/6 (CK5/6) and p63 in a series of breast FNABs, diagnosed as proliferative breast lesions with or without atypia, to see whether these ancillary studies enhance the ability to make an accurate diagnosis by FNAB. Sixty-four breast FNABs were retrieved between January 2000 and December 2005 and included in the study as follows: 29/64 (45%) cases as proliferative with atypia and 35/64 (55%) without atypia. We also included 10 cases of fibroadenoma. All cases had histological follow-up available for correlation. Immunostaining for CK5/6 and p63 was performed on the cell block material in all cases. The percentage of staining cells in the specimen was graded as 0 (0-10%), 1 (11-25%), 2 (26-50%), and 3 (>50%). There were 9/29 (31%) cases in the atypical group that were found to be malignant on resection, compared with 6/35 (17%) in the cases without atypia. In histologically proven malignant cases, CK5/6 was negative in 11/15 (73%) or showed 1+ stain in 2/15 (13%) cases. In benign breast lesions, CK5/6 stained more than 25% of cell proliferation in 44/49 (90%). p63 showed characteristic staining for single naked bipolar nuclei in the background of the specimen (not appreciated by CK5/6) in all fibroadenoma cases. In conclusion, CK5/6 may enhance the ability to differentiate between benign and malignant epithelial proliferations in breast FNABs. In fibroepithelial lesions, p63 may be more useful than CK5/6. Copyright © 2010 Wiley Periodicals, Inc.

  2. Pre-operative and intra-operative detection of axillary lymph node metastases in 108 patients with invasive lobular breast cancer undergoing mastectomy.

    Science.gov (United States)

    Novak, Jerica; Besic, Nikola; Dzodic, Radan; Gazic, Barbara; Vogrin, Andrej

    2018-02-05

    Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy. The object of this study were 102 patients (median age 52, range 34-73 years) with clinically non-suspicious axilla in whom 108 mastectomies were performed after a pre-operative AUS investigation. Whenever a metastasis was detected in a sentinel lymph node, ALND was done. Reports of the pre-operative AUS investigation, US-FNAB, and IIC were compared with definitive histopathological reports of surgical specimens. In 46 cases lymph node metastases were diagnosed. AUS suspicious lymph nodes were found in 29/108 cases and histopathology confirmed metastases in 22/30 cases. US-FNAB was performed in 29 cases with AUS suspicious lymph nodes. Cytology proved metastases in 11/29 cases. Histopathology confirmed metastases in 10/11 cases with only isolated tumor cells found in one case. IIC investigation was performed in 63 cases and in 10/27 cases metastases were confirmed by histopathology. Pre-operative AUS, US-FNAB, and/or IIC investigation enabled ALND during a single surgical procedure in 20/46 patients with metastases in lymph nodes. Pre-operative AUS, US-FNAB, and/or IIC are/is beneficial in patients with ILC planned for mastectomy in order to decrease the number of two stage axillary procedures.

  3. Acceptability of Supplementary Foods for Children with Moderate Acute Malnutrition and Feeding Behaviours During Home-Based Treatment

    DEFF Research Database (Denmark)

    Iuel-Brockdorff, Ann-Sophie Julie D

    Background Moderate acute malnutrition (MAM) affects around 33 million children and is a major global health problem, causing increased morbidity and mortality and delayed cognitive development. Despite the development of lipid-based nutrient supplement (LNS) and enhanced versions of corn-soy blend...... children receiving CBS had leftovers compared to children receiving LNS. Similar supplementary foods used for the prevention and treatment of malnutrition were generally well appreciated in the study context, although LNS was considered different from local foods and to a higher extend associated...

  4. Evaluation of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Huanhuan [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine (China); Yan, Fuhua; Pan, Zilai; Lin, Xiaozhu; Luo, Xianfu; Shi, Cen [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Chen, Xiaoyan [Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Wang, Baisong [Department of Biomedical Statistics, Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Zhang, Huan, E-mail: huanzhangy@126.com [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China)

    2015-02-15

    Highlights: • Colorectal cancer is the third most prevalent cancer and the status of the regional lymph nodes in rectal cancer is considered to be one of the most powerful prognostic factor in the absence of distant metastatic disease. Detecting LNs metastasis is still a challenging problem due to the presence of microscopic metastasis or inflammatory swelling of LNs. • We investigated the value of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. Our study demonstrated that the quantitative normalized iodine concentration (nIC) could be useful for differentiating metastatic and non-metastatic lymph nodes. The combination of nIC in portal venous phase and conventional size criterion could improve the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of rectal cancer. - Abstract: Objectives: To investigate the value of dual energy spectral CT (DEsCT) imaging in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. Methods: Fifty-five patients with rectal cancer underwent the arterial phase (AP) and portal venous phase (PP) contrast-enhanced DEsCT imaging. The virtual monochromatic images and iodine-based material decomposition images derived from DEsCT imaging were interpreted for lymph nodes (LNs) measurement. The short axis diameter and the normalized iodine concentration (nIC) of metastatic and non-metastatic LNs were measured. The two-sample t test was used to compare the short axis diameters and nIC values of metastatic and non-metastatic LNs. ROC analysis was performed to assess the diagnostic performance. Results: One hundred and fifty two LNs including 92 non-metastatic LNs and 60 metastatic LNs were matched using the radiological-pathological correlation. The mean short axis diameter of metastatic LNs was significantly larger than that of the non-metastatic LNs (7.28 ± 2.28 mm vs. 4.90 ± 1.64 mm, P < 0.001). The mean n

  5. Willingness-to-Pay for Lipid-Based Nutrient Supplements in Burkina Faso

    International Nuclear Information System (INIS)

    Guissou, Rosemonde; Adams, Katherine; Xu Yingying; Vosti, Stephen; Hess, Sonja; Ouedraogo, Jean Bosco

    2014-01-01

    Full text: Supplementing young children’s diets with small-quantity lipid-based nutrient supplements (SQ-LNS) is a promising strategy to prevent growth restriction and improve development. It is uncertain how best to scale up the distribution of SQ-LNS and both private and public approaches are being considered. This paper reports on the willingness-to-pay (WTP) by households in rural Burkina Faso for SQ-LNS designed to prevent childhood undernutrition. In a recent randomized controlled nutrition efficacy trial in the Dandé Health District in rural Burkina Faso, 20 g of SQ-LNS per day along with selected health care services have been shown to increase the linear growth and weight gain of children who received the supplement daily from 9-18 months of age. Given the frequency and duration of prescribed consumption of SQ-LNS (one sachet per day, per child) and inter-household differences in poverty, a hybrid distribution system that reaches target consumers through both public channels and retail markets may be recommended; the viability of the latter will hinge on demand. Therefore, policy makers will need to consider household-level demand for SQ-LNS and the factors that influence demand to guide decisions regarding the cost burden borne by recipients versus public sector programs. Using a contingent valuation approach, we solicited, at baseline and six months later, the hypothetical WTP for a daily dose of 20 g of SQ-LNS and a traditional substitute, herbal teas, from a subsample (N = 319) of households participating in the efficacy trial. WTP for SQ-LNS is positive for almost all households, but WTP for SQ-LNS is, on average, lower than WTP for herbal teas. At baseline, average WTP for a day’s supply of SQ-LNS is $0.22 (4th quarter 2011 USD), while average WTP for herbal teas is $0.28. Approximately six months later, average WTP for LNS and for herbal teas, respectively, are $0.21 and $0.25. These results suggest that while households do value SQ-LNS

  6. Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

    Science.gov (United States)

    2018-01-01

    Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies. PMID:29169231

  7. Lunar Navigator - A Miniature, Fully Autonomous, Lunar Navigation, Surveyor, and Range Finder System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Microcosm will use existing hardware and software from related programs to create a prototype Lunar Navigation Sensor (LNS) early in Phase II, such that most of the...

  8. The mismatch repair protein MLH1 marks a subset of strongly interfering crossovers in tomato

    NARCIS (Netherlands)

    Lhuissier, F.G.P.; Offenberg, H.H.; Wittich, P.E.; Vischer, N.O.E.; Heyting, C.

    2007-01-01

    In most eukaryotes, the prospective chromosomal positions of meiotic crossovers are marked during meiotic prophase by protein complexes called late recombination nodules (LNs). In tomato (Solanum lycopersicum), a cytological recombination map has been constructed based on LN positions. We

  9. Interference mitigation for broadcast in hierarchical cell structure networks: Transmission strategy and area spectral efficiency

    KAUST Repository

    Yang, Yuli; Salama, Khaled N.; Aï ssa, Sonia

    2014-01-01

    In this paper, a hierarchical cell structure (HCS) is considered, where an access point (AP) broadcasts to local nodes (LNs) over orthogonal frequency subbands within a local cell located in a macrocell. Since the local cell shares the spectrum

  10. Pharmaceutical and biomedical applications of lipid-based nanocarriers.

    Science.gov (United States)

    Carbone, Claudia; Leonardi, Antonio; Cupri, Sarha; Puglisi, Giovanni; Pignatello, Rosario

    2014-03-01

    Increasing attention is being given to lipid nanocarriers (LNs) as drug delivery systems, due to the advantages offered of a higher biocompatibility and lower toxicity compared with polymeric nanoparticles. Many administration routes are being investigated for LNs, including topical, oral and parenteral ones. LNs are also proposed for specific applications such as cancer treatment, gene therapy, diagnosis and medical devices production. However, the high number of published research articles does not match an equal amount of patents. A recent Review of ours, published in Pharmaceutical Patent Analyst, reported the patents proposing novel methods for the production of LNs. This review work discusses recent patents, filed in 2007-2013 and dealing with the industrial applications of lipid-based nanocarriers for the vectorization of therapeutically relevant molecules, as well as biotech products such as proteins, gene material and vaccines, in the pharmaceutical, diagnostic and biomedical areas.

  11. Number of Lymph Nodes Removed and Survival after Gastric Cancer Resection: An Analysis from the US Gastric Cancer Collaborative.

    Science.gov (United States)

    Gholami, Sepideh; Janson, Lucas; Worhunsky, David J; Tran, Thuy B; Squires, Malcolm Hart; Jin, Linda X; Spolverato, Gaya; Votanopoulos, Konstantinos I; Schmidt, Carl; Weber, Sharon M; Bloomston, Mark; Cho, Clifford S; Levine, Edward A; Fields, Ryan C; Pawlik, Timothy M; Maithel, Shishir K; Efron, Bradley; Norton, Jeffrey A; Poultsides, George A

    2015-08-01

    Examination of at least 16 lymph nodes (LNs) has been traditionally recommended during gastric adenocarcinoma resection to optimize staging, but the impact of this strategy on survival is uncertain. Because recent randomized trials have demonstrated a therapeutic benefit from extended lymphadenectomy, we sought to investigate the impact of the number of LNs removed on prognosis after gastric adenocarcinoma resection. We analyzed patients who underwent gastrectomy for gastric adenocarcinoma from 2000 to 2012, at 7 US academic institutions. Patients with M1 disease or R2 resections were excluded. Disease-specific survival (DSS) was calculated using the Kaplan-Meier method and compared using log-rank and Cox regression analyses. Of 742 patients, 257 (35%) had 7 to 15 LNs removed and 485 (65%) had ≥16 LNs removed. Disease-specific survival was not significantly longer after removal of ≥16 vs 7 to 15 LNs (10-year survival, 55% vs 47%, respectively; p = 0.53) for the entire cohort, but was significantly improved in the subset of patients with stage IA to IIIA (10-year survival, 74% vs 57%, respectively; p = 0.018) or N0-2 disease (72% vs 55%, respectively; p = 0.023). Similarly, for patients who were classified to more likely be "true N0-2," based on frequentist analysis incorporating both the number of positive and of total LNs removed, the hazard ratio for disease-related death (adjusted for T stage, R status, grade, receipt of neoadjuvant and adjuvant therapy, and institution) significantly decreased as the number of LNs removed increased. The number of LNs removed during gastrectomy for adenocarcinoma appears itself to have prognostic implications for long-term survival. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  12. PALNS - A software framework for parallel large neighborhood search

    DEFF Research Database (Denmark)

    Røpke, Stefan

    2009-01-01

    This paper propose a simple, parallel, portable software framework for the metaheuristic named large neighborhood search (LNS). The aim is to provide a framework where the user has to set up a few data structures and implement a few functions and then the framework provides a metaheuristic where ...... parallelization "comes for free". We apply the parallel LNS heuristic to two different problems: the traveling salesman problem with pickup and delivery (TSPPD) and the capacitated vehicle routing problem (CVRP)....

  13. Preoperative computed tomography of the chest in lung cancer patients: the predictive value of calcified lymph nodes for the perioperative outcomes of video-assisted thoracoscopic surgery lobectomy

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Kwang Nam; Lee, Youkyung; Wi, Jae Yeon [Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Moon, Hyeon-Jong; Sung, Yong Won [Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Department of Cardiothoracic Surgery, Seoul (Korea, Republic of)

    2013-12-15

    To determine the predictive value of identifying calcified lymph nodes (LNs) for the perioperative outcomes of video-assisted thoracoscopic surgery (VATS). Fifty-six consecutive patients who underwent VATS lobectomy for lung cancer were included. We evaluated the number and location of calcified LNs on computed tomography (CT). We investigated clinical parameters, including percentage forced expiratory volume in 1 s (FEV{sub 1}%), surgery duration, chest tube indwelling duration, and length of hospital stay. We performed linear regression analysis and multiple comparisons of perioperative outcomes. Mean number of calcified LNs per patient was 0.9 (range, 0-6), mostly located in the hilar-interlobar zone (43.8 %). For surgery duration (mean, 5.0 h), FEV{sub 1}% and emphysema severity were independent predictors (P = 0.010 and 0.003, respectively). The number of calcified LNs was an independent predictor for chest tube indwelling duration (P = 0.030) and length of hospital stay (P = 0.046). Mean duration of chest tube indwelling and hospital stay was 8.8 days and 12.7 days in no calcified LN group; 9.2 and 13.2 in 1 calcified LN group; 12.8 and 19.7 in {>=}2 calcified LNs group, respectively. The presence of calcified LNs on CT can help predict more complicated perioperative course following VATS lobectomy. (orig.)

  14. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules.

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge; Alitalo, Kari

    2015-06-29

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease. © 2015 Aspelund et al.

  15. Enhanced Antibody Responses in a Novel NOG Transgenic Mouse with Restored Lymph Node Organogenesis

    Directory of Open Access Journals (Sweden)

    Takeshi Takahashi

    2018-01-01

    Full Text Available Lymph nodes (LNs are at the center of adaptive immune responses. Various exogenous substances are transported into LNs and a series of immune responses ensue after recognition by antigen–specific lymphocytes. Although humanized mice have been used to reconstitute the human immune system, most lack LNs due to deficiency of the interleukin (IL-2Rγ gene (cytokine common γ chain, γc. In this study, we established a transgenic strain, NOG-pRORγt-γc, in the NOD/shi-scid-IL-2Rγnull (NOG background, in which the γc gene was expressed in a lymph-tissue inducer (LTi lineage by the endogenous promoter of RORγt. In this strain, LN organogenesis was normalized and the number of human T cells substantially increased in the periphery after reconstitution of the human immune system by human hematopoietic stem cell transplantation. The distribution of human T cells differed between NOG-pRORγt-γc Tg and NOG-non Tg mice. About 40% of human T cells resided in LNs, primarily the mesenteric LNs. The LN-complemented humanized mice exhibited antigen-specific immunoglobulin G responses together and an increased number of IL-21+–producing CD4+ T cells in LNs. This novel mouse strain will facilitate recapitulation of human immune responses.

  16. Impact of lymph node burden on survival of high-risk prostate cancer patients following radical prostatectomy and pelvic lymph node dissection

    Directory of Open Access Journals (Sweden)

    Lisa Moris

    2016-12-01

    Full Text Available Aim: To determine the impact of the extent of lymph node invasion (LNI, on long-term oncological outcomes after radical prostatectomy (RP. Material and methods: In this retrospective study we examined the data of 1249 high-risk, non-metastatic PCa patients treated with RP and pelvic lymph node dissection (PLND between 1989 and 2011 at 8 different tertiary institutions. We fitted univariate and multivariate cox models to assess independent predictors of cancer specific survival (CSS and overall survival (OS. The number of positive LN was dichotomized according to the most informative cut-off predicting CSS. Kaplan-Meier curves assessed CSS and OS rates. Only patients with at least 10 LNs removed at PLND were included. This cut-off was chosen as a surrogate for a well performed PNLD.Results: Mean age was 65 years (median: 66, IQR 60-70. Positive surgical margins were present in 53.7% (n=671. Final Gleason score was 2-6 in 12.7% (n=158, 7 in 52% (n=649 and 8-10 in 35.4% (n=442. The median number of LNs removed during PLND was 15 (IQR 12-17. Of all patients, 1128 (90.3% had 0-3 positive LNs, while 126 (9.7% had ≥4 positive LNs. Patients with 0-3 positive LNs had significantly better CSS outcome at 10-year follow-up compared to patients with ≥4 positive LNs (87% vs. 50%; p < 0.0001. Similar results were obtained for OS, with a 72% vs. 37% (p <0.0001 survival at 10 years for patients with 0-3 vs. ≥4 positive LNs, respectively. At multivariate analysis, final Gleason score 8-10, salvage ADT therapy and ≥4 (vs <4 positive LNs were predictors of worse CSS and OS. Pathological stage pT4 was an additional predictor of worse CSS. Conclusions: Four or more positive LNs, pathological stage pT4 and final Gleason score 8-10 represent independent predictors for worse CSS in patients with high-risk PCa. Primary tumor biology remains a strong driver of tumor progression and patients having ≥4 positive LNs could be considered an enriched patient group in

  17. Calcified fibrous pseudotumor of spermatic cord

    International Nuclear Information System (INIS)

    Rodriguez Collar, Tomas Lazaro; Valdes Estevez, Brasily; Nagua Valencia, Miguel Angel; Salinas Olivares, Mercedes Rita

    2009-01-01

    Paratesticular tumors are infrequent and most are benigns. This a case presentation of a patient aged 24 with a history of good health coming to our consultation by presence of a hard and painless 4 cm tumor in right scrotum with a 6 months course. Scrotal ultrasound (US) showed a well circumscribed heterogeneous lesion separate of epididymis and the testis. Fine needle aspiration biopsy (FNAB) was not possible by hardness of tumor. A inguinal surgery was performed and the total tumor exeresis using freezing biopsy negative of malignancy. Final histopathological report was: calcified fibrous pseudotumor of spermatic cord. Patient's course has been satisfactory. Significance of inguinal surgery was confirmed for the paratesticular tumor approach, even more when FNAB it is not conclusive for diagnosis.(author)

  18. Cost-effectiveness of using a molecular diagnostic test to improve preoperative diagnosis of thyroid cancer.

    Science.gov (United States)

    Najafzadeh, Mehdi; Marra, Carlo A; Lynd, Larry D; Wiseman, Sam M

    2012-12-01

    Fine-needle aspiration biopsy (FNAB) is a safe and inexpensive diagnostic procedure for evaluating thyroid nodules.Up to 25% of the results from an FNAB, however, may not be diagnostic or may be indeterminate, leading to a subsequent diagnostic thyroid surgery. A new molecularly based diagnostic test could potentially reduce indeterminate cytological results and, with high accuracy, provide a definitive diagnosis for cancer in thyroid nodules. The aim of the study was to estimate the cost-effectiveness of utilizing a molecular diagnostic (DX) test as an adjunct to FNAB, compared with NoDX, to improve the preoperative diagnosis of thyroid nodules. We constructed a patient-level simulation model to estimate the clinical and economic outcomes of using a DX test compared with current practice (NoDX) for the diagnosis of thyroid nodules. By using a cost-effectiveness framework, we measured incremental clinical benefits in terms of quality-adjusted life-years and incremental costs over a 10-year time horizon. Assuming 95% sensitivity and specificity of the Dx test when used as an adjunct to FNAB, the utilization of the DX test resulted in a gain of 0.046 quality-adjusted life-years (95% confidence interval 0.019-0.078) and a saving of $1087 (95% confidence interval $691-$1533) in direct costs per patient. If the cost of the Dx test is less than $1087 per test, we expect to save quality-adjusted life-years and reduce costs when it is utilized. Sensitivity of the DX test, compared with specificity, had a larger influence on the overall outcomes. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

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    Mehrotra Ravi

    2007-01-01

    Full Text Available Abstract Background Fine needle aspiration biopsy (FNAB is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10 were inadequateinconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65 patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis.

  20. Comparison of Thin-Prep and cell block preparation for the evaluation of Thyroid epithelial lesions on fine needle aspiration biopsy

    Directory of Open Access Journals (Sweden)

    Hammoud Jamal

    2008-01-01

    Full Text Available Abstract Background The objective of this study was to compare the utility of Thin-Prep (TP cytologic preparation with that of Cell Block (CB preparation in the diagnosis of thyroid lesions, mainly follicular epithelial lesions, by fine needle aspiration biopsy (FNAB. Feasibility of using the TP slides for immunocytochemical stains is also discussed. Methods A total of 126 consecutive cases of thyroid FNAB with TP slides and 128 consecutive cases of thyroid FNAB with CB slides were reviewed blindly by two cytopathologists. The presence of colloid, follicular cells, macrophages and lymphocytes/plasma cells were recorded and scored 0–4 on each case based on TP or CB slide review. The cytologic diagnoses were grouped as follows: cyst, colloid nodule, colloid nodule with cystic change, chronic thyroiditis, atypical/neoplastic and non-diagnostic. Results The TP slides had higher diagnostic rate than CB slides. The diagnostic yield was 68% of the TP slides whereas only 24% of the CB slides were diagnostic. Also, only 4 atypical/neoplastic lesions were diagnosed on the TP slides and the corresponding direct smears, while 5 cases of atypical/neoplastic lesions were diagnosed on the smears but could not be diagnosed on the corresponding CB slides. Additionally, the TP slides revealed cytologic features that were not observed on the direct traditional smears of the same case. Conclusion In thyroid FNAB cases, TP slide preparation is superior to CB slide preparation and is more likely to have greater cellularity for diagnosis and detect atypical/neoplastic thyroid lesions, particularly those of follicular cell origin. Furthermore, TP slides appear to detect helpful diagnostic cytologic features and should be considered complementary to, rather than replacing, direct smears.

  1. Promise and pitfalls of molecular markers of thyroid nodules

    OpenAIRE

    Jadhav, S.; Lila, Anurag; Bandgar, Tushar; Shah, Nalini

    2012-01-01

    Thyroid nodules are common in the general population with a prevalence of 5-7% The initial evaluation of thyroid nodules commonly involves thyroid function tests, an ultrasound (USG) and fine needle aspiration biopsy (FNAB). The optimal management of patients with thyroid nodules with indeterminate cytology is plagued by the lack of highly sensitive and specific diagnostic modalities In this article we attempt to review the available literature on the molecular markers which are increasingly ...

  2. Limited Nesting Stress Alters Maternal Behavior and In Vivo Intestinal Permeability in Male Wistar Pup Rats.

    Directory of Open Access Journals (Sweden)

    Nabila Moussaoui

    Full Text Available A few studies indicate that limited nesting stress (LNS alters maternal behavior and the hypothalamic pituitary adrenal (HPA axis of dams and offspring in male Sprague Dawley rats. In the present study, we evaluated the impact of LNS on maternal behavior in Wistar rats, and on the HPA axis, glycemia and in vivo intestinal permeability of male and female offspring. Intestinal permeability is known to be elevated during the first week postnatally and influenced by glucocorticoids. Dams and neonatal litters were subjected to LNS or normal nesting conditions (control from days 2 to 10 postnatally. At day 10, blood was collected from pups for determination of glucose and plasma corticosterone by enzyme immunoassay and in vivo intestinal permeability by oral gavage of fluorescein isothiocyanate-dextran 4kDa. Dams exposed to LNS compared to control showed an increase in the percentage of time spent building a nest (118%, self-grooming (69%, and putting the pups back to the nest (167%. LNS male and female pups exhibited a reduction of body weight by 5% and 4%, adrenal weights/100g body weight by 17% and 18%, corticosterone plasma levels by 64% and 62% and blood glucose by 11% and 12% respectively compared to same sex control pups. In male LNS pups, intestinal permeability was increased by 2.7-fold while no change was observed in females compared to same sex control. There was no sex difference in any of the parameters in control pups except the body weight. These data indicate that Wistar dams subjected to LNS during the first postnatal week have an altered repertoire of maternal behaviors which affects the development of the HPA axis in both sexes and intestinal barrier function in male offspring.

  3. Responsive feeding and child interest in food vary when rural Malawian children are fed lipid-based nutrient supplements or local complementary food.

    Science.gov (United States)

    Flax, Valerie L; Mäkinen, Samppa; Ashorn, Ulla; Cheung, Yin Bun; Maleta, Kenneth; Ashorn, Per; Bentley, Margaret E

    2013-07-01

    Caregiver and child behaviours during feeding have been used to measure responsiveness, which has been recognised as important for child growth and development. The aims of this study were to understand how caregiver and child behaviours differ when feeding lipid-based nutrient supplements (LNS) vs. local complementary food and to detect associations between behaviours and child interest in food. Sixteen moderately underweight 6-17-month-old Malawian children receiving 50 g/day of supplementary LNS for 12 weeks were videotaped during LNS (n = 32) and local complementary feeding (n = 28) episodes. Behaviours were coded at the level of the intended bite (1674 total bites). The analysis used regression models adjusted for within-subject correlation. Caregivers were less likely to allow children to self-feed and more likely to use physical pressure during LNS vs. complementary food bites. Positive caregiver verbalization was infrequent and did not differ by type of food. Higher odds of accepting a bite were associated with the bite containing LNS, odds ratio (OR) 3.05; 90% confidence interval (CI) (1.98, 4.71), the child self-feeding, OR 5.70; 90% CI (2.77, 11.69), and positive caregiver verbalization, OR 2.46; 90% CI (1.26, 4.80), while lower odds of acceptance were associated with negative child verbalization during feeding, OR 0.27; 90% CI (0.17, 0.42). In this sample, caregivers used more responsive feeding practices during bites of local complementary food and were more controlling when feeding LNS. Responsive caregiver behaviours predicted child acceptance of food. These results could be used to design interventions in Malawi to improve responsive feeding practices in general and during LNS use. © 2011 John Wiley & Sons Ltd.

  4. Histological diagnosis of ultrasound-visible breast lesions by large core needle biopsy

    International Nuclear Information System (INIS)

    Sanchis-Querol, E.; Valeros, O.; Collado, A.; Gimenez, J.; Yanguas, C.

    1999-01-01

    We present our experience in the histological diagnosis of breast lesions using ultrasound-guided large core needle biopsy (LCNB), assessing its utility as an alternative to excisional biopsy. We have studied retrospectively a series of 146 cases involving the performance of LCNB. The results were comparable with those of FNAB in 59 cases and with those of surgical aspiration biopsy in 105. Of the 113 lesions identified as malignant by percutaneous large core needle aspiration biopsy, 96 were resected. Surgical aspiration biopsy agreed with LCNB in 100% of cases. Of the 33 lesions identified as benign by LCNB, surgical biopsy detected malignancy in 5. The results obtained establish a specificity for LCNB of 100% and a sensitivity of 96%, both of which are superior to the values for FNAB. Thus, this technique can be considered valid for preoperative diagnosis. LCNB is useful in the preoperative diagnosis of breast lesions, making FNAB and surgical biopsy unnecessary. Moreover, it constitutes a significant change in the management of patients with malignant or undetermined breast lesions. (Author) 8 refs

  5. Cost analysis of intraoperative frozen section examinations in thyroid surgery in a Canadian tertiary center.

    Science.gov (United States)

    Lai, Philip; Segall, Lorne; de Korompay, Nevin; Witterick, Ian; Freeman, Jeremy

    2009-10-01

    To perform a cost analysis of the routine intraoperative frozen section (FS) examinations in the management of patients undergoing thyroid surgery for unilateral thyroid nodules with benign or indeterminate cytology on preoperative fine-needle aspiration biopsies (FNABs). A retrospective chart review of 190 consecutive patients with unilateral thyroid nodules undergoing thyroid surgery was undertaken between March 2006 and March 2008. The results of FNAB, FS, and final histology were obtained from the pathology report. A cost analysis was performed to compare the cost of routine FS examinations to determine malignancy with the cost of performing a second surgical procedure. Of the 169 patients evaluated, there were 53 cases of malignant nodules. Malignancy was diagnosed by FS in 16 of these 53 cases, resulting in a total thyroidectomy and thereby avoiding the need for a completion thyroidectomy. The sensitivity and specificity of FS examination were 30.2% and 100.0%, respectively. The routine use of intraoperative FS examination in cases of benign or indeterminate nodules afforded a total cost savings of $3719.27, or a cost savings of $22.01 per patient. FS examination was useful in guiding our intraoperative management for patients with unilateral thyroid nodules with benign or indeterminate preoperative FNAB. The routine use of FS was cost-effective in our Canadian health care system, even without considering the intangible costs, such as patients' anxiety, emotional stress, and the loss of productivity owing to a second surgical procedure.

  6. Fibroadenoma: can fine needle aspiration biopsy avoid short term follow-up?

    Science.gov (United States)

    Leconte, I; Abraham, C; Galant, C; Sy, M; Berlière, M; Fellah, L

    2012-10-01

    To confirm whether fine needle aspiration biopsy (FNAB) can avoid close monitoring, a source of worry for women patients with a suspected fibroadenoma found by ultrasound, and requiring their compliance. Over 39months, 427 nodules with a diagnosis of fibroadenoma were sampled in 372 patients using ultrasound-guided FNAB. The sonographic appearance of all the nodules suggested BI-RADS category 3 fibroadenomas. The mean size of the fibroadenomas was 9mm. The mean duration of follow-up was 29.7months. Seven nodules had atypical cytology: a microbiopsy and/or excision found a simple fibroadenoma (n=3), mastitis (n=1), a fibroadenoma associated with a papilloma (n=1), fibrosis (n=1) and normal tissue (n=1). Seven other nodules were resected during treatment for synchronous cancer, and were diagnosed as fibroadenomas. Two hundred and seventy-six nodules were followed-up (121 patients were lost to follow-up [n=132]) and the appearance of 263 nodules (95.29%) was stable. Seven nodules, which had increased in size, underwent another FNAB or microbiopsy or surgery. Five nodules were not found again. The borders of one nodule showed modifications. The use of fine needle aspiration biopsy, interpreted by an experienced cytologist, means that short term follow-up of fibroadenomas can be avoided. Copyright © 2012 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  7. Differential diagnosis in the sonographic evaluation of adrenal metastases

    International Nuclear Information System (INIS)

    Ferrari, F.; Fagioli Zucchi, A.; Saloni, E.; Terrosi Vagnoli, P.; Disanto, A.

    1989-01-01

    The sonographic detection of adrenal masses in patients with neoplasms, especially neoplasms of the lung, can be related to the presence of both metastases and adenomas. In order to assess the benign/malignant nature of the such lesions, the adrenal glands of 43 patients with neoplasms (36 of them lung cancers) were studied with sonography (US) and fine needle aspiration biopsy (FNAB): in all, 58 masses were seen (28 monolateral and 15 bilateral). Six lesions (13%) presented with cytological features of benignancy, and on US they appeared as hypoechoic (as compared to the liver), round masses, with regular margins, ranging in size from 1.2 cm to 3.4 cm (average: 2.6 cm). In the remaining 34 patients (80%), cellular material with features of malignancy was obtained with FNAB. The US appearence of these metastases was heterogenous, with the same echogenicity as the liver, and average size >3 cm. On the basis of data obtained, the limit of 3 cm (if we consider the average dimension), corresponds to the threshold of benignancy, as well as the monolateral and hypoechoic appearence of the lesion. To sum up, the use of FNAB should be limited to those lesions which present with typical adenomatous features and for borderline lesions, while the diagnosis of metastases is sufficiently accurate (p 3 cm

  8. Differential diagnosis in the sonographic evaluation of adrenal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, F; Fagioli Zucchi, A; Saloni, E; Terrosi Vagnoli, P [Siena Univ. (Italy). Ist. di Scienze Eidologiche e Radiologiche; Disanto, A [Siena Univ. (Italy). Ist. di Anatomia Patologica

    1989-01-01

    The sonographic detection of adrenal masses in patients with neoplasms, especially neoplasms of the lung, can be related to the presence of both metastases and adenomas. In order to assess the benign/malignant nature of the such lesions, the adrenal glands of 43 patients with neoplasms (36 of them lung cancers) were studied with sonography (US) and fine needle aspiration biopsy (FNAB): in all, 58 masses were seen (28 monolateral and 15 bilateral). Six lesions (13%) presented with cytological features of benignancy, and on US they appeared as hypoechoic (as compared to the liver), round masses, with regular margins, ranging in size from 1.2 cm to 3.4 cm (average: 2.6 cm). In the remaining 34 patients (80%), cellular material with features of malignancy was obtained with FNAB. The US appearence of these metastases was heterogenous, with the same echogenicity as the liver, and average size >3 cm. On the basis of data obtained, the limit of 3 cm (if we consider the average dimension), corresponds to the threshold of benignancy, as well as the monolateral and hypoechoic appearence of the lesion. To sum up, the use of FNAB should be limited to those lesions which present with typical adenomatous features and for borderline lesions, while the diagnosis of metastases is sufficiently accurate (p<0.001) in case of bilateral or isoechoic lesions >3 cm.

  9. A Population-based Study on Lymph Node Retrieval in Patients with Esophageal Cancer: Results from the Dutch Upper Gastrointestinal Cancer Audit.

    Science.gov (United States)

    van der Werf, L R; Dikken, J L; van Berge Henegouwen, M I; Lemmens, V E P P; Nieuwenhuijzen, G A P; Wijnhoven, B P L

    2018-05-01

    For esophageal cancer, the number of retrieved lymph nodes (LNs) is often used as a quality indicator. The aim of this study is to analyze the number of retrieved LNs in The Netherlands, assess factors associated with LN yield, and explore the association with short-term outcomes. This is a population-based study on lymph node retrieval in patients with esophageal cancer, presenting results from the Dutch Upper Gastrointestinal Cancer Audit. For this retrospective national cohort study, patients with esophageal carcinoma who underwent esophagectomy between 2011 and 2016 were included. The primary outcome was the number of retrieved LNs. Univariable and multivariable regression analyses were used to test for association with ≥ 15 LNs. 3970 patients were included. Between 2011 and 2016, the median number of LNs increased from 15 to 20. Factors independently associated with ≥ 15 LNs were: 0-10 kg preoperative weight loss (versus: unknown weight loss, odds ratio [95% confidence interval]: 0.71 [0.57-0.88]), Charlson score 0 (versus: Charlson score 2: 0.76 [0.63-0.92]), cN2 category (reference: cN0, 1.32 [1.05-1.65]), no neoadjuvant therapy and neoadjuvant chemotherapy (reference: neoadjuvant chemoradiotherapy, 1.73 [1.29-2.32] and 2.15 [1.54-3.01]), minimally invasive transthoracic (reference: open transthoracic, 1.46 [1.15-1.85]), open transthoracic (versus open and minimally invasive transhiatal, 0.29 [0.23-0.36] and 0.43 [0.32-0.59]), hospital volume of 26-50 or > 50 resections/year (reference: 0-25, 1.94 [1.55-2.42] and 3.01 [2.36-3.83]), and year of surgery [reference: 2011, odds ratios (ORs) 1.48, 1.53, 2.28, 2.44, 2.54]. There was no association of ≥ 15 LNs with short-term outcomes. The number of LNs retrieved increased between 2011 and 2016. Weight loss, Charlson score, cN category, neoadjuvant therapy, surgical approach, year of resection, and hospital volume were all associated with increased LN yield. Retrieval of ≥ 15 LNs was not associated

  10. Prophylactic Level VII Nodal Dissection as a Prognostic Factor in Papillary Thyroid Carcinoma: a Pilot Study of 27 Patients.

    Science.gov (United States)

    Fayek, Ihab Samy

    2015-01-01

    Prognostic value of prophylactic level VII nodal dissection in papillary thyroid carcinoma has been highlighted. A total of 27 patients with papillary thyroid carcinoma with N0 neck underwent total thyroidectomy with level VI and VII nodal dissection through same collar neck incision. Multicentricity, bilaterality, extrathyroidal extension, level VI and VII lymph nodes were studied as separate and independent prognostic factors for DFS at 24 months. 21 females and 6 males with a mean age of 34.6 years old, tumor size was 5-24 mm. (mean 12.4 mm.), multicentricity in 11 patients 2-4 foci (mean 2.7), bilaterality in 8 patients and extrathyroidal extension in 8 patients. Dissected level VI LNs 2-8 (mean 5 LNs) and level VII LNs 1-4 (mean 1.9). Metastatic level VI LNs 0-3 (mean 1) and level VII LNs 0-2 (mean 0.5). Follow-up from 6-51 months (mean 25.6) with 7 patients showed recurrence (3 local and 4 distant). Cumulative DFS at 24 months was 87.8% and was significantly affected in relation to bilaterality (p-valueVII positive ((p-valueVII nodal involvement. Level VII prophylactic nodal dissection is an important and integral prognostic factor in papillary thyroid carcinoma. A larger multicenter study is crucial to reach a satisfactory conclusion about the necessity and safety of this approach.

  11. Sono-elastography for Differentiating Benign and Malignant Cervical Lymph Nodes: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Ghajarzadeh, Mahsa; Mohammadifar, Mehdi; Azarkhish, Kamran; Emami-Razavi, Seyed Hassan

    2014-01-01

    We did this systematic review to determine diagnostic accuracy of sono-elastography in evaluating cervical lymph nodes (LNs). A highly sensitive search for sono-elastography and LNs was performed in MEDLINE, Cochrane Library, ACP Journal Club, EMBASE, Health Technology assessment, and ISI web of knowledge for studies published prior to December 2012. SPSS version 18 (SPSS Inc., Chicago, IL, USA) used for descriptive analysis and meta-disk version 1.4 applied for meta-analysis. Forest plots for pooled estimates and summery of receiver operating characteristic plots for different cut-offs were produced. The literature and manual search yielded 69 articles, of which 10 were eligible to include. A total of 578 individuals with a total number of 936 cervical LNs was evaluated (502 malignant and 434 benign). The summary sensitivity of the scoring and strain ratio (SR) measurements for the differentiation of benign and malignant LNs were 0.76 (95% CI: 0.71–0.8) and 0.83 (95% CI: 0.78–0.87). The summary specificities were 0.8 (95% confidence interval [CI]: 0.75–0.84) and 0.84 (95% CI: 0.79–0.88), respectively. Area under the curve for scoring system was 0.86 (standard error [SE] = 0.03) and 0.95 (SE = 0.02) for SR measurement. Sono-elastograohy has high accuracy in differentiating benign and malignant cervical LNs. PMID:25709787

  12. Efficiency of B-mode Ultrasound and Strain Elastography in Differentiating Between Benign and Malignant Cervical Lymph Nodes.

    Science.gov (United States)

    Turgut, Eser; Celenk, Cetin; Tanrivermis Sayit, Asli; Bekci, Tumay; Gunbey, Hediye Pinar; Aslan, Kerim

    2017-09-01

    The purpose of this study was to evaluate the diagnostic accuracy and efficiency of ultrasonography (US), especially when combined with strain elastography (SE), in differentiating between benign and malignant cervical lymph nodes (LNs). Forty-one LNs were examined by B-mode US, power Doppler US, and SE. The following imaging features were analyzed: shape, echogenicity, echogenic hilum, calcification, intranodal vascular pattern, elasticity scores (5 categories), and strain ratio. The average strain ratio was calculated as the mean strain of the adjacent sternocleidomastoid muscle divided by the mean strain of the target LN. The results of the US and SE features were compared with the histopathologic findings. The imaging features that were significantly associated with malignant LNs were an increased short-to-long axis diameter ratio, abnormal or absence of hilum, microcalcification, type 2-3-4 vascularity, 3-4-5 elasticity scores, and a high level of strain ratio (P benign and malignant LNs. Strain elastography is useful in differentiating between benign and malignant cervical LNs, thereby informing decisions to perform a biopsy and/or surgery, and facilitating follow-up.

  13. A decision tree model for predicting mediastinal lymph node metastasis in non-small cell lung cancer with F-18 FDG PET/CT.

    Science.gov (United States)

    Pak, Kyoungjune; Kim, Keunyoung; Kim, Mi-Hyun; Eom, Jung Seop; Lee, Min Ki; Cho, Jeong Su; Kim, Yun Seong; Kim, Bum Soo; Kim, Seong Jang; Kim, In Joo

    2018-01-01

    We aimed to develop a decision tree model to improve diagnostic performance of positron emission tomography/computed tomography (PET/CT) to detect metastatic lymph nodes (LN) in non-small cell lung cancer (NSCLC). 115 patients with NSCLC were included in this study. The training dataset included 66 patients. A decision tree model was developed with 9 variables, and validated with 49 patients: short and long diameters of LNs, ratio of short and long diameters, maximum standardized uptake value (SUVmax) of LN, mean hounsfield unit, ratio of LN SUVmax and ascending aorta SUVmax (LN/AA), and ratio of LN SUVmax and superior vena cava SUVmax. A total of 301 LNs of 115 patients were evaluated in this study. Nodular calcification was applied as the initial imaging parameter, and LN SUVmax (≥3.95) was assessed as the second. LN/AA (≥2.92) was required to high LN SUVmax. Sensitivity was 50% for training dataset, and 40% for validation dataset. However, specificity was 99.28% for training dataset, and 96.23% for validation dataset. In conclusion, we have developed a new decision tree model for interpreting mediastinal LNs. All LNs with nodular calcification were benign, and LNs with high LN SUVmax and high LN/AA were metastatic Further studies are needed to incorporate subjective parameters and pathologic evaluations into a decision tree model to improve the test performance of PET/CT.

  14. B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Giuseppina Napolitano

    2013-01-01

    Full Text Available Papillary thyroid cancer (PTC is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs. The ultrasonography (US is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI, recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS, within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity (99.7% and sensitivity (80.9%. The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.

  15. Laboratory for Nuclear Science. High Energy Physics Program

    Energy Technology Data Exchange (ETDEWEB)

    Milner, Richard [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

    2014-07-30

    High energy and nuclear physics research at MIT is conducted within the Laboratory for Nuclear Science (LNS). Almost half of the faculty in the MIT Physics Department carry out research in LNS at the theoretical and experimental frontiers of subatomic physics. Since 2004, the U.S. Department of Energy has funded the high energy physics research program through grant DE-FG02-05ER41360 (other grants and cooperative agreements provided decades of support prior to 2004). The Director of LNS serves as PI. The grant supports the research of four groups within LNS as “tasks” within the umbrella grant. Brief descriptions of each group are given here. A more detailed report from each task follows in later sections. Although grant DE-FG02-05ER41360 has ended, DOE continues to fund LNS high energy physics research through five separate grants (a research grant for each of the four groups, as well as a grant for AMS Operations). We are pleased to continue this longstanding partnership.

  16. Development and Physico-Chemical Characterization of a Shea Butter-Containing Lipid Nutrition Supplement for Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Sloffer

    2017-11-01

    Full Text Available Lipid-based nutrient supplements (LNS are used to prevent and treat moderate and severe acute malnutrition, a leading cause of mortality in children-under-five. The physical and chemical changes of two new LNS products were evaluated before and after accelerated shelf life testing (ASLT according to protocols suggested by the U.S. Agency for International Development (USAID and Doctors without Borders and compared against USAID’s A-20 paste as a control. LNS formulas containing Shea butter from the Shea nut tree (Vitellaria paradoxa, a common fat source in parts of Sub-Saharan Africa, with and without flax-seed oil, as a source of omega-3 fatty acids, were developed. LNS formulas were batched (0.8 kg in a wet grinder, sealed under nitrogen in three-layer mini-pouches (20 g, and underwent ASLT at 40 ± 2 °C for six months with sampling every eight weeks. At each time point, water activity, moisture, peroxide value, oil separation, vitamin C content, and hardness were evaluated. Results showed comparable stability among all formulas with an increase in Aw (p < 0.05 but no change in vitamin C, oil separation, or peroxide value. Addition of Shea butter improved the LNS’s hardness, which remained stable over time. Modifying fat profile in LNS can improve its texture and essential fatty acid content without affecting its storage stability.

  17. Sono-elastography for Differentiating Benign and Malignant Cervical Lymph Nodes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ghajarzadeh, Mahsa; Mohammadifar, Mehdi; Azarkhish, Kamran; Emami-Razavi, Seyed Hassan

    2014-12-01

    We did this systematic review to determine diagnostic accuracy of sono-elastography in evaluating cervical lymph nodes (LNs). A highly sensitive search for sono-elastography and LNs was performed in MEDLINE, Cochrane Library, ACP Journal Club, EMBASE, Health Technology assessment, and ISI web of knowledge for studies published prior to December 2012. SPSS version 18 (SPSS Inc., Chicago, IL, USA) used for descriptive analysis and meta-disk version 1.4 applied for meta-analysis. Forest plots for pooled estimates and summery of receiver operating characteristic plots for different cut-offs were produced. The literature and manual search yielded 69 articles, of which 10 were eligible to include. A total of 578 individuals with a total number of 936 cervical LNs was evaluated (502 malignant and 434 benign). The summary sensitivity of the scoring and strain ratio (SR) measurements for the differentiation of benign and malignant LNs were 0.76 (95% CI: 0.71-0.8) and 0.83 (95% CI: 0.78-0.87). The summary specificities were 0.8 (95% confidence interval [CI]: 0.75-0.84) and 0.84 (95% CI: 0.79-0.88), respectively. Area under the curve for scoring system was 0.86 (standard error [SE] = 0.03) and 0.95 (SE = 0.02) for SR measurement. Sono-elastograohy has high accuracy in differentiating benign and malignant cervical LNs.

  18. VEGF-C Is a Thyroid Marker of Malignancy Superior to VEGF-A in the Differential Diagnostics of Thyroid Lesions.

    Directory of Open Access Journals (Sweden)

    Kosma Woliński

    Full Text Available Thyroid nodular goiter is one of the most common medical conditions affecting even over a half of adult population. The risk of malignancy is rather small but noticeable-estimated by numerous studies to be about 3-10%. The definite differentiation between benign and malignant ones is a vital issue in endocrine practice. The aim of the current study was to assess the expression of vascular endothelial growth factor A (VEGF-A and VEGF-C on the mRNA level in FNAB washouts in case of benign and malignant thyroid nodules and to evaluate the diagnostic value of these markers of malignancy.Patients undergoing fine-needle aspiration biopsy (FNAB in our department between January 2013 and May 2014 were included. In case of all patients who gave the written consent, after ultrasonography (US and fine-needle aspiration biopsy (FNAB performed as routine medical procedure the needle was flushed with RNA Later solution, the washouts were frozen in -80 Celsius degrees. Expression of VEGF-A and VEGF-C and GADPH (reference gene was assessed in washouts on the mRNA level using the real-time PCR technique. Probes of patients who underwent subsequent thyroidectomy and were diagnosed with differentiated thyroid cancer (DTC; proved by post-surgical histopathology were analyzed. Similar number of patients with benign cytology were randomly selected to be a control group.Thirty one DTCs and 28 benign thyroid lesions were analyzed. Expression of VEGF-A was insignificantly higher in patients with DTCs (p = 0.13. Expression of VEGF-C was significantly higher in patients with DTC. The relative expression of VEGF-C (in comparison with GAPDH was 0.0049 for DTCs and 0.00070 for benign lesions, medians - 0.0036 and 0.000024 respectively (p<0.0001.Measurement of expression VEGF-C on the mRNA level in washouts from FNAB is more useful than more commonly investigated VEGF-A. Measurement of VEGF-C in FNAB washouts do not allow for fully reliable differentiation of benign and

  19. Differential expression of galectin-3, CK19, HBME1, and Ret oncoprotein in the diagnosis of thyroid neoplasms by fine needle aspiration biopsy

    Directory of Open Access Journals (Sweden)

    Saleh Husain

    2009-01-01

    Full Text Available Background: Fine needle aspiration biopsy (FNAB is a common and excellent procedure for the evaluation of thyroid lesions that require surgical resection. At times, the FNAB diagnosis can be difficult, particularly of follicular-patterned lesions. Previous studies have shown that some immunohistochemical (IHC markers may be helpful in establishing more accurate diagnosis. In this study, our goal was to evaluate four of the recently investigated markers in differentiating benign from malignant thyroid nodules on FNABs. Materials and Methods: We performed IHC staining of galectin-3, Ret oncoprotein (Ret, HBME-1, and cytokeratin 19 (CK19, on cell block sections of thyroid FNAB cases that had corresponding surgical resections. They included 44 benign lesions (37 hyperplastic or cellular nodules, HN; and 7 follicular adenomas, FA and 27 malignant tumors (6 follicular carcinoma, FC; 19 classic papillary carcinoma, PTC; and 2 follicular variant of papillary carcinoma, FVPC. The stains were done according to the standard avidin-biotin-peroxidase method. Results: Statistical analysis showed that immunoexpression was significantly higher in the malignant group for all four markers. The sensitivity for positive expression for all benign lesions versus malignant tumors was as follows: 10/44 (22.7% versus 25/27 (92.6% for galectin-3; 14/44 (31.8% versus 23/27 (85% for Ret; 12/44 (27.3% versus 24/27 (88.8% for HBME-1; and 13/44 (29.5% versus 23/27 (85% for CK19. The sensitivity and specificity was highest for galectin-3 (92.6% and 77.3%, respectively followed by HMBE-1 (88.9% and 72.7%, respectively. When combining the markers′ expressions, the panel of galectin-3 + HBME-1 showed the highest sensitivity and specificity (90.7% and 75%, respectively, but this was, however, lower than galectin-3 alone (92.3% and 77.3%, respectively. Conclusion: We conclude that galectin-3 is the best single marker in differentiating benign from malignant thyroid lesions with

  20. Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: an analysis for Austria.

    Science.gov (United States)

    Gruber, R; Walter, E; Helbich, T H

    2010-06-01

    To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Overall cost savings for US-guided LCBB over OSB were euro 977 (euro 2,337/euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were euro 1,542 (euro 2,600/euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be euro 18.5 million. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  1. Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: An analysis for Austria

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, R., E-mail: renate.gruber@meduniwien.ac.a [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Walter, E. [Institute of Pharmacoeconomic Research, Wolfengasse 4/7, A-1010 Vienna (Austria); Helbich, T.H. [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2010-06-15

    Purpose: To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. Materials and methods: In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Results: Overall cost savings for US-guided LCBB over OSB were Euro 977 ( Euro 2,337/ Euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were Euro 1,542 ( Euro 2,600/ Euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. Conclusion: From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be Euro 18.5 million.

  2. Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: An analysis for Austria

    International Nuclear Information System (INIS)

    Gruber, R.; Walter, E.; Helbich, T.H.

    2010-01-01

    Purpose: To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. Materials and methods: In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Results: Overall cost savings for US-guided LCBB over OSB were Euro 977 ( Euro 2,337/ Euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were Euro 1,542 ( Euro 2,600/ Euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. Conclusion: From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be Euro 18.5 million.

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

    Directory of Open Access Journals (Sweden)

    Jennifer A Flemming

    2009-01-01

    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.

  4. Math anxiety differentially affects WAIS-IV arithmetic performance in undergraduates.

    Science.gov (United States)

    Buelow, Melissa T; Frakey, Laura L

    2013-06-01

    Previous research has shown that math anxiety can influence the math performance level; however, to date, it is unknown whether math anxiety influences performance on working memory tasks during neuropsychological evaluation. In the present study, 172 undergraduate students completed measures of math achievement (the Math Computation subtest from the Wide Range Achievement Test-IV), math anxiety (the Math Anxiety Rating Scale-Revised), general test anxiety (from the Adult Manifest Anxiety Scale-College version), and the three Working Memory Index tasks from the Wechsler Adult Intelligence Scale-IV Edition (WAIS-IV; Digit Span [DS], Arithmetic, Letter-Number Sequencing [LNS]). Results indicated that math anxiety predicted performance on Arithmetic, but not DS or LNS, above and beyond the effects of gender, general test anxiety, and math performance level. Our findings suggest that math anxiety can negatively influence WAIS-IV working memory subtest scores. Implications for clinical practice include the utilization of LNS in individuals expressing high math anxiety.

  5. Lesch-nyhan syndrome in an Indian child

    Directory of Open Access Journals (Sweden)

    Priyanka Chandekar

    2015-01-01

    Full Text Available Hypoxanthine guanine phosphoribosyl transferase-1 (HGPRT-1 leading to Lesch-Nyhan syndrome (LNS is one of the important causes of self-mutilation. Hereby, we report a case of LNS in a three and half-year-old male child, who presented with characteristic self-mutilating behavior. He had history of developmental delay, difficulty in social interaction, attention deficit and features of autism. His serum blood biochemistry was normal except for low hemoglobin levels and raised serum uric acid levels. With a diagnosis of LNS, the child was treated with allopurinol. With various modalities of physical restraint, his self-mutilating behavior came under control and currently the patient is being followed up.

  6. Sentinel node detection in melanomas using contrast-enhanced ultrasound

    DEFF Research Database (Denmark)

    Nielsen, K. Rue; Klyver, H.; Chakera, A. Hougaard

    2009-01-01

    in humans. PURPOSE: To investigate the possible use of CEUS in detecting SN in patients with malignant melanomas (MM), and to improve the method by using different concentrations of contrast agent and various positions of the extremity. MATERIAL AND METHODS: Ten patients with MM on an extremity and one...... healthy volunteer were included. One milliliter of a contrast agent (Sonovue; Bracco, Milan, Italy) was injected subcutaneously on both sides of the scar from the excised tumor. Contrast-enhanced lymph channels and lymph nodes (LNs) were searched for using low-mechanical-index CEUS and by stimulated...... tissue damage, as the contrast agent was not registered for subcutaneous administration. RESULTS: In one patient, two contrast-enhanced inguinal LNs were visualized by CEUS, corresponding to two inguinal SNs found by scintigraphic imaging. No contrast-enhanced lymph channels or LNs were visualized in any...

  7. A method for evaluation of proton plan robustness towards inter-fractional motion applied to pelvic lymph node irradiation

    DEFF Research Database (Denmark)

    Andersen, Andreas G; Casares-Magaz, Oscar; Muren, Ludvig P

    2015-01-01

    of the pelvic lymph nodes (LNs) from different beam angles. Patient- versus population-specific patterns in dose deterioration were explored. MATERIAL AND METHODS: Patient data sets consisting of a planning computed tomography (pCT) as well as multiple repeat CT (rCT) scans for three patients were used......BACKGROUND: The benefit of proton therapy may be jeopardized by dose deterioration caused by water equivalent path length (WEPL) variations. In this study we introduced a method to evaluate robustness of proton therapy with respect to inter-fractional motion and applied it to irradiation...... in deterioration patterns were found for the investigated patients, with beam angles delivering less dose to rectum, bladder and overall normal tissue identified around 40° and around 150°-160° for the left LNs, and corresponding angles for the right LNs. These angles were also associated with low values of WEPL...

  8. Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

    Science.gov (United States)

    Iannotti, Lora L; Dulience, Sherlie Jean Louis; Green, Jamie; Joseph, Saminetha; François, Judith; Anténor, Marie-Lucie; Lesorogol, Carolyn; Mounce, Jacqueline; Nickerson, Nathan M

    2014-01-01

    Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm. A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

  9. A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy

    International Nuclear Information System (INIS)

    Fokas, Emmanouil; Eccles, Cynthia; Patel, Neel; Chu, Kwun-Ye; Warren, Samantha; McKenna, W. Gillies; Brunner, Thomas B.

    2013-01-01

    Background and purpose: Contouring of target volumes varies significantly in radiotherapy of pancreatic ductal adenocarcinoma (PDAC). There is a lack of consensus as to whether elective lymph nodes (eLN’s) should be included or not in the planning target volume (PTV). In the present study we analyzed the dosimetric coverage of the eLN’s and organs at risk (OAR) by comparing four different contouring guidelines. Methods and materials: PTVs were delineated with (Oxford and RTOG guidelines) or without (Michigan and SCALOP guidelines) including the eLNs in eleven patients with PDAC. eLNs included the peripancreatic, paraaortic, paracaval, celiac trunk, superior mesenteric and portal vein clinical target volumes (CTVs). A 3D-CRT plan (50.40 Gy in 28 fractions) was performed to analyze and compare the dosimetric coverage of all eLNs and OAR between the 4 contouring guidelines. Results: The size of Oxford and RTOG PTVs was comparable and significantly larger than the SCALOP and Michigan PTVs. Interestingly the eLNs received a significant amount of incidental dose irradiation by PTV-based plans that only aimed to treat the tumor without the eLNs. The dosimetric coverage of eLN presented a large variability according to the respective contouring methods. The difference in the size of the 4 PTVs was reflected to the dose distribution at the OAR. Conclusions: Our study provides important information regarding the impact of different contouring guidelines on the dose distribution to the eLNs and the OAR in patients with locally advanced PDAC treated with radiotherapy

  10. The utility of intraoperative ultrasound in modified radical neck dissection: a pilot study.

    Science.gov (United States)

    Agcaoglu, Orhan; Aliyev, Shamil; Taskin, Halit Eren; Aksoy, Erol; Siperstein, Allan; Berber, Eren

    2014-04-01

    Although the value of surgeon-performed neck ultrasound (SPUS) for thyroid nodules has been validated, the utility of intraoperative ultrasound (US) in modified radical neck dissection (MRND) has not been reported in the literature. The aim of this study was to analyze the utility of intraoperative SPUS in assessing the completeness of MRND for thyroid cancer. Between 2007 and 2011, a total of 25 patients underwent MRND by 1 surgeon for thyroid cancer. All patients underwent intraoperative SPUS, which was repeated at the end of the neck dissection (completion US) to look for missed lymph nodes (LNs). There were 10 male and 15 female patients. Pathology included 23 papillary and 2 medullary carcinomas. The number of LNs removed per case was 23 ± 2, and the number of positive was LNs 5 ± 1. In 4 (16%) cases, intraoperative US detected 7 residual LNs, which would have been missed, if completion US were not done. These missed LNs were located in low-level IV (3 nodes), high-level II (2 nodes), and posterior level V (2 nodes) and measured 1.4 ± 0.2 cm. At follow-up, recurrence was seen in 2 (8%) patients, including a superior mediastinal recurrence in a patient with tall cell cancer and a jugular LN recurrence at level II in another patient with papillary thyroid cancer. This pilot study shows that intraoperative SPUS can help assess the completeness of MRND. According to our results, intraoperative completion US identifies LNs missed by palpation 16% of the time.

  11. Providing lipid-based nutrient supplements does not affect developmental milestones among Malawian children.

    Science.gov (United States)

    Mangani, Charles; Cheung, Yin Bun; Maleta, Kenneth; Phuka, John; Thakwalakwa, Chrissie; Dewey, Kathryn; Manary, Mark; Puumalainen, Taneli; Ashorn, Per

    2014-01-01

    To assess whether using lipid-based nutrient supplements (LNS) to complement the diets of infants and young children affected when they achieved selected developmental milestones. In rural Malawi, 840 6-month-old healthy infants were enrolled to a randomised trial. Control participants received no supplements, others were provided with milk-containing LNS, soy-containing LNS or corn-soy blend (CSB) for 12 months. Outcomes were the age at which they achieved key milestone: motor (walking with assistance, standing and walking alone, running), social (drinking from a cup and eating by themselves) and language (saying single comprehensible words and waving goodbye). The mean age at which the subjects walked with assistance was 42.5, 42.3, 42.7 and 43.2 weeks in the control, milk-LNS, soy-LNS and CSB groups, respectively (p = 0.748). There were also no significant differences in the mean age at standing alone (45.0, 44.9, 45.1 and 46.3 weeks), walking alone (54.6, 55.1, 55.3, 56.5 weeks), running (64.6, 63.7, 64.8, 65.9 weeks) or any other social or language milestones (each p > 0.10). The findings do not support a hypothesis that providing tested formulations and doses of micronutrient-fortified LNS or CSB would have an impact on when young children in rural Malawi achieved selected developmental milestones. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Analysis of the prognostic factors for low rectal cancer with the pT1-2NxM0 stage after abdominoperineal resection.

    Science.gov (United States)

    Zhang, Xing-mao; Ma, Chao; Sun, Da-yong; Wang, Zheng; Zhou, Zhi-xiang

    2015-01-01

    This study was designed to explore the factors influencing local recurrence and survival for low rectal cancer with pT1-2NxM0 stage after an abdominoperineal resection (APR). Data of 429 patients confirmed to have pT1-2NxM0 after APR were reviewed. The recurrence rate in patients with intraoperative perforation, less than 12 lymph nodes (LNs) harvested, T2 staging, and positive circumferential resection margin (CRM) was 25.1, 19.9, 9.5, and 26.1% compared with 6.9, 7.0, 0, and 5.8% in patients with no perforation, 12 or more LNs harvested, T1, and negative CRM. The 5-year survival rate in patients with age of at least 70, perforation, less than 12 LNs harvested, T2, and positive CRM was 71.1, 60.8, 58.8, 69.9, and 46.0%, but 73.4, 73.5, 73.8, 89.4, and 75.0% in patients with age less than 70, no perforation, 12 or more LNs harvested, T1, and negative CRM. Meanwhile, patients with N0, N1, and N2 had a survival rate of 90.7, 69.9, and 63.9%. Multivariate analysis showed that perforation (PCRM status (P=0.002) were associated with local recurrence, whereas age of the patients (P=0.023), N staging (PCRM status (P=0.004) were associated with survival. APR was affected by patients' age, operation performer, perforation, number of LNs harvested, T staging, N staging, differentiation, and CRM status. Perforation, number of LNs harvested, T staging, differentiation, and CRM status were independent factors for recurrence; meanwhile, age of the patients, N staging, differentiation, and CRM status were independent factors influencing survival.

  13. A Clinical Decision Support System Using Ultrasound Textures and Radiologic Features to Distinguish Metastasis From Tumor-Free Cervical Lymph Nodes in Patients With Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Abbasian Ardakani, Ali; Reiazi, Reza; Mohammadi, Afshin

    2018-03-30

    This study investigated the potential of a clinical decision support approach for the classification of metastatic and tumor-free cervical lymph nodes (LNs) in papillary thyroid carcinoma on the basis of radiologic and textural analysis through ultrasound (US) imaging. In this research, 170 metastatic and 170 tumor-free LNs were examined by the proposed clinical decision support method. To discover the difference between the groups, US imaging was used for the extraction of radiologic and textural features. The radiologic features in the B-mode scans included the echogenicity, margin, shape, and presence of microcalcification. To extract the textural features, a wavelet transform was applied. A support vector machine classifier was used to classify the LNs. In the training set data, a combination of radiologic and textural features represented the best performance with sensitivity, specificity, accuracy, and area under the curve (AUC) values of 97.14%, 98.57%, 97.86%, and 0.994, respectively, whereas the classification based on radiologic and textural features alone yielded lower performance, with AUCs of 0.964 and 0.922. On testing the data set, the proposed model could classify the tumor-free and metastatic LNs with an AUC of 0.952, which corresponded to sensitivity, specificity, and accuracy of 93.33%, 96.66%, and 95.00%. The clinical decision support method based on textural and radiologic features has the potential to characterize LNs via 2-dimensional US. Therefore, it can be used as a supplementary technique in daily clinical practice to improve radiologists' understanding of conventional US imaging for characterizing LNs. © 2018 by the American Institute of Ultrasound in Medicine.

  14. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibucá, Honduras.

    Science.gov (United States)

    Siega-Riz, Anna M; Estrada Del Campo, Yaniré; Kinlaw, Alan; Reinhart, Gregory A; Allen, Lindsay H; Shahab-Ferdows, Setareh; Heck, Jeff; Suchindran, Chirayath M; Bentley, Margaret E

    2014-05-01

    Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data. At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence. These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children. © 2014 John Wiley & Sons Ltd.

  15. Detection of Occult Micrometastases in Patients With Clinical Stage I Non-Small-Cell Lung Cancer: A Prospective Analysis of Mature Results of CALGB 9761 (Alliance).

    Science.gov (United States)

    Martin, Linda W; D'Cunha, Jonathan; Wang, Xiaofei; Herzan, Debra; Gu, Lin; Abraham, Naif; Demmy, Todd L; Detterbeck, Frank C; Groth, Shawn S; Harpole, David H; Krasna, Mark J; Kernstine, Kemp; Kohman, Leslie J; Patterson, G Alexander; Sugarbaker, David J; Vollmer, Robin T; Maddaus, Michael A; Kratzke, Robert A

    2016-05-01

    Outcomes after resection of stage I non-small-cell lung cancer (NSCLC) are variable, potentially due to undetected occult micrometastases (OM). Cancer and Leukemia Group B 9761 was a prospectively designed study aimed at determining the prognostic significance of OM. Between 1997 and 2002, 502 patients with suspected clinical stage I (T1-2N0M0) NSCLC were prospectively enrolled at 11 institutions. Primary tumor and lymph nodes (LNs) were collected and sent to a central site for molecular analysis. Both were assayed for OM using immunohistochemistry (IHC) for cytokeratin (AE1/AE3) and real-time reverse transcriptase polymerase chain reaction (RT-PCR) for carcinoembryonic antigen. Four hundred eighty-nine of the 502 enrolled patients underwent complete surgical staging. Three hundred four patients (61%) had pathologic stage I NSCLC (T1, 58%; T2, 42%) and were included in the final analysis. Fifty-six percent had adenocarcinomas, 34% had squamous cell carcinomas, and 10% had another histology. LNs from 298 patients were analyzed by IHC; 41 (14%) were IHC-positive (42% in N1 position, 58% in N2 position). Neither overall survival (OS) nor disease-free survival was associated with IHC positivity; however, patients who had IHC-positive N2 LNs had statistically significantly worse survival rates (hazard ratio, 2.04, P = .017). LNs from 256 patients were analyzed by RT-PCR; 176 (69%) were PCR-positive (52% in N1 position, 48% in N2 position). Neither OS nor disease-free survival was associated with PCR positivity. NSCLC tumor markers can be detected in histologically negative LNs by AE1/AE3 IHC and carcinoembryonic antigen RT-PCR. In this prospective, multi-institutional trial, the presence of OM by IHC staining in N2 LNs of patients with NSCLC correlated with decreased OS. The clinical significance of this warrants further investigation. © 2016 by American Society of Clinical Oncology.

  16. Detection of Occult Micrometastases in Patients With Clinical Stage I Non–Small-Cell Lung Cancer: A Prospective Analysis of Mature Results of CALGB 9761 (Alliance)

    Science.gov (United States)

    D’Cunha, Jonathan; Wang, Xiaofei; Herzan, Debra; Gu, Lin; Abraham, Naif; Demmy, Todd L.; Detterbeck, Frank C.; Groth, Shawn S.; Harpole, David H.; Krasna, Mark J.; Kernstine, Kemp; Kohman, Leslie J.; Patterson, G. Alexander; Sugarbaker, David J.; Vollmer, Robin T.; Maddaus, Michael A.; Kratzke, Robert A.

    2016-01-01

    Purpose Outcomes after resection of stage I non–small-cell lung cancer (NSCLC) are variable, potentially due to undetected occult micrometastases (OM). Cancer and Leukemia Group B 9761 was a prospectively designed study aimed at determining the prognostic significance of OM. Materials and Methods Between 1997 and 2002, 502 patients with suspected clinical stage I (T1-2N0M0) NSCLC were prospectively enrolled at 11 institutions. Primary tumor and lymph nodes (LNs) were collected and sent to a central site for molecular analysis. Both were assayed for OM using immunohistochemistry (IHC) for cytokeratin (AE1/AE3) and real-time reverse transcriptase polymerase chain reaction (RT-PCR) for carcinoembryonic antigen. Results Four hundred eighty-nine of the 502 enrolled patients underwent complete surgical staging. Three hundred four patients (61%) had pathologic stage I NSCLC (T1, 58%; T2, 42%) and were included in the final analysis. Fifty-six percent had adenocarcinomas, 34% had squamous cell carcinomas, and 10% had another histology. LNs from 298 patients were analyzed by IHC; 41 (14%) were IHC-positive (42% in N1 position, 58% in N2 position). Neither overall survival (OS) nor disease-free survival was associated with IHC positivity; however, patients who had IHC-positive N2 LNs had statistically significantly worse survival rates (hazard ratio, 2.04, P = .017). LNs from 256 patients were analyzed by RT-PCR; 176 (69%) were PCR-positive (52% in N1 position, 48% in N2 position). Neither OS nor disease-free survival was associated with PCR positivity. Conclusion NSCLC tumor markers can be detected in histologically negative LNs by AE1/AE3 IHC and carcinoembryonic antigen RT-PCR. In this prospective, multi-institutional trial, the presence of OM by IHC staining in N2 LNs of patients with NSCLC correlated with decreased OS. The clinical significance of this warrants further investigation. PMID:26926677

  17. Direct in vivo evidence for increased proliferation of CLL cells in lymph nodes compared to bone marrow and peripheral blood

    DEFF Research Database (Denmark)

    Herndon, Thomas M; Chen, Shih-Ann; Saba, Nakhle S

    2017-01-01

    of active cell proliferation remains to be definitively determined. Based on findings that CLL cells in LNs have increased expression of B-cell activation genes, we tested the hypothesis that the fraction of 'newly born' cells would be highest in the LNs. Using a deuterium oxide ((2)H) in vivo labeling...... method in which patients consumed deuterated (heavy) water ((2)H2O), we determined CLL cell kinetics in concurrently obtained samples from LN, PB and BM. The LN was identified as the anatomical site harboring the largest fraction of newly born cells, compared to PB and BM. In fact, the calculated birth...

  18. Lymphoscintigraphy for sentinel lymph node mapping in Japanese patients with malignant skin neoplasms of the lower extremities. Comparison with previously investigated Japanese lymphatic anatomy

    International Nuclear Information System (INIS)

    Miura, Hiroyuki; Ono, Shuichi; Nagahata, Morio

    2010-01-01

    Lymph nodes (LN) and lymphatic drainage were identified by lymphoscintigraphy using 99m Tc-phytate in order to map the sentinel lymph nodes (SLNs) in patients with malignant skin neoplasms of the lower extremities, and to compare the results with an atlas of Japanese lymphatic anatomy. Sentinel lymphoscintigraphs of 18 patients with malignant skin neoplasms of the lower extremities (9 men, 9 women; age range 45-84 years, mean age 66 years) were analyzed retrospectively, and the LNs detected were identified as SLNs or secondary nodes. The patterns of lymphatic drainage were divided into three different categories: initial drainage into inguinal LN without visualization of popliteal LNs (inguinal type), initial drainage into popliteal LNs and then into intrapelvic LNs (popliteal type), and initial drainage into both popliteal and inguinal LNs (inguinal and popliteal type). More than half of the cases were the inguinal and popliteal type, as both inguinal and popliteal LNs were identified as SLNs. In the cases in which the hallux and its surrounding area were injected, all were the inguinal type and popliteal LNs were not visualized. In one case, only dynamic images detected lymphatic drainage without visualization of popliteal LNs. In contrast to the previously published literature on Japanese lymphatic anatomy, SLN lymphatic drainage from the skin of the lower extremities was wide and overlapping in many areas. However, in agreement with currently accepted anatomy, only the great saphenous lymphatic vessel drained the skin of the hallux and its surrounding area. The present results suggest that it is important to confirm lymphatic drainage in order to identify SLNs in the lower extremities. The patterns of lymphatic drainage from the skin of the foot were divided into three different categories. In contrast to previously published Japanese lymphatic anatomy, lymphatic drainage from the skin of the lower extremities was wide and overlapping in many areas. However

  19. Imaging of Lymph Flow in Breast Cancer Patients after Microdose Administration of a Near-Infrared Fluorophore: Feasibility Study1

    Science.gov (United States)

    Sevick-Muraca, Eva M.; Sharma, Ruchi; Rasmussen, John C.; Marshall, Milton V.; Wendt, Juliet A.; Pham, Hoang Q.; Bonefas, Elizabeth; Houston, Jessica P.; Sampath, Lakshmi; Adams, Kristen E.; Blanchard, Darlene Kay; Fisher, Ronald E.; Chiang, Stephen B.; Elledge, Richard; Mawad, Michel E.

    2011-01-01

    Purpose To prospectively demonstrate the feasibility of using indocyanine green, a near-infrared (NIR) fluorophore at the minimum dose needed for noninvasive optical imaging of lymph nodes (LNs) in breast cancer patients undergoing sentinel lymph node mapping (SLNM). Materials and Methods Informed consent was obtained from 24 women (age range, 30–85 years) who received intradermal subcutaneous injections of 0.31–100 μg indocyanine green in the breast in this IRB-approved, HIPAA-compliant, dose escalation study to find the minimum microdose for imaging. The breast, axilla, and sternum were illuminated with NIR light and the fluorescence generated in the tissue was collected with an NIR-sensitive intensified charged-coupled device. Lymphoscintigraphy was also performed. Resected LNs were evaluated for the presence of radioactivity, blue dye accumulation, and fluorescence. The associations between the resected LNs that were fluorescent and (a) the time elapsed between NIR fluorophore administration and resection and (b) the dosage of NIR fluorophores were tested with the Spearman rank and Pearson product moment correlation tests, respectively. Results Lymph imaging consistently failed with indocyanine green microdosages between 0.31 and 0.77 μg. When indocyanine green dosages were 10 μg or higher, lymph drainage pathways from the injection site to LNs were imaged in eight of nine women; lymph propulsion was observed in seven of those eight. When propulsion in the breast and axilla regions was present, the mean apparent velocities ranged from 0.08 to 0.32 cm/sec, the time elapsed between “packets” of propelled fluid varied from 14 to 92 seconds. In patients who received 10 μg of indocyanine green or more, a weak negative correlation between the fluorescence status of resected LNs and the time between NIR fluorophore administration and LN resection was found. No statistical association was found between the fluorescence status of resected LNs and the dose of

  20. A Novel Therapy for Inflammatory Bowel Disease-Dual Regulatory T-Cell Programming

    Science.gov (United States)

    2017-08-01

    Subtask 1: to determine 1,25(OH)2D concentration by ELISA in the dLNs following subcutaneous infusion of the different DCs. 1-3 Subtask 2: to...Achieved: 1. Subtask-1: In one experiment, we failed to detect a significant amount of 1,25(OH)2D by ELISA in the dLNs following subcutaneous...injections of the different DCs. Potential reasons include: 1) the ELISA method was not sufficiently sensitive; 2) we had a problem extracting the

  1. Neutron scattering (Progress-Report) January - December 1992

    International Nuclear Information System (INIS)

    1993-02-01

    The Laboratory for Neutron Scattering (LNS) is a joint venture between the Eidgenoessische Technische Hochschule Zurich (ETHZ) and the Paul Scherrer Institut Wuerenlingen/Villigen (PSI). The present report summarizes the laboratory's activities in 1992 as well as the work performed by external users at the reactor Saphir. It is intended as an interim description of ongoing research projects and as such may not contain the final conclusions of the analysis. However, the number and quality of the reports reflects very well the standard of experiments performed at the LNS. (author) figs., tabs., refs

  2. 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 ...

  3. The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy platforms in prostate cancer detection: a systematic review

    NARCIS (Netherlands)

    Gayet, M.; Aa, A. van der; Beerlage, H.P.; Schrier, B.P.; Mulders, P.F.A.; Wijkstra, H.

    2016-01-01

    Despite limitations considering the presence, staging and aggressiveness of prostate cancer, ultrasonography (US)-guided systematic biopsies (SBs) are still the 'gold standard' for the diagnosis of prostate cancer. Recently, promising results have been published for targeted prostate biopsies (TBs)

  4. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies.

    LENUS (Irish Health Repository)

    Mandl, Peter

    2012-01-01

    To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR).

  5. The role of ultrasound-guided nephrostomy catheter drainage in the management of peripheral pyogenic lung abscess

    Directory of Open Access Journals (Sweden)

    Amira A Gaballah

    2018-01-01

    Conclusion US-guided PTD using nephrostomy catheter for peripheral lung abscess is safe and effective; it can improve the outcome, shorten the duration and reduce the need for surgery in lung abscess treatment with less complications.

  6. Contribution of ultrasound-guided fine-needle aspiration cell blocks of metastatic supraclavicular lymph nodes to the diagnosis of lung cancer

    Directory of Open Access Journals (Sweden)

    Hai-Ying Tian

    2015-01-01

    Conclusion: Cell-block samples from US-guided FNA is a promising, relatively noninvasive technique to provide additional information in lung cancer diagnosis. Analysis of cell blocks allows for genetic analysis of the patients with supraclavicular lymph nodes metastasis.

  7. Role of Ultrasound Guided Platelet-Rich Plasma (PRP Injection in Treatment of Lateral Epicondylitis

    Directory of Open Access Journals (Sweden)

    Enass M. Khattab

    2017-06-01

    Conclusion: We concluded that US-guided platelet-rich plasma (PRP injection for treatment of lateral epicondylitis was a safe, minimally invasive and effective procedure in improving the sonographic and pathological changes of common extensor tendon (CET.

  8. The Usefulness of Intensivist-Performed Bedside Drainage of Pleural Effusion via Ultrasound-Guided Pigtail Catheter

    Directory of Open Access Journals (Sweden)

    Joo Won Min

    2014-08-01

    CONCLUSIONS: Intensivist-performed bedside drainage of pleural effusion via ultrasound (US-guided pigtail catheter is useful and safe and may be recommended in some patients in an intensive care unit.

  9. Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access

    International Nuclear Information System (INIS)

    Chiba, Emiko; Hamamoto, Kohei; Nagashima, Michio; Matsuura, Katsuhiko; Okochi, Tomohisa; Tanno, Keisuke; Tanaka, Osamu

    2016-01-01

    PurposeTo evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.Subjects and MethodsTwenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients’ pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient’s motor/sensory paralysis after PTA was also examined.ResultsThe mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.ConclusionUS-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.Level of EvidenceLevel 4 (case series).

  10. Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access

    Energy Technology Data Exchange (ETDEWEB)

    Chiba, Emiko, E-mail: chibaemi23@comet.ocn.ne.jp; Hamamoto, Kohei, E-mail: hkouhei917@gmail.com [Jichi Medical University, Department of Radiology, Saitama Medical Center (Japan); Nagashima, Michio, E-mail: nagamic00@gmail.com [Asahikawa Medical University, Department of Emergency Medicine (Japan); Matsuura, Katsuhiko, E-mail: kmatsur@gmail.com; Okochi, Tomohisa, E-mail: t-shachi@dj8.so-net.ne.jp; Tanno, Keisuke, E-mail: tankichi1974@gmail.com; Tanaka, Osamu, E-mail: otanaka@omiya.jichi.ac.jp [Jichi Medical University, Department of Radiology, Saitama Medical Center (Japan)

    2016-10-15

    PurposeTo evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.Subjects and MethodsTwenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients’ pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient’s motor/sensory paralysis after PTA was also examined.ResultsThe mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.ConclusionUS-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.Level of EvidenceLevel 4 (case series).

  11. The effects of timing of fine needle aspiration biopsies on gene expression profiles in breast cancers

    International Nuclear Information System (INIS)

    Wong, Vietty; Wang, Dong-Yu; Warren, Keisha; Kulkarni, Supriya; Boerner, Scott; Done, Susan Jane; Leong, Wey Liang

    2008-01-01

    DNA microarray analysis has great potential to become an important clinical tool to individualize prognostication and treatment for breast cancer patients. However, with any emerging technology, there are many variables one must consider before bringing the technology to the bedside. There are already concerted efforts to standardize protocols and to improve reproducibility of DNA microarray. Our study examines one variable that is often overlooked, the timing of tissue acquisition, which may have a significant impact on the outcomes of DNA microarray analyses especially in studies that compare microarray data based on biospecimens taken in vivo and ex vivo. From 16 patients, we obtained paired fine needle aspiration biopsies (FNABs) of breast cancers taken before (PRE) and after (POST) their surgeries and compared the microarray data to determine the genes that were differentially expressed between the FNABs taken at the two time points. qRT-PCR was used to validate our findings. To examine effects of longer exposure to hypoxia on gene expression, we also compared the gene expression profiles of 10 breast cancers from clinical tissue bank. Using hierarchical clustering analysis, 12 genes were found to be differentially expressed between the FNABs taken before and after surgical removal. Remarkably, most of the genes were linked to FOS in an early hypoxia pathway. The gene expression of FOS also increased with longer exposure to hypoxia. Our study demonstrated that the timing of fine needle aspiration biopsies can be a confounding factor in microarray data analyses in breast cancer. We have shown that FOS-related genes, which have been implicated in early hypoxia as well as the development of breast cancers, were differentially expressed before and after surgery. Therefore, it is important that future studies take timing of tissue acquisition into account

  12. Ultrathin needle (25G) aspiration lung biopsy: diagnostic accuracy and complication rates

    International Nuclear Information System (INIS)

    Oikonomou, A.; Matzinger, F.R.; Seely, J.M.; Dennie, C.J.; Macleod, P.J.

    2004-01-01

    The aim of this study was to evaluate the diagnostic accuracy and complication rate of 25-G fine-needle aspiration biopsy (FNAB) of the lung in patients with suspected malignant focal lesions and abnormal lung function. The 25-G FNAB was performed in 123 patients who underwent prebiopsy CT and pulmonary function tests. Retrospective evaluation included pulmonary function, cytology, size of the lesion, depth of location, presence of emphysema on CT, needle passes, pneumothorax and drainage. The final diagnosis (gold standard) was based on histopathology after surgical resection or follow-up and response to treatment. Sixty-one patients had normal lung function or mild impairment (group 1) and 62 had moderate or severe impairment (group 2). Pneumothorax occurred in 26 of 126 procedures (20.6%) with drainage needed in 11 (8.7%). In group 2 pneumothorax occurred in 19 of 63 procedures (30.15%) with drainage needed in 11 (17.5%). The sensitivity, specificity and diagnostic accuracy of cytology results were 93.6, 100 and 94.4%, respectively. FEV1 (p=0.014), FEV1/FVC (p=0.005), FEF25-75 (p=0.001), DLCO (p=0.013) and presence of emphysema on CT (p<0.001) correlated with pneumothorax (Students t test). The 25-G lung FNAB is accurate and safe in diagnosing malignancy in patients with severe lung functional abnormality. Patients with moderate to severe airway obstruction have a higher prevalence of pneumothorax than patients with mild or no functional impairment

  13. Proposal for a novel management of indeterminate thyroid nodules on the basis of cytopathological subclasses.

    Science.gov (United States)

    Rossi, Martina; Lupo, Sabrina; Rossi, Roberta; Franceschetti, Paola; Trasforini, Giorgio; Bruni, Stefania; Tagliati, Federico; Buratto, Mattia; Lanza, Giovanni; Damiani, Luca; Degli Uberti, Ettore; Zatelli, Maria Chiara

    2017-07-01

    Indeterminate thyroid nodules include heterogeneous lesions that could benefit from a differential management. Our aim is to better define the management of the Bethesda System for Reporting Thyroid Cytopathology class III and IV nodules, by identifying cytological subcategories among Bethesda System for Reporting Thyroid Cytopathology class III associated with different clinical risk, by means of ultrasound, repeated FNAB, and BRAFV600E molecular analysis. We also evaluated the outcome of nodules not operated, over a 5-year follow-up. Out of 460 nodules (269 Bethesda System for Reporting Thyroid Cytopathology class III and 191 Bethesda System for Reporting Thyroid Cytopathology class IV), 344 were operated on surgical group and 116 followed-up conservatively (follow-up group). Bethesda System for Reporting Thyroid Cytopathology class III was divided into four subcategories on the basis of cytomorphological features (III-1, III-2, III-3, III-4). Clinical risk was defined on the basis of histological, cytological, and ultrasound data. Malignancy was higher in Bethesda System for Reporting Thyroid Cytopathology class III vs. Bethesda System for Reporting Thyroid Cytopathology class IV (34.4 vs. 26.2 %; p management of Bethesda System for Reporting Thyroid Cytopathology III and IV classes and related subcategories: surgery may be indicated in Bethesda System for Reporting Thyroid Cytopathology class III-1, III-4, and IV; a conservative follow-up avoiding repeated FNAB may be appropriated in class III-3, while repeated FNAB may be useful in class III-2.

  14. A Comparison between 18F-FDG PET/CT Imaging and Biological and Radiological Findings in Restaging of Hepatoblastoma Patients

    Directory of Open Access Journals (Sweden)

    Angelina Cistaro

    2013-01-01

    Full Text Available Background. In this study we retrospectively evaluated if 18F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging. Procedure. Nine patients (mean age: 5.9 years; range: 3.1–12 years surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard. Results. α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but 18F-FDG-PET/CT provided a better definition of disease extent; in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. 18F-FDG-PET/CT showed an agreement of 100% (8/8 with FNAB results. Conclusions. 18F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients.

  15. Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma

    DEFF Research Database (Denmark)

    Norling, Rikke; Buron, Birgitte Marie Due; Therkildsen, Marianne Hamilton

    2014-01-01

    INTRODUCTION: Clinical staging of patients with oral squamous cell carcinoma (OSCC) is crucial for the choice of treatment. Computed tomography (CT) and/or magnetic resonance imaging (MRI) are typically recommended and used for staging of the cervical lymph nodes (LNs). Although ultrasonography (US...

  16. Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U

    2015-01-01

    PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...

  17. The accumulation of regulatory T cells in the hepatic hilar lymph nodes in biliary atresia.

    Science.gov (United States)

    Sakamoto, Naoya; Muraji, Toshihiro; Ohtani, Haruo; Masumoto, Kouji

    2017-10-01

    A proposed etiopathogenesis of biliary atresia (BA) involves T-cell-mediated inflammatory bile duct damage and progressive hepatic fibrosis. Pediatric surgeons often observe swelling of the hepatic hilar lymph nodes during the Kasai procedure. Given the importance of regulatory mechanisms in immune responses, the present study was designed to analyze the quantitative changes of regulatory T cells (T reg cells) in the hepatic hilar lymph nodes (hepatic hilar LNs) and peripheral blood (PB) in BA. The hepatic hilar LNs and PB obtained during the Kasai procedure were analyzed by flow cytometry. The ratios of total and active Tregs to the total CD4 + cells in the PB and the hepatic hilar LNs were compared. In patients with BA, the ratios of both the total and active T reg cells in the hepatic hilar LNs were higher than those in the PB (total T reg cells: PB vs. LN; P hilar lymph nodes of BA patients. This finding could shed light on the pathogenesis of BA.

  18. A scintillating fibre-based profiler for low intensity ion beams

    Energy Technology Data Exchange (ETDEWEB)

    Finocchiaro, P. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Amato, A. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Ciavola, G. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Cuttone, G. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Gu, M. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Raia, G. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Rovelli, A. [Istituto Nazionale di Fisica Nucleare, Catania (Italy)

    1997-01-11

    In the framework of the EXCYT radioactive ion beam facility, now under development at LNS Catania, we have developed a new beam profile monitor based on a scintillating fibre and a photodetector. Its sensitivity allows the detection of single beam particles in pulse mode, thus representing a useful tool for diagnostics of low and very low intensity beams. (orig.).

  19. A scintillating fibre-based profiler for low intensity ion beams

    International Nuclear Information System (INIS)

    Finocchiaro, P.; Amato, A.; Ciavola, G.; Cuttone, G.; Gu, M.; Raia, G.; Rovelli, A.

    1997-01-01

    In the framework of the EXCYT radioactive ion beam facility, now under development at LNS Catania, we have developed a new beam profile monitor based on a scintillating fibre and a photodetector. Its sensitivity allows the detection of single beam particles in pulse mode, thus representing a useful tool for diagnostics of low and very low intensity beams. (orig.)

  20. At the ISR intersection I-4 and Split-Field Magnet Facility.

    CERN Multimedia

    1983-01-01

    Five experiments were still taking data in the last year of the ISR life (as a collider): R418 - study of light-ion collisions; R419 - study of events with forward identified particles; R420 - ln(s) physics in ppbar collisions; R421 - comparison of pp and ppbar collisions; R422 - heavy flavour production.

  1. Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the posiitive effect of lipid-based nutrient supplements on breast milk B-vitamins

    Science.gov (United States)

    Background: There is little information on B-vitamin concentrations in human milk or how they are affected by maternal B-vitamin deficiencies, antiretroviral (ARV) therapy or maternal supplementation. Objective: To evaluate effects of ARV therapy and/or lipid-based nutrient supplements (LNS) on B-v...

  2. Multiplicites associated with the production of pions, kaons or protons of high transverse momentum, at the ISR

    International Nuclear Information System (INIS)

    Alper, B.; Aston, D.; Clark, A.G.; Duke, P.J.; Evans, W.M.; Gee, C.N.P.; Gray, R.J.; Groves, E.S.; Holloway, L.E.; Jackson, J.N.; Morris, J.V.; Ott, R.J.; Rock, S.E.; Shah, T.P.; Shave, A.J.; Thresher, J.J.; Wenzel, W.A.

    1976-01-01

    The mean charged multiplicity (M) in the Central Region, associated with high-Psub(T) π +- , K +- , p or antip at 90 0 , shows a linear dependence on ln(s) and Psub(T), and depends on the particle type. (author)

  3. Context-Dependent Development of Lymphoid Stroma from Adult CD34+ Adventitial Progenitors

    DEFF Research Database (Denmark)

    Sitnik, Katarzyna Maria; Wendland, Kerstin; Weishaupt, Holger

    2016-01-01

    Despite the key role of primary and secondary lymphoid organ stroma in immunity, our understanding of the heterogeneity and ontogeny of these cells remains limited. Here, we identify a functionally distinct subset of BP3-PDPN+PDGFRβ+/α+CD34+ stromal adventitial cells in both lymph nodes (LNs...

  4. Fund af lymfeknuder ved kolorektal cancer

    DEFF Research Database (Denmark)

    Schmidt, Mads Bo; Engel, Ulla; Mogensen, Anne Mellon

    2009-01-01

    that may influence the detection of LNs, including patient- as well as surgeon- and pathologist-related issues. The pathologist-related variable most probably shapes the yield the most. Introduction of guidelines focusing on the most appropriate technique may secure better and more consistent results...

  5. A new method for the determination of very small Γγ partial widths

    Science.gov (United States)

    Cardella, Giuseppe; Acosta, Luis; Auditore, Lucrezia; Camaiani, Alberto; Filippo, Enrico De; Luca, Saverio De; Gelli, Nicla; Gnoffo, Brunilde; Favela, Francisco; Fornal, Bogdan; Lanzalone, Gaetano; Leoni, Silvia; Maiolino, Concetta; Martorana, Nunzia Simona; Nannini, Adriana; Norella, Sebastianella; Pagano, Angelo; Pagano, Emanuele Vincenzo; Papa, Massimo; Pirrone, Sara; Politi, Giuseppe; Porto, Francesco; Quattrocchi, Lucia; Rizzo, Francesca; Russotto, Paolo; Santonocito, Domenico; Trifirò, Antonio; Trimarchì, Marina

    2018-01-01

    We present a new method for the measurement of very small Γγ partial width that is important for the synthesis of elements in astrophysics. The method is based on the simultaneous detection of scattered beam, residual nucleus and decay γ rays. This method is optimized for the use of the CHIMERA detector at LNS. Experimental details are described.

  6. Thymic and lymph node mesenchymal subsets can be derived from PDGFRα/β+Gp38+CD34+ICAM1- vascular adventitial precursors

    DEFF Research Database (Denmark)

    Sitnik, Katarzyna Maria; Wendland, Kerstin; Weishaupt, Holger

    While discrete Gp38- and Gp38+ mesenchymal populations have previously been described in the lymph nodes (LNs) and in the thymus the putative relationship between LN and thymic mesenchymal cells remains unclear. Here, using transcriptome profiling as well as phenotypic and localization studies we...

  7. Diversity and wiring variability of visual local neurons in the Drosophila medulla M6 stratum.

    Science.gov (United States)

    Chin, An-Lun; Lin, Chih-Yung; Fu, Tsai-Feng; Dickson, Barry J; Chiang, Ann-Shyn

    2014-12-01

    Local neurons in the vertebrate retina are instrumental in transforming visual inputs to extract contrast, motion, and color information and in shaping bipolar-to-ganglion cell transmission to the brain. In Drosophila, UV vision is represented by R7 inner photoreceptor neurons that project to the medulla M6 stratum, with relatively little known of this downstream substrate. Here, using R7 terminals as references, we generated a 3D volume model of the M6 stratum, which revealed a retinotopic map for UV representations. Using this volume model as a common 3D framework, we compiled and analyzed the spatial distributions of more than 200 single M6-specific local neurons (M6-LNs). Based on the segregation of putative dendrites and axons, these local neurons were classified into two families, directional and nondirectional. Neurotransmitter immunostaining suggested a signal routing model in which some visual information is relayed by directional M6-LNs from the anterior to the posterior M6 and all visual information is inhibited by a diverse population of nondirectional M6-LNs covering the entire M6 stratum. Our findings suggest that the Drosophila medulla M6 stratum contains diverse LNs that form repeating functional modules similar to those found in the vertebrate inner plexiform layer. © 2014 Wiley Periodicals, Inc.

  8. Autocrine CCL19 blocks dendritic cell migration toward weak gradients of CCL21

    DEFF Research Database (Denmark)

    Hansen, Morten; Met, Özcan; Larsen, Niels Bent

    2016-01-01

    Background aims. Maturation of dendritic cells (DCs) induces their homing from peripheral to lymphatic tissues guided by CCL21. However, in vitro matured human monocyte-derived DC cancer vaccines injected intradermally migrate poorly to lymph nodes (LNs). In vitro maturation protocols generate DCs...

  9. Effects of Cannabinoid Exposure during Adolescence on the Conditioned Rewarding Effects of WIN 55212-2 and Cocaine in Mice: Influence of the Novelty-Seeking Trait

    Directory of Open Access Journals (Sweden)

    M. Rodríguez-Arias

    2016-01-01

    Full Text Available Adolescent exposure to cannabinoids enhances the behavioural effects of cocaine, and high novelty-seeking trait predicts greater sensitivity to the conditioned place preference (CPP induced by this drug. Our aim was to evaluate the influence of novelty-seeking on the effects of adolescent cannabinoid exposure. Adolescent male mice were classified as high or low novelty seekers (HNS and LNS in the hole-board test. First, we evaluated the CPP induced by the cannabinoid agonist WIN 55212-2 (0.05 and 0.075 mg/kg, i.p. in HNS and LNS mice. Then, HNS and LNS mice were pretreated i.p. with vehicle, WIN 55212-2 (0.1 mg/kg, or cannabinoid antagonist rimonabant (1 mg/kg and were subsequently conditioned with WIN 55212-2 (0.05 mg/kg, i.p. or cocaine (1 or 6 mg/kg, i.p.. Only HNS mice conditioned with the 0.075 mg/kg dose acquired CPP with WIN 55212-2. Adolescent exposure to this cannabinoid agonist increased the rewarding effects of 1 mg/kg of cocaine in both HNS and LNS mice, and in HNS mice it also increased the reinstating effect of a low dose of cocaine. Our results endorse a role for individual differences such as a higher propensity for sensation-seeking in the development of addiction.

  10. Mise au point

    African Journals Online (AJOL)

    RND), a metastatic lymph node was found in 9 cases. One hundred forty patients underwent uni or bilateral LNS, ... Les aires ganglionnaires étaient libres dans tous les cas. Une para- lysie récurrentielle unilatérale était notée chez 1 patient.

  11. Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Wook; Choi, Dong Gil; Kim, Kyoung Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-07-15

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  12. Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

    International Nuclear Information System (INIS)

    Choi, Jin Wook; Choi, Dong Gil; Kim, Kyoung Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin

    2012-01-01

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  13. The SINQ data acquisition environment

    Energy Technology Data Exchange (ETDEWEB)

    Maden, D [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1996-11-01

    The data acquisition environment for the neutron scattering instruments supported by LNS at SINQ is described. The intention is to provide future users with the necessary background to the computing facilities on site rather than to present a user manual for the on-line system. (author) 5 figs., 6 refs.

  14. Effect of village-wide use of long-lasting insecticidal nets on visceral Leishmaniasis vectors in India and Nepal: a cluster randomized trial.

    Science.gov (United States)

    Picado, Albert; Das, Murari L; Kumar, Vijay; Kesari, Shreekant; Dinesh, Diwakar S; Roy, Lalita; Rijal, Suman; Das, Pradeep; Rowland, Mark; Sundar, Shyam; Coosemans, Marc; Boelaert, Marleen; Davies, Clive R

    2010-01-26

    Visceral leishmaniasis (VL) control in the Indian subcontinent is currently based on case detection and treatment, and on vector control using indoor residual spraying (IRS). The use of long-lasting insecticidal nets (LN) has been postulated as an alternative or complement to IRS. Here we tested the impact of comprehensive distribution of LN on the density of Phlebotomus argentipes in VL-endemic villages. A cluster-randomized controlled trial with household P. argentipes density as outcome was designed. Twelve clusters from an ongoing LN clinical trial--three intervention and three control clusters in both India and Nepal--were selected on the basis of accessibility and VL incidence. Ten houses per cluster selected on the basis of high pre-intervention P. argentipes density were monitored monthly for 12 months after distribution of LN using CDC light traps (LT) and mouth aspiration methods. Ten cattle sheds per cluster were also monitored by aspiration. A random effect linear regression model showed that the cluster-wide distribution of LNs significantly reduced the P. argentipes density/house by 24.9% (95% CI 1.80%-42.5%) as measured by means of LTs. The ongoing clinical trial, designed to measure the impact of LNs on VL incidence, will confirm whether LNs should be adopted as a control strategy in the regional VL elimination programs. The entomological evidence described here provides some evidence that LNs could be usefully deployed as part of the VL control program. ClinicalTrials.gov CT-2005-015374.

  15. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

    Science.gov (United States)

    van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

    2017-08-01

    Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

  16. Large Neighborhood Search and Adaptive Randomized Decompositions for Flexible Jobshop Scheduling

    DEFF Research Database (Denmark)

    Pacino, Dario; Van Hentenryck, Pascal

    2011-01-01

    This paper considers a constraint-based scheduling approach to the flexible jobshop, a generalization of the traditional jobshop scheduling where activities have a choice of machines. It studies both large neighborhood (LNS) and adaptive randomized de- composition (ARD) schemes, using random...

  17. Lymph Nodes and Cancer Metastasis: New Perspectives on the Role of Intranodal Lymphatic Sinuses

    Directory of Open Access Journals (Sweden)

    Rui-Cheng Ji

    2016-12-01

    Full Text Available The lymphatic system is essential for transporting interstitial fluid, soluble antigen, and immune cells from peripheral tissues to lymph nodes (LNs. Functional integrity of LNs is dependent on intact lymphatics and effective lymph drainage. Molecular mechanisms that facilitate interactions between tumor cells and lymphatic endothelial cells (LECs during tumor progression still remain to be identified. The cellular and molecular structures of LNs are optimized to trigger a rapid and efficient immune response, and to participate in the process of tumor metastasis by stimulating lymphangiogenesis and establishing a premetastatic niche in LNs. Several molecules, e.g., S1P, CCR7-CCL19/CCL21, CXCL12/CXCR4, IL-7, IFN-γ, TGF-β, and integrin α4β1 play an important role in controlling the activity of LN stromal cells including LECs, fibroblastic reticular cells (FRCs and follicular dendritic cells (DCs. The functional stromal cells are critical for reconstruction and remodeling of the LN that creates a unique microenvironment of tumor cells and LECs for cancer metastasis. LN metastasis is a major determinant for the prognosis of most human cancers and clinical management. Ongoing work to elucidate the function and molecular regulation of LN lymphatic sinuses will provide insight into cancer development mechanisms and improve therapeutic approaches for human malignancy.

  18. Characterization, electrical transport and magnetic properties of the rare earth misfit layer compounds (TbS)(1.21)NbS2, (TbS)(1.20)TaS2, (DyS)(1.22)NbS2 and (DyS)(1.21)TaS2

    NARCIS (Netherlands)

    Zhou, W.Y.; Meetsma, A.; deBoer, J.L.; Wiegers, G.A

    1996-01-01

    X-ray powder and single-crystal X-ray diffraction of the title compounds showed that they are planar intergrowth compounds, built of alternating sandwiches TS2 (T=Nb, Ta) and double layers LnS (Ln=Tb, Dy), present in three orientational variants related by rotations of 120 degrees around the c axis

  19. Is there a common SUV threshold in oncological FDG PET/CT, at least for some common indications? A retrospective study

    International Nuclear Information System (INIS)

    Nguyen, Nghi C.; Kaushik, Aarti; Wolverson, Michael K.; Osman, Medhat M.

    2011-01-01

    Purpose. We retrospectively compared the maximum standard uptake value (SUVmax) of FDG PET in four different sites to evaluate whether a common diagnostic SUVmax threshold may exist in these tumor locations. We further postulate that the SUVmax thresholds are higher in thoracic lesions than in extrathoracic lesions. Material and methods. N = 143 patients in four subgroups underwent a FDG PET/CT: a) 42 patients for solitary pulmonary nodules (SPNs) characterization with b) respective mediastinal lymph nodes (LNs), c) 65 patients for LN staging of head and neck cancer, and d) 36 cancer patients diagnosed with adrenal lesions. Receiver operating characteristics of SUVmax values were evaluated. Results. The SUVmax were statistically significantly greater in malignant than in benign lesions. For SPNs and mediastinal LNs, a SUVmax > 3.6 each resulted in a sensitivity of 81% and 87%, and a specificity of 94% and 89%. For cervical LNs and adrenal glands, a SUVmax > 2.2 each showed a sensitivity of 98% and 100%, and a specificity of 83% and 93%. Conclusion. A common SUVmax threshold did not exist in the four studied subgroups. The variable FDG uptake in SPNs and mediastinal LNs are associated with the high prevalence of inflammation/infection within the chest. Similar SUVmax thresholds however may exist for extrathoracic regions where the prevalence of inflammation/infection is low

  20. Serological markers of sand fly exposure to evaluate insecticidal nets against visceral leishmaniasis in India and Nepal: a cluster-randomi trial

    DEFF Research Database (Denmark)

    Gidwani, K; Picado, A; Rijal, S

    2011-01-01

    Background: Visceral leishmaniasis is the world’ second largest vector-borne parasitic killer and a neglected tropical disease, prevalent in poor communities. Long-lasting insecticidal nets (LNs) are a low cost proven vector intervention method for malaria control; however, their effectiveness...

  1. Maternal cortisol and stress are associated with birth outcomes, but are not affected by lipid-based micronutrient supplements during pregnancy: an analysis of data from a randomized controlled trial in rural Malawi

    Science.gov (United States)

    Background: Prenatal micronutrient supplements have been found to increase birth weight, but mechanisms for increased growth are poorly understood. Our hypotheses were that 1) women who receive lipid-based micronutrient supplements (LNS) during pregnancy would have lower salivary cortisol concentrat...

  2. Poorly-differentiated colorectal neuroendocrine tumour: CT differentiation from well-differentiated neuroendocrine tumour and poorly-differentiated adenocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Hee [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kim, Se Hyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Han, Joon Koo [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2017-09-15

    The differentiation of poorly-differentiated neuroendocrine tumours (PD-NETs), well-differentiated NETs (WD-NETs), and adenocarcinomas (ADCs) is important due to different management options and prognoses. This study is to find the differential CT features of colorectal PD-NETs from WD-NETs and ADCs. CT features of 25 colorectal WD-NETs, 36 PD-NETs, and 36 ADCs were retrospectively reviewed. Significant variables were assessed using univariate and multivariate analyses. Receiver operating characteristics analysis determined the optimal cut-off value of tumour and lymph node (LN) size. Large size, rectum location, ulceroinfiltrative morphology without intact overlying mucosa, heterogeneous attenuation with necrosis, presence of ≥3 enlarged LNs, and metastasis were significant variables to differentiate PD-NETs from WD-NETs (P < 0.05). High attenuation on arterial phase, persistently high enhancement pattern, presence of ≥6 enlarged LNs, large LN size, and wash-in/wash-out enhancement pattern of liver metastasis were significant variables to differentiate PD-NETs from ADCs (P < 0.05). Compared to WD-NETs, colorectal PD-NETs are usually large, heterogeneous, and ulceroinfiltrative mass without intact overlying mucosa involving enlarged LNs and metastasis. High attenuation on arterial phase, presence of enlarged LNs with larger size and greater number, and wash-in/wash-out enhancement pattern of liver metastasis can be useful CT discriminators of PD-NETs from ADCs. (orig.)

  3. The SINQ data acquisition environment

    International Nuclear Information System (INIS)

    Maden, D.

    1996-01-01

    The data acquisition environment for the neutron scattering instruments supported by LNS at SINQ is described. The intention is to provide future users with the necessary background to the computing facilities on site rather than to present a user manual for the on-line system. (author) 5 figs., 6 refs

  4. Thomson Parabola Spectrometer: a powerful tool to get on-line plasma information

    International Nuclear Information System (INIS)

    Altana, C.; Schillaci, F.; Anzalone, A.; Cirrone, G.A.P; Tudisco, S.; Lanzalone, G.; Muoio, A.

    2015-01-01

    In this contribution we report the results of an experimental measurement performed with a TPS developed at INFN-LNS within the ELIMED project, by means of a powerful and self-consistent technique as a diagnostic tool for the ionic acceleration study in laser-generated-plasmas. (authors)

  5. Thomson Parabola Spectrometer: a powerful tool to get on-line plasma information

    Energy Technology Data Exchange (ETDEWEB)

    Altana, C. [Laboratori Nazionali del Sud - INFN - Catania (Italy); Universita degli Studi di Catania - Dip.to di Fisica e Astronomia - Catania (Italy); Schillaci, F.; Anzalone, A.; Cirrone, G.A.P; Tudisco, S. [Laboratori Nazionali del Sud - INFN - Catania (Italy); Lanzalone, G. [Laboratori Nazionali del Sud - INFN - Catania (Italy); Univerita Kore di Enna - Enna (Italy); Muoio, A. [Laboratori Nazionali del Sud - INFN - Catania (Italy); Universita degli Studi di Messina - Dip.to di Fisica e di Scienze della Terra - Messina (Italy)

    2015-07-01

    In this contribution we report the results of an experimental measurement performed with a TPS developed at INFN-LNS within the ELIMED project, by means of a powerful and self-consistent technique as a diagnostic tool for the ionic acceleration study in laser-generated-plasmas. (authors)

  6. [Renal oncocytoma in the single kidney after previous surgery of renal carcinoma. Apropos of 2 cases].

    Science.gov (United States)

    Veneroni, L; Canclini, L; Berti, G L; Giola, V; Leidi, G L; Maccaroni, A; Raimoldi, A; Sironi, M; Assi, A; Bacchioni, A M

    1997-12-01

    Renal oncocytoma is a neoplasm which rarely occurs in patients with solitary kidney, the other being absent because of a previous nephrectomy performed for renal cancer. We present two case reports and a literature review. We have studied some important problems such as the histogenesis, the potential for malignancy, the diagnosis, the treatment and the follow up. The high incidence of coexistence of renal oncocytoma and renal cell carcinoma has important clinical implications. We would like to emphasize the importance of preoperatory FNAB, nephron sparing surgery and very careful follow up.

  7. Ultrasonography-guided fine-needle aspiration biopsy for thyroid nodules: effective technique and a peculiar smear method

    International Nuclear Information System (INIS)

    Park, Kyeong Rok; Rho, Myung Ho; Kim, Dong Wook; Koo, Yong Woon; Lee, Kyeong Hee; Kang, Tae Woo

    2006-01-01

    We wanted to evaluate the effective methods that are appropriate for an endemic area of thyroid disease and to compare the differences of cytologic diagnostic rates with and without using a peculiar smear technique. We analyzed the incidence rate of insufficient results, complications and the total procedure times of 1,126 thyroid nodules in 776 patients who underwent US-FNAB (ultrasonography-guided fine-needle aspiration biopsy) from January to December 2005. We compared the diagnostic rate between the two groups; the groups' tests were performed with a peculiar smear technique (Group A, n 313) or with a ventional smear technique (Group B, n = 250). According to the size of the thyroid nodule, the incidence rate of an insufficient result on US-FNAB and the mean total procedure time for 1126 thyroid nodules in 776 patients were measured as 16.9% (52/308) and 208 seconds for nodules under 0.5 cm, 9.8% (30/306) and 160 seconds for nodules between 0.5 cm-10 cm, and 6.0% (30/504) and 134 seconds for nodules over 1.0 cm. These 776 patients showed no significant complication, except for mild pain. In Group A, the incidence rate of an insufficient result was calculated as 15.1% (14/93) for the group with nodules under 0.5 cm, 5.3% (5/95) for the group with nodules between 0.5 cm-1.0 cm, 4.8% (6/125) for the group with nodules over 1.0 cm, and 8.0% (25/313) for the total A Group. In Group B, the incidence rate of an insufficient result was measured as 33.3% (15/45) for the group with nodules under 0.5 cm, 28.1% (25/89) for the group with nodules between 0.5 cm-1.0 cm, 21.4% (24/112) for the group with nodules over 1.0 cm, and 25.7% (63/245) for the total B group. There was a statistically significant correlation between the rate of an insufficient result and the peculiar smear technique or the size of the thyroid nodule. We consider that US-FNAB is very simple, safe and accurate diagnostic method for thyroid nodules, and US-FNAB with a peculiar smear technique is able to

  8. Granular cell tumor of the breast: a report of the three cases

    International Nuclear Information System (INIS)

    Mellado, M.; Pina, L.; Cojo, R.; Arias-Camison, I.

    2000-01-01

    Granular cell tumors (GCT) of the breast are uncommon benign neoplasms that are usually indistinguishable from breast cancer with respect to their clinical and radiological presentation. FNAB can be a usefull diagnostic tool, but histological examination is essential for the correct diagnosis. This benign tumor should be considered among the diagnostic possibilities in the presence of a lesion with mammographic and ultrasonographic indications of highly probable malignancy. We present three cases of breast GCT that mimicked primary breast cancer. Benign neoplasm was diagnosed and local excision was carried out rather than mastectomy and lymphadenectomy. (Author) 9 refs

  9. Sentinel lymph node biopsy in breast cancer--experience with the combined use of dye and radioactive tracer at Aarhus University Hospital

    DEFF Research Database (Denmark)

    Lauridsen, Mette Cathrine; Garne, Jens Peter; Sørensen, Flemming Brandt

    2004-01-01

    -needle aspiration biopsy (FNAB) were not included. For identifying the SLNs, a combination of Tc-99m-labelled human albumin (Solco-ALBU-RES) and blue dye (Patent Blue V) was used. No lymphoscintigraphy was performed. The SLN was successfully identified in 122 out of 124 (98%) patients and 66 (54%) patients were...... found to have metastatic involvement of the axillary lymph nodes. In 52 (79%) of these patients, the SLNs were the only nodes involved, 28 (54%) had micrometastasis only. The false-negative rate was 1.5%. This method has proven valid in the staging of the axilla in patients with breast cancer...

  10. Effectiveness of food supplements in increasing fat-free tissue accretion in children with moderate acute malnutrition: A randomised 2 × 2 × 3 factorial trial in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Christian Fabiansen

    2017-09-01

    Full Text Available Children with moderate acute malnutrition (MAM are treated with lipid-based nutrient supplement (LNS or corn-soy blend (CSB. We assessed the effectiveness of (a matrix, i.e., LNS or CSB, (b soy quality, i.e., soy isolate (SI or dehulled soy (DS, and (c percentage of total protein from dry skimmed milk, i.e., 0%, 20%, or 50%, in increasing fat-free tissue accretion.Between September 9, 2013, and August 29, 2014, a randomised 2 × 2 × 3 factorial trial recruited 6- to 23-month-old children with MAM in Burkina Faso. The intervention comprised 12 weeks of food supplementation providing 500 kcal/day as LNS or CSB, each containing SI or DS, and 0%, 20%, or 50% of protein from milk. Fat-free mass (FFM was assessed by deuterium dilution technique. By dividing FFM by length squared, the primary outcome was expressed independent of length as FFM index (FFMI accretion over 12 weeks. Other outcomes comprised recovery rate and additional anthropometric measures. Of 1,609 children, 4 died, 61 were lost to follow-up, and 119 were transferred out due to supplementation being switched to non-experimental products. No children developed allergic reaction. At inclusion, 95% were breastfed, mean (SD weight was 6.91 kg (0.93, with 83.5% (5.5 FFM. In the whole cohort, weight increased 0.90 kg (95% CI 0.88, 0.93; p 0.05. LNS compared to CSB resulted in 128 g (95% CI 67, 190; p < 0.01 greater weight gain if both contained SI, but there was no difference between LNS and CSB if both contained DS (mean difference 22 g; 95% CI -40, 84; p = 0.49 (interaction p = 0.017. Accordingly, SI compared to DS increased weight by 89 g (95% CI 27, 150; p = 0.005 when combined with LNS, but not when combined with CSB. A limitation of this and other food supplementation trials is that it is not possible to collect reliable data on individual adherence.Based on this study, children with MAM mainly gain fat-free tissue when rehabilitated. Nevertheless, LNS yields more fat-free tissue and

  11. Consideration of myocardial FDG uptake in differentiation of mediastinal lymph node of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Eo, Jae Seon; Lee, Won Woo; Chung, Jin Haeng; So, Young; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun

    2004-01-01

    The whole body FDG PET suffers from poor diagnostic competency in differentiation of mediastinal lymph node (LN) in non-small cell lung cancer. In addition to LN FDG uptake. We considered myocardial FDG uptake in mediastinal lymph node staging. Thirty-nine non-small cell lung cancer patients (male: female = 32: 7, age = 63±11 years) who underwent preoperative whole body FDG PET were enrolled. There were 18 squamous cell cancer, 13 adenocarcinoma, and 8 others. Maximum standard uptake values (maxSUVs) of myocardium and LNs using lean body weight were measured and compared with pathological results. Among 187 LNs which were confirmed postoperatively, 31 were malignant, and 156 benign. Of 31 malignant LNs, only 11 were visible on FDG PET (sensitivity : 35.5% = 11/31) but majority of 20 nonvisible metastatic LNs had relevant cause of false negative (11 peribroncheal, 3 mucine producing adenocarcinoma, or 6 low amount of tumor cells). Of 156 benign LNs, 137 were nonvisible (specificity : 87.8% 137/156) and 19 visible. Under subgroup analysis of 30 visible LNs on whole body FDG PET (11 malignant, and 19 benign), maxSUV of myocardium (p = 0.020) as well as maxSUV of LN (p = 0.002) were significant predictor of malignant LN in multivariate analysis. Using the ROC curve, a cut-off value of LN maxSUV > 2.4 provided sensitivity of 81.8% and specificity of 63.2% (AUC 0.775, 95% confidence interval = 0.586 to 0.906). Meanwhile, the composite criterion of LN maxSUV plus square root of myocardial maxSUV > 4.65 provided slightly improved diagnostic competencies (sensitivity 90.9%, specificity 84.2%, AUC 0.876, 95% confidence interval 0.704 to 0.966) (p = 0.08). Taking into consideration myocardial FDG uptake may improve the diagnostic competency of whole body FDG PET in differentiation of mediastinal LNs of non-small cell lung cancer

  12. Designing Targets for Elective Nodal Irradiation in Lung Cancer Radiotherapy: A Planning Study

    International Nuclear Information System (INIS)

    Kepka, Lucyna; Tatro, Daniel; Moran, Jean M.; Quint, Leslie E.; Hayman, James A.; Ten Haken, Randall K.; Kong Fengming

    2009-01-01

    Purpose: To assess doses received by mediastinal and hilar lymph node stations (LNS) delineated according to published recommendations when 'standard' two-dimensional (2D) elective fields are applied and to assess doses to critical structures when fields are designed using 2D and three-dimensional (3D) treatment planning for elective irradiation. Methods and Materials: LNS were delineated on axial CT scans according to existing recommendations. For each case and tumor location, 2D anteroposterior-posteroanterior (AP-PA) elective fields were applied using the AP-PA CT topograms. From the 2D portal fields, 3D dose distributions were then calculated to particular LNS. Next, 3D plans were prepared for elective nodal irradiation for tumors of different lobes. Doses for critical structures were compared for 2D and 3D plans. Results: LNS 1/2R, 1/2L, 3A, 3P, 5, 6, and 8 were not adequately covered in a substantial part of plans by standard 2D portals when guidelines for delineation were strictly followed. The magnitude of the lack of coverage increased with margin application. There was a trend for a higher yet probably still safe dose delivered to lung for 3D plans compared with 2D plans with a prescription dose of 45 Gy. Conclusions: 2D fields did not entirely cover LNS delineated according to the recommendations for 3D techniques. A strict adherence to these guidelines may lead to larger portals than traditionally constructed using 2D methods. Some modifications for clinical implementation are discussed.

  13. Impact of splenic hilar lymph node metastasis on prognosis in patients with advanced gastric cancer.

    Science.gov (United States)

    Son, Taeil; Kwon, In Gyu; Lee, Joong Ho; Choi, Youn Young; Kim, Hyoung-Il; Cheong, Jae-Ho; Noh, Sung Hoon; Hyung, Woo Jin

    2017-10-13

    Impact of splenic hilar LN dissection during total gastrectomy for proximal advanced gastric cancer is controversial. The objective of this study was to assess the impact on prognosis of splenic hilar lymph node(LN) metastasis compared to that of metastasis to other regional LN groups. Patients who underwent total gastrectomy with D2 LN dissection from 2000 to 2010 were reviewed retrospectively. The clinicopathologic characteristics and long-term results of patients with splenic hilar LN metastasis were compared to those of patients with only metastasis to other extraperigastric LNs (stations #8a, #9, #11, or #12a). To investigate the survival benefit of performing splenic hilar LN dissection, the estimated therapeutic index for the procedure was calculated by multiplying the incidence of metastases in the hilar region by the survival rates for individuals with nodal involvement in that region. Of 602 patients, 87(14.5%) had hilar LN metastasis. The 5-year overall and relapse-free survival rates for patients with hilar LN metastasis were 24.1% and 12.1%, respectively. These rates were similar to those for patients with metastasis to other extraperigastric LNs ( P > 0.05), with similar recurrence patterns. Overall survival in the hilar LN metastasis group was better than that for patients with distant metastasis( P hilar LN dissection was 3.5, which was similar to index values for LN dissection at other extraperigastric LNs. Dissection of splenic hilar LNs during total gastrectomy for advanced gastric cancer allows for a prognosis similar to that achieved with dissection of extraperigastric LNs.

  14. Primary simian immunodeficiency virus SIVmnd-2 infection in mandrills (Mandrillus sphinx).

    Science.gov (United States)

    Onanga, Richard; Souquière, Sandrine; Makuwa, Maria; Mouinga-Ondeme, Augustin; Simon, François; Apetrei, Cristian; Roques, Pierre

    2006-04-01

    Mandrills are the only nonhuman primate (NHP) naturally infected by two types of simian immunodeficiency virus (SIV): SIVmnd-1 and SIVmnd-2. We have already reported that the high SIVmnd-1 replication during primary infection contrasts with only transient changes in CD4+ and CD8+ cell counts. Since early virus-host interactions predict viral control and disease progression in human immunodeficiency virus-infected patients, we investigated the dynamics of SIVmnd-2 primary infection in mandrills to examine the impact on immune effectors in blood and lymph nodes (LNs). To avoid in vitro strain selection, all mandrills in this study received plasma from SIVmnd-2-infected mandrills. SIVmnd-2 plasma viremia peaked at 10(7) to 10(8) RNA copies/ml between days 7 and 10. This peak was followed in all four monkeys by a decline in virus replication, with a set point level of 10(5) to 10(6) RNA copies/ml at day 42 postinfection (p.i.). Viral DNA load in PBMC and LNs also peaked between days 7 and 10 (10(5) to 10(6) DNA copies/10(6) cells) and stabilized at 10(3) to 10(4) DNA copies/10(6) cells during the chronic phase. Anti-SIVmnd-2 antibodies were detected starting from days 28 to 32. A transitory decline of CD3+ CD4+ cells in the LNs occurred in animals with high peak VLs. CD4+ and CD8+ T-cell activation in blood and LNs was noted between days 5 and 17 p.i., surrounding the peak of viral replication. This was most significant in the LNs. Activation markers then returned to preinfection values despite continuous and active viral replication during the chronic infection. The dynamics of SIVmnd-2 infection in mandrills showed a pattern similar to that of SIVmnd-1 infection. This might be a general feature of nonpathogenic SIV natural African NHP models.

  15. The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

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    Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (United States); Brinkmann, Debra H.; Ward, Shelly B. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Durski, Jolanta [Department of Radiology, Nuclear Medicine Program, Mayo Clinic, Rochester, Minnesota (United States); Laack, Nadia N.; Yan, Elizabeth; Schomberg, Paula J.; Garces, Yolanda I. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Suman, Vera J. [Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota (United States); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2013-03-15

    Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.

  16. The addition of SPECT/CT lymphoscintigraphy to breast cancer radiation planning spares lymph nodes critical for arm drainage.

    Science.gov (United States)

    Cheville, Andrea L; Brinkmann, Debra H; Ward, Shelly B; Durski, Jolanta; Laack, Nadia N; Yan, Elizabeth; Schomberg, Paula J; Garces, Yolanda I; Suman, Vera J; Petersen, Ivy A

    2013-03-15

    This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial.

    Science.gov (United States)

    Tesfaye, Markos; Kaestel, Pernille; Olsen, Mette Frahm; Girma, Tsinuel; Yilma, Daniel; Abdissa, Alemseged; Ritz, Christian; Michaelsen, Kim F; Hanlon, Charlotte; Friis, Henrik

    2016-06-01

    To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART) and to investigate the effects of timing of supplementation by comparing with supplementation during the subsequent 3 months. A randomised controlled trial was conducted in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17 kg/m(2) and given daily supplements of 200 g of LNS containing whey or soya either during the first 3 months or the subsequent months of ART. The outcome was measured in terms of total quality-of-life scores on the adapted version of the WHOQOL-HIV-BREF assessed at baseline, three and six months. Of the 282 participants, 186 (66.0%) were women. The mean age (SD) was 32.8 (±9.0) years, and the mean (SD) total quality-of-life score was 82.0 (±14.8) at baseline assessment. At 3 months, participants who received LNS showed better quality of life than those who only received ART without LNS (β = 6.2, 95% CI: 2.9: 9.6). At 6 months, there was no difference in total quality-of-life score between the early and delayed supplementation groups (β = 3.0, 95% CI: -0.4: 6.4). However, the early supplementation group showed higher scores on the social and spirituality domains than the delayed group. LNS given during the first three months of ART improves the quality of life of PLHIV. © 2016 John Wiley & Sons Ltd.

  18. Endoscopic tattooing of early colon carcinoma enhances detection of lymph nodes most prone to harbor tumor burden.

    Science.gov (United States)

    Aldecoa, Iban; Montironi, Carla; Planell, Nuria; Pellise, Maria; Fernandez-Esparrach, Gloria; Gines, Angels; Delgado, Salvadora; Momblan, Dulce; Moreira, Leticia; Lopez-Ceron, Maria; Rakislova, Natalia; Martinez-Palli, Graciela; Balust, Jaume; Bombi, Josep Antoni; de Lacy, Antonio; Castells, Antoni; Balaguer, Francesc; Cuatrecasas, Miriam

    2017-02-01

    Colorectal cancer (CRC) screening programs result in the detection of early-stage asymptomatic carcinomas suitable to be surgically cured. Lymph nodes (LN) from early CRC are usually small and may be difficult to collect. Still, at least 12 LNs should be analyzed from colectomies, to ensure a reliable pN0 stage. Presurgical endoscopic tattooing improves LN procurement. In addition, molecular detection of occult LN tumor burden in histologically pN0 CRC patients is associated with a decreased survival rate. We aimed to study the impact of presurgical endoscopic tattooing on the molecular detection of LN tumor burden in early colon neoplasms. A prospective cohort study from a CRC screening-based population was performed at a tertiary academic hospital. LNs from colectomies with and without preoperative endoscopic tattooing were assessed by two methods, hematoxylin and eosin (HE), and RT-LAMP, to detect tumor cytokeratin 19 (CK19) mRNA. We compared the amount of tumor burden and LN yields from tattooed and non-tattooed specimens. HE and RT-LAMP analyses of 936 LNs were performed from 71 colectomies containing early carcinomas and endoscopically unresectable adenomas (8 pT0, 17 pTis, 27 pT1, 19 pT2); 47 out of 71 (66.2 %) were tattooed. Molecular positivity correlated with the presence of tattoo in LN [p < 0.001; OR 3.1 (95 % CI 1.7-5.5)]. A significantly higher number of LNs were obtained in tattooed specimens (median 17 LN vs. 14.5 LN; p = 0.019). Endoscopic tattooing enables the analysis of those LNs most prone to harbor tumor cells and improves the number of LN harvested.

  19. Associations of maternal nutrition during pregnancy and post-partum with maternal cognition and caregiving.

    Science.gov (United States)

    Prado, Elizabeth L; Ashorn, Ulla; Phuka, John; Maleta, Kenneth; Sadalaki, John; Oaks, Brietta M; Haskell, Marjorie; Allen, Lindsay H; Vosti, Steve A; Ashorn, Per; Dewey, Kathryn G

    2018-04-01

    Pregnant and post-partum women require increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess (a) differences in maternal cognition and caregiving between women in Malawi who received different nutritional supplements, (b) 14 effect modifiers, and (c) associations of cognition and caregiving with biomarkers of iron, Vitamin A, B-vitamin, and fatty acid status. In a randomized controlled trial (n = 869), pregnant women daily received either multiple micronutrients (MMN), 20 g/day lipid-based nutrient supplements (LNS), or a control iron/folic acid (IFA) tablet. After delivery, supplementation continued in the MMN and LNS arms, and the IFA control group received placebo until 6 months post-partum, when cognition (n = 712), caregiving behaviour (n = 669), and biomarkers of nutritional status (n = 283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI [0.01, 0.39], p = .03) higher than the LNS arm in mental rotation. Among subgroups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than the IFA arm in verbal fluency. Breastmilk docosahexaenoic acid and Vitamin B12 concentrations were positively associated with verbal fluency and digit span forward (adjusting for covariates ps < .05). In this population in Malawi, maternal supplementation with MMN or LNS did not positively affect maternal cognition or caregiving. Maternal docosahexaenoic acid and B12 status may be important for post-partum attention and executive function. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  20. Ghanaian parents' perceptions of pre and postnatal nutrient supplements and their effects.

    Science.gov (United States)

    Adams, Katherine P; Okronipa, Harriet; Adu-Afarwuah, Seth; Arimond, Mary; Kumordzie, Sika; Oaks, Brietta M; Ocansey, Maku E; Young, Rebecca R; Vosti, Stephen A; Dewey, Kathryn G

    2018-04-15

    Small-quantity lipid-based nutrient supplements (SQ-LNS) have been studied in efficacy and effectiveness trials, but little is known about how parents perceive the products and their effects. In a randomised trial in Ghana, efficacy of SQ-LNS provided to women during pregnancy and the first 6 months postpartum and to their children from 6 to 18 months of age was assessed by comparison with iron-folic acid (IFA) capsules and multiple micronutrient (MMN) capsules provided to women. In a follow-up study conducted when the index children from the original trial were between 4 and 6 years of age, we used survey-based methods to assess retrospective and current parental perceptions of nutrient supplements generally and of SQ-LNS and their effects compared with perceptions IFA and MMN capsules. Most parents perceived that the assigned supplements (SQ-LNS, IFA, or MMN) positively impacted the mother during pregnancy (approximately 89% of both mothers and fathers) and during lactation (84% of mothers and 86% of fathers). Almost all (≥90%) of mothers and fathers perceived that the assigned supplement positively impacted the index child and expected continued positive impacts on the child's health and human capital into the future. A smaller percentage of parents perceived negative impacts of the supplements (7%-17% of mothers and 4%-12% of fathers). Perceptions of positive impacts and of negative impacts did not differ by intervention group. The results suggest that similar populations would likely be receptive to programs to deliver SQ-LNS or micronutrient capsules. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  1. High Endothelial Venules and Lymphatic Vessels in Tertiary Lymphoid Organs: Characteristics, Functions, and Regulation

    Directory of Open Access Journals (Sweden)

    Nancy H Ruddle

    2016-11-01

    Full Text Available High endothelial venules (HEVs and lymphatic vessels (LVs are essential for the function of the immune system, by providing communication between the body and lymph nodes (LNs, specialized sites of antigen presentation and recognition. HEVs bring in naïve and central memory cells and LVs transport antigen, antigen presenting cells, and lymphocytes in and out of LNs. Tertiary lymphoid organs (TLOs are accumulations of lymphoid and stromal cells that arise and organize at ectopic sites in response to chronic inflammation in autoimmunity, microbial infection, graft rejection, and cancer. TLOs are distinguished from primary lymphoid organs-the thymus and bone marrow, and secondary lymphoid organs (SLOs-the LNs, spleen, and Peyer’s patches, in that they arise in response to inflammatory signals, rather than in ontogeny. TLOs usually do not have a capsule, but are rather contained within the confines of another organ. Their structure, cellular composition, chemokine expression, and vascular and stromal support resemble SLOs and are the defining aspects of TLOs. T and B cells, antigen presenting cells, fibroblast reticular cells and other stromal cells and vascular elements including HEVs and LVs are all typical components of TLOS. A key question is whether the HEVs and LVs play comparable roles and are regulated similarly to those in LNs. Data are presented that support this concept, especially with regard to TLO HEVs. Emerging data suggest that the functions and regulation of TLO LVs are also similar to those in LNs. These observations support the concept that TLOs are not merely cellular accumulations, but are functional entities that provide sites to generate effector cells, and that their HEVs and LVs are crucial elements in those activities.

  2. Acoustic Radiation Force Impulse Imaging for the Differentiation of Benign and Malignant Lymph Nodes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zhang, Peige; Zhang, Li; Zheng, Shaoping; Yu, Cheng; Xie, Mingxing; Lv, Qing

    2016-01-01

    To evaluate the overall performance of acoustic radiation force impulse imaging (ARFI) in differentiating between benign and malignant lymph nodes (LNs) by conducting a meta-analysis. PubMed, Embase, Web of Science, the Cochrane Library and the China National Knowledge Infrastructure were comprehensively searched for potential studies through August 13th, 2016. Studies that investigated the diagnostic power of ARFI for the differential diagnosis of benign and malignant LNs by using virtual touch tissue quantification (VTQ) or virtual touch tissue imaging quantification (VTIQ) were collected. The included articles were published in English or Chinese. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the methodological quality. The pooled sensitivity, specificity, and the area under the summary receiver operating characteristic (SROC) curve (AUC) were calculated by means of a bivariate mixed-effects regression model. Meta-regression analysis was performed to identify the potential sources of between study heterogeneity. Fagan plot analysis was used to explore the clinical utilities. Publication bias was assessed using Deek's funnel plot. Nine studies involving 1084 LNs from 929 patients were identified to analyze in the meta-analysis. The summary sensitivity and specificity of ARFI in detecting malignant LNs were 0.87 (95% confidence interval [CI], 0.83-0.91) and 0.88 (95% CI, 0.82-0.92), respectively. The AUC was 0.93 (95% CI, 0.90-0.95). The pooled DOR was 49.59 (95% CI, 26.11-94.15). Deek's funnel plot revealed no significant publication bias. ARFI is a promising tool for the differentiation of benign and malignant LNs with high sensitivity and specificity.

  3. LFA-1 expression in a series of colorectal adenocarcinomas.

    Science.gov (United States)

    Papas, Maria G; Karatzas, Pantelis S; Papanikolaou, Ioannis S; Karamitopoulou, Evanthia; Delicha, Eumorphia M; Adler, Andreas; Triantafyllou, Konstantinos; Thomopoulou, Georgia-Heleni; Patsouris, Efstratios; Lazaris, Andreas C

    2012-09-01

    LFA-1 is an adhesion molecule which belongs to the β2-integrin family. Overexpression of LFA-1 in hepatic natural killer cells has been associated with increased apoptosis of neoplastic cells in colorectal cancer (CRC); moreover, studies in CRC have linked LFA-1 overexpression in neoplastic cells with vascular intrusion through adhesion to endothelial cells, thus implying a possible role in creation of metastases. We studied the expression of LFA-1 in a series of 82 patients with CRC. A standard three-step immunohistochemical analysis was performed on formalin-fixed, paraffin-embedded tissue sections. An IgG2a anti-CD11a monoclonal antibody was used. Cases were characterized according to clinicopathological variables including sex, age, tumor localization, size, grade, Dukes stage, wall invasion, and presence of metastatic lymph nodes (mLNs) or distal metastases. LFA-1 was expressed at the primary tumor site in 51 cases and 6/33 cases with metastatic lymphnodes. In Dukes D cases (n = 4), only one case was LFA-1(+). LFA-1 expression at the primary tumor site was associated with the absence of metastatic disease and with Dukes B stage. However, in those cases with LFA-1 expression in cancer cells in mLNs, this was associated with its expression at the primary tumor site. The positive association of LFA-1 expression in mLNs when the primary tumor site is also LFA-1(+) could imply an adaptation advantage of this specific cellular clone to its micro-environment, predisposing it to creation of mLNs, pointing to a role for LFA-1 in creation of mLNs in CRC.

  4. Viral CTL escape mutants are generated in lymph nodes and subsequently become fixed in plasma and rectal mucosa during acute SIV infection of macaques.

    Directory of Open Access Journals (Sweden)

    Thomas H Vanderford

    2011-05-01

    Full Text Available SIV(mac239 infection of rhesus macaques (RMs results in AIDS despite the generation of a strong antiviral cytotoxic T lymphocyte (CTL response, possibly due to the emergence of viral escape mutants that prevent recognition of infected cells by CTLs. To determine the anatomic origin of these SIV mutants, we longitudinally assessed the presence of CTL escape variants in two MamuA*01-restricted immunodominant epitopes (Tat-SL8 and Gag-CM9 in the plasma, PBMCs, lymph nodes (LN, and rectal biopsies (RB of fifteen SIV(mac239-infected RMs. As expected, Gag-CM9 did not exhibit signs of escape before day 84 post infection. In contrast, Tat-SL8 escape mutants were apparent in all tissues by day 14 post infection. Interestingly LNs and plasma exhibited the highest level of escape at day 14 and day 28 post infection, respectively, with the rate of escape in the RB remaining lower throughout the acute infection. The possibility that CTL escape occurs in LNs before RBs is confirmed by the observation that the specific mutants found at high frequency in LNs at day 14 post infection became dominant at day 28 post infection in plasma, PBMC, and RB. Finally, the frequency of escape mutants in plasma at day 28 post infection correlated strongly with the level Tat-SL8-specific CD8 T cells in the LN and PBMC at day 14 post infection. These results indicate that LNs represent the primary source of CTL escape mutants during the acute phase of SIV(mac239 infection, suggesting that LNs are the main anatomic sites of virus replication and/or the tissues in which CTL pressure is most effective in selecting SIV escape variants.

  5. Impact of Clinical Salmonellosis in Veal Calves on the Recovery of Salmonella in Lymph Nodes at Harvest.

    Science.gov (United States)

    Muñoz-Vargas, Lohendy; Finney, Sarah K; Hutchinson, Holden; Masterson, Margaret A; Habing, Greg

    2017-11-01

    The objective of this study was to determine the prevalence, serotypes, antimicrobial resistance phenotypes, and pulsed-field gel electrophoresis (PFGE) patterns of Salmonella recovered in feces and mesenteric and prefemoral lymph nodes (LNs) from cohorts of calves with and without a confirmed outbreak of salmonellosis. In a prospective cohort study, 160 calves from four farms without a reported outbreak (nonoutbreak farms) were sampled at farm and harvest. In addition, harvest samples from 80 calves of two farms with a confirmed outbreak (outbreak farms) were collected. A culture protocol for Salmonella isolation was applied for all samples and recovered isolates were further characterized by serotyping, antimicrobial susceptibility testing, and PFGE. Among nonoutbreak farms, Salmonella was recovered from 0% (0/160) farm fecal samples, 3.7% (6/160) harvest fecal swabs, 21.9% (35/160) mesenteric LNs, and 0.6% (1/160) prefemoral LNs. Serotypes identified in nonoutbreak herds included Salmonella Typhimurium, Cerro, Hartford, and Newport. Most isolates (64.3%, 27/42) exhibited a unique multidrug-resistant (MDR) phenotype, including resistance to extended-spectrum cephalosporins. Salmonella prevalence in harvest fecal samples and prefemoral LNs among calves from outbreak farms was numerically higher, but not significantly different than those without an outbreak. Serotypes recovered from outbreak farms included Salmonella Heidelberg and Typhimurium, and the monophasic Salmonella Typhimurium strains 4,5,12:i:- and 4,12:i:-, which have been also reported as highly pathogenic in humans. All isolates (33/33) exhibited an MDR phenotype. Salmonella strains recovered from ill calves in two outbreaks had indistinguishable PFGE patterns, suggesting between-farm transmission. In addition, the genotype of Salmonella Heidelberg causing an outbreak among calves was recovered from three prefemoral LNs of surviving members of the cohort at harvest. Implementation of preharvest

  6. Nanoparticulate STING agonists are potent lymph node-targeted vaccine adjuvants.

    Science.gov (United States)

    Hanson, Melissa C; Crespo, Monica P; Abraham, Wuhbet; Moynihan, Kelly D; Szeto, Gregory L; Chen, Stephanie H; Melo, Mariane B; Mueller, Stefanie; Irvine, Darrell J

    2015-06-01

    Cyclic dinucleotides (CDNs) are agonists of stimulator of IFN genes (STING) and have potential as vaccine adjuvants. However, cyclic di-GMP (cdGMP) injected s.c. shows minimal uptake into lymphatics/draining lymph nodes (dLNs) and instead is rapidly distributed to the bloodstream, leading to systemic inflammation. Here, we encapsulated cdGMP within PEGylated lipid nanoparticles (NP-cdGMP) to redirect this adjuvant to dLNs. Compared with unformulated CDNs, encapsulation blocked systemic dissemination and markedly enhanced dLN accumulation in murine models. Delivery of NP-cdGMP increased CD8+ T cell responses primed by peptide vaccines and enhanced therapeutic antitumor immunity. A combination of a poorly immunogenic liposomal HIV gp41 peptide antigen and NP-cdGMP robustly induced type I IFN in dLNs, induced a greater expansion of vaccine-specific CD4+ T cells, and greatly increased germinal center B cell differentiation in dLNs compared with a combination of liposomal HIV gp41 and soluble CDN. Further, NP-cdGMP promoted durable antibody titers that were substantially higher than those promoted by the well-studied TLR agonist monophosphoryl lipid A and comparable to a much larger dose of unformulated cdGMP, without the systemic toxicity of the latter. These results demonstrate that nanoparticulate delivery safely targets CDNs to the dLNs and enhances the efficacy of this adjuvant. Moreover, this approach can be broadly applied to other small-molecule immunomodulators of interest for vaccines and immunotherapy.

  7. Ultrasound-Guided Peripheral Intravenous Access in the Emergency Department: Patient-Centered Survey

    Directory of Open Access Journals (Sweden)

    Keith Boniface

    2011-05-01

    Full Text Available Introduction: To assess characteristics, satisfaction, and disposition of emergency department (ED patients who successfully received ultrasound (US-guided peripheral intravenous (IV access. Methods: This is a prospective observational study among ED patients who successfully received US-guided peripheral IV access by ED technicians. Nineteen ED technicians were taught to use US guidance to obtain IV access. Training sessions consisted of didactic instruction and hands-on practice. The US guidance for IV access was limited to patients with difficult access. After successfully receiving an US-guided peripheral IV, patients were approached by research assistants who administered a 10-question survey. Disposition information was collected after the conclusion of the ED visit by accessing patients’ electronic medical record. Results: In total, 146 surveys were completed in patients successfully receiving US-guided IVs. Patients reported an average satisfaction with the procedure of 9.2 of 10. Forty-two percent of patients had a body mass index (BMI of greater than 30, and 17.8% had a BMI of more than 35. Sixty-two percent reported a history of central venous catheter placement. This patient population averaged 3 ED visits per year in the past year. Fifty-three percent of the patients were admitted. Conclusion: Patients requiring US-guided IVs in our ED are discharged home at the conclusion of their ED visit about half of the time. These patients reported high rates of both difficult IV access and central venous catheter placement in the past. Patient satisfaction with US-guided IVs was very high. These data support the continued use of US-guided peripheral IVs in this patient population. [West J Emerg Med. 2011;12(4:475–477.

  8. Success rate and complications of internal jugular vein catheterization with and without ultrasonography guide.

    Science.gov (United States)

    Karimi-Sari, Hamidreza; Faraji, Mehrdad; Mohazzab Torabi, Saman; Asjodi, Gholamreza

    2014-12-01

    Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran. This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate. In this randomized controlled trial, patients who were candidate for internal jugular vein catheterization, and referred to Baqiyatallah Hospital ED were randomly allocated into US-guided CVC and anatomical landmarks guided CVC groups. Central vein access time, number of attempts, success rate, and complications in each group were evaluated. Mann-Whitney U, chi-square and Fisher exact tests along with Pearson and Spearman correlation coefficients were used to analyze the data. Out of 100 patients, 56 were male and 44 were female. No significant differences were found between the US-guided and traditional landmark methods of CVC insertion in terms of age, gender, BMI, and site of catheter insertion. The mean access time was significantly lower in the US-guided group (37.12 ± 17.33 s vs. 63.42 ± 35.19 s, P < 0.001). The mean number of attempts was also significantly lower in the US-guided group (1.12 ± 0.3 vs. 1.58 ± 0.64 times, P < 0.001). Eighty-eight percent of patients in the US-guided group were catheterized in the first attempt, while 50% of patients in the traditional landmark group were catheterized in the second or more attempts (P < 0.001). The success rate was 100% in the US-guided group, while it was 88% in the landmark group (P = 0.013). Moreover, the rate of complications was significantly lower in the US-guided group (4% vs. 24%, P = 0.004). The US-guided method for CVC placement was superior to the traditional landmark method in terms of access time, number of attempts, success rate, and fewer complications.

  9. Biopsy techniques for intraocular tumors

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    Pukhraj Rishi

    2016-01-01

    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.

  10. Desmoplastic small round cell tumour: Cytological and immunocytochemical features

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    Filho Adhemar

    2005-01-01

    Full Text Available Abstract Background Desmoplastic small round cell tumor (DSRCT is a rare and highly aggressive neoplasm. The cytological diagnosis of these tumors can be difficult because they show morphological features quite similar to other small round blue cells tumors. We described four cases of DSRCT with cytological sampling: one obtained by fine needle aspiration biopsy (FNAB and three from serous effusions. The corresponding immunocytochemical panel was also reviewed. Methods Papanicolaou stained samples from FNAB and effusions were morphologically described. Immunoreaction with WT1 antibody was performed in all cytological samples. An immunohistochemical panel including the following antibodies was performed in the corresponding biopsies: 34BE12, AE1/AE3, Chromogranin A, CK20, CK7, CK8, Desmin, EMA, NSE, Vimentin and WT1. Results The smears showed high cellularity with minor size alteration. Nuclei were round to oval, some of them with inconspicuous nucleoli. Tumor cells are clustered, showing rosette-like feature. Tumor cells in effusions and FNA were positive to WT1 in 3 of 4 cytology specimens (2 out 3 effusions and one FNA. Immunohistochemical reactions for vimentin, NSE, AE1/AE3 and WT1 were positive in all cases in tissue sections. Conclusion The use of an adjunct immunocytochemical panel coupled with the cytomorphological characteristics allows the diagnosis of DSRCT in cytological specimens.

  11. Diagnostic accuracy of tuberculous lymphadenitis fine needle aspiration biopsy confirmed by PCR as gold standard

    Science.gov (United States)

    DSuryadi; Delyuzar; Soekimin

    2018-03-01

    Indonesia is the second country with the TB (tuberculosis) burden in the world. Improvement in controlling TB and reducing the complications can accelerate early diagnosis and correct treatment. PCR test is a gold standard. However, it is quite expensive for routine diagnosis. Therefore, an accurate and cheaper diagnostic method such as fine needle aspiration biopsy is needed. The study aimsto determine the accuracy of fine needle aspiration biopsy cytology in the diagnosis of tuberculous lymphadenitis. A cross-sectional analytic study was conducted to the samples from patients suspected with tuberculous lymphadenitis. The fine needle aspiration biopsy (FNAB)test was performed and confirmed by PCR test.There is a comparison to the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of both methods. Sensitivity (92.50%), specificity (96.49%), accuracy (94.85%), positive predictive value (94.87%) and negative predictive value (94.83%) were in FNAB test compared to gold standard. We concluded that fine needle aspiration biopsy is a recommendation for a cheaper and accurate diagnostic test for tuberculous lymphadenitis diagnosis.

  12. Idiopathic Granulomatous Mastitis Associated with Erythema Nodosum

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    Tuğba Özlem Kalaycı

    2016-04-01

    Full Text Available Background: Idiopathic granulomatous mastitis (IGM is an uncommon benign chronic inflammatory breast disease, and erythema nodosum (EN is an extremely rare systemic manifestation of IGM. Here, we report a rare case of IGM accompanied by EN. Case Report: A 32-year-old patient was admitted to our clinic with a history of a tender mass in the right breast. On physical examination, the right breast contained a hard, tender mass in the lower half with in-drawing of the nipple. She had florid EN affecting both legs. She was evaluated with mammography, ultrasound, power Doppler ultrasound, non-enhancing magnetic resonance imaging (MRI, dynamic contrast-enhanced MRI, fine needle aspiration biopsy (FNAB and excisional biopsy. Time-intensity curves showed a type II pattern on dynamic contrast-enhanced MRI, which has an intermediate probability for malignancy. The FNAB reported a benign cytology suggestive of a granulomatous inflammation, which was also supported by the histopathological findings. A partial mastectomy was performed following medical treatment. There was no recurrence at 1-year follow-up. Conclusion: IGM should be considered in the differential diagnosis of EN. Although histopathological examination remains the only method for the definite diagnosis of IGM, MRI can be helpful in the diagnosis or differentiation of benign lesions from malignant ones.

  13. Relative quantification of PIK3CA gene expression level in fine-needle aspiration biopsy thyroid specimens collected from patients with papillary thyroid carcinoma and non-toxic goitre by real-time RT-PCR

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    Wojciechowska-Durczyńska Katarzyna

    2010-08-01

    Full Text Available Abstract Background Recent studies have shown that the phosphatidylinositol 3-kinase (PI3K signaling pathway is important regulator of many cellular events, including apoptosis, proliferation and motility. PI3K pathway alterations (PIK3CA gene mutations and/or amplification have been observed in various human tumours. In the majority of diagnosed cases, mutations are localized in one of the three "hot spots" in the gene, responsible for coding catalytic subunit α of class I PI3K (PIK3CA. Mutations and amplification of PIK3CA gene are characteristic for thyroid cancer, as well. Methods The aim of our study was to examine a gene expression level of PIK3CA in fine-needle aspiration biopsy (FNAB thyroid specimens in two types of thyroid lesions, papillary thyroid carcinoma (PTC and non-toxic goitre (NTG. Following conventional cytological examination, 42 thyroid FNAB specimens, received from patients with PTC (n = 20 and NTG (n = 22, were quantitatively evaluated regarding PIK3CA expression level by real-time PCR in the ABI PRISM® 7500 Sequence Detection System. Results Significantly higher expression level (RQ of PIK3CA in PTC group has been noted in comparison with NTG group (p Conclusion These observations may suggest role of PIK3CA alterations in PTC carcinogenesis.

  14. Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules

    International Nuclear Information System (INIS)

    Algin, Oktay; Algin, Efnan; Gokalp, Gokhan; Ocakog, Gokhan; Erdog an, Cuneyt; Saraydaroglu, Ozlem; Ercan Tuncel, Prof

    2010-01-01

    To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (Bmode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules

  15. Qualitative ultrasound elastography assessment of benign thyroid nodules: Patterns and intra-observer acquisition variability

    International Nuclear Information System (INIS)

    Lacout, Alexis; Chevenet, Carole; Thariat, Juliette; Figl, Andrea; Marcy, Pierre-Yves

    2013-01-01

    To report and evaluate qualitative elastography patterns by using gray-scale and Doppler ultrasound (US) in patients presenting with benign thyroid nodules and to evaluate the reproducibility of US elastography examinations. Institutional review board approval was obtained, and all patients provided informed consent. Over a 3-month time period, all consecutive adult patients were referred to our institution to undergo a thyroid nodule fine-needle aspiration biopsy (FNAB) procedure. Patients presenting with benign cytology according to the Bethesda 2008 classification were prospectively enrolled in the study. Each thyroid nodule was assessed by using gray-scale, Doppler US, and elastography acquisitions by a single operator (A. L.). Multiple elastography acquisitions per thyroid nodule were performed and elastography scorings of the nodules were compared with each other. Nineteen patients (16 women and 3 men, mean age 58 years) with 22 thyroid nodules were included in the present study. Elastographic patterns 1, 2, and 3 were reported (23% nodules showed pattern 3). The elastography pattern showed a strong variability in 13 nodules (59%). The elastography acquisition result variability involved the “malignant” pattern 3 in 36% of cases. Almost one-third of benign thyroid nodules displayed pattern 3 on qualitative US elastography. The intra-observer variability of the benign thyroid elastography scoring is wide, thus limiting the thyroid nodule US examination accuracy. In FNAB-proven benign thyroid nodules, elastography pattern 3 is frequent and cannot be used as a strong indicator of thyroid malignancy

  16. Three-dimensional cytomorphology in fine needle aspiration biopsy of medullary thyroid carcinoma.

    Science.gov (United States)

    Chang, T C; Lai, S M; Wen, C Y; Hsiao, Y L; Huang, S H

    2001-01-01

    To elucidate three-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of medullary thyroid carcinoma (MTC). ENAB was performed on tumors from five patients with MTC. The aspirate was stained and observed under a light microscope (LM). The aspirate was also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). For transmission electron microscopy (TEM), the specimen was fixed, dehydrated, embedded in an Epon mixture, cut with an ultramicrotome, mounted on copper grids, electron doubly stained with uranium acetate and lead citrate, and observed with TEM. Findings under SEM were correlated with those under LM and TEM. Under SEM, 3-D cytomorphology of MTC displayed a disorganized cellular arrangement with indistinct cell borders in three cases. The cell surface was uneven and had granular protrusions that corresponded to secretory granules observed under TEM. In one case with multiple endocrine neoplasia type IIB, there were abundant granules on the cell surface. In one case of sporadic MTC with multinucleated tumor giant cells and small cells, granular protrusions also were noted on the cell surface. Granular protrusion was a characteristic finding in FNAB of MTC tinder SEM and might be helpful in the differential diagnosis.

  17. Co-Existence of Thyroid Nodule and Thyroid Cancer in Children and Adolescents with Hashimoto Thyroiditis: A Single-Center Study.

    Science.gov (United States)

    Keskin, Meliksah; Savas-Erdeve, Senay; Aycan, Zehra

    2016-01-01

    Currently, there is an inadequate number of studies on nodule and malignancy development in children and adolescents with Hashimoto thyroiditis (HT). Patients who were diagnosed with HT between 2004 and 2013 were included in the study. The HT diagnosis was made with a heterogeneous appearance on thyroid ultrasonography and the elevation of antithyroid peroxidase and/or anti-thyroglobulin antibodies. Fine-needle aspiration biopsy (FNAB) was performed in cases with a nodule size >1 cm or who had ultrasonography findings indicating malignancy. A total of 39 (13%) thyroid nodules were detected in 300 patients with a diagnosis of HT. Papillary thyroid carcinoma (PTC) was diagnosed in 2 of the 12 cases in whom FNAB was performed. The thyroid nodule was detected at the same time as HT in the 2 cases with malignancy. The PTC diagnosis was made 2 years after the HT diagnosis in the first case and 3 years later in the second case. The largest diameter of the thyroid nodule was 5 mm in both cases. The thyroid nodule rate on an HT background was found to be 13%, and the thyroid malignancy rate was 0.67% in our study. © 2016 S. Karger AG, Basel.

  18. Mogućnosti citologije u diferencijalnoj dijagnozi tiroidnog nodusa

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    Tatić Svetislav

    2011-01-01

    Full Text Available Fine-needle aspiration biopsy (FNAB plays an important role in the evaluation of thyroid nodules and the selection of patients for surgical treatment. It is complementary with clinical, ultrasonographical, radionuclid and radiographic investigations in the assessment of true nature of thyroid nodule. Cytological findings can be classified as non-representative, suspicious, benign or malignant or into 8 diagnostic categories: benign colloid nodules, cystis lesions, different types of thyroiditis, cellular microfollicular lesions, Hurthle-cell lesions, primary malignant tumors, other lesions and the non-diagnostic category. FNAB is successful in the diagnosis of benign cystic thyroid lesions, Hashimoto thyroiditis, anaplastic and papillary thyroid carcinoma, while it is less precise in the diagnosis of medullary carcinoma, lymphoma and secondary thyroid tumors. Follicular, as well as, Hurthle-cell thyroid carcinoma cannot be cytologically differentiated from follicular and Hurthle-cell adenoma of the thyroid gland. Immunocytochemistry may facilitate the diagnosis of thyroid tumors with follicular origin, applying galectin-3, cytokeratin 19 and HBME-1, whereas medullary thyroid carcinoma is typically proved with calcitonin immunostaining.

  19. Role of Nuclear Medicine in the Diagnosis of Benign Thyroid Diseases.

    Science.gov (United States)

    Garberoglio, Sara; Testori, Ornella

    2016-01-01

    A deep understanding of thyroid pathophysiology is the basis for diagnosing and treating benign thyroid diseases with radioactive materials, known as radiopharmaceuticals, which are introduced into the body by injection or orally. After the radiotracer administration, the patient becomes the emitting source, and several devices have been studied to detect and capture these emissions (gamma or beta-negative) and transform them into photons, parametric images, numbers and molecular information. Thyroid scintigraphy is the only technique that allows the assessment of thyroid regional function and, therefore, the detection of areas of autonomously functioning thyroid nodules. Scintigraphy visualizes the distribution of active thyroid tissue and displays the differential accumulation of radionuclides in the investigated cells, thus providing a functional map. Moreover, this technique is a fundamental tool in the clinical and surgical management of thyroid diseases, including: single thyroid nodules with a suppressed thyroid-stimulating hormone level, for which fine-needle aspiration biopsy (FNAB) is used to identify hot nodules; multinodular goiters, especially larger ones, to identify cold or indeterminate areas requiring FNAB and hot areas that do not need cytologic evaluation, and to evaluate mediastinal extension; the diagnosis of ectopic thyroid tissue; subclinical hyperthyroidism to identify occult hyperfunctioning tissue; follicular lesions to identify a functioning cellular adenoma that could be benign, although such nodules are mostly cold on scintigraphy; to distinguish low-uptake from high-uptake thyrotoxicosis, and to determine eligibility for radioiodine therapy. © 2016 S. Karger AG, Basel.

  20. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

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    José L. Arias-Buría

    2015-01-01

    Full Text Available Objective. To compare effects of ultrasound- (US- guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n=17 group or exercise (n=19 group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions. Shoulder pain (NPRS and disability (DASH were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P<0.01: individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention.

  1. The role of ultrasound-guided vacuum-assisted removal of gynecomastia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, You Me [Dankook University Hospital, Cheonan (Korea, Republic of)

    2008-02-15

    To evaluate the role of performing ultrasound (US)-guided vacuum-assisted breast biopsies for the treatment (mammotome excision) of gynecomastia. Between November 2005 and December 2006, nine male patients underwent US-guided mammotome excision for eleven cases of true gynecomastia. The patient ages ranged from 14 to 55 years (mean age, 32.3 years). US-guided mammotome excision was performed with an 11-gauge needle in seven cases and an 8-gauge needle in four cases. After the procedure, the cigarette method using gauze packing was performed. The number of samples, procedure time and presence of complications were evaluated. Scheduled follow-up physical and US examinations were performed after three and six months. For 11 cases of US-guided mammotome excision of gynecomastia, the number of samples ranged from 12-126 (mean, 66) and the procedure time ranged from 10-42 minutes (mean time, 25.1 minutes). Clinical significant complications did not occur immediately after the procedure and complications were not seen after a follow-up examination in any of the cases. At the 3-and 6-month follow up examinations, all of the patients showed a normal male physical appearance on a physical examination and there was no evidence of hypoechoic glandular tissues as seen on ultrasonograms. US-guided mammotome excision is effective for the treatment of small, glandular true gynecomastia and is suggested as a new modality to replace the need for surgery or liposuction.

  2. Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger.

    Science.gov (United States)

    Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W-M; Manzo, Mahamane L; Grais, Rebecca F

    2014-09-01

    Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual "hunger gaps." Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies-including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only-on the incidence of SAM and MAM among children aged 6-23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm-80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm-80 cm of participating households were assessed at each monthly distribution from August to December 2011. Primary endpoints were SAM

  3. Assessment of pain score and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

    Directory of Open Access Journals (Sweden)

    Liao LJ

    2017-12-01

    Full Text Available Li-Jen Liao,1 Wu-Chia Lo,1 Wan-Lun Hsu,2 Po-Wen Cheng,1 Cheng-Ping Wang3 1Department of Otolaryngology, Far Eastern Memorial Hospital, 2Genomics Research Center, Academia Sinica, 3Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China Objective: The aim of this study was to evaluate pain scores and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy (US-FNAB of thyroid nodules without and with local anesthesia (LA. Materials and methods: The US-FNAB procedure was performed on 183 patients with and without LA. One puncture was made for solid nodules, and if patients could tolerate it, a two-puncture technique was used for nodules with a cystic change. Four-point verbal rating scores were assessed by a nursing assistant after completion of US-FNAB. To be an adequate specimen, at least six groups of follicular cells are required, and each group should contain at least 10 cells.Results: Immediately after US-FNAB, 92% of patients with LA and 80% without LA reported no or mild pain (p=0.01. Most patients tolerated the procedure well, with no pain (82.5% reported 5 minutes after the procedure. In univariate logistic regression, irregular boundary (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.04–6.06, p=0.04, calcification (OR: 2.86, 95% CI: 1.06–7.76, p=0.04, and LA (OR: 0.35, 95% CI: 0.15–0.86, p=0.02 were significantly associated with immediate moderate or severe pain. Specimen adequacy was significantly associated with age (OR: 0.95, 95% CI: 0.92–0.97, p<0.01, heterogeneous echo-texture (OR: 1.76, 95% CI: 1.23–5.17, p=0.01, predominate solid architecture (OR: 2.78, 95% CI: 1.42–5.41, p<0.01, and the use of LA (OR: 3.34, 95% CI: 1.70–6.56, p<0.01. In multivariate logistic regression, patients receiving LA had lower risk of moderate or severe pain (OR: 0.25, 95% CI: 0.09–0.67, p=0.01 and higher chances of specimen adequacy (OR: 4.84, 95% CI: 2.17–10.7, p<0

  4. Maternal and Child Supplementation with Lipid-Based Nutrient Supplements, but Not Child Supplementation Alone, Decreases Self-Reported Household Food Insecurity in Some Settings.

    Science.gov (United States)

    Adams, Katherine P; Ayifah, Emmanuel; Phiri, Thokozani E; Mridha, Malay K; Adu-Afarwuah, Seth; Arimond, Mary; Arnold, Charles D; Cummins, Joseph; Hussain, Sohrab; Kumwenda, Chiza; Matias, Susana L; Ashorn, Ulla; Lartey, Anna; Maleta, Kenneth M; Vosti, Stephen A; Dewey, Kathryn G

    2017-12-01

    Background: It is unknown whether self-reported measures of household food insecurity change in response to food-based nutrient supplementation. Objective: We assessed the impacts of providing lipid-based nutrient supplements (LNSs) to women during pregnancy and postpartum and/or to their children on self-reported household food insecurity in Malawi [DOSE and DYAD trial in Malawi (DYAD-M)], Ghana [DYAD trial in Ghana (DYAD-G)], and Bangladesh [Rang-Din Nutrition Study (RDNS) trial]. Methods: Longitudinal household food-insecurity data were collected during 3 individually randomized trials and 1 cluster-randomized trial testing the efficacy or effectiveness of LNSs (generally 118 kcal/d). Seasonally adjusted Household Food Insecurity Access Scale (HFIAS) scores were constructed for 1127 DOSE households, 732 DYAD-M households, 1109 DYAD-G households, and 3671 RDNS households. The impact of providing LNSs to women during pregnancy and the first 6 mo postpartum and/or to their children from 6 to 18-24 mo on seasonally adjusted HFIAS scores was assessed by using negative binomial models (DOSE, DYAD-M, and DYAD-G trials) and mixed-effect negative binomial models (RDNS trial). Results: In the DOSE and DYAD-G trials, seasonally adjusted HFIAS scores were not different between the LNS and non-LNS groups. In the DYAD-M trial, the average household food-insecurity scores were 14% lower ( P = 0.01) in LNS households than in non-LNS households. In the RDNS trial, compared with non-LNS households, food-insecurity scores were 17% lower ( P = 0.02) during pregnancy and the first 6 mo postpartum and 15% lower ( P = 0.02) at 6-24 mo postpartum in LNS households. Conclusions: The daily provision of LNSs to mothers and their children throughout much of the "first 1000 d" may improve household food security in some settings, which could be viewed as an additional benefit that may accrue in households should policy makers choose to invest in LNSs to promote child growth and development

  5. Ultrasound-guided genitourinary interventions: principles and techniques

    Directory of Open Access Journals (Sweden)

    Byung Kwan Park

    2017-10-01

    Full Text Available Ultrasound (US is often used to guide various interventional procedures in the genitourinary (GU tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  6. Ultrasound-guided genitourinary interventions: principles and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-10-15

    Ultrasound (US) is often used to guide various interventional procedures in the genitourinary (GU) tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  7. Ultrasound-guided interstitial laser photocoagulation of an autonomous thyroid nodule

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Hegedüs, Laszlo

    2003-01-01

    effects and often necessitates multiple treatment sessions. We present a case of a 17-year-old female successfully treated with ultrasound (US)-guided percutaneous interstitial laser photocoagulation (ILP) for an AFTN. Initially, she had a serum thyrotropin (TSH) of 0.01 mU/L and normal peripheral thyroid.......9 mL (40% reduction) without further alterations during an additional 9 months of follow-up. Side effects were transient thyrotoxicosis and local pain as seen with PEI. To our knowledge, this is the first reported case of ILP used in a patient with a pretoxic thyroid nodule. US-guided thermic tissue...

  8. Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Fana, Viktoria

    2017-01-01

    and tenosynovitis were randomised into two double-blind groups: (A) 'intramuscular group', receiving intramuscular injection of betamethasone and US-guided intratenosynovial isotonic saline injection and (B) 'intratenosynovial group' receiving saline intramuscularly and US-guided intratenosynovial betamethasone......% (2/24) versus 44% (11/25), that is, difference of ?36pp (?58pp to ?13pp), p=0.003. Most US, clinical and patient-reported scores improved more in the 'intratenosynovial group' at all follow-up visits. Conclusions In this randomised double-blind clinical trial, patients with RA and tenosynovitis...

  9. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

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

    2011-01-01

    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....

  10. Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

    OpenAIRE

    Jung, Hyun Kyung; Moon, Hee Jung; Kim, Min Jung; Kim, Eun-Kyung

    2014-01-01

    Purpose: To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. Methods: We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assist...

  11. Percutaneous catheter drainage of pancreatic pseudocysts

    International Nuclear Information System (INIS)

    Karnel, F.; Gebauer, A.; Jantsch, H.; Prayer, L.; Schurawitzki, H.; Feil, W.

    1991-01-01

    The results of CT/US-guided percutaneous drainage in 35 patients with pancreatic pseudocysts are reported. 27 patients recovered without surgery and no further treatment was required. 8 patients required a subsequent surgery due to recurrence. The role of CT/US-guided percutaneous drainage in pancreatic pseudocysts as well as an analysis of the technical aspects associated with a successful procedure are discussed. Although US may be used, we believe CT is safer and allows more precise localisation and guidance in the treatment of pseudocysts. (orig.) [de

  12. Percutaneous catheter drainage of pancreatic pseudocysts. Perkutane Katheterdrainage von Pankreaspseudozysten

    Energy Technology Data Exchange (ETDEWEB)

    Karnel, F.; Gebauer, A.; Jantsch, H.; Prayer, L.; Schurawitzki, H. (Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria) Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)); Feil, W. (1. Chirurgische Universitaetsklinik, Vienna (Austria))

    1991-09-01

    The results of CT/US-guided percutaneous drainage in 35 patients with pancreatic pseudocysts are reported. 27 patients recovered without surgery and no further treatment was required. 8 patients required a subsequent surgery due to recurrence. The role of CT/US-guided percutaneous drainage in pancreatic pseudocysts as well as an analysis of the technical aspects associated with a successful procedure are discussed. Although US may be used, we believe CT is safer and allows more precise localisation and guidance in the treatment of pseudocysts. (orig.).

  13. The effect of nutritional supplementation on quality of life in people living with HIV

    DEFF Research Database (Denmark)

    Tesfaye Woldeyohannes, Markos; Kæstel, Pernille; Olsen, Mette Frahm

    2016-01-01

    the subsequent 3 months. METHODS: Randomized controlled trial in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17kg/m(2) and given daily supplements of 200 grams of LNS containing whey or soy either during the first 3......OBJECTIVE: To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART), and to investigate the effects of timing of supplementation by comparing with supplementation during...... months or the subsequent months of ART. The outcome was measured in terms of total quality of life scores on the adapted version of the WHOQOL-HIV-BREF assessed at baseline, 3 and 6 months. RESULTS: Of the 282 participants, 186 (66.0%) were women. The mean age (standard deviation SD) was 32.8 (±9...

  14. Effect of nutrient supply on photosynthesis and pigmentation to short-term stress (UV radiation) in Gracilaria conferta (Rhodophyta)

    International Nuclear Information System (INIS)

    Figueroa, F.L.; Israel, A.; Neori, A.; Martinez, B.; Malta, E.J.; Put, A.; Inken, S.; Marquardt, R.; Abdala, R.; Korbee, N.

    2010-01-01

    The effects of increased photosynthetic active radiation (PAR), UV radiation (UVR), and nutrient supply on photosynthetic activity, pigment content, C:N ratio and biomass yield were studied in tank cultivated Gracilaria conferta (Rhodophyta). Electron transport rate (ETR) and biliprotein content were higher under high nutrient supply (HNS), obtained from fishpond effluents, compared to low nutrient supply (LNS), in contrast to mycosporine-like amino acids (MAAs) dynamic. The high MAA content in LNS-algae could be explained by higher UVR penetration in the thallus and by the competition for the use of nutrients with other processes. Effective quantum yield decreased after short-term exposure to high irradiance whereas full recovery in shade was produced only under slightly heat shock. UVA radiation provoked an additional decrease in photosynthesis under high water temperature. UVB radiation reversed UVA's negative effect mainly with HNS. Results support that nutrient-sufficiency help G. conferta to resist environmental changes as short-term temperature increase.

  15. Ovarian mass mimicking malignancy: a case report

    International Nuclear Information System (INIS)

    Kim, Yong Il; Kim, Seok Ki; Lee, Jeong Won; Lee, Sang Mi; Kim, Tae Sung

    2010-01-01

    A 32-year-old female who suffered from abdominal pain underwent 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the diagnostic workup of pelvic mass lesions. Cystic mass lesions in the bilateral ovaries showed wall thickening and intense hypermetabolism along the rim. In addition, multifocal intense hypermetabolic lymphadenopathies were seen in the left paraaortic lymph node (LN), aortocaval LN, and both common iliac LNs. We interpreted these findings as bilateral ovarian cancer with retroperitoneal metastatic lymphadenopathies rather than endometriosis with reactive lymphadenopathies rather than endometriosis with reactive lymphadenopathies. However, Histopathological examination confirmed the ovarian mass lesions as tubo-ovarian abscesses. We report a case that even if simultaneous hypermetabolic retroperitoneal LNs are seen, intense hypermetabolic lesions in both ovaries can be in consequence of inflammatory change

  16. [Effects of a lipid-based nutrient supplement on hemoglobin levels and anthropometric indicators in children from five districts in Huánuco Peru].

    Science.gov (United States)

    Vargas-Vásquez, Alejandro; Bado, Ricardo; Alcázar, Lorena; Aquino, Oscar; Rodríguez, Amelia; Novalbos, José Pedro

    2015-01-01

    Objectives . To determine the effect of consumption of a lipid-based nutrient supplement (LNS) on hemoglobin levels, anemia and anthropometric indicators in children aged six to eleven months old in five districts in the province of Ambo in the region of Huanuco, Peru. A pre-experimental, pre-post study was performed. The study population included children aged six to eleven months old in 19 health facilities in five districts with very high vulnerability to chronic malnutrition in the province of Ambo, Huanuco. Data from 147 children who received the lipid-based nutrient supplement (LNS) from six to eleven months old were obtained. The mean hemoglobin significantly increased by 0.67 g/dL (panemia dropped by 27 percentage points (panemia in children under twelve months, which might constitute an effective alternative to prevent and control childhood anemia.

  17. Quality of Life Among People Living with HIV in Jimma, Ethiopia: the Role of Mental Health, Food and Nutrition

    DEFF Research Database (Denmark)

    Woldeyohannes, Markos Tesfaye

    which might affect their quality of life. Among others, food insecurity is a common problem among PLHIV, and HIV programs in lowincome settings often provide food support and nutritional counselling. However, the effect of nutritional intervention on quality of life of PLHIV has not been adequately...... to adequate food and nutrition is an important aspect of quality of life among PLHIV in low-income settings. Supplementation with LNS for PLHIV initiating ART has a beneficial effect on quality of life in the short term. Food insecurity and poor mental health are independently associated with lower quality...... of life among PLHIV. Food support in HIV programs need to consider the food security status of PLHIV in addition to their nutritional status. The long-term effects of early supplementation with LNS on quality of life need further investigation. Future studies are needed to establish causal association...

  18. Small-quantity lipid-based nutrient supplements, together with malaria and diarrhoea treatment, improve growth and prevent MAM in young Burkinabe children

    International Nuclear Information System (INIS)

    Hess, Sonja Y; Abbeddou, Souheila; Somé, Jerome W; Vosti, Stephen A; Brown, Kenneth H; Yakes Jimenez, Elizabeth; Ouédraogo, Zinéwindé P; Guissou, Rosemonde M; Ouédraogo, Jean-Bosco

    2014-01-01

    Background: Supplementing young children’s diets with small-quantity lipid-based nutrient supplements (LNS) may prevent growth restriction, but the optimal amount of zinc to include in these products is uncertain. Objectives: To assess zinc-related functional responses among young Burkinabe children who received LNS without or with varied amounts of zinc, and to compare these outcomes among children who do or do not receive LNS and selected health services. Methods: In a partially masked, placebo-controlled, randomized trial, 34 communities were assigned to immediate (II) or non-intervention (NI) cohorts. 2469 eligible II children were randomly assigned to 1 of 4 groups to receive LNS containing 0, 5 or 10 mg zinc (and placebo tablet) or LNS without zinc and 5 mg zinc tablet from 9 to 18 months of age. The daily ration of LNS was 20 g which provided 118 kcal along with 20 other micronutrients in addition to zinc. Weekly morbidity surveillance was conducted at children’s homes; malaria treatment was provided for confirmed malaria, and ORS for reported diarrhea. Children in NI (n = 797) received neither supplements nor illness treatment. At 9 and 18 months, length, weight, mid-upper arm circumference (MUAC) and hemoglobin (Hb) concentration were measured in all children. Results: Reported adherence was 97 ± 5% for LNS and tablets. Mean baseline Hb was 89 ± 15 g/L, and 91% were anemic (Hb <110 g/L). At 18 months, change in Hb was greater in II cohort than NI (+8 vs -1 g/L, p<0.0001), but 79% of II were still anemic (vs. 91% in NI). During the 9 month follow-up in the II cohort, the incidence of diarrhea and malaria was 1.15 ± 1.18 and 0.55 ± 0.54 episodes per 100 child-days, respectively and did not differ by intervention group. At baseline, mean length-for-age z-score (LAZ), weight-for-length z-score (WLZ) and MUAC were -1.21 ± 1.10, -0.99 ± 1.05 and 133 ± 12 mm, respectively, in all groups combined. Mean length, weight and MUAC were significantly greater

  19. Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    Moon, K.L. Jr.; Federle, M.P.; Abrams, D.I.; Volberding, P.; Lewis, B.J.

    1984-01-01

    Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease

  20. Ovarian mass mimicking malignancy: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Il; Kim, Seok Ki; Lee, Jeong Won; Lee, Sang Mi; Kim, Tae Sung [National Cancer Center, Goyang (Korea, Republic of)

    2010-12-15

    A 32-year-old female who suffered from abdominal pain underwent {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the diagnostic workup of pelvic mass lesions. Cystic mass lesions in the bilateral ovaries showed wall thickening and intense hypermetabolism along the rim. In addition, multifocal intense hypermetabolic lymphadenopathies were seen in the left paraaortic lymph node (LN), aortocaval LN, and both common iliac LNs. We interpreted these findings as bilateral ovarian cancer with retroperitoneal metastatic lymphadenopathies rather than endometriosis with reactive lymphadenopathies rather than endometriosis with reactive lymphadenopathies. However, Histopathological examination confirmed the ovarian mass lesions as tubo-ovarian abscesses. We report a case that even if simultaneous hypermetabolic retroperitoneal LNs are seen, intense hypermetabolic lesions in both ovaries can be in consequence of inflammatory change

  1. Prostate cancer nodal oligometastasis accurately assessed using prostate-specific membrane antigen positron emission tomography-computed tomography and confirmed histologically following robotic-assisted lymph node dissection.

    Science.gov (United States)

    O'Kane, Dermot B; Lawrentschuk, Nathan; Bolton, Damien M

    2016-01-01

    We herein present a case of a 76-year-old gentleman, where prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT) was used to accurately detect prostate cancer (PCa), pelvic lymph node (LN) metastasis in the setting of biochemical recurrence following definitive treatment for PCa. The positive PSMA PET-CT result was confirmed with histological examination of the involved pelvic LNs following pelvic LN dissection.

  2. Hadronic multiplicity and total cross-section: a new scaling in wide energy range

    International Nuclear Information System (INIS)

    Kobylinsky, N.A.; Martynov, E.S.; Shelest, V.P.

    1983-01-01

    The ratio of mean multiplicity to total cross-section is shown to be the same for all the Regge models and to rise with energy as lns which is confirmed by experimental data. Hence, a power of multiplicity growth is unambiguously connected with that of total cross-section. As regards the observed growth, approximately ln 2 s, it tells about a dipole character of pomeron singularity

  3. A self-calibrating ion beam profiler based on a CsI scintillator

    Energy Technology Data Exchange (ETDEWEB)

    Finocchiaro, P. E-mail: finocchiaro@lns.infn.it; Ciavola, G.; Cosentino, L.; Gu, M.; Raia, G.; Rovelli, A

    1999-11-21

    We report on the test results obtained with a prototype beam profiler based on a thin slit and a CsI scintillator, read out by means of a compact photomultiplier. Such a device has proven to be suitable to perform ion beam diagnostics at low and very low intensities. In particular, our device is suitable for being used in the energy and intensity ranges expected at the EXCYT radioactive ion beam facility, that is currently under development at LNS Catania.

  4. Beam diagnostic elements at the Laboratorio Nazionale del Sud

    International Nuclear Information System (INIS)

    Calabretta, L.; Cuttone, G.; Raia, G.

    1988-01-01

    The choice of the main beam diagnostic elements at the LNS has to take into account the future installation of the Milan Superconducting Cyclotron and its matching to the MP tandem in Catania. A diagnostic box, consisting of a home-made beam profile monitor, a pair of slits and a Faraday cup, has been designed according to these particular requirements. The main features of these diagnostic elements and preliminary results are described. (orig.)

  5. A self-calibrating ion beam profiler based on a CsI scintillator

    International Nuclear Information System (INIS)

    Finocchiaro, P.; Ciavola, G.; Cosentino, L.; Gu, M.; Raia, G.; Rovelli, A.

    1999-01-01

    We report on the test results obtained with a prototype beam profiler based on a thin slit and a CsI scintillator, read out by means of a compact photomultiplier. Such a device has proven to be suitable to perform ion beam diagnostics at low and very low intensities. In particular, our device is suitable for being used in the energy and intensity ranges expected at the EXCYT radioactive ion beam facility, that is currently under development at LNS Catania

  6. Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation.

    Science.gov (United States)

    Komatsu, Tetsuya; Kunieda, Etsuo; Kitahara, Tadashi; Akiba, Takeshi; Nagao, Ryuta; Fukuzawa, Tsuyoshi

    2016-01-01

    More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V20 of the lung, D(1cm3) of the spinal cord, D(1cm3) and D(10cm3) of the esophagus and D(10cm3) of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible. © The Author 2015. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  7. Nutrient supplementation may adversely affect maternal oral health--a randomised controlled trial in rural Malawi.

    Science.gov (United States)

    Harjunmaa, Ulla; Järnstedt, Jorma; Dewey, Kathryn G; Ashorn, Ulla; Maleta, Kenneth; Vosti, Stephen A; Ashorn, Per

    2016-01-01

    Nutritional supplementation during pregnancy is increasingly recommended especially in low-resource settings, but its oral health impacts have not been studied. Our aim was to examine whether supplementation with multiple micronutrients (MMN) or small-quantity lipid-based nutrient supplements affects dental caries development or periodontal health in a rural Malawian population. The study was embedded in a controlled iLiNS-DYAD trial that enrolled 1391 pregnant women Women were provided with one daily iron-folic acid capsule (IFA), one capsule with 18 micronutrients (MMN) or one sachet of lipid-based nutrient supplements (LNS) containing protein, carbohydrates, essential fatty acids and 21 micronutrients. Oral examination of 1024 participants was conducted and panoramic X-ray taken within 6 weeks after delivery. The supplement groups were similar at baseline in average socio-economic, nutritional and health status. At the end of the intervention, the prevalence of caries was 56.7%, 69.1% and 63.3% (P = 0.004), and periodontitis 34.9%, 29.8% and 31.2% (P = 0.338) in the IFA, MMN and LNS groups, respectively. Compared with the IFA group, women in the MMN group had 0.60 (0.18-1.02) and in the LNS group 0.59 (0.17-1.01) higher mean number of caries lesions. In the absence of baseline oral health data, firm conclusions on causality cannot be drawn. However, although not confirmatory, the findings are consistent with a possibility that provision of MMN or LNS may have increased the caries incidence in this target population. Because of the potential public health impacts, further research on the association between gestational nutrient interventions and oral health in low-income settings is needed. © 2015 John Wiley & Sons Ltd.

  8. Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial.

    Science.gov (United States)

    Okronipa, Harriet; Adu-Afarwuah, Seth; Lartey, Anna; Ashorn, Per; Vosti, Stephen A; Young, Rebecca R; Dewey, Kathryn G

    2018-02-01

    We examined the impact on depression at 6 months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20 weeks gestation (n = 1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6 months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6 months postpartum. Maternal depressive symptoms were measured at 6 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS = 382, IFA = 387 and MMN = 382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n = 1151) and those who were not (n = 169). At 6 months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS = 13.1%, IFA = 11.2% and MMN = 14.7%. P = 0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed  = 0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.

  9. Mediastinal lymph node enlargement in patients with valvular heart disease: CT evaluation and clinical correlation

    International Nuclear Information System (INIS)

    Park, Hye Ju; Jung, Jung Im; Ahn, Myeong Im; Han, Dae Hee; Park, Seog Hee

    2016-01-01

    To evaluate the presence, size and location of enlarged mediastinal lymph nodes (LNs) in patients with valvular heart disease (VHD) using computed tomography scans in correlation with ejection fraction (EF). We retrospectively evaluated 30 patients with VHD, without pre-existing diseases that could cause lymphadenopathy (LAP). The presence, size, and location of LNs greater than 1 cm in short axis diameter were evaluated. The location of mediastinal LNs was recorded according to the International Association for the Study of Lung Cancer. Furthermore, we evaluated the presence of pulmonary edema, pleural effusion, and other thoracic abnormalities and evaluated EF of the heart on transthoracic echocardiography. Sixteen patients (53%) had at least 1 enlarged mediastinal LN. The most frequent locations were lower paratracheal (4R, n = 8/4L, n = 6), subcarinal (7, n = 5) and right upper paratracheal (2R, n = 4) regions. The frequency of mediastinal LAP was higher in patients with aortic regurgitation (2 of 2, 100%) followed by mitral regurgitation (8 of 11, 73%); it was also high in patients with pulmonary edema (80%), pleural effusion (81%), or both (77%), as compared to patients without pulmonary edema or pleural effusion (17%) (p = 0.001). Ten of 30 patients showed an abnormal EF of < 55%; among them, 8 had mediastinal LAP. However, the relationship between EF and LAP was not statistically significant (p = 0.058). Mediastinal LN enlargement is common in patients with VHD, especially in cases of pulmonary edema and pleural effusion. Enlarged mediastinal LNs were frequently observed with abnormal EF, however, the relationship between EF and mediastinal LAP was not statistically significant.

  10. Infra-red divergences and Regge behaviour in QCD

    International Nuclear Information System (INIS)

    Jaroszewicz, T.

    1980-01-01

    We analyze high energy behaviour of multi-gluon exchange amplitudes in the leading-lns approximation in perturbation theory. Working in the Coulomb gauge and employing Ward identities we derive an integral equation for the n-gluon system in the exchange channel. We find that the Regge behaviour is associated with exponentiation of leading infrared divergences, and the position of the j-plane singularities is determined by the colour quantum numbers of the exchanged system. (author)

  11. High-energy behaviour in a non-abelian gauge theory. Pt. 3

    International Nuclear Information System (INIS)

    Bartels, J.

    1991-07-01

    The high energy limit (Regge limit) of a spontaneously broken SU(2) gauge theory is studied beyond the leading-lns approximation. Calculations are based upon the analytic structure of scattering amplitudes in generalized Regge limits, and the resulting amplitudes satisfy reggeon unitarity in the t-channel as well as unitarity in the s-channel. The calculations lead to a systematic construction of a reggeon field theory. (orig.)

  12. Prostate cancer nodal oligometastasis accurately assessed using prostate-specific membrane antigen positron emission tomography-computed tomography and confirmed histologically following robotic-assisted lymph node dissection

    Directory of Open Access Journals (Sweden)

    Dermot B O′Kane

    2016-01-01

    Full Text Available We herein present a case of a 76-year-old gentleman, where prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT was used to accurately detect prostate cancer (PCa, pelvic lymph node (LN metastasis in the setting of biochemical recurrence following definitive treatment for PCa. The positive PSMA PET-CT result was confirmed with histological examination of the involved pelvic LNs following pelvic LN dissection.

  13. Limited immune surveillance in lymphoid tissue by cytolytic CD4+ T cells during health and HIV disease

    Science.gov (United States)

    McLane, Laura M.; Steblyanko, Maria; Anikeeva, Nadia; Ablanedo-Terrazas, Yuria; Demers, Korey; Eller, Michael A.; Streeck, Hendrik; Jansson, Marianne; Sönnerborg, Anders; Canaday, David H.; Naji, Ali; Wherry, E. John; Robb, Merlin L.; Reyes-Teran, Gustavo; Sykulev, Yuri; Betts, Michael R.

    2018-01-01

    CD4+ T cells subsets have a wide range of important helper and regulatory functions in the immune system. Several studies have specifically suggested that circulating effector CD4+ T cells may play a direct role in control of HIV replication through cytolytic activity or autocrine β-chemokine production. However, it remains unclear whether effector CD4+ T cells expressing cytolytic molecules and β-chemokines are present within lymph nodes (LNs), a major site of HIV replication. Here, we report that expression of β-chemokines and cytolytic molecules are enriched within a CD4+ T cell population with high levels of the T-box transcription factors T-bet and eomesodermin (Eomes). This effector population is predominately found in peripheral blood and is limited in LNs regardless of HIV infection or treatment status. As a result, CD4+ T cells generally lack effector functions in LNs, including cytolytic capacity and IFNγ and β-chemokine expression, even in HIV elite controllers and during acute/early HIV infection. While we do find the presence of degranulating CD4+ T cells in LNs, these cells do not bear functional or transcriptional effector T cell properties and are inherently poor to form stable immunological synapses compared to their peripheral blood counterparts. We demonstrate that CD4+ T cell cytolytic function, phenotype, and programming in the peripheral blood is dissociated from those characteristics found in lymphoid tissues. Together, these data challenge our current models based on blood and suggest spatially and temporally dissociated mechanisms of viral control in lymphoid tissues. PMID:29652923

  14. Skill Transfer and Virtual Training for IND Response Decision-Making: Project Summary and Next Steps

    Science.gov (United States)

    2016-04-12

    Lincoln Laboratory MASSACHUSETTS INSTITUTE OF TECHNOLOGY LEXINGTON, MASSACHUSETTS Technical Report 1209 Skill Transfer and Virtual ...specifically authorized by the U.S. Government may violate any copyrights that exist in this work. Skill Transfer and Virtual Training for IND Response...lns:ull of lmme<lla:e 0 evacua!lon). but many aspects are the same (such as !’laVIng fresh water . knowing evacua:Jon routn. and tlavtng a

  15. Counterintelligence Screening Needed lo Reduce Security Threat That Unscreened Local National Linguists Pose to U.S. Forces (REDACTED)

    Science.gov (United States)

    2012-12-07

    Logistics Civil Augmentation Program MEP Mission Essential Personnel MFR Memorandum for Record OCI Organizational Conflict of Interest OCONUS Outside...reports would draw conclusions and recollllllel1dations on the retention, hir.ing, or threat posed by the LNs. MEP would send thjl MFRs to tlie...office responsible for issning badges on the local installations if the MFRs had no negative CI infonnation. If the MFRs had CI exploitable information

  16. The KK-bar system at low relative energies and the problem of the f0 (975) and a0 (983) mesons

    International Nuclear Information System (INIS)

    Frascaria, R.

    1992-01-01

    Meson production near threshold is a spectroscopic tool in the studies of meson structure. Some interesting features of meson production near threshold in few body reactions are emphasized. In particular, the region of KK-bar thresholds studied in pd→ 3 He X at LNS could be an excellent tool to bring new information about the a 0 (983) and f 0 (975) meson structure dilemma. (author) 11 refs., 5 figs

  17. Preliminary study of the 19F(7Li,7Be)19O reaction at 52 MeV with MAGNEX

    CERN Document Server

    Cavallaro, M; Cappuzzello, F; Carbone, D; Foti, A; Orrigo, S E A; Rodrigues, M R D; Schillaci, M; Borello-Lewin, T; Petrascu, H

    2010-01-01

    The 19F(7Li,7Be)19O charge-exchange reaction at 52 MeV incident energy has been performed at INFN-LNS in Catania using the MAGNEX spectrometer. The use of an algebraic ray-reconstruction technique has allowed to extract the 19O excitation energy spectrum and the experimental angular distributions obtained with a single angular setting of the spectrometer.

  18. High-energy resolution Thomson Parabola spectrometer for laser plasma diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Cirrone, G. A. P.; Schillaci, F. [Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali del Sud, Via Santa Sofia 62, Catania, Italy and Institute of Physics of the ASCR, ELI-Beamlines project, Na Slovance 2, Prague (Czech Republic); Carpinelli, M. [INFN Sezione di Cagliari, c/o Dipartimento di Fisica, Università di Cagliari, Cagliari (Italy); Cuttone, G.; Romano, F. [Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali del Sud, Via Santa Sofia 62, Catania (Italy); Maggiore, M. [Institute of Physics of the ASCR, ELI-Beamlines project, Na Slovance 2, Prague, Czech Republic and Laboratori Nazionali di Legnaro, INFN, Via Università 2, Legnaro (PD) (Italy); Ter-Avetisyan, S. [Laboratori Nazionali di Legnaro, INFN, Via Università 2, Legnaro (PD) (Italy); Tramontana, A. [Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali del Sud, Via Santa Sofia 62, Catania, Italy and School of Mathematics and Physics, The Queen' s University Belfast, BT7 1NN (United Kingdom); Velyhan, A. [Institute of Physics of the ASCR, ELI-Beamlines project, Na Slovance 2, Prague (Czech Republic)

    2013-07-26

    Thomson Parabola (TP) spectrometers are widely used devices for laser-driven beam diagnostics as they provide a complete set of information on the accelerated particles. A novel TP has been developed at LNS with a design able to detect protons up to 20 MeV. The layout design and some results obtained during the experimental campaign at PALS laboratory will be reported in the following.

  19. Mediastinal lymph node enlargement in patients with valvular heart disease: CT evaluation and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Ju; Jung, Jung Im; Ahn, Myeong Im; Han, Dae Hee; Park, Seog Hee [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-04-15

    To evaluate the presence, size and location of enlarged mediastinal lymph nodes (LNs) in patients with valvular heart disease (VHD) using computed tomography scans in correlation with ejection fraction (EF). We retrospectively evaluated 30 patients with VHD, without pre-existing diseases that could cause lymphadenopathy (LAP). The presence, size, and location of LNs greater than 1 cm in short axis diameter were evaluated. The location of mediastinal LNs was recorded according to the International Association for the Study of Lung Cancer. Furthermore, we evaluated the presence of pulmonary edema, pleural effusion, and other thoracic abnormalities and evaluated EF of the heart on transthoracic echocardiography. Sixteen patients (53%) had at least 1 enlarged mediastinal LN. The most frequent locations were lower paratracheal (4R, n = 8/4L, n = 6), subcarinal (7, n = 5) and right upper paratracheal (2R, n = 4) regions. The frequency of mediastinal LAP was higher in patients with aortic regurgitation (2 of 2, 100%) followed by mitral regurgitation (8 of 11, 73%); it was also high in patients with pulmonary edema (80%), pleural effusion (81%), or both (77%), as compared to patients without pulmonary edema or pleural effusion (17%) (p = 0.001). Ten of 30 patients showed an abnormal EF of < 55%; among them, 8 had mediastinal LAP. However, the relationship between EF and LAP was not statistically significant (p = 0.058). Mediastinal LN enlargement is common in patients with VHD, especially in cases of pulmonary edema and pleural effusion. Enlarged mediastinal LNs were frequently observed with abnormal EF, however, the relationship between EF and mediastinal LAP was not statistically significant.

  20. A real-time prediction model for post-irradiation malignant cervical lymph nodes.

    Science.gov (United States)

    Lo, W-C; Cheng, P-W; Shueng, P-W; Hsieh, C-H; Chang, Y-L; Liao, L-J

    2018-04-01

    To establish a real-time predictive scoring model based on sonographic characteristics for identifying malignant cervical lymph nodes (LNs) in cancer patients after neck irradiation. One-hundred forty-four irradiation-treated patients underwent ultrasonography and ultrasound-guided fine-needle aspirations (USgFNAs), and the resultant data were used to construct a real-time and computerised predictive scoring model. This scoring system was further compared with our previously proposed prediction model. A predictive scoring model, 1.35 × (L axis) + 2.03 × (S axis) + 2.27 × (margin) + 1.48 × (echogenic hilum) + 3.7, was generated by stepwise multivariate logistic regression analysis. Neck LNs were considered to be malignant when the score was ≥ 7, corresponding to a sensitivity of 85.5%, specificity of 79.4%, positive predictive value (PPV) of 82.3%, negative predictive value (NPV) of 83.1%, and overall accuracy of 82.6%. When this new model and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) were 0.89 and 0.81, respectively (P real-time sonographic predictive scoring model was constructed to provide prompt and reliable guidance for USgFNA biopsies to manage cervical LNs after neck irradiation. © 2017 John Wiley & Sons Ltd.

  1. Prognostic classifications of lymph node involvement in lung cancer and current International Association for the Study of Lung Cancer descriptive classification in zones.

    Science.gov (United States)

    Riquet, Marc; Arame, Alex; Foucault, Christophe; Le Pimpec Barthes, Françoise

    2010-09-01

    The lymphatic drainage of solid organ tumors crosses through the lymph nodes (LNs) whose tumoral involvement may still be considered as local disease. Concerning lung cancer, LN involvement may be intrapulmonary (N1), and mediastinal and/or extra-thoracic. More than 30 years ago, mediastinal involved LNs were all considered as N2, and outside the scope of surgery. In 1978, Naruke presented an original article entitled 'Lymph node mapping and curability at various levels of metastasis in resected lung cancer', demonstrating that N2 was not a contraindication to surgery in all patients. The map permitted to localize the favorable N2 on the lung cancer ipsilateral side of the mediastinum. Several maps ensued aiming to discriminate between right and left involvement (1983), and to distinguish N2 (ipsilateral) and N3 (contralateral) mediastinal LN involvement (1983, 1986). The last map (1997 regional LN classification) was recently replaced by a descriptive classification in anatomical zones. This new LN map of the TNM classification for lung cancer is a step toward using anatomical view points which might be the best way to better understand lung cancer lymphatic spread. Nowadays, the LNs are easily identified by current radiological imaging, and their resectability may be anticipated. Each LN chain may be removed by en-bloc lymphadenectomy performed during radical lung resection, a safe procedure which seems to be more oncological based than sampling, and which avoids the source of discrepancies pointed out during the labeling of LN stations by surgeons.

  2. Homeostatic NF-κB Signaling in Steady-State Migratory Dendritic Cells Regulates Immune Homeostasis and Tolerance.

    Science.gov (United States)

    Baratin, Myriam; Foray, Chloe; Demaria, Olivier; Habbeddine, Mohamed; Pollet, Emeline; Maurizio, Julien; Verthuy, Christophe; Davanture, Suzel; Azukizawa, Hiroaki; Flores-Langarica, Adriana; Dalod, Marc; Lawrence, Toby

    2015-04-21

    Migratory non-lymphoid tissue dendritic cells (NLT-DCs) transport antigens to lymph nodes (LNs) and are required for protective immune responses in the context of inflammation and to promote tolerance to self-antigens in steady-state. However, the molecular mechanisms that elicit steady-state NLT-DC maturation and migration are unknown. By comparing the transcriptome of NLT-DCs in the skin with their migratory counterparts in draining LNs, we have identified a novel NF-κB-regulated gene network specific to migratory DCs. We show that targeted deletion of IKKβ in DCs, a major activator of NF-κB, prevents NLT-DC accumulation in LNs and compromises regulatory T cell conversion in vivo. This was associated with impaired tolerance and autoimmunity. NF-κB is generally considered the prototypical pro-inflammatory transcription factor, but this study describes a role for NF-κB signaling in DCs for immune homeostasis and tolerance that could have implications in autoimmune diseases and immunity. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Is elective nodal irradiation beneficial in patients with pathologically negative lymph nodes after neoadjuvant chemotherapy and breast-conserving surgery for clinical stage II–III breast cancer? A multicentre retrospective study (KROG 12-05)

    Science.gov (United States)

    Noh, J M; Park, W; Suh, C-O; Keum, K C; Kim, Y B; Shin, K H; Kim, K; Chie, E K; Ha, S W; Kim, S S; Ahn, S D; Shin, H S; Kim, J H; Lee, H-S; Lee, N K; Huh, S J; Choi, D H

    2014-01-01

    Background: To evaluate the effects of elective nodal irradiation (ENI) in clinical stage II–III breast cancer patients with pathologically negative lymph nodes (LNs) (ypN0) after neoadjuvant chemotherapy (NAC) followed by breast-conserving surgery (BCS) and radiotherapy (RT). Methods: We retrospectively analysed 260 patients with ypN0 who received NAC followed by BCS and RT. Elective nodal irradiation was delivered to 136 (52.3%) patients. The effects of ENI on survival outcomes were evaluated. Results: After a median follow-up period of 66.2 months (range, 15.6–127.4 months), 26 patients (10.0%) developed disease recurrence. The 5-year locoregional recurrence-free survival and disease-free survival (DFS) for all patients were 95.5% and 90.5%, respectively. Pathologic T classification (0−is vs 1 vs 2–4) and the number of LNs sampled (ENI. Elective nodal irradiation also did not affect survival outcomes in any of the subgroups according to pathologic T classification or the number of LNs sampled. Conclusions: ENI may be omitted in patients with ypN0 breast cancer after NAC and BCS. But until the results of the randomised trials are available, patients should be put on these trials. PMID:24481403

  4. Is elective nodal irradiation beneficial in patients with pathologically negative lymph nodes after neoadjuvant chemotherapy and breast-conserving surgery for clinical stage II-III breast cancer? A multicentre retrospective study (KROG 12-05).

    Science.gov (United States)

    Noh, J M; Park, W; Suh, C-O; Keum, K C; Kim, Y B; Shin, K H; Kim, K; Chie, E K; Ha, S W; Kim, S S; Ahn, S D; Shin, H S; Kim, J H; Lee, H-S; Lee, N K; Huh, S J; Choi, D H

    2014-03-18

    To evaluate the effects of elective nodal irradiation (ENI) in clinical stage II-III breast cancer patients with pathologically negative lymph nodes (LNs) (ypN0) after neoadjuvant chemotherapy (NAC) followed by breast-conserving surgery (BCS) and radiotherapy (RT). We retrospectively analysed 260 patients with ypN0 who received NAC followed by BCS and RT. Elective nodal irradiation was delivered to 136 (52.3%) patients. The effects of ENI on survival outcomes were evaluated. After a median follow-up period of 66.2 months (range, 15.6-127.4 months), 26 patients (10.0%) developed disease recurrence. The 5-year locoregional recurrence-free survival and disease-free survival (DFS) for all patients were 95.5% and 90.5%, respectively. Pathologic T classification (0-is vs 1 vs 2-4) and the number of LNs sampled (ENI. Elective nodal irradiation also did not affect survival outcomes in any of the subgroups according to pathologic T classification or the number of LNs sampled. ENI may be omitted in patients with ypN0 breast cancer after NAC and BCS. But until the results of the randomised trials are available, patients should be put on these trials.

  5. Extended Salvage Pelvic Lymph Node Dissection in Patients with Recurrent Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Daniar K. Osmonov

    2014-01-01

    Full Text Available Background. Treatment of patients with a biochemical recurrence (BCR of prostate cancer (PCa is generally difficult and without valid treatment options. Since 2004 we have been developing therapeutic possibilities for these patients. Methods. We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of 40.3±20.8 months. Group 1 (n=10: salvage radical prostatectomy (sRP with SePLND (salvage extended pelvic lymph nodes dissection (initial treatment: combined brachytherapy. Group 2 (n=22: SePLND (initial treatment: radical prostatectomy (RP. Group 3 (n=9: SePLND (initial treatment: RP and adjuvant radiation therapy (RT. We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response. Results. Group 1: 60% with BCR-freedom (mean 27.2 months. Group 2: 63.6% with BCR-freedom (mean 17.5 months. Group 3: 33.3% with BCR-freedom (mean 17.6 months. In total, BCR-freedom was observed in 23 of 41 patients (56.1% after salvage surgery. 75.6% of all patients showed a BR. 765 LNs were removed and 14.8% of these were LN+. Conclusions. The BCR-free period and BR are comparable in all three groups. Sensibility to ADT can be reestablished and prolonged as a result of SePLND. Multicenter studies are needed for a reliable output.

  6. Preoperative multidetector CT manifestations of perigastric lymph nodes in patients with early gastric cancer and pN0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jung Hyun; Yu, Jeong Sik; Chung, Jae Joon; Lim, Joo Hee; Cho, Eun Suk; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2013-11-15

    To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0. One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis. When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p < 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p < 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR. Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.

  7. Antigen-specific tolerance inhibits autoimmune uveitis in pre-sensitized animals by deletion and CD4+CD25+ T-regulatory cells.

    Science.gov (United States)

    Matta, Bharati; Jha, Purushottam; Bora, Puran S; Bora, Nalini S

    2010-02-01

    The objective of this study was to inhibit experimental autoimmune anterior uveitis (EAAU) by establishing antigen-specific immune tolerance in animals pre-sensitized with melanin-associated antigen (MAA). Intravenous administration of MAA on days 6, 7, 8 and 9 post-immunization induced tolerance and inhibited EAAU in all Lewis rats. The number of cells (total T cells, CD4(+) T cells and CD8(+) T cells) undergoing apoptosis dramatically increased in the popliteal lymph nodes (LNs) of the tolerized animals compared with non-tolerized animals. In addition, Fas ligand (FasL), TNF receptor 1 (TNFR1) and caspase-8 were upregulated in tolerized rats. Proliferation of total lymphocytes, CD4(+)T cells and CD8(+) T cells (harvested from the popliteal LNs) in response to antigenic stimulation was drastically reduced in the state of tolerance compared with the cells from non-tolerized animals. The level of interferon (IFN)-gamma and IL-2 decreased, whereas TGF-beta2 was elevated in the state of tolerance. Furthermore, the number of CD4(+)CD25(+)FoxP3(+) regulatory T cells (Tregs) increased in the popliteal LNs of tolerized animals compared with non-tolerized animals. In conclusion, our results suggest that deletion of antigen-specific T cells by apoptosis and active suppression mediated by Tregs has an important role in the induction of antigen specific immune tolerance in animals with an established immune response against MAA.

  8. A 62-MeV Proton Beam for the Treatment of Ocular Melanoma at Laboratori Nazionali del Sud-INFN

    Science.gov (United States)

    Cirrone, G. A. P.; Cuttone, G.; Lojacono, P. A.; Lo Nigro, S.; Mongelli, V.; Patti, I. V.; Privitera, G.; Raffaele, L.; Rifuggiato, D.; Sabini, M. G.; Salamone, V.; Spatola, C.; Valastro, L. M.

    2004-06-01

    At the Istituto Nazionale di Fisica Nucleare-Laboratori Nazionali del Sud (INFN-LNS) in Catania, Italy, the first Italian protontherapy facility, named Centro di AdroTerapia e Applicazioni Nucleari Avanzate (CATANA) has been built in collaboration with the University of Catania. It is based on the use of the 62-MeV proton beam delivered by the K=800 Superconducting Cyclotron installed and working at INFN-LNS since 1995. The facility is mainly devoted to the treatment of ocular diseases like uveal melanoma. A beam treatment line in air has been assembled together with a dedicated positioning patient system. The facility has been in operation since the beginning of 2002 and 66 patients have been successfully treated up to now. The main features of CATANA together with the clinical and dosimetric features will be extensively described; particularly, the proton beam line, that has been entirely built at LNS, with all its elements, the experimental transversal and depth dose distributions of the 62-MeV proton beam obtained for a final collimator of 25-mm diameter and the experimental depth dose distributions of a modulated proton beam obtained for the same final collimator. Finally, the clinical results over 1 yr of treatments, describing the features of the treated diseases will be reported.

  9. Implementing IEC 61850-7-420 DER Logical Nodes in a single board

    Directory of Open Access Journals (Sweden)

    Anderson Salazar-Zuluaga

    2017-09-01

    Full Text Available This article discusses the implementation of a variety of logical nodes (LNs of power generation systems based on distributed energy resources (DER in a single board computer (SBC. The SBC allows for the acquisition and encapsulation of analog signals from a photovoltaic (PV array with batteries, based on the IEC 61850-7-420 standard. To achieve this, an SBC integrated with an analog-digital conversion card (ADC enables to read the system’s analog values. The SBC communicates with the ADC card to encapsulate the collected data in the IEC 61850 data object by using the corresponding logical node (LN. An open license library was used to create the IEC 61850 server inside the SBC and the driver of the ADC card manufacturer to communicate both cards. This work aims to develop LNs for DERs in such way that manufacturers of power generation technologies based on renewable sources (such as the sun and/or the wind implement Intelligent Electronic Devices (IED and controllers in accordance with the scope of the standard for these logical nodes (LNs. Finally, the communication testing of the implementation and the results obtained are presented.

  10. Lipid nanoparticles based on butyl-methoxydibenzoylmethane: in vitro UVA blocking effect

    International Nuclear Information System (INIS)

    Niculae, G; Lacatusu, I; Badea, N; Meghea, A

    2012-01-01

    The aim of the present study was to obtain efficient lipid nanoparticles loaded with butyl-methoxydibenzoylmethane (BMDBM) in order to develop cosmetic formulations with enhanced UVA blocking effect. For this purpose, two adequate liquid lipids (medium chain triglycerides and squalene) have been used in combination with two solid lipids (cetyl palmitate and glyceryl stearate) in order to create appropriate nanostructured carriers with a disordered lipid network able to accommodate up to 1.5% BMDBM. The lipid nanoparticles (LNs) were characterized in terms of particle size, zeta potential, entrapment efficiency, loading capacity and in vitro UVA blocking effect. The efficiency of lipid nanoparticles in developing some cosmetic formulations has been evaluated by determining the in vitro erythemal UVA protection factor. In order to quantify the photoprotective effect, some selected cream formulations based on BMDBM-LNs and a conventional emulsion were exposed to photochemical UV irradiation at a low energy to simulate the solar energy during the midday. The results obtained demonstrated the high ability of cream formulations based on BMDBM-LNs to absorb more than 96% of UVA radiation. Moreover, the developed cosmetic formulations manifest an enhanced UVA blocking effect, the erythemal UVA protection factor being four times higher than those specific to conventional emulsions. (paper)

  11. Lipid nanoparticles based on butyl-methoxydibenzoylmethane: in vitro UVA blocking effect

    Science.gov (United States)

    Niculae, G.; Lacatusu, I.; Badea, N.; Meghea, A.

    2012-08-01

    The aim of the present study was to obtain efficient lipid nanoparticles loaded with butyl-methoxydibenzoylmethane (BMDBM) in order to develop cosmetic formulations with enhanced UVA blocking effect. For this purpose, two adequate liquid lipids (medium chain triglycerides and squalene) have been used in combination with two solid lipids (cetyl palmitate and glyceryl stearate) in order to create appropriate nanostructured carriers with a disordered lipid network able to accommodate up to 1.5% BMDBM. The lipid nanoparticles (LNs) were characterized in terms of particle size, zeta potential, entrapment efficiency, loading capacity and in vitro UVA blocking effect. The efficiency of lipid nanoparticles in developing some cosmetic formulations has been evaluated by determining the in vitro erythemal UVA protection factor. In order to quantify the photoprotective effect, some selected cream formulations based on BMDBM-LNs and a conventional emulsion were exposed to photochemical UV irradiation at a low energy to simulate the solar energy during the midday. The results obtained demonstrated the high ability of cream formulations based on BMDBM-LNs to absorb more than 96% of UVA radiation. Moreover, the developed cosmetic formulations manifest an enhanced UVA blocking effect, the erythemal UVA protection factor being four times higher than those specific to conventional emulsions.

  12. Investigation of the feasibility of elective irradiation to neck level Ib using intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma: a retrospective analysis

    International Nuclear Information System (INIS)

    Zhang, Fan; Cheng, Yi-Kan; Li, Wen-Fei; Guo, Rui; Chen, Lei; Sun, Ying; Mao, Yan-Ping; Zhou, Guan-Qun; Liu, Xu; Liu, Li-Zhi; Lin, Ai-Hua; Tang, Ling-Long; Ma, Jun

    2015-01-01

    To assess the feasibility of elective neck irradiation to level Ib in nasopharyngeal carcinoma (NPC) using intensity-modulated radiation therapy (IMRT). We retrospectively analyzed 1438 patients with newly-diagnosed, non-metastatic and biopsy-proven NPC treated with IMRT. Greatest dimension of level IIa LNs (DLN-IIa) ≥ 20 mm and/or level IIa LNs with extracapsular spread (ES), oropharynx involvement and positive bilateral cervical lymph nodes (CLNs) were independently significantly associated with metastasis to level Ib LN at diagnosis. No recurrence at level Ib was observed in the 904 patients without these characteristics (median follow-up, 38.7 months; range, 1.3–57.8 months), these patients were classified as low risk. Level Ib irradiation was not an independent risk factor for locoregional failure-free survival, distant failure-free survival, failure-free survival or overall survival in low risk patients. The frequency of grade ≥ 2 subjective xerostomia at 12 months after radiotherapy was not significantly different between low risk patients who received level Ib-sparing, unilateral level Ib-covering or bilateral level Ib-covering IMRT. Level Ib-sparing IMRT should be safe and feasible for patients without a DLN-IIa ≥ 20 mm and/or level IIa LNs with ES, positive bilateral CLNs or oropharynx involvement at diagnosis. Further investigations based on specific criteria for dose constraints for the submandibular glands are warranted to confirm the benefit of elective level Ib irradiation

  13. Providing lipid-based nutrient supplement during pregnancy does not reduce the risk of maternal P falciparum parasitaemia and reproductive tract infections: a randomised controlled trial.

    Science.gov (United States)

    Nkhoma, Minyanga; Ashorn, Per; Ashorn, Ulla; Dewey, Kathryn G; Gondwe, Austrida; Mbotwa, John; Rogerson, Stephen; Taylor, Steve M; Maleta, Kenneth

    2017-01-17

    Maternal infections are associated with maternal and foetal adverse outcomes. Nutrient supplementation during pregnancy may reduce the occurrence of infections by improving maternal immunity. We aimed to investigate the impact of small-quantity lipid-based nutrient supplement (SQ-LNS) on the occurrence of Plasmodium falciparum parasitaemia during pregnancy and trichomoniasis, vaginal candidiasis and urinary tract infection (UTI) after delivery. Pregnant Malawian women enrolled in the iLiNS-DYAD trial receiving daily supplementation with SQ-LNS, multiple micronutrients (MMN) or iron & folic acid (IFA) from UTI using urine dipstick analysis. The prevalence of each infection by intervention group was estimated at the prescribed time points and the global null hypothesis was tested using logistic regression. Adjusted analyses were performed using preselected covariates. The prevalence of P. falciparum parasitaemia was 10.7% at 32 gw, 9% at 36 gw, and 8.3% by RDT and 20.2% by PCR at delivery. After delivery the prevalence of trichomoniasis was 10.5%, vaginal candidiasis was 0.5%, and UTI was 3.1%. There were no differences between intervention groups in the prevalence of any of the infections. In this population, SQ-LNS did not influence the occurrence of maternal P. falciparum parasitaemia, trichomoniasis, vaginal candidiasis or UTI. Identifier: NCT01239693 (10 November 2010).

  14. Three-dimensional computer-assisted dissection of pancreatic lymphatic anatomy on human fetuses: a step toward automatic image alignment.

    Science.gov (United States)

    Bardol, T; Subsol, G; Perez, M-J; Genevieve, D; Lamouroux, A; Antoine, B; Captier, G; Prudhomme, M; Bertrand, M M

    2018-05-01

    Pancreatic cancer is the fourth cause of death by cancer worldwide. Lymph node (LN) involvement is known to be the main prognostic factor. However, lymphatic anatomy is complex and only partially characterized. The aim of the study was to study the pancreatic lymphatic system using computer-assisted anatomic dissection (CAAD) technique and also to update CAAD technique by automatizing slice alignment. We dissected three human fetuses aged from 18 to 34 WA. 5-µm serial sections of duodeno-pancreas and spleen blocks were stained (hematoxylin-eosin, hematoxylin of Mayer and Masson trichrome), scanned, aligned and modeled in three dimensions. We observed a rich, diffuse but not systematized lymphatic network in the peri-pancreatic region. There was an equal distribution of LNs between the cephalic and body-tail portions. The lymphatic vascularization appeared in continuity from the celiac trunk to the distal ends of its hepatic and splenic arterial branches parallel to the nerve ramifications of the celiac plexus. We also observed a continuity between the drainage of the pancreatic head and the para-aortic region posteriorly. In view of the wealth of peri-pancreatic LNs, the number of LNs to harvest could be increased to improve nodal staging and prognostic evaluation. Pancreatic anatomy as described does not seem to be compatible with the sentinel LN procedure in pancreatic surgery. Finally, we are now able to offer an alternative to manual alignment with a semi-automated alignment.

  15. Neutron scattering

    International Nuclear Information System (INIS)

    1991-02-01

    The annual report on hand gives an overview of the research work carried out in the Laboratory for Neutron Scattering (LNS) of the ETH Zuerich in 1990. Using the method of neutron scattering, it is possible to examine in detail the static and dynamic properties of the condensed material. In accordance with the multidisciplined character of the method, the LNS has for years maintained a system of intensive co-operation with numerous institutes in the areas of biology, chemistry, solid-state physics, crystallography and materials research. In 1990 over 100 scientists from more than 40 research groups both at home and abroad took part in the experiments. It was again a pleasure to see the number of graduate students present, who were studying for a doctorate and who could be introduced into the neutron scattering during their stay at the LNS and thus were in the position to touch on central ways of looking at a problem in their dissertation using this modern experimental method of solid-state research. In addition to the numerous and interesting ways of formulating the questions to explain the structure, nowadays the scientific programme increasingly includes particularly topical studies in connection with high temperature-supraconductors and materials research

  16. Improving CT detection sensitivity for nodal metastases in oesophageal cancer with combination of smaller size and lymph node axial ratio

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jianfang [Chinese Academy of Medical Sciences and Peking Union Medical College, National Cancer Center/Cancer Hospital, Beijing (China); Capital Medical University Electric Power Teaching Hospital, Beijing (China); Wang, Zhu; Qu, Dong; Yao, Libo [Chinese Academy of Medical Sciences and Peking Union Medical College, National Cancer Center/Cancer Hospital, Beijing (China); Shao, Huafei [Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai (China); Liu, Jian [Meitan General Hospital, Beijing (China)

    2018-01-15

    To investigate the value of CT with inclusion of smaller lymph node (LN) sizes and axial ratio to improve the sensitivity in diagnosis of regional lymph node metastases in oesophageal squamous cell carcinoma (OSCC). The contrast-enhanced multidetector row spiral CT (MDCT) multiplanar reconstruction images of 204 patients with OSCC were retrospectively analysed. The long-axis and short-axis diameters of the regional LNs were measured and axial ratios were calculated (short-axis/long-axis diameters). Nodes were considered round if the axial ratio exceeded the optimal LN axial ratio, which was determined by receiver operating characteristic analysis. A positive predictive value (PPV) exceeding 50% is needed. This was achieved only with LNs larger than 9 mm in short-axis diameter, but nodes of this size were rare (sensitivity 37.3%, specificity 96.4%, accuracy 85.8%). If those round nodes (axial ratio exceeding 0.66) between 7 mm and 9 mm in size were considered metastases as well, it might improve the sensitivity to 67.2% with a PPV of 63.9% (specificity 91.6%, accuracy 87.2%). Combination of a smaller size and axial ratio for LNs in MDCT as criteria improves the detection sensitivity for LN metastases in OSCC. (orig.)

  17. Dissolving Microneedle Arrays for Transdermal Delivery of Amphiphilic Vaccines.

    Science.gov (United States)

    An, Myunggi; Liu, Haipeng

    2017-07-01

    Amphiphilic vaccine based on lipid-polymer conjugates is a new type of vaccine capable of self-delivering to the immune system. When injected subcutaneously, amphiphilic vaccines efficiently target antigen presenting cells in the lymph nodes (LNs) via a unique albumin-mediated transport and uptake mechanism and induce potent humoral and cellular immune responses. However, whether this new type of vaccine can be administrated via a safe, convenient microneedle-based transdermal approach remains unstudied. For such skin barrier-disruption systems, a simple application of microneedle arrays (MNs) is desired to disrupt the stratum corneum, and for rapid and pain-free self-administration of vaccines into the skin, the anatomic place permeates with an intricate mesh of lymphatic vessels draining to LNs. Here the microneedle transdermal approach is combined with amphiphilic vaccines to create a simple delivery approach which efficiently traffic molecular vaccines into lymphatics and draining LNs. The rapid release of amphiphilic vaccines into epidermis upon application of dissolving MNs to the skin of mice generates potent cellular and humoral responses, comparable or superior to those elicited by traditional needle-based immunizations. The results suggest that the amphiphilic vaccines delivered by dissolving MNs can provide a simple and safer vaccination method with enhanced vaccine efficacy. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Segmentation of 3-D High-Frequency Ultrasound Images of Human Lymph Nodes Using Graph Cut With Energy Functional Adapted to Local Intensity Distribution.

    Science.gov (United States)

    Kuo, Jen-Wei; Mamou, Jonathan; Wang, Yao; Saegusa-Beecroft, Emi; Machi, Junji; Feleppa, Ernest J

    2017-10-01

    Previous studies by our group have shown that 3-D high-frequency quantitative ultrasound (QUS) methods have the potential to differentiate metastatic lymph nodes (LNs) from cancer-free LNs dissected from human cancer patients. To successfully perform these methods inside the LN parenchyma (LNP), an automatic segmentation method is highly desired to exclude the surrounding thin layer of fat from QUS processing and accurately correct for ultrasound attenuation. In high-frequency ultrasound images of LNs, the intensity distribution of LNP and fat varies spatially because of acoustic attenuation and focusing effects. Thus, the intensity contrast between two object regions (e.g., LNP and fat) is also spatially varying. In our previous work, nested graph cut (GC) demonstrated its ability to simultaneously segment LNP, fat, and the outer phosphate-buffered saline bath even when some boundaries are lost because of acoustic attenuation and focusing effects. This paper describes a novel approach called GC with locally adaptive energy to further deal with spatially varying distributions of LNP and fat caused by inhomogeneous acoustic attenuation. The proposed method achieved Dice similarity coefficients of 0.937±0.035 when compared with expert manual segmentation on a representative data set consisting of 115 3-D LN images obtained from colorectal cancer patients.

  19. T Cell Zone Resident Macrophages Silently Dispose of Apoptotic Cells in the Lymph Node.

    Science.gov (United States)

    Baratin, Myriam; Simon, Léa; Jorquera, Audrey; Ghigo, Clément; Dembele, Doulaye; Nowak, Jonathan; Gentek, Rebecca; Wienert, Stephan; Klauschen, Frederick; Malissen, Bernard; Dalod, Marc; Bajénoff, Marc

    2017-08-15

    In lymph nodes (LNs), dendritic cells (DCs) are thought to dispose of apoptotic cells, a function pertaining to macrophages in other tissues. We found that a population of CX3CR1 + MERTK + cells located in the T cell zone of LNs, previously identified as DCs, are efferocytic macrophages. Lineage-tracing experiments and shield chimeras indicated that these T zone macrophages (TZM) are long-lived macrophages seeded in utero and slowly replaced by blood monocytes after birth. Imaging the LNs of mice in which TZM and DCs express different fluorescent proteins revealed that TZM-and not DCs-act as the only professional scavengers, clearing apoptotic cells in the LN T cell zone in a CX3CR1-dependent manner. Furthermore, similar to other macrophages, TZM appear inefficient in priming CD4 T cells. Thus, efferocytosis and T cell activation in the LN are uncoupled processes designated to macrophages and DCs, respectively, with implications to the maintenance of immune homeostasis. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Clinical relevance of DNA microarray analyses using archival formalin-fixed paraffin-embedded breast cancer specimens

    International Nuclear Information System (INIS)

    Sadi, Al Muktafi; Wang, Dong-Yu; Youngson, Bruce J; Miller, Naomi; Boerner, Scott; Done, Susan J; Leong, Wey L

    2011-01-01

    The ability of gene profiling to predict treatment response and prognosis in breast cancers has been demonstrated in many studies using DNA microarray analyses on RNA from fresh frozen tumor specimens. In certain clinical and research situations, performing such analyses on archival formalin fixed paraffin-embedded (FFPE) surgical specimens would be advantageous as large libraries of such specimens with long-term follow-up data are widely available. However, FFPE tissue processing can cause fragmentation and chemical modifications of the RNA. A number of recent technical advances have been reported to overcome these issues. Our current study evaluates whether or not the technology is ready for clinical applications. A modified RNA extraction method and a recent DNA microarray technique, cDNA-mediated annealing, selection, extension and ligation (DASL, Illumina Inc) were evaluated. The gene profiles generated from FFPE specimens were compared to those obtained from paired fresh fine needle aspiration biopsies (FNAB) of 25 breast cancers of different clinical subtypes (based on ER and Her2/neu status). Selected RNA levels were validated using RT-qPCR, and two public databases were used to demonstrate the prognostic significance of the gene profiles generated from FFPE specimens. Compared to FNAB, RNA isolated from FFPE samples was relatively more degraded, nonetheless, over 80% of the RNA samples were deemed suitable for subsequent DASL assay. Despite a higher noise level, a set of genes from FFPE specimens correlated very well with the gene profiles obtained from FNAB, and could differentiate breast cancer subtypes. Expression levels of these genes were validated using RT-qPCR. Finally, for the first time we correlated gene expression profiles from FFPE samples to survival using two independent microarray databases. Specifically, over-expression of ANLN and KIF2C, and under-expression of MAPT strongly correlated with poor outcomes in breast cancer patients. We

  1. Ultrasonographic findings of papillary carcinoma of the thyroid according to the size: Especially less than 0.5 cm

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Yung; Kim, Yun Min; Lee, Hyun Bok; Cho, Nam Soo [Dept. of Diagonostic Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Yoon, Joon [Dept. of Radiologic Technology, Dongnam Health College, (Korea, Republic of)

    2013-06-15

    The Korean Thyroid Association recommends fine-needle aspiration biopsy (FNAB) for nodules more than 0.5 cm in diameter. But nodules, smaller than 0.5 cm have been found in papillary carcinomas of the thyroid (PTC) at the health promotion center at SMC. We wanted to evaluate the ultrasonographic findings according to size of nodule in proven PTCs by FNAB, especially less than 0.5 cm. All nodules were classified into three groups by their longest diameter : less than 0.5 cm, more than 0.5 cm but less than 1 cm, and more than 1 cm. Sonographic findings suggesting malignancy were analyzed according to their size groups. Of 288 malignant nodules, 21.5 % (62/288) were less than 0.5 cm , 54.9 % (158/288) were more than 0.5 cm but less than 1 cm, 23.6 % (68/288) exceeded 1 cm. A taller-than-wide shape was observed in 90.3 % (56/62) of nodules less than 0.5 cm, and 48.5 % (33/68) of nodules exceeding 1 cm (p<0.001). There were no well-defined smooth nodules among nodules less than 0.5 cm, and spiculated or irregular margin nodules increased as the size increased (p=0.024). Nodules of size less than 0.5 cm did not showed hyper or isoechogenicity. Hypoechogenicity was greater than the marked hypoechogenicity in each group (p=0.034). Micro- or macro-calcifications were not founded in 77.4 % (48/62) of the nodule group sized less than 0.5 cm. From the small size of the group, micro- or macrocalcifications were observed 21.0 % (13/62), 48.1 % (76/158), 64.7 % (44/68), so the number of nodules containing micro- or macro-calcification increased as size increased (p<0.001). PTCs less than 0.5 cm in size on ultrasonography had taller than-wide shape, spiculated or irregular and ill-defined margins, and exhibited hypo and markedly hypoechogenicity, but microor macro-calcifications were not common. These ultrasonographic features of nodules less than 0.5 cm can be useful in reporting and guiding FNABs or follow-up exams.

  2. Audit of percutaneous nephrostomy in Rabat Urological Centre ...

    African Journals Online (AJOL)

    US guided PCN had success rate of 13 (86.6%), CT guided PCN eight (80%) while blindly PCN 2(100%). The overall complications were minimal. Conclusions: The success of PCN procedures depend mainly on the degree of hydronephrosis and selection of the appropriate image guidance. Key Words: Blind PCN, CT ...

  3. Comparison of ultrasound-guided versus anatomical landmark ...

    African Journals Online (AJOL)

    Background Femoral vein cannulation may be required during major surgery in infants and children and may prove to be life saving under certain conditions. This study compared ultrasound (US)-guided cannulation of the femoral vein in infants with the traditional anatomical landmark-guided technique. Methods Eighty ...

  4. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

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

    2011-01-01

    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....

  5. Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

    International Nuclear Information System (INIS)

    Jung, Hyun Kyung; Moon, Hee Jung; Kim, Min Jung; Kim, Eun Kyung

    2014-01-01

    To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assisted excision, n=35) or breast ultrasonography (n=20). Of the 126 patients who underwent surgical excision or US-guided vacuum-assisted excision, 114 patients were diagnosed with benign lesions, 10 patients with borderline lesions (benign phyllodes tumor), and two patients with malignant phyllodes tumors. The probabilities of lesions being benign, borderline and malignant were 91.8% (134/146), 6.8% (10/146), and 1.4% (2/146), respectively. Of 13 patients who had growing masses on follow-up ultrasonography, three (23.1%) were non-benign (two benign phyllodes tumors and one malignant phyllodes tumor). US-guided core needle biopsy of probably benign breast mass 2 cm or larger was accurate (98.6%) enough to rule out malignancy. But, it was difficult to rule out borderline lesions even when they were diagnosed as benign.

  6. Ultrasonography and color Doppler in juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Laurell, Louise; Court-Payen, Michel; Nielsen, Susan

    2011-01-01

    hypertrophy, effusion) and by color Doppler (synovial hyperemia) before and 4 weeks after US-guided steroid injection. Results US detected 121 compartments with active disease (joints, tendon sheaths and 1 ganglion cyst). Multiple compartments were involved in 80% of the ankle regions. The talo-crural joint...

  7. Retrospective Analysis of the Accuracy of Ultrasound-Guided Magnetic Resonance Arthrogram Injections of the Hip in the Office Setting.

    Science.gov (United States)

    Jernick, Michael; Walker Gallego, Edward; Nuzzo, Michael

    2017-12-01

    Ultrasound (US)-guided intra-articular hip injections have been proposed in the literature to be accurate, reliable, and safe alternatives to fluoroscopy-guided injections. To evaluate the accuracy of US-guided magnetic resonance (MR) arthrogram injections of the hip performed in the office setting by a single orthopaedic surgeon and elucidate the potential effects that patient age, sex, and body mass index (BMI) have on contrast placement. Case series; Level of evidence, 4. From a review of the senior author's office database, 89 patients (101 hips) who had US-guided MR arthrogram injections performed between December 2014 and June 2016 were identified. Official radiology reports were evaluated to determine whether extra-articular contrast was noted. Patient variables, including BMI, age, and sex, were evaluated between patients who had inappropriately placed contrast and those who did not. Of the 101 hip injections, there were 6 cases that demonstrated inadequate contrast placement within the joint, likely secondary to extravasation or incorrect placement; however, an MR arthrogram was adequately interpreted in all cases. There were no significant differences noted between those with appropriate versus inappropriate contrast placement when evaluating BMI ( P = .57), age ( P = .33), or sex ( P = .67), and neither group had an adverse event. US-guided injections are safe and accurate alternatives to fluoroscopy-guided injections in the office setting, with 94% accuracy. Furthermore, BMI, age, and sex did not play a statistically significant role among patients with inappropriately placed contrast.

  8. Ultrasound-guided compression repair of pseudoaneurysms of brachial and femoral arteries - 2 cases-

    International Nuclear Information System (INIS)

    Kim, Hak Soo; Choi, Yeon Hyeon; Kim, Ji Eun; Lee, Sang Hoon; Kim, Myung A; Kim, Tae Kyoung; Cho, Jae Min

    1994-01-01

    Ultrasound-guided compression repair of postcatherization pseudoaneurysm has been reported recently. We successfuly treated two cases of cardiac catherization-related pseudoaneurysms of brachial and femoral arteries with compression repair technique under color Doppler US-guidance. We regard US-guided compression repair as a saft and effective first-line treatment for catherization-related pseudoaneurysm

  9. A New Ultrasound-Guided Puncture Device with Augmented Degrees of Performance Freedom and Ability to Attach to Most Convex Probes

    International Nuclear Information System (INIS)

    Jung, Sung Il; Son, Kyu Ri; Kim, Young Jun; Jeon, Hae Jeong; Park, Sang Woo; Cho, Jeong Yeon; Kim, Seung Hyup

    2008-01-01

    To evaluate the performance of a newly-designed ultrasound (US)-guided puncture device. A newly-designed US-guided puncture device was composed of a guide segment and an attachable segment. The guide segment allowed the needle to be placed in the plane of US view with a maximal degree of freedom, and the attachable segment was designed to attach to most convex US probes. Six operators punctured 144 targets in phantoms using either the new device (n = 72) or free-hand technique (n = 72). The number of required needle passages and the necessary procedure times were compared between the two groups. The number of required needle passages and the necessary procedure time were significantly reduced in five operators when the newly-designed US-guided puncture device was used (p < 0.05). A newly-designed US-guided puncture device, which allows for a maximal degree of freedom in needle placement and can attach to most convex US probes, showed good performance in our study

  10. Check In / Check Out. The Public Space as an Internet of Things

    NARCIS (Netherlands)

    van t Hof, C.C.G.; van Est, R.; Daemen, F.

    2011-01-01

    Mobile phones, public transport smart cards, security cameras and GPS systems in our car - we are surrounded by digital devices. They track us, guide us, help us, and control us. The book Check In / Check Out. The Public Space as an Internet of Things shows us how our digital and physical worlds are

  11. Check in / check out : the public space as an internet of things

    NARCIS (Netherlands)

    Hof, van 't C.; Est, van R.; Daemen, F.

    2011-01-01

    Mobile phones, public transport smart cards, security cameras and GPS systems in our car - we are surrounded by digital devices. They track us, guide us, help us, and control us. The book Check In / Check Out. The Public Space as an Internet of Things shows us how our digital and physical worlds are

  12. Ultrasound-guided continuous phrenic nerve block for persistent hiccups.

    NARCIS (Netherlands)

    Renes, S.H.; Geffen, G.J. van; Rettig, H.C.; Gielen, M.J.M.; Scheffer, G.J.

    2010-01-01

    BACKGROUND: Phrenic nerve block can be performed and repeated if necessary for persistent hiccups, when conservative and pharmacological treatment is unsuccessful. We report the first description of an in-plane ultrasound (US)-guided phrenic nerve block (PhNB) with a catheter, after US investigation

  13. Ultrasound-guided needle aspiration of parotid abscess

    Directory of Open Access Journals (Sweden)

    André Takahashi

    2012-01-01

    Full Text Available Ultrasound (US has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.

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

    African Journals Online (AJOL)

    2011-06-15

    Jun 15, 2011 ... guided PFNAB/US-guided PNCB was the diagnostic test in 23.33% cases. It confirmed a highly ..... provides guidance in multiple axial, longitudinal and .... Source of Support: Nil, Con.ict of Interest: None declared. Gani, et al.

  15. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline - March 2017.

    Science.gov (United States)

    Polkowski, Marcin; Jenssen, Christian; Kaye, Philip; Carrara, Silvia; Deprez, Pierre; Gines, Angels; Fernández-Esparrach, Gloria; Eisendrath, Pierre; Aithal, Guruprasad P; Arcidiacono, Paolo; Barthet, Marc; Bastos, Pedro; Fornelli, Adele; Napoleon, Bertrand; Iglesias-Garcia, Julio; Seicean, Andrada; Larghi, Alberto; Hassan, Cesare; van Hooft, Jeanin E; Dumonceau, Jean-Marc

    2017-10-01

    For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation). ESGE suggests neutralizing residual negative pressure in the needle before withdrawing the needle from the target lesion (moderate quality evidence, weak recommendation).ESGE does not recommend for or against using the needle stylet for EUS-guided sampling of solid masses and LNs with FNA needles (high quality evidence, strong recommendation) and suggests using the needle stylet for EUS-guided sampling with FNB needles (low quality evidence, weak recommendation).ESGE suggests fanning the needle throughout the lesion when sampling solid masses and LNs (moderate quality evidence, weak recommendation).ESGE equally recommends EUS-guided sampling with or without on-site cytologic evaluation (moderate quality evidence, strong recommendation). When on-site cytologic evaluation is unavailable, ESGE suggests performance of three to four needle passes with an FNA needle or two to three passes with an FNB needle (low quality evidence, weak recommendation).For diagnostic sampling of pancreatic cystic lesions without a solid component, ESGE suggests emptying the cyst with a single pass of a 22G or 19G needle (low quality evidence, weak recommendation). For pancreatic cystic lesions with a solid component, ESGE suggests sampling of the solid component using the same technique as in the

  16. FDG PET/CT Is Superior to Enhanced CT in Detecting Recurrent Subcentimeter Lesions in the Abdominopelvic Cavity in Colorectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai Jeon; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. Bundang Hospital, Seoul (Korea, Republic of); Lee, Jong Jin [Asan Medical Center, Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    This study aims to compare the performance of contrast enhanced computed tomography (CeCT) and 18 F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. We enrolled 16 patients who were clinically suspected of experiencing a recurrences (6 male, 10 female; mean age 61{+-}14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT and PET/CT confirmed nodules (5.5{+-}4.2 vs. 2.9{+-}2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT and PET/CT confirmed nodules (long axis:1.0{+-}0.3cm vs. 2.0{+-}1.1cm, p=0.001; short axis: 0.8{+-}0.3cm vs. 1.7{+-}0.9cm, p=0.001). Similarly, PET/CT only detected LNs were significantly smaller than CeCT and PET/CT identified LNs (0.7{+-}0.1cm vs. 2.3{+-}1.2cm, p<0.0001). PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

  17. Paratesticular adenocarcinoma. Unusual presentation of metastasis of pancreatic cancer

    International Nuclear Information System (INIS)

    Ocvirk, J.; Seruga, B.

    2007-01-01

    Metastatic paratesticular adenocarcinoma from the pancreatic cancer is very rare. To our knowledge, there are less than 20 cases published in the literature. We experienced a case of paratesticular adenocarcinoma from the primary pancreatic cancer. A 42-year-old man was presented with locoregionally advanced carcinoma of the tail of the pancreas with intraoperatively found liver metastases and with a tumour in the right hemi-scrotum. Ultrasound of the scrotum revealed a paratesticular tumour. A fine needle aspiration biopsy (FNAB) confirmed a poorly differentiated adenocarcinoma and it was in concordance with the diagnosis of the primary tumour. The patient started treatment with chemotherapy with gemcitabine. Unfortunately, he progressed one month later and the treatment was discontinued. Outcome in the adenocarcinoma of the pancreas is dismal. The only possible treatment option for metastatic disease is systemic therapy but the results are disappointing, as in the present case. (author)

  18. Punção aspirativa nos tumores das glândulas salivares: especificidade e sensibilidade Fine needle aspiration in salivary gland tumors: specificity and sensitivity

    Directory of Open Access Journals (Sweden)

    Antonio José Gonçalves

    2007-06-01

    easily established since it is usually based only on the patients' clinical history and imaging exams OBJECTIVE: To evaluate results obtained from fine needle aspiration biopsy (FNAB, comparing them to the histological findings of the respective surgical specimens and analyzing the sensitivity, specificity and accuracy of this method in relation to the diagnosis of malignancy or benignancy. METHODS: Retrospective study with the medical records of 73ee patients' who had salivary gland neoplasms and were submitted to FNAB and surgical treatment. RESULTS: Data disclosed that values of sensitivity were 87.9 % and specificity 85.7 % for diagnosis of benign tumors. For malignant tumors 42.5 % of sensitivity and 98.3 of specificity, were observed. Overall values of accuracy were, respectively, 85.7 % and 87.8 % for positive and negative predictive values in the diagnosis of malignancy by FNAB. CONCLUSIONS: It was shown that FNAB, as supplementary diagnostic method, can be useful for preoperative evaluation and surgical planning especially for malignant neoplasms.

  19. Metastatic tumours to the thyroid gland: report of 3 cases and brief review of the literature

    International Nuclear Information System (INIS)

    Vardar, Enver; Erkan, Nazif; Bayol, Umit; Yılmaz, Cengiz; Dogan, Murat

    2010-01-01

    Metastases to the thyroid are encountered rarely in clinical practice, but the number of cases seems to have increased in recent years. The reason of this increase may be a more frequent use of fine-needle aspiration biopsy (FNAB) and the use of more sophisticated, complicated imaging techniques in patients with thyroid masses. Also, in addition to these reasons, the use of more organo-specific immunohistochemical antibodies in the examination of surgical specimens may affect the differential diagnosis of malignant tumours. Three metastatic tumours to thyroid were found in the retrospective review of malignant thyroid tumours diagnosed between January 1993 and December 2007. The primary tumours were clear cell carcinoma of the kidney, squamous cell carcinoma of the lung and breast carcinoma-ductal type. A detailed clinical history, careful histological examination and essential immunohistochemistry helped in attaining the correct diagnosis

  20. Accuracy of Triple Diagnostic Test in Patients with Thyroid Nodule at Dr. Cipto Mangunkusumo General Hospital

    Directory of Open Access Journals (Sweden)

    Diani Kartini

    2017-04-01

    Full Text Available The aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9% and 31 benign cases (19.3%. Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%, follicular (3%, medullary (0.7%, and anaplastic (6%. The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6% or clinical findings and FNAB (87%. Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98% and malignant probability (92% is high. Keywords: thyroid nodule, triple diagnostic, accuracy.   Akurasi Metode Triple Diagnostic pada Pasien Nodul Tiroid  di RSUPN Dr. Cipto Mangunkusumo   Abstrak Tujuan

  1. Promise and pitfalls of molecular markers of thyroid nodules

    Science.gov (United States)

    Jadhav, S.; Lila, Anurag; Bandgar, Tushar; Shah, Nalini

    2012-01-01

    Thyroid nodules are common in the general population with a prevalence of 5-7% The initial evaluation of thyroid nodules commonly involves thyroid function tests, an ultrasound (USG) and fine needle aspiration biopsy (FNAB). The optimal management of patients with thyroid nodules with indeterminate cytology is plagued by the lack of highly sensitive and specific diagnostic modalities In this article we attempt to review the available literature on the molecular markers which are increasingly being studied for their diagnostic utility in assessing thyroid nodules. The various molecular markers consist of gene mutations, gene re arrangements, RNA based assays and immunohistochemical markers. The molecular markers definitely would help to optimise the management of such patients. PMID:23565369

  2. Promise and pitfalls of molecular markers of thyroid nodules

    Directory of Open Access Journals (Sweden)

    S Jadhav

    2012-01-01

    Full Text Available Thyroid nodules are common in the general population with a prevalence of 5-7% The initial evaluation of thyroid nodules commonly involves thyroid function tests, an ultrasound (USG and fine needle aspiration biopsy (FNAB. The optimal management of patients with thyroid nodules with indeterminate cytology is plagued by the lack of highly sensitive and specific diagnostic modalities In this article we attempt to review the available literature on the molecular markers which are increasingly being studied for their diagnostic utility in assessing thyroid nodules. The various molecular markers consist of gene mutations, gene re arrangements, RNA based assays and immunohistochemical markers. The molecular markers definitely would help to optimise the management of such patients.

  3. Development of an ultrasound-guided technique for retrobulbar nerve block in dromedary camels: a cadaveric study.

    Science.gov (United States)

    Badawy, Adel M; Eshra, Eman A

    2018-03-01

    Description of an ultrasound (US)-guided technique for retrobulbar nerve blockade in dromedary (Camelus dromedarius) cadavers. Prospective experimental cadaveric study that was carried out in three phases: phase I: anatomical dissection and development of US-guided technique; phase II: methylene blue (MB) injection; phase III: contrast medium (CM), US-guided injections with computed tomography (CT) control. A total of 36 orbits from 18 heads were obtained from 18 dromedary cadavers. Phase I: anatomical dissections were carried out bilaterally, using two heads to determine needle site placement. Phase II: a US-guided, lateral, in-plane approach using one of three volumes of MB (3, 6, or 9 mL) was evaluated in six heads (four orbits per volume tested) to establish the ideal injection volume. Injections of MB that strongly stained all retrobulbar nerves were considered successful, whereas insufficient MB volumes resulted in weak or no nerve staining. Phase III: US-guided retrobulbar injection with CM was carried out using 20 orbits. Computed tomography was performed after each injection trial to determine the accuracy of needle placement and CM dispersal. An injection was judged to be successful when the CT images revealed that the needle was located within the retractor bulbi muscle cone and the CM reached the target nerves at the orbitorotundum and the optic foramina. Only injection of 9 mL of MB stained the target nerves sufficiently, whereas there was no or only weak staining with 3 and 6 mL, respectively. Therefore, 9 mL of CM was used for the US-guided injections in phase III. Subsequent CT scans revealed satisfying CM distribution within the ocular muscle cone in 18 of 20 cases (90% success rate). US-guided retrobulbar injection in dromedary cadavers is feasible. Further research is required to assess its practicality and usefulness in vivo. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and

  4. Usefulness and Complications of Ultrasonography- Guided Vacuum Assisted Biopsy for the Removal of Benign Breast Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keum Won; Cho, Young Jun; Hwang, Cheol Mog; Kim, Dae Ho; Oh, Kyoung Jin; Yoon, Dae Sung [Konyang University College of Medicine, Daejeon (Korea, Republic of); Kim, Kyu Soon [Eulji University College of Medicine, Daejeon (Korea, Republic of)

    2010-09-15

    To evaluate the usefulness and complications of ultrasonography (US)- guided vacuum assisted biopsy (VAB) for the removal of benign breast lesions, and the short- and long-term changes after VAB as shown on follow-up US. From January 2007 to May 2008, 110 sonographically benign lesions in 62 patients were sampled via US-guided VAB. We prospectively evaluated the sonographic findings 1 week and 6 months after VAB in all patients to determine the presence of residual tumors, hematomas and scarring. We evaluated the prevalence of hematoma, pain, skin dimpling, fibrotic scarring and residual tumors after US-guided VAB, and determined if correlation existed between complications, size of the lesions and lesion pathology. The age of the patients was 15-65 years, with a mean age of 36.5 years. The pathologic diagnoses were fibroadenomas (41.8%, n = 46), fibrocystic changes (30.9%, n = 34), fibroadenomatoid hyperplasias (13.6%, n = 15), fibroadenomatoid mastopathies (6.3%, n = 7), adenoses (3.6%, n = 4), hamartomas (1.8%, n = 2) and phyllodes tumors (1.8%, n = 2). Complications 1 week after the US-guided VAB included hematomas (n = 39, 35.4%), pain (n = 23, 20.9%), fibrotic scars (n = 26, 23.68%), residual tumors (n = 4, 3.6%) and skin dimplings (n = 4, 3.6%). Complications 6 months after the US-guided VAB included hematomas (n = 12, 10.9%), pain (n = 3 2.7%), fibrotic scars (n = 14, 12.7%), and residual tumors (n = 17, 15.4%). Residual tumor after US-guided VAB existed in association with 15.2% of fibroadenomas (7/46), 14.7% of fibrocystic changes (5/34), 13.3% of fibroadenomatoid hyperplasias (2/15), 25% of adenoses (1/4), and 100% of phyllodes tumors (2/2). US-guided VAB is an effective procedure for removal of benign breast lesion. Periodic follow up studies at 1 week and 6 months after the VAB are useful to assess Post-VAB complications

  5. Usefulness and Complications of Ultrasonography- Guided Vacuum Assisted Biopsy for the Removal of Benign Breast Lesions

    International Nuclear Information System (INIS)

    Kim, Keum Won; Cho, Young Jun; Hwang, Cheol Mog; Kim, Dae Ho; Oh, Kyoung Jin; Yoon, Dae Sung; Kim, Kyu Soon

    2010-01-01

    To evaluate the usefulness and complications of ultrasonography (US)- guided vacuum assisted biopsy (VAB) for the removal of benign breast lesions, and the short- and long-term changes after VAB as shown on follow-up US. From January 2007 to May 2008, 110 sonographically benign lesions in 62 patients were sampled via US-guided VAB. We prospectively evaluated the sonographic findings 1 week and 6 months after VAB in all patients to determine the presence of residual tumors, hematomas and scarring. We evaluated the prevalence of hematoma, pain, skin dimpling, fibrotic scarring and residual tumors after US-guided VAB, and determined if correlation existed between complications, size of the lesions and lesion pathology. The age of the patients was 15-65 years, with a mean age of 36.5 years. The pathologic diagnoses were fibroadenomas (41.8%, n = 46), fibrocystic changes (30.9%, n = 34), fibroadenomatoid hyperplasias (13.6%, n = 15), fibroadenomatoid mastopathies (6.3%, n = 7), adenoses (3.6%, n = 4), hamartomas (1.8%, n = 2) and phyllodes tumors (1.8%, n = 2). Complications 1 week after the US-guided VAB included hematomas (n = 39, 35.4%), pain (n = 23, 20.9%), fibrotic scars (n = 26, 23.68%), residual tumors (n = 4, 3.6%) and skin dimplings (n = 4, 3.6%). Complications 6 months after the US-guided VAB included hematomas (n = 12, 10.9%), pain (n = 3 2.7%), fibrotic scars (n = 14, 12.7%), and residual tumors (n = 17, 15.4%). Residual tumor after US-guided VAB existed in association with 15.2% of fibroadenomas (7/46), 14.7% of fibrocystic changes (5/34), 13.3% of fibroadenomatoid hyperplasias (2/15), 25% of adenoses (1/4), and 100% of phyllodes tumors (2/2). US-guided VAB is an effective procedure for removal of benign breast lesion. Periodic follow up studies at 1 week and 6 months after the VAB are useful to assess Post-VAB complications

  6. Effectiveness of food supplements in increasing fat-free tissue accretion in children with moderate acute malnutrition: A randomised 2 × 2 × 3 factorial trial in Burkina Faso.

    Science.gov (United States)

    Fabiansen, Christian; Yaméogo, Charles W; Iuel-Brockdorf, Ann-Sophie; Cichon, Bernardette; Rytter, Maren J H; Kurpad, Anura; Wells, Jonathan C; Ritz, Christian; Ashorn, Per; Filteau, Suzanne; Briend, André; Shepherd, Susan; Christensen, Vibeke B; Michaelsen, Kim F; Friis, Henrik

    2017-09-01

    Children with moderate acute malnutrition (MAM) are treated with lipid-based nutrient supplement (LNS) or corn-soy blend (CSB). We assessed the effectiveness of (a) matrix, i.e., LNS or CSB, (b) soy quality, i.e., soy isolate (SI) or dehulled soy (DS), and (c) percentage of total protein from dry skimmed milk, i.e., 0%, 20%, or 50%, in increasing fat-free tissue accretion. Between September 9, 2013, and August 29, 2014, a randomised 2 × 2 × 3 factorial trial recruited 6- to 23-month-old children with MAM in Burkina Faso. The intervention comprised 12 weeks of food supplementation providing 500 kcal/day as LNS or CSB, each containing SI or DS, and 0%, 20%, or 50% of protein from milk. Fat-free mass (FFM) was assessed by deuterium dilution technique. By dividing FFM by length squared, the primary outcome was expressed independent of length as FFM index (FFMI) accretion over 12 weeks. Other outcomes comprised recovery rate and additional anthropometric measures. Of 1,609 children, 4 died, 61 were lost to follow-up, and 119 were transferred out due to supplementation being switched to non-experimental products. No children developed allergic reaction. At inclusion, 95% were breastfed, mean (SD) weight was 6.91 kg (0.93), with 83.5% (5.5) FFM. In the whole cohort, weight increased 0.90 kg (95% CI 0.88, 0.93; p increased by 0.083 kg/m2 (95% CI 0.003, 0.163; p = 0.042) in those who received LNS. In contrast, SI did not increase FFMI compared to DS (mean difference 0.038 kg/m2; 95% CI -0.041, 0.118; p = 0.35), irrespective of matrix. Having 20% milk protein was associated with 0.097 kg/m2 (95% CI -0.002, 0.196) greater FFMI accretion than having 0% milk protein, although this difference was not significant (p = 0.055), and there was no effect of 50% milk protein (0.049 kg/m2; 95% CI -0.047, 0.146; p = 0.32). There was no effect modification by season, admission criteria, or baseline FFMI, stunting, inflammation, or breastfeeding (p > 0.05). LNS compared to CSB resulted

  7. Detecção do linfonodo sentinela em câncer da mama: comparação entre métodos

    Directory of Open Access Journals (Sweden)

    Xavier Nilton Leite

    2002-01-01

    Full Text Available Objetivos: avaliar a eficiência da cintilografia mamária, do detector manual de raios gama (probe e do corante azul vital para a localização do linfonodo sentinela (LNS, estabelecendo a sensibilidade, o valor preditivo negativo (VPN e a acurácia do mapeamento do LNS. Métodos: neste estudo estão incluídas 88 pacientes com câncer de mama atendidas consecutivamente e com axila clinicamente negativa. Foi utilizado o radiofármaco tecnécio ligado ao colóide dextran 500 (Dextran 99mTc, para cintilografia pré-operatória, realizada em 58 pacientes, e detecção transoperatória com o probe em 53 pacientes. Destas, 47 tiveram as contagens de irradiação gama anotadas e também o intervalo de tempo decorrido entre a injeção e a cirurgia. Foram empregados 2 mL do corante vital Bleu Patente V, injetado em torno do tumor, 5 minutos antes da incisão cirúrgica na axila em todos os casos. O LNS foi avaliado por congelação em 77 casos e todos pela coloração por hematoxilina e eosina. Resultados: a linfocintilografia, realizada em 58 casos, foi útil em 62,1%, sendo que em nove ocorreu mapeamento de dois linfonodos, e com o probe foram confirmados 45 casos (84,9% dos 53 avaliados. Das 47 com anotação de contagens de raios gama e do tempo decorrido da injeção do radiofármaco até a cirurgia, constituíram-se dois grupos para análise, o grupo dia (27 casos e o grupo outro dia (20 casos, que se mostraram diferentes, com significância estatística, tanto no tempo decorrido quanto nas contagens de raios gama, porém sem interferência nos resultados de detecção do LNS. A associação do probe e do corante azul resultou em sucesso nos 53 casos avaliados, assim como em 32 dos 35 casos em que só o corante foi usado. A média de idade das pacientes foi 58 anos. Quarenta e uma pacientes tiveram linfonodos axilares com metástase e apenas duas com LNS falsamente negativo, dando sensibilidade de 95,3%, VPN de 95,5% e acurácia de 97,6. Conclus

  8. Role of apparent diffusion coefficient values and diffusion weighted magnetic resonance imaging in differentiation between benign and malignant thyroid nodules

    International Nuclear Information System (INIS)

    Incedayi, M.; Sivrioglu, A.; Mutlu, H.; Sonmez, G.; Velioglu, M.; Sildiroglu, O.; Basekim, C.; Kizilkaya, E.

    2012-01-01

    Full text: Objective: The purpose of the study was to differentiate between benign and malignant thyroid nodules using nodule-spinal cord signal intensity and nodule apparent diffusion coefficient (ADC) ratios on diffusion weighted magnetic resonance imaging. Materials and methods: Forty-four patients (27 females, 17 males; mean age 49) with nodules who underwent diffusion weighted magnetic resonance imaging (DW-MRI) were included in this study. The images were acquired with 0, 50, 400 and 1000 s/mm 2 b values. ADC maps were calculated afterwards. Fine needle aspiration biopsies (FNAB) were performed at the same day with DW-MRI acquisition. The diagnosis in patients where malignity was detected after FNAB was confirmed by histopathologic analysis of the operation material. The signal intensities of the spinal cord and the nodule were measured additionally, over b-1000 diffusion weighted images. Nodule /cord signal intensity (SI) ratios were obtained and the digital values were calculated by dividing to ADC values estimated for each nodule. Statistical analysis was performed. Results: The (nodule SI-cord SI)/nodule ADC ratio is calculated in the DW images and a statistically significant relationship was found between this ratio and the histopathology of the nodules (p<0.001). The ratio was determined as 0.27 in benign, and 0.86 in malignant lesions. The result of ROC analysis was statistically significant, and the area under Receiver Operating Characteristic (ROC) curve (100%) was considerably high. The threshold value was calculated as 0.56 according to the ROC analysis. According to this threshold value, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rates for (nodule SI/cord SI)/ADC ratios in differentiating benign from malignant thyroid nodules are calculated as 100%, 97%, 83%, 100%, and 98%, respectively. Conclusion: We have found that (nodule/cord SI)/ nodule ADC ratio has the highest values for

  9. Follicular neoplasms of the thyroid: importance of clinical and cytological correlation.

    Science.gov (United States)

    Granados-García, Martín; Cortés-Flores, Ana Olivia; del Carmen González-Ramírez, Imelda; Cano-Valdez, Ana María; Flores-Hernández, Lorena; Aguilar-Ponce, José Luis

    2010-01-01

    Thyroid cancer presents as nodules. Thyroid nodules are frequent, but only 5-30% are malignant. Fine needle aspiration biopsy (FNAB) is useful for initial evaluation; nevertheless, malignancy is uncertain when follicular neoplasm is reported. Some factors can be associated with malignancy. Therefore, we analyzed our follicular neoplasms in order to identify those factors associated with a higher risk of malignancy. We analyzed the clinical files of consecutive patients with cytological diagnoses of follicular neoplasm. From 1,005 cases of thyroid nodules, 121 were follicular neoplasms according to cytology. Of these, 75 were surgically treated. Definitive report showed 45 benign (60%) and 30 malignant (40%) cases. Benign cases included 29 goiters, 11 follicular adenomas, and 5 cases of thyroiditis. Malignant cases were comprised of 12 papillary carcinomas, 4 follicular carcinomas, 3 papillary carcinomas-follicular variant, 1 lymphoma, 1 teratoma, 5 medullary carcinomas, 2 insular carcinomas, 1 anaplastic carcinoma and 1 metastatic breast carcinoma. Tumor size of benign lesions was 3.43 ± 2.04 cm, and 4.67 ± 2.78 (p = 0.049) for malignant lesions. Age was 46.95 ± 15.39 years for benign lesions and 48.67 ± 17.28 for malignant lesions (p = 0.66). Fifty percent of males showed malignancy vs. 37.7% of females (p < 0.005). Our results suggest that size and gender, but not age, are associated with cytological pattern. Ultrasonographic characteristics may be useful discriminating patients with a higher risk of malignancy. FNAB is a useful tool for initial evaluation of thyroid nodules, but clinical evaluation can enhance predictive value.

  10. Lymphoid tissue neoplasms in the neck region - epidemiological and clinical analysis over 15 years.

    Science.gov (United States)

    Rzepakowska, Anna; Zwierzyńska, Klaudyna; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

    2017-06-30

    Epidemiological and clinical analysis of lymphoid tissue neoplasms in the neck region over a 15-year period. There was performed retrospective analysis of 97 patients, aged 17 to 88 years, mean age of 60.3 years. The analysis included data from subjective study, physical examination, image and histopathological studies Results: Almost all cases were lymphoid neoplasms - 95 patients (98%). B cell lymphoma was the most commonly diagnosed lymphoma - 74 cases (76%), followed by Hodgkin's lymphoma- 19 cases (20%). Only two patients had T-cell lymphoma (2%). There was observed prevalence among women, K: M ratio for the whole group was 51: 46, while male predominance was reported in Hodgkin's lymphoma patients (K: M = 7: 12). Over the 15-year period, there was an increase in the number of lymphoid tumors. The most common location on the neck were lymph nodes - 71 (73.2%). Extranodal localizations (26.8%) were most often associated with salivary glands: parotid and submandibular involvement and with the dominant lymphoma of the marginal zone MALT (14 cases). In 57% of patients the fine needle aspiration biopsy (FNAB) results were false, with positive results only in 32% of patients. Tumors from lymphoid tissue in the neck region are most commonly B-cell lymphomas or Hodgkin,s lymphomas. Non-specific clinical signs and non-specific radiological images, as well as non-diagnostic results o FNAB, make it difficult to effectively differentiate lymphomas with cancer metastasis in neck lymph nodes. Histopathology results of the excised lymph nodes remains a standard for lymphoma diagnosis.

  11. Classification of thyroid nodules using a resonance-frequency-based electrical impedance spectroscopy: progress assessment

    Science.gov (United States)

    Zheng, Bin; Tublin, Mitchell E.; Lederman, Dror; Klym, Amy H.; Brown, Erica D.; Gur, David

    2012-02-01

    The incidence of thyroid cancer is rising faster than other malignancies and has nearly doubled in the United States (U.S.) in the last 30 years. However, classifying between malignant and benign thyroid nodules is often difficult. Although ultrasound guided Fine Needle Aspiration Biopsy (FNAB) is considered an excellent tool for triaging patients, up to 25% of FNABs are inconclusive. As a result, definitive diagnosis requires an exploratory surgery and a large number of these are performed in the U.S. annually. It would be extremely beneficial to develop a non-invasive tool or procedure that could assist in assessing the likelihood of malignancy of otherwise indeterminate thyroid nodules, thereby reducing the number of exploratory thyroidectomies that are performed under general anesthesia. In this preliminary study we demonstrate a unique hand-held Resonance-frequency based Electrical Impedance Spectroscopy (REIS) device with six pairs of detection probes to detect and classify thyroid nodules using multi-channel EIS output signal sweeps. Under an Institutional Review Board (IRB)-approved case collection protocol, this REIS device is being tested in our clinical facility and we have been collecting an initial patient data set since March of this year. Between March and August of 2011, 65 EIS tests were conducted on 65 patients. Among these cases, six depicted pathology-verified malignant cells. Our initial assessment indicates the feasibility of easily applying this REIS device and measurement approach in a very busy clinical setting. The measured resonance frequency differences between malignant and benign nodules could potentially make it possible to accurately classify indeterminate thyroid nodules.

  12. Risk Stratification of Thyroid Incidentalomas Found on PET/CT: The Value of Iodine Content on Noncontrast Computed Tomography.

    Science.gov (United States)

    Kim, Dongwoo; Hwang, Sang Hyun; Cha, Jongtae; Jo, Kwanhyeong; Lee, Narae; Yun, Mijin

    2015-11-01

    The Hounsfield unit (HU) ratio of thyroid nodules was assessed compared to the contralateral thyroid lobe on noncontrast computed tomography (CT) to stratify further the risk of malignancy in thyroid incidentalomas found on 18F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/CT (PET/CT). This retrospective analysis included 82 patients who had thyroid incidentalomas on PET/CT in 2011. On PET/CT, the maximal standardized uptake value ratios of the thyroid nodule compared to liver (T/BSUV) and the HU ratios of the thyroid nodule compared to contralateral thyroid lobe (T/BHU) were calculated. Diagnostic performances of the T/BSUV and T/BHU were compared. The area under the curve of T/BHU was higher than that of T/BSUV (0.941 vs. 0.689, p risk of malignancy was much higher (71.1%) in nodules with a T/BHU cutoff value ≤0.68, whereas it was 0% in nodules with a T/BHU of >0.68. In this study, there were 18 nodules with nondiagnostic (n = 7) or atypia of undetermined significance or follicular lesion of undetermined significance cytologies (n = 11) after fine-needle aspiration biopsy (FNAB). When the T/BHU cutoff value was applied, three (60%) of the five nodules with a T/BHU of ≤0.68 were found to be papillary carcinomas. The remaining 13 nodules with a T/BHU of >0.68 were all benign with a risk of malignancy of 0%. T/BHU is a simple and effective parameter to stratify the risk of malignancy in thyroid incidentalomas found on PET/CT. This may be of clinical relevance in those nodules with nondiagnostic or undetermined significance cytologies upon FNAB in the scheme of current clinical practice.

  13. Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the noninflammatory sacroiliac joint dysfunction: a prospective, randomized, single-blinded study.

    Science.gov (United States)

    Jee, Haemi; Lee, Ji-Hae; Park, Ki Deok; Ahn, Jaeki; Park, Yongbum

    2014-02-01

    To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with noninflammatory SIJ dysfunction. Prospective, randomized controlled trial. University hospital. Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled. All procedures were performed using an FL or US apparatus. Subjects were randomly assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy was applied to verify the correct placement of the injected medication and intravascular injections. Treatment effects and functional improvement were compared at 2 and 12 weeks after the procedures. The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks after the injections without statistical significances between groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization inside the joint, 23 had vascularization around the joint, and 4 had vascularization both inside and around the joint. Three cases of intravascular injections occurred in the FL group. The US-guided approach may facilitate the identification and avoidance of the critical vessels around or within the SIJ. Function and pain relief significantly improved in both groups without significant differences between groups. The US-guided approach was shown to be as effective as the FL-guided approach in treatment effects. However, diagnostic application in the SIJ may be limited because of the significantly lower accuracy rate (87.3%). Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Is ultrasound-guided injection more effective in chronic subacromial bursitis?

    Science.gov (United States)

    Hsieh, Lin-Fen; Hsu, Wei-Chun; Lin, Yi-Jia; Wu, Shih-Hui; Chang, Kae-Chwen; Chang, Hsiao-Lan

    2013-12-01

    Although ultrasound (US)-guided subacromial injection has shown increased accuracy in needle placement, whether US-guided injection produces better clinical outcome is still controversial. Therefore, this study aimed to compare the efficacy of subacromial corticosteroid injection under US guidance with palpation-guided subacromial injection in patients with chronic subacromial bursitis. Patients with chronic subacromial bursitis were randomized to a US-guided injection group and a palpation-guided injection group. The subjects in each group were injected with a mixture of 0.5 mL dexamethasone suspension and 3 mL lidocaine into the subacromial bursa. The primary outcome measures were the visual analog scale for pain and active and passive ranges of motion of the affected shoulder. Secondary outcome measures were the Shoulder Pain and Disability Index, the Shoulder Disability Questionnaire, and the 36-item Short-Form Health Survey (SF-36). The primary outcome measures were evaluated before, immediately, 1 wk, and 1 month after the injection; the secondary outcome measures were evaluated before, 1 wk, and 1 month after the injection. Of the 145 subjects screened, 46 in each group completed the study. Significantly greater improvement in passive shoulder abduction and in physical functioning and vitality scores on the SF-36 were observed in the US-guided group. The pre- and postinjection within-group comparison revealed significant improvement in the visual analog scale for pain and range of motion, as well as in the Shoulder Pain and Disability Index, Shoulder Disability Questionnaire, and SF-36 scores, in both groups. The US-guided subacromial injection technique produced significantly greater improvements in passive shoulder abduction and in some items of the SF-36. US is effective in guiding the needle into the subacromial bursa in patients with chronic subacromial bursitis.

  15. Suprascapular block associated with supraclavicular block: An alternative to isolated interscalene block for analgesia in shoulder instability surgery?

    Science.gov (United States)

    Trabelsi, W; Ben Gabsia, A; Lebbi, A; Sammoud, W; Labbène, I; Ferjani, M

    2017-02-01

    Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. Sixty ASA physical status I-II patients scheduled to undergo shoulder instability surgery were included. Two groups: (i) the SSB+SCB group (n=30) in which the patients received a combination of US-guided SSB (15mL of bupivacaine 0.25%) and US-guided SCB (15mL of bupivacaine 0.25%) and (ii) the ISB group (n=30) in which the patients received US-guided ISB with 30mL of bupivacaine 0.25%. General anesthesia was administered to all patients. During the first 24h, the variables assessed were time to administer the anesthesia, duration of the analgesia, onset and duration of motor and sensory blockade, opioid consumption, cardiovascular stability, complications, and patient satisfaction. Anesthesia induction took more time for the SSB+SCB group than for the ISB group. However, the onset time of motor and sensory blockade was similar in the two groups. Statistical analysis of the visual analog postoperative pain scoring at H0, H6, H12, and H24 showed nonsignificant differences between the groups. Analgesia, the first request for morphine, and total morphine consumption during the first 24h was similar in both groups. No complication was recorded in the SSB+SCB group. However, phrenic nerve block occurred in all patients in the ISB group. US-guided SCB combined with US-guided SSB was as effective as ISB for postoperative analgesia after shoulder instability surgery without decreasing potential side effects. NCT identifier: NCT02397330. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    International Nuclear Information System (INIS)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di; Ionascu, Dan

    2012-01-01

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non–small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non–small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T L N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T L N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 ± 0.7 cm and 0.8 ± 0.3 cm, respectively, for B and T L N. Primary and involved LN expansions were 0.7 ± 0.5 cm and 1.1 ± 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T L N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  17. Prognostic relevance of lymph node ratio and total lymph node count for small bowel adenocarcinoma.

    Science.gov (United States)

    Tran, Thuy B; Qadan, Motaz; Dua, Monica M; Norton, Jeffrey A; Poultsides, George A; Visser, Brendan C

    2015-08-01

    Nodal metastasis is a known prognostic factor for small bowel adenocarcinoma. The goals of this study were to evaluate the number of lymph nodes (LNs) that should be retrieved and the impact of lymph node ratio (LNR) on survival. Surveillance, Epidemiology, and End Results was queried to identify patients with small bowel adenocarcinoma who underwent resection from 1988 to 2010. Survival was calculated with the Kaplan-Meier method. Multivariate analysis identified predictors of survival. A total of 2,772 patients underwent resection with at least one node retrieved, and this sample included equal numbers of duodenal (n = 1,387) and jejunoileal (n = 1,386) adenocarcinomas. There were 1,371 patients with no nodal metastasis (N0, 49.4%), 928 N1 (33.5%), and 474 N2 (17.1%). The median numbers of LNs examined for duodenal and jejunoileal cancers were 9 and 8, respectively. Cut-point analysis demonstrated that harvesting at least 9 for jejunoileal and 5 LN for duodenal cancers resulted in the greatest survival difference. Increasing LNR at both sites was associated with decreased overall median survival (LNR = 0, 71 months; LNR 0-0.02, 35 months; LNR 0.21-0.4, 25 months; and LNR >0.4, 16 months; P < .001). Multivariate analysis confirmed number of LNs examined, T-stage, LN positivity, and LNR were independent predictors of survival. LNR has a profound impact on survival in patients with small bowel adenocarcinoma. To achieve adequate staging, we recommend retrieving a minimum of 5 LN for duodenal and 9 LN for jejunoileal adenocarcinomas. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The Prognostic Relevance of Sentinel Lymph Node Metastases Assessed by PHGR1 mRNA Quantification in Stage I to III Colon Cancer

    Directory of Open Access Journals (Sweden)

    Satu Oltedal

    2018-04-01

    Full Text Available BACKGROUND: Regional lymph node (LN metastasis is a strong and well-established prognostic factor in colon cancer, and recent data suggest a prognostic value of detecting micrometastases and isolated tumor cells in regional LNs. The aim of the study was to investigate the clinical relevance of detecting sentinel lymph node (SLN metastases in colon cancer patients by measuring the novel metastasis marker PHGR1 mRNA. METHODS: Using quantitative reverse-transcription polymerase chain reaction, we measured PHGR1 mRNA levels in SLNs and primary tumors from 206 patients surgically treated for stage I to III colon cancer and 52 normal LNs from patients undergoing surgery for benign colon diseases. The prognostic impact of these findings was evaluated by Kaplan-Meier analysis and Cox proportional-hazards regression. RESULTS: Compared to normal LNs, elevated PHGR1 mRNA levels were detected in SLNs from 56 (89% of the 63 patients with pN+ disease. Furthermore, 68 (48% of the 143 node-negative (pN0 patients had elevated PHGR1 mRNA levels in SLNs, suggesting occult metastases. With a median follow-up of 7.2 years, a significantly shorter recurrence-free (P=.005 and disease-specific (P=.02 survival was observed in patients with elevated PHGR1 mRNA levels in SLNs. Multivariable modeling showed that the SLN PHGR1 mRNA level was an independent prognostic factor. However, when the survival analyses were restricted to pN0 patients, no significant prognostic information was found. CONCLUSION: Measuring PHGR1 mRNA in SLNs provided independent prognostic information on operable colon cancer patients but not in the pN0 subgroup.

  19. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    Energy Technology Data Exchange (ETDEWEB)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ionascu, Dan, E-mail: Dan.ionascu@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-03-15

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non-small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non-small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T{sub L}N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T{sub L}N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 {+-} 0.7 cm and 0.8 {+-} 0.3 cm, respectively, for B and T{sub L}N. Primary and involved LN expansions were 0.7 {+-} 0.5 cm and 1.1 {+-} 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T{sub L}N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  20. Superconducting rf activities at Cornell University

    International Nuclear Information System (INIS)

    Padamsee, H.; Hakimi, M.; Kirchgessner, J.

    1988-01-01

    Development of rf superconductivity for high energy accelerators has been a robust activity at the Cornell Laboratory of Nuclear Studies (LNS) for many years. In order to realize the potential of rf superconductivity, a two-pronged approach has been followed. On the one hand accelerator applications were selected where the existing state-of-the art of superconducting rf is competitive with alternate technologies, then LNS engaged in a program to design, construct and test suitable superconducting cavities, culminating in a full system test in an operating accelerator. On the second front the discovery and invention of ideas, techniques and materials required to make superconducting rf devices approach the ideal in performance has been aggressively pursued. Starting with the development of superconducting cavities for high energy electron synchrotrons, the technology was extended to high energy e + e - storage rings. The LE5 cavity design has now been adopted for use in the Continuous Electron Beam Accelerator Facility (CEBAF). When completed, this project will be one of the largest applications of SRF technology, using 440 LE5 modules[4]. In the last two years, the cavity design and the technology have been transferred to industry and CEBAF. Cornell has tested the early industrial prototypes and cavity pairs. LNS has developed, in collaboration with CEBAF, designs and procedures for cavity pair and cryomodule assembly and testing. Advanced research for future electron accelerators is badly needed if particle physicists hope to expand the energy frontier. Superconducting cavity technology continues to offer attractive opportunities for further advances in achievable voltage at reasonable cost for future accelerators. For Nb, the full potential implies an order of magnitude increase over current capabilities. 20 references, 11 figures

  1. The effects of a lipid‐based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV‐infected Malawian mothers and associations with maternal and infant biomarkers

    Science.gov (United States)

    Shahab‐Ferdows, Setareh; Gertz, Erik; Flax, Valerie L.; Adair, Linda S.; Bentley, Margaret E.; Jamieson, Denise J.; Tegha, Gerald; Chasela, Charles S.; Kamwendo, Debbie; van der Horst, Charles M.; Allen, Lindsay H.

    2017-01-01

    Abstract We evaluated effects of antiretroviral (ARV) therapy and lipid‐based nutrient supplements (LNSs) on iron, copper, and zinc in milk of exclusively breastfeeding HIV‐infected Malawian mothers and their correlations with maternal and infant biomarkers. Human milk and blood at 2, 6, and 24 weeks post‐partum and blood during pregnancy (≤30 weeks gestation) were collected from 535 mothers/infant‐pairs in the Breastfeeding, Antiretrovirals, and Nutrition study. The participants received ARV, LNS, ARV and LNS, or no intervention from 0 to 28 weeks post‐partum. ARVs negatively affected copper and zinc milk concentrations, but only at 2 weeks, whereas LNS had no effect. Among all treatment groups, approximately 80–90% of copper and zinc and negatively correlated with milk iron at 2 and 6 weeks (r = −.18, p milk minerals with each other were the strongest correlations observed (r = .11–.47, p milk higher in iron when ferritin was higher or TfR lower. At 6 weeks, higher maternal α‐1‐acid glycoprotein and C‐reactive protein were associated with higher milk minerals in mildly anaemic women. Infant TfR was lower when milk mineral concentrations were higher at 6 weeks and when mothers were moderately anaemic during pregnancy. ARV affects copper and zinc milk concentrations in early lactation, and maternal haemoglobin during pregnancy and lactation could influence the association between milk minerals and maternal and infant iron status and biomarkers of inflammation. PMID:28851037

  2. Plasma and breast-milk selenium in HIV-infected Malawian mothers are positively associated with infant selenium status but are not associated with maternal supplementation: results of the Breastfeeding, Antiretrovirals, and Nutrition study.

    Science.gov (United States)

    Flax, Valerie L; Bentley, Margaret E; Combs, Gerald F; Chasela, Charles S; Kayira, Dumbani; Tegha, Gerald; Kamwendo, Debbie; Daza, Eric J; Fokar, Ali; Kourtis, Athena P; Jamieson, Denise J; van der Horst, Charles M; Adair, Linda S

    2014-04-01

    Selenium is found in soils and is essential for human antioxidant defense and immune function. In Malawi, low soil selenium and dietary intakes coupled with low plasma selenium concentrations in HIV infection could have negative consequences for the health of HIV-infected mothers and their exclusively breastfed infants. We tested the effects of lipid-based nutrient supplements (LNS) that contained 1.3 times the Recommended Dietary Allowance of sodium selenite and antiretroviral drugs (ARV) on maternal plasma and breast-milk selenium concentrations. HIV-infected Malawian mothers in the Breastfeeding, Antiretrovirals, and Nutrition study were randomly assigned at delivery to receive: LNS, ARV, LNS and ARV, or a control. In a subsample of 526 mothers and their uninfected infants, we measured plasma and breast-milk selenium concentrations at 2 or 6 (depending on the availability of infant samples) and 24 wk postpartum. Overall, mean (± SD) maternal (range: 81.2 ± 20.4 to 86.2 ± 19.9 μg/L) and infant (55.6 ± 16.3 to 61.0 ± 15.4 μg/L) plasma selenium concentrations increased, whereas breast-milk selenium concentrations declined (14.3 ± 11.5 to 9.8 ± 7.3 μg/L) from 2 or 6 to 24 wk postpartum (all P milk selenium from 2 or 6 to 24 wk postpartum (both P milk selenium, but maternal selenium concentrations were positively associated with infant plasma selenium at 2 or 6 and 24 wk postpartum (P milk selenium concentrations. Future research should examine effects of more readily incorporated forms of selenium (ie, selenomethionine) in HIV-infected breastfeeding women.

  3. Oral myeloid cells uptake allergoids coupled to mannan driving Th1/Treg responses upon sublingual delivery in mice.

    Science.gov (United States)

    Soria, I; López-Relaño, J; Viñuela, M; Tudela, J-I; Angelina, A; Benito-Villalvilla, C; Díez-Rivero, C M; Cases, B; Manzano, A I; Fernández-Caldas, E; Casanovas, M; Palomares, O; Subiza, J L

    2018-04-01

    Polymerized allergoids coupled to nonoxidized mannan (PM-allergoids) may represent novel vaccines targeting dendritic cells (DCs). PM-allergoids are better captured by DCs than native allergens and favor Th1/Treg cell responses upon subcutaneous injection. Herein we have studied in mice the in vivo immunogenicity of PM-allergoids administered sublingually in comparison with native allergens. Three immunization protocols (4-8 weeks long) were used in Balb/c mice. Serum antibody levels were tested by ELISA. Cell responses (proliferation, cytokines, and Tregs) were assayed by flow cytometry in spleen and lymph nodes (LNs). Allergen uptake was measured by flow cytometry in myeloid sublingual cells. A quick antibody response and higher IgG2a/IgE ratio were observed with PM-allergoids. Moreover, stronger specific proliferative responses were seen in both submandibular LNs and spleen cells assayed in vitro. This was accompanied by a higher IFNγ/IL-4 ratio with a quick IL-10 production by submandibular LN cells. An increase in CD4 + CD25 high FOXP3 + Treg cells was detected in LNs and spleen of mice treated with PM-allergoids. These allergoids were better captured than native allergens by antigen-presenting (CD45 + MHC-II + ) cells obtained from the sublingual mucosa, including DCs (CD11b + ) and macrophages (CD64 + ). Importantly, all the differential effects induced by PM-allergoids were abolished when using oxidized instead of nonoxidized PM-allergoids. Our results demonstrate for the first time that PM-allergoids administered through the sublingual route promote the generation of Th1 and FOXP3 + Treg cells in a greater extent than native allergens by mechanisms that might well involve their better uptake by oral antigen-presenting cells. © 2018 The Authors. Allergy Published by John Wiley & Sons Ltd.

  4. Dissemination of a highly virulent pathogen: tracking the early events that define infection.

    Directory of Open Access Journals (Sweden)

    Rodrigo J Gonzalez

    2015-01-01

    Full Text Available The series of events that occurs immediately after pathogen entrance into the body is largely speculative. Key aspects of these events are pathogen dissemination and pathogen interactions with the immune response as the invader moves into deeper tissues. We sought to define major events that occur early during infection of a highly virulent pathogen. To this end, we tracked early dissemination of Yersinia pestis, a highly pathogenic bacterium that causes bubonic plague in mammals. Specifically, we addressed two fundamental questions: (1 do the bacteria encounter barriers in disseminating to draining lymph nodes (LN, and (2 what mechanism does this nonmotile bacterium use to reach the LN compartment, as the prevailing model predicts trafficking in association with host cells. Infection was followed through microscopy imaging in addition to assessing bacterial population dynamics during dissemination from the skin. We found and characterized an unexpected bottleneck that severely restricts bacterial dissemination to LNs. The bacteria that do not pass through this bottleneck are confined to the skin, where large numbers of neutrophils arrive and efficiently control bacterial proliferation. Notably, bottleneck formation is route dependent, as it is abrogated after subcutaneous inoculation. Using a combination of approaches, including microscopy imaging, we tested the prevailing model of bacterial dissemination from the skin into LNs and found no evidence of involvement of migrating phagocytes in dissemination. Thus, early stages of infection are defined by a bottleneck that restricts bacterial dissemination and by neutrophil-dependent control of bacterial proliferation in the skin. Furthermore, and as opposed to current models, our data indicate an intracellular stage is not required by Y. pestis to disseminate from the skin to draining LNs. Because our findings address events that occur during early encounters of pathogen with the immune response

  5. Feeding behaviors during home-based treatment of moderate acute malnutrition using corn-soy blends or lipid-based nutrient supplements.

    Science.gov (United States)

    Iuel-Brockdorf, Ann-Sophie; Ouedraogo, Albertine; Ritz, Christian; Draebel, Tania Aase; Ashorn, Per; Filteau, Suzanne; Michaelsen, Kim F

    2017-10-01

    Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn-soy blends (CSB) and lipid-based nutrient supplements (LNS) based on best practice feeding behaviors. The study was conducted as part of a randomized controlled trial assessing the effectiveness of new formulations of CSB and LNS and comprised 1,546 children from 6 to 23 months. The study included a mixed methods approach using questionnaires, focus group discussions and home visits and interviews with a subsample of 20 caretakers of trial participants. We found that LNS, compared to CSB, were more likely to be mixed into other foods (OR [95% CI] 1.7 [1.3-2.2], p = <.001), served with a meal (OR [95% CI] 1.6 [1.1-2.3], p = <.018)or between meals (OR [95% CI] 1.5 [1.1-1.9], p = <.005), and fed using an encouraging feeding style (mean difference in percentage points [95% CI] 23% [6%:40%], p = .01). CSB were more likely to be fed using a forced feeding style (mean difference in percentage points [95% CI] 18% [3%:33%], p = .02) and were often observed to be served unprepared. The main differences in feeding behaviors between the two diet groups were linked to how and when supplements were served. Educational instructions should therefore be adapted according to the supplement provided; when providing CSB, efforts should be made to promote an encouraging feeding style, and emphasis should be made to ensure preparations are made according to recommendations. © 2016 John Wiley & Sons Ltd.

  6. The novelty-seeking phenotype modulates the long-lasting effects of adolescent MDMA exposure.

    Science.gov (United States)

    Rodríguez-Arias, Marta; Vaccaro, Sonia; Arenas, M Carmen; Aguilar, María A; Miñarro, José

    2015-03-15

    Exposure to drugs such as ethanol or cocaine during adolescence induces alterations in the central nervous system that are modulated by the novelty-seeking trait. Our aim was to evaluate the influence of this trait on the long-term effects of MDMA administration during adolescence on spontaneous behavior and conditioned rewarding effects in adulthood. Adolescent mice were classified as high or low novelty seekers (HNS or LNS) according to the hole-board test and received either MDMA (0, 10 or 20mg/kg PND 33-42) or saline. Three weeks later, having entered adulthood (PND>68), one set of mice performed the elevated plus maze and social interaction tests, while another set performed the conditioning place preference (CPP) test induced by cocaine-(1mg/kg) or MDMA-(1mg/kg). Only HNS mice treated with MDMA during adolescence acquired CPP in adulthood with a non-effective dose of cocaine or MDMA. Although it did not produce changes in motor activity, exposure to MDMA during adolescence was associated with more aggressive behaviors (threat and attack) and increased social contacts in HNS mice, while an anxiolytic effect was noted in LNS mice pre-treated with the highest dose of MDMA (20mg/kg). Administration of MDMA (10 or 20mg/kg) induced a decrease in DA levels in the striatum in LNS mice only and lower striatal serotonin levels in mice treated with the highest MDMA dose. Our findings show that adolescent MDMA exposure results in higher sensitivity to the conditioned reinforcing properties of MDMA and cocaine in adult HNS mice, which suggests that the relationship between exposure to MDMA in adolescence and a higher probability of substance is a feature of high novelty seekers only. Copyright © 2015. Published by Elsevier Inc.

  7. Local-Regional Recurrence With and Without Radiation Therapy After Neoadjuvant Chemotherapy and Mastectomy for Clinically Staged T3N0 Breast Cancer

    International Nuclear Information System (INIS)

    Nagar, Himanshu; Mittendorf, Elizabeth A.; Strom, Eric A.; Perkins, George H.; Oh, Julia L.; Tereffe, Welela; Woodward, Wendy A.; Gonzalez-Angulo, Ana M.; Hunt, Kelly K.; Buchholz, Thomas A.; Yu, Tse-Kuan

    2011-01-01

    Purpose: The purpose of this study was to determine local-regional recurrence (LRR) risk according to whether postmastectomy radiation therapy (PMRT) was used to treat breast cancer patients with clinical T3N0 disease who received neoadjuvant chemotherapy (NAC) and mastectomy. Methodsand Materials: Clinicopathology data from 162 patients with clinical T3N0 breast cancer who received NAC and underwent mastectomy were retrospectively reviewed. A total of 119 patients received PMRT, and 43 patients did not. The median number of axillary lymph nodes (LNs) dissected was 15. Actuarial rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Results: At a median follow-up of 75 months, 15 of 162 patients developed LRR. For all patients, the 5-year LRR rate was 9% (95% confidence interval [CI], 4%-14%). The 5-year LRR rate for those who received PMRT was 4% (95% CI, 1%-9%) vs. 24% (95% CI, 10%-39%) for those who did not receive PMRT (p <0.001). A significantly higher proportion of irradiated patients had pathology involved LNs and were ≤40 years old. Among patients who had pathology involved LNs, the LRR rate was lower in those who received PMRT (p <0.001). A similar trend was observed for those who did not have pathology involved LN disease. Among nonirradiated patients, the appearance of pathologic LN disease after NAC was the only clinicopathologic factor examined that significantly correlated with the risk of LRR. Conclusions: Breast cancer patients with clinical T3N0 disease treated with NAC and mastectomy but without PMRT had a significant risk of LRR, even when there was no pathologic evidence of LN involvement present after NAC. PMRT was effective in reducing the LRR rate. We suggest PMRT should be considered for patients with clinical T3N0 disease.

  8. Allergic reaction induced by dermal and/or respiratory exposure to low-dose phenoxyacetic acid, organophosphorus, and carbamate pesticides

    International Nuclear Information System (INIS)

    Fukuyama, Tomoki; Tajima, Yukari; Ueda, Hideo; Hayashi, Koichi; Shutoh, Yasufumi; Harada, Takanori; Kosaka, Tadashi

    2009-01-01

    Several types of pesticides, such as organophosphates, phenoxyacetic acid, and carbamate have a high risk of affecting human health, causing allergic rhinitis and bronchial asthma-like diseases. We used our long-term sensitization method and a local lymph node assay to examine the allergic reactions caused by several types of pesticides. BALB/c mice were topically sensitized (9 times in 3 weeks), then challenged dermally or intratracheally with 2,4-D, BRP, or furathiocarb. One day post-challenge, the mice were processed to obtain biologic materials for use in assays of total IgE levels in serum and bronchoalveolar lavage fluid (BALF); differential cell counts and chemokine levels in BALF; lymphocyte counts and surface antigen expression on B-cells within regional lymph nodes (LNs); and, ex situ cytokine production by cells from these LNs. 2,4-D-induced immune responses characteristic of immediate-type respiratory reactions, as evidenced by increased total IgE levels in both serum and BALF; an influx of eosinophils, neutrophils, and chemokines (MCP-1, eotaxin, and MIP-1β) in BALF; increased surface antigen expression on B-cells IgE and MHC class II production) in both auricular and the lung-associated LNs; and increased Th2 cytokine production (IL-4, IL-5, IL-10, and IL-13) in both auricular and the lung-associated LN cells. In contrast, BRP and furathiocarb treatment yielded, at most, non-significant increases in all respiratory allergic parameters. BRP and furathiocarb induced marked proliferation of MHC Class II-positive B-cells and Th1 cytokines (IL-2, TNF-α, and IFN-γ) in only auricular LN cells. These results suggest that 2,4-D is a respiratory allergen and BRP and furathiocarb are contact allergens. As our protocol detected classified allergic responses to low-molecular-weight chemicals, it thus may be useful for detecting environmental chemical-related allergy.

  9. Prenatal lipid-based nutrient supplements increase cord leptin concentration in pregnant women from rural Burkina Faso.

    Science.gov (United States)

    Huybregts, Lieven; Roberfroid, Dominique; Lanou, Hermann; Meda, Nicolas; Taes, Youri; Valea, Innocent; D'Alessandro, Umberto; Kolsteren, Patrick; Van Camp, John

    2013-05-01

    In developing countries, prenatal lipid-based nutrient supplements (LNSs) were shown to increase birth size; however, the mechanism of this effect remains unknown. Cord blood hormone concentrations are strongly associated with birth size. Therefore, we hypothesize that LNSs increase birth size through a change in the endocrine regulation of fetal development. We compared the effect of daily prenatal LNSs with multiple micronutrient tablets on cord blood hormone concentrations using a randomized, controlled design including 197 pregnant women from rural Burkina Faso. Insulin-like growth factors (IGF) I and II, their binding proteins IGFBP-1 and IGFBP-3, leptin, cortisol, and insulin were quantified in cord sera using immunoassays. LNS was associated with higher cord blood leptin mainly in primigravidae (+57%; P = 0.02) and women from the highest tertile of BMI at study inclusion (+41%; P = 0.02). We did not find any significant LNS effects on other measured cord hormones. The observed increase in cord leptin was associated with a significantly higher birth weight. Cord sera from small-for-gestational age newborns had lower median IGF-I (-9 μg/L; P = 0.003), IGF-II (-79 μg/L; P = 0.003), IGFBP-3 (-0.7 μg/L; P = 0.007), and leptin (-1.0 μg/L; P = 0.016) concentrations but higher median cortisol (+18 μg/L; P = 0.037) concentrations compared with normally grown newborns. Prenatal LNS resulted in increased cord leptin concentrations in primigravidae and mothers with higher BMI at study inclusion. The elevated leptin concentrations could point toward a higher neonatal fat mass.

  10. Inhibitory receptor expression depends more dominantly on differentiation and activation than exhaustion of human CD8 T cells

    Directory of Open Access Journals (Sweden)

    Amandine eLegat

    2013-12-01

    Full Text Available Under conditions of chronic antigen stimulation, such as persistent viral infection and cancer, CD8 T cells may diminish effector function, which has been termed exhaustion. Expression of inhibitory Receptors (iRs is often regarded as a hallmark of exhaustion. Here we studied the expression of eight different iRs by CD8 T cells of healthy humans, including CTLA-4, PD1, TIM3, LAG3, 2B4, BTLA, CD160 and KLRG-1. We show that many iRs are expressed upon activation, and with progressive differentiation to effector cells, even in absence of long-term (chronic antigenic stimulation. In particular, we evaluated the direct relationship between iR expression and functionality in CD8 T cells by using anti-CD3 and anti-CD28 stimulation to stimulate all cells and differentiation subsets. We observed a striking upregulation of certain iRs following the cytokine production wave, in agreement with the notion that iRs function as a negative feedback mechanism. Intriguingly, we found no major impairment of cytokine production in cells positive for a broad array of iRs, as previously shown for PD1 in healthy donors. Rather, the expression of the various iRs strongly correlated with T cell differentiation or activation states, or both. Furthermore, we analyzed CD8 T cells from lymph nodes (LNs of melanoma patients. Interestingly, we found altered iR expression and lower cytokine production by T cells from metastatic LNs, but also from non-metastatic LNs, likely due to mechanisms which are not related to exhaustion. Together, our data shows that expression of iRs per se does not mark dysfunctional cells, but is rather tightly linked to activation and differentiation. This study highlights the importance of considering the status of activation and differentiation for the study and the clinical monitoring of CD8 T cells.

  11. Estradiol Synthesis in Gut-Associated Lymphoid Tissue: Leukocyte Regulation by a Sexually Monomorphic System.

    Science.gov (United States)

    Oakley, Oliver R; Kim, Kee Jun; Lin, Po-Ching; Barakat, Radwa; Cacioppo, Joseph A; Li, Zhong; Whitaker, Alexandra; Chung, Kwang Chul; Mei, Wenyan; Ko, CheMyong

    2016-12-01

    17β-estradiol is a potent sex hormone synthesized primarily by gonads in females and males that regulates development and function of the reproductive system. Recent studies show that 17β-estradiol is locally synthesized in nonreproductive tissues and regulates a myriad of events, including local inflammatory responses. In this study, we report that mesenteric lymph nodes (mLNs) and Peyer's patches (Pps) are novel sites of de novo synthesis of 17β-estradiol. These secondary lymphoid organs are located within or close to the gastrointestinal tract, contain leukocytes, and function at the forefront of immune surveillance. 17β-estradiol synthesis was initially identified using a transgenic mouse with red fluorescent protein coexpressed in cells that express aromatase, the enzyme responsible for 17β-estradiol synthesis. Subsequent immunohistochemistry and tissue culture experiments revealed that aromatase expression was localized to high endothelial venules of these lymphoid organs, and these high endothelial venule cells synthesized 17β-estradiol when isolated and cultured in vitro. Both mLNs and Pps contained 17β-estradiol with concentrations that were significantly higher than those of peripheral blood. Furthermore, the total amount of 17β-estradiol in these organs exceeded that of the gonads. Mice lacking either aromatase or estrogen receptor-β had hypertrophic Pps and mLNs with more leukocytes than their wild-type littermates, demonstrating a role for 17β-estradiol in leukocyte regulation. Importantly, we did not observe any sex-dependent differences in aromatase expression, 17β-estradiol content, or steroidogenic capacity in these lymphoid organs.

  12. Value and efficiency of sentinel lymph node diagnostics in patients with penile carcinoma with palpable inguinal lymph nodes as a new multimodal, minimally invasive approach

    Energy Technology Data Exchange (ETDEWEB)

    Luetzen, Ulf; Zuhayra, Maaz; Marx, Marlies; Zhao, Yi [University Hospital Schleswig Holstein, Campus Kiel, Department of Nuclear Medicine, Molecular Imaging Diagnostics and Therapy, Kiel (Germany); Colberg, Christian; Knuepfer, Stephanie; Juenemann, Klaus-Peter; Naumann, Carsten Maik [University Hospital Schleswig Holstein, Campus Kiel, Department of Urology and Pediatric Urology, Kiel (Germany); Baumann, Rene [University Hospital Schleswig Holstein, Campus Kiel, Department of Radio Oncology, Kiel (Germany); Kaehler, Katharina Charlotte [University Hospital Schleswig Holstein, Campus Kiel, Department of Dermatology, Venerology and Allergology, Kiel (Germany)

    2016-12-15

    The international guidelines recommend sentinel lymph node biopsy (SLNB) for lymph node staging in penile cancer with non-palpable inguinal lymph nodes (LN) but it is not recommended with palpable inguinal LN. The aim of this study was to evaluate the reliability and morbidity of SLNB in combination with an ultrasound-guided resection of suspect inguinal LNs as a new multimodal, minimally invasive staging approach in these patients. We performed SLNB in 26 penile cancer patients with 42 palpable inguinal LNs. Prior to the combined staging procedures the patients underwent an ultrasound examination of the groins as well as planar lymphatic drainage scintigraphy and SPECT/CT scans. During the surgical procedure, the radioactive-labelled sentinel lymph nodes and, in addition, sonographically suspect LNs, were resected under ultrasound guidance. Follow-up screening was done by ultrasound examination of the groins according to the guidelines of the European Association of Urology. Nineteen groins of 42 preoperatively palpable inguinal findings were histologically tumor-positive. SLNB alone showed lymphogenic metastases in 14 groins. Sonography revealed five further metastatic groins, which would not have been detected during SLNB due to a tumor-related blockage of lymphatic drainage or a so-called re-routing of the tracer. During follow-up, none of the 28 groins with tumor-negative LN status showed any LN recurrence in this combined investigation technique. The median follow-up period was 46 (24 to 92) months. Morbidity of this procedure was low at 4.76 % in relation to the number of groins resp. 7.69 % in relation to the number of patients. The results show that this combined procedure is a reliable multimodal diagnostic approach for treatment of penile cancer patients with palpable inguinal LNs. It is associated with low morbidity rates. SLNB alone would lead to a significantly higher false-negative rate in these patients. The encouraging results of this work can

  13. Prenatal Lipid-Based Nutrient Supplements Do Not Affect Pregnancy or Childbirth Complications or Cesarean Delivery in Bangladesh: A Cluster-Randomized Controlled Effectiveness Trial.

    Science.gov (United States)

    Mridha, Malay K; Matias, Susana L; Paul, Rina Rani; Hussain, Sohrab; Sarker, Mostofa; Hossain, Mokbul; Peerson, Janet M; Vosti, Stephen A; Dewey, Kathryn G

    2017-09-01

    Background: Pregnancy and childbirth complications and cesarean delivery are common in Bangladesh. Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on pregnancy and childbirth complications and cesarean delivery. Methods: We conducted the Rang-Din Nutrition Study, a cluster-randomized controlled effectiveness trial within a community health program in rural Bangladesh. We enrolled 4011 pregnant women in early pregnancy. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe + 400 μg folic acid/d) and women in 16 clusters received LNS-PL (20 g/d, 118 kcal) containing essential fatty acids and 22 vitamins and minerals. Pregnancy and childbirth complications and the cesarean delivery rate were secondary outcomes of the study. Results: Women in the LNS-PL group did not differ significantly from the IFA group with respect to mean systolic blood pressure at 36 wk gestation (113 and 112 mm Hg; P = 0.17), diastolic blood pressure at 36 wk gestation (68.9 and 68.7 mmHg; P = 0.88), or mean total number of pregnancy and childbirth complications (0.32 and 0.31; P = 0.86). They also did not differ significantly with respect to the prevalence of high blood pressure at 36 wk (1.74% and 2.03%; P = 0.62), antepartum hemorrhage (0.83% and 1.39%; P = 0.21), prolonged labor (8.34% and 8.79%; P = 0.68), early rupture of membranes (9.30% and 8.45%; P = 0.43), convulsions (1.57% and 1.08%; P = 0.24), high blood pressure in labor (1.54% and 1.19%; P = 0.46), obstructed labor (2.83% and 2.91%; P = 0.90), any complications during pregnancy or childbirth (35.9% and 37.1%; P = 0.64), episiotomy (6.31% and 6.44%; P = 0.90), or cesarean delivery (15.6% and 14.2%; P = 0.48). Conclusion: Compared with IFA, antenatal LNS-PL did not increase or decrease pregnancy and childbirth complications or cesarean delivery among women in rural Bangladesh. This trial was registered at clinicaltrials.gov as NCT01715038. © 2017 American

  14. Ibrutinib-induced lymphocytosis in patients with chronic lymphocytic leukemia

    DEFF Research Database (Denmark)

    Herman, S E M; Niemann, C U; Farooqui, M

    2014-01-01

    Ibrutinib and other targeted inhibitors of B-cell receptor signaling achieve impressive clinical results for patients with chronic lymphocytic leukemia (CLL). A treatment-induced rise in absolute lymphocyte count (ALC) has emerged as a class effect of kinase inhibitors in CLL and warrants further...... investigation. Here we report correlative studies in 64 patients with CLL treated with ibrutinib. We quantified tumor burden in blood, lymph nodes (LNs), spleen and bone marrow, assessed phenotypic changes of circulating cells and measured whole-blood viscosity. With just one dose of ibrutinib, the average...

  15. Beam transfer lines for the Tandem-superconducting cyclotron at Lab. Nazionale del Sud

    International Nuclear Information System (INIS)

    Calabretta, L.; Cuttone, G.; DiBernardo, P.; Giove, D.; Raia, G.; Yan, C.; Cao, L.; Liu, K.

    1988-01-01

    At the L.N.S. an MP-Tandem will be used as injector for the Superconducting Cyclotron. This paper describes the handling beam system for the Superconducting Cyclotron. All the lines are designed to be achromatic. Home made beam profile monitor is the main diagnostic device and its design and preliminary tests are presented. The distributed computer control for all the beam lines and bunching system is described too. The status of beam transfer line from tandem to S.C. and of bunching system is presented

  16. Proton therapy detector studies under the experience gained at the CATANA facility

    International Nuclear Information System (INIS)

    Cuttone, G.; Cirrone, G.A.P.; Di Rosa, F.; Lojacono, P.A.; Lo Nigro, S.; Marino, C.; Mongelli, V.; Patti, I.V.; Pittera, S.; Raffaele, L.; Russo, G.; Sabini, M.G.; Salamone, V.; Valastro, L.M.

    2007-01-01

    Proton therapy represents the most promising radiotherapy technique for external tumor treatments. At Laboratori Nazionali del Sud of the Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania (I), a proton therapy facility is active since March 2002 and 140 patients, mainly affected by choroidal and iris melanoma, have been successfully treated. Proton beams are characterized by higher dose gradients and linear energy transfer with respect to the conventional photon and electron beams, commonly used in medical centers for radiotherapy. In this paper, we report the experience gained in the characterization of different dosimetric systems, studied and/or developed during the last ten years in our proton therapy facility

  17. Exact and heuristic solutions to the Double TSP with Multiple Stacks

    DEFF Research Database (Denmark)

    Petersen, Hanne Løhmann; Archetti, Claudia; Madsen, Oli B.G.

    -pallet, which can be loaded in 3 stacks in a standard 40 foot container. Different exact and heuristic solution approaches to the DTSPMS have been implemented and tested. The exact approaches are based on different mathematical formulations of the problem which are solved using branch-and-cut. One formulation...... instances. The implemented heuristics include tabu search, simulated annealing and large neighbourhood search. Particularly the LNS approach shows promising results. It finds the known optimal solution of smaller instances (15 orders) within 10 seconds in most cases, and in 3 minutes it finds solutions...

  18. Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger

    Science.gov (United States)

    Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W.-M.; Manzo, Mahamane L.; Grais, Rebecca F.

    2014-01-01

    Background Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual “hunger gaps.” Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies—including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only—on the incidence of SAM and MAM among children aged 6–23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. Methods and Findings We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm–80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm–80 cm of participating households were assessed at each monthly distribution from

  19. Does video-assisted mediastinoscopy offer lower false-negative rates for subcarinal lymph nodes compared with standard cervical mediastinoscopy?

    Science.gov (United States)

    Citak, Necati; Buyukkale, Songul; Kok, Abdulaziz; Celikten, Alper; Metin, Muzaffer; Sayar, Adnan; Gurses, Atilla

    2014-10-01

    Theoretically, video-assisted mediastinoscopy (VAM) offers improved staging of subcarinal lymph nodes (LNs) compared with standard cervical mediastinoscopy (SCM). Materials and Between 2006 and 2011, 553 patients (SCM, n = 293; VAM, n = 260) with non-small cell lung carcinoma who underwent mediastinoscopy were investigated. Mediastinoscopy was performed only in select patients based on computed tomography (CT) or positron emission tomography CT scans in our center. The mean number of LNs and stations sampled per case was significantly higher with VAM (n = 7.65 ± 1.68 and n = 4.22 ± 0.83) than with SCM (n = 6.91 ± 1.65 and 3.92 ± 86.4; p < 0.001). The percentage of patients sampled in station 7 was significantly higher with VAM (98.8%) than with SCM (93.8%; p = 0.002). Mediastinal LN metastasis was observed in 114 patients by mediastinoscopy. The remaining 439 patients (203 patients in VAM and 236 in SCM) underwent thoracotomy and systematic mediastinal lymphadenectomy (SML). SML showed mediastinal nodal disease in 23 patients (false-negative [FN] rate, 5.2%). The FN rate was higher with SCM (n = 14, 5.9%) than with VAM (n = 9, 4.4%), although this difference was not statistically significant (p = 0.490). Station 7 was the most predominant station for FN results (n = 15). The FN rate of station 7 was found to be higher with SCM (n = 9, 3.8%) than with the VAM group (n = 6, 2.9%; p = 0.623). FN were more common in mediastinoscopy of subcarinal LNs. VAM allows higher rates of sampling of mediastinal LN stations and station 7, although it did not improve staging of subcarinal LNs. Georg Thieme Verlag KG Stuttgart · New York.

  20. Biased signaling of G protein-coupled receptors - From a chemokine receptor CCR7 perspective

    DEFF Research Database (Denmark)

    Jørgensen, Astrid Sissel; Rosenkilde, Mette M; Hjortø, Gertrud M

    2018-01-01

    of CCL21 displays an extraordinarily strong glycosaminoglycan (GAG) binding, CCR7 plays a central role in coordinating the meeting between mature antigen presenting DCs and naïve T-cells which normally takes place in the lymph nodes (LNs). This process is a prerequisite for the initiation of an antigen...... the cell-based immune system is controlled. Bias comes in three forms; ligand-, receptor- and tissue-bias. Biased signaling is increasingly being recognized as playing an important role in contributing to the fine-tuned coordination of immune cell chemotaxis. In the current review we discuss the recent...

  1. Measurement of neutron yield by 62 MeV proton beam on a thick Beryllium target

    International Nuclear Information System (INIS)

    Alba, R; Cosentino, G; Zoppo, A Del; Pietro, A Di; Figuera, P; Finocchiaro, P; Maiolino, C; Santonocito, D; Schillaci, M; Barbagallo, M; Colonna, N; Boccaccio, P; Esposito, J; Celentano, A; Osipenko, M; Ricco, G; Ripani, M; Viberti, C M; Kostyukov, A

    2013-01-01

    In the framework of research on IVth generation reactors and high intensity neutron sources a low-power prototype neutron amplifier was recently proposed by INFN. It is based on a low-energy, high current proton cyclotron, whose beam, impinging on a thick Beryllium converter, produces a fast neutron spectrum. The world database on the neutron yield from thick Beryllium target in the 70 MeV proton energy domain is rather scarce. The new measurement was performed at LNS, covering a wide angular range from 0 to 150 degrees and an almost complete neutron energy interval. In this contribution the preliminary data are discussed together with the proposed ADS facility.

  2. Proton therapy detector studies under the experience gained at the CATANA facility

    Energy Technology Data Exchange (ETDEWEB)

    Cuttone, G.; Cirrone, G.A.P.; Di Rosa, F. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Lojacono, P.A. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Dipartimento di Fisica ed Astronomia, Universita degli Studi di Catania (Italy); Lo Nigro, S.; Marino, C. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Dipartimento di Fisica ed Astronomia, Universita degli Studi di Catania (Italy); Centro Siciliano di Fisica Nucleare e Struttura della Materia, Catania (Italy); Mongelli, V. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Dipartimento di Fisica ed Astronomia, Universita degli Studi di Catania (Italy); Patti, I.V. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Pittera, S. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Dipartimento di Fisica ed Astronomia, Universita degli Studi di Catania (Italy); Centro Siciliano di Fisica Nucleare e Struttura della Materia, Catania (Italy); Raffaele, L. [A.O.U. Policlinico, Universita degli Studi di Catania (Italy); Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Russo, G. [Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Dipartimento di Fisica ed Astronomia, Universita degli Studi di Catania (Italy); Sabini, M.G. [A.O. Cannizzaro, Catania (Italy); Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy); Salamone, V.; Valastro, L.M. [A.O.U. Policlinico, Universita degli Studi di Catania (Italy); Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali dei Sud, Catania (Italy)

    2007-10-15

    Proton therapy represents the most promising radiotherapy technique for external tumor treatments. At Laboratori Nazionali del Sud of the Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania (I), a proton therapy facility is active since March 2002 and 140 patients, mainly affected by choroidal and iris melanoma, have been successfully treated. Proton beams are characterized by higher dose gradients and linear energy transfer with respect to the conventional photon and electron beams, commonly used in medical centers for radiotherapy. In this paper, we report the experience gained in the characterization of different dosimetric systems, studied and/or developed during the last ten years in our proton therapy facility.

  3. Proton therapy detector studies under the experience gained at the CATANA facility

    Science.gov (United States)

    Cuttone, G.; Cirrone, G. A. P.; Di Rosa, F.; Lojacono, P. A.; Lo Nigro, S.; Marino, C.; Mongelli, V.; Patti, I. V.; Pittera, S.; Raffaele, L.; Russo, G.; Sabini, M. G.; Salamone, V.; Valastro, L. M.

    2007-10-01

    Proton therapy represents the most promising radiotherapy technique for external tumor treatments. At Laboratori Nazionali del Sud of the Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania (I), a proton therapy facility is active since March 2002 and 140 patients, mainly affected by choroidal and iris melanoma, have been successfully treated. Proton beams are characterized by higher dose gradients and linear energy transfer with respect to the conventional photon and electron beams, commonly used in medical centers for radiotherapy.In this paper, we report the experience gained in the characterization of different dosimetric systems, studied and/or developed during the last ten years in our proton therapy facility.

  4. Thiamin and Riboflavin in Human Milk: Effects of Lipid-Based Nutrient Supplementation and Stage of Lactation on Vitamer Secretion and Contributions to Total Vitamin Content.

    Science.gov (United States)

    Hampel, Daniela; Shahab-Ferdows, Setareh; Adair, Linda S; Bentley, Margaret E; Flax, Valerie L; Jamieson, Denise J; Ellington, Sascha R; Tegha, Gerald; Chasela, Charles S; Kamwendo, Debbie; Allen, Lindsay H

    2016-01-01

    While thiamin and riboflavin in breast milk have been analyzed for over 50 years, less attention has been given to the different forms of each vitamin. Thiamin-monophosphate (TMP) and free thiamin contribute to total thiamin content; flavin adenine-dinucleotide (FAD) and free riboflavin are the main contributors to total riboflavin. We analyzed milk collected at 2 (n = 258) or 6 (n = 104), and 24 weeks (n = 362) from HIV-infected Malawian mothers within the Breastfeeding, Antiretrovirals and Nutrition (BAN) study, randomly assigned at delivery to lipid-based nutrient supplements (LNS) or a control group, to investigate each vitamer's contribution to total milk vitamin content and the effects of supplementation on the different thiamin and riboflavin vitamers at early and later stages of lactation, and obtain insight into the transport and distribution of these vitamers in human milk. Thiamin vitamers were derivatized into thiochrome-esters and analyzed by high-performance liquid-chromatography-fluorescence-detection (HPLC-FLD). Riboflavin and FAD were analyzed by ultra-performance liquid-chromatography-tandem-mass-spectrometry (ULPC-MS/MS). Thiamin-pyrophosphate (TPP), identified here for the first time in breast milk, contributed 1.9-4.5% to total thiamin. Free thiamin increased significantly from 2/6 to 24 weeks regardless of treatment indicating an active transport of this vitamer in milk. LNS significantly increased TMP and free thiamin only at 2 weeks compared to the control: median 170 versus 151 μg/L (TMP), 13.3 versus 10.5 μg/L (free thiamin, priboflavin was consistently and significantly increased with LNS (range: 14.8-19.6 μg/L (LNS) versus 5.0-7.4 μg/L (control), priboflavin relative amounts from 92-94:6-8% to 85:15%, indicating a preferred secretion of the free form into breast milk. The continuous presence of FAD in breast milk suggests an active transport and secretion system for this vitamer or possibly formation of this co-enymatic form in the

  5. Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger.

    Directory of Open Access Journals (Sweden)

    Céline Langendorf

    2014-09-01

    Full Text Available BACKGROUND: Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM and severe acute malnutrition (SAM in young children is essential in countries like Niger with annual "hunger gaps." Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs with or without household support (cash or food transfer. To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies-including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer, and cash transfer only-on the incidence of SAM and MAM among children aged 6-23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. METHODS AND FINDINGS: We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm-80 cm (at any time during the study period whatever their nutritional status: three groups received high-quantity LNS (HQ-LNS or medium-quantity LNS (MQ-LNS or Super Cereal Plus (SC+ with cash (€38/month [US$52/month]; one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]. Children 60 cm-80 cm of participating households were assessed at each monthly distribution from August to

  6. Morbidity, Iron Status and Anaemia in Children With Moderate Acute Malnutrition

    DEFF Research Database (Denmark)

    Cichon, Bernardette

    % of total protein). The trial was double blinded with regard to quality of soy and quantity of milk, but not matrix (CSB vs LNS). Haemoglobin (Hb), serum ferritin (SF), serum soluble transferrin receptor (sTfR), serum C-reactive protein (CRP) and serum α1-acid glycoprotein (AGP) were measured at inclusion...... and after supplementation. Furthermore, morbidity data were collected during clinical examinations carried out by nurses and maternal morbidity recalls. Results Between September 2013 and August 2014 1609 children were enrolled and 61 (3.8%) were lost to follow-up. At baseline, 38% of mothers reported...

  7. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial123

    Science.gov (United States)

    Vosti, Stephen A; Dewey, Kathryn G

    2017-01-01

    Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women (n = 1320; gestation) were randomly assigned to receive 60 mg Fe + 400 μg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36 wk of gestation and 6 mo postpartum were analyzed, as were changes from estimated prepregnancy values. We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women (n = 1015) had a mean ± SD weight gain of 7.4 ± 3.7 kg and changes of −1.0 ± 1.7 cm in MUAC and −2.8 ± 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequate GWG on the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups (P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m2: 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively (P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation is

  8. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial.

    Science.gov (United States)

    Adu-Afarwuah, Seth; Lartey, Anna; Okronipa, Harriet; Ashorn, Per; Ashorn, Ulla; Zeilani, Mamane; Arimond, Mary; Vosti, Stephen A; Dewey, Kathryn G

    2017-04-01

    Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women ( n = 1320; gestation) were randomly assigned to receive 60 mg Fe + 400 μg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36 wk of gestation and 6 mo postpartum were analyzed, as were changes from estimated prepregnancy values. We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women ( n = 1015) had a mean ± SD weight gain of 7.4 ± 3.7 kg and changes of -1.0 ± 1.7 cm in MUAC and -2.8 ± 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequate GWG on the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups ( P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m 2 : 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively ( P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation

  9. High energy multi-gluon exchange amplitudes

    International Nuclear Information System (INIS)

    Jaroszewicz, T.

    1980-11-01

    We examine perturbative high energy n-gluon exchange amplitudes calculated in the Coulomb gauge. If n exceeds the minimum required by the t-channel quantum numbers, such amplitudes are non-leading in lns. We derive a closed system of coupled integral equations for the corresponding two-particle n-gluon vertices, obtained by summing the leading powers of ln(N μ psup(μ)), where psup(μ) is the incident momentum and Nsup(μ) the gauge-defining vector. Our equations are infra-red finite, provided the external particles are colour singlets. (author)

  10. GM-CSF-Producing Th Cells in Rats Sensitive and Resistant to Experimental Autoimmune Encephalomyelitis.

    Science.gov (United States)

    Stojić-Vukanić, Zorica; Pilipović, Ivan; Vujnović, Ivana; Nacka-Aleksić, Mirjana; Petrović, Raisa; Arsenović-Ranin, Nevena; Dimitrijević, Mirjana; Leposavić, Gordana

    2016-01-01

    Given that granulocyte macrophage colony-stimulating factor (GM-CSF) is identified as the key factor to endow auto-reactive Th cells with the potential to induce neuroinflammation in experimental autoimmune encephalomyelitis (EAE) models, the frequency and phenotype of GM-CSF-producing (GM-CSF+) Th cells in draining lymph nodes (dLNs) and spinal cord (SC) of Albino Oxford (AO) and Dark Agouti (DA) rats immunized for EAE were examined. The generation of neuroantigen-specific GM-CSF+ Th lymphocytes was impaired in dLNs of AO rats (relatively resistant to EAE induction) compared with their DA counterparts (susceptible to EAE) reflecting impaired CD4+ lymphocyte proliferation and less supportive of GM-CSF+ Th cell differentiation dLN cytokine microenvironment. Immunophenotyping of GM-CSF+ Th cells showed their phenotypic heterogeneity in both strains and revealed lower frequency of IL-17+IFN-γ+, IL-17+IFN-γ-, and IL-17-IFN-γ+ cells accompanied by higher frequency of IL-17-IFN-γ- cells among them in AO than in DA rats. Compared with DA, in AO rats was also found (i) slightly lower surface density of CCR2 (drives accumulation of highly pathogenic GM-CSF+IFN-γ+ Th17 cells in SC) on GM-CSF+IFN-γ+ Th17 lymphocytes from dLNs, and (ii) diminished CCL2 mRNA expression in SC tissue, suggesting their impaired migration into the SC. Moreover, dLN and SC cytokine environments in AO rats were shown to be less supportive of GM-CSF+IFN-γ+ Th17 cell differentiation (judging by lower expression of mRNAs for IL-1β, IL-6 and IL-23/p19). In accordance with the (i) lower frequency of GM-CSF+ Th cells in dLNs and SC of AO rats and their lower GM-CSF production, and (ii) impaired CCL2 expression in the SC tissue, the proportion of proinflammatory monocytes among peripheral blood cells and their progeny (CD45hi cells) among the SC CD11b+ cells were reduced in AO compared with DA rats. Collectively, the results indicate that the strain specificities in efficacy of several mechanisms

  11. Dynamics of GeV light-ion-induced reactions

    International Nuclear Information System (INIS)

    Kwiatkowski, K.; Bracken, D.S.; Foxford, E.R.; Ginger, D.S.; Hsi, W.C.; Morley, K.B.; Viola, V.E.; Wang, G.; Korteling, R.G.; Legrain, R.

    1996-09-01

    Recent results from studies of the 1.8 - 4.8 GeV 3 He + nat Ag, 197 Au reactions at LNS with the ISiS detector array have shown evidence for a saturation in deposition energy and multifragmentation from a low-density source. The collision dynamics have been examined in the context of intranuclear cascade and BUU models, while breakup phenomena have been compared with EES and SMM models. Fragment-fragment correlations and isotope ratios are also investigated. (K.A.)

  12. A broad angular-range measurement of elastic and inelastic scatterings in the 16O on 27Al reaction at 17.5 MeV/u

    International Nuclear Information System (INIS)

    Cappuzzello, F.; Agodi, C.; Bondì, M.; Carbone, D.; Cavallaro, M.; Cunsolo, A.; De Napoli, M.; Foti, A.; Nicolosi, D.; Tropea, S.; Faria, P.N. de; Linares, R.

    2014-01-01

    The elastic and inelastic scattering of 16 O ions on 27 Al target nuclei were measured in a broad angular range (5°<θ lab <40°) at 280 MeV incident energy. The beam was accelerated by the K800 Superconducting Cyclotron at the INFN-LNS laboratory. The ejectiles were detected by the MAGNEX large acceptance magnetic spectrometer. The matching of the beam properties with the optical characteristics of the spectrometer allowed to separate the elastic from the inelastic channels in the energy spectra and measure accurate cross-section distributed over more than eight orders of magnitude down to a few tens of nb/sr

  13. Annual report 1991

    International Nuclear Information System (INIS)

    Decourt, M.; Le Bervet, L.; Leroy, R.; Mangano, M.; Said, A.

    1992-06-01

    DAPNIA, department of Astrophysics, Particle Physics, Nuclear Physics and Associated Instrumentation is a new CEA department, created in July 1991. This report makes the synthesis and gives the prospects of department activities. In Nuclear Physics, 3 topics are studied: nuclear structure with DAPNIA superconducting post-accelerated tandem and GANIL cyclotron, thermodynamics properties with GANIL cyclotron and LNS, and hadronic systems with SPS and SLAC. In Particle Physics, DAPNIA participates in experimental program that has been decided to establish the validity of Standard Model near to electron-positron colliders of LEP. Cryo magnetism and superconducting cavity laboratories contribute to DAPNIA programs and participate in outer programs

  14. Faraday cup: absolute dosimetry for ELIMED beam line

    International Nuclear Information System (INIS)

    Leanza, R.; Romano, F.; Scuderi, V.; Amico, A.G.; Cuttone, G.; Larosa, G.; Milluzzo, G.; Petringa, G.; Pipek, J.; Cirrone, G.A.P.; Margarone, D.; Schillaci, F.

    2017-01-01

    The scientific community has shown a growing interest towards multidisciplinary applications of laser-driven beams. In this framework, the ELIMED (ELI-Beamlines MEDical and multidisciplinary applications) beamline will be the first transport beamline dedicated to the medical and multidisciplinary studies with laser-accelerated ion beams. Detectors for dosimetry represent one of key-element of the ELIMED beamline, allowing a dose delivering with good result as required in the clinical applications. In this contribution, a Faraday Cup for absolute dosimetry, designed and realized at INFN-LNS, is described.

  15. Ion acceleration with a narrow energy spectrum by nanosecond laser-irradiation of solid target

    Energy Technology Data Exchange (ETDEWEB)

    Altana, C., E-mail: altana@lns.infn.it [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Dipartimento di Fisica e Astronomia, Università degli Studi di Catania, Via S. Sofia 64, 95123 Catania (Italy); Lanzalone, G. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Università degli Studi di Enna “Kore,” Via delle Olimpiadi, 94100 Enna (Italy); Mascali, D.; Cirrone, G. A. P.; Schillaci, F.; Tudisco, S. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Muoio, A. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Dipartimento di Fisica e Scienze della Terra, Università degli Studi di Messina, Viale F. D’Alcontres 31, 98166 Messina (Italy)

    2016-02-15

    In laser-driven plasma, ion acceleration of aluminum with the production of a quasi-monoenergetic beam has occurred. A useful device to analyze the ions is the Thomson parabolas spectrometer, a well-known diagnostic that is able to obtain information on charge-to-mass ratio and energy distribution of the charged particles. At the LENS (Laser Energy for Nuclear Science) laboratory of INFN-LNS in Catania, experimental measures were carried out; the features of LENS are: Q-switched Nd:YAG laser with 2 J laser energy, 1064 nm fundamental wavelengths, and 6 ns pulse duration.

  16. Mono-energetic ions emission by nanosecond laser solid target irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Muoio, A., E-mail: Annamaria.Muoio@lns.infn.it [Istituto Nazionale di Fisica Nucleare – Laboratori Nazionali del Sud, Via S. Sofia 62, 95123 Catania (Italy); Dipartimento di Fisica e Scienze della Terra, Università degli Studi di Messina, Viale F.S. D’Alcontres 31, 98166 Messina (Italy); Tudisco, S. [Istituto Nazionale di Fisica Nucleare – Laboratori Nazionali del Sud, Via S. Sofia 62, 95123 Catania (Italy); Altana, C. [Istituto Nazionale di Fisica Nucleare – Laboratori Nazionali del Sud, Via S. Sofia 62, 95123 Catania (Italy); Dipartimento di Fisica e Astronomia, Università degli Studi di Catania, Via S. Sofia 64, 95123 Catania (Italy); Lanzalone, G. [Istituto Nazionale di Fisica Nucleare – Laboratori Nazionali del Sud, Via S. Sofia 62, 95123 Catania (Italy); Università degli Studi di Enna “Kore”, Via delle Olimpiadi, 94100 Enna (Italy); Mascali, D.; Cirrone, G.A.P.; Schillaci, F. [Istituto Nazionale di Fisica Nucleare – Laboratori Nazionali del Sud, Via S. Sofia 62, 95123 Catania (Italy); Trifirò, A. [Dipartimento di Fisica e Scienze della Terra, Università degli Studi di Messina, Viale F.S. D’Alcontres 31, 98166 Messina (Italy); Sezione INFN, Catania (Italy)

    2016-09-01

    An experimental campaign aiming to investigate the acceleration mechanisms through laser–matter interaction in nanosecond domain has been carried out at the LENS (Laser Energy for Nuclear Science) laboratory of INFN-LNS, Catania. Pure Al targets were irradiated by 6 ns laser pulses at different pumping energies, up to 2 J. Advanced diagnostics tools were used to characterize the plasma plume and ion production. We show the preliminary results of this experimental campaign, and especially the ones showing the production of multicharged ions having very narrow energy spreads.

  17. Recurrence pattern of squamous cell carcinoma in the midthoracic esophagus: implications for the clinical target volume design of postoperative radiotherapy

    Directory of Open Access Journals (Sweden)

    Wang X

    2016-10-01

    Full Text Available Xiaoli Wang,1,2,* Yijun Luo,1,2,* Minghuan Li,2 Hongjiang Yan,2 Mingping Sun,2 Tingyong Fan2 1School of Medicine and Life Sciences, Jinan University-Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, People’s Republic of China *These authors contributed equally to this work Background: Postoperative radiotherapy has shown positive efficacy in lowering the recurrence rate and improving the survival rate for patients with esophageal squamous cell carcinoma (ESCC. However, controversies still exist about the postoperative prophylactic radiation target volume. This study was designed to analyze the patterns of recurrence and to provide a reference for determination of the postoperative radiotherapy target volume for patients with midthoracic ESCC.Patients and methods: A total of 338 patients with recurrent or metastatic midthoracic ESCC after radical surgery were retrospectively examined. The patterns of recurrence including locoregional and distant metastasis were analyzed for these patients.Results: The rates of lymph node (LN metastasis were 28.4% supraclavicular, 77.2% upper mediastinal, 32.0% middle mediastinal, 50.0% lower mediastinal, and 19.5% abdominal LNs. In subgroup analyses, the rate of abdominal LN metastasis was significantly higher in patients with histological node-positive than that in patients with histological node-negative (P=0.033. Further analysis in patients with histological node-positive demonstrated that patients with three or more positive nodes are more prone to abdominal LN metastasis, compared with patients with one or two positive nodes (χ2=4.367, P=0.037. The length of tumor and histological differentiation were also the high-risk factors for abdominal LN metastasis.Conclusion: For midthoracic ESCC with histological node-negative, or one or two positive nodes, the supraclavicular and

  18. The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage IA-IIB Cervical Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yu Liu

    2015-01-01

    Full Text Available Background: Pelvic lymph node metastasis (LNM is an important prognostic factor in cervical cancer. Cervical squamous cell carcinoma accounts for approximately 75-80% of all cervical cancers. Analyses of the effects of the number of positive lymph nodes (LNs, unilateral versus bilateral pelvic LNM and a single group versus multiple groups of pelvic LNM on survival and recurrence of cervical squamous cell carcinoma are still lacking. The study aimed to analyze the effects of the number of positive pelvic LNs and a single group versus multiple groups of pelvic LNM on survival and recurrence. Methods: We performed a retrospective review of 296 patients diagnosed with Stage IA-IIB cervical squamous cell carcinoma who received extensive/sub-extensive hysterectomy with pelvic lymphadenectomy/pelvic LN sampling at Peking University People′s Hospital from November 2004 to July 2013. Ten clinicopathological variables were evaluated as risk factors for pelvic LNM: Age at diagnosis, gravidity, clinical stage, histological grade, tumor diameter, lymph-vascular space involvement (LVSI, depth of cervical stromal invasion, uterine invasion, parametrial invasion, and neoadjuvant chemotherapy. Results: The incidence of pelvic LNM was 20.27% (60/296 cases. Pelvic LNM (P = 0.00 was significantly correlated with recurrence. Pelvic LNM (P = 0.00, the number of positive pelvic LNs (P = 0.04 and a single group versus multiple groups of pelvic LNM (P = 0.03 had a significant influence on survival. Multivariate analysis revealed that LVSI (P = 0.00, depth of cervical stromal invasion (P = 0.00 and parametrial invasion (P = 0.03 were independently associated with pelvic LNM. Conclusions: Patients with pelvic LNM had a higher recurrence rate and poor survival outcomes. Furthermore, more than 2 positive pelvic LNs and multiple groups of pelvic LNM appeared to identify patients with worse survival outcomes in node-positive IA-IIB cervical squamous cell carcinoma. LVSI

  19. Season-independent cognitive deficits in seasonal affective disorder and their relation to depressive symptoms

    DEFF Research Database (Denmark)

    Hjordt, Liv Vadskjær; Stenbæk, Dea Siggaard; Ozenne, Brice

    2017-01-01

    Modalities Test (SDMT) and the Simple Reaction Time (SRT) twice; in summer and in winter. Compared to controls, SAD individuals showed significant season-independent impairments in tasks measuring working memory (LNS), cognitive processing speed (SDMT) and motor speed (SRT). In SAD individuals, cognitive...... processing speed was significantly negatively associated with the seasonal change in SAD depressive symptoms. We present novel evidence that in SAD individuals, working memory, cognitive processing- and motor speed is not only impaired in the winter but also in the summer. This suggests that certain...

  20. Long-Term Prognosis of Plantar Fasciitis

    DEFF Research Database (Denmark)

    Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell

    2018-01-01

    , exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

  1. Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules.

    Science.gov (United States)

    Dong, YiJie; Mao, MinJing; Zhan, WeiWei; Zhou, JianQiao; Zhou, Wei; Yao, JieJie; Hu, YunYun; Wang, Yan; Ye, TingJun

    2017-11-09

    Our goal was to assess the diagnostic efficacy of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules according to size and US features. A retrospective correlation was made with 1745 whole thyroidectomy and hemithyroidectomy specimens with preoperative US-guided FNA results. All cases were divided into 5 groups according to nodule size (≤5, 5.1-10, 10.1-15, 15.1-20, and >20 mm). For target nodules, static images and cine clips of conventional US and color Doppler were obtained. Ultrasound images were reviewed and evaluated by two radiologists with at least 5 years US working experience without knowing the results of pathology, and then agreement was achieved. The Bethesda category I rate was higher in nodules larger than 15 mm (P 20 mm) with several US features tended to yield false-negative FNA results. © 2017 by the American Institute of Ultrasound in Medicine.

  2. High Prevalence of Papillary Thyroid Microcarcinoma in Danish Patients

    DEFF Research Database (Denmark)

    Rossing, Maria; Nygaard, Birte; Bennedbæk, Finn Noe

    2012-01-01

    with a cold thyroid nodule undergoing US-guided FNA were prospectively registered. 408 patients underwent thyroid surgery, resulting in 50 cancers and in addition 37 patients had an incidental finding of papillary thyroid microcarcinomas. Based on the diagnostic FNA, we found sensitivity and specificity...... for malignancy. Cancer incidence was 13% among females and 9% among males. The accuracy of a diagnostic set-up based on clinical examination, scintigraphy, US, and US-guided FNA was determined with a 48% rate of histopathological validation in the cohort. The overall thyroid cancer incidence has increased...... worldwide, but our results suggest that the most frequent occurring cancer is an incidental papillary thyroid microcarcinoma of which the clinical significance has yet to be established....

  3. Evaluation of the safety and efficacy of percutaneous radiofrequency ablation for treating multiple breast fibroadenoma.

    Science.gov (United States)

    Li, Ping; Xiao-Yin, Tang; Cui, Dan; Chi, Jia-Chang; Wang, Zhi; Wang, Tao; Qi, Xing-Xing; Zhai, Bo

    2016-12-01

    This study was conducted to evaluate the safety and efficacy of ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) for multiple breast fibroadenoma as an alternative to surgical resection. Sixty-five patients with multiple breast fibroadenoma accepted general anesthesia and US-guided percutaneous RFA in our hospital from September 2014 to January 2016. Contrast-enhanced US (CEUS) was used immediately after operation to determine whether the tumor was ablated completely. The complete ablation rate (CAR) and the change of focal volume were evaluated by CEUS at the 1st month and the 3rd month after operation. All the patients were diagnosed by needle biopsy. Among all the patients, 256 nodules were found. Forty-six nodules (17.96%) were located fibroadenoma.

  4. Brief reports: ultrasound-guided obturator nerve block: a proximal interfascial technique.

    Science.gov (United States)

    Taha, Ahmad Muhammad

    2012-01-01

    In this report, I describe and evaluate a proximal ultrasound (US)-guided obturator nerve block technique using an interfascial local anesthetic (LA) injection deep to the pectineus muscle. The pectineus muscle was identified and followed, while the US probe was tilted cranially until the superior pubic ramus was visualized. In this plane, LA was injected interfascially between the pectineus and obturator externus. The median time required to identify the injection site was 4 seconds (95% confidence interval, 3-5 seconds). The median motor block onset was 4 minutes (95% confidence interval, 3-5 minutes). Both obturator nerve branches were blocked successfully in all patients (100%). The US-guided obturator nerve block using interfascial LA injection inferior to the superior pubic ramus, between the pectineus and obturator externus muscles, was shown to be a simple and successful technique.

  5. Percutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child

    International Nuclear Information System (INIS)

    Oechsle, Susanne; Vollert, Kurt; Buecklein, Wolfgang; Michl, Wolfgang; Roemer, Frank W.

    2006-01-01

    Splanchnic artery aneurysms are very rare in children. We report a 10-year-old girl with a large atraumatic ruptured superior mesenteric artery aneurysm that was considered inoperable. She was ultimately treated with two percutaneous US-guided thrombin injections, which led to complete occlusion of the aneurysm. The aetiology of the aneurysm remained unclear, but a family history was suggestive of a congenital connective tissue disease such as Ehlers-Danlos syndrome subtype IV. (orig.)

  6. Effects of line fiducial parameters and beamforming on ultrasound calibration

    OpenAIRE

    Ameri, Golafsoun; Baxter, John S. H.; McLeod, A. Jonathan; Peters, Terry M.; Chen, Elvis C. S.

    2017-01-01

    Ultrasound (US)-guided interventions are often enhanced via integration with an augmented reality environment, a necessary component of which is US calibration. Calibration requires the segmentation of fiducials, i.e., a phantom, in US images. Fiducial localization error (FLE) can decrease US calibration accuracy, which fundamentally affects the total accuracy of the interventional guidance system. Here, we investigate the effects of US image reconstruction techniques as well as phantom mater...

  7. Percutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child

    Energy Technology Data Exchange (ETDEWEB)

    Oechsle, Susanne; Vollert, Kurt; Buecklein, Wolfgang; Michl, Wolfgang; Roemer, Frank W. [Klinikum Augsburg, Department of Radiology, Augsburg (Germany)

    2006-03-15

    Splanchnic artery aneurysms are very rare in children. We report a 10-year-old girl with a large atraumatic ruptured superior mesenteric artery aneurysm that was considered inoperable. She was ultimately treated with two percutaneous US-guided thrombin injections, which led to complete occlusion of the aneurysm. The aetiology of the aneurysm remained unclear, but a family history was suggestive of a congenital connective tissue disease such as Ehlers-Danlos syndrome subtype IV. (orig.)

  8. Diagnostic CT and percutaneous procedures after pancreatic transplantation

    International Nuclear Information System (INIS)

    Letourneau, J.G.; Hunter, D.W.; Thompson, W.M.; Sutherland, D.E.R.

    1987-01-01

    CT evaluation of the abdomen and pelvis is of great value after pancreatic transplantation. The expected CT appearance after pancreas transportation with both enteric and bladder drainage of exocrine function are presented, as is the appearance of infected and ischemic grafts. The CT detection and CT- and US-guided percutaneous aspiration and drainage of abdominal fluid collections are described. At the authors' institution, such aspiration and drainage procedures have obviated transplant pancreatectomy or surgical abscess drainage in 29% of patients

  9. A Fresh Cadaver Model for the Instruction of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules.

    Science.gov (United States)

    McCrary, Hilary C; Faucett, Erynne A; Hurbon, Audriana N; Milinic, Tijana; Cervantes, Jose A; Kent, Sean L; Adamas-Rappaport, William J

    2017-07-01

    Objective The aim of our study is to determine if a fresh cadaver model (FCM) for the instruction of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules is a practical method for instruction. Study Design Pre- and postinstruction assessment of medical students' ability to perform US-guided FNA of artificially created thyroid nodules placed adjacent to the thyroid gland of a fresh cadaver. Setting University-based fresh cadaver laboratory. Subjects and Methods Study participants included a total of 17 first- and second-year medical students with minimal US training. Technical skills were assessed using a 10-item checklist. In addition, a cognitive assessment regarding the indications, contraindications, and complications of the procedure was completed. A postinstruction assessment was provided for participants 5 weeks after their initial assessment. Differences between pre- and postinstruction assessment scores of technical skills were analyzed using McNemar's test. The mean cognitive knowledge gain was analyzed using a paired 2-sample t test. Results Eight of 10 items on the skills checklist were statistically significant between pre- and postinstruction skills assessment ( P < .05). There was a statistically significant change in cognitive knowledge gain regarding the contraindications of the procedure ( P = .001), but not for indications or complications ( P = .104 and P = .111, respectively). Conclusion US-guided FNA continues to be an important diagnostic procedure in the workup of thyroid nodules, making it an essential skill to integrate into surgical skills lab. Our FCM for the instruction of US-guided FNA is the first of its kind, and this pilot study shows this is a viable method for instruction.

  10. 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)

    2002-06-15

    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.

  11. State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

    Science.gov (United States)

    Kim, Hyung Tae; Kim, Sae Young; Byun, Gyung Jo; Shin, Byung Chul; Lee, Jin Young; Choi, Eun Joo; Choi, Jong Bum; Hong, Ji Hee; Choi, Seung Won

    2017-01-01

    Background Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management. PMID:29123624

  12. Success Rate and Complications of Internal Jugular Vein Catheterization With and Without Ultrasonography Guide

    OpenAIRE

    Karimi-Sari, Hamidreza; Faraji, Mehrdad; Mohazzab Torabi, Saman; Asjodi, Gholamreza

    2014-01-01

    Background: Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran. Objectives: This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate. Patients and Methods: In this randomized controlled trial, patients who were candidate for internal jugular vein ...

  13. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    International Nuclear Information System (INIS)

    Wang Yang; Wang Wei; Wang Longxia; Wang Junyan; Tang Jie

    2011-01-01

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  14. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Wang Yang [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Wei, E-mail: wangyang301301@yahoo.com.cn [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Longxia; Wang Junyan; Tang Jie [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2011-07-15

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  15. Pneumothorax and the Value of Chest Radiography after Ultrasound-Guided Thoracocentesis

    International Nuclear Information System (INIS)

    Pihlajamaa, K.; Bode, M.K.; Puumalainen, T.; Lehtimaeki, A.; Marjelund, S.; Tikkakoski, T.

    2004-01-01

    Purpose: To determine the incidence, the operator's experience, and other variables that may influence the development of pneumothorax or re-expansion edema after ultrasound (US)-guided thoracocentesis. Material and Methods: The medical records of 264 procedures in 212 patients who had undergone US-guided thoracocentesis in our radiology department or intensive care unit during the period 1996-2001 were retrospectively reviewed. Results: Post-thoracocentesis pneumothorax occurred in 11 cases, the incidence being 4.2% (11/264). None of the pneumothoraces occurred in the 10 mechanically ventilated patients. All but one patient with pneumothorax were asymptomatic or had only minor symptoms. Chest tube drainage was needed in one patient with a large pneumothorax. No re-expansion edema was recorded, although 1500 ml or more pleural fluid was aspirated in 29 patients. The operator's experience had no effect on the complication rate. Needle size was the only significant variable that contributed to the pneumothorax rate. Conclusion: US-guided thoracocentesis can be done equally as safely by residents as by senior radiologists. The safety and feasibility of the method are evident among mechanically ventilated intensive care patients. Our results do not support the routine use of post-thoracocentesis chest radiography

  16. Pregnancy-associated breast disease: radiologic features and diagnostic dilemmas.

    Science.gov (United States)

    Son, Eun Ju; Oh, Ki Keun; Kim, Eun Kyung

    2006-02-28

    In this paper, we evaluate the radiological features of pregnancy-associated breast lesions and discuss the difficulties in diagnosis by imaging. We selected patients who were diagnosed with pregnancy-associated breast lesions during the previous 5 years. All patients complained of palpable lesions in the breast and underwent ultrasonographic (US) examination, the first choice for examination of pregnancy-related breast lesions. Any suspicious lesions found by the US were recommended for a US-guided core biopsy, US-guided fine needle aspiration (FNA), or surgery. Various breast lesions were detected during pregnancy and lactation, including breast cancer, mastitis and abscesses, lactating adenoma, galactoceles, lobular hyperplasia, and fibroadenomas. The imaging features of pregnancy-associated breast lesions did not differ from the features of non-pregnancy-associated breast lesions; however, some pregnancy-associated benign lesions had suspicious sonographic features. A US-guided core biopsy was necessary for differentiating benign from malignant. In patients with breast cancer, the cancer was often advanced at the time of diagnosis. In conclusion, various pregnancy-related breast lesions were detected and the imaging of these lesions had variable findings. Breast ultrasound could be an excellent imaging modality for diagnosis and differentiation between benign and malignant lesions. However, when the imaging results are suspicious, a biopsy should be performed to obtain a pathologic diagnosis.

  17. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

    Directory of Open Access Journals (Sweden)

    Sanjeev Bhoi

    2012-01-01

    Full Text Available Background: Patients require procedural sedation and analgesia (PSA for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED. Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%, femoral-7 (14%, brachial- 29 (58%, median -6 (12%, and radial 2 (4% nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10 and at 1 hour was 2(IQR 0-4. Median reduction in VAS score was 7.44 (IQR 8-10(75%, 1-2(25% (P=0.0001. Median procedure time was 9 minutes (IQR 3, 12 minutes and median time to reduction of pain was 5 minutes (IQR 1,15 minutes. No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.

  18. Development of a fresh cadaver model for instruction of ultrasound-guided breast biopsy during the surgery clerkship: pre-test and post-test results among third-year medical students.

    Science.gov (United States)

    McCrary, Hilary C; Krate, Jonida; Savilo, Christine E; Tran, Melissa H; Ho, Hang T; Adamas-Rappaport, William J; Viscusi, Rebecca K

    2016-11-01

    The aim of our study was to determine if a fresh cadaver model is a viable method for teaching ultrasound (US)-guided breast biopsy of palpable breast lesions. Third-year medical students were assessed both preinstruction and postinstruction on their ability to perform US-guided needle aspiration or biopsy of artificially created masses using a 10-item checklist. Forty-one third-year medical students completed the cadaver laboratory as part of the surgery clerkship. Eight items on the checklist were found to be significantly different between pre-testing and post-testing. The mean preinstruction score was 2.4, whereas the mean postinstruction score was 7.10 (P cadaver models have been widely used in medical education. However, there are few fresh cadaver models that provide instruction on procedures done in the outpatient setting. Our model was found to be an effective method for the instruction of US-guided breast biopsy among medical students. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: a new approach for obese and non-obese patients.

    Science.gov (United States)

    Gesualdo, Loreto; Cormio, Luigi; Stallone, Giovanni; Infante, Barbara; Di Palma, Anna Maria; Delli Carri, Paolo; Cignarelli, Mauro; Lamacchia, Olga; Iannaccone, Salvatore; Di Paolo, Salvatore; Morrone, Luigi; Aucella, Filippo; Carrieri, Giuseppe

    2008-03-01

    Percutaneous ultrasound (US)-guided renal biopsy is the gold standard in the evaluation of renal diseases, but some patients, such as the obese, may not be eligible for this procedure. Aim of this study was to determine the feasibility, efficacy and safety of US-guided percutaneous renal biopsy in supine antero-lateral position (SALP) in high-risk patients (BMI > 30 and/or respiratory difficulty), as well as to compare the overall outcome of SALP with that of traditional prone position (PP) in low-risk patients (BMI SALP (Group 2), whereas 20 high-risk patients received US-guided renal biopsy in SALP (Group 3) and were our observational cohort study. Comfort compliance and breathing difficulty in each group were evaluated by the Visual Analogue Scale (VAS). Bleeding complications were evaluated through US renal scanning. Mean operating time was 7 min. Comfort compliance and breathing difficulty were significantly better for SALP in both low- and high-risk patients; there were no significant differences in pain after biopsy among the three groups. Bleeding complications were slightly higher in Group 1. Diagnostic yield was similar in all groups. SALP is reliable, minimally invasive, easy, highly successful, timesaving and almost free from severe side-effects. A better VAS score for breathing difficulty and comfort compliance characterizes this procedure, making it particularly suitable for obese patients.

  20. Does Ultrasound-Guided Directional Vacuum-Assisted Removal Help Eliminate Abnormal Nipple Discharge in Patients with Benign Intraductal Single Mass?

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jung Min; Cho, Na Ri Ya; Moon, Woo Kyung [Seoul National University Hospital, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University Hospital, Seoul (Korea, Republic of); Chung, Se Yeong [Seoul National University Boramae Hospital, Seoul (Korea, Republic of); Jang, Mi Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2009-12-15

    To evaluate whether the removal of an intraductal mass using an ultrasound (US)-guided directional vacuum-assisted device can eliminate symptoms in patients presenting with abnormal nipple discharge. Between March 2004 and October 2006, 36 patients who presented with abnormal nipple discharge, underwent US-guided, 11-gauge vacuum-assisted biopsy for a benign intraductal single mass on US. The ability of the procedure to eliminate nipple discharge was evaluated by physical examination during follow-up US. Lesion characteristics, biopsy variables, and histologic features were analyzed to identify factors affecting symptom resolution. Of the 36 lesions, 25 (69%) were intraductal papillomas, 10 (28%) were fibrocystic changes, and one (3%) was a fibroadenoma. The nipple discharge disappeared in 69% (25 of 36) of the women at a mean follow-up time of 25 months (range 12-42 month). There was no difference in the lesion characteristics, biopsy variables, and the histologic features between groups that eliminated the symptom compared those with persistent nipple discharge. US-guided directional vacuum-assisted removal of an intraductal mass appears to eliminate nipple discharge in only 69% of patients and thus, it should not be considered as an alternative to surgical excision.

  1. Ultrasound guided percutaneous removal of wooden foreign bodies in the extremities with hydro-dissection technique

    Energy Technology Data Exchange (ETDEWEB)

    Park, HeeJin; Lee, So Yeon; Chung, Eun Chul; Rho, Myung Ho [Dept. of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Lee, Sung Moon; Son, Eun Seok [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Lee, Sun Joo [Dept. of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of)

    2015-12-15

    We described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases.Four patients referred to the radiology department for US evaluation and US-guided percutaneous removal of the FBs in the upper and lower extremities between November, 2006 and November, 2013 were included in this study. The procedures started with US evaluation for the exact location and shape of the FB. A 5 mm-sized skin incision was made at the site of the nearest point from the FB where no passing arteries or tendons were present. We adopted a hydro dissection technique to separate the FB from adjacent tissue using a 2% lidocaine solution. Injected anesthetics detached the FBs from surrounding tissue and thereby facilitated removal. After the tip of the mosquito forceps reached the FB, the wooden FBs were removed. The mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance. Ultrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps.

  2. Role of microRNAs and microRNA machinery in the pathogenesis of diffuse large B-cell lymphoma

    International Nuclear Information System (INIS)

    Caramuta, S; Lee, L; Özata, D M; Akçakaya, P; Georgii-Hemming, P; Xie, H; Amini, R-M; Lawrie, C H; Enblad, G; Larsson, C; Berglund, M; Lui, W-O

    2013-01-01

    Deregulation of microRNA (miRNA) expression has been documented in diffuse large B-cell lymphoma (DLBCL). However, the impact of miRNAs and their machinery in DLBCL is not fully determined. Here, we assessed the role of miRNA expression and their processing genes in DLBCL development. Using microarray and RT-qPCR approaches, we quantified global miRNAs and core components of miRNA-processing genes expression in 75 DLBCLs (56 de novo and 19 transformed) and 10 lymph nodes (LN). Differential miRNA signatures were identified between DLBCLs and LNs, or between the de novo and transformed DLBCLs. We also identified subsets of miRNAs associated with germinal center B-cell phenotype, BCL6 and IRF4 expression, and clinical staging. In addition, we showed a significant over-expression of TARBP2 in de novo DLBCLs as compared with LNs, and decreased expression of DROSHA, DICER, TARBP2 and PACT in transformed as compared with de novo cases. Interestingly, cases with high TARBP2 and DROSHA expression had a poorer chemotherapy response. We further showed that TARBP2 can regulate miRNA-processing efficiency in DLBCLs, and its expression inhibition decreases cell growth and increases apoptosis in DLBCL cell lines. Our findings provide new insights for the understanding of miRNAs and its machinery in DLBCL

  3. The importance of tattoo pigment in sentinel lymph nodes.

    Science.gov (United States)

    Soran, Atilla; Menekse, Ebru; Kanbour-Shakir, Amal; Tane, Kaori; Diego, Emilia; Bonaventura, Marguerite; Johnson, Ronald

    2017-01-01

    The presence of pigment in axillary lymph nodes (LN) secondary to migration of tattoo ink can imitate the appearance of a blue sentinel lymph node (SLN) on visual inspection, causing the operator to either miss the true SLN or excise more than is needed. We present patients with tattoos ipsilateral to an early stage breast cancer who underwent a SLN biopsy. Patients were retrospectively reviewed from medical records and clinicopathologic data was collected. A total of 52 LNs were retrieved from 15 patients for sentinel mapping and 29 of them had tattoo pigmentation on pathologic evaluation. Of those 29 SLNs, 2 of them (6.9%) were pigmented, but did not contain either blue dye or Tc-99m (pseudopigmented SLN). Two (3.8%) SLNs were positive for metastasis; both of these had either blue dye or Tc99m uptake, and 1 demonstrated tattoo pigment in the node. In this cohort of patients with ipsilateral tattoos, removed more LNs lead to unnecessary excision which may important for increasing the risk of arm morbidity from SLN biopsy. However, the presence of tattoo pigment did not interfere with understaging for axillary mapping and it did not effect of pathological identification of SLNs positivity.

  4. α-Synuclein Immunotherapy Blocks Uptake and Templated Propagation of Misfolded α-Synuclein and Neurodegeneration

    Directory of Open Access Journals (Sweden)

    Hien T. Tran

    2014-06-01

    Full Text Available Accumulation of misfolded alpha-synuclein (α-syn into Lewy bodies (LBs and Lewy neurites (LNs is a major hallmark of Parkinson’s disease (PD and dementia with LBs (DLB. Recent studies showed that synthetic preformed fibrils (pffs recruit endogenous α-syn and induce LB/LN pathology in vitro and in vivo, thereby implicating propagation and cell-to-cell transmission of pathological α-syn as mechanisms for the progressive spread of LBs/LNs. Here, we demonstrate that α-syn monoclonal antibodies (mAbs reduce α-syn pff-induced LB/LN formation and rescue synapse/neuron loss in primary neuronal cultures by preventing both pff uptake and subsequent cell-to-cell transmission of pathology. Moreover, intraperitoneal (i.p. administration of mAb specific for misfolded α-syn into nontransgenic mice injected intrastriatally with α-syn pffs reduces LB/LN pathology, ameliorates substantia nigra dopaminergic neuron loss, and improves motor impairments. We conclude that α-syn antibodies could exert therapeutic effects in PD/DLB by blocking entry of pathological α-syn and/or its propagation in neurons.

  5. Co-localization of a CD1d-binding glycolipid with an adenovirus-based malaria vaccine for a potent adjuvant effect.

    Science.gov (United States)

    Li, Xiangming; Huang, Jing; Kawamura, Akira; Funakoshi, Ryota; Porcelli, Steven A; Tsuji, Moriya

    2017-05-31

    A CD1d-binding, invariant (i) natural killer T (NKT)-cell stimulatory glycolipid, α-Galactosylceramide (αGalCer), has been shown to act as an adjuvant. We previously identified a fluorinated phenyl ring-modified αGalCer analog, 7DW8-5, displaying a higher binding affinity for CD1d molecule and more potent adjuvant activity than αGalCer. In the present study, 7DW8-5 co-administered intramuscularly (i.m.) with a recombinant adenovirus expressing a Plasmodium yoelii circumsporozoite protein (PyCSP), AdPyCS, has led to a co-localization of 7DW8-5 and a PyCSP in draining lymph nodes (dLNs), particularly in dendritic cells (DCs). This occurrence initiates a cascade of events, such as the recruitment of DCs to dLNs and their activation and maturation, and the enhancement of the ability of DCs to prime CD8+ T cells induced by AdPyCS and ultimately leading to a potent adjuvant effect and protection against malaria. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Metastatic lymph-node clearance from head and neck-epidermoid carcinomas following radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ohara, Kiyoshi; Tatsuzaki, Hideo; Kurosaki, Yoshihisa; Fuji, Hiroshi; Myo-Min; Itai, Yuji [Tsukuba Univ. (Japan). Dept. of Radiology; Hara, Akira; Kusakari, Jun [Tsukuba Univ. (Japan). Dept. of Otolaryngology; Ogata, Takesaburo [Tsukuba Univ. (Japan). Inst. of Clinical Medicine]|[Ibaraki Prefectural Univ. of Health Sciences (Japan). Dept. of Pathology

    1999-08-01

    Although tumor clearance is a common criterion in assessing the impact of radiotherapy (RT), it is not always reliable. Patterns of tumor clearance were determined using 91 metastatic lymph nodes (LNs) from 51 patients with head and neck tumors treated by definitive RT (61-80 Gy) or preoperative RT (43-65 Gy). Clearance rate (CR) was estimated as a daily volume decrement expressed as a ratio to the pre-RT LN volume. CR was greater for the so-called radioresponsive nasopharyngeal subgroups and more poorly differentiated than those of oral cavity and well-differentiated, respectively. Histologically, LNs that were removed following RT consisted mainly of fibrous tissues, necrotic tissues, and few cancer cells. There was no difference in CR between the cancer-cell-positive group (n=21) and the cancer-cell-negative groups (n=31). Although the CR may reflect inherent radiosensitivity of tumor cells, tumor persistence predicts the amount of oncologically inactive materials rather than that of remaining cancer cells. (orig.)

  7. Metastatic lymph-node clearance from head and neck-epidermoid carcinomas following radiotherapy

    International Nuclear Information System (INIS)

    Ohara, Kiyoshi; Tatsuzaki, Hideo; Kurosaki, Yoshihisa; Fuji, Hiroshi; Myo-Min; Itai, Yuji; Hara, Akira; Kusakari, Jun; Ogata, Takesaburo; Ibaraki Prefectural Univ. of Health Sciences

    1999-01-01

    Although tumor clearance is a common criterion in assessing the impact of radiotherapy (RT), it is not always reliable. Patterns of tumor clearance were determined using 91 metastatic lymph nodes (LNs) from 51 patients with head and neck tumors treated by definitive RT (61-80 Gy) or preoperative RT (43-65 Gy). Clearance rate (CR) was estimated as a daily volume decrement expressed as a ratio to the pre-RT LN volume. CR was greater for the so-called radioresponsive nasopharyngeal subgroups and more poorly differentiated than those of oral cavity and well-differentiated, respectively. Histologically, LNs that were removed following RT consisted mainly of fibrous tissues, necrotic tissues, and few cancer cells. There was no difference in CR between the cancer-cell-positive group (n=21) and the cancer-cell-negative groups (n=31). Although the CR may reflect inherent radiosensitivity of tumor cells, tumor persistence predicts the amount of oncologically inactive materials rather than that of remaining cancer cells. (orig.)

  8. Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer

    International Nuclear Information System (INIS)

    Bluemel, Christina; Herrmann, Ken; Buck, Andreas K.; Lapa, Constantin; Kuebler, Alexander; Hartmann, Stefan; Linz, Christian; Mueller-Richter, Urs; Geissinger, Eva; Wild, Vanessa

    2014-01-01

    The aim of this study was to prospectively evaluate the feasibility and potential advantages of freehand single-photon emission computed tomography (fhSPECT) compared with conventional intraoperative localization techniques for sentinel lymph node biopsy (SLNB) in oral cancer. Between November 2012 and February 2014, 23 consecutive patients with clinical T1/T2 oral squamous cell carcinoma and a cN0 neck were recruited. All patients underwent SLNB followed by elective neck dissection (END). All patients received preoperative lymphoscintigraphy. To