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Sample records for repeat graft biopsy

  1. Optimizing prostate biopsy for repeat transrectal prostate biopsies patients

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  2. Value of repeat biopsy in lupus nephritis flares

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    Greloni, G; Scolnik, M; Marin, J; Lancioni, E; Quiroz, C; Zacariaz, J; De la Iglesia Niveyro, P; Christiansen, S; Pierangelo, M A; Varela, C F; Rosa-Diez, G J; Catoggio, L J; Soriano, E R

    2014-01-01

    Objectives Renal flares are common in lupus nephritis (LN), and class switch is thought to be characteristic. There is no agreement on indications for performing a repeat renal biopsy. Our objective was to retrospectively review patients who had more than one renal biopsy performed on clinical indications, and analyse clinical, pathological and treatment changes after successive biopsies. Methods Forty-five patients with LN and one or more repeat renal biopsies were included, with a total of 116 biopsies. Results Of the 71 repeat biopsies, pathological transition occurred in 39 (54.9%). When having a previous biopsy with a proliferative lesion, class switch occurred in 55.6%, with 24.4% evolving into non-proliferative classes. When previous biopsy was class V, transition to other classes occurred in 58.3% and changes were all into proliferative classes. Conversion from one pure proliferative form to another (class III to class IV or vice versa) happened in 11.3% of the rebiopsies, with 62 rebiopsies (87.3%) leading to a change in the treatment regimen. Conclusions Histological transformations were common, and they occurred when the previous biopsy had non-proliferative lesions as well as when lesions were proliferative. Treatments were modified after repeat renal biopsy in the majority of patients. In this experience, kidney repeat biopsies were useful in guiding treatment of LN flares. PMID:25396056

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

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    Marilda Mazzali

    1999-03-01

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

  4. Repeated nondiagnostic result of thyroid fine-needle aspiration biopsy.

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    Ziemiańska, Klaudia; Kopczyński, Janusz; Kowalska, Aldona

    2016-01-01

    Fine-needle aspiration biopsy (FNAB) is the most accurate and cost-effective method to evaluate the risk of malignancy of thyroid nodules, but approximately 1-24% of FNABs generate a nondiagnostic result (ND-FNAB). The aim of this study was to determine the predictive factors of a repeated nondiagnostic result of FNAB. A total of 4018 FNABs performed in a territorial referral centre were analysed, of which 288 (7.17%) were nondiagnostic. Medical records were available for 245 biopsies performed in 228 patients. The retrospective analysis of factors that may influence a repeat ND-FNAB, including demographic, clinical and ultrasound characteristics, was performed. A repeat FNAB was performed in 159 nodules giving a diagnostic result in 79.2% of cases. The time between the biopsies ranged from 1 to 611 days (mean 154.4, median 119). The timing of a repeat FNAB did not significantly alter the diagnostic output (p = 0.29). In the univariate analysis, significant predictors of a repeat ND-FNAB were older patient age (p = 0.02), L-thyroxine supplementation (p = 0.05), and a history of (131)I therapy (p < 0.0001). In the multivariate analysis, only a history of (131)I therapy was a statistically significant risk factor for a repeat ND-FNAB (p = 0.002). Patients with a history of (131)I therapy and ND-FNAB should undergo periodic ultrasonographic assessment rather than a repeat biopsy. The interval between repeated FNABs recommended by guidelines does not affect the diagnostic output.

  5. Preimplantation biopsy predicts delayed graft function, glomerular filtration rate and long-term graft survival of transplanted kidneys

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    José A. Pedroso

    2016-01-01

    Full Text Available The predictive value of preimplantation biopsies for long-term graft function is often limited by conflicting results. The aim of this study was to evaluate the influence of time-zero graft biopsy histological scores on early and late graft function, graft survival and patient survival, at different time points. We retrospectively analyzed 284 preimplantation biopsies at a single center, in a cohort of recipients with grafts from live and deceased donors (standard and nonstandard, and their impact in posttransplant renal function after a mean follow-up of 7 years (range 1-16. Implantation biopsy score (IBS, a combination score derived from 4 histopathological aspects, was determined from each sample. The correlation with incidence of delayed graft function (DGF, creatinine clearance (1st, 3rd and 5th posttransplant year and graft and patient survival at 1 and 5 years were evaluated. Preimplantation biopsies provided somewhat of a prognostic index of early function and outcome of the transplanted kidney in the short and long term. In the immediate posttransplantation period, the degree of arteriolosclerosis and interstitial fibrosis correlated better with the presence of DGF. IBS values between 4 and 6 were predictive of worst renal function at 1st and 3rd years posttransplant and 5-year graft survival. The most important histological finding, in effectively transplanted grafts, was the grade of interstitial fibrosis. Patient survival was not influenced by IBS. Higher preimplantation biopsy scores predicted an increased risk of early graft losses, especially primary nonfunction. Graft survival (at 1st and 5th years after transplant but not patient survival was predicted by IBS.

  6. A review of repeat prostate biopsies and the influence of technique on cancer detection: our experience.

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    Quinlan, M R

    2012-02-01

    BACKGROUND: Follow-up of patients with an initial negative prostate biopsy, but surrounding whom a suspicion of prostate cancer persists, is difficult. In addition, debate exists as to the optimal technique for repeat prostate biopsy. AIMS: To assess the cancer detection rate on repeat prostate biopsy. METHODS: We reviewed patients who underwent prostate biopsy in our department in 2005 who had >or=1 previous biopsy within the preceding 5 years. Cancer detection rate on repeat biopsy and the influence of the number of biopsy cores were recorded. RESULTS: Cancer detection rate on repeat biopsy was 15.4%, with approximately 60% detected on the first repeat biopsy, but approximately 10% not confirmed until the fourth repeat biopsy. Gleason score was similar regardless of the time of diagnosis (6.1-6.5). Mean interval between first biopsy and cancer diagnosis (range 18-55 months) depended on the number of repeat procedures. There was an association between the number of biopsy cores and cancer detection. CONCLUSIONS: This study supports the practice of increasing the number of cores taken on initial and first repeat biopsy to maximise prostate cancer detection and reduce the overall number of biopsies needed.

  7. ANALYSIS OF 312 CASES OF REPEAT CORONARY ARTERY BYPASS GRAFTING

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    陈长志; 陆佩中

    2003-01-01

    Objective To evaluate repeat coronary artery bypass grafting (CABG) in 312 patients.Methods The data of 312 patients (average age 65±9 years) who had CABG operation in Hartford hospital were collected and analyzed. The mean duration follow up after the first CABG was 11.8±4.5 years. A total of 1069 bypass grafts were performed. Among them, 386 were arterial grafts such as internal mammary artery, radial artery and gastroepiploic artery; 682 were venous grafts and 1 Gore-Tex graft. Results The operative mortality was 4. 5%. Fifteen patients (4. 8%) had peri-operative myocardial infarction and 46 patients (15%) had low cardiac output syndrome. Intra-aortic balloon pump (IABP) was used in 131 patients before, during and after operation. One hundred and nineteen patients weaned off IABP and recovered. ConclusionAlthough the difficulties and risk factors were increased, the results of redo CABG were still good.

  8. The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

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    Agata Stanek-Widera

    2016-05-01

    Full Text Available Fine needle aspiration biopsy (FNA is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE. We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100% cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100% provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100% specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment indicates that repeat FNA in order to confirm the diagnosis is unnecessary.

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

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    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

    2017-01-01

    for detection of csPCa in men undergoing repeat biopsies. Material and Methods MpMRI was performed prior to re-biopsy in 289 prospectively enrolled patients. All underwent repeat TRUSbx followed by targeted biopsies (MRITB) of any mpMRI-identified lesion. MpMRI suspicion grade, PSA level, and density (PSAd...

  10. Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer?

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    Pietro Pepe

    2015-10-01

    Full Text Available ABSTRACT Purpose: Detection rate for anterior prostate cancer (PCa in men who underwent initial and repeat biopsy has been prospectively evaluated. Materials and Methods: From January 2013 to March 2014, 400 patients all of Caucasian origin (median age 63.5 years underwent initial (285 cases and repeat (115 cases prostate biopsy; all the men had negative digital rectal examination and the indications to biopsy were: PSA values > 10 ng/mL, PSA between 4.1-10 or 2.6-4 ng/mL with free/total PSA≤25% and ≤20%, respectively. A median of 22 (initial biopsy and 31 cores (repeat biopsy were transperineally performed including 4 cores of the anterior zone (AZ and 4 cores of the AZ plus 2 cores of the transition zone (TZ, respectively. Results: Median PSA was 7.9 ng/mL; overall, a PCa was found in 180 (45% patients: in 135 (47.4% and 45 (36% of the men who underwent initial and repeat biopsy, respectively. An exclusive PCa of the anterior zone was found in the 8.9 (initial biopsy vs 13.3% (repeat biopsy of the men: a single microfocus of cancer was found in the 61.2% of the cases; moreover, in 7 out 18 AZ PCa the biopsy histology was predictive of significant cancer in 2 (28.5% and 5 (71.5% men who underwent initial and repeat biopsy, respectively. Conclusions: However AZ biopsies increased detection rate for PCa (10% of the cases, the majority of AZ PCa with histological findings predictive of clinically significant cancer were found at repeat biopsy (about 70% of the cases.

  11. Donation after cardiac death liver transplantation: Graft quality evaluation based on pretransplant liver biopsy.

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    Xia, Weiliang; Ke, Qinghong; Wang, Ye; Feng, Xiaowen; Guo, Haijun; Wang, Weilin; Zhang, Min; Shen, Yan; Wu, Jian; Xu, Xiao; Yan, Sheng; Zheng, Shusen

    2015-06-01

    Donation after cardiac death (DCD) liver grafts are associated with inferior clinical outcomes and high discard rates because of poor graft quality. We investigated the predictive value of DCD liver biopsy for the pretransplant graft quality evaluation. DCD liver transplants that took place between October 2010 and April 2014 were included (n = 127). Histological features of graft biopsy samples were analyzed to assess risk factors for graft survival. Macrovesicular steatosis ≥ 20% [hazard ratio (HR) = 2.973; P = 0.045] and sinusoidal neutrophilic infiltrate (HR = 6.969; P = 0.005) were confirmed as independent risk factors for graft survival; hepatocellular swelling, vacuolation, and necrosis failed to show prognostic value. Additionally, a donor serum total bilirubin level ≥ 34.2 μmol/L was also associated with a lower probability of graft survival. Our analysis indicates that macrovesicular steatosis ≥ 20% and sinusoidal neutrophilic infiltrate are novel and useful histological markers for DCD liver grafts with unacceptable quality. This finding can be used by transplant surgeons to improve DCD liver acceptance protocols.

  12. Changes in pathological pattern and treatment regimens based on repeat renal biopsy in lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    WANG Guo-bao; XU Zheng-jin; LIU Hong-fa; ZHOU Qiu-gen; ZHOU Zhan-mei; JIA Nan

    2012-01-01

    Background Relapses occur frequently in patients with lupus nephritis.Renal biopsy is the gold standard for assessing renal activity and hence guiding the treatment.Whether repeat renal biopsy is helpful during flares of lupus nephritis remains inconclusive.In the present study,we retrospectively reviewed the patients with lupus nephritis who had more than one renal biopsy with the hope to find the clinical value of repeat biopsy.Methods Patients who had a diagnosis of lupus nephritis and two or more renal biopsies were selected from the database of the patient pathology registration at this renal division.Renal biopsy was evaluated according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification of lupus nephritis.The pathological patterns and treatment regimens were analyzed after a repeat biopsy.Results We identified 44 systemic lupus erythematosus patients with serial renal biopsies.In total,there were 94 renal biopsies.Overall,the pathological transition occurred in 64% instances according to the ISN/RPS class.When the transition was analyzed according to proliferative,membranous or mix lesions,it showed different profile:35% in patients with proliferative lesion,23.5% patients with mix lesions,100% in patients with pure membranous lesion.The pathological transition could not be predicted by any clinical characteristics.After the repeat renal biopsy,34% of patients had a change in their treatment regimens.Conclusions The pathological conversion was very prevalent in patients with lupus nephritis.However,the transitions became less prevalent when they were analyzed according to pure membranous,proliferative,and mix lesion.Repeat biopsy might be helpful to avoid unnecessary increased immunosuppression therapy.

  13. Renal graft survival according to Banff 2013 classification in indication biopsies

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    Carlos Arias-Cabrales

    2016-11-01

    Conclusions: The Banff 2013 classification facilitates a histological diagnosis in 95% of indication biopsies. While diagnostic category 6 is the most common, a change in the predominant histopathology was observed according to time elapsed since transplantation. Antibody-mediated changes are associated with worse graft survival.

  14. Development and validation of risk score for predicting positive repeat prostate biopsy in patients with a previous negative biopsy in a UK population

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    Matthews Fiona

    2009-07-01

    Full Text Available Abstract Background Little evidence is available to determine which patients should undergo repeat biopsy after initial benign extended core biopsy (ECB. Attempts have been made to reduce the frequency of negative repeat biopsies using PSA kinetics, density, free-to-total ratios and Kattan's nomogram, to identify men more likely to harbour cancer but no single tool accurately predicts biopsy outcome. The objective of this study was to develop a predictive nomogram to identify men more likely to have a cancer diagnosed on repeat prostate biopsy. Methods Patients with previous benign ECB undergoing repeat biopsy were identified from a database. Association between age, volume, stage, previous histology, PSA kinetics and positive repeat biopsy was analysed. Variables were entered stepwise into logistic regression models. A risk score giving the probability of positive repeat biopsy was estimated. The performance of this score was assessed using receiver characteristic (ROC analysis. Results 110 repeat biopsies were performed in this period. Cancer was detected in 31% of repeat biopsies at Hospital (1 and 30% at Hospital (2. The most accurate predictive model combined age, PSA, PSA velocity, free-to-total PSA ratio, prostate volume and digital rectal examination (DRE findings. The risk model performed well in an independent sample, area under the curve (AUCROC was 0.818 (95% CI 0.707 to 0.929 for the risk model and 0.696 (95% CI 0.472 to 0.921 for the validation model. It was calculated that using a threshold risk score of > 0.2 to identify high risk individuals would reduce repeat biopsies by 39% while identifying 90% of the men with prostate cancer. Conclusion An accurate multi-variable predictive tool to determine the risk of positive repeat prostate biopsy is presented. This can be used by urologists in an outpatient setting to aid decision-making for men with prior benign histology for whom a repeat biopsy is being considered.

  15. Biopsies

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    ... News Physician Resources Professions Site Index A-Z Biopsies - Overview A biopsy is the removal of tissue ... What are the limitations of biopsies? What are biopsies? A biopsy is the removal of tissue in ...

  16. Repeated biopsies in patients with prostate cancer on active surveillance

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    Thomsen, Frederik B; Marcussen, Niels; Berg, Kasper D;

    2015-01-01

    were included. The International Society of Urological Pathology 2005 Gleason scoring system was used for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa (κ) statistics were used to compare...... the interobserver agreement. RESULTS: The overall Gleason score agreement was 68.8% with a weighted κ of 0.670. The interobserver agreement was 79.6% for meeting the AS selection criteria. According to the three progression definitions applied, overall agreement was between 80.7% and 89.0% with weighted κ values...

  17. Renal graft survival according to Banff 2013 classification in indication biopsies.

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    Arias-Cabrales, Carlos; Redondo-Pachón, Dolores; Pérez-Sáez, María José; Gimeno, Javier; Sánchez-Güerri, Ignacio; Bermejo, Sheila; Sierra, Adriana; Burballa, Carla; Mir, Marisa; Crespo, Marta; Pascual, Julio

    The impact of acute rejection in kidney graft survival is well known, but the prognosis of other diagnoses is uncertain. We evaluated the frequency and impact on graft survival of different diagnostic categories according to the Banff 2013 classification in a cohort of renal transplant recipients. Retrospective study of 495 renal biopsies by indication in 322 patients from 1990-2014. Two independent observers reviewed the histological reports, reclassifying according to the Banff 2013 classification. Of 495 biopsies, 28 (5.7%) were not diagnostic. Of the remaining 467, 10.3% were «normal» (category 1), 19.6% antibody-mediated changes (category 2), 5.9% «borderline» changes (category 3), 8.7% T-cell-mediated rejection (category 4), 23.4% interstitial fibrosis/tubular atrophy (IFTA) (category 5) and 26.5% with other diagnoses (category 6). As time after transplantation increases, diagnoses of categories 1, 3 and 4 decrease, while categories 5 and 2 increase. Worse graft survival with category 2 diagnosis was observed (45% at 7.5 years, HR 4.29 graft loss [95% CI, 2.39-7.73]; P≤.001, compared to category 1). Grafts with «unfavourable histology» (chronic antibody-mediated rejection, moderate-severe IFTA) presented worse survival that grafts with «favourable histology» (normal, acute tubular necrosis, mild IFTA). The Banff 2013 classification facilitates a histological diagnosis in 95% of indication biopsies. While diagnostic category 6 is the most common, a change in the predominant histopathology was observed according to time elapsed since transplantation. Antibody-mediated changes are associated with worse graft survival. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  18. Decreased infiltration of macrophage scavenger receptor-positive cells in initial negative biopsy specimens is correlated with positive repeat biopsies of the prostate.

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    Nonomura, Norio; Takayama, Hitoshi; Kawashima, Atsunari; Mukai, Masatoshi; Nagahara, Akira; Nakai, Yasutomo; Nakayama, Masashi; Tsujimura, Akira; Nishimura, Kazuo; Aozasa, Katsuyuki; Okuyama, Akihiko

    2010-06-01

    Macrophage scavenger receptor (MSR)-positive inflammatory cells and tumor-associated macrophages (TAMs) have been reported to regulate the growth of various cancers. In this study, the infiltration of MSR-positive cells and TAMs was analyzed to predict the outcome of repeat biopsy in men diagnosed as having no malignancy at the first prostate biopsy. Repeat biopsy of the prostate was carried out in 92 patients who were diagnosed as having no malignancy at the first biopsy. Of these, 30 patients (32.6%) were positive for prostate cancer at the repeat biopsy. Tumor-associated macrophages and MSR-positive cells were immunohistochemically stained with mAbs CD68 and CD204, respectively. Six ocular measuring fields were chosen randomly under a microscope at x400 power in the initial negative biopsy specimens, and the mean TAM and MSR counts for each case were determined. No difference in TAM count was found between the cases with or without prostate cancer. By contrast, the MSR count in patients with cancer was significantly lower than that in patients without cancer at the repeat biopsy (P biopsies, or TAM count. Decreased infiltration of MSR-positive cells in negative first biopsy specimens was correlated with positive findings in the repeat biopsy. The MSR count might be a good indicator for avoiding unnecessary repeat biopsies.

  19. Repeat prostate biopsy accuracy: simulator-based comparison of two- and three-dimensional transrectal US modalities.

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    Cool, Derek W; Connolly, Michael J; Sherebrin, Shi; Eagleson, Roy; Izawa, Jonathan I; Amann, Justin; Romagnoli, Cesare; Romano, Walter M; Fenster, Aaron

    2010-02-01

    To compare the accuracy of biopsy with two-dimensional (2D) transrectal ultrasonography (US) with that of biopsy with conventional three-dimensional (3D) transrectal US and biopsy with guided 3D transrectal US in the guidance of repeat prostate biopsy procedures in a prostate biopsy simulator. The institutional review board approved this retrospective study. Five residents and five experts performed repeat biopsies with a biopsy simulator that contained the transrectal US prostate images of 10 patients who had undergone biopsy. Simulated repeat biopsies were performed with 2D transrectal US, conventional 3D transrectal US, and guided 3D transrectal US (an extension of 3D transrectal US that enables active display of biopsy targets). The modalities were compared on the basis of time per biopsy and how accurately simulated repeat biopsies could be guided to specific targets. The probability for successful biopsy of a repeat target was calculated for each modality. Guided 3D transrectal US was significantly (P < .01) more accurate for simulated biopsy of repeat targets than was 2D or 3D transrectal US, with a biopsy accuracy of 0.86 mm +/- 0.47 (standard deviation), 3.68 mm +/- 2.60, and 3.60 mm +/- 2.57, respectively. Experts had a 70% probability of sampling a prior biopsy target volume of 0.5 cm(3) with 2D transrectal US; however, the probability approached 100% with guided 3D transrectal US. Biopsy accuracy was not significantly different between experts and residents for any modality; however, experts were significantly (P < .05) faster than residents with each modality. Repeat biopsy of the prostate with 2D transrectal US has limited accuracy. Compared with 2D transrectal US, the biopsy accuracy of both experts and residents improved with guided 3D transrectal US but did not improve with conventional 3D transrectal US.

  20. THE PROGNOSTIC AND DIAGNOSTIC VALUE OF REPEATED TRANSRECTAL PROSTATE SATURATION BIOPSY

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    M. A. Kurdzhiev

    2014-08-01

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

  1. Detection rate of clinically insignificant prostate cancer increases with repeat prostate biopsies

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    Bumsoo Park; Seong-Soo Jeon; Sung-Ho Ju; Byong-Chang Jeong; Seong-Il Seo; Hyun-Moo Lee; Han-Yong Choi

    2013-01-01

    To analyze if clinically insignificant prostate cancer (ClPC) is more frequently detected with repeat prostate biopsies,we retrospectively analyzed the records of 2146 men diagnosed with prostate cancer after one or more prostate biopsies.The patients were divided into five groups according to the number of prostate biopsies obtained,e.g.group 1 had one biopsy,group 2 had two biopsies and group 3 had three biopsies.Of the 2146 patients diagnosed with prostate cancer,1956 (91.1%),142 (6.6%),38 (1.8%),9 (0.4%) and 1 (0.1%) men were in groups 1,2,3,4 and 5,respectively.Groups 4 and 5 were excluded because of the small sample sizes.The remaining three groups (groups 1,2 and 3) were statistically analyzed.There were no differences in age or prostate-specific antigen level among the three groups.ClPC was detected in 201 (10.3%),28 (19.7%) and 9 (23.7%) patients in groups 1,2 and 3,respectively (P<0.001).A multivariate analysis showed that the number of biopsies was an independent predictor to detect CIPC (0R=2.688 for group 2; 0R=4.723 for group 3).In conclusion,patients undergoing multiple prostate biopsies are more likely to be diagnosed with CIPC than those who only undergo one biopsy.However,the risk still exists that the patient could have clinically significant prostate cancer.Therefore,when counseling patients with regard to serial repeat biopsies,the possibility of prostate cancer overdiagnosis and overtreatment must be balanced with the continued risk of clinically significant disease.

  2. 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?

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    2016-01-01

    Purpose: 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. Methods: 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. 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. Conclusion: 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. PMID:27068131

  3. 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?

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    Na Lae Eun

    2016-07-01

    Full Text Available Purpose: 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. Methods: 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. 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. Conclusion: 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.

  4. 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?

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    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.

  5. A Prospective Comparison of Selective Multiparametric Magnetic Resonance Imaging Fusion-Targeted and Systematic Transrectal Ultrasound-Guided Biopsies for Detecting Prostate Cancer in Men Undergoing Repeated Biopsies

    DEFF Research Database (Denmark)

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

    2017-01-01

    + 3) cancers (14/64 vs. 41/74) and more patients with intermediate/high-grade cancers (GS ≥3 + 4) (50/64 vs. 33/74) using fewer biopsy cores compared with TRUS-bx (p targeted-only" approach in men with PI-RADS ≥3 lesions reduced the number of men requiring repeated biopsies......INTRODUCTION: The aim of the study was to compare the prostate cancer (PCa) detection rate of systematic transrectal ultrasound-guided biopsies (TRUS-bx) and multiparametric-MRI targeted biopsies (mp-MRI-bx) in a repeat biopsy setting and evaluate the clinical significance following an "MRI-targeted...... by 50%, decreased low-grade cancer diagnoses by 66%, and increased intermediate/high-grade cancer diagnoses by 52%. CONCLUSIONS: MRI-targeted biopsies have a high detection rate for significant PCa in patients with prior negative transrectal ultrasound-guided biopsies and preferentially detect...

  6. The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy.

    Science.gov (United States)

    Simmons, Lucy A M; Kanthabalan, Abi; Arya, Manit; Briggs, Tim; Barratt, Dean; Charman, Susan C; Freeman, Alex; Gelister, James; Hawkes, David; Hu, Yipeng; Jameson, Charles; McCartan, Neil; Moore, Caroline M; Punwani, Shonit; Ramachandran, Navin; van der Meulen, Jan; Emberton, Mark; Ahmed, Hashim U

    2017-04-25

    Transrectal prostate biopsy has limited diagnostic accuracy. Prostate Imaging Compared to Transperineal Ultrasound-guided biopsy for significant prostate cancer Risk Evaluation (PICTURE) was a paired-cohort confirmatory study designed to assess diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) in men requiring a repeat biopsy. All underwent 3 T mpMRI and transperineal template prostate mapping biopsies (TTPM biopsies). Multiparametric MRI was reported using Likert scores and radiologists were blinded to initial biopsies. Men were blinded to mpMRI results. Clinically significant prostate cancer was defined as Gleason ⩾4+3 and/or cancer core length ⩾6 mm. Two hundred and forty-nine had both tests with mean (s.d.) age was 62 (7) years, median (IQR) PSA 6.8 ng ml (4.98-9.50), median (IQR) number of previous biopsies 1 (1-2) and mean (s.d.) gland size 37 ml (15.5). On TTPM biopsies, 103 (41%) had clinically significant prostate cancer. Two hundred and fourteen (86%) had a positive prostate mpMRI using Likert score ⩾3; sensitivity was 97.1% (95% confidence interval (CI): 92-99), specificity 21.9% (15.5-29.5), negative predictive value (NPV) 91.4% (76.9-98.1) and positive predictive value (PPV) 46.7% (35.2-47.8). One hundred and twenty-nine (51.8%) had a positive mpMRI using Likert score ⩾4; sensitivity was 80.6% (71.6-87.7), specificity 68.5% (60.3-75.9), NPV 83.3% (75.4-89.5) and PPV 64.3% (55.4-72.6). In men advised to have a repeat prostate biopsy, prostate mpMRI could be used to safely avoid a repeat biopsy with high sensitivity for clinically significant cancers. However, such a strategy can miss some significant cancers and overdiagnose insignificant cancers depending on the mpMRI score threshold used to define which men should be biopsied.

  7. Clinical utility of the PCA3 urine assay in European men scheduled for repeat biopsy.

    NARCIS (Netherlands)

    Haese, A.; Taille, A de la; Poppel, H van; Marberger, M.; Stenzl, A.; Mulders, P.F.A.; Huland, H.; Abbou, C.C.; Remzi, M.; Tinzl, M.; Feyerabend, S.; Stillebroer, A.B.; Gils, M.P.M.Q.; Schalken, J.A.

    2008-01-01

    BACKGROUND: The Prostate CAncer gene 3 (PCA3) assay has shown promise as an aid in prostate cancer (pCA) diagnosis in identifying men with a high probability of a positive (repeat) biopsy. OBJECTIVE: This study evaluated the clinical utility of the PROGENSA PCA3 assay. DESIGN, SETTING, AND PARTICIPA

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

    Directory of Open Access Journals (Sweden)

    A. V. Karman

    2017-01-01

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

  9. Repeated Renal Biopsy - A Predictive Tool to Assess the Probability of Renal Flare in Lupus Nephritis.

    Science.gov (United States)

    Piñeiro, Gastón J; Arrizabalaga, Pilar; Solé, Manel; Abellana, Rosa M; Espinosa, Gerard; Cervera, Ricard

    2016-01-01

    How one responds to treatment of lupus nephritis (LN) is based on clinical features, but the activity in renal biopsy (RB) is uncertain. We have described the therapeutic decisions after performing a repeated RB on the assessment of response to intravenous cyclophosphamide (IC) and the possible prognostic role of this repeated RB. Clinical, laboratory and histological features at the initial RB and repeated RB were analyzed in 35 patients. Data in the initial versus the repeated RB were serum creatinine 1.23 ± 1.08 and 0.96 ± 0.45 mg/dl (p < 0.05), glomerular filtration rate <60 ml/min in 12 and 5% patients and proteinuria 4.1 ± 2.8 vs. 0.6 1.1 g/day (p < 0.05). Significant differences were detected in hematuria, nephrotic syndrome and serological immune features. Complete renal remission was reached in 60% (n = 21) at the time of the repeated RB, partial remission in 31.4% (n = 11), and no response IC in 8.6% (n = 3). Nine patients showed proliferative forms in the repeated RB, 3 of them had proteinuria <1 g/day. Just after the repeated RB, 34.3% increased or started a new immunosuppressive therapy, 17.1% remained with the same complementary IST, and 14.3% decreased or stopped it. In the follow-up post repeated RB, 34.5% without active lesions showed a renal flare versus 77.8% with active lesions (p = 0.04). The mean time was 120 and 45 months, respectively. A repeated biopsy in LN distinguishes patients in true remission from those in apparent remission. By doing this, we can identify patients who could benefit from intensified treatment and for whom unnecessary treatment methods can be modified or eliminated. © 2016 S. Karger AG, Basel.

  10. Addressing the need for repeat prostate biopsy: new technology and approaches.

    Science.gov (United States)

    Blute, Michael L; Abel, E Jason; Downs, Tracy M; Kelcz, Frederick; Jarrard, David F

    2015-08-01

    No guidelines currently exist that address the need for rebiopsy in patients with a negative diagnosis of prostate cancer on initial biopsy sample analysis. Accurate diagnosis of prostate cancer in these patients is often complicated by continued elevation of serum PSA levels that are suggestive of prostate cancer, resulting in a distinct management challenge. Following negative initial findings of biopsy sample analysis, total serum PSA levels and serum PSA kinetics are ineffective indicators of a need for a repeat biopsy; therefore, patients suspected of having prostate cancer might undergo several unnecessary biopsy procedures. Several alternative strategies exist for identifying men who might be at risk of prostate cancer despite negative findings of biopsy sample analysis. Use of other serum PSA-related measurements enables more sensitive and specific diagnosis and can be combined with knowledge of clinicopathological features to improve outcomes. Other options include the FDA-approved Progensa(®) test and prostate imaging using MRI. Newer tissue-based assays that measure methylation changes in normal prostate tissue are currently being developed. A cost-effective strategy is proposed in order to address this challenging clinical scenario, and potential directions of future studies in this area are also described.

  11. Wedge Versus Core Biopsy at Time Zero: Which Provides Better Predictive Value for Delayed Graft Function With the Remuzzi Histological Scoring System?

    Science.gov (United States)

    Yong, Z Z; Aitken, E L; Khan, K H; Kingsmore, D B

    2015-01-01

    Histopathological features on time-zero renal biopsies correlate with graft outcome after renal transplantation. With increasing numbers of marginal donors, assessment of pre-implantation graft quality is essential. The clinician's choice of wedge or core biopsy is performed without evidence of efficacy or safety. This study aims to compare the information derived from wedge biopsy versus core biopsy. Prospective evaluation of 37 wedge biopsies and 30 core biopsies was performed. Histopathological data were collected on number of glomeruli and arterioles observed, and Remuzzi scoring for glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriolar narrowing was performed. Clinical data on delayed graft function (DGF) were also collated. Sensitivity, specificity, and positive and negative predictive values for DGF were compared. Patient demographics between the two cohorts were comparable. No complications of biopsies occurred; 81% of wedge biopsies versus 50% of core biopsies had >10 glomeruli (P = .01), whereas 32% of wedge biopsies and 57% of core biopsies had >2 arterioles (P = .02). Wedge biopsies were more likely to identify pathology with more glomerulosclerosis, tubular atrophy (P value of Remuzzi ≥ 4 for predicting DGF was better on wedge biopsy (45.5% versus 0%; P core biopsies for identifying clinically significant histopathological findings on pre-implantation renal biopsy. We believe that the wedge biopsy is the method of choice for time-zero biopsies. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Rejuvenation of Sequoia sempervirens by Repeated Grafting of Shoot Tips onto Juvenile Rootstocks in Vitro 1

    Science.gov (United States)

    Huang, Li-Chun; Lius, Suwenza; Huang, Bau-Lian; Murashige, Toshio; Mahdi, El Fatih M.; Van Gundy, Richard

    1992-01-01

    Repeated grafting of 1.5-centimeter long shoot tips from an adult Sequoia sempervirens tree onto fresh, rooted juvenile stem cuttings in vitro resulted in progressive restoration of juvenile traits. After four successive grafts, stem cuttings of previously adult shoots rooted as well, branched as profusely, and grew with as much or more vigor as those of seedling shoots. Reassays disclosed retention for 3 years of rooting competence at similar levels as originally restored. Adventitious shoot formation was remanifested and callus development was depressed in stem segments from the repeatedly grafted adult. The reversion was associated with appearance and disappearance of distinctive leaf proteins. Neither gibberellic acid nor N6-beneyladenine as nutrient supplements duplicated the graft effects. ImagesFigure 2Figure 5Figure 8 PMID:16668609

  13. Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Cheikh, Alexandre Ben; Girouin, Nicolas [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France)]|[Universite de Lyon, Lyon (France)]|[Universite de Lyon 1, faculte de medecine Lyon Nord, Lyon (France); Colombel, Marc; Marechal, Jean-Marie [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France); Gelet, Albert [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France)]|[Inserm, U556, Lyon (France); Bissery, Alvine; Rabilloud, Muriel [Hospices Civils de Lyon, Department of Biostatistics, Lyon (France)]|[Universite de Lyon 1, UMR CNRS 5558, Laboratoire Biostatistiques-Sante, Pierre-Benite (France); Lyonnet, Denis [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France)]|[Universite de Lyon, Lyon (France)]|[Universite de Lyon 1, faculte de medecine Lyon Nord, Lyon (France)]|[Inserm, U556, Lyon (France); Rouviere, Olivier [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France)]|[Universite de Lyon, Lyon (France)]|[Universite de Lyon 1, faculte de medecine Lyon Nord, Lyon (France)]|[Inserm, U556, Lyon (France)]|[Hopital Edouard Herriot, Department of Urinary and Vascular Radiology, Pavillon P Radio, Lyon Cedex 03 (France)

    2009-03-15

    We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV. (orig.)

  14. Repeat aortocoronary bypass grafting. Early and late results.

    Science.gov (United States)

    Kobayashi, T; Mendez, A M; Zubiate, P; Vanstrom, N R; Yokoyama, T; Kay, J H

    1978-04-01

    Seventy-nine patients underwent repeat myocardial revascularization between March 1971 and January 1977. The initial procedure was performed at the St. Vincent Medical Center, Los Angeles, in 70 (2.0 percent) of 3,526 patients undergoing surgery for coronary arterial disease and in nine more patients was performed at other hospitals; the second operation followed the first procedure at an interval of from three weeks to 78 months. Five deaths (6 percent) occurred while patients were hospitalized, and six deaths (8 percent) occurred later. Two of the six later deaths were from noncardiac causes. Complications were not different from those that occurred during primary procedures. Thirty-six (60 percent) of 60 patients undergoing repeat surgery since 1973 did not receive any transfusions of blood during or after surgery. Of 48 patients followed-up for periods ranging from 12 to 70 months after the second operation, angina was completely relieved in 18 patients (38 percent), improved in 16 patients (33 percent), unchanged in 11 patients (23 percent), and worse in three patients (6 percent).

  15. Plugged percutaneous biopsy of the liver in living-donor liver transplantation recipients suspected to have graft rejection.

    Science.gov (United States)

    Kim, Sung Jung; Won, Je Hwan; Kim, Young Bae; Wang, Hee-Jung; Kim, Bong-Wan; Kim, Haeryoung; Kim, Jinoo

    2017-07-01

    Background Percutaneous biopsy is a widely-accepted technique for acquiring histologic samples of the liver. When there is concern for bleeding, plugged percutaneous biopsy (PPB) may be performed, which involves embolization of the biopsy tract. Purpose To evaluate the efficacy and safety of PPB of the liver in patients suspected to have graft rejection after living-donor liver transplantation (LDLT). Material and Methods During January 2007 and December 2013, 51 patients who underwent PPB of the liver under the suspicion of post-LDLT graft rejection were retrospectively analyzed. A total of 73 biopsies were performed. Biopsy was performed with a 17-gauge core needle and 18-gauge cutting needle. The needle tract was embolized using gelatin sponge (n = 44) or N-butyl cyanoacrylate (NBCA) (n = 29). The specimens were reviewed to determine their adequacy for histologic diagnosis. We reviewed all medical records after PPB. Results Specimens were successfully acquired in all procedures (100%). They were adequate for diagnosis in 70 cases (95.9%) and inadequate in three (1.3%). Average of 9.8 complete portal tracts was counted per specimen. One minor complication (1.4%) occurred where the patient had transient fever after the procedure. Conclusion PPB is easy and safe to perform in LDLT recipients and provides high diagnostic yield.

  16. Postprandial Responses to Lipid and Carbohydrate Ingestion in Repeated Subcutaneous Adipose Tissue Biopsies in Healthy Adults

    Directory of Open Access Journals (Sweden)

    Aimee L. Dordevic

    2015-07-01

    Full Text Available Adipose tissue is a primary site of meta-inflammation. Diet composition influences adipose tissue metabolism and a single meal can drive an inflammatory response in postprandial period. This study aimed to examine the effect lipid and carbohydrate ingestion compared with a non-caloric placebo on adipose tissue response. Thirty-three healthy adults (age 24.5 ± 3.3 year (mean ± standard deviation (SD; body mass index (BMI 24.1 ± 3.2 kg/m2, were randomised into one of three parallel beverage groups; placebo (water, carbohydrate (maltodextrin or lipid (dairy-cream. Subcutaneous, abdominal adipose tissue biopsies and serum samples were collected prior to (0 h, as well as 2 h and 4 h after consumption of the beverage. Adipose tissue gene expression levels of monocyte chemoattractant protein-1 (MCP-1, interleukin 6 (IL-6 and tumor necrosis factor-α (TNF-α increased in all three groups, without an increase in circulating TNF-α. Serum leptin (0.6-fold, p = 0.03 and adipose tissue leptin gene expression levels (0.6-fold, p = 0.001 decreased in the hours following the placebo beverage, but not the nutrient beverages. Despite increased inflammatory cytokine gene expression in adipose tissue with all beverages, suggesting a confounding effect of the repeated biopsy method, differences in metabolic responses of adipose tissue and circulating adipokines to ingestion of lipid and carbohydrate beverages were observed.

  17. Postprandial Responses to Lipid and Carbohydrate Ingestion in Repeated Subcutaneous Adipose Tissue Biopsies in Healthy Adults.

    Science.gov (United States)

    Dordevic, Aimee L; Pendergast, Felicity J; Morgan, Han; Villas-Boas, Silas; Caldow, Marissa K; Larsen, Amy E; Sinclair, Andrew J; Cameron-Smith, David

    2015-07-01

    Adipose tissue is a primary site of meta-inflammation. Diet composition influences adipose tissue metabolism and a single meal can drive an inflammatory response in postprandial period. This study aimed to examine the effect lipid and carbohydrate ingestion compared with a non-caloric placebo on adipose tissue response. Thirty-three healthy adults (age 24.5 ± 3.3 year (mean ± standard deviation (SD)); body mass index (BMI) 24.1 ± 3.2 kg/m2, were randomised into one of three parallel beverage groups; placebo (water), carbohydrate (maltodextrin) or lipid (dairy-cream). Subcutaneous, abdominal adipose tissue biopsies and serum samples were collected prior to (0 h), as well as 2 h and 4 h after consumption of the beverage. Adipose tissue gene expression levels of monocyte chemoattractant protein-1 (MCP-1), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) increased in all three groups, without an increase in circulating TNF-α. Serum leptin (0.6-fold, p = 0.03) and adipose tissue leptin gene expression levels (0.6-fold, p = 0.001) decreased in the hours following the placebo beverage, but not the nutrient beverages. Despite increased inflammatory cytokine gene expression in adipose tissue with all beverages, suggesting a confounding effect of the repeated biopsy method, differences in metabolic responses of adipose tissue and circulating adipokines to ingestion of lipid and carbohydrate beverages were observed.

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

    DEFF Research Database (Denmark)

    Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta

    2015-01-01

    -RADS) and Likert classification. All underwent repeated TRUS-bx (10 cores) and mp-MRI-bx under visual TRUS guidance of any mp-MRI-suspicious lesion not targeted by systematic TRUS-bx. RESULTS: PCa was found in 39 out of 83 patients (47%) and mp-MRI identified at least one lesion with some degree of suspicion...... in all 39 patients. Both PI-RADS and Likert scoring showed a high correlation between suspicion of malignancy and biopsy results (p

  19. Gene expression in human skeletal muscle: alternative normalization method and effect of repeated biopsies.

    Science.gov (United States)

    Lundby, Carsten; Nordsborg, Nikolai; Kusuhara, Keiko; Kristensen, Kristina Møller; Neufer, P Darrell; Pilegaard, Henriette

    2005-10-01

    The reverse transcriptase-polymerase chain reaction (RT-PCR) method has lately become widely used to determine transcription and mRNA content in rodent and human muscle samples. However, the common use of endogenous controls for correcting for variance in cDNA between samples is not optimal. Specifically, we investigated (1) a new normalization method based on determining the cDNA content by the flourophores PicoGreen and OliGreen, (2) effect of repeated muscle biopsies on mRNA gene expression, and (3) the spatial heterogeneity in mRNA expression across the muscle. Standard curves using oligo standards revealed a high degree of sensitivity and linearity (2.5-45 ng; R2>0.99) with OliGreen reagent, as was the case for OliGreen analyses with standard curves constructed from serial dilutions of representative RT samples (R2 >0.99 for a ten times dilution range of a representative reversed transcribed (RT) sample). Likewise, PicoGreen reagent detected the RNA:DNA hybrid content in RT samples with great sensitivity. Standard curves constructed from both double-stranded lambda DNA (1-10 ng) and from serial dilutions of representative RT samples consistently resulted in linearity with R2 >0.99. The present determination of cDNA content in reversed transcribed human skeletal muscle RNA samples by both PicoGreen and OliGreen analyses suggests that these fluorophores provide a potential alternative normalization procedure for human gene expression studies. In addition, the present study shows that multiple muscle biopsies obtained from the same muscle do not influence the mRNA response induced by an acute exercise bout for any of the genes examined.

  20. A new technique for repeated biopsies of the mammary gland in dairy cows allotted to Latin-square design studies.

    Science.gov (United States)

    de Lima, Luciano S; Martineau, Eric; De Marchi, Francilaine E; Palin, Marie-France; Dos Santos, Geraldo T; Petit, Hélène V

    2016-07-01

    The objective of this study was to develop a technique for carrying out repeated biopsies of the mammary gland of lactating dairy cows that provides enough material to monitor enzyme activities and gene expression in mammary secretory tissue. A total of 16 Holstein cows were subjected to 4 mammary biopsies each at 3-week intervals for a total of 64 biopsies. A 0.75-cm incision was made through the skin and subcutaneous tissue of the mammary gland and a trocar and cannula were inserted using a circular motion. The trocar was withdrawn and a syringe was plugged into the base of the cannula to create a vacuum for sampling mammary tissue. To reduce bleeding, hand pressure was put on the surgery site after biopsy and skin closure and ice was applied for at least 2 h after the biopsy using a cow bra. The entire procedure took an average of 25 min. Two attempts were usually enough to obtain 800 mg of tissue. Visual examination of milk samples 10 d after the biopsy indicated no trace of blood, except in samples from 2 cows. All wounds healed without infection and subcutaneous hematomas resorbed within 7 d. There was no incidence of mastitis throughout the lactation. This technique provides a new tool for biopsy of the mammary gland repeated at short intervals with the main effect being a decrease in milk production. Although secondary complications leading to illness or death are always a risk with any procedure, this biopsy technique was carried out without complications to the health of animals and with no incidence of mastitis during the lactation.

  1. Early changes in scores of chronic damage on transplant kidney protocol biopsies reflect donor characteristics, but not future graft function.

    Science.gov (United States)

    Caplin, Ben; Veighey, Kristin; Mahenderan, Arundathi; Manook, Miriam; Henry, Joanne; Nitsch, Dorothea; Harber, Mark; Dupont, Peter; Wheeler, David C; Jones, Gareth; Fernando, Bimbi; Howie, Alexander J; Veitch, Peter

    2013-01-01

    The amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single-center cohort, we examined the relationship between donor-, recipient-, and transplantation-associated factors and change in a morphometric index of chronic damage (ICD) between protocol biopsies performed at implantation and at 2-3 months. We then investigated whether early delta ICD predicted subsequent biochemical outcomes. We found little evidence to support differences between the study group, who had undergone serial biopsies, and a contemporaneous control group, who had not. In allografts with serial biopsies (n = 162), there was an increase in ICD between implantation (median: 2%, IQR:0-8) and 2-3 months post-transplant (median 8% IQR:4-15; p live donors was independently associated with smaller early post-transplant increases in ICD. There was no evidence for a difference in delta ICD between donation after cardiac death vs. donation after brain death, nor association with length of cold ischemia. After adjustment for GFR at the time of the second biopsy, delta ICD after three months did not predict allograft function at one yr. These findings suggest that graft damage develops shortly after transplantation and reflects donor factors, but does not predict future biochemical outcomes.

  2. Acute phase response in the primiparous dairy cows after repeated percutaneous liver biopsy during the transition period.

    Science.gov (United States)

    Jawor, P; Brzozowska, A; Słoniewski, K; Kowalski, Z M; Stefaniak, T

    2016-01-01

    The aim of this study was to evaluate the acute phase response of dairy cows to repeated liver biopsy in order to estimate the safety of this procedure during the transition period. Liver biopsies (up to 1000 mg of liver tissue) were conducted twice a day, 7 days before expected parturition and 3 days after calving. The number of needle insertions for each biopsy was recorded and was dependent on the amount of obtained tissue. Blood samples were taken on day 7 before expected parturition, then on days 3, 4, 7 and 14 after calving. Body temperature was measured daily in all 30 cows from day 3 until day 14 after calving. The concentrations of haptoglobin, serum amyloid A, fibrinogen and interleukin-6 were determined in serum and plasma. In 16.7% of cows, the rectal body temperature rose by ≥ 0.5°C on the day after liver biopsy. Although the concentrations of haptoglobin, serum amyloid A and fibrinogen increased significantly after calving (pbiopsies on the acute phase reaction and repeated biopsy during the transition period had no effect on body temperature. Therefore, the procedure may be regarded as safe for cows during the transition period.

  3. Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation

    Directory of Open Access Journals (Sweden)

    Karla Lais Pêgas

    2014-04-01

    Full Text Available Introduction: Pre-implantation kidney biopsy is a decision-making tool when considering the use of grafts from deceased donors with expanded criteria, implanting one or two kidneys and comparing this to post-transplantation biopsies. The role of histopathological alterations in kidney compartments as a prognostic factor in graft survival and function has had conflicting results. Objective: This study evaluated the prevalence of chronic alterations in pre-implant biopsies of kidney grafts and the association of findings with graft function and survival in one year post-transplant. Methods: 110 biopsies were analyzed between 2006 and 2009 at Santa Casa de Porto Alegre, including live donors, ideal deceased donors and those with expanded criteria. The score was computed according to criteria suggested by Remuzzi. The glomerular filtration rate (GFR was calculated using the abbreviated MDRD formula. Results: No statistical difference was found in the survival of donors stratified according to Remuzzi criteria. The GFR was significantly associated with the total scores in the groups with mild and moderate alterations, and in the kidney compartments alone, by univariate analysis. The multivariate model found an association with the presence of arteriosclerosis, glomerulosclerosis, acute rejection and delayed graft function. Conclusion: Pre-transplant chronic kidney alterations did not influence the post-transplantation one-year graft survival, but arteriosclerosis and glomerulosclerosis is predictive of a worse GFR. Delayed graft function and acute rejection are independent prognostic factors.

  4. Harvesting olecranon bone graft in adults by using bone biopsy trephine

    Directory of Open Access Journals (Sweden)

    Fatih Kabakas

    2016-08-01

    Conclusion: Bone graft harvesting with trephine is technically easy and fast, and donor site morbidity is diminished compared other methods and donor sites. It can be performed under axillary anesthesia and provides adequate amounts of bone graft for upper extremity reconstructions. [Hand Microsurg 2016; 5(2.000: 44-49

  5. Renal graft biopsy assists diagnosis and treatment of renal allograft dysfunction after kidney transplantation: a report of 106 cases.

    Science.gov (United States)

    Han, Yong; Guo, Hui; Cai, Ming; Xiao, Li; Wang, Qiang; Xu, Xiaoguang; Huang, Haiyan; Shi, Bingyi

    2015-01-01

    Acute antibody mediated rejection (AMR) is one of the most important complications after kidney transplantation. Renal graft biopsy is safe and reliable without adverse effects on the patients and transplanted kidneys, which was of great instructive significance in diagnosis and treatment of renal allograft dysfunction after renal transplantation. This paper reported a case series of 106 patients underwent renal allograft biopsies. All biopsies were evaluated according to the Banff 2007 schema. 52 examples were obtained within 1 month after transplantation, and there were another 20 examples in one to two months and other 34 examples in two to three months. Appropriate therapy was applied and clinical outcomes were observed. All patients received renal biopsies and anti-inflammatory and hemostasis treatment without complications. There were 2 cases of hyperacute rejection, and 15 cases of acute AMR. All Paraffin-embedded samples were stained by HE, periodic acid-Schiff (PAS), Masson, and immunohistochemistry (C4d, cd20, cd45RO, SV40). All samples were found C4d immunohistochemical staining positive. Patients with acute AMR were managed by steroid intravenous pulse therapy, Rabbit anti-thymocyte globulin intravenous pulse therapy, anti CD20 monoclonal antibody intravenous therapy and so on. Two cases of hyperacute rejection had renal failure, and received kidney excision; 12 cases in 15 cases of AMR recovered, another 2 cases did not recover with high-level creatine, and other 2 cases of renal allograft received excision.

  6. Application of transrectal ultrasound-guided repeat needle biopsy in the diagnosis of prostate cancer in Chinese population: A retrospective study

    Directory of Open Access Journals (Sweden)

    Yi Wang

    2016-01-01

    Full Text Available Background: Transrectal ultrasound-guided repeat needle biopsy (TUGRNB is widely used for diagnosis of prostate cancer (PCa. However, significance of TUGRNB in Chinese population was rarely reported. A retrospective study was conducted to evaluate the significance of TUGRNB applied in prediction of PCa in Chinese population. Materials and Methods: A total of 960 from January 2009 to December 2012 were included. Repeat needle biopsy rate and PCa positive detection rate were evaluated. Relationship between prostate specific antigen (PSA levels and PCa positive rates was analyzed. Results: PCa positive detection rate after initial needle biopsy was 28.4%, which was lower than the rate of repeat needle biopsy (40%. The rate for immediate transurethral resection (TUR, surgery after initial needle biopsy, was 27.1%, however with a low PCa positive detection rate (0.66%. The repeat needle biopsy rate was lower compared with the initial biopsy rate (P 20 ng/ml, PCa positive rate was significantly higher than those with PSA < 20 ng/ml (P < 0.05. Conclusion: PCa positive detection rate following repeat needle biopsy in Chinese population was higher, although the repeated needle biopsy rate was still in a low level. TUGRNB should attract more attention in the diagnosis of PCa.

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

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

    2005-09-15

    Purpose. Prostatic intra-epithelial neoplasia (PIN) is considered a pre-malignant lesion and the main precursor of invasive prostatic adenocarcinoma. A PIN diagnosis established by prostate needle biopsy poses a difficult clinical management. problem. We retrospectively reviewed our three-year experience in order to identify criteria for referring patients to repeat biopsy. Materials and methods. We reviewed the repeat biopsy records of 72 patients in whom PIN had been detected on initial US-guided needle biopsy of the prostate. All the patients had a minimum of 6 biopsy cores taken, and they all had PSA > 4 ng/ml. Results. Adenocarcinoma was detected in 15 patients out of 50 (30%) with an initial diagnosis of low-grade PIN and in 10 patients out of 22 (45.4%) with high grade PIN, in 7 out of 18 (39%) in whom PSA levels had decreased during the observation interval, in 16 patients out of 46 (35%) in whom the PSA had increased and in 2 patients out of 8 (25%) with stable PSA. Conclusions. Our results seem to confirm that PIN can be considered a precursor of prostatic adenocarcinoma or a histological alteration often associated with it. Patients with low-grade PIN and particularly those with high-grade PIN should be regularly subjected to repeat biopsy at short intervals due to the high frequency of the final diagnosis of carcinoma. No agreement has been reached on the time interval between the first and the second biopsy. The PSA changes during the observation period are not a statistically significant parameter to suggest the repetition of prostatic biopsy. [Italian] Scopo. La neoplasia prostatica intraepiteliale (PIN) e considerata una lesione premaligna ed il precursore principale dell'adenocarcinoma prostatico infiltrante. La diagnosi di PIN ottenuta con l'agobiopsia della prostata rappresenta un difficile problema gestionale clinico. In una valutazione retrospettiva della nostra esperienza di 3 anni si e cercato di individuare i criteri che possano

  8. POST-REPERFUSION LIVER BIOPSY AND ITS VALUE IN PREDICTING MORTALITY AND GRAFT DYSFUNCTION AFTER LIVER TRANSPLANTATION.

    Science.gov (United States)

    Zanchet, Marcos Vinícius; Silva, Larissa Luvison Gomes da; Matias, Jorge Eduardo Fouto; Coelho, Júlio Cezar Uili

    2016-01-01

    The outcome of the patients after liver transplant is complex and to characterize the risk for complications is not always easy. In this context, the hepatic post-reperfusion biopsy is capable of portraying alterations of prognostic importance. To compare the results of liver transplantation, correlating the different histologic features of the hepatic post-reperfusion biopsy with graft dysfunction, primary non-function and patient survival in the first year after transplantation. From the 377 transplants performed from 1996 to 2008, 164 patients were selected. Medical records were reviewed and the following clinical outcomes were registered: mortality in 1, 3, 6 and 12 months, graft dysfunction in varied degrees and primary graft non-function. The post-reperfusion biopsies had been examined by a blinded pathologist for the outcomes. The following histological variables had been evaluated: ischemic alterations, congestion, steatosis, neutrophilic exudate, monomorphonuclear infiltrate and necrosis. The variables associated with increased mortality were: steatosis (p=0.02209), monomorphonuclear infiltrate (p=0.03935) and necrosis (ptransplant. A evolução dos pacientes após transplante hepático é complexa e caracterizar o risco para complicações nem sempre é fácil. Nesse contexto, a biópsia hepática pós-reperfusão é capaz de retratar alterações de importância prognóstica. Avaliar os resultados no primeiro ano após transplante hepático, correlacionando as alterações histológicas à biópsia hepática pós-reperfusão com a sobrevida, a disfunção e o não-funcionamento primário do enxerto. Dos 377 transplantes ocorridos de 1996 a 2008, 164 pacientes foram selecionados para estudo. Os seguintes desfechos clínicos foram registrados: mortalidade em 1, 3, 6 e 12 meses, disfunção do enxerto em graus variados e o não-funcionamento primário do enxerto. As biópsias pós-reperfusão foram examinadas por um patologista sem conhecimento dos

  9. Optimal timing for a repeat fine-needle aspiration biopsy of thyroid nodule following an initial nondiagnostic fine-needle aspiration.

    Science.gov (United States)

    Deniwar, Ahmed; Hammad, AbdulRahman Y; Ali, Daniah Bu; Alsaleh, Nuha; Lahlouh, Maha; Sholl, Andrew B; Moroz, Krzysztof; Aslam, Rizwan; Thethi, Tina; Kandil, Emad

    2017-02-01

    In the case of a nondiagnostic thyroid fine-needle aspiration (FNA) biopsy result, recent guidelines from the Bethesda system recommend repeat thyroid FNA after 3 months to prevent false-positive results. We aimed to examine our institutional data to determine whether the 3-month period affects the diagnostic yield of repeat biopsies. A retrospective review of patient records over a 5-year period at our institution was performed. Patients who required repeat FNA due to nondiagnostic results were included. The time between the FNA biopsies, adequacy of the FNA specimens, as well as the surgical pathology diagnosis were analyzed. We identified 317 patients who required a repeat FNA. Of these, 96 (30.3%) patients had repeat FNAs less than 3 months after initial biopsy, while 221 (69.7%) patients had repeat FNAs in greater than 3 months. One hundred five patients were referred to our clinic with an initial nondiagnostic biopsy from an outside institution. Repeat FNA was nondiagnostic in 35 patients (11.04%) in the total study population. There was no difference in satisfactory diagnostic yield between repeat FNAs performed greater than 3 months (201 patients, 90.95%) or less than 3 months (81 patients, 84.38%) after the initial biopsy (P = .117). Of the 35 patients with repeat nondiagnostic biopsy, 17 patients underwent diagnostic lobectomy and 3 (17.6%) patients were found to have malignant disease. Early (biopsy interval would alleviate stress on patients with benign nodules and expedite surgical intervention in patients with malignancy. Published by Elsevier Inc.

  10. Value of the first post-transplant biopsy for predicting long-term cardiac allograft vasculopathy (CAV and graft failure in heart transplant patients.

    Directory of Open Access Journals (Sweden)

    Carlos A Labarrere

    Full Text Available BACKGROUND: Cardiac allograft vasculopathy (CAV is the principal cause of long-term graft failure following heart transplantation. Early identification of patients at risk of CAV is essential to target invasive follow-up procedures more effectively and to establish appropriate therapies. We evaluated the prognostic value of the first heart biopsy (median: 9 days post-transplant versus all biopsies obtained within the first three months for the prediction of CAV and graft failure due to CAV. METHODS AND FINDINGS: In a prospective cohort study, we developed multivariate regression models evaluating markers of atherothrombosis (fibrin, antithrombin and tissue plasminogen activator [tPA] and endothelial activation (intercellular adhesion molecule-1 in serial biopsies obtained during the first three months post-transplantation from 172 patients (median follow-up = 6.3 years; min = 0.37 years, max = 16.3 years. Presence of fibrin was the dominant predictor in first-biopsy models (Odds Ratio [OR] for one- and 10-year graft failure due to CAV = 38.70, p = 0.002, 95% CI = 4.00-374.77; and 3.99, p = 0.005, 95% CI = 1.53-10.40 and loss of tPA was predominant in three-month models (OR for one- and 10-year graft failure due to CAV = 1.81, p = 0.025, 95% CI = 1.08-3.03; and 1.31, p = 0.001, 95% CI = 1.12-1.55. First-biopsy and three-month models had similar predictive and discriminative accuracy and were comparable in their capacities to correctly classify patient outcomes, with the exception of 10-year graft failure due to CAV in which the three-month model was more predictive. Both models had particularly high negative predictive values (e.g., First-biopsy vs. three-month models: 99% vs. 100% at 1-year and 96% vs. 95% at 10-years. CONCLUSIONS: Patients with absence of fibrin in the first biopsy and persistence of normal tPA in subsequent biopsies rarely develop CAV or graft failure during the next 10 years and potentially could be monitored less invasively

  11. Evaluation of ultrasound-assisted Menghini technique in liver graft biopsy

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    Marcel Vieira da Nóbrega

    2009-03-01

    Full Text Available Objective: To report on the experience of implementing ultrasound-assisted Menghini technique in the evaluation of liver transplant dysfunction. Methods: Menghini technique uses a suction needle, through percutaneous access, allowing a fast puncture (less than one second, which can help reduce the incidence of complications. Rresults: A total of 87 biopsies performed with 16-gauge suction needles were studied in a period of 15 months. Ultrasound was used to access the presence of perihepatic liquid or collections, biliary and vascular disorders, to mark a safe puncture site and for post-procedure control. The main biopsy indication was elevation of liver enzymes. In 81 cases, one fragment was collected and satisfactory samples were obtained in 85 procedures (97.7%. Minor complications occurred in six patients (6.9%, five with local pain and one with vagal reaction. There was a major complication (1.1%, hemothorax, which was diagnosed by clinical and radiological control examination and then treated. Cconclusions: Menghini technique to obtain liver tissue is quick, effective and safe, but it has always to follow the general care aspects of any intervention procedure. The ultrasound before and after the procedure helps marking an appropriate puncture site, may enhance the effectiveness of the method and is useful to identify possible early complications.

  12. Repeated, Close Physician Coronary Artery Bypass Grafting Teams Associated with Greater Teamwork.

    Science.gov (United States)

    Everson, Jordan; Funk, Russell J; Kaufman, Samuel R; Owen-Smith, Jason; Nallamothu, Brahmajee K; Pagani, Francis D; Hollingsworth, John M

    2017-05-04

    To determine whether observed patterns of physician interaction around shared patients are associated with higher levels of teamwork as perceived by physicians. Michigan Medicare beneficiaries who underwent coronary artery bypass grafting (CABG) procedures at 24 hospitals in the state between 2008 and 2011. We assessed hospital teamwork using the teamwork climate scale in the Safety Attitudes Questionnaire. After aggregating across CABG discharges at these hospitals, we mapped the physician referral networks (including both surgeons and nonsurgeons) that served them and measured three network properties: (1) reinforcement, (2) clustering, and (3) density. We then used multilevel regression models to identify associations between network properties and teamwork at the hospitals on which the networks were anchored. In hospitals where physicians repeatedly cared for patients with the same colleagues, physicians perceived better teamwork (β-reinforcement = 3.28, p = .003). When physicians who worked together also had other colleagues in common, the reported teamwork was stronger (β clustering = 1.71, p = .001). Reported teamwork did not change when physicians worked with a higher proportion of other physicians at the hospital (β density = -0.58, p = .64). In networks with higher levels of reinforcement and clustering, physicians perceive stronger teamwork, perhaps because the strong ties between them create a shared understanding; however, sharing patients with more physicians overall (i.e., density) did not lead to stronger teamwork. Clinical and organizational leaders may consider designing the structure of clinical teams to increase interactions with known colleagues and repeated interactions between providers. © Health Research and Educational Trust.

  13. Accuracy of 3 Tesla pelvic phased-array multiparametric MRI in diagnosing prostate cancer at repeat biopsy

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2014-12-01

    Full Text Available Introduction. Multiparametric pelvic magnetic resonance imaging (mpMRI accuracy in prostate cancer (PCa diagnosis was evaluated. Materials and Methods. From June 2011 to December 2013, 168 patients (median 65 years with negative digital rectal examination underwent repeat transperineal saturation biopsy (SPBx; median 28 cores for persistently high or increasing PSA values, PSA >10 ng/ml or PSA values between 4.1-10 o r 2.6-4 ng/ml with free/total PSA < 25% and < 20%, respectively. All patients underwent mpMRI using a 3.0 Tesla scanner equipped with surface 16 channels phased-array coil and lesions suspicious for PCa were submitted to additional targeted biopsies. Results. A T1c PCa was found in 66 (39% cases; SPBx and mpMRI-suspicious targeted biopsy diagnosed 60 (91% and 52 (78.8% cancers missing 6 (all of the anterior zone and 14 cancers (12 and 2 of the lateral margins and anterior zone, respectively; in detail, mpMRI missed 12 (18.1% PCa charaterized by microfocal (1 positive core with greatest percentage of cancer and Gleason score equal to 5% and 6, respectively disease at risk for insignificant cancer. The diameter of the suspicious mpMRI lesion was directly correlated to the diagnosis of PCa with poor Gleason score (p < 0.05; detection rate of cancer for each suspicious mpMRI core was 35.3%. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive value of mpMRI in diagnosing PCa was 75.7%, 82.5%, 71.8%, 78.9%, 87.9%, respectively. Conclusion. Multiparametric pMRI improved SPBx accuracy in diagnosing significant anterior PCa; the diameter of mpMRI suspicious lesion resulted significantly predictive of aggressive cancers.

  14. The Effect of Repeat Cardiopulmonary bypass on Epicardial Microflow and Graft Flow during Intra-operative Heart Failure

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective The relationship between graft blood flow, epicardial microflow,mean arterial pressure and hemorheologic changes was studied during intraoperative heart failure.Methods These parameters were done to evaluate the use of repeated cardiopulmonary bypass supportfor the intraoperative heart failure following aorto-coronary bypass surgery. Included in this study were10 patients with a mean age of 7 0 and unstable angina undergoing coronary bypass grafting and suffer-ing from intraoperative heart failure. The epicardiai microflow, graft flow, mean arterial pressureand blood cell filterability were measured. Resluts During heart failure, the mean arterial pressurefell by 41 % ( P < 0. 01 ), graft flow by 67 % ( P < 0. 01 ) and epicardialmicro flow by 64 % ( P <0. 01 ). After 1 5 to 56 min of assisted cardiopulmonary bypass support, the epicardial mioroflow andgraft flow were partially restored, while red cell and white cell filterability was reduced by 31% and644 % respectively ( P < 0. 01 ). There were significant correlations between graft flow, epicardial mi-croflow, blooxd cell filterability and cardiopulmonary bypass time. All patients recovered and were dis-charged from the hospital. Conclusion It is concluded that the use of temporary assisted CPB sup-port to treat intrapoperative heart failure allows the recovery of the myocardium and thereby restores themean arterial pressure. The recovery of graft flow and epicardial flow occurred to a lesser extent. TheCPB support seemed to be suitable for about 60 rain probably because of increasing disturbance to theblood cell filterability, graft flow and the epicardial microcirculation.

  15. Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration.

    Science.gov (United States)

    Choi, Sang Hyun; Baek, Jung Hwan; Lee, Jeong Hyun; Choi, Young Jun; Hong, Min Ji; Song, Dong Eun; Kim, Jae Kyun; Yoon, Jong Ho; Kim, Won Bae

    2014-11-01

    To evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeated fine-needle aspiration (FNA) for thyroid nodules with initially non-diagnostic FNA results. From October 2008 to December 2011, 360 nodules - 180 consecutive repeated FNAs and 180 consecutive CNBs -- from 360 patients (83 men, 277 women; mean age, 54.4 years) with initially non-diagnostic FNA results were analyzed retrospectively. The incidence of non-diagnostic results, inconclusive results, diagnostic surgery, and diagnostic performance of repeated FNA and CNB were assessed, and factors affecting second non-diagnostic results were evaluated. CNB achieved a significantly lower non-diagnostic and inconclusive rate than repeated FNA (1.1 % versus 40.0 %, P needle biopsy achieved a lower number of non-diagnostic and inconclusive results. • Core-needle biopsy achieved better diagnostic performance. • Use of core-needle biopsy could prevent unnecessary diagnostic surgery. • Repeated fine-needle aspiration was significantly associated with a second non-diagnosis.

  16. Repeatability of and relationship between potential COPD biomarkers in bronchoalveolar lavage, bronchial biopsies, serum, and induced sputum.

    Directory of Open Access Journals (Sweden)

    Stefan Röpcke

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is a chronic inflammatory disease, primarily affecting the airways. Stable biomarkers characterizing the inflammatory phenotype of the disease, relevant for disease activity and suited to predict disease progression are needed to monitor the efficacy and safety of drug interventions. We therefore analyzed a large panel of markers in bronchoalveolar lavage, bronchial biopsies, serum and induced sputum of 23 healthy smokers and 24 smoking COPD patients (GOLD II matched for age and gender. Sample collection was performed twice within a period of 6 weeks. Assays for over 100 different markers were validated for the respective matrices prior to analysis. In our study, we found 51 markers with a sufficient repeatability (intraclass correlation coefficient >0.6, most of these in serum. Differences between groups were observed for markers from all compartments, which extends (von-Willebrand-factor and confirms (e.g. C-reactive-protein, interleukin-6 previous findings. No correlations between lung and serum markers were observed, including A1AT. Airway inflammation defined by sputum neutrophils showed only a moderate repeatability. This could be improved, when a combination of neutrophils and four sputum fluid phase markers was used to define the inflammatory phenotype.In summary, our study provides comprehensive information on the repeatability and interrelationship of pulmonary and systemic COPD-related markers. These results are relevant for ongoing large clinical trials and future COPD research. While serum markers can discriminate between smokers with and without COPD, they do not seem to sufficiently reflect the disease-associated inflammatory processes within the airways.

  17. Effect of repeated subcutaneous injections of carbon dioxide (CO2) on inflammation linked to hypoxia in adipose tissue graft.

    Science.gov (United States)

    Nisi, G; Barberi, L; Ceccaccio, L; Cuomo, R; Sisti, A; Castagna, A; Zerini, I; Brandi, C; Grimaldi, L; D'Aniello, C

    2015-12-01

    The purposes of this study was to assess the effect of repeated subcutaneous injections of CO2 on adipose tissue graft survival in immunosuppressed female nude mice. The authors designed an experimental study using volume measures, histopathological analysis and nuclear magnetic resonance of fat graft. The effect of repeated subcutaneous injection of CO2 is not yet investigated Approximately 0.5 ml of human fat were transplanted in a group of female nude mice. The mice were treated with 3 injections of 80 µl each carbon dioxide (total 240 µl) for 7 weeks. Initially, in vivo measurements were conducted and subsequently a comprehensive histopathological analysis was performed. The presence of inflammation was graded absent to minimal in animals treated with CO2 while a minimal to moderate grade was assigned to the control group. CO2 injection enhances the inflammatory response of the implanted tissue and reduces the reabsorption rate. The treatment may improve the graft survival in a more prolonged time-frame.

  18. Eosinophilic density in graft biopsies positive for rejection and blood eosinophil count can predict development of post-transplant digestive tract eosinophilia.

    Science.gov (United States)

    Bush, Jonathan W; Mohammad, Saeed; Melin-Aldana, Hector; Kagalwalla, Amir F; Arva, Nicoleta C

    2016-06-01

    EGID is a known post-transplant complication. Its etiology has been related to antirejection medication, but other factors may also play a role as only few transplant recipients develop EGID despite standardized treatment. This study aimed to determine whether EGID is associated with rejection events and with a specific phenotype of the rejection-positive graft biopsies in children with solid organ transplant. All patients with liver, heart, and kidney transplant followed at our institution were included in the study. Digestive tract eosinophilia was more common in heart and liver recipients and was a rare event after renal transplantation. Subjects with EGID had higher incidence of rejection and elevated peripheral blood AEC. The first rejection event and high AEC values preceded EGID diagnosis in the majority of patients. Histologically, the initial rejection-positive graft biopsy revealed accentuated eosinophilia in EGID patients compared with non-EGID cohort, which correlated with higher blood eosinophil counts at the time of first rejection episode. Prominent graft tissue and peripheral blood eosinophilia prior to EGID diagnosis suggests a predisposition for eosinophil activation in patients with post-transplant digestive eosinophilic disorder. These parameters can be used as markers for subsequent development of EGID. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. ASSOCIATION BETWEEN DE NOVO DONOR SPECIFIC HLA ANTIBODY, C4D STAINING IN RENAL GRAFT BIOPSY AND GRAFT OUTCOME: A SINGLE CENTER EXPERIENCE.

    Science.gov (United States)

    Cicciarelli, James; Cho, Yong W; Koss, Michael; Helstab-Houston, Kathryn; Mendez, Robert; Kasahara, Noriyuki; Hutchinson, Ian V; Shah, Tariq

    2009-01-01

    In 69 renal transplant recipients (RTR), all had a functioning graft (SCr HLA antibodies and 41 (59%) had DSA. The proportion of C4d positivity was significantly higher in patients with DSA (HLA Class I only, II only, and I & II) in comparison to patients without post-transplant HLA antibodies. The incidence of graft failure (including current SCr > 4.0) in RTR with HLA Class II antibodies (Class II only or I & II) was significantly higher than in RTR without post-transplant HLA antibodies (P=0.03).Even after amelioration of rejection, the RTR with Class II DSA group continued to fail beyond 2 years after transplantation when compared with the other 2 groups (None/NDSA or HLA Class I only), however, the difference in graft survival between HLA Class II and None/NDSA groups did not reach statistical significance (log-rank P=0.32). Significant association between C4d staining, post-transplant HLA Class II antibodies and graft failure strongly suggests the importance of post-transplant HLA antibodies. HLA Class II DSAs may be an indicator of chronic allograft nephropathy (CAN) proceeding to graft loss. We propose that amelioration of CAN graft loss may be affected by monitoring and identification of DSA with appropriate immunosuppression of these antibodies.

  20. High levels of IDO-expressing CD16+ peripheral cells, and Tregs in graft biopsies from kidney transplant recipients under belatacept treatment.

    Science.gov (United States)

    Furuzawa-Carballeda, J; Lima, G; Uribe-Uribe, N; Avila-Casado, C; Mancilla, E; Morales-Buenrostro, L E; Pérez-Garrido, J; Pérez, M; Cárdenas, G; Llorente, L; Alberú, J

    2010-11-01

    Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-degrading enzyme that suppresses T-lymphocyte activity. Costimulation blockade through CTLA4lg increases IDO in antigen-presenting cells. The suppressive effect of IDO is thought to be mediated by Foxp3+CD4+CD25+ regulatory T-cells (Tregs). In this descriptive study, we evaluated the percentage of IDO-expressing peripheral cell subpopulations as well as Tregs in 27 stable kidney transplant recipients receiving either belatacept (LEA29Y), a daughter compound of abatacept (CTLA4lg; n = 19) or cyclosporine (n = 8). Blood samples were obtained at 24 ± 2 months (belatacept) and 23 ± 6 months (cyclosporine) of treatment. Intracellular IDO was analyzed by flow cytometry in CD14+, CD11c+, CD16+, CD56+, and CD8+ cell subpopulations. Tregs were assessed by intracellular Foxp3 detection in CD4+CD25+ cells. CD3+, CD4+, CD8+, CD20+, CD68+, IDO+, and Foxp3+ cells were evaluated by immunohistochemistry on graft biopsies obtained preimplantation, at 12 months posttransplant, and in subjects with dysfunction during the first 12 months. Only percentages of CD16+/IDO+-expressing peripheral monocytes were significantly increased among the group receiving belatacept. No differences were observed in peripheral Tregs between the groups. In contrast, higher percentages of Tregs, CD4+, CD8+, and CD68+ cells were noted in dysfunction and at 12 months vs baseline among graft biopsies in subjects receiving belatacept, and also among dysfunction cohorts of belatacept vs Cyclosporine treatment. Patients receiving belatacept showed greater amounts of peripheral blood CD16+/IDO+ cells and Tregs on graft biopsies than those under cyclosporine treatment. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. Early changes in scores of chronic damage on transplant kidney protocol biopsies reflect donor characteristics, but not future graft function

    OpenAIRE

    Caplin, B; Veighey, K.; Mahenderan, A.; Manook, M.; Henry, J; Nitsch, D; Harber, M.; Dupont, P.; Wheeler, D.C.; G. Jones; Fernando, B.; Howie, A J; Veitch, P

    2013-01-01

    The amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single-center cohort, we examined the relationship between donor-, recipient-, and transplantation-associated factors and change in a morphometric index of chronic damage (ICD) between protocol biopsies performed at implantation and at 2-3 months. We then investigated whether early delta ICD predicted subsequent biochemical outcomes. We found little...

  2. Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance.

    Science.gov (United States)

    Choi, Young Jun; Baek, Jung Hwan; Suh, Chong Hyun; Shim, Woo Hyun; Jeong, Boseul; Kim, Jae Kyun; Song, Dong Eun; Kim, Tae Yong; Chung, Ki-Wook; Lee, Jeong Hyun

    2017-02-01

    The purpose of this study was to evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeat fine-needle aspiration (FNA) for thyroid nodules that are initially read as atypia/follicular lesion of undetermined significance (AUS/FLUS) on FNA. Among 2631 initial AUS/FLUS FNA results, 505 consecutive nodules (295 repeat FNAs and 210 CNBs) were retrospectively analyzed. The primary outcome was inconclusive (ie, nondiagnostic or AUS/FLUS). The secondary outcomes included inconclusive results of the subcategory, risk factors for inconclusive results, and diagnostic performance. CNB demonstrated significantly fewer inconclusive results than repeat FNA for the overall nodules (40.9% vs 63%; p < .001). Repeat FNA and group FLUS were significant risk factors for inconclusive results (odds ratio = 1.92; p =.001 and odds ratio = 2.08; p <.001, respectively). All diagnostic performances using CNB were higher than repeat FNAs. CNB is more useful than repeat FNAs for reducing inconclusive results and improving the diagnostic performance of thyroid nodules with initial AUS/FLUS FNA results. © 2016 Wiley Periodicals, Inc. Head Neck 39: 361-369, 2017. © 2016 Wiley Periodicals, Inc.

  3. A repeatedly recurrent desmoplastic ameloblastoma after removal and allobone graft: Radiographic features compared with histological changes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk; Jang, Hyun Seon; Seo, Yo Seob; Kim, Jin Soo [School of Dentistry, Chosun University, Gwangju (Korea, Republic of)

    2013-09-15

    A 40-year-old man suffered from a repeatedly recurrent desmoplastic ameloblastoma in the right maxillary anterior and premolar regions. During the first visit, the patient was provisionally histopathologically diagnosed with a developmental cyst, and it was confirmed to be unicystic ameloblastoma and resected. Four years later, the lesion recurred, and was diagnosed as a desmoplastic type of ameloblastoma and removed again. Then, 5 years after the second surgery, the lesion recurred again, and was diagnosed as a type containing a follicular pattern, recurrent ameloblastoma. A panoramic radiograph showed a multilocular and mixed radiolucent/radiopaque expansile lesion at the first visit, a unilocular cystic lesion confined to the premolar area at the second visit, and a small soap bubble appearance in the molar area in the final visit. Cone-beam computed tomographic images of the final recurrence of the tumor revealed multiple small cyst-like structures in the right maxillary anterior and posterior regions.

  4. The PCA3 test for guiding repeat biopsy of prostate cancer and its cut-off score: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yong Luo

    2014-06-01

    Full Text Available The specificity of prostate-specific antigen (PSA for early intervention in repeat biopsy is unsatisfactory. Prostate cancer antigen 3 (PCA3 may be more accurate in outcome prediction than other methods for the early detection of prostate cancer (PCa. However, the results were inconsistent in repeated biopsies. Therefore, we performed a systematic review and meta-analysis to evaluate the role of PCA3 in outcome prediction. A systematic bibliographic search was conducted for articles published before April 2013, using PubMed, Medline, Web of Science, Embase and other databases from health technology assessment agencies. The quality of the studies was assessed on the basis of QUADAS criteria. Eleven studies of diagnostic tests with moderate to high quality were selected. A meta-analysis was carried out to synthesize the results. The results of the meta-analyses were heterogeneous among studies. We performed a subgroup analysis (with or without inclusion of high-grade prostatic intraepithelial neoplasia (HGPIN and atypical small acinar proliferation (ASAP. Using a PCA3 cutoff of 20 or 35, in the two sub-groups, the global sensitivity values were 0.93 or 0.80 and 0.79 or 0.75, specificities were 0.65 or 0.44 and 0.78 or 0.70, positive likelihood ratios were 1.86 or 1.58 and 2.49 or 1.78, negative likelihood ratios were 0.81 or 0.43 and 0.91 or 0.82 and diagnostic odd ratios (ORs were 5.73 or 3.45 and 7.13 or 4.11, respectively. The areas under the curve (AUCs of the summary receiver operating characteristic curve were 0.85 or 0.72 and 0.81 or 0.69, respectively. PCA3 can be used for repeat biopsy of the prostate to improve accuracy of PCa detection. Unnecessary biopsies can be avoided by using a PCa cutoff score of 20.

  5. The PCA3 test for guiding repeat biopsy of prostate cancer and its cut-off score:a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yong Luo; Xin Gou; Peng Huang; Chan Mou

    2014-01-01

    The speciifcity of prostate-speciifc antigen (PSA) for early intervention in repeat biopsy is unsatisfactory. Prostate cancer antigen 3 (PCA3) may be more accurate in outcome prediction than other methods for the early detection of prostate cancer (PCa). However, the results were inconsistent in repeated biopsies. Therefore, we performed a systematic review and meta-analysis to evaluate the role of PCA3 in outcome prediction. A systematic bibliographic search was conducted for articles published before April 2013, using PubMed, Medline, Web of Science, Embase and other databases from health technology assessment agencies. The quality of the studies was assessed on the basis of QUADAS criteria. Eleven studies of diagnostic tests with moderate to high quality were selected. A meta-analysis was carried out to synthesize the results. The results of the meta-analyses were heterogeneous among studies. We performed a subgroup analysis (with or without inclusion of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP)). Using a PCA3 cutoff of 20 or 35, in the two sub-groups, the global sensitivity values were 0.93 or 0.80 and 0.79 or 0.75, speciifcities were 0.65 or 0.44 and 0.78 or 0.70, positive likelihood ratios were 1.86 or 1.58 and 2.49 or 1.78, negative likelihood ratios were 0.81 or 0.43 and 0.91 or 0.82 and diagnostic odd ratios (ORs) were 5.73 or 3.45 and 7.13 or 4.11, respectively. The areas under the curve (AUCs) of the summary receiver operating characteristic curve were 0.85 or 0.72 and 0.81 or 0.69, respectively. PCA3 can be used for repeat biopsy of the prostate to improve accuracy of PCa detection. Unnecessary biopsies can be avoided by using a PCa cutoff score of 20.

  6. Biopsy of the transplanted kidney--role of protocol biopsies.

    Science.gov (United States)

    Masin-Spasovska, J; Spasovski, G

    2012-01-01

    Traditionally, renal allograft biopsies were performed mainly in the setting of acute graft dysfunction. Recently, there has been a change of paradigms. Several reports suggested that acute rejection of the graft and chronic allograft nephropathy are often subclinical without any deterioration in the graft function. This raises the issue of biopsies in functionally stable allografts (e.g. protocol biopsies) and the clinically useful information they provide. Namely, recent reports provide evidence in favour of treating biopsy-proven subclinical rejections. Moreover, by early identification of chronic histological lesions, protocol biopsies give an opportunity for individualized immunosuppressive regimen and use of targeted therapeutic strategies, in order to prevent chronic allograft dysfunction and improve long-term graft outcome. In this review, diagnostic, therapeutic and research benefit information on protocol biopsies performed in stable kidney recipients are described.

  7. Expression profile of mammalian target of rapamycin-related proteins in graft biopsy specimens: Significance for predicting interstitial fibrosis after kidney transplantation.

    Science.gov (United States)

    Ogawa, Satoshi; Ishimura, Takeshi; Miyake, Hideaki; Fujisawa, Masato

    2017-03-01

    To investigate the influence of the expression profile of mammalian target of rapamycin-related proteins on the development of interstitial fibrosis after kidney transplantation. Immunohistochemical staining was carried out to evaluate the expression of five mammalian target of rapamycin-related proteins (phosphorylated-Akt, Ras homolog enriched in brain, phosphorylated-mammalian target of rapamycin, phosphorylated-p70 ribosomal S6 kinase and phosphorylated-4E binding protein 1) in graft biopsy specimens obtained from 77 patients at 3 months after kidney transplantation. The change of the estimated glomerular filtration rate and the change of the fibrosis index (defined as the change in the percent area of fibrosis on Masson's trichrome-stained sections of biopsy specimens) from 3 months to 3 years after kidney transplantation were determined. There was a significant correlation between change of the estimated glomerular filtration and change of the fibrosis index in the 77 patients. Univariate analysis identified expression of phosphorylated-Akt, phosphorylated-mammalian target of rapamycin and phosphorylated-p70 ribosomal S6 kinase, as well as donor type and pre-transplant dialysis duration, as significant predictors of a change of the fibrosis index >10%. However, only phosphorylated-mammalian target of rapamycin expression, phosphorylated-p70 ribosomal S6 kinase expression and donor type were independently associated with a change of the fibrosis index >10% according to multivariate analysis. These findings suggest that mammalian target of rapamycin-related proteins are involved in the development of interstitial fibrosis after kidney transplantation. © 2017 The Japanese Urological Association.

  8. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  9. Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Portalez, Daniel [Clinique Pasteur, 45, Department of Radiology, Toulouse (France); Rollin, Gautier; Mouly, Patrick; Jonca, Frederic; Malavaud, Bernard [Hopital de Rangueil, Department of Urology, Toulouse Cedex 9 (France); Leandri, Pierre [Clinique Saint Jean, 20, Department of Urology, Toulouse (France); Elman, Benjamin [Clinique Pasteur, 45, Department of Urology, Toulouse (France)

    2010-12-15

    To compare T2-weighted MRI and functional MRI techniques in guiding repeat prostate biopsies. Sixty-eight patients with a history of negative biopsies, negative digital rectal examination and elevated PSA were imaged before repeat biopsies. Dichotomous criteria were used with visual validation of T2-weighted MRI, dynamic contrast-enhanced MRI and literature-derived cut-offs for 3D-spectroscopy MRI (choline-creatine-to-citrate ratio >0.86) and diffusion-weighted imaging (ADC x 10{sup 3} mm{sup 2}/s < 1.24). For each segment and MRI technique, results were rendered as being suspicious/non-suspicious for malignancy. Sextant biopsies, transition zone biopsies and at least two additional biopsies of suspicious areas were taken. In the peripheral zones, 105/408 segments and in the transition zones 19/136 segments were suspicious according to at least one MRI technique. A total of 28/68 (41.2%) patients were found to have cancer. Diffusion-weighted imaging exhibited the highest positive predictive value (0.52) compared with T2-weighted MRI (0.29), dynamic contrast-enhanced MRI (0.33) and 3D-spectroscopy MRI (0.25). Logistic regression showed the probability of cancer in a segment increasing 12-fold when T2-weighted and diffusion-weighted imaging MRI were both suspicious (63.4%) compared with both being non-suspicious (5.2%). The proposed system of analysis and reporting could prove clinically relevant in the decision whether to repeat targeted biopsies. (orig.)

  10. 重复穿刺活检中高级别上皮内瘤对前列腺癌的预测价值%Prediction value of high-grade prostatic intraepithelial neoplasia for prostate cancer on repeat biopsies

    Institute of Scientific and Technical Information of China (English)

    Huilian Hou; Xuebin Zhang; Xu Li; Xingfa Chen; Chunbao Wang; Guanjun Zhang; Honghan Wang; Huilin Gong; Yuan Deng; Min Wang

    2011-01-01

    Objective: The significance of isolated high-grade prostatic intraepithelial neoplasia in initial biopsy as an predictor for prostate cancer has been extensively research, and the true relationship remnant is no clear till now. The aim of this study is to evaluate prediction value of cancer on repeat biopsy in patients with high-grade prostatic intraepithelial neoplasia,using multivariate analysis. Methods: Thirty-eight men with a diagnosis of isolated high-grade prostatic intraepithelial neoplasia in initial needle biopsy were studies, in the Fist Affiliated Hospital of Medical School of Xi'an Jiaotong University, from January 2003 to March 2009. These samples were using immunostaining of p63 and 34βE12 and P504s, with a median follow-up of 525 (range, 7 to 1650) days, and to researched the incidence of subsequent prostate cancer, and to predicted the risk of prostate cancer in clinicopathological parameters of isolated high-grade prostatic intraepithelial neoplasia on repeat biopsies by logistic regression analysis. Results: There were 10 of 38 (26.3%) men with prostate cancer on repeat biopsies after diagnosis isolated high-grade prostatic intraepithelial neoplasia in initial biopsy, of the rates of prostate cancer were 80% for micropapillary and 75% for cribriform high-grade prostatic intraepithelial neoplasia (P < 0.05), respectively. The positive cores of isolated high-grade prostatic intraepithelial neoplasia was the important for the risk of prostate cancer using Multifactor logistic regression analysis. The time range in 30 to 690 days was stronger risk for prostate cancer detection after diagnosis isolated HGPIN in initial biopsy. p63 and 34βE12 were disrupted positive expression, and P504S was weak positive expression in the 61% isolated high-grade prostatic intraepithelial neoplasia. Conclusion: Isolated high-grade prostatic intraepithelial neoplasia on repeat biopsy conferred a 26.3% risk of prostate cancer, and this risk level is lower than the

  11. Avoiding a Systematic Error in Assessing Fat Graft Survival in the Breast with Repeated Magnetic Resonance Imaging

    DEFF Research Database (Denmark)

    Glovinski, Peter Viktor; Herly, Mikkel; Müller, Felix C

    2016-01-01

    Several techniques for measuring breast volume (BV) are based on examining the breast on magnetic resonance imaging. However, when techniques designed to measure total BV are used to quantify BV changes, for example, after fat grafting, a systematic error is introduced because BV changes lead to ...... for assessing BV changes to determine fat graft retention and may be useful for evaluating and comparing available surgical techniques for breast augmentation and reconstruction using fat grafting.......Several techniques for measuring breast volume (BV) are based on examining the breast on magnetic resonance imaging. However, when techniques designed to measure total BV are used to quantify BV changes, for example, after fat grafting, a systematic error is introduced because BV changes lead...... to contour alterations of the breast. The volume of the altered breast includes not only the injected volume but also tissue previously surrounding the breast. Therefore, the quantitative difference in BV before and after augmentation will differ from the injected volume. Here, we present a new technique...

  12. Gum biopsy

    Science.gov (United States)

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  13. Skin Biopsy

    Science.gov (United States)

    ... I Help Someone Who's Being Bullied? Volunteering Skin Biopsy KidsHealth > For Teens > Skin Biopsy Print A A ... español Biopsia de piel What Is a Skin Biopsy and Who Would Need One? In a biopsy, ...

  14. Repeated intrathecal administration of plasmid DNA complexed with polyethylene glycol-grafted polyethylenimine led to prolonged transgene expression in the spinal cord.

    Science.gov (United States)

    Shi, L; Tang, G P; Gao, S J; Ma, Y X; Liu, B H; Li, Y; Zeng, J M; Ng, Y K; Leong, K W; Wang, S

    2003-07-01

    Gene delivery into the spinal cord provides a potential approach to the treatment of spinal cord traumatic injury, amyotrophic lateral sclerosis, and spinal muscular atrophy. These disorders progress over long periods of time, necessitating a stable expression of functional genes at therapeutic levels for months or years. We investigated in this study the feasibility of achieving prolonged transgene expression in the rat spinal cord through repeated intrathecal administration of plasmid DNA complexed with 25 kDa polyethylenimine (PEI) into the lumbar subarachnoid space. With a single injection, DNA/PEI complexes could provide transgene expression in the spinal cord 40-fold higher than naked plasmid DNA. The transgene expression at the initial level persisted for about 5 days, with a low-level expression being detectable for at least 8 weeks. When repeated dosing was tested, a 70% attenuation of gene expression was observed following reinjection at a 2-week interval. This attenuation was associated with apoptotic cell death and detected even using complexes containing a noncoding DNA that did not mediate any gene expression. When each component of the complexes, PEI polymer or naked DNA alone, were tested in the first dosing, no reduction was found. Using polyethylene glycol (PEG)-grafted PEI for DNA complexes, no attenuation of gene expression was detected after repeated intrathecal injections, even in those rats receiving three doses, administered 2 weeks apart. Lumbar puncture is a routine and relatively nontraumatic clinical procedure. Repeated administration of DNA complexed with PEG-grafted PEI through this less invasive route may prolong the time span of transgene expression when needed, providing a viable strategy for the gene therapy of spinal cord disorders.

  15. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam (Korea, Republic of); Shin, Byung Seok; Ohm, Joon Young; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2015-07-15

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency.

  16. Repeat Targeted Prostate Biopsy under Guidance of Multiparametric MRI-Correlated Real-Time Contrast-Enhanced Ultrasound for Patients with Previous Negative Biopsy and Elevated Prostate-Specific Antigen: A Prospective Study

    Science.gov (United States)

    Jang, Dong Ryul; Jung, Dae Chul; Oh, Young Taik; Noh, Songmi; Han, Kyunghwa; Kim, Kiwook; Rha, Koon-Ho; Choi, Young Deuk; Hong, Sung Joon

    2015-01-01

    Objectives To prospectively determine whether multi-parametric MRI (mpMRI) - contrast-enhanced ultrasound (CEUS) correlated, imaging-guided target biopsy (TB) method could improve the detection of prostate cancer in re-biopsy setting of patients with prior negative biopsy. Methods From 2012 to 2014, a total of 42 Korean men with a negative result from previous systematic biopsy (SB) and elevated prostate-specific antigen underwent 3T mpMRI and real-time CEUS guided TB. Target lesions were determined by fusion of mpMRI and CEUS. Subsequently, 12-core SB was performed by a different radiologist. We compared core-based cancer detection rates (CaDR) using the generalized linear mixed model (GLIMMIX) for each biopsy method. Results Core-based CaDR was higher in TB (17.92%, 38 of 212 cores) than in SB (6.15%, 31 of 504 cores) (p biopsy of patients with prior negative biopsy can improve CaDR based on the number of cores taken. PMID:26083348

  17. Renography and biopsy-verified acute rejection in renal allotransplanted patients receiving cyclosporin A

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, H.S.; Nielsen, S.L.; Larsen, S.; Lokkegaard, H.

    1987-01-01

    Acute impairment of renal function caused by cyclosporin A can be hard to differentiate from acute rejection. Therefore, kidney function after cadaveric allograft transplantation was repeatedly determined by renography in 42 patients receiving either high dose cyclosporin A (32 patients) or azathioprine and prednisone (10 patients) until a graft biopsy showed either acute rejection or no rejection within the first 5 postoperative weeks. The graft function as judged from the renograms was significantly poorer when cyclosporin A was used than when azathioprine and prednisone were the immunosuppressants. In the azathioprine and prednisone group a biopsy showing acute rejection was always preceded by a deterioration in the renogram. In cyclosporin A treated patients a graft biopsy following an early deterioration in the renogram showed acute rejection in only 56% of the biopsies. It was not possible to identify a time course or a function level of the renogram that could predict rejection in these patients. It is concluded that graft biopsies should be used liberally to diagnose rejection during cyclosporin A treatment if surgical complications after transplantations have been ruled out. Radionuclide studies may offer an invaluable aid in determining a nonnephrotoxic initial dose of the drug.

  18. Liver biopsy

    Science.gov (United States)

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

  19. Nerve biopsy

    Science.gov (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  20. Biopsy - polyps

    Science.gov (United States)

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  1. Bladder biopsy

    Science.gov (United States)

    Biopsy - bladder ... A bladder biopsy can be done as part of a cystoscopy . Cystoscopy is a telescopic examination of the inside of the ... informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate ...

  2. Synovial biopsy

    Science.gov (United States)

    Biopsy - synovial membrane ... fluid in and out of the area. A biopsy grasper is inserted through the trocar and turned ... Synovial biopsy helps diagnose gout and bacterial infections, or rule out other infections. It can be used to diagnose ...

  3. Systematic kidney biopsies after acute allograft pyelonephritis.

    Science.gov (United States)

    Cartery, Claire; Guilbeau-Frugier, Céline; Esposito, Laure; Sallusto, Federico; Guitard, Joelle; Cardeau-Desangles, Isabelle; Cointault, Olivier; Game, Xavier; Rostaing, Lionel; Kamar, Nassim

    2013-06-01

    Scarce data exist regarding the effect of acute graft pyelonephritis on kidney histology after a kidney transplant. This study sought to assess the kidney histology at 1 month, and kidney function at 1 year, after acute graft pyelonephritis in kidney transplant patients. All kidney transplant patients with acute graft pyelonephritis between October 2006, and December 2008, underwent a kidney biopsy 1 month later (n=28). Histologic findings were compared with those observed in a control group (n=28) who underwent a protocol kidney biopsy at 1 year posttransplant and did not present with acute graft pyelonephritis. Patients were matched according to age, sex, and immunosuppressive regimen. Kidney function was impaired by the acute graft pyelonephritis episodes at the time of biopsy. In 40% of patients, the estimated glomerular filtration rate did not return to baseline by 1 month after acute graft pyelonephritis and remained impaired thereafter. Three patients had features of acute rejection. Tubulitis was seen more frequently in the acute graft pyelonephritis group, especially in patients in whom estimated glomerular filtration rate did not completely recover by 1 month after acute graft pyelonephritis. Patients with acute graft pyelonephritis who had inflammatory infiltrate of > 20% 1 month after acute graft pyelonephritis had worse kidney function 1 year later. After transplant, when kidney function remains impaired 1 month after acute graft pyelonephritis, kidney biopsies allowed graft rejection diagnosis and predicted kidney function recovery.

  4. Tongue biopsy

    Science.gov (United States)

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

  5. Needle Biopsy

    Science.gov (United States)

    ... for a day or two During the needle biopsy Your health care team will position you in ... if you're feeling uncomfortable. After the needle biopsy Once your doctor has collected enough cells or ...

  6. Does Obesity Modify the Ability of Prebiopsy Prostate Specific Antigen to Detect Prostate Cancer on Repeat Biopsy? Results from the REDUCE Study.

    Science.gov (United States)

    Vidal, Adriana C; Howard, Lauren E; Moreira, Daniel M; Castro-Santamaria, Ramiro; Andriole, Gerald L; Freedland, Stephen J

    2015-07-01

    Higher body mass index is linked to lower prostate specific antigen. This has given rise to concerns that prostate specific antigen may be less reliable for predicting prostate cancer among obese men. We tested the accuracy of prebiopsy prostate specific antigen for predicting prostate cancer across body mass index categories. We used the REDUCE study, which tested dutasteride for prostate cancer risk reduction in men with a prostate specific antigen of 2.5 to 10.0 ng/ml and a negative pre-study biopsy. All men were required to have a biopsy at 2 and 4 years independent of prostate specific antigen. We assessed the performance of prebiopsy prostate specific antigen to predict overall and high grade prostate cancer (Gleason sum 7 or greater) in each body mass index group using AUC. Of 6,103 men who had a 2-year biopsy 1,646 (27%) were normal weight, 3,209 (53%) were overweight and 1,248 (20%) were obese. Mean adjusted prostate specific antigen for normal weight, overweight and obese subjects on placebo was 7.73, 7.17 and 6.79 ng/ml (p-trend=0.192), and on dutasteride 3.16, 2.93 and 2.62 ng/ml (p=0.008). AUC analysis using raw prostate specific antigen data for predicting prostate cancer ranged from 0.60 to 0.64 in the placebo arm and 0.58 to 0.66 in the dutasteride arm with no difference across body mass index categories (p-interactions ≥0.212). Similar results were found for high grade prostate cancer with AUC ranging from 0.69 to 0.70 in the placebo arm and 0.65 to 0.75 in the dutasteride arm but no differences across body mass index categories (p-interactions ≥0.157). Among men with a previous negative biopsy the accuracy of prebiopsy prostate specific antigen to predict overall and high grade prostate cancer was independent of body mass index. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Ligand peptide-grafted PEGylated liposomes using HER2 targeted peptide-lipid derivatives for targeted delivery in breast cancer cells: The effect of serine-glycine repeated peptides as a spacer.

    Science.gov (United States)

    Suga, Tadaharu; Fuchigami, Yuki; Hagimori, Masayori; Kawakami, Shigeru

    2017-02-22

    Ligand peptide-grafted PEGylated liposomes have been widely studied for targeted drug delivery systems. Because ligand peptides are commonly grafted using PEG as a spacer on the surface of PEGylated liposomes, the interaction between ligand peptides and their corresponding receptors can be interrupted by steric hindrance of the PEG layer. Therefore, we aimed to develop ligand peptide-lipid derivatives to enhance the targeting efficiency of ligand peptide-grafted PEGylated liposomes, and designed a new ligand peptide-lipid derivatives having serine-glycine repeats (SG)n as a spacer based on the peptide length calculated by PyMol (v0.99). We selected KCCYSL (KCC) as the ligand peptide for binding to human epidermal growth factor receptor-2 (HER2). We synthesized new KCC-(SG)n-lipid derivatives (n=3, 5, 7) and evaluated their cellular association in breast cancer cells. KCC-(SG)n/PEGylated liposomes dramatically increased cellular association on HER2-positive breast cancer cells. The results suggest that KCC can be grafted on the surface of KCC-(SG)n/PEGylated liposomes prepared from KCC-(SG)n-lipid derivatives (n=3, 5, 7). In summary, we succeeded in developing KCC-(SG)n-lipid derivatives for the preparation of ligand peptide-grafted PEGylated liposomes.

  8. Comparison of initial and tertiary centre second opinion reads of multiparametric magnetic resonance imaging of the prostate prior to repeat biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Nienke L. [University Hospital RWTH Aachen, Department of Diagnostic and Interventional Radiology, Aachen (Germany); Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Koo, Brendan C.; Gallagher, Ferdia A. [Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Warren, Anne Y. [Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Pathology, Cambridge (United Kingdom); Doble, Andrew; Gnanapragasam, Vincent; Bratt, Ola; Kastner, Christof [Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Urology, Cambridge (United Kingdom); Barrett, Tristan [Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); University of Cambridge School of Clinical Medicine, Department of Radiology, Box 218, Cambridge (United Kingdom)

    2017-06-15

    To investigate the value of second-opinion evaluation of multiparametric prostate magnetic resonance imaging (MRI) by subspecialised uroradiologists at a tertiary centre for the detection of significant cancer in transperineal fusion prostate biopsy. Evaluation of prospectively acquired initial and second-opinion radiology reports of 158 patients who underwent MRI at regional hospitals prior to transperineal MR/untrasound fusion biopsy at a tertiary referral centre over a 3-year period. Gleason score (GS) 7-10 cancer, positive predictive value (PPV) and negative (NPV) predictive value (±95 % confidence intervals) were calculated and compared by Fisher's exact test. Disagreement between initial and tertiary centre second-opinion reports was observed in 54 % of cases (86/158). MRIs had a higher NPV for GS 7-10 in tertiary centre reads compared to initial reports (0.89 ± 0.08 vs 0.72 ± 0.16; p = 0.04), and a higher PPV in the target area for all cancer (0.61 ± 0.12 vs 0.28 ± 0.10; p = 0.01) and GS 7-10 cancer (0.43 ± 0.12 vs 0.2 3 ± 0.09; p = 0.02). For equivocal suspicion, the PPV for GS 7-10 was 0.12 ± 0.11 for tertiary centre and 0.11 ± 0.09 for initial reads; p = 1.00. Second readings of prostate MRI by subspecialised uroradiologists at a tertiary centre significantly improved both NPV and PPV. Reporter experience may help to reduce overcalling and avoid overtargeting of lesions. (orig.)

  9. SATURATION BIOPSY OF THE PROSTATE (REVIEW

    Directory of Open Access Journals (Sweden)

    A. V. Sadchenko

    2014-07-01

    Full Text Available Prostate biopsy is the principal method of diagnois of prostate cancer, allowing to start the adequate treatment. The tactics of the patients, which have negative initial biopsy, is a subject of discussion. Saturation biopsy is a “gold standard„ of diagnostics of PCA with repeat biopsy. Saturation biopsy of the prostate is not a primary procedure, usually apply in patients with negative biopsies in anamnesis, patients with multifocal PIN and ASAP. Saturation biopsy allows to more precisely predict the volume and degree of malignancy of PCA, that can be used for planning tactics of active surveillance and focal therapy.

  10. Dynamics of Graft Function Measured by DNA-Technology in a Patient with Severe Aplastic Anemia and Repeated Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Anna Karastaneva

    2014-01-01

    Full Text Available Although bone marrow transplantation (BMT from an HLA identical sibling is considered as treatment of choice in pediatric patients with severe aplastic anemia (SAA, a significant number of them experience graft failure (GF after BMT. We report a case of an 8-year-old male patient with SAA who presented with a complicated posttransplant course due to parvovirus B19 infection and GF. A subsequent attempt to support the graft by antithymocyte globulin (ATG and a peripheral stem cell boost resulted in transitory autologous recovery of hematopoiesis followed by mixed chimerism, supported by donor lymphocyte infusions (DLIs and finally graft rejection with relapse of SAA. Permanent complete chimerism was achieved by a second BMT. Dynamics of graft function, measured by a single nucleotide polymorphism (SNPs analysis, are discussed.

  11. Kidney Biopsy

    Science.gov (United States)

    ... Care Provider People should talk with their health care provider about medical conditions they have and all prescribed and over- ... biopsy, a person should talk with their health care provider about medical conditions and allergies they have and all medications ...

  12. Lymph node biopsy

    Science.gov (United States)

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  13. Concurrent biopsies of both grafts in recipients of simultaneous pancreas and kidney demonstrate high rates of discordance for rejection as well as discordance in type of rejection - a retrospective study.

    Science.gov (United States)

    Parajuli, Sandesh; Arpali, Emre; Astor, Brad C; Djamali, Arjang; Aziz, Fahad; Redfield, Robert R; Sollinger, Hans W; Kaufman, Dixon B; Odorico, Jon; Mandelbrot, Didier A

    2017-07-03

    It is commonly assumed that in simultaneous pancreas and kidney (SPK) recipients, rejection of the two organs is concordant. As a result, concurrent biopsies of both organs are rarely performed and there are limited histological data on how often rejection is in fact discordant. We reviewed all SPK recipients transplanted at the University of Wisconsin between January 01, 2001, and December 31, 2016, that underwent biopsy of both organs. We included all patients whose biopsies were within 30 days. If patients were treated for rejection between biopsies, they were excluded if the biopsies were more than 4 days apart. Ninety-one simultaneous biopsies were performed within 30 days of each other, and 40 met our inclusion criteria. A total of 25 (62.5%) patients had concordance of biopsy findings: 11 had rejection of both organs, and 14 had no rejection of either organ. The other 15 (37.5%) were discordant for rejection, with 10 having pancreas-only rejection and five kidney-only rejection. It was striking to find that four of the 11 patients with concordance for rejection (36%) had different types (AMR, ACR, or mixed) of rejection in the two organs. This large series of simultaneous pancreas and kidney biopsies demonstrates the continued utility of performing biopsies of both organs. © 2017 Steunstichting ESOT.

  14. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

    Directory of Open Access Journals (Sweden)

    Smriti Hari

    2016-01-01

    Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates.

  15. Nasal mucosal biopsy

    Science.gov (United States)

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  16. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  17. Cold knife cone biopsy

    Science.gov (United States)

    ... squamous cells - cone biopsy; Pap smear - cone biopsy; HPV - cone biopsy; Human papilloma virus - cone biopsy; Cervix - ... exam. The health care provider will place an instrument (speculum) into your vagina to better see the ...

  18. Renal Graft Fibrosis and Inflammation Quantification by an Automated Fourier-Transform Infrared Imaging Technique.

    Science.gov (United States)

    Vuiblet, Vincent; Fere, Michael; Gobinet, Cyril; Birembaut, Philippe; Piot, Olivier; Rieu, Philippe

    2016-08-01

    Renal interstitial fibrosis and interstitial active inflammation are the main histologic features of renal allograft biopsy specimens. Fibrosis is currently assessed by semiquantitative subjective analysis, and color image analysis has been developed to improve the reliability and repeatability of this evaluation. However, these techniques fail to distinguish fibrosis from constitutive collagen or active inflammation. We developed an automatic, reproducible Fourier-transform infrared (FTIR) imaging-based technique for simultaneous quantification of fibrosis and inflammation in renal allograft biopsy specimens. We generated and validated a classification model using 49 renal biopsy specimens and subsequently tested the robustness of this classification algorithm on 166 renal grafts. Finally, we explored the clinical relevance of fibrosis quantification using FTIR imaging by comparing results with renal function at 3 months after transplantation (M3) and the variation of renal function between M3 and M12. We showed excellent robustness for fibrosis and inflammation classification, with >90% of renal biopsy specimens adequately classified by FTIR imaging. Finally, fibrosis quantification by FTIR imaging correlated with renal function at M3, and the variation in fibrosis between M3 and M12 correlated well with the variation in renal function over the same period. This study shows that FTIR-based analysis of renal graft biopsy specimens is a reproducible and reliable label-free technique for quantifying fibrosis and active inflammation. This technique seems to be more relevant than digital image analysis and promising for both research studies and routine clinical practice.

  19. Sleep Quality and Emotional Correlates in Taiwanese Coronary Artery Bypass Graft Patients 1 Week and 1 Month after Hospital Discharge: A Repeated Descriptive Correlational Study.

    Science.gov (United States)

    Yang, Pei-Lin; Huang, Guey-Shiun; Tsai, Chien-Sung; Lou, Meei-Fang

    2015-01-01

    Poor sleep quality is a common health problem for coronary artery bypass graft patients, however few studies have evaluated sleep quality during the period immediately following hospital discharge. The aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge. We used a descriptive correlational design for this study. One week after discharge, 87 patients who had undergone coronary artery bypass surgery completed two structured questionnaires: the Pittsburgh Sleep Quality Index and the Hospital Anxiety and Depression Scale. Three weeks later (1 month after discharge) the patients completed the surveys again. Pearson correlations, t-tests, ANOVA and linear multiple regression analysis were used to analyze the data. A majority of the participants had poor sleep quality at 1 week (82.8%) and 1 month (66.7%) post-hospitalization, based on the global score of the Pittsburgh Sleep Quality Index. Despite poor sleep quality at both time-points the sleep quality at 1 month was significantly better than at 1-week post hospitalization. Poorer sleep quality correlated with older age, poorer heart function, anxiety and depression. The majority of participants had normal levels of anxiety at 1 week (69.0%) and 1 month (88.5%) as measured by the Hospital Anxiety and Depression Scale. However, some level of depression was seen at 1 week (78.1%) and 1 month (59.7%). Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality. Sleep quality, anxiety and depression all significantly improved 1 month after hospital discharge. However, more than half of the participants continued to have poor sleep quality and some level of depression. Health care personnel should be encouraged to assess sleep and emotional status in patients after coronary artery

  20. Evaluation and analysis of graft hypertrophy by means of arthroscopy, biochemical MRI and osteochondral biopsies in a patient following autologous chondrocyte implantation for treatment of a full-thickness-cartilage defect of the knee.

    Science.gov (United States)

    Niemeyer, Philipp; Uhl, Markus; Salzmann, Gian M; Morscheid, Yannik P; Südkamp, Norbert P; Madry, Henning

    2015-06-01

    Graft hypertrophy represents a characteristic complication following autologous chondrocyte implantation (ACI) for treatment of cartilage defects. Although some epidemiological data suggest that incidence is associated with first-generation ACI using autologous chondrocyte implantation, it has also been reported in other technical modifications of ACI using different biomaterials. Nevertheless, it has not been described in autologous, non-periosteum, implant-free associated ACI. In addition, little is known about histological and T2-relaxation appearance of graft hypertrophy. The present case report provides a rare case of extensive graft hypertrophy following ACI using an autologous spheres technique with clinical progression over time. Detailed clinical, MR tomographic and histological evaluation has been performed, which demonstrates a high quality of repair tissue within the hypertrophic as well as non-hypertrophic transplanted areas of the repair tissue. No expression of collagen type X (a sign of chondrocyte hypertrophy), only slight changes of the subchondral bone and a nearly normal cell-matrix ratio suggest that tissue within the hypertrophic area does not significantly differ from intact and high-quality repair tissue and therefore seems not to cause graft hypertrophy. This is in contrast to the assumption that histological hypertrophy might cause or contribute to an overwhelming growth of the repair tissue within the transplantation site. Data presented in this manuscript might contribute to further explain the etiology of graft hypertrophy following ACI.

  1. Bone lesion biopsy

    Science.gov (United States)

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

  2. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  3. Muscle biopsy (image)

    Science.gov (United States)

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  4. Skin lesion biopsy

    Science.gov (United States)

    ... procedure will leave a small indented area. This type of biopsy is often done when a skin cancer is ... may have stitches to close the area. This type of biopsy is often done to diagnose rashes . EXCISIONAL BIOPSY ...

  5. Biopsy with the New Essen Biopsy Forceps

    Directory of Open Access Journals (Sweden)

    Peter G. Traine

    2013-01-01

    Full Text Available Purpose. To present initial experience with a novel biopsy method, the Essen biopsy forceps. Therefore, two patients with diagnostic suspicion of uveal melanoma underwent biopsy for histopathological confirmation. Case Presentation. Two patients presented with painless unilateral vision reduction. Ultrasound revealed the diagnostic suspicion of uveal melanoma. Therefore, biopsy with the Essen biopsy forceps using a sutureless 23-gauge three-port vitrectomy system was performed. The specimens were then submitted to a pathologist and processed. Histopathology of the obtained specimen confirmed the diagnostic suspicion of choroid melanoma in both patients. Conclusion. Essen biopsy forceps is a very practicable alternative method to the FNAB, allowing a combined histopathological and immunohistochemical examination for achieving high diagnostic accuracy at minimal risk.

  6. Prostate biopsy strategies: current state of the art.

    Science.gov (United States)

    Mian, Badar M

    2004-05-01

    Prostate-specific antigen testing and prostate biopsy have revolutionized our ability to detect prostate cancer at an early stage. The transrectal ultrasound-guided biopsy procedure has undergone a number of modifications over the past 10 years to meet our goal of early detection of cancer at a curable stage. Biopsy schemes have evolved from lesion-directed biopsies to systematic mapping of the peripheral zone of the prostate, which harbors almost all of the significant tumor foci. An increase in the number of biopsy cores from 6 to 10 (or 12) has resulted in a significant improvement in the detection of clinically localized cancer, without any appreciable increase in the number of indolent cancers. Current biopsy schemes also have enhanced our ability to determine the true prognostic value of pathologic lesions such as high-grade prostatic intraepithelial neoplasia and atypical small acinar proliferation which have been associated with cancer detection in repeat biopsies. I discuss the rationale behind, and the outcomes of, various biopsy strategies. More than 15 years after PSA testing was popularized for early detection, a number of men are presenting for evaluation regarding repeat prostate biopsy for various clinical indications. The indications, biopsy scheme, and cancer detection rates for repeat prostate biopsy are discussed in detail.

  7. Transvenous Renal Transplant Biopsy via a Transfemoral Approach.

    Science.gov (United States)

    Schmid, A; Jacobi, J; Kuefner, M A; Lell, M; Wuest, W; Mayer-Kadner, I; Benz, K; Schmid, M; Amann, K; Uder, M

    2013-05-01

    Percutaneous renal biopsy (PRB) of kidney transplants might be prevented by an elevated risk of bleeding or limited access to the allograft. In the following, we describe our initial experience with 71 transvenous renal transplant biopsies in 53 consecutive patients with unexplained reduced graft function who were considered unsuitable candidates for PRB (4.2% of all renal transplant biopsies at our institution). Biopsies were performed via the ipsilateral femoral vein with a renal biopsy set designed for transjugular renal biopsy (TJRB) of native kidneys. Positioning of the biopsy system within the transplant vein was achievable in 58 of 71 (81.7%) procedures. The specimen contained a median of 10 glomeruli (range 0-38). Tissue was considered as adequate for diagnosis in 56 of 57 (98.2%) biopsies. With respect to BANFF 50.9% of the specimen were adequate (>10 glomeruli), 47.4% marginally adequate (1-9 glomeruli) and 1.8% inadequate (no glomeruli). After implementation of real-time assessment all specimen contained glomeruli. One of the fifty-eight (1.8%) procedure-related major complications occurred (hydronephrosis requiring nephrostomy due to gross hematuria). Transfemoral renal transplant biopsy (TFRTB) is feasible and appears to be safe compared to PRB. It offers a useful new alternative for histological evaluation of graft dysfunction in selected patients with contraindications to PRB.

  8. Sentinel node biopsy (image)

    Science.gov (United States)

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...

  9. Mediastinoscopy with biopsy

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003864.htm Mediastinoscopy with biopsy To use the sharing features on this page, please enable JavaScript. Mediastinoscopy with biopsy is a procedure in which a lighted instrument ( ...

  10. Sentinel Lymph Node Biopsy

    Science.gov (United States)

    ... Ask about Your Diagnosis Research Sentinel Lymph Node Biopsy On This Page What are lymph nodes? What ... lymph node? What is a sentinel lymph node biopsy? What happens during an SLNB? What are the ...

  11. Nerve biopsy (image)

    Science.gov (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  12. Salivary gland biopsy

    Science.gov (United States)

    ... also be performed to diagnose diseases such as Sjogren syndrome . How to Prepare for the Test There is ... few days after the biopsy. The biopsy for Sjogren syndrome requires an injection of the anesthetic in the ...

  13. Percutaneous liver biopsy.

    Science.gov (United States)

    Rustagi, Tarun; Newton, Eric; Kar, Premashish

    2010-01-01

    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  14. Characteristics of repeated renal biopsy-proven primary focal segmental glomerulosclerosis in children%重复肾活检为原发性局灶节段性肾小球硬化症患儿临床病理分析

    Institute of Scientific and Technical Information of China (English)

    何瑞娟; 肖慧捷; 刘景城; 王素霞; 杨霁云

    2012-01-01

    目的 对8例经重复肾活检确诊为原发性局灶节段性肾小球硬化症(PFSGS)的患儿进行研究,探讨临床-病理相关性,两次肾活检病理类型的联系以及重复肾活检的指征.方法 回顾分析近10年在北京大学第一医院儿科肾活检的病例,对其中8例重复肾活检、并最终确诊为PFSGS的病例进行分析,总结其临床特点、重复肾活检的指征、前后两次肾活检病理类型的不同,以及治疗反应.其中局灶节段性肾小球硬化症(FSGS)分型依据2004年D'Agati提出的最新分型标准.结果 8例患儿首次发病年龄在1 ~12岁,临床诊断均为肾病综合征.首次肾穿年龄1.1 ~15.0岁,随访时间10个月~14年.重复肾活检的原因为治疗反应差,持续大量蛋白尿不缓解,伴或不伴肾功能下降.3例患儿两次肾活检均在北京大学第一医院完成,第1次病理类型分别为:系膜增生、FSGS细胞型(CELL)及FSGS顶端型(GTL).第2次肾穿后,分别加用或更换免疫抑制剂,3例出现肾功能下降或终末期肾病,起病年龄均在1岁左右;2例FSGS塌陷型(COLL)者,1例重复肾活检发现伴随亚急性小管间质肾炎.结论 PFSGS是一组临床病理综合征,临床表现以肾病综合征多见.在病程中出现治疗反应差,病情持续不缓解时,通常提示病理转型.系膜增生可以转化为FSGS,FSGS各亚型也可发生转换.塌陷型及发病年龄小者预后差.%Objective To analyze the characteristics of repeated renal biopsy-proven primary focal segmental glomerulosclerosis (PFSGS) in 8 children,and to reveal the relationship between clinical features and pathology,between the two times of renal biopsy pathology,and the indications for repeated renal biopsy.Method The records of cases who ever experienced renal biopsy in this hospital were reviewed,of whom 8 cases of repeated renal biopsy-proven PFSGS were enrolled.The clinical manifestations,the reason why they had renal biopsy again

  15. Biopsy (For Parents)

    Science.gov (United States)

    ... Teaching Kids to Be Smart About Social Media Biopsy KidsHealth > For Parents > Biopsy Print A A A What's in this article? ... Questions en español Biopsias What It Is A biopsy is a test that's performed to examine tissue ...

  16. Resolution of severe graft steatosis following dual-graft living donor liver transplantation.

    Science.gov (United States)

    Moon, DeokBog; Lee, SungGyu; Hwang, Shin; Kim, KiHun; Ahn, ChulSoo; Park, KwangMin; Ha, TaeYong; Song, GiWon

    2006-07-01

    Although severely steatotic liver grafts are not suitable for transplantation, they have been used when other, more optimal donors were not available, especially for living donor liver transplantation (LDLT) using two liver grafts. Here we present two cases of dual-graft LDLT in which the recipients showed rapid and complete clearing of fat from livers with previously severe steatosis. In the first case, two left lateral segment grafts were used, one of which was 70% steatotic. Preoperative and posttransplant two-week liver-to-spleen computed tomography-value (L/S) ratios were 0.48 and 1.25, respectively. A liver biopsy taken two weeks after transplantation showed that the fatty changes had almost disappeared. The second case used one left lobe and one left lateral segment graft, the latter of which was 80% steatotic. Preoperative and two-week L/S ratio were 0.58 and 1.34, respectively, and a liver biopsy taken two weeks after transplantation showed less than 3% steatosis. The two donors of the severely steatotic liver grafts recovered uneventfully. These findings show that the fat content of the liver grafts was rapidly removed after transplantation. This observation is helpful in understanding the recovery sequences following transplantation of steatotic liver grafts, as well as expanding the acceptability of steatotic liver grafts.

  17. Utility of protocol kidney biopsies for de novo donor-specific antibodies.

    Science.gov (United States)

    Parajuli, Sandesh; Reville, Patrick K; Ellis, Thomas M; Djamali, Arjang; Mandelbrot, Didier A

    2017-08-14

    There is limited information about the role of protocol kidney biopsies for de novo donor-specific antibodies (dnDSA) in kidney transplant recipients, especially in those with stable graft function. We initiated a routine posttransplant DSA monitoring and surveillance biopsy program for dnDSA since 2014. We identified 45 kidney transplant recipients with dnDSA detected between January 2014 and February 2017 who underwent kidney biopsy within 60 days of detection of dnDSA. Twenty-nine (64%) had stable graft function and 16 (36%) had impaired graft function at the time of dnDSA detection. Even in the group with stable graft function, we found a high rate of rejection (53%) on biopsy. Eighty-eight percent of patients with impaired graft function had rejection. Those patients with impaired graft function had significantly lower estimated glomerular filtration rate at 12 months postbiopsy and at last follow-up. Those with impaired graft function had more graft failures; however, this result was not statistically significant. The high rate of asymptomatic rejection, and the fact that outcomes in asymptomatic patients are poor, is in support of the utility of surveillance biopsies in patients with dnDSA. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. Bone graft

    Science.gov (United States)

    ... around the area. The bone graft can be held in place with pins, plates, or screws. Why ... Orthopaedic Surgery, San Francosco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  19. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  20. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  1. Abdominal wall fat pad biopsy

    Science.gov (United States)

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... method of taking an abdominal wall fat pad biopsy . The health care provider cleans the skin on ...

  2. Needle Biopsy of the Lung

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Needle Biopsy of the Lung Needle biopsy of the lung ... Needle Biopsy of Lung Nodules? What is Needle Biopsy of the Lung? A lung nodule is relatively ...

  3. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

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

  4. Analysis of bone biopsies.

    Science.gov (United States)

    Goodrich, J A; Difiore, R J; Tippens, J K

    1983-11-01

    The orthopedic surgeon is frequently confronted with the decision of when to perform a bone biopsy and whether to do a needle biopsy or an open biopsy. Frequently consultations are received from other services requesting bone biopsies with questionable indications. The indications and contraindications for performing bone biopsies are discussed as well as advantages and disadvantages of either closed or open technique. Four selective cases are discussed with illustrations. The challenge of undiagnosed osseous lesions is best met by rational evaluation of each individual case and coordinated with the team effort of the primary care physician, surgeon, pathologist, and radiologist. The decision for either an open or closed biopsy technique must be based on the experience and skills of the surgeon and pathologist.

  5. Appropriateness of Liver Biopsy

    OpenAIRE

    Thierry Poynard; Vlad Ratziu; Pierre Bedossa

    2000-01-01

    This review aims to discuss the appropriateness of liver biopsy in two frequent liver diseases, hepatitis C and alcoholic liver disease. The medical literature, published between 1965 and 1999, was reviewed by using MEDLINE. Only 0.1% of the publications were devoted specifically to the appropriateness of liver biopsy. Not all studies observed a significant agreement among doctors on the decision to use liver biopsy. Therefore, there is a possibility that hepatologists have significant, heter...

  6. Graft Fibrosis After Pediatric Liver Transplantation : Ten Years of Follow-up

    NARCIS (Netherlands)

    Scheenstra, Rene; Peeters, Paul M. G. J.; Verkade, Henkjan J.; Gouw, Annette S. H.

    2009-01-01

    Previously we reported the presence of portal fibrosis in 31% (n = 84) of the grafts in protocol biopsies I year after pediatric liver transplantation (LTx). To assess the natural history of graft fibrosis after pediatric liver transplantation, we extended the analysis of graft histology in follow-u

  7. Open lung biopsy

    Science.gov (United States)

    ... CT scan Disseminated tuberculosis Granulomatosis with polyangiitis Lung cancer - small cell Lung disease Lung needle biopsy Malignant mesothelioma Pulmonary tuberculosis Rheumatoid lung disease Sarcoidosis Simple pulmonary eosinophilia ...

  8. Geometric systematic prostate biopsy.

    Science.gov (United States)

    Chang, Doyoung; Chong, Xue; Kim, Chunwoo; Jun, Changhan; Petrisor, Doru; Han, Misop; Stoianovici, Dan

    2017-04-01

    The common sextant prostate biopsy schema lacks a three-dimensional (3D) geometric definition. The study objective was to determine the influence of the geometric distribution of the cores on the detection probability of prostate cancer (PCa). The detection probability of significant (>0.5 cm(3)) and insignificant (geometric distribution of the cores was optimized to maximize the probability of detecting significant cancer for various prostate sizes (20-100cm(3)), number of biopsy cores (6-40 cores) and biopsy core lengths (14-40 mm) for transrectal and transperineal biopsies. The detection of significant cancer can be improved by geometric optimization. With the current sextant biopsy, up to 20% of tumors may be missed at biopsy in a 20 cm(3) prostate due to the schema. Higher number and longer biopsy cores are required to sample with an equal detection probability in larger prostates. Higher number of cores increases both significant and insignificant tumor detection probability, but predominantly increases the detection of insignificant tumors. The study demonstrates mathematically that the geometric biopsy schema plays an important clinical role, and that increasing the number of biopsy cores is not necessarily helpful.

  9. Lung needle biopsy

    Science.gov (United States)

    ... biopsy Lung tissue biopsy References Ettinger DS. Lung cancer and other pulmonary neoplasms. In: Goldman L, Schafer AI, eds. Goldman's ... 2010:chap 47. Read More Aspiration ... by: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, ...

  10. Needle biopsy of histoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    Sinner, W.N.

    1980-12-01

    A case of histoplasmosis, simulating a bronchogenic carcinoma, was needle biopsied. Histoplasma capsulatum organisms were found in great numbers. Needle biopsy established an accurate diagnosis making an exploratory thoracotomy unnecessary and preventing the patient from an already planned lobectomy. Specific treatment with Amphotericin B healed the lesion.

  11. Ureteral retrograde brush biopsy

    Science.gov (United States)

    ... biopsy URL of this page: //medlineplus.gov/ency/article/003906.htm Ureteral retrograde brush biopsy To use ... minutes. A cystoscope is first placed through the urethra into the bladder. Cystoscope is a tube with a ... results may show cancer cells ( carcinoma ). This test is often used to ...

  12. Histological assessment of pre-transplant kidney biopsies is reproducible and representative.

    NARCIS (Netherlands)

    Snoeijs, M.G.; Boonstra, L.A.; Buurman, W.A.; Goldschmeding, R.; Suylen, R.J. van; Heurn, L.W.E. van; Peutz-Kootstra, C.J.

    2010-01-01

    AIMS: Histological examination of pre-transplant renal biopsy specimens can be used to select grafts from older donors after cardiac death (DCD) with a satisfactory transplant outcome. The aim was to determine whether such biopsy specimens can be reproducibly scored between pathologists and are repr

  13. Histological assessment of pre-transplant kidney biopsies is reproducible and representative.

    NARCIS (Netherlands)

    Snoeijs, M.G.; Boonstra, L.A.; Buurman, W.A.; Goldschmeding, R.; Suylen, R.J. van; Heurn, L.W.E. van; Peutz-Kootstra, C.J.

    2010-01-01

    AIMS: Histological examination of pre-transplant renal biopsy specimens can be used to select grafts from older donors after cardiac death (DCD) with a satisfactory transplant outcome. The aim was to determine whether such biopsy specimens can be reproducibly scored between pathologists and are repr

  14. Improved transvenous liver biopsy needle

    DEFF Research Database (Denmark)

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

    1979-01-01

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

  15. Biopsy: Types of Biopsy Procedures Used to Diagnose Cancer

    Science.gov (United States)

    ... Cancer You might be nervous about an upcoming biopsy. Learning about biopsies and how and why they're done may ... reduce your anxiety. By Mayo Clinic Staff A biopsy is a procedure to remove a piece of ...

  16. PATHOMORPHOLOGY OF ZERO BIOPSIES OF DONOR KIDNEYS

    Directory of Open Access Journals (Sweden)

    M. L. Arefjev

    2011-01-01

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

  17. No need for biopsies

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  18. Clinical role of the renal transplant biopsy

    Science.gov (United States)

    Williams, Winfred W.; Taheri, Diana; Tolkoff-Rubin, Nina; Colvin, Robert B.

    2013-01-01

    Percutaneous needle core biopsy is the definitive procedure by which essential diagnostic and prognostic information on acute and chronic renal allograft dysfunction is obtained. The diagnostic value of the information so obtained has endured for over three decades and has proven crucially important in shaping strategies for therapeutic intervention. This Review provides a broad outline of the utility of performing kidney graft biopsies after transplantation, highlighting the relevance of biopsy findings in the immediate and early post-transplant period (from days to weeks after implantation), the first post-transplant year, and the late period (beyond the first year). We focus on how biopsy findings change over time, and the wide variety of pathological features that characterize the major clinical diagnoses facing the clinician. This article also includes a discussion of acute cellular and humoral rejection, the toxic effects of calcineurin inhibitors, and the widely varying etiologies and characteristics of chronic lesions. Emerging technologies based on gene expression analyses and proteomics, the in situ detection of functionally relevant molecules, and new bioinformatic approaches that hold the promise of improving diagnostic precision and developing new, refined molecular pathways for therapeutic intervention are also presented. PMID:22231130

  19. Wilson disease:Histopathological correlations with treatment on follow-up liver biopsies

    Institute of Scientific and Technical Information of China (English)

    Sandy; Cope-Yokoyama; Milton; J; Finegold; Giacomo; Carlo; Sturniolo; Kyoungmi; Kim; Claudia; Mescoli; Massimo; Rugge; Valentina; Medici

    2010-01-01

    AIM:To investigate the progression of hepatic histopathology in serial liver biopsies from Wilson disease(WD)patients.METHODS:We report a group of 12 WD patients treated with zinc and/or penicillamine who underwent multiple follow-up liver biopsies.Demographic,clinical and laboratory data were gathered and all patients underwent an initial biopsy and at least one repeat biopsy.RESULTS:Time to repeat biopsy ranged from 2 to 12 years.Six patients(non-progressors)showed stable hepatic histology or improvement....

  20. Colposcopy - directed biopsy

    Science.gov (United States)

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

  1. Oropharynx lesion biopsy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003850.htm Oropharynx lesion biopsy To use the sharing features on this ... Department of Otolaryngology - Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. ...

  2. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  3. Where Do TRUS- and MRI Guided Biopsies Miss Significant Prostate Cancer?

    DEFF Research Database (Denmark)

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

    2017-01-01

    OBJECTIVE: To identify the location of missed sPCa lesions by transrectal ultrasound-guided (TRUSbx) and multiparametric MRI-guided biopsies (mpMRIbx) in men undergoing repeat biopsies. METHODS: 289 men with prior negative TRUSbx underwent mpMRI. The location of any suspicious lesion was registered...... and scored using PIRADS v1 classification according to the likelihood of being sPCa. All patients underwent repeat (re-)TRUSbx and targeted mpMRIbx (image fusion) of any suspicious lesion. Biopsy results were compared and the location of missed sPCa lesions were registered. Cancer significance was defined as...... techniques in men undergoing repeat biopsies....

  4. Corpus vitreum, retina og chorioidea biopsi

    DEFF Research Database (Denmark)

    Scherfig, Erik Christian Høegh

    2002-01-01

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

  5. The Terry Biopsy Needle

    Science.gov (United States)

    Bond, Alan F.; Murphy, Fergus A.; Nanson, Eric M.

    1963-01-01

    Six illustrative cases are reported to demonstrate the versatility of the Terry biopsy needle as a useful instrument for obtaining satisfactory biopsy specimens from the liver and from other tissues as well. The apparatus and method of use are described and illustrated. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6aFig. 6bFig. 7Fig. 8Fig. 9Fig. 10Fig. 11 PMID:13968726

  6. Biopsy in Musculoskeletal Tumors

    Directory of Open Access Journals (Sweden)

    Mohammad Gharehdaghi

    2014-09-01

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

  7. Percutaneous CT-guided needle biopsies of musculoskeletal tumors: a 5-year analysis of non-diagnostic biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Torriani, Martin; Rosenthal, Daniel I. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute for Technology Assessment, Department of Radiology, Boston, MA (United States); Springfield, Dempsey S. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)

    2015-12-15

    To study non-diagnostic CT-guided musculoskeletal biopsies and take steps to minimize them. Specifically we asked: (1) What malignant diagnoses have a higher non-diagnostic rate? (2) What factors of a non-diagnostic biopsy may warrant more aggressive pursuit? (3) Do intra-procedural frozen pathology (FP) or point-of-care (POC) cytology reduce the non-diagnostic biopsy rate ?This study was IRB-approved and HIPAA-compliant. We retrospectively reviewed 963 consecutive CT-guided musculoskeletal biopsies. We categorized pathology results as malignant, benign, or non-diagnostic and recorded use of FP or POC cytology. Initial biopsy indication, final diagnosis, method of obtaining the final diagnosis of non-diagnostic biopsies, age of the patient, and years of biopsy attending experience were recorded. Groups were compared using Pearson's χ{sup 2} test or Fisher's exact test. In all, 140 of 963 (15 %) biopsies were non-diagnostic. Lymphoma resulted in more non-diagnostic biopsies (P < 0.0001). While 67% of non-diagnostic biopsies yielded benign diagnoses, 33% yielded malignant diagnoses. Patients whose percutaneous biopsy was indicated due to the clinical context without malignancy history almost always generated benign results (96 %). Whereas 56% of biopsies whose indication was an imaging finding of a treatable lesion were malignant, 20% of biopsies whose indication was a history of malignancy were malignant. There was no statistically significant difference in the nondiagnostic biopsy rates of pediatric versus adult patients (P = 0.8) and of biopsy attendings with fewer versus more years of experience (P = 0.5). The non-diagnostic rates of biopsies with FP (8 %), POC cytology (25 %), or neither (24 %) were significantly different (P < 0.0001). Lymphoma is the malignant diagnosis most likely to result in a non-diagnostic biopsy. If the clinical and radiologic suspicion for malignancy is high, repeat biopsy is warranted. If the clinical context suggests a

  8. Midazolam sedation for percutaneous liver biopsy.

    Science.gov (United States)

    Alexander, J A; Smith, B J

    1993-12-01

    Control of patient respiration is needed to safely perform percutaneous liver biopsy (PLB) and may be adversely affected by sedation. The purpose of this study was to evaluate the safety of PLB with intravenous midazolam and to evaluate patient acceptance of PLB with and without sedation. Two hundred seventeen consecutive patients underwent 301 percutaneous liver biopsies. One hundred fifty-one of the biopsies were done after the patients were sedated with intravenous midazolam immediately before the biopsy. The last 61 patients were questioned after the biopsy to evaluate the discomfort of the procedure, their memory of the procedure, and their willingness to undergo another PLB. The major complication rate was similar in the midazolam-treated (0.7%) and untreated (0.7%) groups. The midazolam-treated patients had a numerically lower mean pain score (1.5 +/- 0.4 vs 4.0 +/- 0.7) (mean +/- SEM) (P = 0.07) and significantly lower mean memory score (4.8 +/- 0.7 vs 9.9 +/- 0.1) (P < 0.01) than the untreated patients. The treated and untreated groups had similar mean willingness for repeat PLB scores (9.3 +/- 0.3 vs 9.1 +/- 0.6). We conclude that: (1) there is no increased risk of PLB with midazolam and (2) patients have less memory of the procedure with midazolam.

  9. Punch Biopsy Results of Nasopharynx Pathologies

    Directory of Open Access Journals (Sweden)

    İsa Özbay

    2016-03-01

    Full Text Available Objective: Although nasopharynx (NF has an anatomi­cally distant sites to view, biopsy can be taken easily from NF by the help of an endoscope in order to reach a defini­tive diagnosis. In this study, NF pathology results in the patient group were analyzed retrospectively. Methods: NF biopsy results of 80 patients who were ad­mitted to Ear, Nose and Throat (ENT clinic of Dumlupınar University Evliya Celebi Education and Research Hospital between September 2012-February 2016 were included in the study, retrospectively. NF has been viewed to rule out NF cancer under general or local anesthesia by rigid or flexible endoscopes and punch biopsies were taken. Results: NF patients who underwent biopsy were com­posed of 25 (31.2% females and 55 (68.8% males and the average age was 35.33. Histopathological results in 3 patients (3.7% were malignant. The pathology (96.3% were identified as chronic lymphoid hyperplasia and lym­phoid processes in the remaining 77 patients. 4 patients underwent repeat biopsy follow-on clinical suspicion of malignancy, but ultimately malignancy was not observed. Conclusion: NF biopsy is a method which is easily ap­plied in the examination of the cancer and other masses of NF. In this study, age, sex, clinical and histopathologic analysis of the patients who underwent NF biopsies were discussed in the light of the literature. J Clin Exp Invest 2016; 7 (1: 83-86

  10. Computational optical biopsy

    Directory of Open Access Journals (Sweden)

    Jiang Ming

    2005-06-01

    Full Text Available Abstract Optical molecular imaging is based on fluorescence or bioluminescence, and hindered by photon scattering in the tissue, especially in patient studies. Here we propose a computational optical biopsy (COB approach to localize and quantify a light source deep inside a subject. In contrast to existing optical biopsy techniques, our scheme is to collect optical signals directly from a region of interest along one or multiple biopsy paths in a subject, and then compute features of an underlying light source distribution. In this paper, we formulate this inverse problem in the framework of diffusion approximation, demonstrate the solution uniqueness properties in two representative configurations, and obtain analytic solutions for reconstruction of both optical properties and source parameters.

  11. Breast Biopsy System

    Science.gov (United States)

    1994-01-01

    Charge Coupled Devices (CCDs) are high technology silicon chips that connect light directly into electronic or digital images, which can be manipulated or enhanced by computers. When Goddard Space Flight Center (GSFC) scientists realized that existing CCD technology could not meet scientific requirements for the Hubble Space Telescope Imagining Spectrograph, GSFC contracted with Scientific Imaging Technologies, Inc. (SITe) to develop an advanced CCD. SITe then applied many of the NASA-driven enhancements to the manufacture of CCDs for digital mammography. The resulting device images breast tissue more clearly and efficiently. The LORAD Stereo Guide Breast Biopsy system incorporates SITe's CCD as part of a digital camera system that is replacing surgical biopsy in many cases. Known as stereotactic needle biopsy, it is performed under local anesthesia with a needle and saves women time, pain, scarring, radiation exposure and money.

  12. PERCUTANEOUS PLEURAL BIOPSY

    Directory of Open Access Journals (Sweden)

    M. Bahadori

    1966-01-01

    Full Text Available I have carried out 22 biopsies in 20 Patients, in fifteen I used a Vim _ Silverman Needle, and in the remainder a curetting type Needle, In 12 cases (60% the diagnosis that was made; in 3 cases, inadequate tissue, was obtained; in two cases a fibromuscular tissue, in one case a fatty tissue and in one case the specimen was of hepatic tissue. Even with the small biopsy specimen obtained with the Needle it is easy to recognize malignant tissue if present.

  13. Transjugular liver biopsy.

    Science.gov (United States)

    Ble, Michel; Procopet, Bogdan; Miquel, Rosa; Hernandez-Gea, Virginia; García-Pagán, Juan Carlos

    2014-11-01

    Liver biopsy is still the gold standard for evaluation of acute and chronic liver diseases, despite achievements regarding noninvasive diagnosis and staging in liver diseases. Transjugular liver biopsy (TJLB) has proved a good option when ascites and/or significant coagulopathy precludes a percutaneous approach. Because diagnostic hemodynamic procedures can be performed during the same session, it is useful in many clinical settings, regardless of the absence of percuteaneous contraindications. TJLB is a safe technique able to provide good-quality specimens with a low rate of complications. This article presents an overview of TJLB that discusses the technique, applicability, indications, contraindications, complications, and diagnostic accuracy.

  14. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI-guided prostate biopsy uses imaging ... Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI-guided prostate biopsies are performed ...

  15. Is liver biopsy mandatory in children with chronic hepatitis C?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Liver biopsy is considered the most accurate means to estimate the necroinflammatory activity and the extent of fibrosis. However, histology evaluation is an invasive procedure associated with risk to the patient, risk of sampling error and diagnostic inconsistencies due to inter- and intra-observer error. On the basis of histological studies performed so far, chronic hepatitis C in children appears morphologically benign in the majority of cases.At the Pediatric Liver Unit of our university, a total of 67 children with chronic hep, atitis C underwent liver biopsy.Liver biopsy was repeated 5.5 years after the initial histological evaluation in 21 children. On a total number of 88 liver biopsies, micronodular cirrhosis was detected only in one genotype 1b-infected obese child. Since liver histology investigation of a child with chronic hepatitis C has few chances to highlight severe lesions, we question how liver biopsy helps in the management of children with chronic hepatitis C.

  16. Percutaneous renal tumour biopsy.

    Science.gov (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo

    2014-09-01

    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  17. 肾组织活检在移植肾功能损害的诊断与鉴别诊断中的价值%The value of biopsy in diagnosis and differentiate diagnosis of human renal allo graft impairment

    Institute of Scientific and Technical Information of China (English)

    陈惠萍; 曾彩虹; 季曙明; 尹广; 陈劲松; 朱茂艳; 黎磊石

    2001-01-01

    目的探讨移植肾组织活检在移植肾功能损害的诊断与鉴别诊断中的价值。方法对158例移植肾组织活检资料进行回顾分析。结果 158例中以急性排斥反应多见,共55例(34.8 ? %),移植肾改变35例(22.2? % ),临界改变32例(20.2? %),慢性排斥反应13例(8.3 ? %),系膜增生性病变1 3例(8.3? %),急性肾小管坏死6例(3.8 %),新月体性肾炎、溶血性尿毒综合征和毛细血管内增生性肾炎各1例(0.6 %);血中环孢素A的浓度与急性排斥反应的发生率无明确正相关关系;临床诊断与肾组织活检结果尚存在一些差异。结论肾组织活检对明确诊断及提高临床诊断的正确率及选择治疗方案有重要价值。%Objective  To investigate the relation between clinical diagnosis and histologic lesion in renal allograft patients who received graft biopsies. Method 158 cases undergoing renal allograft biopsies fro m June 1996 to Dec. 1998 were analyzed retrospectively. Results Among the 158 cases, acute rejection occurred in 5 5 cases (34.8 %), renal allograft change in 35 cases (22.2 %), borderl ine lesion in 32 cases (20.2 %), chronic rejection in 13 cases (8.3 % ), mesangial proliferative lesion in 13 cases (8.3 %), acute tubular necros is in 6 cases (3.8 %), glomerular crescents formation in 1 case (0.6? %), HUS in 1 case (0.6 %), endocappillary proliferative lesion in 1 case ( 0.6 %). The level of CsA in plasma had no relation with the occurrence of a cute rejection. The difference between clinical and histological diagnosis were encountered in some patients. Conclusions The renal biops y might be essential for establishing the correct diagnosis of renal allograft d y sfunction and so selecting the appropriate management.

  18. Suction-modified needle biopsy technique for the human soleus muscle.

    Science.gov (United States)

    Cotter, Joshua A; Yu, Alvin; Kreitenberg, Arthur; Haddad, Fadia H; Baker, Michael J; Fox, John C; Adams, Gregory R

    2013-10-01

    The needle biopsy technique for the soleus muscle is of particular interest because of the muscle's unique fiber type distribution, contractile properties, and sensitivity to unloading. Unlike other commonly biopsied muscles, the soleus is not fully superficial and is in close proximity to neurovascular structures, resulting in a more challenging biopsy. Because of this, a standardized protocol for performing needle biopsies on the human soleus muscle that is safe, reliable, and repeatable is presented. Ultrasonography was used on an initial set of 12 subjects to determine the optimal biopsy zone, thereby guiding the location of the incision site. There were 45 subjects recruited who attended 2 separate biopsy sessions. Each biopsy session incorporated 3 passes of the biopsy needle proximal, posterior, and distal using suction from a portable vacuum source producing 3 separate muscle specimens. There were 84 soleus muscle biopsy procedures which were successfully conducted yielding 252 total samples without complication. Ultrasonography was used to confirm biopsy needle infiltration of the soleus muscle. Average sample weight obtained per pass was 61.5 +/- 15.7 mg. Histochemistry and molecular analyses demonstrated a considerably higher amount of slow type I MHC in comparison to the vastus lateralis, providing verification for the successful sampling of the soleus muscle. The procedure presented consists of a detailed protocol to accurately and consistently obtain muscle biopsy samples from the human soleus muscle. We have demonstrated that the human soleus biopsy is a safe, reliable, and repeatable procedure providing ample tissue for multiple types of analyses.

  19. Bone Marrow Aspiration and Biopsy

    Science.gov (United States)

    ... Advertising & Sponsorship: Policy | Opportunities Bone Marrow Aspiration and Biopsy Share this page: Was this page helpful? Also ... Examination Formal name: Bone Marrow Aspiration; Bone Marrow Biopsy Related tests: Complete Blood Count ; WBC Differential ; Reticulocyte ...

  20. No need for biopsies

    DEFF Research Database (Denmark)

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

    2011-01-01

    The aim of the study was to compare three sampling techniques used in routine diagnostics to identify the microbiota in chronic venous leg ulcers. A total of 46 patients with persisting venous leg ulcers were included in the study. At inclusion, swab, biopsy and filter paper pad samples were...... collected. After 4 weeks, additional biopsy and filter paper pad samples were collected. Bacteria were isolated and identified at species level by standard methods. The most common bacterial species detected was Staphylococcus aureus found in 89% of the ulcers. No methicillin-resistant S. aureus isolates...... were found. We did not find any significant differences regarding the bacterial species isolated between the three sampling techniques. However, using multiple techniques led to identification of more species. Our study suggests that it is sufficient to use swab specimens to identify the bacterial...

  1. Deployment Repeatability

    Science.gov (United States)

    2016-04-01

    controlled to great precision, but in a Cubesat , there may be no attitude determination at all. Such a Cubesat might treat sun angle and tumbling rates as...could be sensitive to small differences in motor controller timing. In these cases, the analyst might choose to model the entire deployment path, with...knowledge of the material damage model or motor controller timing precision. On the other hand, if many repeated and environmentally representative

  2. Complications in Transbronchial Lung Biopsy

    OpenAIRE

    Hue, Sung Ho

    1987-01-01

    Transbronchial lung biopsy was performed in 68 patients with various lung diseases. As an inital diagnostic procedure in diffuse and localized lung diseases, trasbronchial lung biopsy offers an attractive alternative to open lung biopsy. Recently imporvement in the development of medical technology has greatly facilitated this technique, but it must be kept in mind that a transbronchial lung biopsy is not without complication and sometimes potentially serious complications may occur. This stu...

  3. Muscle biopsies off-set normal cellular signaling in surrounding musculature

    DEFF Research Database (Denmark)

    Krag, Thomas O; Hauerslev, Simon; Dahlqvist, Julia R

    2013-01-01

    muscle tissue for at least 3 weeks after the biopsy was performed and magnetic resonance imaging suggests that an effect of a biopsy may persist for at least 5 months. Cellular signaling after a biopsy resembles what is seen in severe limb-girdle muscular dystrophy type 2I with respect to protein......Studies of muscle physiology and muscular disorders often require muscle biopsies to answer questions about muscle biology. In this context, we have often wondered if muscle biopsies, especially if performed repeatedly, would affect interpretation of muscle morphology and cellular signaling. We...... hypothesized that muscle morphology and cellular signaling involved in myogenesis/regeneration and protein turnover can be changed by a previous muscle biopsy in close proximity to the area under investigation. Here we report a case where a past biopsy or biopsies affect cellular signaling of the surrounding...

  4. Immunoglobulin deposits in peripheral nerve endings detected by skin biopsy in patients with IgM M proteins and neuropathy

    DEFF Research Database (Denmark)

    Jønsson, V; Jensen, T S; Friis, M L;

    1987-01-01

    biopsies provide a simple effective method of detecting immunoglobulin binding to peripheral nerves in patients suspected of having an autoimmune neuropathy. In contrast to sural nerve biopsy, skin biopsy does not cause sensory loss or pain in a denervated area and can easily be repeated....

  5. Optimization of Prostate Biopsy: the Role of Magnetic Resonance Imaging Targeted Biopsy in Detection, Localization and Risk Assessment

    Science.gov (United States)

    Bjurlin, Marc A.; Meng, Xiaosong; Le Nobin, Julien; Wysock, James S.; Lepor, Herbert; Rosenkrantz, Andrew B.; Taneja, Samir S.

    2014-01-01

    Purpose Optimization of prostate biopsy requires addressing the shortcomings of standard systematic transrectal ultrasound guided biopsy, including false-negative rates, incorrect risk stratification, detection of clinically insignificant disease and the need for repeat biopsy. Magnetic resonance imaging is an evolving noninvasive imaging modality that increases the accurate localization of prostate cancer at the time of biopsy, and thereby enhances clinical risk assessment and improves the ability to appropriately counsel patients regarding therapy. In this review we 1) summarize the various sequences that comprise a prostate multiparametric magnetic resonance imaging examination along with its performance characteristics in cancer detection, localization and reporting standards; 2) evaluate potential applications of magnetic resonance imaging targeting in prostate biopsy among men with no previous biopsy, a negative previous biopsy and those with low stage cancer; and 3) describe the techniques of magnetic resonance imaging targeted biopsy and comparative study outcomes. Materials and Methods A bibliographic search covering the period up to October 2013 was conducted using MEDLINE®/PubMed®. Articles were reviewed and categorized based on which of the 3 objectives of this review was addressed. Data were extracted, analyzed and summarized. Results Multiparametric magnetic resonance imaging consists of anatomical T2-weighted imaging coupled with at least 2 functional imaging techniques. It has demonstrated improved prostate cancer detection sensitivity up to 80% in the peripheral zone and 81% in the transition zone. A prostate cancer magnetic resonance imaging suspicion score has been developed, and is depicted using the Likert or PI-RADS (Prostate Imaging Reporting and Data System) scale for better standardization of magnetic resonance imaging interpretation and reporting. Among men with no previous biopsy, magnetic resonance imaging increases the frequency of

  6. Ultrasound-guided renal biopsy with automated biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Pil Yeob; Kwon, Jae Soo [Masan Samsung Hospital, Masan (Korea, Republic of)

    1998-01-01

    To elevate the diagnostic yield and complications of percutaneous ultrasound-guided renal biopsy using a biopsy gun in patients with diffuse renal disease. Using an automated biopsy gun mounted with a 16 G needle, biopsies were performed on 90 patients with diffuse renal disease. In a total of 95 biopsies, diagnostic yield, the mean number of glomeruli and frequency of complication were retrospectively analysed. Tissue adequate for histological diagnosis was obtained in 92 % of procedures. Mean glomerular yield was 8.3, and complications were seen in 26% of the procedures, 25 % of these were minor, and 1% were major. For the diagnosis of diffuse renal disease, ultrasound-guided percutaneous renal biopsy using an automated biopsy gun is accurate and safe. (author). 25 refs., 1 tab.

  7. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  8. Value of Targeted Prostate Biopsy Using Magnetic Resonance–Ultrasound Fusion in Men with Prior Negative Biopsy and Elevated Prostate-specific Antigen

    Science.gov (United States)

    Sonn, Geoffrey A.; Chang, Edward; Natarajan, Shyam; Margolis, Daniel J.; Macairan, Malu; Lieu, Patricia; Huang, Jiaoti; Dorey, Frederick J.; Reiter, Robert E.; Marks, Leonard S.

    2013-01-01

    Background Conventional biopsy fails to detect the presence of some prostate cancers (PCas). Men with a prior negative biopsy but persistently elevated prostate-specific antigen (PSA) pose a diagnostic dilemma, as some harbor elusive cancer. Objective To determine whether use of magnetic resonance–ultrasound (MR-US) fusion biopsy results in improved detection of PCa compared to repeat conventional biopsy. Design, setting, and participants In a consecutive-case series, 105 subjects with prior negative biopsy and elevated PSA values underwent multiparametric magnetic resonance imaging (MRI) and fusion biopsy in an outpatient setting. Intervention Suspicious areas on multiparametric MRI were delineated and graded by a radiologist; MR–US fusion biopsy was performed by a urologist using the Artemis device; targeted and systematic biopsies were obtained regardless of MRI result. Outcome measurements and statistical analysis Detection rates of all PCa and clinically significant PCa (Gleason ≥3 + 4 or Gleason 6 with maximal cancer core length ≥4 mm) were determined. The yield of targeted biopsy was compared to systematic biopsy. The ability of an MRI grading system to predict clinically significant cancer was investigated. Stepwise multivariate logistic regression analysis was performed to determine predictors of significant cancer on biopsy. Results and limitations Fusion biopsy revealed PCa in 36 of 105 men (34%; 95% confidence interval [CI], 25–45). Seventy-two percent of men with PCa had clinically significant disease; 21 of 23 men (91%) with PCa on targeted biopsy had significant cancer compared to 15 of 28 (54%) with systematic biopsy. Degree of suspicion on MRI was the most powerful predictor of significant cancer on multivariate analysis. Twelve of 14 (86%) subjects with a highly suspicious MRI target were diagnosed with clinically significant cancer. Conclusions MR-US fusion biopsy provides improved detection of PCa in men with prior negative biopsies

  9. Different Methods for Prostate Biopsy and Biopsy Protocols

    Directory of Open Access Journals (Sweden)

    Mahyar Ghafoori

    2011-05-01

    Full Text Available Prostate carcinoma is one of the most common"nmalignancies among men. Increasing mortality rates due"nto prostate carcinoma have been observed worldwide."nThis disease usually progresses imperceptibly, for this"nreason; screening programs aimed at early detection"nhave been developed. The prostate specific antigen"n(PSA test is among the best screening tools available"nin medicine today because it is recognized as the best"nmarker for its early detection."nIn case of abnormal rise in PSA, the patient usually"nrefers for prostate biopsy under the guide of trans"nrectal ultrasonography (TRUS. Different methods are"nrecognized for prostate biopsy that may be divided"ninto two main categories namely, systematic biopsy"nand targeted biopsy."nIn systematic biopsy we divide the prostate gland"nrandomly to different sections and obtain biopsy"nspecimens from each section.The protocol of systematic biopsy is different among"ndifferent institutions. The number of biopsy specimens"ncould be started from less than 6 to more than 20"nbiopsies in some institutions. Increasing the number"nof biopsy specimens increases the detection rate for"nprostate cancer increasing the complications such"nas post biopsy prostatitis and septicemia, which are"nthe most important, as well. In scheduling a biopsy"nprotocol with high number of biopsies it is preferred"nto hospitalize the patient and prescribe intravenous"nantibiotics."nTargeted biopsy of the prostate means obtaining biopsy"nspecimens from a pathologic lesion that is suspicious"nfor prostate cancer. Different modalities could be"nused for detecting prostate cancer within the prostate"ngland. Transrectal ultrasonography, ultrasonography"nwith the use of ultrasound contrast agents, MRI of the"nprostate with the use of endorectal coil, dynamic MR"nstudy with contrast agent, diffusion weighted imaging"nof the prostate and MR spectroscopy all could help"nin the detection of a suspicious tumoral mass in the

  10. The accuracy of colposcopic biopsy

    DEFF Research Database (Denmark)

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

    2011-01-01

    We evaluated the overall agreement between colposcopically directed biopsies and the definitive excisional specimens within the context of three clinical trials. A total of 737 women aged 16-45 who had a cervical biopsy taken within 6 months before their definitive therapy were included. Per......-protocol, colposcopists were to also obtain a representative cervical biopsy immediately before definitive therapy. Using adjudicated histological diagnoses, the initial biopsies and the same day biopsies were correlated with the surgically excised specimens. The overall agreement between the biopsies taken within 6...... degree of variance in the correlation, the overall agreement was 92% for CIN2-3/AIS. The overall agreement between the same day biopsy and definitive therapy specimen was 56% (weighted kappa = 0.41) (95% CI: 0.36-0.47), and the underestimation of CIN2-3/AIS was 57%. There were significant associations...

  11. Beyond Diagnosis: Evolving Prostate Biopsy in the Era of Focal Therapy

    Directory of Open Access Journals (Sweden)

    J. L. Dominguez-Escrig

    2011-01-01

    Full Text Available Despite decades of use as the “gold standard” in the detection of prostate cancer, the optimal biopsy regimen is still not universally agreed upon. While important aspects such as the need for laterally placed biopsies and the importance of apical cancer are known, repeated studies have shown significant patients with cancer on subsequent biopsy when the original biopsy was negative and an ongoing suspicion of cancer remained. Attempts to maximise the effectiveness of repeat biopsies have given rise to the alternate approaches of saturation biopsy and the transperineal approach. Recent interest in focal treatment of prostate cancer has further highlighted the need for accurate detection of prostate cancer, and in response, the introduction of transperineal template-guided biopsy. While the saturation biopsy approach and the transperineal template approach increase the detection rate of cancer in men with a previous negative biopsy and appear to have acceptable morbidity, there is a lack of clinical trials evaluating the different biopsy strategies. This paper reviews the evolution of prostatic biopsy and current controversies.

  12. For Women Facing a Breast Biopsy

    Science.gov (United States)

    ... Cancer Breast Cancer Early Detection and Diagnosis Breast Biopsy When other tests show that you might have ... before getting a breast biopsy. Fine needle aspiration biopsy In a fine needle aspiration (FNA) biopsy , a ...

  13. Sepsis and 'superbugs': should we favour the transperineal over the transrectal approach for prostate biopsy?

    Science.gov (United States)

    Grummet, Jeremy P; Weerakoon, Mahesha; Huang, Sean; Lawrentschuk, Nathan; Frydenberg, Mark; Moon, Daniel A; O'Reilly, Mary; Murphy, Declan

    2014-09-01

    To determine the rate of hospital re-admission for sepsis after transperineal (TP) biopsy using both local data and worldwide literature, as there is growing interest in TP biopsy as an alternative to transrectal ultrasonography (TRUS)-guided biopsy for patients undergoing repeat prostate biopsy. Pooled prospective databases on TP biopsy from multiple centres in Melbourne were queried for rates of re-admission for infection. A literature review of PubMed and Embase was also conducted using the search terms: 'prostate biopsy, fever, infection, sepsis, septicaemia and complications'. In all, 245 TP biopsies were performed (111 at Alfred Health, 92 at Epworth Healthcare, 38 at Peter MacCallum Cancer Centre, and four at other institutions). The rate of hospital re-admission for infection was zero. The literature review showed that the rate of sepsis after TRUS biopsy appears to be rising with increasing rates of multi-resistant bacteria found in rectal flora, and is as high as 5%. However, the rate of sepsis from published series of TP biopsy approached zero. Both local and international data suggest a negligible rate of sepsis with TP biopsy. This compares to a concerning rise in the rate of sepsis after TRUS biopsy due to the increasing prevalence of multi-resistant bacteria in rectal flora. Although TRUS biopsy is convenient, cheap and quick to perform, we think that TP biopsy should now be offered as an option, not only to patients undergoing repeat prostate biopsy, but to all patients in whom a prostate biopsy is indicated. © 2013 The Authors. BJU International © 2013 BJU International.

  14. Percutaneous transbiliary biopsy.

    Science.gov (United States)

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

    2017-01-01

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

  15. Significant impact of transperineal template biopsy of the prostate at a single tertiary institution

    Directory of Open Access Journals (Sweden)

    Sean Huang

    2015-01-01

    Conclusions: Transperineal biopsy at our institution showed a high rate of disease-upgrading, with a large proportion involving anterior and transition zones. A significant amount of patients went on to receive curative treatment. TPB is a valuable diagnostic procedure with minimal risk of developing urosepsis. We believe TBP should be offered as an option for all repeat prostate biopsies and considered as an option for initial prostate biopsy.

  16. No change in complication rate using spring-loaded gun compared to traditional percutaneous renal allograft biopsy techniques.

    Science.gov (United States)

    Kovalik, E C; Schwab, S J; Gunnells, J C; Bowie, D; Smith, S R

    1996-06-01

    The previous methods to biopsy renal allografts at our institution involved the use of the Franklin-Silverman or Tru-Cut needles. Unfortunately they had a significant rate of post biopsy bleeding secondary to deep penetration when excess force was used to penetrate a tough transplant capsule. Although spring loaded biopsy devices have been widely used for native kidney biopsies over the past three years, the complication rate for renal allograft biopsies has not been sufficiently evaluated. We describe our experience using a disposable spring loaded biopsy device on transplanted renal grafts. Fifty-four biopsies were performed with the device, all under ultrasound guidance. The ASAP automatic biopsy system by Medi-tech was used comprising of a spring loaded gun with a 15 cm long 15 GA needle echogenic tip and 17 mm specimen notch. All patients were ultrasounded immediately post biopsy to look for hematomas. Compared to 55 previous biopsies performed using Tru-Cut needles, we conclude that the ASAP automated biopsy system proved equally effective in obtaining adequate tissue for diagnosis with fewer post-biopsy hematomas compared to traditional biopsy methods.

  17. Optimizing Performance and Interpretation of Prostate Biopsy : A Critical Analysis of the Literature

    NARCIS (Netherlands)

    Chun, Felix K. -H.; Epstein, Jonathan I.; Ficarra, Vincenzo; Freedland, Stephen J.; Montironi, Rodolfo; Montorsi, Francesco; Shariat, Shahrokh F.; Schroder, Fritz H.; Scattoni, Vincenzo

    2010-01-01

    Context: The number and location of biopsy cores and the interpretation of prostate biopsy in different clinical settings remain the subjects of continuing debate. Objective: Our aim was to review the current evidence regarding the performance and interpretation of initial, repeat, and saturation pr

  18. Optimizing Performance and Interpretation of Prostate Biopsy : A Critical Analysis of the Literature

    NARCIS (Netherlands)

    Chun, Felix K. -H.; Epstein, Jonathan I.; Ficarra, Vincenzo; Freedland, Stephen J.; Montironi, Rodolfo; Montorsi, Francesco; Shariat, Shahrokh F.; Schroder, Fritz H.; Scattoni, Vincenzo

    2010-01-01

    Context: The number and location of biopsy cores and the interpretation of prostate biopsy in different clinical settings remain the subjects of continuing debate. Objective: Our aim was to review the current evidence regarding the performance and interpretation of initial, repeat, and saturation pr

  19. Interpreting CD56+ and CD163+ infiltrates in early versus late renal transplant biopsies.

    Science.gov (United States)

    Shin, Sung; Kim, Young Hoon; Cho, Yong Mee; Park, Yangsoon; Han, Seungbong; Choi, Byung Hyun; Choi, Ji Yoon; Han, Duck Jong

    2015-01-01

    CD56+ and CD163+ cell infiltration in human kidney transplant biopsies have not been fully evaluated. We investigated the association of CD56+ and CD163+ cell infiltration with human kidney transplant biopsies with antibody- or T-cell-mediated rejection (TCMR) and other histologic lesions. One hundred and seventy four clinically indicated transplant biopsies were included in this analysis. Immunohistochemical staining for C4d, CD56 and CD163 was performed. One hundred and seventy four indication biopsies were divided into early (≤1 year posttransplant; n = 49) and late (>1 year posttransplant; n = 125) biopsies. High numbers of CD56+ cells were uncommon in early biopsies except for those with antibody-mediated rejection (AMR) only. On the other hand, high numbers of CD56+ cells were observed in late biopsies diagnosed as TCMR only, AMR only, and TCMR combined with AMR. In early biopsies, both CD56+ and CD163+ infiltrates correlated strongly with interstitial inflammation, tubulitis, and peritubular capillaritis (ptc) scores. The ci and ct scores, however, were correlated only with the number of CD56+ cells. In late biopsies, on the other hand, the number of CD56+ infiltrates was correlated only with ptc, while the number of CD163+ infiltrates was weakly correlated with any histologic lesion. Multivariable analyses showed that chronic active AMR and the number of CD56+ cells/10 HPF were independently associated with death-censored graft failure post-biopsy. The number of CD163+ cells was not correlated with any pathologic lesion and post-biopsy graft failure. CD56+ infiltrates were also associated with interstitial fibrosis and tubular atrophy. Intragraft CD56+ cell infiltrates were significantly associated with AMR and subsequent poor clinical outcomes. © 2015 S. Karger AG, Basel.

  20. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2013-01-01

    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  1. Histological Value of Duodenal Biopsies

    Directory of Open Access Journals (Sweden)

    Limci Gupta

    2005-01-01

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

  2. Morbidity after percutaneous liver biopsy.

    OpenAIRE

    Lichtman, S; Guzman, C; Moore, D.; Weber, J L; Roberts, E.A.

    1987-01-01

    The safety of percutaneous liver biopsy with a 1.2 mm Menghini needle in infants aged one year or less was investigated. One hundred and eighty four procedures performed from 1975 to 1985 were reviewed. There were no deaths or major complications within 48 hours associated with the procedure. In five instances specific complications occurred: a drop in haemoglobin concentration (three), transient hypotension (one), and haematoma at the biopsy site (one). The result of liver biopsy was diagnos...

  3. Polypeptide Grafted Hyaluronan: Synthesis and Characterization

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaojun [ORNL; Messman, Jamie M [ORNL; Mays, Jimmy [ORNL; Baskaran, Durairaj [University of Tennessee, Knoxville (UTK)

    2010-01-01

    Poly(L-leucine) grafted hyaluronan (HA-g-PLeu) has been synthesized via a Michael addition reaction between primary amine terminated poly(L-leucine) and acrylate-functionalized HA (TBAHA-acrylate). The precursor hyaluronan was first functionalized with acrylate groups by reaction with acryloyl chloride in the presence of triethylamine in N,N-dimethylformamide. 1H NMR analysis of the resulting product indicated that an increase in the concentration of acryloylchoride with respect to hydroxyl groups on HA has only a moderate effect on functionalization efficiency, f. A precise control of stoichiometry was not achieved, which could be attributed to partial solubility of intermolecular aggregates and the hygroscopic nature of HA. Michael addition at high [PLeu- NH2]/[acrylate]TBAHA ratios gave a molar grafting ratio of only 0.20 with respect to the repeat unit of HA, indicating grafting limitation due to insolubility of the grafted HA-g-PLeu. Soluble HA-g-PLeu graft copolymers were obtained for low grafting ratios (<0.039) with <8.6% by mass of PLeu and were characterized thoroughly using light scattering, 1H NMR, FT-IR, and AFM techniques. Light scattering experiments showed a strong hydrophobic interaction between PLeu chains, resulting in aggregates with segregated nongrafted HA segments. This yields local networks of aggregates, as demonstrated by atomic force microscopy. Circular dichroism spectroscopy showed a -sheet conformation for aggregates of poly(L-leucine).

  4. Olecranon bone graft: revisited.

    Science.gov (United States)

    Mersa, Berkan; Ozcelik, Ismail Bulent; Kabakas, Fatih; Sacak, Bulent; Aydin, Atakan

    2010-09-01

    Autogenous bone grafts are frequently in use in the field of reconstructive upper extremity surgery. Cancellous bone grafts are applied to traumatic osseous defects, nonunions, defects after the resection of benign bone tumors, arthrodesis, and osteotomy procedures. Cancellous bone grafts do not only have benefits such as rapid revascularization, but they also have mechanical advantages. Despite the proximity to the primary surgical field, cancellous olecranon grafts have not gained the popularity they deserve in the field of reconstructive hand surgery. In this study, the properties, advantages, and technical details of harvesting cancellous olecranon grafts are discussed.

  5. Ultrasound-guided chest biopsies.

    Science.gov (United States)

    Middleton, William D; Teefey, Sharlene A; Dahiya, Nirvikar

    2006-12-01

    Pulmonary nodules that are surrounded by aerated lung cannot be visualized with sonography. Therefore, percutaneous biopsy must be guided with computed tomography or fluoroscopy. Although this restriction only applies to central lung nodules, it has permeated referral patterns for other thoracic lesions and has retarded the growth of ultrasound-guided interventions. Nevertheless, sonography is an extremely flexible modality that can expeditiously guide many biopsy procedures in the thorax. Peripheral pulmonary nodules can be successfully biopsied with success rates exceeding 90% and complications rates of less than 5%. Orienting the probe parallel to the intercostal space facilitates biopsies of peripheral pulmonary nodules. Anterior mediastinal masses that extend to the parasternal region are often easily approachable provided the internal mammary vessels, costal cartilage, and deep great vessels are identified and avoided. Superior mediastinal masses can be sampled from a suprasternal or supraclavicular approach. Phased array probes or tightly curved arrays may provide improved access for biopsies in this location. Posterior mediastinal masses are more difficult to biopsy with ultrasound guidance because of the overlying paraspinal muscles. However, when posterior mediastinal masses extend into the posterior medial pleural region, they can be biopsied with ultrasound guidance. Because many lung cancers metastasize to the supraclavicular nodes, it is important to evaluate the supraclavicular region when determining the best approach to obtain a tissue diagnosis. When abnormal supraclavicular nodes are present, they often are the easiest and safest lesions to biopsy.

  6. Delayed hemorrhage from hepatic artery after ultrasound-guided percutaneous liver biopsy: A case report

    Institute of Scientific and Technical Information of China (English)

    Fen-Yu Ren; Xi-Xu Piao; Ailian Jin

    2006-01-01

    Percutaneous liver biopsy is considered one of the most important diagnostic tools to evaluate diffuse liver diseases. Pseudoaneurysm of hepatic artery is an unusual complication after ultrasound-guided percutaneous liver biopsy. Delayed hemorrhage occurs much less frequently. We report a case of pseudoaneurysm of the hepatic artery of a 46-year-old man who was admitted for abdominal pain after 4 d of liver biopsy. The bleeding was controlled initially by angiographic embolization.However, recurrent bleeding could not be controlled by repeat angiography, and the patient died 4 d after admission from multiorgan failure. The admittedly rare possibility of delayed hemorrhage should be considered whenever a liver biopsy is performed.

  7. Tectonic corneal graft for conjunctival rhinosporidiosis with scleral melt

    Directory of Open Access Journals (Sweden)

    Pushpa Jacob

    2011-01-01

    Full Text Available A 16 year old girl presented with irritation and watering of the right eye for 3 months. On examination, the superior perilimbal sclera was ectatic with incarcerated uveal tissue covered by conjunctiva. The conjunctiva showed discreet, yellow white mucoid spots. Excision biopsy of the conjunctiva showed subepithelial spherules of sporangia containing numerous endospores, suggestive of rhinosporidiosis. Diathermy was applied to flatten the staphyloma. The ectatic area was covered with a corneal patch graft. The patient was started on prednisolone acetate eye drops and oral dapsone for 6 months. Corneal graft was well incorporated and conjunctivalized by 3 months. Since the graft was not seen within the palpebral aperture, there was good cosmetic result. The corneal graft had the added advantage of transparency which allowed visualization of the underlying tissue to diagnose early recurrence. There was no recurrence at 6 months.

  8. Ultrastructural study of grafted autologous cultured human epithelium.

    Science.gov (United States)

    Aihara, M

    1989-01-01

    An electron microscopical study of grafted autologous cultured human epithelium is presented. Biopsy samples were collected from four patients with full thickness burns at 9 days, 6 weeks and 5-21 months after grafting of the cultured epithelium. By the sixth week after transplantation, grafted cultured epithelial sheets had developed to consist of 10 to 20 layers of cells and the epithelium showed distinct basal, spinous, granular and horny layers, and a patchy basement membrane had formed. Langerhans cells and melanocytes were identifiable. From 5 months onwards flat basal cells became oval, and oval keratohyalin granules in the keratinocytes also assumed a normal irregular shape. Membrane-coating granules in the keratinocytes increased in number. The fine structures of desmosomes also showed a normal mature appearance. Furthermore, complete extension of the basement membrane could be observed. The maturation of cultured human epithelium is complete by 5 months after grafting.

  9. COMPOUNDING PHARMACIES' POTENTIAL TO CREATE Graft Storage Solutions for Bypass Surgeries.

    Science.gov (United States)

    Guth, Michael A S

    2015-01-01

    Several studies have addressed the optimal storage conditions for vascular grafts during bypass surgery. These studies have repeatedly shown that placing vascular graft conduits in isotonic saline solutions, and to a lesser extent in heparinized autologous blood, leads to a profound decline in endothelial cell viability. Endothelial damage to vein grafts can occur at multiple points during a coronary artery bypass graft surgery procedure: graft harvesting, handling, flushing, storage, anastomosis, and arterialization (e.g., damage caused by exposure to arterial blood pressure). This damage to endothelial cells causes the release of pro-inflammatory chemical signals that trigger thrombosis, intimal hyperplasia, and accelerated graft atherosclerosis, all of which ultimately contribute to graft failure. Cardiothoracic surgeons performing coronary artery bypass graft surgery and vascular surgeons performing peripheral artery bypass graft surgery have attempted to overcome the damage to the vascular grafts by using buffers to maintain the physiological pH of the storage solution. However, the endothelial layers in the grafts would benefit from having proper oxygenation and antioxidants added to the storage solution. Compounding pharmacies can perform a vital role in ensuring the patency of the vascular grafts by creating compounded flushing and storage solutions that have an optimal mix of nitric oxide substrates, antioxidants, and other nutrients for the endothelium. Maintaining structural and functional viability of the endothelia in grafts by using an appropriate vessel storage medium would lead to improved long-term graft patency.

  10. LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS

    Directory of Open Access Journals (Sweden)

    E.S. Stolyarevich

    2014-01-01

    Full Text Available Rejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods. This is a retrospective study that analyzed 294 needle core biopsy specimens from 265 renal transplant recipients with late (48,8 ± 46,1 months after transplantation allograft dysfunction caused by late acute rejection (LAR, n = 193 or chronic rejection (CR, n = 78 or both (n = 23. C4d staining was performed by immunofl uorescence (IF on frozen sections using a standard protocol. Results. Peritubular capillary C4d deposition was identifi ed in 36% samples with acute rejection and in 62% cases of chronic rejection (including 67% cases of transplant glomerulopathy, and 50% – of isolated chronic vasculopathy. 5-year graft survival for LAR vs CR vs their combination was 47, 13 and 25%, respectively. The outcome of C4d– LAR was (p < 0,01 better than of C4d+ acute rejection: at 60 months graft survival for diffuse C4d+ vs C4d− was 33% vs 53%, respectively. In cases of chronic rejection C4d+ vs C4d– it was not statistically signifi cant (34% vs 36%. Conclusion. In long-term allograft biopsy C4d positivity is more haracteristic for chronic rejection than for acute rejection. Only diffuse C4d staining affects the outcome. C4d– positivity is associated with worse allograft survival in cases of late acute rejection, but not in cases of chronic rejection. 

  11. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI- ... Ultrasound-and MRI-guided Prostate Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI- ...

  12. Differential gene expression pattern in biopsies with renal allograft pyelonephritis and allograft rejection

    Science.gov (United States)

    Oghumu, Steve; Nori, Uday; Bracewell, Anna; Zhang, Jianying; Bott, Cherri; Nadasdy, Gyongyi M.; Brodsky, Sergey V.; Pelletier, Ronald; Satoskar, Abhay R.; Nadasdy, Tibor; Satoskar, Anjali A.

    2016-01-01

    Differentiating acute pyelonephritis (APN) from acute rejection (AR) in renal allograft biopsies can sometimes be difficult because of overlapping clinical and histologic features, lack of positive urine cultures, and variable response to antibiotics. We wanted to study differential gene expression between AR and APN using biopsy tissue. Thirty-three biopsies were analyzed using NanoString multiplex platform and PCR (6 transplant baseline biopsies, 8 AR, 15 APN [8 culture positive, 7 culture negative], and 4 native pyelonephritis [NP]). Additional 22 biopsies were tested by PCR to validate the results. CXCL9, CXCL10, CXCL11, and IDO1 were the top differentially expressed genes, upregulated in AR. Lactoferrin (LTF) and CXCL1 were higher in APN and NP. No statistically significant difference in transcript levels was seen between culture-positive and culture-negative APN biopsies. Comparing the overall mRNA signature using Ingenuity pathway analysis, interferon-gamma emerged as the dominant upstream regulator in AR and allograft APN, but not in NP (which clustered separately). Our study suggests that chemokine pathways in graft APN may differ from NP and in fact resemble AR, due to a component of alloreactivity, resulting in variable response to antibiotic treatment. Therefore, cautious addition of steroids might help in resistant cases of graft APN. PMID:27352120

  13. Differential gene expression pattern in biopsies with renal allograft pyelonephritis and allograft rejection.

    Science.gov (United States)

    Oghumu, Steve; Nori, Uday; Bracewell, Anna; Zhang, Jianying; Bott, Cherri; Nadasdy, Gyongyi M; Brodsky, Sergey V; Pelletier, Ronald; Satoskar, Abhay R; Nadasdy, Tibor; Satoskar, Anjali A

    2016-09-01

    Differentiating acute pyelonephritis (APN) from acute rejection (AR) in renal allograft biopsies can sometimes be difficult because of overlapping clinical and histologic features, lack of positive urine cultures,and variable response to antibiotics. We wanted to study differential gene expression between AR and APN using biopsy tissue. Thirty-three biopsies were analyzed using NanoString multiplex platform and PCR (6 transplant baseline biopsies, 8 AR, 15 APN [8 culture positive, 7 culture negative], and 4 native pyelonephritis [NP]). Additional 22 biopsies were tested by PCR to validate the results. CXCL9, CXCL10, CXCL11, and IDO1 were the top differentially expressed genes, upregulated in AR. Lactoferrin (LTF) and CXCL1 were higher in APN and NP. No statistically significant difference in transcript levels was seen between culture-positive and culture-negative APN biopsies. Comparing the overall mRNA signature using Ingenuity pathway analysis, interferon-gamma emerged as the dominant upstream regulator in AR and allograft APN, but not in NP (which clustered separately). Our study suggests that chemokine pathways in graft APN may differ from NP and in fact resemble AR, due to a component of alloreactivity, resulting in variable response to antibiotic treatment. Therefore, cautious addition of steroids might help in resistant cases of graft APN.

  14. Needle biopsy of skeletal muscle: a review of 10 years experience.

    Science.gov (United States)

    Edwards, R H; Round, J M; Jones, D A

    1983-01-01

    Over 1,000 needle biopsies have been carried out at University College Hospital in London. Needle biopsy has been used by us for histochemical and electron microscopic examination of muscle during the diagnosis and treatment of neuropathic and myopathic disorders, for the diagnosis of mitochondrial myopathies, to study the course of recovery in polymyositis, and for investigations into muscle changes in systemic lupus erythematosus (SLE) and other autoimmune conditions. We have developed a microprocessor system for the measurement of muscle fiber areas, and needle biopsy specimens provide suitable material for such measurements. We have also used needle biopsy specimens for studies of protein turnover using stable isotopes and for trace metal and electrolyte analyses. Needle biopsy is safe and rapid. As the patient usually experiences only minimal discomfort and there is no permanent scar, repeat biopsies are well tolerated allowing follow-up studies after treatment.

  15. Biopsy results of Bosniak 2F and 3 cystic lesions

    DEFF Research Database (Denmark)

    Rasmussen, René; Hørlyck, Arne; Nielsen, Tommy Kjærgaard

    Purpose: The distinction between benign and malignant complex cystic renal lesions remains a challenge. Bosniak 2F lesions are often followed with repeated CT for a minimum of five years, often entailing a high exposure to radiation. The aim of the present study was to evaluate whether biopsy could...... be helpful in clinical decisions. Material and Methods: From March 2013 - December 2014 a total of 295 percutaneous ultrasound guided biopsies from 287 patients with a suspected malignant renal lesion were performed at our institution. All cases were reviewed in PACS by (RR) and lesions presenting...... with a cystic change were re-evaluated and re-categorized after the Bosniak classification system. The re-evaluation and re-categorization was performed in consensus by a junior radiologist (RR) and an uro-radiological expert (OG). Results: Biopsies from eighteen Bosniak 2F cystic lesions were pathologically...

  16. Meniscal allograft transplantation. Part 1: systematic review of graft biology, graft shrinkage, graft extrusion, graft sizing, and graft fixation.

    Science.gov (United States)

    Samitier, Gonzalo; Alentorn-Geli, Eduard; Taylor, Dean C; Rill, Brian; Lock, Terrence; Moutzouros, Vasilius; Kolowich, Patricia

    2015-01-01

    To provide a systematic review of the literature regarding five topics in meniscal allograft transplantation: graft biology, shrinkage, extrusion, sizing, and fixation. A systematic literature search was conducted using the PubMed (MEDLINE), ScienceDirect, and EBSCO-CINAHL databases. Articles were classified only in one topic, but information contained could be reported into other topics. Information was classified according to type of study (animal, in vitro human, and in vivo human) and level of evidence (for in vivo human studies). Sixty-two studies were finally included: 30 biology, 3 graft shrinkage, 11 graft extrusion, 17 graft size, and 6 graft fixation (some studies were categorized in more than one topic). These studies corresponded to 22 animal studies, 22 in vitro human studies, and 23 in vivo human studies (7 level II, 10 level III, and 6 level IV). The principal conclusions were as follows: (a) Donor cells decrease after MAT and grafts are repopulated with host cells form synovium; (b) graft preservation alters collagen network (deep freezing) and causes cell apoptosis with loss of viable cells (cryopreservation); (c) graft shrinkage occurs mainly in lyophilized and gamma-irradiated grafts (less with cryopreservation); (d) graft extrusion is common but has no clinical/functional implications; (e) overall, MRI is not superior to plain radiograph for graft sizing; (f) graft width size matching is more important than length size matching; (g) height appears to be the most important factor influencing meniscal size; (h) bone fixation better restores contact mechanics than suture fixation, but there are no differences for pullout strength or functional results; and (i) suture fixation has more risk of graft extrusion compared to bone fixation. Systematic review of level II-IV studies, Level IV.

  17. Getting the Most Out of Liver Biopsy.

    Science.gov (United States)

    Lidbury, Jonathan A

    2017-05-01

    Histopathologic evaluation of liver biopsy specimens yields information that is not otherwise obtainable and is frequently essential for diagnosing hepatic disease. Percutaneous needle biopsy, laparoscopic biopsy, and surgical biopsy each have their own set of advantages and disadvantages. Care should be taken to ensure an adequate amount of tissue is collected for meaningful histologic evaluation. Because sampling error is a limitation of hepatic biopsy, multiple liver lobes should be biopsied. This article discusses the indications for liver biopsy, associated risks, advantages and disadvantages of different biopsy techniques, and strategies to get the most useful information possible out of this process. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Endoscopic duodenal biopsy in children

    Directory of Open Access Journals (Sweden)

    El Mouzan Mohammad

    2006-01-01

    Full Text Available Background: Biopsy of the small bowel is frequently obtained by endoscopic forceps instead of the classical suction capsule, yet reports from developing countries are scarce. Aim of the study: to report our experience on the diagnostic value of this procedure in our community. Patients and methods: A retrospective analysis of all endoscopic duodenal biopsies (EDB, performed on all patients below 18 years of age. Data retrieved from the records included age, gender, nationality, indication for biopsy, the endoscopic findings, and the results of histopathology. Results: From 1993 to 2002, 241 endoscopic biopsies were performed on 241 consecutive children. Most of the children (96% were Saudi nationals, the age range between six weeks to 18 years, and male to female ratio was 0.7: 1. All of the biopsy material was adequate for routine histopathology. The commonest indications for biopsy were short stature and chronic diarrhea in 116/241 (48% and 102/241 (43% of the children respectively. Refractory rickets accounted for 11/241 (5% of the indications. The prevalence of villous atrophy was highest in children presenting with chronic diarrhea (40%, compared to short stature (22%. Other less common, but important findings were villous atrophy in three unusual conditions (one refractory rickets, one unexplained anemia, and one polyendocrinopathy, two cases of intestinal Giardia lamblia infestation, three cases of intestinal lymphangiectasis and one case of Mycobacterium avium intracellulare. Unexpected endoscopic findings were documented in 34/241 (14% of the children. Conclusions: Endoscopic duodenal biopsy is adequate not only for the diagnosis of villous atrophy, but also for the detection of other gastroenteropathies. Accordingly, when expertise and equipments are available, EDB should be the procedure of choice not only in industrialized but also in developing countries.

  19. Raman-based detection of hydroxyethyl starch in kidney allograft biopsies as a potential marker of allograft quality in kidney transplant recipients

    Science.gov (United States)

    Vuiblet, Vincent; Fere, Michael; Bankole, Ezechiel; Wynckel, Alain; Gobinet, Cyril; Birembaut, Philippe; Piot, Olivier; Rieu, Philippe

    2016-09-01

    In brain-dead donor resuscitation, hydroxyethyl starch (HES) use has been associated with presence of osmotic-nephrosis-like lesions in kidney transplant recipients. Our aim was to determine whether the presence of HES in protocol renal graft biopsies at three months (M3) after transplantation is associated with renal graft quality. According to the HES administered to the donor during the procurement procedure, two groups of patients were defined according graft exposition to HES: HES group, (N = 20) and control group (N = 6). Detection and relative quantification of HES was performed by Raman spectroscopy microimaging on M3 protocol renal graft biopsies. Statistical analyses were used to investigate the association between Raman data and graft characteristics. HES spectral signal was revealed negative in the control group, whereas it was positive in 40% of biopsies from the HES group. In the HES group, a stronger HES signal was associated with a lower risk of graft failure measured by the Kidney Donor Risk Index (KDRI) and was correlated with the allograft kidney function. Thus, HES accumulation in donor kidney, as probed by Raman biophotonic technique, is correlated with the quality of donor kidney and consequently the graft renal function and graft survival.

  20. Acute graft versus host disease

    Directory of Open Access Journals (Sweden)

    Vogelsang Georgia B

    2007-09-01

    Full Text Available Abstract Acute graft-versus-host disease (GVHD occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen. About 35%–50% of hematopoietic stem cell transplant (HSCT recipients will develop acute GVHD. The exact risk is dependent on the stem cell source, age of the patient, conditioning, and GVHD prophylaxis used. Given the number of transplants performed, we can expect about 5500 patients/year to develop acute GVHD. Patients can have involvement of three organs: skin (rash/dermatitis, liver (hepatitis/jaundice, and gastrointestinal tract (abdominal pain/diarrhea. One or more organs may be involved. GVHD is a clinical diagnosis that may be supported with appropriate biopsies. The reason to pursue a tissue biopsy is to help differentiate from other diagnoses which may mimic GVHD, such as viral infection (hepatitis, colitis or drug reaction (causing skin rash. Acute GVHD is staged and graded (grade 0-IV by the number and extent of organ involvement. Patients with grade III/IV acute GVHD tend to have a poor outcome. Generally the patient is treated by optimizing their immunosuppression and adding methylprednisolone. About 50% of patients will have a solid response to methylprednisolone. If patients progress after 3 days or are not improved after 7 days, they will get salvage (second-line immunosuppressive therapy for which there is currently no standard-of-care. Well-organized clinical trials are imperative to better define second-line therapies for this disease. Additional management issues are attention to wound infections in skin GVHD and fluid/nutrition management in gastrointestinal GVHD. About 50% of patients with acute GVHD will eventually have manifestations of chronic GVHD.

  1. Successful endovascular treatment of a hemodialysis graft pseudoaneurysm by covered stent and direct percutaneous thrombin injection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2011-07-25

    Vascular access for hemodialysis remains a challenge for nephrologists, vascular surgeons, and interventional radiologists alike. Arteriovenous fistula and synthetic grafts remain the access of choice for long-term hemodialysis; however, they are subject to complications from infection and repeated needle cannulation. Pseudoaneurysms are an increasingly recognized adverse event. At present, there are many minimally invasive methods to repair these wall defects. We present a graft pseudoaneurysm, which required a combination of endovascular stent graft placement and percutaneous thrombin injection for successful occlusion.

  2. Protocol biopsies for renal transplantation

    Directory of Open Access Journals (Sweden)

    Rush David

    2010-01-01

    Full Text Available Protocol biopsies in renal transplantation are those that are procured at predetermined times post renal transplantation, regardless of renal function. These biopsies have been useful to study the natural history of the transplanted kidney as they have detected unexpected - i.e. "subclinical" pathology. The most significant subclinical pathologies that have been detected with protocol biopsies have been acute lesions, such as cellular and antibody mediated rejection, and chronic lesions, such as interstitial fibrosis and tubular atrophy, and transplant glomerulopathy. The potential benefit of early recognition of the above lesions is that their early treatment may result in improved long-term outcomes. Conversely, the identification of normal histology on a protocol biopsy, may inform us about the safety of reduction in overall immunosuppression. Our centre, as well as others, is attempting to develop non-invasive methods of immune monitoring of renal transplant patients. However, we believe that until such methods have been developed and validated, the protocol biopsy will remain an indispensable tool for the complete care of renal transplant patients.

  3. Sugar and acid interconversion in tomato fruits based on biopsy sampling of locule gel and pericarp tissue

    NARCIS (Netherlands)

    Schouten, R.E.; Woltering, E.J.; Tijskens, L.M.M.

    2016-01-01

    This study deals with quantifying sugar and acids levels important for the perceived taste of tomatoes (Solanum lycopersicum). Sugar and acids levels were measured repeatedly on the same tomato using tissue samples obtained with a biopsy needle in combination with HPLC protocols. Biopsies of

  4. Systematic ultrasound-guided saturation and template biopsy of the prostate: Indications and advantages of extended sampling

    NARCIS (Netherlands)

    Isbarn, H.; Briganti, B.; Visschere, P.J. De; Futterer, J.J.; Ghadjar, P.; Giannarini, G.; Ost, P.; Ploussard, G.; Sooriakumaran, P.; Surcel, C.; Oort, I.M. van; Yossepowitch, O.; Bergh, R. van den

    2015-01-01

    OBJECTIVES: Prostate biopsy (PB) is the gold standard for the diagnosis of prostate cancer (PCa). However, the optimal number of biopsy cores remains debatable. We sought to compare contemporary standard (10-12 cores) vs. saturation (=18 cores) schemes on initial as well as repeat PB. METHODS: A non

  5. Systematic ultrasound-guided saturation and template biopsy of the prostate: Indications and advantages of extended sampling

    NARCIS (Netherlands)

    Isbarn, H.; Briganti, B.; Visschere, P.J. De; Futterer, J.J.; Ghadjar, P.; Giannarini, G.; Ost, P.; Ploussard, G.; Sooriakumaran, P.; Surcel, C.; Oort, I.M. van; Yossepowitch, O.; Bergh, R. van den

    2015-01-01

    OBJECTIVES: Prostate biopsy (PB) is the gold standard for the diagnosis of prostate cancer (PCa). However, the optimal number of biopsy cores remains debatable. We sought to compare contemporary standard (10-12 cores) vs. saturation (=18 cores) schemes on initial as well as repeat PB. METHODS: A

  6. Minimal change disease in graft versus host disease: a podocyte response to the graft?

    Science.gov (United States)

    Huskey, Janna; Rivard, Chris; Myint, Han; Lucia, Scott; Smith, Maxwell; Shimada, Michiko; Ishimoto, Takuji; Araya, Carlos; Garin, Eduardo H; Johnson, Richard J

    2013-12-01

    Nephrotic syndrome is a rare complication of hematopoietic cell transplantation. It has been suggested that nephrotic syndrome may represent a limited form of graft-versus-host disease although the pathological link between these two entities remains unclear. In this paper, we report a case of a 61-year-old female who underwent nonmyeloablative allogenic stem cell transplantation for T-cell prolymphocytic leukemia and subsequently developed biopsy proven minimal change disease shortly after cessation of her immunosuppression therapy. Urinary CD80 was markedly elevated during active disease and disappeared following corticosteroid-induced remission. We hypothesize that alloreactive donor T cells target the kidney and induce podocyte expression of CD80 that results in proteinuria from limited 'graft versus host' disease.

  7. Repeat-until-success quantum repeaters

    Science.gov (United States)

    Bruschi, David Edward; Barlow, Thomas M.; Razavi, Mohsen; Beige, Almut

    2014-09-01

    We propose a repeat-until-success protocol to improve the performance of probabilistic quantum repeaters. Conventionally, these rely on passive static linear-optics elements and photodetectors to perform Bell-state measurements (BSMs) with a maximum success rate of 50%. This is a strong impediment for entanglement swapping between distant quantum memories. Every time a BSM fails, entanglement needs to be redistributed between the corresponding memories in the repeater link. The key ingredients of our scheme are repeatable BSMs. Under ideal conditions, these turn probabilistic quantum repeaters into deterministic ones. Under realistic conditions, our protocol too might fail. However, using additional threshold detectors now allows us to improve the entanglement generation rate by almost orders of magnitude, at a nominal distance of 1000 km, compared to schemes that rely on conventional BSMs. This improvement is sufficient to make the performance of our scheme comparable to the expected performance of some deterministic quantum repeaters.

  8. The use of a Perma-Flow graft for coronary artery bypass surgery.

    Science.gov (United States)

    Schmid, C; Weyand, M; Kerber, S; Breithardt, G; Scheld, H H

    1996-01-01

    We report on our first clinical use of a Perma-Flow graft for coronary artery bypass surgery (CABG). It may well be that repeated successful use of this graft will offer a chance for revascularization to patients who might otherwise have been denied for lack of appropriate vessels.

  9. Anterior cruciate ligament graft tensioning. Is the maximal sustained one-handed pull technique reproducible?

    LENUS (Irish Health Repository)

    O'Neill, Barry J

    2011-07-20

    Abstract Background Tensioning of anterior cruciate ligament (ACL) reconstruction grafts affects the clinical outcome of the procedure. As yet, no consensus has been reached regarding the optimum initial tension in an ACL graft. Most surgeons rely on the maximal sustained one-handed pull technique for graft tension. We aim to determine if this technique is reproducible from patient to patient. Findings We created a device to simulate ACL reconstruction surgery using Ilizarov components and porcine flexor tendons. Six experienced ACL reconstruction surgeons volunteered to tension porcine grafts using the device to see if they could produce a consistent tension. None of the surgeons involved were able to accurately reproduce graft tension over a series of repeat trials. Conclusions We conclude that the maximal sustained one-handed pull technique of ACL graft tensioning is not reproducible from trial to trial. We also conclude that the initial tension placed on an ACL graft varies from surgeon to surgeon.

  10. Anterior cruciate ligament graft tensioning. Is the maximal sustained one-handed pull technique reproducible?

    Directory of Open Access Journals (Sweden)

    Hirpara Kieran M

    2011-07-01

    Full Text Available Abstract Background Tensioning of anterior cruciate ligament (ACL reconstruction grafts affects the clinical outcome of the procedure. As yet, no consensus has been reached regarding the optimum initial tension in an ACL graft. Most surgeons rely on the maximal sustained one-handed pull technique for graft tension. We aim to determine if this technique is reproducible from patient to patient. Findings We created a device to simulate ACL reconstruction surgery using Ilizarov components and porcine flexor tendons. Six experienced ACL reconstruction surgeons volunteered to tension porcine grafts using the device to see if they could produce a consistent tension. None of the surgeons involved were able to accurately reproduce graft tension over a series of repeat trials. Conclusions We conclude that the maximal sustained one-handed pull technique of ACL graft tensioning is not reproducible from trial to trial. We also conclude that the initial tension placed on an ACL graft varies from surgeon to surgeon.

  11. Motorized fusion guided prostate biopsy: phantom study

    Science.gov (United States)

    Seifabadi, Reza; Xu, Sheng; Aalamifar, Fereshteh; Pinto, Peter; Wood, Bradford J.

    2017-03-01

    Purpose: Fusion of Magnetic Resonance Imaging (MRI) with intraoperative real-time Ultrasound (US) during prostate biopsy has significantly improved the sensitivity of transrectal ultrasound (TRUS) guided cancer detection. Currently, sweeping of the TRUS probe to build a 3D volume as part of the fusion process and the TRUS probe manipulation for needle guidance are both done manually. A motorized, joystick controlled, probe holder was custom fabricated that can potentially reduce inter-operator variability, provide standardization of needle placement, improve repeatability and uniformity of needle placement, which may have impacts upon the learning curve after clinical deployment of this emerging approach. Method: a 2DOF motorized probe holder was designed to provide translation and rotation of a triplane TRUS end firing probe for prostate biopsy. The probe holder was joystick controlled and can assist manipulation of the probe during needle insertion as well as in acquiring a smoother US 2D to 3D sweep in which the 3D US volume for fusion is built. A commercial MRI-US fusion platform was used. Three targets were specified on MR image of a commercial prostate phantom. After performing the registration, two operators performed targeting, once manually and once with the assistance of the motorized probe holder. They repeated these tasks 5 times resulting in a total of 30 targeting events. Time of completion and mechanical error i.e. distance of the target from the needle trajectory in the software user interface were measured. Repeatability in reaching a given target in a systematic and consistent way was measured using a scatter plot showing all targets in the US coordinate system. Pearson product-moment correlation coefficient (PPMCC) was used to demonstrate the probe steadiness during targeting. Results: the completion time was 25+/-17 sec, 25+/-24 sec, and 27+/-15 sec for free hand and 24+/-10 sec, 22.5+/-10 sec, and 37+/-10 sec for motorized insertion, for target

  12. Skin graft - slideshow

    Science.gov (United States)

    ... ency/presentations/100100.htm Skin graft - series—Normal anatomy To use the sharing features on this page, ... 2017 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason ...

  13. Imaging and pathology findings after an initial negative MRI-US fusion-guided and 12-core extended sextant prostate biopsy session

    Science.gov (United States)

    Hong, Cheng William; Walton-Diaz, Annerleim; Rais-Bahrami, Soroush; Hoang, Anthony N.; Türkbey, Barış; Stamatakis, Lambros; Xu, Sheng; Amalou, Hayet; Minhaj Siddiqui, M.; Nix, Jeffrey W.; Vourganti, Srinivas; Merino, Maria J.; Choyke, Peter L.; Wood, Bradford J.; Pinto, Peter A.

    2014-01-01

    PURPOSE A magnetic resonance imaging-ultrasonography (MRI-US) fusion-guided prostate biopsy increases detection rates compared to an extended sextant biopsy. The imaging characteristics and pathology outcomes of subsequent biopsies in patients with initially negative MRI-US fusion biopsies are described in this study. MATERIALS AND METHODS We reviewed 855 biopsy sessions of 751 patients (June 2007 to March 2013). The fusion biopsy consisted of two cores per lesion identified on multiparametric MRI (mpMRI) and a 12-core extended sextant transrectal US (TRUS) biopsy. Inclusion criteria were at least two fusion biopsy sessions, with a negative first biopsy and mpMRI before each. RESULTS The detection rate on the initial fusion biopsy was 55.3%; 336 patients had negative findings. Forty-one patients had follow-up fusion biopsies, but only 34 of these were preceded by a repeat mpMRI. The median interval between biopsies was 15 months. Fourteen patients (41%) were positive for cancer on the repeat MRI-US fusion biopsy. Age, prostate-specific antigen (PSA), prostate volume, PSA density, digital rectal exam findings, lesion diameter, and changes on imaging were comparable between patients with negative and positive rebiopsies. Of the patients with positive rebiopsies, 79% had a positive TRUS biopsy before referral (P = 0.004). Ten patients had Gleason 3+3 disease, three had 3+4 disease, and one had 4+4 disease. CONCLUSION In patients with a negative MRI-US fusion prostate biopsy and indications for repeat biopsy, the detection rate of the follow-up sessions was lower than the initial detection rate. Of the prostate cancers subsequently found, 93% were low grade (≤3+4). In this low risk group of patients, increasing the follow-up time interval should be considered in the appropriate clinical setting. PMID:24509182

  14. Biopsy techniques for intraocular tumors

    Directory of Open Access Journals (Sweden)

    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.

  15. Vacuum enhanced cutaneous biopsy instrument

    Science.gov (United States)

    Collins, Joseph

    2000-01-01

    A syringe-like disposable cutaneous biopsy instrument equipped with a tubular blade at its lower end, and designed so that a vacuum is created during use, said vacuum serving to retain undeformed a plug of tissue cut from a patient's skin.

  16. Spectrum of pediatric skin biopsies

    Directory of Open Access Journals (Sweden)

    Grace D′costa

    2007-01-01

    Full Text Available Background: Skin diseases are common in childhood and they are common reasons for pediatric visits to the hospital. In spite of this high occurrence, there are very few prospective studies addressing this issue. Aims: The present study was directed at determining the spectrum of dermato-pathological lesions encountered in a large general tertiary care hospital, over a two-year period. Materials and Methods: 107 cases formed the total sample studied, in a part prospective and part retrospective study. A detailed clinical history was recorded on a proforma prepared for the purpose and gross photographs were taken wherever possible. Results: Skin biopsies accounted for 7.29% of the total surgical pathology load, 55.44% of the total pediatric biopsies and 10.82% of the total number of skin biopsies. The age and sex distribution pattern revealed that the maximum number of biopsies (62.61% were of older children, with a male preponderance (57.94%. The anatomic distribution pattern indicated predominant involvement of the limbs (59.82%. The maximum numbers of cases were of infectious nature (24.29%; the most frequently encountered being borderline tuberculoid Hansen′s disease (8.4%. A positive correlation with the clinical diagnosis was obtained in 56.07% cases. Conclusions: Histopathology contributed to the diagnosis in a significant number of (82.23% cases, indicating its importance and utility.

  17. Biopsy techniques for intraocular tumors

    Science.gov (United States)

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-01-01

    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. PMID:27488148

  18. The Role of Biopsy in Pediatric Dermatopathology

    Directory of Open Access Journals (Sweden)

    Fatma Şule Afşa

    2011-09-01

    Full Text Available Background and Design: Pediatric dermatology is characterized by skin disorders which have frequencies different from those in adults. Skin biopsies are necessary for differential diagnosis and clinicopathologic correlation is very important. The aim of this study was to evaluate retrospectively the pediatric dermatology cases in whom biopsy was performed for differential diagnosis and to investigate the contribution of biopsy to diagnosis of skin disorders. Material and Methods: The cases from whom biopsy was taken in the pediatric dermatology clinic during a three-year period were evaluated retrospectively for pre-diagnoses, biopsy diagnoses, and success of biopsies.Results: Two hundred thirteen (1.7% skin biopsies had been taken from a total of 12420 patients. Henoch-Schönlein purpura, psoriasis, pityriasis lichenoides, pityriasis rosea, lichen planus, pityriasis rubra pilaris, erythema multiforme, atopic dermatitis, granuloma annulare, and pigmented purpuric dermatosis were the most frequent skin disorders diagnosed dermatopathologically. In a total of 120 (56.3% cases, the biopsy diagnosis was within the pre-diagnosis and a biopsy consistency was present. In 25 (11.7% cases, biopsy had no contribution to the differential diagnosis. An absolutely different diagnosis which was incompatible with the pre-diagnosis had been reported in 10 (4.6% cases. Conclusion: In pediatric dermatology, skin biopsy is very helpful for the differential diagnosis. An easy biopsy procedure for the patient, an effective designation of biopsy indication, a good dermatopathologic correlation and an experienced team of pediatric dermatopathology increase the success of skin biopsies.

  19. Retroperitoneoscopic renal biopsy in children

    Directory of Open Access Journals (Sweden)

    Carlos M. Jesus

    2007-08-01

    Full Text Available OBJECTIVE: We present our experience in a series of 17 consecutive pediatric patients submitted to retroperitoneal laparoscopic renal biopsy. MATERIALS AND METHODS: Retroperitoneal laparoscopic renal biopsy (LRB was performed in 5 boys and 12 girls. Mean age was 8.1 years and age range from 2 to 12. Two or three trocars were used to expose the inferior pole of the kidney, remove enough cortical parenchymal specimen and fulgurate the biopsy site. Assessment included surgical time, estimated blood loss, hospitalization period, analgesia requirements, complications and number of glomeruli present in the specimen. RESULTS: LRB was successfully performed in all 15 patients (88%. In two cases, LRB was not possible to be performed. One patient was converted to a transperitoneal laparoscopy due to tear in the peritoneum. The other patient had had previous abdominal surgery and, during retroperitoneal balloon dilation, the peritoneum was opened and the open biopsy was performed. A third patient had postoperatively a perirenal hematoma, which was solved spontaneously. Complication rate was 17.6% (3/17 cases. Mean operative time was 65 minutes, while mean estimated blood loss was 52 mL, mean hospital stay was 2.2 days and mean analgesic requirement was 100 mg of tramadol. The mean number of glomeruli present in the specimen was 60. CONCLUSION: Retroperitoneal laparoscopic renal biopsy in children is a simple, safe. Bleeding is still the most common complication. However, direct vision usually allows a safe control of this drawback. In our institution, laparoscopic approach is the chosen procedure in pediatric patients older than one - year - old.

  20. When to biopsy seminal vesicles.

    Science.gov (United States)

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

    2015-05-01

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

  1. Carotid artery grafting for restenosis after carotid endarterectomy.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Beloiartsev, D F; Burtseva, E A; Fedorov, E E

    2007-01-01

    The paper analyzes outcomes of 12 internal carotid artery (ICA) graftings for repeat stenosis after carotid endarterectomy (CEA) in 11 patients. In 6 cases restenosis occurred after eversion CEA, in 5 - after conventional patch CEA, and in 1 case - after ICA patch angioplasty for post-CEA restenosis. Critical restenosis >75% in reconstruction area was an indication for surgical intervention. There was 1 case of graft thrombosis in early postoperative period with hemispherical stroke and lethal outcome. Eight patients were examined in late postoperative period. Mean follow-up was 34?+/-?8.44 months (from 16 to 48 months). No cerebrovascular disturbances in operated ICA feeding area were detected. In 6 patients graft patency was good, while 2 smoking patients with diabetes mellitus and hyperlipidemia demonstrated repeat restenosis of proximal anastomosis >70%.

  2. 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....

  3. 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....

  4. The evolution of untreated borderline and subclinical rejections at first month kidney allograft biopsy in comparison with histological changes at 6 months protocol biopsies.

    Science.gov (United States)

    Masin-Spasovska, J; Spasovski, G; Dzikova, S; Petrusevska, G; Dimova, B; Lekovski, Lj; Popov, Z; Ivanovski, N; Polenakovic, M

    2005-08-01

    Our study sought to identify the possible implications of histological findings of borderline and subclinical rejections as well as histological markers of chronic allograft nephropathy (CAN) in protocol biopsies at 1 and 6 months after living-related kidney transplantation. Twenty-eight paired allograft biopsies were blindly reviewed using Banff '97 criteria, among which only 10.7% (6/56) showed no histopathological lesions. BR was found in 9/28 (32.1%) and 6/28 (21.4%), and SR in 3/28 (10.7%) and 10/28 (35.7%) of the patients, in the 1 and 6 month biopsies, respectively. The mean CAN score (sum of histological markers for chronicity) increased significantly at 6 months biopsy, 1.57 +/- 1.36 vs. 4.36 +/- 2.32 (p ), the high CI group had a mean CAN score of 2.36 +/- 1.15 at 1 month, which increased to 5.14 +/- 1.99 at 6 months biopsy (188.9%). The proportion of these changes in low CI group were also increased from 0.79 +/- 1.12 to 3.57 +/- 2.38 (451.9%). In conclusion, a protocol 1 month biopsy may uncover a high prevalence of BR or SR in stable allografts. The presence of an untreated BR or SR in biopsies with low chronicity index showed greater susceptibility to histological deterioration on the 6 month biopsy, associated with rapid impairment of graft function and chronic allograft nephropathy.

  5. The use of a short-acting benzodiazepine to reduce the risk of syncopal episodes during upright stereotactic breast biopsy

    Energy Technology Data Exchange (ETDEWEB)

    James, J.J. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom)]. E-mail: jjames3@ncht.trent.nhs.uk; Wilson, A.R.M. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom); Evans, A.J. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom); Burrell, H. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom); Cornford, E.J. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom); Hamilton, L.J. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom)

    2005-03-01

    The use of sublingual lorazepam provides a safe and effective means of reducing the risk of syncopal episodes during upright stereotactic breast biopsy. Sublingual lorazepam, 2-4 mg, was received by 19 women undergoing a total of 20 stereotactic procedures. Of 14 women who had previously fainted during upright stereotactic biopsy, 13 had a successful repeat biopsy following administration of sublingual lorazepam. All 4 women who received lorazepam for significant anxiety had successful biopsies. Stereotactic guided wire localization also was performed in 2 cases.

  6. Do clinical diagnoses correlate with pathological diagnoses in cardiac transplant patients? The importance of endomyocardial biopsy

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric

    2009-01-01

    . Patient records were reviewed for preoperative clinical diagnoses and other relevant data, including pretransplant endomyocardial biopsy (EMB) results, information regarding left ventricular assist devices and, finally, evidence of disease recurrence in the grafted heart. RESULTS: A shift......, arrhythmogenic right ventricle dysplasia (100%), cardiac sarcoidosis (83%) and iron overload toxicity- associated cardiomyopathy (100%) had been misdiagnosed in pretransplantation investigations. Investigations before transplantation did not include an EMB. Of all 296 patients, 51 patients (17%) were...

  7. Perigraft seroma with minute observations after Gore-Tex graft implantation.

    Science.gov (United States)

    Ando, Takashi; Morito, Haruna; Okada, Hiroshi; Furukawa, Hiroshi

    2015-11-01

    Perigraft seroma is a very rare postoperative complication following abdominal aortic aneurysm repair. A 74-year-old man with history of esophageal cancer surgery, underwent Gore-Tex graft replacement for an abdominal aortic aneurysm. A 50-mm perigraft seroma was noted one year later, increasing to over 70 mm in the next 6 months. We resected the Gore-Tex graft and replaced it with a Dacron graft via a repeat laparotomy. We observed the resected Gore-Tex graft in detail using electron microscopy to investigate the mechanism of perigraft seroma. © The Author(s) 2014.

  8. Critical progressive small-graft injury caused by intrasinusoidal pressure elevation following living donor liver transplantation.

    Science.gov (United States)

    Sugimoto, H; Kaneko, T; Hirota, M; Nagasaka, T; Kobayashi, T; Inoue, S; Takeda, S; Kiuchi, T; Nakao, A

    2004-11-01

    In adult-to-adult living liver transplantation, small-for-size graft syndrome sometimes occurs. The relationship between the hemodynamic changes and histologic findings has not been studied in patients with failure of small-for-size grafts. We analyzed the relationship between the postoperative hemodynamic changes and pathologic findings in patients with small-for-size grafts that ended in graft failure. From March 1999 to December 2002, adult-to-adult living-donor liver transplantation with small-size grafts (graft volume/standard liver volume less than 40%) was performed in eight patients. Three patients died from graft failure caused by overperfusion, which was diagnosed from pathologic findings. We analyzed the relation between hepatic hemodynamic parameters, such as portal venous blood velocity or splenic arterial pulsatility index, and histologic changes in patients with graft failure. Severe portal hyperperfusion (90 cm/sec at the umbilical portion) was observed on postoperative day 1. Among patients with graft failure, critical hemodynamic changes, such as sudden onset of extremely deteriorated portal venous blood flow, occurred during the early postoperative period (postoperative day 5, 3, 6, respectively). Histologic examination revealed vacuolar changes in the cytoplasm of hepatocytes, and submassive necrosis indicated intrasinusoidal pressure elevation. These changes were not observed in the biopsy obtained soon after reperfusion. In conclusion, critically decreased vascular beds may cause intrasinusoidal pressure elevation and sinusoidal circulatory disturbances.

  9. Testing Biopsy and Cytology Specimens for Cancer

    Science.gov (United States)

    ... Your Diagnosis Exams and Tests for Cancer Testing Biopsy and Cytology Specimens for Cancer Waiting to hear ... who tell you whether the cells in your biopsy sample are cancer or not. How is cancer ...

  10. Melanoma Biopsy Results Can Differ, Worrying Patients

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166955.html Melanoma Biopsy Results Can Differ, Worrying Patients Doctor discovers ... her dermatologist said her skin biopsy indicated possible melanoma, she knew just what to do -- get a ...

  11. Tissue Biopsies in Diabetes Research

    DEFF Research Database (Denmark)

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

    2007-01-01

    Type 2 diabetes is characterized by insulin resistance in major metabolic tissues such as skeletal muscle, liver and fat cells, and failure of the pancreatic ß-cells to compensate for this abnormality (1,2). Skeletal muscle is the major site of glucose disposal in response to insulin, and insulin...... resistance of glucose disposal and glycogen synthesis in this tissue are hallmark features of type 2 diabetes in humans (2,3). During the past two decades, we have carried out more than 1200 needle biopsies of skeletal muscle to study the cellular mechanisms underlying insulin resistance in type 2 diabetes....... Together with morphological studies, measurement of energy stores and metabolites, enzyme activity and phosphorylation, gene and protein expression in skeletal muscle biopsies have revealed a variety of cellular abnormalities in patients with type 2 diabetes and prediabetes. The possibility to establish...

  12. Testicular biopsy in prepubertal boys

    DEFF Research Database (Denmark)

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

    2016-01-01

    in undervirilized patients with 46,XY disorders of sexual development. Testicular histology is also of considerable value in the prediction of both fertility potential and risk of cancer in individuals with undescended testes, particularly those with intraabdominal undescended testes. New possibilities......No consensus exists regarding the precise role of testicular biopsy in prepubertal boys, although it is considered useful for assessing the potential consequences of undescended testes on fertility. Current scientific knowledge indicates that surgeons should broaden indications for this procedure...... for the preservation of fertility after gonadotoxic chemotherapy - even for prepubertal boys - are emerging. Cryopreservation of testicular tissue samples for the preservation of fertility - although still an experimental method at present - is appealing in this context. In our opinion, testicular biopsy...

  13. PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2013-08-01

    Full Text Available While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3 test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. The PCA3 test was performed before ≥12-core initial prostate biopsy, along with standard risk factor assessment. Diagnostic performance of the PCA3 test was evaluated. The three available nomograms (Hansen’s and Chun’s nomograms, as well as the updated Prostate Cancer Prevention Trial risk calculator; PCPT were applied to the cohort, and their predictive accuracies were assessed in terms of biopsy outcome: the presence of any prostate cancer (PCa and high-grade prostate cancer (HGPCa. The PCA3 score provided significant predictive accuracy. While the PCPT risk calculator appeared less accurate; both Chun’s and Hansen’s nomograms provided good calibration and high net benefit on decision curve analyses. When applying nomogram-derived PCa probability thresholds ≤30%, ≤6% of HGPCa would have been missed, while avoiding up to 48% of unnecessary biopsies. The urinary PCA3 test and PCA3-incorporating nomograms can be considered as reliable tools to aid in the initial biopsy decision.

  14. FIBULA AND ILIAC BONE GRAFTING WITH INTERNAL FIXATION FOR GAINT CELL TUMOUR OF PROXIMAL TIBIA

    Directory of Open Access Journals (Sweden)

    Nishant Gaonkar

    2015-02-01

    Full Text Available Middle aged old female with swelling in left knee suggestive of giant cell tumour was treated with excisional biopsy with curettage, phenol cauterisation , bone graft and proximal tibia locking plate fixation. Sample sent for histopathology was consistent with diagnosis of giant cell tumour. No recurrence has been seen after 1 year of follow up.

  15. [Chickenpox, burns and grafts].

    Science.gov (United States)

    Rojas Zegers, J; Fidel Avendaño, L

    1979-01-01

    An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.

  16. Alveolar bone grafting

    Directory of Open Access Journals (Sweden)

    Lilja Jan

    2009-10-01

    Full Text Available In patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.

  17. Repeated Prolonged Exercise Decreases Maximal Fat Oxidation in Older Men

    DEFF Research Database (Denmark)

    Morville, Thomas; Rosenkilde, Mads; Munch-Andersen, Thor

    2017-01-01

    INTRODUCTION/PURPOSE: Fat metabolism and muscle adaptation was investigated in 6 older trained men (age: 61 ± 4 years; VO2max: 48 ± 2 mL kg min) following repeated prolonged exercise). METHODS: 2706 km (1,681 miles) cycling was performed over 14 days and a blood sample and a muscle biopsy were...

  18. Advances in Liquid Biopsy and its Clinical Application in the Diagnosis 
and Treatment of Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Difan ZHENG

    2016-06-01

    Full Text Available With the advances of technology, great progresses have been made in liquid biopsy in recent years. Liquid biopsy is currently playing a more and more important role in early diagnosis and treatment of cancer. Compared with traditional tissue biopsy, liquid biopsy is more popular in clinical practice due to its non-invasiveness, convenience and high repeatability. It has huge potential in the future. This review introduces circulating tumor cells (CTCs and circulating tumor DNA (ctDNA as the most important objects in liquid biopsy, mainly focusing on their history, biological characteristics, detection technologies, limitations and applications in non-small cell lung cancer.

  19. 20 CFR 718.106 - Autopsy; biopsy.

    Science.gov (United States)

    2010-04-01

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

  20. Breast magnetic resonance imaging guided biopsy

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  1. Arteriovenous shunt graft ulceration with sinus and graft epithelialization

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2015-03-01

    Full Text Available Arteriovenous fistula and grafts are used as access sites for patients with chronic kidney disease and are prone for complications. Stent grafts are used to treat access site complications. We report a rare and unusual finding of epithelialization of the sinus tract and the lumen of a polytetrafluoroethylene graft, following ulceration of the overlying skin.

  2. Subepithelial connective tissue graft for root coverage: clinical case reports and histologic evaluation.

    Science.gov (United States)

    Roman, Alexandra; Câmpian, R; Domşa, I; Soancă, Andrada; Gocan, H

    2010-01-01

    If the clinical goal of the periodontal plastic surgery is the complete root coverage of gingival recessions, then the microscopically goal standard is to obtain a true periodontal regeneration. Only the histological examination can reveal cellular events unrolled into the grafted tissue-root surface interface and the nature of the clinically observed attachment. To our knowledge, there are no studies that obtained the biopsies of grafted tissues from humans, in vivo, and so, the aim of the present study was to develop such a method, using a bone marrow biopsy needle. Two patients with gingival recessions were treated with coronally advanced flap and subepithelial connective tissue graft, and the clinical and histological results were observed. Complete root coverage was obtained for both cases. Clinically, the grafted tissues seemed to be attached to the root surfaces. The histological findings revealed dense grafted tissues, providing long-term stability of the area. No ligament or bone, characteristic for periodontal regeneration were observed. However, no sign of healing characterized by a long junctional epithelium was observed either. This indicated that the healing that occurred in our cases was a long connective tissue attachment, which has been shown to be stable over time. However, even if the method we proposed is not invasive, it is very difficult to convince the patient to accept a biopsy elevation once the exposed root surface was covered.

  3. Control of Grafting Density and Distribution in Graft Polymers by Living Ring-Opening Metathesis Copolymerization.

    Science.gov (United States)

    Lin, Tzu-Pin; Chang, Alice B; Chen, Hsiang-Yun; Liberman-Martin, Allegra L; Bates, Christopher M; Voegtle, Matthew J; Bauer, Christina A; Grubbs, Robert H

    2017-03-15

    Control over polymer sequence and architecture is crucial to both understanding structure-property relationships and designing functional materials. In pursuit of these goals, we developed a new synthetic approach that enables facile manipulation of the density and distribution of grafts in polymers via living ring-opening metathesis polymerization (ROMP). Discrete endo,exo-norbornenyl dialkylesters (dimethyl DME, diethyl DEE, di-n-butyl DBE) were strategically designed to copolymerize with a norbornene-functionalized polystyrene (PS), polylactide (PLA), or polydimethylsiloxane (PDMS) macromonomer mediated by the third-generation metathesis catalyst (G3). The small-molecule diesters act as diluents that increase the average distance between grafted side chains, generating polymers with variable grafting density. The grafting density (number of side chains/number of norbornene backbone repeats) could be straightforwardly controlled by the macromonomer/diluent feed ratio. To gain insight into the copolymer sequence and architecture, self-propagation and cross-propagation rate constants were determined according to a terminal copolymerization model. These kinetic analyses suggest that copolymerizing a macromonomer/diluent pair with evenly matched self-propagation rate constants favors randomly distributed side chains. As the disparity between macromonomer and diluent homopolymerization rates increases, the reactivity ratios depart from unity, leading to an increase in gradient tendency. To demonstrate the effectiveness of our method, an array of monodisperse polymers (PLA(x)-ran-DME(1-x))n bearing variable grafting densities (x = 1.0, 0.75, 0.5, 0.25) and total backbone degrees of polymerization (n = 167, 133, 100, 67, 33) were synthesized. The approach disclosed in this work therefore constitutes a powerful strategy for the synthesis of polymers spanning the linear-to-bottlebrush regimes with controlled grafting density and side chain distribution, molecular

  4. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  5. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  6. Primary renal graft thrombosis

    NARCIS (Netherlands)

    Bakir, N; Sluiter, WJ; Ploeg, RJ; van Son, WJ; Tegzess, Adam

    1996-01-01

    Background. Renal allograft thrombosis is a serious complication of kidney transplantation that ultimately leads to graft loss. Its association with acute and hyperacute rejection is well documented; however, in a large proportion of patients the precise cause remains obscure. The exact incidence an

  7. Left ventricular assist device implantation via left thoracotomy: alternative to repeat sternotomy.

    Science.gov (United States)

    Pierson, Richard N; Howser, Renee; Donaldson, Terri; Merrill, Walter H; Dignan, Rebecca J; Drinkwater, Davis C; Christian, Karla G; Butler, Javed; Chomsky, Don; Wilson, John R; Clark, Rick; Davis, Stacy F

    2002-03-01

    Repeat sternotomy for left ventricular assist device insertion may result in injury to the right heart or patent coronary grafts, complicating intraoperative and postoperative management. In 4 critically ill patients, left thoracotomy was used as an alternative to repeat sternotomy. Anastomosis of the outflow conduit to the descending thoracic aorta provided satisfactory hemodynamic support.

  8. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection

    Energy Technology Data Exchange (ETDEWEB)

    Pallwein, Leo; Struve, Peter; Aigner, Friedrich; Gradl, Johann; Schurich, Matthias; Frauscher, Ferdinand [Medical University Innsbruck, Department of Radiology 2/Uroradiology, Innsbruck (Austria); Mitterberger, Michael; Horninger, Wolfgang; Bartsch, Georg [Medical University Innsbruck, Department of Urology, Innsbruck (Austria); Pedross, Florian [Medical Universit Innsbruck, Department of Medical Statistics, Information and Health Economics, Innsbruck (Austria)

    2007-09-15

    A prospective study was performed to determine the value of sonoelastography (SE) targeted biopsy for prostate cancer (PCa) detection. A series of 230 male screening volunteers was examined. Two independent examiners evaluated each subject. One single investigator performed {<=}5 SE targeted biopsies into suspicious regions in the peripheral zone only. The stiffness of the lesion was displayed by SE and color-coded from red (soft) to blue (hard). Hard lesions were considered as malignant and targeted by biopsy. Subsequently, another examiner performed ten systematic biopsies. Cancer detection rates of the two techniques were compared. Cancer was detected in 81 of the 230 patients (35%), including 68 (30%) by SE targeted biopsy and in 58 (25%) by systematic biopsy. Cancer was detected by targeted biopsy alone in 23 patients (10%) and by systematic biopsy alone in 13 patients (6%). The detection rate for SE targeted biopsy cores (12.7% or 135 of 1,109 cores) was significantly better than for systematic biopsy cores (5.6% or 130 of 2,300 cores, P < 0.001). SE targeted biopsy in a patient with cancer was 2.9-fold more likely to detect PCa than systematic biopsy. SE targeted biopsy detected more cases of PCa than systematic biopsy, with fewer than half the number of biopsy cores in this prostate-specific antigen screening population. (orig.)

  9. Grafting with rootstocks induces extensive transcriptional re-programming in the shoot apical meristem of grapevine.

    Science.gov (United States)

    Cookson, Sarah Jane; Ollat, Nathalie

    2013-10-02

    Grafting is widely used in the agriculture of fruit-bearing crops; rootstocks are known to confer differences in scion biomass in addition to improving other traits of agricultural interest. However, little is known about the effect of rootstocks on scion gene expression. The objective of this study was to determine whether hetero-grafting the grapevine variety Vitis vinifera cv. 'Cabernet Sauvignon N' with two different rootstocks alters gene expression in the shoot apex in comparison to the auto-grafted control. Cabernet Sauvignon was hetero-grafted with two commercial rootstock genotypes and auto-grafted with itself. Vigor was quantified by measurements of root, stem, leaf and trunk biomass. Gene expression profiling was done using a whole genome grapevine microarray; four pools of five shoot apex samples were harvested 4 months after grafting for each scion/rootstock combination. The rootstocks increased stem biomass or conferred increased vigor by the end of the first growth cycle. Globally hetero-grafting two different genotypes together triggered an increase in shoot apex gene expression; however no genes were differentially expressed between the two hetero-grafts. The functional categories related to DNA, chromatin structure, histones, flavonoids and leucine rich repeat containing receptor kinases were the most enriched in the up-regulated genes in the shoot apex of hetero-grafted plants. The choice of rootstock genotype had little effect on the gene expression in the shoot apex; this could suggest that auto- and hetero-grafting was the major factor regulating gene expression.

  10. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy uses sound waves ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration biopsy of the ...

  11. Quantum repeated games revisited

    CERN Document Server

    Frackiewicz, Piotr

    2011-01-01

    We present a scheme for playing quantum repeated 2x2 games based on the Marinatto and Weber's approach to quantum games. As a potential application, we study twice repeated Prisoner's Dilemma game. We show that results not available in classical game can be obtained when the game is played in the quantum way. Before we present our idea, we comment on the previous scheme of playing quantum repeated games.

  12. Antecedent thermal injury worsens split-thickness skin graft quality: A clinically relevant porcine model of full-thickness burn, excision and grafting.

    Science.gov (United States)

    Carlsson, Anders H; Rose, Lloyd F; Fletcher, John L; Wu, Jesse C; Leung, Kai P; Chan, Rodney K

    2017-02-01

    Current standard of care for full-thickness burn is excision followed by autologous split-thickness skin graft placement. Skin grafts are also frequently used to cover surgical wounds not amenable to linear closure. While all grafts have potential to contract, clinical observation suggests that antecedent thermal injury worsens contraction and impairs functional and aesthetic outcomes. This study evaluates the impact of antecedent full-thickness burn on split-thickness skin graft scar outcomes and the potential mediating factors. Full-thickness contact burns (100°C, 30s) were created on the backs of anesthetized female Yorkshire Pigs. After seven days, burn eschar was tangentially excised and covered with 12/1000th inch (300μm) split-thickness skin graft. For comparison, unburned wounds were created by sharp excision to fat before graft application. From 7 to 120days post-grafting, planimetric measurements, digital imaging and biopsies for histology, immunohistochemistry and gene expression were obtained. At 120days post-grafting, the Observer Scar Assessment Scale, colorimetry, contour analysis and optical graft height assessments were performed. Twenty-nine porcine wounds were analyzed. All measured metrics of clinical skin quality were significantly worse (pskin graft quality, likely by multiple mechanisms including burn-related inflammation, microscopically inadequate excision, and dysregulation of tissue remodeling. A valid, reliable, clinically relevant model of full-thickness burn, excision and skin replacement therapy has been demonstrated. Future research to enhance quality of skin replacement therapies should be directed toward modulation of inflammation and assessments for complete excision.

  13. Muscle biopsy in Pompe disease

    Directory of Open Access Journals (Sweden)

    Lineu Cesar Werneck

    2013-05-01

    Full Text Available Pompe disease (PD can be diagnosed by measuring alpha-glucosidase levels or by identifying mutations in the gene enzyme. Muscle biopsies can aid diagnosis in doubtful cases. Methods: A review of muscle biopsy from 19 cases of PD (infantile, 6 cases; childhood, 4 cases; and juvenile/adult, 9 cases. Results: Vacuoles with or without glycogen storage were found in 18 cases. All cases had increased acid phosphatase activity. The vacuole frequency varied (almost all fibers in the infantile form to only a few in the juvenile/adult form. Atrophy of type 1 and 2 fibers was frequent in all forms. Atrophic angular fibers in the NADH-tetrazolium reductase and nonspecific esterase activity were observed in 4/9 of the juvenile/adult cases. Conclusion: Increased acid phosphatase activity and vacuoles were the primary findings. Most vacuoles were filled with glycogen, and the adult form of the disease had fewer fibers with vacuoles than the infantile or childhood forms.

  14. Kidney Biopsy: An Experience from Tertiary Hospital.

    Science.gov (United States)

    Ghimire, Madhav; Pahari, Bishnu; Paudel, Navaraj; Das, Gayatri; Das, Gopal Chandra; Sharma, Sanjib Kumar

    2014-01-01

    Kidney Biopsy is an important diagnostic tool in Nephrology. It is useful in Nephrology in terms of diagnosis, prognosis and management. There is little information on renal biopsy data from central Nepal. We describe our center`s experience in kidney biopsy in term of histological patterns, complications and outcomes. We prospectively analyzed the biopsies data of patients over a period of one and half year. All kinds of kidney disease patients were included for kidney biopsy, irrespective of their clinical syndromes and underlying diagnosis. A total of 75 biopsies were analyzed. Majority of them were females; 42 (56%). Most of the biopsies; 63 (84%) were from younger subjects ≤ 45 years and majority of them fell in the age group 11-20 years. Most common clinical renal syndrome to undergo biopsy was Sub Nephrotic range Proteinuria in 40 (53.3%). Among comorbid conditions, 40 (53.3%) had Hypertension. The most common histological pattern seen was Mesangial proliferative Glomerulonephritis seen in 18 (24%). Among complications associated with the procedure, macroscopic hematuria was seen in 5 (6.7%) cases and clinically significant perinephric hematoma causing pain was seen in 4 (5.3%). There was no mortality associated with biopsy procedure. Sub Nephrotic range Proteinuria was the commonest clinical renal Syndrome observed. In terms of renal histology, Mesangial Proliferative Glomerulonephritis (MesPGN) was the commonest histological pattern observed. Kidney biopsy is a safe procedure without any significant adverse events.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-02-15

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

  16. Thyroid fine-needle aspiration biopsy and thyroid cancer diagnosis: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Li-Ying Huang

    Full Text Available Thyroid cancer is the most common endocrine gland malignancy and fine-needle aspiration biopsy is widely used for thyroid nodule evaluation. Repeated aspiration biopsies are needed due to plausible false-negative results. This study aimed to investigate the overall relationship between aspiration biopsy and thyroid cancer diagnosis, and to explore factors related to shorter diagnostic time.This nationwide retrospective cohort study retrieved data from the Longitudinal Health Insurance Database in Taiwan. Subjects without known thyroid malignancies and who received the first thyroid aspiration biopsy after 2004 were followed-up from 2004 to 2009 (n = 7700. Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were used for data analysis.Of 7700 newly-aspirated patients, 276 eventually developed thyroid cancer (malignancy rate 3.6%. Among the 276 patients with thyroid cancer, 61.6% underwent only one aspiration biopsy and 81.2% were found within the first year after the initial aspiration. Cox proportional hazards model revealed that aspiration frequency (HR 1.07, 95% CI 1.06-1.08, ultrasound frequency (HR 1.02, 95% CI 1.01-1.03, older age, male sex, and aspiration biopsies arranged by surgery, endocrinology or otolaryngology subspecialties were all associated with shorter time to thyroid cancer diagnosis.About 17.4% of thyroid cancer cases received more than two aspiration biopsies and 18.8% were diagnosed one year after the first biopsy. Regular follow-up with repeated aspiration or ultrasound may be required for patients with clinically significant thyroid nodules.

  17. [Grafting of carotid arteries].

    Science.gov (United States)

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D

    2005-01-01

    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  18. Stereotactic breast biopsy: pitfalls and pearls.

    Science.gov (United States)

    Huang, Monica L; Adrada, Beatriz E; Candelaria, Rosalind; Thames, Deborah; Dawson, Debora; Yang, Wei T

    2014-03-01

    Stereotactic breast biopsies have become indispensable and the standard of care for patients in whom screening mammography or tomosynthesis reveals breast lesions suggestive of malignancy. A variety of stereotactic biopsy systems and needle types are now available, which allow more accurate sampling of lesions as well as successful biopsy of lesions in difficult locations in patients of all body habitus. We discuss how to plan, perform, and follow up stereotactic biopsies. Most importantly, we offer suggestions on how to avoid problems and complications and detail how to achieve technical success even in the most challenging cases. Stereotactic biopsy has proven over time to be an accurate and acceptable alternative to surgical biopsy for histopathologic diagnosis of breast abnormalities. Successful performance of this minimally invasive procedure spares women from undergoing potentially deforming and expensive procedures to diagnose breast disease.

  19. Buccal Mucosal Graft Urethroplasty

    Directory of Open Access Journals (Sweden)

    Angela M. Arlen

    2010-01-01

    Full Text Available At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases. Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%. The single-stage buccal graft success rate was 86.4% (19 of 22 cases. Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%, including superficial wound infection (one, superficial wound dehiscence (two, and abscess/fistula formation requiring reoperation (one. The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

  20. Photoacoustic biopsy: a feasibility study

    Science.gov (United States)

    Xu, Guan; Tomlins, Scott A.; Siddiqui, Javed; Davis, Mandy A.; Kunju, Lakshmi P.; Wei, John T.; Wang, Xueding

    2015-03-01

    Photoacoustic (PA) measurements encode the information associated with both physical microstructures and chemical contents in biological tissues. A two-dimensional physio-chemical spectrogram (PCS) can be formulated by combining the power spectra of PA signals acquired at a series of optical wavelengths. The analysis of PCS, or namely PA physio-chemical analysis (PAPCA), enables the quantification of the concentrations and the spatial distributions of a variety of chemical components in the tissue. The chemical components and their distribution are the two major features observed in the biopsy procedures which have been regarded as the gold standard of the diagnosis of many diseases. Taking non-alcoholic fatty liver disease and prostate cancer for example, this study investigates the feasibility of PAPCA in characterizing the histopathological changes in the diseased conditions in biological tissue. A catheter based setup facilitating measurement in deep tissues was also proposed and tested.

  1. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection.

    Science.gov (United States)

    Pallwein, Leo; Mitterberger, Michael; Struve, Peter; Horninger, Wolfgang; Aigner, Friedrich; Bartsch, Georg; Gradl, Johann; Schurich, Matthias; Pedross, Florian; Frauscher, Ferdinand

    2007-09-01

    A prospective study was performed to determine the value of sonoelastography (SE) targeted biopsy for prostate cancer (PCa) detection. A series of 230 male screening volunteers was examined. Two independent examiners evaluated each subject. One single investigator performed stiffness of the lesion was displayed by SE and color-coded from red (soft) to blue (hard). Hard lesions were considered as malignant and targeted by biopsy. Subsequently, another examiner performed ten systematic biopsies. Cancer detection rates of the two techniques were compared. Cancer was detected in 81 of the 230 patients (35%), including 68 (30%) by SE targeted biopsy and in 58 (25%) by systematic biopsy. Cancer was detected by targeted biopsy alone in 23 patients (10%) and by systematic biopsy alone in 13 patients (6%). The detection rate for SE targeted biopsy cores (12.7% or 135 of 1,109 cores) was significantly better than for systematic biopsy cores (5.6% or 130 of 2,300 cores, P cancer was 2.9-fold more likely to detect PCa than systematic biopsy. SE targeted biopsy detected more cases of PCa than systematic biopsy, with fewer than half the number of biopsy cores in this prostate-specific antigen screening population.

  2. Nerve Biopsy In The Diagnosis Of Leporsy

    Directory of Open Access Journals (Sweden)

    Hazra B

    1997-01-01

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

  3. Needle muscle biopsy and its application

    Directory of Open Access Journals (Sweden)

    Meng-long CHEN

    2015-07-01

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

  4. Surface staining of small intestinal biopsies

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1977-01-01

    Small intestinal biopsies are most often by routine examined under a stereo-microscope, prior to embedding for histological examination. This is done in order to get a view of the appearance of the mucosal pattern, especially villus configuration. The distinctness of the surface pattern however......, is improved considerably if the biopsies are stained with Alcian Green and/or PAS before they are examined. In the present paper a detailed description is given of staining of small intestinal biopsies as whole mounts. The difference between the unstained and the stained biopsies is illustrated by a few...

  5. Importance of liver biopsy findings in immunosuppression management: biopsy monitoring and working criteria for patients with operational tolerance.

    Science.gov (United States)

    2012-10-01

    Obstacles to morbidity-free long-term survival after liver transplantation (LT) include complications of immunosuppression (IS), recurrence of the original disease and malignancies, and unexplained chronic hepatitis and graft fibrosis. Many programs attempt to minimize chronic exposure to IS by reducing dosages and stopping steroids. A few programs have successfully weaned a highly select group of recipients from all IS without apparent adverse consequences, but long-term follow-up is limited. Patients subjected to adjustments in IS are usually followed by serial liver chemistry tests, which are relatively insensitive methods for detecting allograft damage. Protocol biopsy has largely been abandoned for hepatitis C virus-negative recipients, at least in part because of the inability to integrate routine histopathological findings into a rational clinical management algorithm. Recognizing a need to more precisely categorize and determine the clinical significance of findings in long-term biopsy samples, the Banff Working Group on Liver Allograft Pathology has reviewed the literature, pooled the experience of its members, and proposed working definitions for biopsy changes that (1) are conducive to lowering IS and are compatible with operational tolerance (OT) and (2) raise concern for closer follow-up and perhaps increased IS during or after IS weaning. The establishment of guidelines should help us to standardize analyses of the effects of various treatments and/or weaning protocols and more rigorously categorize patients who are assumed to show OT. Long-term follow-up using standardized criteria will help us to determine the consequences of lowering IS and to define and determine the incidence and robustness of OT in liver allografts.

  6. Reconfigurable multiport EPON repeater

    Science.gov (United States)

    Oishi, Masayuki; Inohara, Ryo; Agata, Akira; Horiuchi, Yukio

    2009-11-01

    An extended reach EPON repeater is one of the solutions to effectively expand FTTH service areas. In this paper, we propose a reconfigurable multi-port EPON repeater for effective accommodation of multiple ODNs with a single OLT line card. The proposed repeater, which has multi-ports in both OLT and ODN sides, consists of TRs, BTRs with the CDR function and a reconfigurable electrical matrix switch, can accommodate multiple ODNs to a single OLT line card by controlling the connection of the matrix switch. Although conventional EPON repeaters require full OLT line cards to accommodate subscribers from the initial installation stage, the proposed repeater can dramatically reduce the number of required line cards especially when the number of subscribers is less than a half of the maximum registerable users per OLT. Numerical calculation results show that the extended reach EPON system with the proposed EPON repeater can save 17.5% of the initial installation cost compared with a conventional repeater, and can be less expensive than conventional systems up to the maximum subscribers especially when the percentage of ODNs in lightly-populated areas is higher.

  7. Revisiting the TALE repeat.

    Science.gov (United States)

    Deng, Dong; Yan, Chuangye; Wu, Jianping; Pan, Xiaojing; Yan, Nieng

    2014-04-01

    Transcription activator-like (TAL) effectors specifically bind to double stranded (ds) DNA through a central domain of tandem repeats. Each TAL effector (TALE) repeat comprises 33-35 amino acids and recognizes one specific DNA base through a highly variable residue at a fixed position in the repeat. Structural studies have revealed the molecular basis of DNA recognition by TALE repeats. Examination of the overall structure reveals that the basic building block of TALE protein, namely a helical hairpin, is one-helix shifted from the previously defined TALE motif. Here we wish to suggest a structure-based re-demarcation of the TALE repeat which starts with the residues that bind to the DNA backbone phosphate and concludes with the base-recognition hyper-variable residue. This new numbering system is consistent with the α-solenoid superfamily to which TALE belongs, and reflects the structural integrity of TAL effectors. In addition, it confers integral number of TALE repeats that matches the number of bound DNA bases. We then present fifteen crystal structures of engineered dHax3 variants in complex with target DNA molecules, which elucidate the structural basis for the recognition of bases adenine (A) and guanine (G) by reported or uncharacterized TALE codes. Finally, we analyzed the sequence-structure correlation of the amino acid residues within a TALE repeat. The structural analyses reported here may advance the mechanistic understanding of TALE proteins and facilitate the design of TALEN with improved affinity and specificity.

  8. Use of cultured mucosal grafts to cover defects caused by vestibuloplasty: an in vivo study.

    Science.gov (United States)

    Raghoebar, G M; Tomson, A M; Scholma, J; Blaauw, E H; Witjes, M J; Vissink, A

    1995-08-01

    In oral and maxillofacial surgery palatal mucosal grafts are routinely used to cover mucosal defects caused by vestibuloplasty. However, the quantity of palatal mucosa is a limiting factor in more extensive operations. This study investigated whether autologous cultured sheets of mucosa can serve as a dressing for these wounds. Punch biopsies (diameter, 4 mm) were taken from the hard palate of eight patients (five men, three women; mean age 43 years). Epithelial cells were enzymatically dissociated from these tissue specimens and grown in vitro in the presence of a fibroblast feeder layer. Within 3 weeks, a transplantable epithelial sheet of about 20 cm2 was obtained. The sheet was detached from the culture flask by enzyme treatment and fixed to a carrier of Vaseline (Cheeseborough Ponds Inc, Greenwich, CT) gauze. Using a split-mouth technique, the sheet was placed on half of a mucosal defect created by vestibuloplasty, while the other half of the defect was covered by a conventional split-thickness palatal graft. Both the cultured and conventional graft were held in place by the patient's relined denture fixed with perimandibular sutures. One week postsurgery, the denture and Vaseline gauze were removed. Three months after vestibuloplasty, biopsy specimens of each grafted site were taken and processed for light and transmission electron microscopy (LM, TEM). Three months postsurgery, the grafted mucosa of both sites bore close resemblance to palatal mucosa. Both the cultured and split-thickness grafts were vascularized, did not evoke a homograft reaction, and showed a smooth graft/lip mucosal junction and minimal wound contraction. LM and TEM revealed that both types of grafts formed a fully differentiated keratinizing mucosa with a well-developed basement membrane and rete ridges, comparable with the histology and ultrastructure of palatal mucosa in situ. It was concluded from this study that cultured mucosa can serve as a proper dressing for mucosal defects

  9. Noninvasive imaging of islet grafts using positron-emission tomography

    Science.gov (United States)

    Lu, Yuxin; Dang, Hoa; Middleton, Blake; Zhang, Zesong; Washburn, Lorraine; Stout, David B.; Campbell-Thompson, Martha; Atkinson, Mark A.; Phelps, Michael; Gambhir, Sanjiv Sam; Tian, Jide; Kaufman, Daniel L.

    2006-07-01

    Islet transplantation offers a potential therapy to restore glucose homeostasis in type 1 diabetes patients. However, islet transplantation is not routinely successful because most islet recipients gradually lose graft function. Furthermore, serological markers of islet function are insensitive to islet loss until the latter stages of islet graft rejection. A noninvasive method of monitoring islet grafts would aid in the assessment of islet graft survival and the evaluation of interventions designed to prolong graft survival. Here, we show that recombinant adenovirus can engineer isolated islets to express a positron-emission tomography (PET) reporter gene and that these islets can be repeatedly imaged by using microPET after transplantation into mice. The magnitude of signal from engineered islets implanted into the axillary cavity was directly related to the implanted islet mass. PET signals attenuated over the following weeks because of the transient nature of adenovirus-mediated gene expression. Because the liver is the preferred site for islet implantation in humans, we also tested whether islets could be imaged after transfusion into the mouse liver. Control studies revealed that both intrahepatic islet transplantation and hyperglycemia altered the biodistribution kinetics of the PET probe systemically. Although transplanted islets were dispersed throughout the liver, clear signals from the liver region of mice receiving PET reporter-expressing islets were detectable for several weeks. Viral transduction, PET reporter expression, and repeated microPET imaging had no apparent deleterious effects on islet function after implantation. These studies lay a foundation for noninvasive quantitative assessments of islet graft survival using PET. diabetes | transplantation

  10. How to Perform Selective Liver Biopsy in Living Liver Donors Using Plain Computed Tomography.

    Science.gov (United States)

    Moon, Sun-Kyeong; Park, Yo-Han; Moon, Deok-Bog; Hwang, Shin; Ahn, Chul-Soo; Kim, Ki-Hun; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan; Park, Gil-Chun; Lee, Sung-Gyu

    2016-11-01

    Preoperative donor liver biopsy is the criterion standard to verify the quality of a liver. However, it can cause some complications, thus this study was designed to know whether selective liver biopsy is possible or not, and to find a subgroup that does not require preoperative biopsy. We reviewed preoperative images and postoperative outcome in 118 donors from September 2013 to January 2014. Visual grading of steatosis on plain computed tomography (CT) was performed and compared steatosis on preoperative liver biopsy was done within 7 days from the CT scan. Visual grades of plain CT were 1 (n = 50, 42.4%), 2 (n = 47, 39.8%), 3 (n = 13, 11.0%), 4 (n = 7, 5.9%), and 1 (n = 1, 0.8%). Macrovesicular steatosis on liver biopsy according to visual grades were 1 (0.67 ± 1.3%), 2 (1.67 ± 1.8%), 3 (6.23 ± 6.4%), 4 (14.7 ± 16.6), and 5 (30%). Right liver grafts including right lobe, modified right lobe, and extended right lobe were procured in 106 (89.9%) donors, and 16% (17/106) of the donors were visual grades 3, 4, and 5. Eleven donors (64.7%) were accepted for right liver donation after liver biopsy, whereas 6 (35.3%) donors were deemed possible to donate right liver after weight reduction and reevaluation of steatosis. Transient hepatic dysfunction after right hepatectomy was significantly increased according to the increment of visual grade. Preoperative liver biopsy may not be necessary in visual grade 1 or 2 donors, but should be performed for grade 3 and 4 donors based on recipient's urgency so as to decide whether to proceed with right hepatectomy or not.

  11. Chronic graft versus host disease and nephrotic syndrome.

    Science.gov (United States)

    Barbouch, Samia; Gaied, Hanene; Abdelghani, Khaoula Ben; Goucha, Rim; Lakhal, Amel; Torjemen, Lamia; Hamida, Fethi Ben; Abderrahim, Ezzedine; Maiz, Hedi Ben; Adel, Khedher

    2014-09-01

    Disturbed kidney function is a common complication after bone marrow transplantation. Recently, attention has been given to immune-mediated glomerular damage related to graft versus host disease (GVHD). We describe a 19-year-old woman who developed membranous glomerulonephritis after bone marrow transplantation (BMT). Six months later, she developed soft palate, skin and liver lesions considered to be chronic GVHD. Fifteen months after undergoing BMT, this patient presented with nephrotic syndrome. A renal biopsy showed membranous glomerulonephritis associated with a focal segmental glomerulosclerosis. She was started on corticosteroid treatment with good outcome.

  12. Chronic graft versus host disease and nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Samia Barbouch

    2014-01-01

    Full Text Available Disturbed kidney function is a common complication after bone marrow transplantation. Recently, attention has been given to immune-mediated glomerular damage related to graft versus host disease (GVHD. We describe a 19-year-old woman who developed membranous glomerulonephritis after bone marrow transplantation (BMT. Six months later, she developed soft palate, skin and liver lesions considered to be chronic GVHD. Fifteen months after undergoing BMT, this patient presented with nephrotic syndrome. A renal biopsy showed mem-branous glomerulonephritis associated with a focal segmental glomerulosclerosis. She was started on corticosteroid treatment with good outcome.

  13. Renal mass biopsy--a renaissance?

    Science.gov (United States)

    Lane, Brian R; Samplaski, Mary K; Herts, Brian R; Zhou, Ming; Novick, Andrew C; Campbell, Steven C

    2008-01-01

    Advances in our understanding of the natural history and limited aggressive potential of many small renal masses, expanding treatment options and the integration of molecular factors into prognostic and therapeutic algorithms have stimulated renewed interest in percutaneous renal mass biopsy. A comprehensive literature review was performed using MEDLINE/PubMed to evaluate the indications, techniques, complications and efficacy of renal mass biopsy. Reported techniques of renal mass biopsy vary widely with different modes of radiographic guidance, needle size, number of cores and pathological analyses. Percutaneous renal mass biopsy with 2 or 3 cores using 18 gauge needles may improve diagnostic accuracy without increasing morbidity. Serious complications of percutaneous biopsy are rare and the minor complication rate in recent series has been less than 5%. The reported rate of technical failure of renal mass biopsy due to insufficient material was about 9% before 2001 and 5% in more recent studies. The likelihood of indeterminate or inaccurate pathological findings has decreased from 10% to 4% when comparing clinical studies before and since 2001. Currently a total success rate of greater than 90% is attainable using renal mass biopsy with standard histopathological analysis. Recent studies demonstrated that combining immunohistochemical and molecular analyses may further improve renal mass biopsy accuracy. Research on expanded analysis of percutaneous renal mass biopsy specimens should remain a top priority. Enhanced renal mass biopsy should not change treatment in most patients with small renal masses, who should be treated with surgical excision. However, future clinical algorithms will likely incorporate enhanced biopsy in situations in which decision making is more challenging.

  14. Endothelial cell chimerism by fluorescence in situ hybridization in gender mismatched renal allograft biopsies

    Institute of Scientific and Technical Information of China (English)

    BAI Hong-wei; SHI Bing-yi; QIAN Ye-yong; NA Yan-qun; ZENG Xuan; ZHONG Ding-rong; LU Min; ZOU Wan-zhong; WU Shi-fei

    2007-01-01

    Background The blood vessels of a transplanted organ are the interface between donor and recipient. The endothelium in the blood vessels is thought to be the major target for graft rejection. Endothelial cells of a transplanted organ can be of recipient origin after transplantation. In this study, we tested whether endothelial chimerism correlated with the graft rejection and cold ischemia.Methods We studied the biopsy samples from 34 renal transplants of female recipients who received the kidney from a male donor for the presence of endothelial cells of recipient origin. We examined the tissue sections of renal biopsy samples by fluorescence in situ hybridization (FISH) for the presence of endothelial cells containing two X chromosomes using a biotinylated Y chromosome probe and digoxigenin labelled X chromosome probe, and then analyzed the relationship between the endothelial cell chimerism and the rejection and cold ischemia.Results Endothelial chimerism was common and irrespective of rejections (P>0.05). The cold ischemic time of chimerism group was longer than no chimerism group ((14.83±4.03) hours vs (11.27±3.87) hours, P<0.05).Conclusions There is no correlation between the percentage of recipient endothelial cells in vascular endothelial cells and the type of graft rejection. The endothelium damaged by ischemic injury might be repaired by the endothelial cells from the recipient.

  15. Recursive quantum repeater networks

    CERN Document Server

    Van Meter, Rodney; Horsman, Clare

    2011-01-01

    Internet-scale quantum repeater networks will be heterogeneous in physical technology, repeater functionality, and management. The classical control necessary to use the network will therefore face similar issues as Internet data transmission. Many scalability and management problems that arose during the development of the Internet might have been solved in a more uniform fashion, improving flexibility and reducing redundant engineering effort. Quantum repeater network development is currently at the stage where we risk similar duplication when separate systems are combined. We propose a unifying framework that can be used with all existing repeater designs. We introduce the notion of a Quantum Recursive Network Architecture, developed from the emerging classical concept of 'recursive networks', extending recursive mechanisms from a focus on data forwarding to a more general distributed computing request framework. Recursion abstracts independent transit networks as single relay nodes, unifies software layer...

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

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1984-01-01

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

  17. Pain and Anxiety During Bone Marrow Biopsy

    NARCIS (Netherlands)

    Tanasale, Betty; Kits, Jenne; Kluin, Philip M.; Trip, Albert; Kluin-Nelemans, Hanneke C.

    2013-01-01

    A bone marrow biopsy is considered to be painful, often causing anxiety. We observed large differences between patients and wondered which factors cause pain and anxiety. In a prospective study, 202 patients were analyzed. Experienced hematologists and fellows in training (17% of biopsies) performed

  18. Pain and Anxiety During Bone Marrow Biopsy

    NARCIS (Netherlands)

    Tanasale, Betty; Kits, Jenne; Kluin, Philip M.; Trip, Albert; Kluin-Nelemans, Hanneke C.

    2013-01-01

    A bone marrow biopsy is considered to be painful, often causing anxiety. We observed large differences between patients and wondered which factors cause pain and anxiety. In a prospective study, 202 patients were analyzed. Experienced hematologists and fellows in training (17% of biopsies) performed

  19. Revascularisation pattern of ruptured flexor tendon grafts in anterior cruciate ligament reconstruction: A histological study.

    Science.gov (United States)

    Figueroa, D; Martínez, R; Calvo, R; Scheu, M; Gallegos, M; Vaisman, A; Martínez, C; González, A

    For successful anterior cruciate ligament (ACL) reconstruction, revascularisation and histological maturation are necessary, as their failure can cause graft rupture. The purpose of this study was to describe differences in the histological maturation of early failed plasty (less than 12 months after surgery) and late failed plasty (more than 12 months after surgery) in patients with re-rupture after ACL reconstruction with hamstring tendons. A descriptive observational study was conducted on a consecutive series of 20 patients whose ACL reconstruction had failed. Graft biopsy samples were obtained during the revision surgery from the proximal, medial, and distal graft remnants. The samples were evaluated by light microscopy, and the vascularity and maturation of the samples were established by histological scoring. The most common aetiology of reconstruction failure (86.6%) was a specific event with non-contact mechanism. The patients with re-rupture of their ACL plasty less than 12 months after surgery had substance vessels that were less deep. The distal segment of the graft in those patients showed a delay in histological maturation with fewer collagen fibres. In patients whose ACL grafts failed less than 12 months after surgery, a lower distribution of blood vessels and collagen fibres was found that were less ordered in the distal graft. These results indicate a delay in maturation, which leads to a higher risk of graft failure. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Evaluation of Stress Scores Throughout Radiological Biopsies

    Directory of Open Access Journals (Sweden)

    Turkoglu

    2016-06-01

    Full Text Available Background Ultrasound-guided biopsy procedures are the most prominent methods that increase the trauma, stress and anxiety experienced by the patients. Objectives Our goal was to examine the level of stress in patients waiting for radiologic biopsy procedures and determine the stress and anxiety level arising from waiting for a biopsy procedure. Patients and Methods This prospective study included 35 female and 65 male patients who were admitted to the interventional radiology department of Kartal Dr. Lütfi Kirdar training and research hospital, Istanbul between the years 2014 and 2015. They filled out the adult resilience scale consisting of 33 items. Patients who were undergoing invasive radiologic interventions were grouped according to their phenotypic characteristics, education level (low, intermediate, and high, and biopsy features (including biopsy localization: neck, thorax, abdomen, and bone; and the number of procedures performed, 1 or more than 1. Before the biopsy, they were also asked to complete the depression-anxiety-stress scale (DASS 42, state-trait anxiety inventory scale (STAI-I, and continuous anxiety scale STAI-II. A total of 80 patients were biopsied (20 thyroid and parathyroid, 20 thorax, 20 liver and kidney, and 20 bone biopsies. The association between education levels (primary- secondary, high school and postgraduate and the number of biopsies (1 and more than 1 with the level of anxiety and stress were evaluated using the above-mentioned scales. Results Evaluation of sociodemographic and statistical characteristics of the patients showed that patients with biopsy in the neck region were moderately and severely depressed and stressed. In addition, the ratio of severe and extremely severe anxiety scores was significantly high. While the STAI-I and II scores were lined up as neck > bone > thorax > abdomen, STAI-I was higher in neck biopsies compared to thorax and abdomen biopsies. Regarding STAI-I and II scales, patients

  1. Grafting the alar rim: application as anatomical graft.

    Science.gov (United States)

    Gruber, Ronald P; Fox, Paige; Peled, Anne; Belek, Kyle A

    2014-12-01

    Alar rim contour and alar rim grafts have become essential components of rhinoplasty. Ideally, grafts of the nose should be anatomical in shape. So doing might make grafts of the alar rim more robust. The authors considered doing that by applying the graft as a continuous extension of the lateral crus. Twelve patients (two men and 10 women) constituted the study group (seven primary and five secondary cases). Of those, there were five concave rims, two concave rims with rim retraction, two boxy tips, and three cephalically oriented lateral crura. Surgical technique included the following: (1) an open approach was used; (2) a marginal incision that ignored the caudal margin of the lateral crus (the incision went straight posteriorly to a point 5 to 6 mm from the rim margin) was used; (3) a triangular graft was made to cover the exposed vestibular skin; (4) it was secured end to end to the caudal border of the lateral crus; and (5) the poster end was allowed to sit in a small subcutaneous pocket. Follow-up was 11 to 19 months. All 12 patients exhibited good rims as judged by a blinded panel. Rim retraction was not fully corrected in one patient, but no further treatment was required. One patient did require a secondary small rim graft for residual rim concavity. The concept of grafting the alar rim is strongly supported by the authors' results. The modifications the authors applied by designing the graft to be anatomical in shape has been a technical help.

  2. Computed tomography-guided biopsy. I. Overview.

    Science.gov (United States)

    Haaga, J R; Reich, N E; Havrilla, T R; Alfidi, R J; Meaney, T F

    1978-03-01

    The authors are preparing a series of communications on CT-guided biopsy procedures to be published in future issues of this journal. The present article, which previously appeared in the Cleveland Clinic Quarterly, is intended to serve as an introduction to the concept of CT-guided biopsies. Because the principles of the biopsy procedure remain the same, we do not believe that a "rewrite" of the previously published article would be required. We hope that by presenting this article and subsequent articles concerning the use of CT-guided biopsies, the reader will acquire an appreciation of the proper role of this exciting new technique in comparison to the available imaging modalities. We believe that as individuals become more experienced with the imaging capabilities of these CT devices, they will want to develop the technique of obtaining biopsy confirmation of the imaging diagnosis.

  3. Delayed culture of Leishmania in skin biopsies.

    Science.gov (United States)

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

    1999-01-01

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

  4. Transjugular liver biopsy: indications, technique and results.

    Science.gov (United States)

    Dohan, A; Guerrache, Y; Boudiaf, M; Gavini, J-P; Kaci, R; Soyer, P

    2014-01-01

    Transjugular liver biopsy is a safe, effective and well-tolerated technique to obtain liver tissue specimens in patients with diffuse liver disease associated with severe coagulopathies or massive ascites. Transjugular liver biopsy is almost always feasible. The use of ultrasonographic guidance for percutaneous puncture of the right internal jugular vein is recommended to decrease the incidence of local cervical minor complications. Semiautomated biopsy devices are very effective in obtaining optimal tissue samples for a precise and definite histological diagnosis with a very low rate of complication. The relative limitations of transjugular liver biopsy are the cost, the radiation dose given to the patient, the increased procedure time by comparison with the more common percutaneous liver biopsy, and the need of a well-trained interventional radiologist.

  5. Biopsy needle detection in transrectal ultrasound.

    Science.gov (United States)

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

    2011-01-01

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

  6. The liquid biopsy in lung cancer.

    Science.gov (United States)

    Ansari, Junaid; Yun, Jungmi W; Kompelli, Anvesh R; Moufarrej, Youmna E; Alexander, Jonathan S; Herrera, Guillermo A; Shackelford, Rodney E

    2016-11-01

    The incidence of lung cancer has significantly increased over the last century, largely due to smoking, and remains the most common cause of cancer deaths worldwide. This is often due to lung cancer first presenting at late stages and a lack of curative therapeutic options at these later stages. Delayed diagnoses, inadequate tumor sampling, and lung cancer misdiagnoses are also not uncommon due to the limitations of the tissue biopsy. Our better understanding of the tumor microenvironment and the systemic actions of tumors, combined with the recent advent of the liquid biopsy, may allow molecular diagnostics to be done on circulating tumor markers, particularly circulating tumor DNA. Multiple liquid biopsy molecular methods are presently being examined to determine their efficacy as surrogates to the tumor tissue biopsy. This review will focus on new liquid biopsy technologies and how they may assist in lung cancer detection, diagnosis, and treatment.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  8. CHALLENGES IN TREATMENT OF RENAL GRAFT ACUTE ANTIBODY-MEDIATED REJECTION

    Directory of Open Access Journals (Sweden)

    A. I. Sushkov

    2016-01-01

    Full Text Available Diagnostic criteria and treatment protocols for acute antibody-mediated rejection (AMR of kidney allograft remain controversial. We report the case of early severe AMR after primary kidney transplantation. The graft removal was considered in the absence of treatment efficacy and in the presence of systemic infl ammatory response syndrome. However, at surgery the graft looked normal and it was not removed. The repeated treatment course (plasmapheresis, antithymocyte globulin, intravenous immunoglobulin and rituximab was effective. The patient has good and stable graft function in 1 year after transplantation. 

  9. Suction blister grafting - Modifications for easy harvesting and grafting

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Full Text Available Suction blister grafting is a simple modality of treatment of patients with resistant and stable vitiligo. But raising the blisters may be time consuming and transferring to the recipient site may be difficult as the graft is ultrathin. By doing some modifications we can make the technique simpler and easier. We can decrease the blister induction time by intradermal injection of saline, exposure to Wood′s lamp, intrablister injection of saline. By these methods we can decrease the blister induction time from 2-3 hrs to 45-90 minutes. After harvesting the graft, it can be transferred to the recipient area by taking the graft on a sterile glass slide, on the gloved finger, rolling the graft over a sterile syringe and then spreading on the recipient area, or taking on the sterile wrapper of paraffin dressing and then placing over the recipient area.

  10. A Case of Dermatomyositis with Esophageal Fistula in Whom Blind Mucosal Biopsy Detected Occult Oropharyngeal Carcinoma

    Directory of Open Access Journals (Sweden)

    Miho Kabuto

    2014-11-01

    Full Text Available We present a case of anti-transcription intermediary factor 1 (anti-TIF-1 antibody-positive dermatomyositis with concomitant esophageal fistula and extensive truncal erythema. The characteristic cutaneous features and presence of anti-TIF-1 antibodies were predictive for internal malignancy. However, repeated examinations for internal malignancy showed none, and blind mucosal biopsy was needed to diagnose oropharyngeal carcinoma. We should note the possibility of occult nasopharyngeal carcinoma and consider performing blind mucosal biopsy in dermatomyositis with esophageal fistula, especially with extensive truncal erythema.

  11. Possibility of transrectal photoacoustic imaging-guided biopsy for detection of prostate cancer

    Science.gov (United States)

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

    2017-03-01

    A transrectral ultrasonography (TRUS) guided prostate biopsy is mandatory for histological diagnosis in patients with an elevated serum prostate-specific antigen (PSA), but its diagnostic accuracy is not satisfactory; therefore, a considerable number of patients are forced to have an unnecessary repeated biopsy. Photoacoustic (PA) imaging has the ability to visualize the distribution of hemoglobin clearly. Thus, there is the potential to acquire different maps of small vessel networks between cancerous and normal tissue. We developed an original TRUS-type PA probe consisting of a microconvex array transducer with an optical illumination system providing coregistered PA and ultrasound images. The purpose of this study is to demonstrate the clinical possibility of a transrectral PA image. The prostate biopsy cores obtained by transrectal systemic biopsies under TRUS guidance were stained with HE staining and anti-CD34 antibodies as a marker of the endothelium of the blood vessel in order to find a pattern in the map of a small vessel network, which allows for imaging-based identification of prostate cancer. We analyzed the association of PA signal patterns, the cancer location by a magnetic resonance imaging (MRI) study, and the pathological diagnosis with CD34 stains as a prospective intervention study. In order to demonstrate the TRUS-merged-with-PA imaging guided targeted biopsy combined with a standard biopsy for capturing the clinically significant tumors, we developed a puncture needle guide attachment for the original TRUS-type PA probe.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Lee, Jong Tae; Kim, Myeong Jin; Yoo, Hyung Sik; Kim, Ki Whang; Park, Ki Ill; Chung, Hyun Joo [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    1995-05-15

    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.

  13. MRI-guided biopsy and fine needle aspiration biopsy (FNAB) in the diagnosis of musculoskeletal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kerimaa, Pekka, E-mail: pekka.kerimaa@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Marttila, Antti, E-mail: antti.marttila@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Hyvönen, Pekka, E-mail: pekka.hyvonen@ppshp.fi [Department of Surgery, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Ojala, Risto, E-mail: risto.ojala@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Lappi-Blanco, Elisa, E-mail: elisa.lappi-blanco@ppshp.fi [Department of Pathology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Tervonen, Osmo, E-mail: osmo.tervonen@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Blanco Sequeiros, Roberto, E-mail: roberto.blanco@oulu.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland)

    2013-12-01

    Objectives: The purpose of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) guided musculoskeletal biopsy and the value of fine needle aspiration biopsy (FNAB) when combined with histologic biopsy. Materials and methods: A total of 172 biopsies were performed under MRI guidance, 170 were histologic biopsies. In 112 cases, a fine needle aspiration biopsy was also performed. In two cases, a stand-alone FNAB was performed. The diagnostic performance was evaluated retrospectively by comparing the histopathologic and cytologic diagnosis with the current or final diagnosis after at least one year of clinical and imaging follow-up. A 0.23 T open MRI scanner with an interventional stereotactic guidance system was used. Results: The overall diagnostic accuracy of MRI guided biopsy was 0.95, sensitivity 0.91, specificity 0.98, positive predictive value (ppv) 0.97 and negative predictive value (npv) 0.93. The diagnostic accuracy of trephine biopsy alone was 0.93, sensitivity 0.89, specificity 0.98, ppv 0.97 and npv 0.91 and accuracy for FNAB alone was 0.85, sensitivity 0.80, specificity 0.90, ppv 0.89 and npv 0.82. Conclusions: MRI guidance is a feasible and accurate tool in percutaneous musculoskeletal biopsies. Fine needle biopsy is a useful low-cost supplement to histologic biopsy.

  14. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  15. Polyether/Polyester Graft Copolymers

    Science.gov (United States)

    Bell, Vernon L., Jr.; Wakelyn, N.; Stoakley, D. M.; Proctor, K. M.

    1986-01-01

    Higher solvent resistance achieved along with lower melting temperature. New technique provides method of preparing copolymers with polypivalolactone segments grafted onto poly (2,6-dimethyl-phenylene oxide) backbone. Process makes strong materials with improved solvent resistance and crystalline, thermally-reversible crosslinks. Resulting graft copolymers easier to fabricate into useful articles, including thin films, sheets, fibers, foams, laminates, and moldings.

  16. Graft selection in cerebral revascularization.

    Science.gov (United States)

    Baaj, Ali A; Agazzi, Siviero; van Loveren, Harry

    2009-05-01

    Cerebral revascularization constitutes an important treatment modality in the management of complex aneurysms, carotid occlusion, tumor, and moyamoya disease. Graft selection is a critical step in the planning of revascularization surgery, and depends on an understanding of graft and regional hemodynamics, accessibility, and patency rates. The goal of this review is to highlight some of these properties.

  17. Additional benefit of using a risk-based selection for prostate biopsy: an analysis of biopsy complications in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer.

    Science.gov (United States)

    Chiu, Peter K; Alberts, Arnout R; Venderbos, Lionne D F; Bangma, Chris H; Roobol, Monique J

    2017-09-01

    To investigate biopsy complications and hospital admissions that could be reduced by the use of European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculators. All biopsies performed in the Rotterdam section of the ERSPC between 1993 and 2015 were included. Biopsy complications and hospital admission data were prospectively recorded in questionnaires that were completed 2 weeks after biopsy. The ERSPC risk calculators 3 (RC3) and 4 (RC4) were applied to men attending the first and subsequent rounds of screening, respectively. Applying the predefined RC3/4 probability thresholds for prostate cancer (PCa) risk of ≥12.5% and high-grade PCa risk ≥3%, we assessed the number of complications, admissions and costs that could be reduced by avoiding biopsies in men below these thresholds. A total of 10 747 biopsies with complete questionnaires were included. For these biopsies a complication rate of 67.9% (7294/10 747), a post-biopsy fever rate of 3.9% (424/10747) and a hospital admission rate of 0.9% (92/10747) were recorded. The fever rate was found to be static over the years, but the hospital admission rate tripled from 0.6% (1993-1996) to 2.1% (2009-2015). Among 7704 biopsies which fit the criteria for RC3 or RC4, 35.8% of biopsies (2757/7704), 37.4% of complications (1972/5268), 39.4% of fever events (128/325) and 42.3% of admissions (30/71) could have been avoided by using one of the risk calculators. More complications could have been avoided if RC4 had been used and for more recent biopsies (2009-2015). Our findings show that 35.9% of the total cost of biopsies and complication treatment could have been avoided. A significant proportion of biopsy complications, hospital admissions and costs could be reduced if biopsy decisions were based on ERSPC risk calculators instead of PSA only. This effect was most prominent in more recent biopsies and in men with repeated biopsies or screening. © 2017 The Authors BJU International © 2017 BJU

  18. Radiation grafting on natural films

    Science.gov (United States)

    Lacroix, M.; Khan, R.; Senna, M.; Sharmin, N.; Salmieri, S.; Safrany, A.

    2014-01-01

    Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37-40 N mm-1) and puncture deformation (PD=6.5-9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282-296 N mm-1 and PD of 5.0-5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films.

  19. The Pentapeptide Repeat Proteins

    Energy Technology Data Exchange (ETDEWEB)

    Vetting,M.; Hegde, S.; Fajardo, J.; Fiser, A.; Roderick, S.; Takiff, H.; Blanchard, J.

    2006-01-01

    The Pentapeptide Repeat Protein (PRP) family has over 500 members in the prokaryotic and eukaryotic kingdoms. These proteins are composed of, or contain domains composed of, tandemly repeated amino acid sequences with a consensus sequence of [S, T,A, V][D, N][L, F]-[S, T,R][G]. The biochemical function of the vast majority of PRP family members is unknown. The three-dimensional structure of the first member of the PRP family was determined for the fluoroquinolone resistance protein (MfpA) from Mycobacterium tuberculosis. The structure revealed that the pentapeptide repeats encode the folding of a novel right-handed quadrilateral {beta}-helix. MfpA binds to DNA gyrase and inhibits its activity. The rod-shaped, dimeric protein exhibits remarkable size, shape and electrostatic similarity to DNA.

  20. Rectal forceps biopsy procedure in cystic fibrosis: technical aspects and patients perspective for clinical trials feasibility.

    Science.gov (United States)

    Servidoni, Maria F; Sousa, Marisa; Vinagre, Adriana M; Cardoso, Silvia R; Ribeiro, Maria A; Meirelles, Luciana R; de Carvalho, Rita B; Kunzelmann, Karl; Ribeiro, Antônio F; Ribeiro, José D; Amaral, Margarida D

    2013-05-20

    Measurements of CFTR function in rectal biopsies ex vivo have been used for diagnosis and prognosis of Cystic Fibrosis (CF) disease. Here, we aimed to evaluate this procedure regarding: i) viability of the rectal specimens obtained by biopsy forceps for ex vivo bioelectrical and biochemical laboratory analyses; and ii) overall assessment (comfort, invasiveness, pain, sedation requirement, etc.) of the rectal forceps biopsy procedure from the patients perspective to assess its feasibility as an outcome measure in clinical trials. We compared three bowel preparation solutions (NaCl 0.9%, glycerol 12%, mannitol), and two biopsy forceps (standard and jumbo) in 580 rectal specimens from 132 individuals (CF and non-CF). Assessment of the overall rectal biopsy procedure (obtained by biopsy forceps) by patients was carried out by telephone surveys to 75 individuals who underwent the sigmoidoscopy procedure. Integrity and friability of the tissue specimens correlate with their transepithelial resistance (r = -0.438 and -0.305, respectively) and are influenced by the bowel preparation solution and biopsy forceps used, being NaCl and jumbo forceps the most compatible methods with the electrophysiological analysis. The great majority of the individuals (76%) did not report major discomfort due to the short procedure time (max 15 min) and considered it relatively painless (79%). Importantly, most (88%) accept repeating it at least for one more time and 53% for more than 4 times. Obtaining rectal biopsies with a flexible endoscope and jumbo forceps after bowel preparation with NaCl solution is a safe procedure that can be adopted for both adults and children of any age, yielding viable specimens for CFTR bioelectrical/biochemical analyses. The procedure is well tolerated by patients, demonstrating its feasibility as an outcome measure in clinical trials.

  1. Plasma PGFM and progesterone concentrations, luteolysis moment and estrous cycle length in Nelore cows submitted to uterine biopsies

    Directory of Open Access Journals (Sweden)

    I. Martin

    2015-10-01

    Full Text Available ABSTRACTIn this study, endometrial samples were collected in 14 Nelore cows on days zero (ovulation, five, nine, thirteen and nineteen of the estrous cycle (biopsy group, and in 15 females these collections weren't performed (control group. Biopsies were done on the uterine horn endometrium contralateral to the ovary with corpus luteum. Blood samples were taken at -24, -16, -8, 0 +8, +16 and +24 hours in relation to progesterone drop (<1ng/mL, zero moment and evaluated for 13, 14-dihydro-15-keto prostaglandin F2-alpha (PGFM by radioimmunoassay (RIA. Plasma progesterone concentration was determined by RIA every 24 hours. Data were analyzed by ANOVA using the PROC GLM and MIXED of the SAS. The mean value for PGFM during the entire period evaluated was greater in the biopsy group. The mean concentration of PGFM at moment zero was not different between the groups; the mean concentration of PGFM was higher in the biopsy group before and after the drop in progesterone level. The maximum mean concentration observed was not different between the groups; however, the mean minimum concentration was different with high values in the biopsy group. Although the PGFM concentrations were higher in the biopsy group, the biopsy and control groups had similar length of estrous cycle showing that repeated endometrial biopsy on the side contralateral to the ovary with corpus luteum does not affect luteolysis and the length of the estrous cycle.

  2. Acute Page kidney following renal allograft biopsy: a complication requiring early recognition and treatment.

    Science.gov (United States)

    Chung, J; Caumartin, Y; Warren, J; Luke, P P W

    2008-06-01

    The acute Page kidney phenomenon occurs as a consequence of external compression of the renal parenchyma leading to renal ischemia and hypertension. Between January 2000 and September 2007, 550 kidney transplants and 518 ultrasound-guided kidney biopsies were performed. During that time, four recipients developed acute oligo-anuria following ultrasound-guided allograft biopsy. Emergent doppler-ultrasounds were performed demonstrating absence of diastolic flow as well as a sub-capsular hematoma of the kidney. Prompt surgical exploration with allograft capsulotomy was performed in all cases. Immediately after capsulotomy, intraoperative Doppler study demonstrated robust return of diastolic flow. Three patients maintained good graft function, and one kidney was lost due to acute antibody-mediated rejection. We conclude that postbiopsy anuria associated with a subcapsular hematoma and acute absence of diastolic flow on doppler ultrasound should be considered pathognomonic of APK. All renal transplant specialists should be able to recognize this complication, because immediate surgical decompression can salvage the allograft.

  3. A histopathological score on baseline biopsies from elderly donors predicts outcome 1 year after renal transplantation

    DEFF Research Database (Denmark)

    Toft, Birgitte G; Federspiel, Birgitte H; Sørensen, Søren S

    2012-01-01

    Kidneys from elderly deceased patients and otherwise marginal donors may be considered for transplantation and a pretransplantation histopathological score for prediction of postoperative outcome is warranted. In a retrospective design, 29 baseline renal needle biopsies from elderly deceased donors...... wall thickness of arteries and/or arterioles. Nineteen renal baseline biopsies from 15 donors (age: 64 ± 10 years) were included and following consensus the histopathological score was 4.3 ± 2.1 (intraclass correlation coefficient: 0.81; confidence interval: 0.66-0.92). The donor organs were used...... for single renal transplantation (recipient age: 47 ± 3 years). Two grafts were lost after the transplantation. In the remaining 17 recipients the 1-year creatinine clearance (54 ± 6 mL/min) correlated to the baseline histopathological score (r(2) = 0.59; p

  4. Repeating the Past

    Science.gov (United States)

    Moore, John W.

    1998-05-01

    As part of the celebration of the Journal 's 75th year, we are scanning each Journal issue from 25, 50, and 74 years ago. Many of the ideas and practices described are so similar to present-day "innovations" that George Santayana's adage (1) "Those who cannot remember the past are condemned to repeat it" comes to mind. But perhaps "condemned" is too strong - sometimes it may be valuable to repeat something that was done long ago. One example comes from the earliest days of the Division of Chemical Education and of the Journal.

  5. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Adel S. Ahmed

    2016-04-01

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

  7. Radial scars without atypia in percutaneous biopsy specimens: can they obviate surgical biopsy?

    Science.gov (United States)

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

    2017-06-06

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

  8. Quantification of degree of steatosis in extended criteria donor grafts with standardized histologic techniques: implications for graft survival.

    Science.gov (United States)

    Frongillo, F; Avolio, A W; Nure, E; Mulè, A; Pepe, G; Magalini, S C; Agnes, S

    2009-05-01

    The gap between the availability of livers from organ donors and the increased demand has led many centers to apply strategies to reduce this deficit. Splitting of cadaveric organs for use in 2 recipients; domino transplantation; and organs from living donors, non-heart-beating donors, and extended-criteria donors (ECDs) are all currently used in orthotopic liver transplantation (OLT). Fatty changes in the donor liver are a risk factor for poor function after OLT; however, the presence of steatosis, frequently present in livers from ECDs, does not exclude the use of these organs. Since January 2000 at our institution, we observed 39 steatotic grafts that were stratified istologically as follows: low steatosis, 5% to 15%; mild steatosis, 16% to 30%; moderate steatosis, 31% to 60%; and severe steatosis (>60%). Histologic techniques can enable identification of the type of fatty change as macrovesicular and microvesicular. These alterations have different effects on primary nonfunction and primary dysfunction. Fifteen grafts, all with severe or moderate, macrovesicular changes were discarded. Twenty-four fatty grafts with low to moderate steatosis were utilized for transplant. Sections from 2 liver biopsies (1 wedge in the left lobe and 1 needle in the right lobe) were stained with hematoxylin-eosin, Masson trichrome, Gomori reticulin, and oil red O. The OLT was performed only in patients with a MELD (Model for End-Stage Liver Disease) score lower than 27. The rate of primary dysfunction was 12.5%, and of primary nonfunction 8.4%. The 6-month graft survival for all fatty livers was 80%. We encourage the careful use of grafts with low to moderate steatosis in recipients without additional risks.

  9. Excellent outcomes of liver transplantation using severely steatotic grafts from brain-dead donors.

    Science.gov (United States)

    Wong, Tiffany C L; Fung, James Y Y; Chok, Kenneth S H; Cheung, Tan To; Chan, Albert C Y; Sharr, William W; Dai, Wing Chiu; Chan, See Ching; Lo, Chung Mau

    2016-02-01

    Liver grafts with macrovesicular steatosis of > 60% are considered unsuitable for deceased donor liver transplantation (DDLT) because of the unacceptably high risk of primary nonfunction (PNF) and graft loss. This study reports our experience in using such grafts from brain-dead donors. Prospectively collected data of DDLT recipient outcomes from 1991 to 2013 were retrospectively analyzed. Macrovesicular steatosis > 60% at postperfusion graft biopsy was defined as severe steatosis. In total, 373 patients underwent DDLT. Nineteen patients received severely steatotic grafts (ie, macrovesicular steatosis > 60%), and 354 patients had grafts with ≤ 60% steatosis (control group). Baseline demographics were comparable except that recipient age was older in the severe steatosis group (51 versus 55 years; P = 0.03). Median Model for End-Stage Liver Disease (MELD) score was 20 in the severe steatosis group and 22 in the control group. Cold ischemia time (CIT) was 384 minutes in the severe steatosis group and 397.5 minutes in the control group (P = 0.66). The 2 groups were similar in duration of stay in the hospital and in the intensive care unit. Risk of early allograft dysfunction (0/19 [0%] versus 1/354 [0.3%]; P>0.99) and 30-day mortality (0/19 [0%] versus 11/354 [3.1%]; P = 0.93) were also similar between groups. No patient developed PNF. The 1-year and 3-year overall survival rates in the severe steatosis group were both 94.7%. The corresponding rates in the control group were 91.8% and 85.8% (P = 0.55). The use of severely steatotic liver grafts from low-risk donors was safe, and excellent outcomes were achieved; however, these grafts should be used with caution, especially in patients with high MELD score. Keeping a short CIT was crucial for the successful use of such grafts in liver transplantation.

  10. Dendritic Cells in Kidney Transplant Biopsy Samples Are Associated with T Cell Infiltration and Poor Allograft Survival.

    Science.gov (United States)

    Batal, Ibrahim; De Serres, Sacha A; Safa, Kassem; Bijol, Vanesa; Ueno, Takuya; Onozato, Maristela L; Iafrate, A John; Herter, Jan M; Lichtman, Andrew H; Mayadas, Tanya N; Guleria, Indira; Rennke, Helmut G; Najafian, Nader; Chandraker, Anil

    2015-12-01

    Progress in long-term renal allograft survival continues to lag behind the progress in short-term transplant outcomes. Dendritic cells are the most efficient antigen-presenting cells, but surprisingly little attention has been paid to their presence in transplanted kidneys. We used dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin as a marker of dendritic cells in 105 allograft biopsy samples from 105 kidney transplant recipients. High dendritic cell density was associated with poor allograft survival independent of clinical variables. Moreover, high dendritic cell density correlated with greater T cell proliferation and poor outcomes in patients with high total inflammation scores, including inflammation in areas of tubular atrophy. We then explored the association between dendritic cells and histologic variables associated with poor prognosis. Multivariate analysis revealed an independent association between the densities of dendritic cells and T cells. In biopsy samples with high dendritic cell density, electron microscopy showed direct physical contact between infiltrating lymphocytes and cells that have the ultrastructural morphologic characteristics of dendritic cells. The origin of graft dendritic cells was sought in nine sex-mismatched recipients using XY fluorescence in situ hybridization. Whereas donor dendritic cells predominated initially, the majority of dendritic cells in late allograft biopsy samples were of recipient origin. Our data highlight the prognostic value of dendritic cell density in allograft biopsy samples, suggest a new role for these cells in shaping graft inflammation, and provide a rationale for targeting dendritic cell recruitment to promote long-term allograft survival.

  11. Status quo and development trend of breast biopsy technology

    OpenAIRE

    Zhang, Yan-Jun; Wei, Lichun; Li, Jie; Yi-qiong ZHENG; Li, Xi-Ru

    2013-01-01

    Triple assessment is a standard method for assessment of breast diseases, which includes clinical evaluation, radiographic assessment and pathological assessment. Biopsy for breast disease is the gold standard for pathological assessment, including incisional biopsy, excisional biopsy, core needle biopsy, vacuum-assisted biopsy and bite biopsy. With the continuous advancement of diagnostic and treatment technology for breast cancer, collection of diseased tissue has also undergone a gradual t...

  12. All-optical repeater.

    Science.gov (United States)

    Silberberg, Y

    1986-06-01

    An all-optical device containing saturable gain, saturable loss, and unsaturable loss is shown to transform weak, distorted optical pulses into uniform standard-shape pulses. The proposed device performs thresholding, amplification, and pulse shaping as required from an optical repeater. It is shown that such a device could be realized by existing semiconductor technology.

  13. Bidirectional Manchester repeater

    Science.gov (United States)

    Ferguson, J.

    1980-01-01

    Bidirectional Manchester repeater is inserted at periodic intervals along single bidirectional twisted pair transmission line to detect, amplify, and transmit bidirectional Manchester 11 code signals. Requiring only 18 TTL 7400 series IC's, some line receivers and drivers, and handful of passive components, circuit is simple and relatively inexpensive to build.

  14. The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates.

    Science.gov (United States)

    Koegelenberg, Coenraad Frederik N; Irusen, Elvis Malcom; von Groote-Bidlingmaier, Florian; Bruwer, Johannes Willem; Batubara, Enas Mansour A; Diacon, Andreas Henri

    2015-10-01

    We assessed the utility of ultrasound to guide the selection of closed pleural biopsy technique and site and to assess the respective contributions of repeat thoracentesis and closed pleural biopsy in 100 consecutive patients with undiagnosed pleural exudates. Thoracentesis was more likely to be diagnostic in TB than malignancy (77.8% vs 31.0%, p<0.001). The addition of ultrasound-guided biopsy increased the combined yield for all diagnoses from 48.0% to 90.0% (p<0.001), for malignancy from 31.0% to 89.7% (p<0.001) and for TB from 77.8% to 88.9% (p=0.688). Our findings suggest that this minimally invasive approach has a high diagnostic yield. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Gene Expression analysis of the endometrium after endometrial biopsy in fertile women

    DEFF Research Database (Denmark)

    Olesen, Mia Steengaard; Starnawska, Anna; Agerholm, Inge;

    Background Recent data indicate, that therapeutic endometrial injury, may enhance implantation in assisted reproductive therapy (ART). Aim The aim of this pilot study was to investigate the gene expression and epigenetic modifications after an endometrial biopsy in fertile women. Material...... (baseline) and repeated in the next cycle at day LH+7 (after biopsy). Endometrial biopsies were homogenized and RNA/DNA extracted. Gene expression was analyzed using RNAseq. DNA methylation was analyzed using Illumina 450K methylation array. Results Preliminary results show differentially expressed genes...... and Methods The study is part of a large prospective clinical study. Six fertile women, with no prior use of intrauterine device or anticonception pills, underwent a therapeutic endometrial injury with a Pipelle de CornierR in two consecutive cycles. The endometrial samples were taken at cycle day LH+7...

  16. Graft stability after endothelial keratoplasty

    Directory of Open Access Journals (Sweden)

    Jovanović Vesna

    2015-01-01

    Full Text Available Bacground/Aim. Techniques for replacing the corneal endothelium have been improved. The host-graft interface is the key to graft adhesion and visual recovery. The aim of this study was to establish graft stability after Descemet stripping with endothelial keratoplasty (DSEK, compare it to the graft stability after endothelial keratoplasty with the intact posterior corneal layers (nDSEK in the rabbit cornea, and to investigate the nature of wound healing. Methods. Adult white rabbits (n = 20 were divided in two experimental groups: ten rabbits underwent monocular DSEK, and ten rabbits underwent endothelial keratoplasty without Descemet stripping (nDSEK. On the second postoperative day a horizontal dislocation of the graft was tried using the Lindstrom roller in each animal. Corneas were processed for the light microscopy study. Results. Rolling the Lindstrom instrument over the corneal surface did not cause horizontal dislocation in any of the operated eyes. In the DSEK group light microscopy revealed the lack of inflammation and fibrosis at the clearly distinctive donor-recipient interface (DRI. Retrocorneal membrane was found in two eyes. In nDSEK group, the host Descemet` s membrane (DM was intact without endothelial cells, with good graft apposition, without inflammation, fibrosis, or retrocorneal membrane. Conclusion. This study suggests that there is no difference in graft stability in DSEK compared to nDSEK in rabbit corneas. Wounds healed at DRI by hypocellular scarring only in both experimental groups.

  17. Prostate biopsy tracking with deformation estimation

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2011-01-01

    Transrectal biopsies under 2D ultrasound (US) control are the current clinical standard for prostate cancer diagnosis. The isoechogenic nature of prostate carcinoma makes it necessary to sample the gland systematically, resulting in a low sensitivity. Also, it is difficult for the clinician to follow the sampling protocol accurately under 2D US control and the exact anatomical location of the biopsy cores is unknown after the intervention. Tracking systems for prostate biopsies make it possible to generate biopsy distribution maps for intra- and post-interventional quality control and 3D visualisation of histological results for diagnosis and treatment planning. They can also guide the clinician toward non-ultrasound targets. In this paper, a volume-swept 3D US based tracking system for fast and accurate estimation of prostate tissue motion is proposed. The entirely image-based system solves the patient motion problem with an a priori model of rectal probe kinematics. Prostate deformations are estimated with ...

  18. GoM Coastal Biopsy Surveys - NRDA

    Data.gov (United States)

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

  19. Salivary Gland Biopsy for Sjogren's Syndrome

    NARCIS (Netherlands)

    Delli, Konstantina; Vissink, Arjan; Spijkervet, Fred K. L.

    2014-01-01

    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjogren's syndrome (SS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and other connective tissue disorders. SS has characteristic microscopic findings involving lymphocytic infiltration surrounding the excretory ducts

  20. Salivary Gland Biopsy for Sjogren's Syndrome

    NARCIS (Netherlands)

    Delli, Konstantina; Vissink, Arjan; Spijkervet, Fred K. L.

    2014-01-01

    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjogren's syndrome (SS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and other connective tissue disorders. SS has characteristic microscopic findings involving lymphocytic infiltration surrounding the excretory ducts

  1. Mass Spectrometry Based Metabolomics Comparison of Liver Grafts from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD) Used in Human Orthotopic Liver Transplantation

    OpenAIRE

    Hrydziuszko, Olga; Perera, M. Thamara P. R; Laing, Richard; Kirwan, Jennifer; Silva, Michael A; Richards, Douglas A.; Murphy, Nick; Mirza, Darius F; Viant, Mark R.

    2016-01-01

    Use of marginal liver grafts, especially those from donors after circulatory death (DCD), has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27...

  2. Status quo and development trend of breast biopsy technology.

    Science.gov (United States)

    Zhang, Yan-Jun; Wei, Lichun; Li, Jie; Zheng, Yi-Qiong; Li, Xi-Ru

    2013-02-01

    Triple assessment is a standard method for assessment of breast diseases, which includes clinical evaluation, radiographic assessment and pathological assessment. Biopsy for breast disease is the gold standard for pathological assessment, including incisional biopsy, excisional biopsy, core needle biopsy, vacuum-assisted biopsy and bite biopsy. With the continuous advancement of diagnostic and treatment technology for breast cancer, collection of diseased tissue has also undergone a gradual transition from traditional open surgery to biopsy. This review summarizes the current situation and development of breast biopsy technology to provide an insight into the latest details such as the safety and reliability as the basis for selection of the most appropriate techniques for specific settings.

  3. Navigation-guided endoscopic biopsy for intraparenchymal brain tumor.

    Science.gov (United States)

    Tsuda, Kyoji; Ishikawa, Eiichi; Zaboronok, Alexander; Nakai, Kei; Yamamoto, Tetsuya; Sakamoto, Noriaki; Uemae, Yoji; Tsurubuchi, Takao; Akutsu, Hiroyoshi; Ihara, Satoshi; Ayuzawa, Satoshi; Takano, Shingo; Matsumura, Akira

    2011-01-01

    To evaluate the efficacy of intraparenchymal brain tumor biopsy using endoscopy and a navigation system (navigation-guided endoscopic biopsy) as a diagnostic tool, a case series of intraparenchymal tumor biopsies was reviewed. Navigation-guided endoscopic biopsy was applied in 9 cases, stereotactic needle biopsy in 16 cases, and open biopsy with or without navigation system in 34 cases. In all biopsy cases, 84.7% of biopsy points were sampled accurately, and 93.2% of diagnoses by biopsy were correct. Comparison of each type of biopsy showed that the resected volumes in navigation-guided endoscopic biopsy and open biopsy tended to be larger than those in stereotactic biopsy, and the mean operation time for the open biopsy procedure was the longest. To define the most applicable device or examination method to increase sampling accuracy, various factors were analyzed in 59 procedures. Navigation-guided endoscopic biopsy was the most accurate of the three types of biopsy, although the statistical difference was not significant. Older patients, histological diagnosis of high-grade glioma or malignant lymphoma, positive photodynamic diagnosis, and positive intraoperative pathology were significant factors in improving the sampling accuracy. Navigation-guided endoscopic biopsy could provide a larger sample volume within a relatively short operation time. The biopsy can be easily combined with both photodynamic diagnosis and intraoperative pathology, significantly improving the histological diagnostic yield.

  4. Ultrasound-guided percutaneous renal biopsy with an automated biopsy gun in diffuse renal disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Yang; Moon, Jeoung Mi; Park, Ji Hyun; Kwon, Jae Soo; Song, Ik Hoon; Kim, Sung Rok [Masan Koryo General Hospital, Masan (Korea, Republic of)

    1994-12-15

    We evaluated the effectiveness and clinical usefulness of percutaneous renal biopsy by using automated biopsy gun under the real-time ultrasonographic guidance that was performed in 17 patients with diffuse renal disease. We retrospectively analysed the histopathological diagnosis and the patients' status after percutaneous renal biopsy.Adequate amount of tissue for the histologic diagnosis could be obtained in al patients. Histopathologic diagnosis included the minimal change nephrotic syndrome in 6 patients, the membrano proliferative glomerulonephritis in 4,the membranous glomerulonephritis in 2, the glomerulosclerosis in 2, Ig A nephropathy in 2, and the normal finding in 1. Significant complication occurred in only one patient who developed a transient loss of sensation at and around the biopsy site. In conclusion, automated biopsy gun was a very useful device in performing percutaneous biopsy for diffuse renal disease with a high success rate and a low complication rate

  5. Graft nephrectomy: The SGPGI experience

    Directory of Open Access Journals (Sweden)

    Nand Kishore Arvind

    2002-01-01

    Full Text Available Background: Graft nephrectomy is often considered a hazardous procedure with high morbidity and occasional mortality, and this may pose a technical challenge. The aim of this study was to evaluate the indications, etiology and complications following graft nephrectomy. Materials and Methods: From 1988 to 2001, among total of 1,019 live related renal transplants carried at our center, 46 underwent graft nephrectomy. Patients were divided into 2 groups depending on timing of graft re-moval. The early group included 27 patients (within 2 months of transplantation while in late group (graft re-moval after 2 months of transplantation there were 19 patients. The 2 groups were compared in terms of indica-tion, etiology and complications. Results: In early group the indications for graft removal were acute rejection, thrombosis/infarction and hyper-acute rejection, while in late group the indications were pain, hematuria, fever, hypertension and infection along with chronic failure. Overall, the external iliac artery in-jury occurred in I and 4 patients in early and late group respectively. Major blood loss occurred in I and 6 pa-tients in early and late graft removal respectively. There were 2 deaths in early group due to ftdminant pneumoni-tis that progressed to sepsis and disseminated intravascu-lar coagulation. There were 9 major wound infections all in early group except in 2 patients of late group. Respira-tory infections occurred in 14 patients in early group and 1 in late group. In early group patients had CNS compli-cations in form of seizures, clinical depression and delusional psychosis in 12 patients. Conclusions: Our experience highlights the risk in-volved in graft nephrectomies. Severe acute rejection and thrombosis lead to early graft nephrectomies. Pain, hematuria, infection and hypertension in setting of chronic rejection are predominant causes for the delayed graft ne- phrectomies. Early graft nephrectomy, though technically easy, is

  6. Testicular biopsy: clinical practice and interpretation

    Institute of Scientific and Technical Information of China (English)

    Gert R Dohle; Saad Elzanaty; Niels J van Casteren

    2012-01-01

    Testicular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia.Recent guidelines for male infertility have limited the indications for a diagnostic testicular biopsy to the confirmation ofobstructive azoospermia in men with normal size testes and normal reproductive hormones.Nowadays,testicular biopsies are mainly performed for sperm harvesting in men with non-obstructive azoospermia,to be used for intracytoplasmic sperm injection.Testicular biopsy is also performed in men with risk factors for testicular malignancy.In a subgroup of infertile men,there is an increased risk for carcinoma in situ of the testis,especially in men with a history of cryptorchidism and testicular malignancy and in men with testicular atrophy.Ultrasonographic abnormalities,such as testicular microlithiasis,inhomogeneous parenchyma and lesions of the testes,further increase the risk of carcinoma in situ (CIS) in these men.For an accurate histological classification,proper tissue handling,fixation,preparation of the specimen and evaluation are needed.A standardized approach to testicular biopsy is recommended.In addition,approaches to the detection of CIS of the testis testicular immunohistochemistry are mandatory.In this mini-review,we describe the current indications for testicular biopsies in the diagnosis and management of male infertility.

  7. Free vascularized fibula graft to treat chondroblastoma of the hip.

    Science.gov (United States)

    Riedel, Barth; Franklin, Corinna; Seal, Alex; Stevanovic, Milan

    2012-02-17

    Chondroblastomas are rare tumors that present in the epiphysis of the long bones. Bone grafting following aggressive surgical curettage has yielded the best results. When present in the femoral head, they pose a higher risk of recurrence due to the difficulty of achieving an adequate resection without destroying the structural integrity of the weight-bearing surface. This article describes a case of surgical treatment of a chondroblastoma of the femoral head with the use of a free vascularized fibula graft. A 26-year-old woman had several months of increasing left hip pain and decreased range of motion. Imaging studies confirmed a large bubbly lesion with sclerotic borders in the left femoral head consistent with chondroblastoma. After performing an aggressive and complete excisional biopsy, a large cavitary defect remained in the femoral head. Reconstruction of the defect and structural support was achieved using a free vascularized fibula. Nine years postoperatively, the patient had full hip motion, no pain, and no radiographic evidence of collapse. A free vascularized fibula graft is an excellent option for the reconstruction of a large femoral head defect after chondroblastoma resection.

  8. Design of a Sapling Branch Grafting Robot

    Directory of Open Access Journals (Sweden)

    Qun Sun

    2014-01-01

    Full Text Available The automatic sapling grafting methods and grafting robot technologies are not comprehensively studied despite the fact that they are urgently required in practice. For this reason, a sapling grafting robot is developed to implement automatic grafting for saplings. The developed grafting robot includes clipping mechanism, moving mechanism, cutting mechanism, binding mechanism, and Arduino MCU based control system, which is capable of clipping, moving, positioning, cutting, grafting, and binding saplings. Experiments show that the stock cutting efficiency is 98.4%, the scion cutting efficiency is 98.9%, the grafting efficiency is 87.3%, and the binding efficiency is 68.9%.

  9. Vascular graft infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Skov Jensen, J; Prag, J;

    1995-01-01

    Vascular graft infection is one of the most serious complications in vascular surgery. It is associated with mortality rates ranging from 25% to 75% and with morbidity in the form of amputation in approximately 30% of patients. Staphylococcus aureus is the leading pathogen. With conventional...... laboratory techniques, the percentage of culture-negative yet grossly infected vascular grafts seems to be increasing and is not adequately explained by the prior use of antibiotics. We have recently reported the first case of aortic graft infection with Mycoplasma. We therefore suggest the hypothesis...... that the large number of culture-negative yet grossly infected vascular grafts may be due to Mycoplasma infection not detected with conventional laboratory technique....

  10. Synthesis and characterization of polypyrrole grafted chitin

    Science.gov (United States)

    Ramaprasad, A. T.; Latha, D.; Rao, Vijayalakshmi

    2017-05-01

    Synthesis and characterization of chitin grafted with polypyrrole (PPy) is reported in this paper. Chitin is soaked in pyrrole solution of various concentrations for different time intervals and polymerized using ammonium peroxy disulphate (APS) as an initiator. Grafting percentage of polypyrrole onto chitin is calculated from weight of chitin before and after grafting. Grafting of polymer is further verified by dissolution studies. The grafted polymer samples are characterized by FTIR, UV-Vis absorption spectrum, XRD, DSC, TGA, AFM, SEM and conductivity studies.

  11. Evaluation of autogenous grafts used in vestibuloplasty.

    Science.gov (United States)

    Metin, M; Dolanmaz, D; Alkan, A

    2003-01-01

    Vestibuloplasty is indicated when prosthesis stability is poor due to mandibular or maxillary atrophy. The use of autogenous grafts to provide sufficient vestibular depth is widely accepted. In this retrospective study, the outcomes of vestibuloplasty performed on 41 patients using various types of autogenous grafts (full-thickness skin, dermal, reversed dermal, meshed skin and palatal mucosal) are presented. The best results were obtained with palatal mucosal grafts, but graft size is limited. Meshed skin grafts were shown to be the best alternative.

  12. Gene expression in human skeletal muscle: alternative normalization method and effect of repeated biopsies

    DEFF Research Database (Denmark)

    Lundby, Carsten; Nordsborg, Nikolai; Kusuhara, K.

    2005-01-01

    The reverse transcriptase-polymerase chain reaction (RT-PCR) method has lately become widely used to determine transcription and mRNA content in rodent and human muscle samples. However, the common use of endogenous controls for correcting for variance in cDNA between samples is not optimal. Spec...

  13. Crystallization studies of polyethylene -poly(ethylene glycol) graft copolymers

    Science.gov (United States)

    Mark, P. R.; Hovey, G. E.; Murthy, N. S.; Breitenkamp, K.; Kade, M.; Emerick, T.

    2006-03-01

    Structure and crystallization behavior of three copolymers obtained by grafting poly (ethylene glycol) (PEG) chains to polyethylene (PE) main chain was investigated by variable temperature x-ray diffraction and thermal analysis. The results show that PEG side chains and PE main chains crystallize into separate domains. This is especially true when grafted chains are long (50 and 100 repeat units), in which the PEG domains are same as in PEG homopolymer both in structure and in melting behavior. In the copolymer with shorter chains (25 repeat units), the PEG crystals are not distinct and melting is broad. The PEG domains can be dissolved in water or ethanol without altering the mechanical integrity of the film. PE crystallites in both samples are similar to that in PE homopolymer. For instance, the thermal expansion of the basal cell plane (a- and b-axes) of the PE domains agrees well with that of PE homopolymer over the entire temperature range from ambient to melt. However, the chain-axis dimension PE-lattice in the copolymer is shorter by ˜ 0.05 å and the basal dimensions are larger by ˜ 0.05 å. The changes in these dimensions due to the changes in the length of the grafted PEG chains were investigated.

  14. Duct Leakage Repeatability Testing

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-01-01

    Duct leakage often needs to be measured to demonstrate compliance with requirements or to determine energy or Indoor Air Quality (IAQ) impacts. Testing is often done using standards such as ASTM E1554 (ASTM 2013) or California Title 24 (California Energy Commission 2013 & 2013b), but there are several choices of methods available within the accepted standards. Determining which method to use or not use requires an evaluation of those methods in the context of the particular needs. Three factors that are important considerations are the cost of the measurement, the accuracy of the measurement and the repeatability of the measurement. The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards.

  15. Comparison of CT and PET/CT for biopsy guidance in oncological patients.

    Science.gov (United States)

    Cerci, Juliano J; Tabacchi, Elena; Bogoni, Mateos; Delbeke, Dominique; Pereira, Carlos Cunha; Cerci, Rodrigo J; Krauzer, Cassiano; Sakamoto, Danielle Giacometti; Fanti, Stefano; Vitola, João Vicente

    2017-08-01

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected

  16. Small renal mass biopsy--how, what and when: report from an international consensus panel.

    Science.gov (United States)

    Tsivian, Matvey; Rampersaud, Edward N; del Pilar Laguna Pes, Maria; Joniau, Steven; Leveillee, Raymond J; Shingleton, William B; Aron, Monish; Kim, Charles Y; DeMarzo, Angelo M; Desai, Mihir M; Meler, James D; Donovan, James F; Klingler, Hans Christoph; Sopko, David R; Madden, John F; Marberger, Michael; Ferrandino, Michael N; Polascik, Thomas J

    2014-06-01

    To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: 'non-diagnostic samples' should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications.

  17. In vitro validation of flow measurements in an aortic nitinol stent graft by velocity-encoded MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rengier, Fabian, E-mail: f.rengier@dkfz.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); German Cancer Research Center (dkfz) Heidelberg, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Delles, Michael, E-mail: delles@kit.edu [Karlsruhe Institute of Technology (KIT), Department of Informatics, Institute for Anthropomatics, Adenauerring 2, 76131 Karlsruhe (Germany); Weber, Tim Frederik, E-mail: Tim.Weber@med.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Boeckler, Dittmar, E-mail: dboeckler@me.com [University Hospital Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Ley, Sebastian, E-mail: ley@gmx.net [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich, E-mail: Hans-Ulrich.Kauczor@med.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Tengg-Kobligk, Hendrik von, E-mail: h.vontengg@dkfz.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); German Cancer Research Center (dkfz) Heidelberg, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2011-10-15

    Purpose: To validate flow measurements within an aortic nickel-titanium (nitinol) stent graft using velocity-encoded cine magnetic resonance imaging (VEC MRI) and to assess intraobserver agreement of repeated flow measurements. Materials and methods: An elastic tube phantom mimicking the descending aorta was developed with the possibility to insert an aortic nitinol stent graft. Different flow patterns (constant, sinusoidal and pulsatile aortic flow) were applied by a gear pump. A two-dimensional phase-contrast sequence was used to acquire VEC perpendicular cross-sections at six equidistant levels along the phantom. Each acquisition was performed twice with and without stent graft, and each dataset was analysed twice by the same reader. The percental difference of the measured flow volume to the gold standard (pump setting) was defined as the parameter for accuracy. Furthermore, the intraobserver agreement was assessed. Results: Mean accuracy of flow volume measurements was -0.45 {+-} 1.63% without stent graft and -0.18 {+-} 1.45% with stent graft. Slightly lower accuracy was obtained for aortic flow both without (-2.31%) and with (-1.29%) stent graft. Accuracy was neither influenced by the measurement position nor by repeated acquisitions. There was significant intraobserver agreement with an intraclass correlation coefficient of 0.87 (without stent graft, p < 0.001) and 0.80 (with stent graft, p < 0.001). The coefficient of variance was 0.25% without stent graft and 0.28% with stent graft. Conclusion: This study demonstrated high accuracy and excellent intraobserver agreement of flow measurements within an aortic nitinol stent graft using VEC MRI. VEC MRI may give new insights into the haemodynamic consequences of endovascular aortic repair.

  18. Bone Grafting: Sourcing, Timing, Strategies, and Alternatives.

    Science.gov (United States)

    Egol, Kenneth A; Nauth, Aaron; Lee, Mark; Pape, Hans-Christoph; Watson, J Tracy; Borrelli, Joseph

    2015-12-01

    Acute fractures, nonunions, and nonunions with bone defects or osteomyelitis often need bone graft to facilitate union. There are several factors to consider when it is determined that a bone graft is needed. These factors include the source of the bone graft (autograft vs. allograft), proper timing for placement of the bone graft, strategies to avoid further complications (particularly in the setting of osteomyelitis), and with the development of a variety of bone graft substitutes, whether alternatives to autograft are available and appropriate for the task at hand. Autograft bone has commonly been referred to as the "gold standard" of bone grafts, against which the efficacy of other grafts has been measured. The best timing for when to place a bone graft or substitute is also somewhat controversial, particularly after an open fracture or a potentially contaminated bed. The treatment of infected nonunions, particularly those that require a graft to facilitate healing, can be quite challenging. Typically, the infection is completely eradicated before placement of a bone graft, but achieving a sterile bed and the timing of a bone graft require strategic thinking and planning. This review outlines the benefits of autografts, the most suitable sites for harvesting bone grafts, the timing of bone graft procedures, the potential risks and benefits of grafting in the face of infection, and the currently available bone graft extenders.

  19. CT fluoroscopy guided transpleural cutting needle biopsy of small ({<=}2.5 cm) subpleural pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, Helmut; Oschatz, Elisabeth; Eisenhuber, Edith; Wohlschlager, Helmut [Otto Wagner Hospital, Department of Radiology, Sanatoriumsstrasse 2, 1140 Vienna (Austria); Mostbeck, Gerhard H., E-mail: gerhard.mostbeck@wienkav.at [Otto Wagner Hospital, Department of Radiology, Sanatoriumsstrasse 2, 1140 Vienna (Austria)

    2011-01-15

    Purpose: Small subpleural pulmonary lesions are difficult to biopsy. While the direct, short needle path has been reported to have a lower rate of pneumothorax, the indirect path provides a higher diagnostic yield. Therefore, we tried to optimize the needle pathway and minimize the iatrogenic pneumothorax risk by evaluating a CT fluoroscopy guided direct approach to biopsy subpleural lesions. Material and methods: Between 01/2005 and 01/2007, CT fluoroscopy guided core biopsies were performed in 24 patients. Using our technique, the tip of the guide needle remains outside the visceral pleura (17 G coaxial guide needle, 18 G Biopsy-gun, 15 or 22 mm needle path). The position of the lesion relative to the needle tip can be optimized using CT fluoroscopy by adjusting the breathing position of the patient. The Biopty gun is fired with the needle tip still outside the pleural space. Cytological smears are analyzed by a cytopathologist on-site, and biopsies are repeated as indicated with the coaxial needle still outside the pleura. Results: Median nodule size was 1.6 cm (0.7-2.3 cm). A definitive diagnosis was obtained in 22 patients by histology and/or cytology. In one patient, only necrotic material could be obtained. In another patient, the intervention had to be aborted as the dyspnoic patient could not follow breathing instructions. An asymptomatic pneumothorax was present in seven patients; chest tube placement was not required. Conclusion: The presented biopsy approach has a high diagnostic yield and is especially advantageous for biopsies of small subpleural lesions in the lower lobes.

  20. Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

    Directory of Open Access Journals (Sweden)

    Erdal Benli

    2016-01-01

    Full Text Available Aim. The aim of this study is to evaluate whether leaving the biopsy needle used during prostate needle biopsy in 10% povidone-iodine (betadine solution affects the infectious complications forming after biopsy. Material and Method. This study retrospectively evaluated the data of 176 patients with prostate biopsy performed between December 2012 and April 2014. Patients in Group 1 (n=89 were given ofloxacin as a prophylactic antibiotic before biopsy. Patients in Group 2 (n=87 had the biopsy needle left in povidone-iodine solution for 1 minute before each use, in addition to antibiotic prophylaxis. The two groups were compared in terms of infective complications developing after biopsy. Results were analyzed using the Mann–Whitney U test and Fisher’s exact test. Results. The distribution of infective complications after biopsy according to group was as follows. Group 1, not using betadine, had 15.7% fever, 13.5% hospital stay, 12.4% urinary retention, 10.1% prostatitis, and 5.6% sepsis. The distribution of the same complications in Group 2 using betadine was identified as 5.7% fever, 4.6% hospital stay, 3.4% urinary retention, 2.3% prostatitis, and 0% sepsis. The use of betadine was found to significantly reduce the infectious complications after biopsy compared to the control group (p<0.05. Conclusion. At the end of this study leaving the prostate needle in povidone-iodine solution before each use during prostate biopsy was found to reduce the infective complications and hospital stay after biopsy.

  1. Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

    Science.gov (United States)

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

    2017-07-01

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

  2. Protein levels of heme oxygenase-1 during reperfusion in human kidney transplants with delayed graft function.

    Science.gov (United States)

    Ollinger, Robert; Kogler, Pamela; Biebl, Matthias; Sieb, Michael; Sucher, Robert; Bösmüller, Claudia; Troppmair, Jakob; Mark, Walter; Weiss, Helmut; Margreiter, Raimund

    2008-01-01

    Delayed graft function (DGF) as a consequence of ischemia reperfusion injury (IRI) is associated with a decrease in long-term allograft survival. Heme oxygenase-1 (HO-1) is a stress responsive gene that is highly expressed in multiple pathological processes. The aim of our study was to analyze whether HO-1 protein levels in human kidney transplants during IRI correlate with the incidence of DGF. Kidney biopsies were obtained from 27 kidney allografts at two time points: at the end of cold storage and shortly after reperfusion. Samples were analyzed for HO-1 protein levels by Western blot. Heme oxygenase-1 protein levels were significantly higher in post-reperfusion biopsies (39.4 vs. 13.7 arbitrary units, p = 0.001). In pre-reperfusion biopsies no association was observed between HO-1 protein levels and DGF. In post-reperfusion biopsies, higher levels of HO-1 protein were measured in kidneys with DGF (53.7 vs. 36.2 arbitrary units, p = 0.064). DGF kidneys showed a significantly higher increase from pre- to post-reperfusion in HO-1 protein (42.0 vs. 18.7 arbitrary units, p = 0.025). Heme oxygenase-1 protein levels shortly after allograft reperfusion are closely related with initial graft function. Assessment thereof may be considered a valuable tool to predict DGF.

  3. Skin and kidney histological changes in graft-versus-host disease (GVHD) after kidney transplantation.

    Science.gov (United States)

    Pintar, Tadeja; Alessiani, Mario; Pleskovič, Alojz; Pleskovič, Aleš; Zorc-Pleskovič, Ruda; Milutinović, Aleksandra

    2011-05-01

    Kidney transplantation (Ktx) is generally performed during end stage renal disease due to a loss of the kidneys' ability to filter wastes from the circulatory system. Acute graft-versus-host disease (GVHD) after Ktx is a life-threatening complication that progresses to organ failure, systemic complications, and death. The current study evaluated the significance of histologic findings of GVHD as obtained from skin biopsies following Ktx in swine. A swine model of Ktx with tacrolimus-based immunosuppression was used to assess possible correlations between acute-graft-cellular rejection and skin histological findings for prediction of GVHD. Animals were divided into a Ktx treatment group or a control group with no Ktx and skin and kidney biopsies were histologically assessed at postoperative days 0, 15, 30, 45 and 60. Skin samples were analyzed and classified from grade 1 to 4 of skin GVHD and the major histopathological changes of kidney acute cellular rejection were described using Banff's score system. We observed a significant linear correlation between the histological grading values of skin biopsy changes and the histological grading values of kidney biopsies (Kendall's tau_b=0.993) in the Ktx experimental group. No histological changes were observed in controls. Our findings demonstrate the diagnostic value of staging skin GVHD after Ktx and suggest it's future utility for monitoring long term Ktx-induced changes.

  4. Obesity does not correlate with adverse pathologic findings on transperineal template-guided mapping biopsy of the prostate.

    Science.gov (United States)

    Bittner, Nathan; Merrick, Gregory S; Stewart, Renee; Andreini, Hugo; Taubenslag, Walter; Curtis, Rodney; Butler, Wayne M; Wallner, Kent E

    2011-01-01

    Obesity has correlated with adverse pathologic features on prostate biopsy and may predispose to a higher rate of prostate cancer-related death after radical prostatectomy. In this study, we examine the potential relationship between body mass index (BMI) and histopathologic findings on transperineal template-guided mapping biopsy of the prostate (TTMB). From January 2005 to January 2008, 244 consecutive patients underwent TTMB using an anatomic-based technique. The criteria for TTMB included previously negative transrectal ultrasound (TRUS) biopsy with persistently elevated PSA and/or diagnosis of ASAP, or HG-PIN. The study population was divided into 4 different BMI cohorts (BMI prostate volume, were not significantly different between the various BMI cohorts. On average, the study population had undergone 1.7 TRUS biopsies before TTMB. Of the 244 study patients, 112 (45.9%), were diagnosed with prostate adenocarcinoma on TTMB. There was no difference in the rate of cancer detection between the different BMI cohorts. Among patients diagnosed with prostate cancer, BMI did not correlate with Gleason score or percent of positive biopsy cores. When the geography of biopsy-positive cores was analyzed, there were no statistically significant differences in cancer location among the different BMI groups. In this study, obesity did not predispose toward higher Gleason score, larger cancer volume, or geographic cancer distribution on repeat biopsy with TTMB. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. [Frameless stereotactic biopsy: diagnostic yield and complications].

    Science.gov (United States)

    Castle, Maria; Nájera, Edinson; Samprón, Nicolas; Bollar, Alicia; Urreta, Iratxe; Urculo, Enrique

    2014-01-01

    The aim of this study was to evaluate the variables that could modify the diagnostic yield of frameless stereotactic biopsy, as well as its complications. This was a retrospective study of frameless stereotactic biopsies carried out between July 2008 and December 2011 at Donostia University Hospital. The variables studied were size, distance to the cortex, contrast uptake and location. A total of 70 patients were included (75 biopsies); 39 males and 31 females with an age range between 39 and 83 years. The total diagnostic yield in our series was 97.1%. For lesions >19mm, the technique offered a sensitivity of 95.2% (95% CI: 86.9-98.4) and specificity of 57.1% (95% CI: 25.0-84.2). The yield was lower for lesions within 17mm of the cortex: sensitivity of 74.6% (95% CI: 62.1-84.7) and specificity of 71.4% (95% CI: 29.0-96.3). Seven (10%) patients developed complications after the first biopsy and none after the second. The diagnostic yield was lower for lesions less than 2cm in size and located superficially. In this series we did not observe an increased rate of complications after a second biopsy. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  6. Fate of monocortical bone blocks grafted in the human maxilla: a histological and histomorphometric study.

    Science.gov (United States)

    Zerbo, Ilara R; de Lange, Gert L; Joldersma, Manon; Bronckers, Antonius L J J; Burger, Elisabeth H

    2003-12-01

    Local bone defects in the anterior maxilla are commonly grafted with monocortical blocks of autologous bone in order to restore the defect site prior to the placement of dental implants. Increasing evidence suggests that osteocytes are involved in the control of bone remodelling and thus may be important for optimalisation of bone structure around implants, and thus for implant osseointegration. However, it is not well known whether osteocytes will survive when bone blocks are grafted into defects. We grafted 19 patients with monocortical bone blocks derived from the symphysis, to the defect site in the maxillary alveolar process. The bone grafts were left to heal for times varying from 2.5 to 7 months. During implant installation, bone biopsies were removed using a trephine burr, and processed for hard tissue histology. Bone histology and histomorphometry were then carried out in order to gain insight into the density, viability and remodelling of the graft. Clinically, all the bone grafts were successful, with no implant failures, and little resorption was seen. Histologically, bone volume expressed as percentage of tissue volume at the implant site varied from 27% to 57% with an overall average of 41%. Bone fields with empty osteocyte lacunae were observed and measured. The amount of this so-called nonvital bone (NVB) varied between 1% and 34% of the total tissue volume. The amount of NVB decreased significantly with the time of healing. The data suggest that the majority of the osteocytes of the monocortical bone do not survive grafting. The results indicate that the NVB is progressively remodelled into new vital bone 7 months after grafting.

  7. Detection of Helicobacter pylori DNA in Aortic and Left Internal Mammary Artery Biopsies

    Science.gov (United States)

    Iriz, Erkan; Cirak, Meltem Yalinay; Engin, Evren Doruk; Zor, Mustafa Hakan; Erer, Dilek; Ozdogan, Mehmet Emin; Turet, Sevgi; Yener, Ali

    2008-01-01

    We investigated the relationship between acute coronary ischemia and the presence of Helicobacter pylori DNA in aortic regions that were absent macroscopic atheromatous plaques. The study group (Group 1) consisted of 42 patients who underwent coronary artery bypass grafting. Biopsy samples were obtained from 2 different locations: from regions of the aorta that were free (macroscopically) of atheromatous plaque (Group 1A), and from the internal mammary artery (Group 1B). The control group (Group 2) of 10 patients who had no atherosclerotic vascular disease provided aortic tissue samples for comparison. The real-time polymerase chain reaction method was used to detect H. pylori DNA in all biopsy samples. Eleven of 42 aortic tissue samples (26%) in Group 1A were positive for H. pylori DNA. Neither biopsies from the left internal mammary arteries of those patients nor biopsies from the aortas of the control group (Group 2) were positive for H. pylori DNA. There was a statistically significant difference between 1A and 1B in terms of H. pylori positivity (P=0.001). In Group 1 as a whole, acute coronary ischemia was more prevalent in the H. pylori-positive patients than in the H. pylori-negative patients (P=0.001). To our knowledge, this is the 1st study to investigate the detection of H. pylori DNA in aortic biopsy samples that are macroscopically free of atheromatous plaque. Such detection in patients who have atherosclerotic coronary artery disease could be an important indication of the role of microorganisms in the pathogenesis of atherosclerosis. PMID:18612444

  8. Treating Breast Conservation Therapy Defects with Brava and Fat Grafting: Technique, Outcomes, and Safety Profile.

    Science.gov (United States)

    Mirzabeigi, Michael N; Lanni, Michael; Chang, Catherine S; Stark, Ran Y; Kovach, Stephen J; Wu, Liza C; Serletti, Joseph M; Bucky, Louis P

    2017-09-01

    Fat grafting has been demonstrated as a means of reconstructing breast conservation therapy defects. However, there is continued uncertainty regarding its clinical efficacy and oncologic safety. Furthermore, the role of external preexpansion (i.e., with the Brava device) remains unclear in this setting. The purpose of this study was to examine the safety and clinical outcomes of Brava/fat grafting following breast conservation therapy. A retrospective chart review was performed on all patients undergoing fat grafting following breast conservation therapy. Complications were defined as either a clinically palpable oil cyst/area of fat necrosis or infection. The mean time of follow-up was 2.3 years. A total of 27 fat grafting sessions were performed on 20 patients, with an overall complication rate of 25 percent. The mean interval from completion of radiation therapy to fat grafting was 7 years and was not a significant predictor for complications (p = 0.46). Among those who underwent repeated grafting, there was no difference in the complication rates between their first and second encounters (p = 0.56). There was no difference in complication rates between patients with Brava preexpansion and those without preexpansion. Patients undergoing Brava preexpansion had a significantly higher initial fill volume in comparison with those who did not (219 cc versus 51 cc; p = 0.0017). There were no cases of locoregional cancer recurrence following fat grafting. Brava preexpansion was associated with higher initial fill volume in the setting of breast conservation therapy defects.

  9. Temporary Placement of Stent Grafts in Postsurgical Benign Biliary Strictures: a Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Vellody, Ranjith; Willatt, Jnonathon M.; Arabi, Mohammad; Cwikiel, Wojciech B [Division of Interventional Radiology, University of Michigan, Ann Arbor (United States)

    2011-11-15

    To evaluate the effect of temporary stent graft placement in the treatment of benign anastomotic biliary strictures. Nine patients, five women and four men, 22-64 years old (mean, 47.5 years), with chronic benign biliary anastomotic strictures, refractory to repeated balloon dilations, were treated by prolonged, temporary placement of stent-grafts. Four patients had strictures following a liver transplantation; three of them in bilio-enteric anastomoses and one in a choledocho-choledochostomy. Four of the other five patients had strictures at bilio-enteric anastomoses, which developed after complications following laparoscopic cholecystectomies and in one after a Whipple procedure for duodenal carcinoma. In eight patients, balloon-expandable stent-grafts were placed and one patient was treated by insertion of a self-expanding stent-graft. In the transplant group, treatment of patients with bilio-enteric anastomoses was unsuccessful (mean stent duration, 30 days). The patient treated for stenosis in the choledocho-choledochostomy responded well to consecutive self-expanding stent-graft placement (total placement duration, 112 days). All patients with bilio-enteric anastomoses in the non-transplant group were treated successfully with stent-grafts (mean placement duration, 37 days). Treatment of benign biliary strictures with temporary placement of stent-grafts has a positive effect, but is less successful in patients with strictures developed following a liver transplant.

  10. Modified technique to increase nostril cross-sectional area after using rib and septal cartilage graft over alar nasal cartilages.

    Science.gov (United States)

    Wulkan, Marcelo; Sá, Alvaro Julio de Andrade; Alonso, Nivaldo

    2012-10-01

    Describe a modified technique to increase nostril cross-sectional area using rib and septal cartilage graft over alar nasal cartilages. A modified surgical technique was used to obtain, carve and insert cartilage grafts over alar nasal cartilages. This study used standardized pictures and measured 90 cadaveric nostril cross-sectional area using Autocad(®); 30 were taken before any procedure and 60 were taken after grafts over lateral crura (30 using costal cartilage and 30 using septal cartilage). Statistical analysis were assessed using a model for repeated measures and ANOVA (Analysis of Variance) for the variable "area". There's statistical evidence that rib cartilage graft is more effective than septal cartilage graft. The mean area after the insertion of septal cartilage graft is smaller than the mean area under rib graft treatment (no confidence interval for mean difference contains the zero value and all P-values are below the significance level of 5%). The technique presented is applicable to increase nostril cross section area in cadavers. This modified technique revealed to enhance more nostril cross section area with costal cartilage graft over lateral crura rather than by septal graft.

  11. Coronary artery bypass grafting in a patient with organophosphate poisoning.

    Science.gov (United States)

    Pieris, Rajeeva R; Fernando, Ravindra

    2015-08-30

    A 43-year-old male, with no previous history of mental illness, was diagnosed with coronary heart disease, after which he became acutely depressed and attempted suicide by ingesting an organophosphate pesticide. He was admitted to an intensive care unit and treated with pralidoxime, atropine, and oxygen. His coronary occlusion pattern required early coronary artery bypass grafting (CABG) surgery. His family, apprehensive of a repeat suicidal attempt, requested surgery be performed as soon as possible. He recovered well from the OP poisoning and was mentally fit to express informed consent 2 weeks after admission. Seventeen days after poisoning, he underwent coronary artery bypass grafting and recovered uneventfully. Six years later, he remains in excellent health. We report this case because to the best of our knowledge there is no literature regarding CABG performed soon after organophosphate poisoning.

  12. Performing bone marrow biopsies with or without sedation: a comparison.

    Science.gov (United States)

    Giannoutsos, I; Grech, H; Maboreke, T; Morgenstern, G

    2004-06-01

    Although intravenous sedation (ISED) in addition to a local anaesthetic (LA) is commonly used in the performance of a bone marrow aspirate and trephine (BMAT), it is not clear under what circumstances and in which way sedation may be most beneficial. In this study, information was gathered using a questionnaire, from 112 patients shortly after undergoing BMAT; the duration of the procedures and the length of the biopsy cores were measured and any complications noted. Most patients (68%) chose to receive LA only, and almost all (74/76) were happy with their decision. Patients who received sedation gave lower pain scores than patients receiving LA only (1 vs. 3) and were found to have lower levels of apprehension at the thought of having a repeat procedure. Patients having a repeat BMAT showed a slightly increased preference for having sedation compared with patients who were undergoing it for the first time. There is some concern that guidelines regarding the use of ISED for procedures other than BMAT are not always adhered to, and current practice may be best revealed by a large-scale audit of sedation practice for the performance of BMAT. Patients should be given the choice of having ISED if the appropriate resources are available, but in most cases the additional small risk of receiving sedation can be avoided.

  13. Oral biopsy: Oral pathologist′s perspective

    Directory of Open Access Journals (Sweden)

    K L Kumaraswamy

    2012-01-01

    Full Text Available Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

  14. Muscle biopsy findings in inflammatory myopathies.

    Science.gov (United States)

    Dalakas, Marinos C

    2002-11-01

    The inflammatory myopathies encompass a heterogeneous group of acquired muscle diseases characterized clinically, by muscle weakness, and histologically, by inflammatory infiltrates within the skeletal muscles. The group of these myopathies comprise three major and discrete subsets: polymyositis (PM), dermatomyositis (DM), and inclusion body myositis (IBM). Each subset retains its characteristic clinical, immunopathologic, and morphologic features regardless of whether it occurs separately or in connection with other systemic diseases. Although the diagnosis of these disorders is based on the combination of clinical examination, electromyographic data, serum muscle enzyme levels, various autoantibodies, and the muscle biopsy findings, the muscle biopsy offers the most definitive diagnostic information in the majority of the cases. This article summarizes the main histologic features that characterize PM, DM, or IBM and emphasizes the main pitfalls associated with interpretation of the biopsies.

  15. Renal Biopsy in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Eugenia Espinel

    2015-05-01

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

  16. Prostate cancer detection with MR-ultrasound fusion biopsy: the role of systematic and targeted biopsies

    Science.gov (United States)

    Filson, Christopher P.; Natarajan, Shyam; Margolis, Daniel J.A.; Huang, Jiaoti; Lieu, Patricia; Dorey, Frederick J.; Reiter, Robert E.; Marks, Leonard S.

    2015-01-01

    BACKGROUND To evaluate performance of magnetic resonance (MR)-ultrasound guided fusion biopsy in diagnosing clinically significant prostate cancer (csCaP). METHODS 1042 men underwent multi-parametric MRI (mpMRI) and fusion biopsy consecutively in a prospective trial (2009 – 2014). An expert reader graded mpMRI regions of interest (ROI) 1–5 using published protocols. The fusion biopsy device was used to obtain targeted cores from ROIs (when present) followed by a fusion-image guided 12-core systematic biopsy in all men, even if no suspicious ROI. Primary endpoint was detection of clinically significant CaP (i.e., Gleason score ≥ 7). RESULTS Among 825 men with ≥ 1 suspicious ROI of grade 3 or higher, 289 (35%) had csCaP. Powerful predictors of csCaP were ROI grade (grade 5 vs 3, OR 6.5, pbiopsies detected more csCaP (n=289) than targeting (n=229) or systematic biopsy alone (n=199). Among patients with no suspicious ROI, 35 (16%) had csCaP on systematic biopsy. CONCLUSION In this prospective trial, MR-ultrasound fusion biopsy allowed detection of csCaP with a direct relationship with ROI grade and PSA density. The combination of targeted and systematic biopsy detected more csCaP than either modality alone; systematic biopsies revealed csCaP in 16% of men with no suspicious MRI target. Advantages of this new biopsy method are apparent, but issues of cost, training, and reliability await resolution prior to widespread adoption. PMID:26749141

  17. High-risk prostate cancer: value of multi-modality 3T MRI-guided biopsies after previous negative biopsies

    NARCIS (Netherlands)

    Fütterer, J.J.; Verma, S.; Hambrock, T.; Yakar, D.; Barentsz, J.O.

    2012-01-01

    Transrectal ultrasound-guided biopsy is the gold standard for prostate cancer detection. The latter detection rates of random systematic TRUS-guided biopsy do not exceed 44\\%. As a consequence other biopsy methods have been explored. One of these methods is MR-guided biopsy (MRGB), which revealed de

  18. Repeatability of Cryogenic Multilayer Insulation

    Science.gov (United States)

    Johnson, W. L.; Vanderlaan, M.; Wood, J. J.; Rhys, N. O.; Guo, W.; Van Sciver, S.; Chato, D. J.

    2017-01-01

    Due to the variety of requirements across aerospace platforms, and one off projects, the repeatability of cryogenic multilayer insulation has never been fully established. The objective of this test program is to provide a more basic understanding of the thermal performance repeatability of MLI systems that are applicable to large scale tanks. There are several different types of repeatability that can be accounted for: these include repeatability between multiple identical blankets, repeatability of installation of the same blanket, and repeatability of a test apparatus. The focus of the work in this report is on the first two types of repeatability. Statistically, repeatability can mean many different things. In simplest form, it refers to the range of performance that a population exhibits and the average of the population. However, as more and more identical components are made (i.e. the population of concern grows), the simple range morphs into a standard deviation from an average performance. Initial repeatability testing on MLI blankets has been completed at Florida State University. Repeatability of five GRC provided coupons with 25 layers was shown to be +/- 8.4 whereas repeatability of repeatedly installing a single coupon was shown to be +/- 8.0. A second group of 10 coupons have been fabricated by Yetispace and tested by Florida State University, through the first 4 tests, the repeatability has been shown to be +/- 16. Based on detailed statistical analysis, the data has been shown to be statistically significant.

  19. Retroperitoneoscopic renal biopsy: still a good indication!

    Science.gov (United States)

    Micali, Salvatore; Dandrea, Matteo; De Carne, Cosimo; Martorana, Eugenio; De Stefani, Stefano; Cappelli, Gianni; Bianchi, Giampaolo

    2014-01-01

    The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal. We present a case of a Jehovah's Witness patient with severe obesity, in whom conventional retroperitoneal laparoscopic renal biopsy was preferred to the LESS technique.

  20. Evolution of skin grafting for treatment of burns: Reverdin pinch grafting to Tanner mesh grafting and beyond.

    Science.gov (United States)

    Singh, Mansher; Nuutila, Kristo; Collins, K C; Huang, Anne

    2017-09-01

    Skin grafting is the current standard care in the treatment of full thickness burns. It was first described around 1500 BC but the vast majority of advancements have been achieved over the past 200 years. An extensive literature review was conducted on Pubmed, Medline and Google Scholar researching the evolution of skin grafting techniques. The authors concentrated on the major landmarks of skin grafting and also provide an overview of ongoing research efforts in this field. The major innovations of skin grafting include Reverdin pinch grafting, Ollier grafting, Thiersch grafting, Wolfe grafting, Padgett dermatome and modifications, Meek-wall microdermatome and Tanner mesh grafting. A brief description of the usage, advantages and limitations of each technique is included in the manuscript. Skin grafting technique have evolved significantly over past 200 years from Reverdin pinch grafting to modern day meshed skin grafts using powered dermatome. Increasing the expansion ratio and improving the cosmetic and functional outcome are the main focus of ongoing skin grafting research and emerging techniques (such as Integra(®), Recell(®), Xpansion(®)) are showing promise. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  1. Development of an in vitro porcine aorta model to study the stability of stent grafts in motor vehicle accidents.

    Science.gov (United States)

    Darvish, Kurosh; Shafieian, Mehdi; Romanov, Vasily; Rotella, Vittorio; Salvatore, Michael D; Blebea, John

    2009-04-01

    Endovascular stent grafts for the treatment of thoracic aortic aneurysms have become increasingly utilized and yet their locational stability in moderate chest trauma is unknown. A high speed impact system was developed to study the stability of aortic endovascular stent grafts in vitro. A straight segment of porcine descending aorta with stent graft was constrained in a custom-made transparent urethane casing. The specimen was tested in a novel impact system at an anterior inclination of 45 deg and an average deceleration of 55 G, which represented a frontal automobile crash. Due to the shock of the impact, which was shown to be below the threshold of aortic injury, the stent graft moved 0.6 mm longitudinally. This result was repeatable. The presented experimental model may be helpful in developing future grafts to withstand moderate shocks experienced in motor vehicle accidents or other dynamic loadings of the chest.

  2. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach

    Science.gov (United States)

    2011-01-01

    Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. Methods A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Results Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P biopsy group (81/719, 11.3%) than in the 8-gauge vacuum-assisted biopsy group (18/724, 2.5%) were recommended for further diagnostic surgical removal of additional tissue from the same anatomical site of the affected breast in an immediate fashion for indeterminate/inconclusive findings seen on the original ultrasound-guided diagnostic breast biopsy procedure. Significantly more (P biopsy group (54/719, 7.5%) than in the 8-gauge vacuum-assisted biopsy group (9/724, 1.2%) personally requested further

  3. REMODELING CHARACTERISTICS AND COLLAGEN DISTRIBUTIONS OF BIOLOGIC SCAFFOLD MATERIALS BIOPSIED FROM POSTMASTECTOMY BREAST RECONSTRUCTION SITES

    Science.gov (United States)

    Cavallo, Jaime A.; Gangopadhyay, Noopur; Dudas, Jason; Roma, Andres A.; Jasielec, Mateusz S.; Baty, Jack; Baalman, Sara; Frisella, Margaret M.; Tenenbaum, Marissa M.; Myckatyn, Terence M.; Matthews, Brent D.; Deeken, Corey R.

    2015-01-01

    OBJECTIVE The study purpose was to evaluate the associations between patient characteristics and the histologic remodeling scores of acellular dermal matrices (ADMs) biopsied from breast reconstruction sites in the first attempt to generate a multivariable risk prediction model of non-constructive remodeling. It was hypothesized that host characteristics and surgical site assessments predict the degree of graft remodeling for ADMs used during breast reconstruction. METHODS ADMs were biopsied from the breast reconstruction sites of n=62 patients during a subsequent breast procedure, stained with Hematoxylin and Eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics [cell types (CT), cell infiltration (CI), extracellular matrix (ECM) deposition, scaffold degradation (SD), fibrous encapsulation (FE), and neovascularization (NEO)] and a mean composite score (CR). Biopsies were stained with Sirius Red and Fast Green, and analyzed to determine the collagen I:III ratio. Based on univariate analyses between subject clinical characteristics and the histologic remodeling scores, cohort variables were selected for multivariable regression models using a p ≤0.20. RESULTS The CR score model yielded 3 variables: pack-year history, corticosteroid use, and radiation timing (r2pseudo=0.81). The model for collagen I yielded 2 variables: corticosteroid use and reason for reoperation (r2pseudo=0.78). The model for collagen III yielded 1 variable: reason for reoperation (r2pseudo=0.35). CONCLUSION These preliminary results constitute the first steps in generating a risk prediction model that predicts the patients and clinical circumstances most likely to experience non-constructive remodeling of biologic grafts used to reconstruct the breast. PMID:25910026

  4. Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports

    Directory of Open Access Journals (Sweden)

    J. Ramírez

    2013-01-01

    Full Text Available We report two cases of adenoviral infection in kidney transplant recipients that presented with different clinical characteristics under similar demographic and posttransplant conditions. The first case presented with fever, gross haematuria, and acute graft dysfunction 15 days following renal transplantation. A graft biopsy, analyzed with immunohistochemistry, yielded negative results. However, the diagnosis was confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. The immunosuppression dose was reduced, and ribavirin treatment was started, for which the patient quickly developed toxicity. Antiviral treatment allowed for transient response; however, a relapse occurred. The viral real-time PCR became negative upon immunosuppression reduction and administration of IVIG; graft function normalized. In the second case, the patient presented with fever and dysuria 1 month after transplantation. The initial imaging studies revealed graft enlargement and areas of hypoperfusion. In this case, the diagnosis was also confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. Adenoviral nephritis was confirmed through a graft biopsy analyzed with light microscopy, immunohistochemistry, and PCR in frozen tissue. The immunosuppression dose was reduced, and IVIG was administered obtaining excellent clinical results along with a negative real-time PCR.

  5. Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?

    Energy Technology Data Exchange (ETDEWEB)

    Schimmoeller, L.; Quentin, M.; Blondin, D.; Dietzel, F.; Schleich, C.; Thomas, C.; Antoch, G. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Hiester, A.; Rabenalt, R.; Albers, P.; Arsov, C. [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany); Gabbert, H.E. [University Dusseldorf, Medical Faculty, Department of Pathology, Dusseldorf (Germany)

    2016-11-15

    This study evaluates the feasibility of performing less than two core biopsies per MRI-lesion when performing targeted MR-guided in-bore prostate biopsy. Retrospectively evaluated were 1545 biopsy cores of 774 intraprostatic lesions (two cores per lesion) in 290 patients (66 ± 7.8 years; median PSA 8.2 ng/ml) regarding prostate cancer (PCa) detection, Gleason score, and tumor infiltration of the first (FBC) compared to the second biopsy core (SBC). Biopsies were acquired under in-bore MR-guidance. For the biopsy cores, 491 were PCa positive, 239 of 774 (31 %) were FBC and 252 of 771 (33 %) were SBC (p = 0.4). Patient PCa detection rate based on the FBC vs. SBC were 46 % vs. 48 % (p = 0.6). For clinically significant PCa (Gleason score ≥4 + 3 = 7) the detection rate was 18 % for both, FBC and SBC (p = 0.9). Six hundred and eighty-seven SBC (89 %) showed no histologic difference. On the lesion level, 40 SBC detected PCa with negative FBC (7.5 %). Twenty SBC showed a Gleason upgrade from 3 + 3 = 6 to ≥3 + 4 = 7 (2.6 %) and 4 to ≥4 + 3 = 7 (0.5 %). The benefit of a second targeted biopsy core per suspicious MRI-lesion is likely minor, especially regarding PCa detection rate and significant Gleason upgrading. Therefore, a further reduction of biopsy cores is reasonable when performing a targeted MR-guided in-bore prostate biopsy. (orig.)

  6. Vestibuloplasty: allograft versus mucosal graft.

    Science.gov (United States)

    Hashemi, H M; Parhiz, A; Ghafari, S

    2012-04-01

    The aim of the present study was to compare the application of alloderm and mucosal graft for vestibuloplasty. This randomized controlled trial with split mouth design was carried out on 20 edentulous patients. Patients underwent vestibuloplasty surgery with the Clark technique. Half of the prepared bed in each patient was covered with alloderm and the other half with mucosal graft. Vestibule depth (width of fixed tissue) and relapse in the two sides immediately after surgery, and 1, 3 and 6 months after surgery were measured and compared. Statistical analysis was carried out using the Kolmogorov-Smirnov, Student's paired t and Friedman tests. The width of the fixed tissue in the alloderm graft at 1, 3 and 6 month intervals was significantly lower than that in the autograft (Pvestibuloplasty. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. All rights reserved.

  7. Personalized cancer medicine guided by liquid biopsies

    NARCIS (Netherlands)

    N. Beije (Nick)

    2017-01-01

    markdownabstractThe capacity to optimally treat cancer patients is nowadays challenged by several factors. These challenges are particularly caused by tumor heterogeneity and plasticity, causing tumor characteristics to change over time and under treatment pressure. The use of liquid biopsies sample

  8. Histopathological study of cystoscopic bladder biopsies

    Directory of Open Access Journals (Sweden)

    R Baidya

    2015-03-01

    Full Text Available Background: Urinary bladder diseases constitute an important source of clinical signs and symptoms which are more disabling than lethal. The prevalence of bladder tumor in developed countries is approximately six times higher compared with that in developing countries. The aim of this study was to find out various lesions in urinary bladder biopsies and its frequencies.Materials and Methods: This was a five year retrospective study from January 2008 to December 2013, carried out at B&B Hospital, Lalitpur. All the relevant data of 324 patients who had undergone cystoscopic biopsy of urinary bladder were included in the study. All blocks were retrieved and stained with Hematoxylin and Eosin stain and examined under light microscope.Results: The spectrum of pathological lesions included inflammations and tumors. Non-neoplastic lesions were predominant (61.11% followed by Transitional cell tumors accounted for 124 cases (38.27%. Non-neoplastic lesions comprises of cystitis and tuberculosis. Papillary urothelial neoplasms was the most common tumors seen in this study with 55 low grade, and 54 high grade Papillary urothelial carcinoma according to recent WHO grading. Single cases each of adenocarcinoma and paraganglioma were diagnosed.Conclusion: Cystoscopic biopsies help in the early diagnosis and treatment of various bladder lesions. Analysis of cystoscopic biopsies was done to ascertain the type of urinary bladder lesions in our country.Journal of Pathology of Nepal (2015 Vol. 5, 717-719

  9. Core biopsies of the breast: Diagnostic pitfalls

    Directory of Open Access Journals (Sweden)

    Megha Joshi

    2011-01-01

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

  10. Liver biopsy in liver patients with coagulopathy

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  11. Endoscopic biopsy: Duodenal ulcer penetrating into liver

    Institute of Scientific and Technical Information of China (English)

    Baybora Kircali; Tülay Saricam; Aysegul Ozakyol; Eser Vardareli

    2005-01-01

    @@ TO THE EDITOR We have read with interest the recent report by E Kayacetin and S Kayacetin of Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy[1] since we diagnosed the duodenal ulcer which penetrated into liver similarly. This is a rather unusual case because of the fifth case in the literature and responding to medical therapy.

  12. Study of prostate biopsy robot system

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yong-de; ZHANG Long; ZHAO Yan-jiang; ZHANG Yan-hua

    2009-01-01

    A system for prostate biopsy with robot assistance was proposed. The system consists of Motoman robot, needle insertion mechanism, and control software. A experiment was held with this software, and it proved that the whole system is simple, reliable and good application.

  13. Biopsy of Brainstem Gliomas Using Flexible Endoscopes.

    Science.gov (United States)

    Torres-Corzo, Jaime Gerardo; Sanchez-Rodriguez, Jose; Castillo-Rueda, Juan Lucino; Falcon-Escobedo, Reynaldo; Cervantes, Dominic; Rodriguez-Della Vecchia, Roberto; Vinas-Rios, Juan Manuel

    2015-07-01

    To describe our experience and the results obtained in performing transventricular brainstem biopsy with the use of flexible neuroendoscops. We identified patients who underwent a neuroendoscopic procedure with brainstem lesion biopsy to obtain histopathologic diagnosis and to treat obstructive hydrocephalus. All patients had follow-up examinations at months 1, 3, 6, and 12 postsurgery and then annually. Seven patients had a transventricular biopsy of the brainstem performed. Of those, five were pediatric patients. The median age was 10 years (range: 3-26 years). Five of them were female and two male. Four patients presented with secondary obstructive hydrocephalus. The main clinical presentations were intracranial hypertension syndrome in four patients, motor neuron disease in four patients, two with decreased state of alertness, two with gait ataxia, and one with Parinaud syndrome. The types of tumors found in the histopathology and their location were one ventral (pons) and one aqueductal anaplastic astrocytoma, two ventral, one aqueductal, and one attached to the floor of the fourth ventricle pilocytic astrocytoma and one ventral low-grade astrocytoma. The route taken to approach the ventral tumors was made through premammillary fenestration. The tumors of the aqueduct and floor of the fourth ventricle were approached transaqueductally. The use of flexible endoscops for biopsy of ventral, dorsal (tectum lamina quadrigemina), and diffuse brainstem tumors is a useful, effective, and safe procedure that also allows to treat obstructive hydrocephalus secondary to the tumors. Georg Thieme Verlag KG Stuttgart · New York.

  14. Personalized cancer medicine guided by liquid biopsies

    NARCIS (Netherlands)

    N. Beije (Nick)

    2017-01-01

    markdownabstractThe capacity to optimally treat cancer patients is nowadays challenged by several factors. These challenges are particularly caused by tumor heterogeneity and plasticity, causing tumor characteristics to change over time and under treatment pressure. The use of liquid biopsies sample

  15. Reducing infection rates after prostate biopsy.

    Science.gov (United States)

    Wagenlehner, Florian M E; Pilatz, Adrian; Waliszewski, Przemyslaw; Weidner, Wolfgang; Johansen, Truls E Bjerklund

    2014-02-01

    Over the years, prostate biopsy has become the gold-standard technique for diagnosing prostate carcinoma. Worldwide, several million prostate biopsies are performed every year, most commonly using the transrectal approach. Preoperative antibiotic prophylaxis with fluoroquinolones has been shown to be effective for reducing infection rates. However, in recent years, an increase in febrile infection rates after transrectal prostate biopsy (from 1% to 4%) has been reported in retrospective and prospective studies. The predominant risk factor for infection seems to be the presence of fluoroquinolone-resistant bacteria in faeces. Patients at risk of fluoroquinolone resistance should receive carefully selected antibiotics at sufficient concentrations to be effective. Targeted prophylaxis after rectal flora swabbing has been shown to be efficacious compared with empirical antibiotic prophylaxis. Several forms of bowel preparations are under investigation, although none have yet been shown to significantly reduce infection rates. Perineal prostate biopsy is currently being evaluated as a strategy for preventing the inoculation of rectal flora, but limited data support this approach at present.

  16. Psychiatric disorder associated with vacuum-assisted breast biopsy clip placement: a case report

    Directory of Open Access Journals (Sweden)

    Zografos George C

    2008-10-01

    Full Text Available Abstract Introduction Vacuum-assisted breast biopsy is a minimally invasive technique that has been used increasingly in the treatment of mammographically detected, non-palpable breast lesions. Clip placement at the biopsy site is standard practice after vacuum-assisted breast biopsy. Case presentation We present the case of a 62-year-old woman with suspicious microcalcifications in her left breast. The patient was informed about vacuum-assisted breast biopsy, including clip placement. During the course of taking the patient's history, she communicated excellently, her demeanor was normal, she disclosed no intake of psychiatric medication and had not been diagnosed with any psychiatric disorders. Subsequently, the patient underwent vacuum-assisted breast biopsy (11 G under local anesthesia. A clip was placed at the biopsy site. The pathological diagnosis was of sclerosing adenosis. At the 6-month mammographic follow-up, the radiologist mentioned the existence of the metallic clip in her breast. Subsequently, the woman presented complaining about "being spied [upon] by an implanted clip in [her] breast" and repeatedly requested the removal of the clip. The patient was referred to the specialized psychiatrist of our breast unit for evaluation. The Mental State Examination found that systematized paranoid ideas of persecutory type dominated her daily routines. At the time, she believed that the implanted clip was one of several pieces of equipment being used to keep her under surveillance, the other equipment being her telephone, cameras and television. Quite surprisingly, she had never had a consultation with a mental health professional. The patient appeared depressed and her insight into her condition was impaired. The prevalent diagnosis was schizotypal disorder, whereas the differential diagnosis comprised delusional disorder of persecutory type, affective disorder with psychotic features or comorbid delusional disorder with major depression

  17. EFFICACY OF IMMUNOHISTOCHEMISTRY IN PROSTATE NEEDLE BIOPSIES

    Directory of Open Access Journals (Sweden)

    Tameem Afroz

    2016-10-01

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

  18. Positive predictive value of high-grade prostatic intraepithelial neoplasia in initial core needle biopsies of prostate adenocarcinoma--a study with complete sampling of hemi-prostates with corresponding negative biopsy findings.

    Science.gov (United States)

    Delatour, Nicolas L D Roustan; Mai, Kien T

    2008-09-01

    High-grade prostatic intraepithelial neoplasia (HGPIN) is a putative premalignant lesion of prostate adenocarcinoma (PCa). The significance of isolated HGPIN in initial biopsy cores as a marker of PCa in repeat biopsies has been extensively investigated, but little is known of the true occurrence of PCa in this setting, because repeat biopsies can miss the focus of cancer. In this study, a hemi-prostate model was used to define the true positive predictive value of HGPIN in core biopsies in predicting PCa. From 132 consecutive resected prostate specimens, 70 hemi-prostates with all corresponding biopsy cores negative for PCa were thoroughly examined. Of the 70 hemi-prostates, 38 had PCa (including 8 with clinically significant PCa), and 11 had HGPIN. In the group of 38 hemi-prostate with PCa, 7 were associated with HGPIN-positive biopsies. No statistically significant difference was found between the hemi-prostates with or without PCa, regarding the presence, microscopic pattern, or multiple core involvement of HGPIN in the biopsies. The positive predictive value of HGPIN in predicting for clinically significant PCa was 27%, the negative predictive value was 87%, the sensitivity was 38%, and the specificity was 91% (P = 0.04, statistically significant). In addition, the positive predictive value of multiple cores with HGPIN in predicting for clinically significant PCa was 75% (negative predictive value 92%). The results of the present study have failed to support HGPIN as a statistically significant predictor for the occurrence of PCa. More importantly, however, HGPIN and multiple core involvement did seem to be a useful marker for clinically significant PCa.

  19. Prevention of primary vascular graft infection with silver-coated polyester graft in a porcine model

    DEFF Research Database (Denmark)

    Gao, H; Sandermann, J; Prag, J;

    2010-01-01

    To evaluate the efficacy of a silver-coated vascular polyester graft in the prevention of graft infection after inoculation with Staphylococcus aureus in a porcine model.......To evaluate the efficacy of a silver-coated vascular polyester graft in the prevention of graft infection after inoculation with Staphylococcus aureus in a porcine model....

  20. Complications of percutaneous renal tumor biopsy: An analysis of 340 consecutive biopsies

    DEFF Research Database (Denmark)

    René Rasmussen, Lars; Loft, Martina; Høyer, Søren;

    Purpose Ultrasound Guided Percutaneous Kidney Biopsy (UGPKB) plays a major role in diagnosis of renal tumours. There seems to be little consensus regarding post-biopsy observation period. We aim to identify complications in UGPKB among outpatients with a suspected malignant renal lesion as well...... as the timing of onset of these complications, helping to clarify the optimal observation period. Many studies in this field suggest a lower complication risk for outpatients compared to hospitalized patients. In the latter group, an observation period of 24h after biopsy is often recommended. Material...... discrepancy. Results As for one third of the patients, analysed up until now, we find a total of one major complication and a few minor, all arisen within less than 6 hours after biopsy. Conclusions Rates of both major and minor complications in UGPKB are very low suggesting a shorter observation period...

  1. Feasibility of fine-needle aspiration biopsy and its applications in superficial cervical lesion biopsies.

    Science.gov (United States)

    Xu, Dong; Xu, Hai-Miao; Li, Ming-Kui; Chen, Li-Yu; Wang, Li-Jing

    2014-01-01

    The aim of the study was to investigate the feasibility and value of clinical application of fine-needle aspiration histological biopsy via ultrasound-guided thyroid nodule and enlarged cervical lymph node fine-needle aspiration histological biopsy. Fine-needle aspiration cytological and histological biopsies and surgical treatments were performed on 982 patients with thyroid nodule and 1435 patients with enlarged cervical lymph nodes. A comparative study of the histological and cytological examination results and post-surgical etiology results was subsequently conducted. Among the 982 thyroid nodule patients, the acquisition rates were 89.8% (882/982) for fine-needle aspiration histological biopsy and 96.2% (945/982) for cytological biopsy, while among the 1435 patients with enlarged cervical lymph nodes, the acquisition rate for fine-needle aspiration cytological biopsy was slightly higher than that for histological biopsy, with values of 95.7% (1374/1435) and 91.4% (1312/1435), respectively. For the thyroid nodule patients, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 98.5%, 100%, and 98.9%, respectively, whereas those of the cytological results were 86.8%, 82.9%, and 85.6%, respectively; the differences between the 2 biopsy methods were statistically significant (P < 0.05). For the patients with enlarged cervical lymph nodes, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 96.3%, 99.8%, and 97.6%, respectively, whereas the those of the cytological results were 76.8%, 92.1%, and 82.2%, respectively; again, the differences between the 2 methods were statistically significant (P < 0.05). In conclusion, Fine-needle aspiration histological biopsy is a reliable and highly

  2. Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors

    Science.gov (United States)

    Harmon, Stephanie A.; Tuite, Michael J.; Jeraj, Robert

    2016-10-01

    Site selection for image-guided biopsies in patients with multiple lesions is typically based on clinical feasibility and physician preference. This study outlines the development of a selection algorithm that, in addition to clinical requirements, incorporates quantitative imaging data for automatic identification of candidate lesions for biopsy. The algorithm is designed to rank potential targets by maximizing a lesion-specific score, incorporating various criteria separated into two categories: (1) physician-feasibility category including physician-preferred lesion location and absolute volume scores, and (2) imaging-based category including various modality and application-specific metrics. This platform was benchmarked in two clinical scenarios, a pre-treatment setting and response-based setting using imaging from metastatic prostate cancer patients with high disease burden (multiple lesions) undergoing conventional treatment and receiving whole-body [18F]NaF PET/CT scans pre- and mid-treatment. Targeting of metastatic lesions was robust to different weighting ratios and candidacy for biopsy was physician confirmed. Lesion ranked as top targets for biopsy remained so for all patients in pre-treatment and post-treatment biopsy selection after sensitivity testing was completed for physician-biased or imaging-biased scenarios. After identifying candidates, biopsy feasibility was evaluated by a physician and confirmed for 90% (32/36) of high-ranking lesions, of which all top choices were confirmed. The remaining cases represented lesions with high anatomical difficulty for targeting, such as proximity to sciatic nerve. This newly developed selection method was successfully used to quantitatively identify candidate lesions for biopsies in patients with multiple lesions. In a prospective study, we were able to successfully plan, develop, and implement this technique for the selection of a pre-treatment biopsy location.

  3. Differences in pain perception during open muscle biopsy and Bergstroem needle muscle biopsy

    OpenAIRE

    Dengler J; Linke P; Gdynia HJ; Wolf S.; Ludolph AC; Vajkoczy P; Meyer T

    2014-01-01

    Julius Dengler,1 Peter Linke,2 Hans J Gdynia,3 Stefan Wolf,1 Albert C Ludolph,3 Peter Vajkoczy,1 Thomas Meyer2 1Department of Neurosurgery, 2Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; 3Department of Neurology, Universitätsklinikum Ulm, Ulm, GermanyPurpose: Open surgical muscle biopsy (OB) and percutaneous Bergstroem needle muscle biopsy (NB) are equally accepted procedures. However, there are no data comparing intrapr...

  4. Grafting efficiency of synthetic polymers onto biomaterials: a comparative study of grafting-from versus grafting-to.

    Science.gov (United States)

    Hansson, Susanne; Trouillet, Vanessa; Tischer, Thomas; Goldmann, Anja S; Carlmark, Anna; Barner-Kowollik, Christopher; Malmström, Eva

    2013-01-14

    In the present study, the two grafting techniques grafting-from - by activators regenerated by electron transfer atom transfer radical polymerization (ARGET ATRP) - and grafting-to - by copper(I)-catalyzed azide-alkyne cycloaddition (CuAAC) - were systematically compared, employing cellulose as a substrate. In order to obtain a meaningful comparison, it is crucial that the graft lengths of the polymers that are grafted from and to the substrates are essentially identical. Herein, this was achieved by utilizing the free polymer formed in parallel to the grafting-from reaction as the polymer for the grafting-to reaction. Four graft lengths were investigated, and the molar masses of the four free polymers (21 ≤ M(n) ≤ 100 kDa; 1.07 ≤ Đ(M) ≤ 1.26), i.e. the polymers subsequently employed in the grafting-to reaction, were shown to be in the same range as the molar masses of the polymers grafted from the surface (23 ≤ M(n) ≤ 87 kDa; 1.08 ≤ Đ(M) ≤ 1.31). The molecular weights of the chains grafted from the surface were established after cleavage from the cellulose substrates via size exclusion chromatography (SEC). High-resolution Fourier transform infrared microscopy (FT-IRM) was employed as an efficient tool to study the spatial distribution of the polymer content on the grafted substrates. In addition, the functionalized substrates were analyzed by X-ray photoelectron spectroscopy (XPS), contact angle (CA) measurements, and field-emission scanning electron microscopy (FE-SEM). For cellulose substrates modified via the grafting-from approach, the content of polymer on the surfaces increased with increasing graft length, confirming the possibility to tailor not only the length of the polymer grafts but also the polymeric content on the surface. In comparison, for the grafting-to reaction, the grafted content could not be controlled by varying the length of the preformed polymer: the polymer content was essentially the same for the four graft lengths

  5. CT-guided bone biopsy: Initial experience with a commercially available hand held Black and Decker{sup TM} drill

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, O. [Department of Radiology, Adelaide and Meath, Hospital, Tallaght, Dublin 24 (Ireland); Benfayed, W. [Department of Radiology, Adelaide and Meath, Hospital, Tallaght, Dublin 24 (Ireland); Geoghegan, T. [Department of Radiology, Adelaide and Meath, Hospital, Tallaght, Dublin 24 (Ireland); Al-Ismail, K. [Department of Radiology, King Faisal Hospital (Saudi Arabia); Munk, P.L. [Department of Radiology, Musculo-Skeletal division, Vancouver General Hospital, 899 W. 12th Ave., Vancouver, BC V5Z 1M9 (Canada); Torreggiani, William C. [Department of Radiology, Adelaide and Meath, Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail: william.torreggiani@amnch.ie

    2007-01-15

    Purpose: To describe the use of a simple commercially available Black and Decker{sup TM} hand based drill in performing CT-guided bone biopsies. Materials and methods: Three international institutions were enrolled in the study. In each centre, a fellowship trained musculoskeletal radiologist directed the assessment of a hand based commercial drill for performing CT-guided bone biopsies. A specially designed component was engineered which allowed the connection of a standard bone biopsy set to a commercial drill. The component was distributed to the three centres involved. Over a 3-year period, data from all three institutions was collected. Information regarding technical success, diagnostic data and complication rates were all collated to assess the technical feasibility of this technique. Results: In total 68 patients underwent bone biopsy using a hand held commercial drill. Technical success was achieved in 65 patients. Diagnostic material was obtained in 53 patients. Non-diagnostic material was obtained in 12 patients. Five out of the 12 patients with non-diagnostic material had repeat biopsies with diagnostic material obtained in 2 of these. No major complications occurred in any patient. Conclusion: CT-guided bone biopsy using a hand held commercial drill has a technically high success rate with minimal complications.

  6. STUDY OF GRAFT SITES IN EPOXY GRAFT COPOLYMERS BY QUANTUM CHEMISTRY CALCULATIONS

    Institute of Scientific and Technical Information of China (English)

    Song Chen; Xiao-yu Li

    2009-01-01

    Exploration and characterization of grafting productions by experimental methods are often cumbersome or sometimes impossible. Therefore, quantum chemistry calculations were performed to characterize the graft sites of epoxy resin. According to the Gibbs free energy criterion of the second law of thermodynamic, the reported graft sites were confirmed, and more important, some unreported graft sites were found. In addition, method of increasing the number of graft sites was studied in this article.

  7. RELEVANCE OF ARTHROSCOPIC SYNOVIAL BIOPSY IN JOINT DISORDERS - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Kali Vara Prasad

    2015-10-01

    Full Text Available BACK GROUND : Synovial biopsy is considered as the gold standard in the diagnosis of various joint disorders and synovial diseases. But sometimes the definitive diagnosis is elusive only by doing biopsy then clinical, hematological and x - ray examinations will help. The advantage with arthroscopic synovial biopsy is that it is easy to perform, minimal discomfort to the patient and can be done at intervals if the diagnosis can n ot be made in the first examination. MATERIAL & METHODS : The present study was conducted in the Department of Orthopedics & Traumatology, Osmania General Hospital/ Medical College, Hyderabad. The duration of the study was from Sept 2012 to Sept 2014. CONCLUSIONS : Arthroscopic synovial biopsy is the mainstay in the management of Joint disorders and Synovial diseases. It is patient friendly and repeated procedures can be undertaken when the definitive diagnosis could not be established in the initial attempt, as is common in some cases of Non - specific synovitis, later being diagnosed either as Osteoarthritis or Rheumatoid Arthritis. This is the greatest advantage in using this procedure.

  8. Polyether-polyester graft copolymer

    Science.gov (United States)

    Bell, Vernon L. (Inventor)

    1987-01-01

    Described is a polyether graft polymer having improved solvent resistance and crystalline thermally reversible crosslinks. The copolymer is prepared by a novel process of anionic copolymerization. These polymers exhibit good solvent resistance and are well suited for aircraft parts. Previous aromatic polyethers, also known as polyphenylene oxides, have certain deficiencies which detract from their usefulness. These commercial polymers are often soluble in common solvents including the halocarbon and aromatic hydrocarbon types of paint thinners and removers. This limitation prevents the use of these polyethers in structural articles requiring frequent painting. In addition, the most popular commercially available polyether is a very high melting plastic. This makes it considerably more difficult to fabricate finished parts from this material. These problems are solved by providing an aromatic polyether graft copolymer with improved solvent resistance and crystalline thermally reversible crosslinks. The graft copolymer is formed by converting the carboxyl groups of a carboxylated polyphenylene oxide polymer to ionic carbonyl groups in a suitable solvent, reacting pivalolactone with the dissolved polymer, and adding acid to the solution to produce the graft copolymer.

  9. The caudal septum replacement graft.

    Science.gov (United States)

    Foda, Hossam M T

    2008-01-01

    To describe a technique for reconstructing the lost tip support in cases involving caudal septal and premaxillary deficiencies. The study included 120 patients with aesthetic and functional nasal problems resulting from the loss of caudal septal and premaxillary support. An external rhinoplasty approach was performed to reconstruct the lost support using a cartilaginous caudal septum replacement graft and premaxillary augmentation with Mersilene mesh. The majority of cases (75%) involved revisions in patients who had previously undergone 1 or more nasal surgical procedures. A caudal septum replacement graft was combined with premaxillary augmentation in 93 patients (77.5%). The mean follow-up period was 3 years (range, 1-12 years). The technique succeeded in correcting the external nasal deformities in all patients and resulted in a significant improvement in breathing in 74 patients (86%) with preoperative nasal obstruction. There were no cases of infection, displacement, or extrusion. The caudal septum replacement graft proved to be very effective in restoring the lost tip support in patients with caudal septal deficiency. Combining the graft with premaxillary augmentation using Mersilene mesh helped increase support and stability over long-term follow-up.

  10. Percutaneous biopsy of a metastatic common iliac lymph node using hydrodissection and a semi-automated biopsy gun

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Seong Yoon; Park, Byung Kwan [Dept. of Radiology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-06-15

    Percutaneous biopsy is a less invasive technique for sampling the tissue than laparoscopic biopsy or exploratory laparotomy. However, it is difficult to perform biopsy of a deep-seated lesion because of the possibility of damage to the critical organs. Recently, we successfully performed CT-guided biopsy of a metastatic common iliac lymph node using hydrodissection and semi-automated biopsy devices. The purpose of this case report was to show how to perform hydrodissection and how to use a semi-automated gun for safe biopsy of a metastatic common iliac lymph node.

  11. [Soft tissues volumes changing in malar and cheek area after fat grafting].

    Science.gov (United States)

    Nadtochiy, A G; Grischenko, S V; Malitskaya, O A

    2016-01-01

    To improve the predictability of facial soft tissues fat grafting results tissue thickness dynamics before and 1 year postoperatively was assessed by means of ultrasonic method in 58 patients under standardized position of the ultrasonic transducer, physical and technical scanning conditions. The study revealed direct correlation of soft tissues thickness increase after fat grafting with the initial thickness of recipient area tissues. One year after fat grafting 60-65% of additional thickness remained in the lower regions of malar-cheek area (with the greatest soft tissues thickness), and only 25-27% preserved in the upper regions with the minimal initial thickness of soft tissues. I.e. to achieve necessary correction volume in a zone with small initial soft tissues thickness it is necessary to increase the amount of fat grafting stages. As the rates of soft tissues thickness in correction area change during 3-4 months after fat grafting remaining stable after this period it is expedient to assess postoperative results and to carry out repeated fat grafting not earlier than 4 months after operation.

  12. Guidelines for processing and reporting of prostatic needle biopsies

    NARCIS (Netherlands)

    Th.H. van der Kwast (Theo); C. Lopes; C. Santonja; C.G. Pihl; I. Neetens; P. Martikainen (Pekka); S. di Lollo; L. Bubendorf; R.F. Hoedemaeker

    2003-01-01

    textabstractThe reported detection rate of prostate cancer, lesions suspicious for cancer, and prostatic intraepithelial neoplasia (PIN) in needle biopsies is highly variable. In part, technical factors, including the quality of the biopsies, the tissue processing, and histopatholo

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  14. Factors that can minimize bleeding complications after renal biopsy.

    Science.gov (United States)

    Zhu, M S; Chen, J Z; Xu, A P

    2014-10-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding diatheses, amyloidosis, advanced age, gender and so on. Our primary purpose of this review is to summarize current measures in recent years literature aiming at minimizing the bleeding complication after the renal biopsy, including the drug application before and after renal biopsy, operation details in percutaneous renal biopsies, nursing and close monitoring after the biopsy and other kinds of biopsy methods.

  15. A Prospective Randomized Trial of Two Different Prostate Biopsy Schemes

    Science.gov (United States)

    2016-07-03

    Prostate Cancer; Local Anesthesia; Prostate-Specific Antigen/Blood; Biopsy/Methods; Image-guided Biopsy/Methods; Prostatic Neoplasms/Diagnosis; Prostate/Pathology; Prospective Studies; Humans; Male; Ultrasonography, Interventional/Methods

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

    African Journals Online (AJOL)

    2011-06-11

    Jun 11, 2011 ... The sensitivity of PSA was 99.2%. ... Needle biopsy allows appropriate surgical treatment for patients whose .... 715 consecutive breast biopsies with at least two year follow‑up of benign lesions. ... The effects of castration.

  17. A randomised controlled trial comparing use of lignocaine periprostatic nerve block alone and combined with diclofenac suppository for patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy.

    Science.gov (United States)

    Ooi, Wei Ling; Hawks, Cynthia; Tan, Andrew H H; Hayne, Dickon

    2014-11-01

    To examine whether or not the combination of diclofenac suppository with peri-prostatic nerve block (PPNB) was effective in reducing the degree of pain experienced during transrectal ultrasound (TRUS)-guided prostate biopsy in a randomised single-blind placebo-controlled trial. In all, 96 patients having a planned TRUS-guided prostate biopsy were randomised into one of the following arms on a 1:1 basis: 10 mL 1% lignocaine PPNB and placebo suppository (control) or 10 mL 1% lignocaine PPNB and 100 mg diclofenac suppository (treatment). Pain scores were recorded using the Numerical Rating Scale for pain (0-10) at the following time-points: (i) introduction of probe, (ii) during biopsy, (iii) 1 h after biopsy, (iv) later that evening (≈6 h after biopsy) and (v) 1 day after biopsy. Patients were asked about their preferred method for pain control if a repeat TRUS-guided prostate biopsy was required: local anaesthetic (LA) again or intravenous sedation. There were no significant differences in age (P = 0.653) or PSA level (P = 0.584) between either study arm. The differences in pain scores between the control and treatment groups were not significant at Time 1 (probe insertion; P = 0.299), Time 2 (biopsy; P = 0.983), Time 4 (evening after; P = 0.231) and Time 5 (1 day after biopsy; P = 0.384). At Time 3 (1 h after biopsy), the control pain scale scores were statistically significantly higher than the treatment pain scale scores (P = 0.044). There was no difference between treatment (87%) and control (80%) groups as to whether they would prefer to repeat the biopsy under LA (P = 0.373). The use of a diclofenac suppository with PPNB did not show any clinically meaningful effect in decreasing pain or improving tolerability of TRUS-guided prostate biopsy and is not recommended. PPNB TRUS-guided biopsy is extremely well tolerated, with >80% of patients electing for subsequent LA biopsy if required. © 2014 The Authors. BJU International © 2014 BJU

  18. Skin biopsy in assessing meralgia paresthetica.

    Science.gov (United States)

    Wongmek, Arada; Shin, Susan; Zhou, Lan

    2016-04-01

    Meralgia paresthetica is a focal neuropathy caused by compression of the lateral femoral cutaneous nerve (LFCN). The disease can be difficult to assess by neurophysiological or imaging studies. We studied 5 patients who presented to our neuromuscular clinic from April 2012 to December 2014 with a clinical suspicion of meralgia paresthetica and had skin biopsies with intraepidermal nerve fiber density (IENFD) evaluation. The mean age at onset was 37.2 (range 21-59) years. There were 4 women and 1 man. Two were obese, 2 wore tight jeans, and 1 had mild diabetes mellitus. IENFD was reduced in the symptomatic proximal thigh in all 5 patients and was also reduced in the asymptomatic thigh in 2 patients. It was normal in the distal leg in 4 patients. Meralgia paresthetica is associated with loss of small intraepidermal nerve fibers. Skin biopsy with IENFD evaluation may be a useful diagnostic tool for this disease. © 2016 Wiley Periodicals, Inc.

  19. Higher Prostate Cancer Grade Groups Are Detected in Patients Undergoing Multiparametric MRI-targeted Biopsy Compared With Standard Biopsy.

    Science.gov (United States)

    Gordetsky, Jennifer B; Thomas, John V; Nix, Jeffrey W; Rais-Bahrami, Soroush

    2017-01-01

    Recent studies have suggested that multiparametric magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided prostate biopsy can detect more clinically significant prostate cancers, which could impact patient management. As many of the studies evaluating MRI/US fusion-guided prostate biopsy were conducted in specialized quaternary care centers, the question remains whether this technology is transferable to general practice. Our study assesses the diagnostic ability of MRI/US fusion-guided prostate biopsy compared with standard biopsy in the new era of prostate cancer Grade Grouping. We reviewed our prostate biopsy database evaluating men who underwent MRI/US fusion-guided prostate biopsy with concurrent standard 12-core extended-sextant biopsy. Patient demographics and pathologic findings were reviewed. All patient biopsies were performed by 1 of 2 urologic oncologists. Tumors were given a Grade Group for each biopsy based on the core with the highest grade in each case. A total of 191 patients underwent MRI/US fusion-guided biopsy with concurrent 12-core extended sextant biopsy, with a cancer detection rate of 56%. The average number of biopsy cores obtained via the targeted approach was significantly less than those obtained by standard biopsy, 4.8 cores versus 12 cores, respectively, Pbiopsy, 41.4% and 49.2%, respectively, P=0.15. However, when comparing the 2 techniques, the degree of detection of ≥Grade Group 3 tumors significantly favored targeted biopsy over standard biopsy (P=0.009). MRI/US fusion-guided prostate biopsy is equivalent to the standard-of-care 12-core biopsy in terms of cancer detection and superior in detecting higher grade disease.

  20. Expansion of protein domain repeats.

    Directory of Open Access Journals (Sweden)

    Asa K Björklund

    2006-08-01

    Full Text Available Many proteins, especially in eukaryotes, contain tandem repeats of several domains from the same family. These repeats have a variety of binding properties and are involved in protein-protein interactions as well as binding to other ligands such as DNA and RNA. The rapid expansion of protein domain repeats is assumed to have evolved through internal tandem duplications. However, the exact mechanisms behind these tandem duplications are not well-understood. Here, we have studied the evolution, function, protein structure, gene structure, and phylogenetic distribution of domain repeats. For this purpose we have assigned Pfam-A domain families to 24 proteomes with more sensitive domain assignments in the repeat regions. These assignments confirmed previous findings that eukaryotes, and in particular vertebrates, contain a much higher fraction of proteins with repeats compared with prokaryotes. The internal sequence similarity in each protein revealed that the domain repeats are often expanded through duplications of several domains at a time, while the duplication of one domain is less common. Many of the repeats appear to have been duplicated in the middle of the repeat region. This is in strong contrast to the evolution of other proteins that mainly works through additions of single domains at either terminus. Further, we found that some domain families show distinct duplication patterns, e.g., nebulin domains have mainly been expanded with a unit of seven domains at a time, while duplications of other domain families involve varying numbers of domains. Finally, no common mechanism for the expansion of all repeats could be detected. We found that the duplication patterns show no dependence on the size of the domains. Further, repeat expansion in some families can possibly be explained by shuffling of exons. However, exon shuffling could not have created all repeats.

  1. MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Zangos, Stephan [Johann Wolfgang Goethe-University, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt/Main (Germany); Johann Wolfgang Goethe-University, Institute for Diagnostic and Interventional Radiology, Frankfurt/Main (Germany); Eichler, Katrin; Engelmann, Kerstin; Ahmed, Mukhtiar; Dettmer, Sebastian; Herzog, Christopher; Pegios, Wasilios; Wetter, A.; Lehnert, Thomas; Mack, Martin G.; Vogl, Thomas J. [Johann Wolfgang Goethe-University, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt/Main (Germany)

    2005-01-01

    The purpose of this study was to examine the feasibility and safety of MR-guided biopsies with a transgluteal approach in patients with uncertain or suspicious prostate lesions. Twenty-five patients with uncertain or suspicious focal prostate lesions detected by high-field MR imaging of the prostate gland using endorectal coil imaging were biopsied with a transgluteal approach in a low-field MRI system (0.2 T, Concerto, Siemens). The procedures were guided using T1-weighted FLASH sequences. The prostate gland was biopsied repeatedly with a coaxial technique through a 15-gauge pencil tip with a 16-gauge biopsy handy (median 3.8 samples per patient). Complications and biopsy findings were documented retrospectively. Using T1-weighted sequences biopsy procedures were performed successfully with MR guidance in all cases without any side effects or complications. The median intervention time was 11.3 min. Pathological findings revealed ten cases of hyperplasia or atrophy, three cases of prostatitis, ten cases of carcinoma and two cases of normal tissue. The clinical follow-up showed that in two patients prostate cancer was missed at MR-guided biopsy. Transgluteal MR-guided biopsy of the prostate gland is a safe and promising approach for histological clarification of uncertain or suspicious lesions. (orig.)

  2. [Is undirected liver biopsy a safe procedure?].

    Science.gov (United States)

    Oliva, L; Hirt, M

    1993-09-01

    In the authors' group of 976 umaimed liver biopsies (ULB) 10 complications were recorded. The authors described them and compared them with reports from the world literature. Two patients from the group died after ULB. One as a result of biopsy from haemoperitoneum, the other patient died with delirium tremens after surgery called for by persisting peritoneal syndrome. In eight patients mild complications were involved. In five patients complications receded spontaneously, in three after administration of an analgetic. From the submitted paper ensues that ULB is not quite safe, even when used by an experienced physician and when all contraindications are respected. A smooth course is not ensured by a risk-free diagnosis, previous uncomplicated biopsies normal prebioptic haemocoagulation tests. It is essential to realize this with regard to every patient where we indicate ULB. It is better to omit it unless we are unequivocally convinced of its asset. The question thus is: What will be the benefit of ULB for the patient?

  3. Ex Vivo Machine Perfusion in VCA with a Novel Oxygen Carrier System to Enhance Graft Preservation and Immunologic Outcomes

    Science.gov (United States)

    2016-12-01

    the utilization of this new preservation technology in composite tissue allotransplants (CTAs). The experiments were successful in showing the role...a new application of our technology previously and successfully performed in both porcine and human liver allografts. Machine Perfusion of the...current standard of care. Both groups were followed for 7 days. The VRAM grafts were biopsied on days 2, 4 and 7. An end-study necropsy was performed

  4. Posterior repair with perforated porcine dermal graft

    Directory of Open Access Journals (Sweden)

    G. Bernard Taylor

    2008-02-01

    Full Text Available OBJECTIVE: To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measured and compared. MATERIALS AND METHODS: This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (PelvicolTM CR Bard Covington, GA USA. The incidence of postoperative vaginal incision separation (dehiscence was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols. RESULTS: Seventeen percent of patients (21/127 who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71 of patients who received perforated grafts (p = 0.078. Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively. There was no difference in the flexibility of the two grafts (p = 0.20. CONCLUSION: Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.

  5. Dynamics of bone graft healing around implants

    Directory of Open Access Journals (Sweden)

    Narayan Venkataraman

    2015-01-01

    A few questions arise pertaining to the use of bone grafts along with implants are whether these are successful in approximation with implant. Do they accelerate bone regeneration? Are all defects ultimately regenerated with new viable bone? Is the bone graft completely resorbed or integrated in new bone? Does the implant surface characteristic positively affect osseointegration when used with a bone graft? What type of graft and implant surface can be used that will have a positive effect on the healing type and time? Finally, what are the dynamics of bone graft healing around an implant? This review discusses the cellular and molecular mechanisms of bone graft healing in general and in vicinity of another foreign, avascular body, namely the implant surface, and further, the role of bone grafts in osseointegration and/or clinical success of the implants.

  6. Renal graft irradiation in acute rejection

    Energy Technology Data Exchange (ETDEWEB)

    Pilepich, M.V.; Sicard, G.A.; Breaux, S.R.; Etheredge, E.E.; Blum, J.; Anderson, C.B.

    1983-03-01

    To evaluate the effect of graft irradiation in the treatment of acute rejection of renal transplants, a randomized study was conducted from 1978 to 1981. Patients with acute rejection were given standard medical management in the form of intravenous methylprednisolone, and were chosen randomly to receive either graft irradiation (175 rads every other day, to a total of 525 rads) or simulated (sham) irradiation. Eighty-three rejections occurring in 64 grafts were randomized to the protocol. Rejection reversal was recorded in 84.5% of control grafts and 75% of the irradiated grafts. Recurrent rejections were more frequent and graft survival was significantly lower in the irradiated group (22%) than in the control group (54%). Graft irradiation does not appear to be beneficial in the treatment of acute rejection of renal transplants when used in conjunction with high-dose steroids.

  7. Starch Modification by Graft Copolymerization of Acrylonitrile

    Institute of Scientific and Technical Information of China (English)

    刘瑞贤; 李莉; 茹宗玲; 张黎明; 高建平; 田汝川

    2003-01-01

    The graft copolymerization of acrylonitrile (AN) onto starch under the initiation of potassium permanganate was investigated. The effect of various reaction conditions on the graft copolymerization was studied. The relationships between the grafting rate and the initiator concentration of potassium permanganate, monomer acrylonitrile and backbone starch, as well as reaction temperature were established. The oxidation reaction of starch with manganic ions and valence changes of manganic ions during the graft copolymerization were discussed. The results show that manganic ion Mn7+ underwent a series of valence changes during the graft copolymerization: Mn(Ⅶ) → Mn(Ⅳ) → Mn(Ⅲ) → Mn(Ⅱ). The grafting rate of the graft copolymerization of acrylonitrile onto starch is also given.

  8. DWI Repeaters and Non-Repeaters: A Comparison.

    Science.gov (United States)

    Weeber, Stan

    1981-01-01

    Discussed how driving-while-intoxicated (DWI) repeaters differed signigicantly from nonrepeaters on 4 of 23 variables tested. Repeaters were more likely to have zero or two dependent children, attend church frequently, drink occasionally and have one or more arrests for public intoxication. (Author)

  9. To Repeat or Not to Repeat a Course

    Science.gov (United States)

    Armstrong, Michael J.; Biktimirov, Ernest N.

    2013-01-01

    The difficult transition from high school to university means that many students need to repeat (retake) 1 or more of their university courses. The authors examine the performance of students repeating first-year core courses in an undergraduate business program. They used data from university records for 116 students who took a total of 232…

  10. [Hepatitis B infection transmission by anti-HBc-positive grafts].

    Science.gov (United States)

    Bárcena, Rafael

    2014-07-01

    In Spain, the rate of anti-HBc positive, HBsAg-negative carriers is approximately 10% of adults between the ages of 26 and 65 years. It is therefore impossible to exclude these donors without increasing the mortality of recipients on waiting lists. The incidence of de novo hepatitis B infection in HBsAg-negative recipients of anti-HBc-positive donors is high without prophylaxis and is related to the serological state of the recipient against HBV. Anti-HBc and anti-HBs-positive recipients have low risk, with or without prophylaxis. This patient group therefore does not require prophylaxis but rather periodic posttransplantation checkups. For the other recipient groups (naïve, anti-Hbc and anti-HBs isolates), prophylaxis with IgG HB, lamivudine or combined therapy decreases the incidence of infection. These patients should be treated with prophylaxis immediately after transplantation. Depending on the risk, cost and benefit, patients should currently be treated with lamivudine 100mg/d indefinitely or for longer periods (>10 years). Periodic checkups of HBsAg should be conducted, and if there is graft dysfunction then HBV DNA should be checked. IF HBV DNA is discovered in the donor and found to be positive in serum or in the biopsy, the prophylaxis should be an analogue with a high barrier to resistance from the start. Grafts from anti-HBc-positive donors are not considered at-risk grafts and are used according to donor severity, without being determined by the recipient's serological profile. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  11. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endomyocardial biopsy device. 870.4075 Section 870...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4075 Endomyocardial biopsy device. (a) Identification. An endomyocardial biopsy device is a device used in a catheterization...

  12. Tumor Seeding With Renal Cell Carcinoma After Renal Biopsy

    OpenAIRE

    M.F.B. Andersen; Norus, T.P.

    2016-01-01

    Tumor seeding following biopsy of renal cell carcinoma is extremely rare with an incidence of 1:10.000. In this paper two cases with multiple recurrent RRC metastasis in the biopsy tract following biopsy of renal tumor is presented and the current literature is shortly discussed.

  13. Early subclinical rejection treated with low dose i.v. steroids is not associated to graft survival impairment: 13-years' experience at a single center.

    Science.gov (United States)

    Gigliotti, Paolo; Lofaro, Danilo; Leone, Francesca; Papalia, Teresa; Senatore, Massimino; Greco, Rosita; Perri, Anna; Vizza, Donatella; Lupinacci, Simona; Toteda, Giuseppina; La Russa, Antonella; De Stefano, Roberto; Romeo, Francesco; Bonofiglio, Renzo

    2016-06-01

    Subclinical rejection (SCR) has been variably associated with reduced graft survival, development and progression of interstitial fibrosis/tubular atrophy and chronic allograft nephropathy, but data are controversial concerning SCR treatment in terms of graft survival improvement. In this single-center retrospective study, we enrolled 174 adult kidney transplant recipients with a protocol biopsy performed at 30 days after transplantation to evaluate the incidence rate and risk factors for early SCR and its impact on 10-year graft survival. Five patients showed primary non function and were excluded. Among 159/169 (94.08 %) patients with stable graft function who underwent protocol biopsy, 17 (10.7 %) showed signs of SCR and were treated with low-dose intravenous (i.v.) steroids. Ten patients showed functional impairment, 8 (4.73 %) resulting as acute rejection. At multivariate analysis, donor age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01-1.09], and delayed graft function (DGF) (OR 1.08, 95 % CI 1.03-1.12) were significantly associated with SCR. The 10-year graft survival rate in the SCR group was similar to that in the normal-findings group (76.5 vs. 74.9 % respectively; p = 0.61). At multivariate Cox regression, acute [hazard ratio (HR) 5.22, 95 % CI 1.70-16.01], but not sub-clinical, rejection was independently associated with long-term graft failure. In conclusion, early protocol biopsy is a useful and safe tool to detect early SCR which seems not to affect the long-term survival. We suggest that this could be, probably, linked to early SCR treatment with low dose i.v. steroids.

  14. Detection of anti-HLA antibodies with flow cytometry in needle core biopsies of renal transplants recipients with chronic allograft nephropathy.

    Science.gov (United States)

    Martin, Laurent; Guignier, Fredy; Bocrie, Olivier; D'Athis, Philippe; Rageot, David; Rifle, Gérard; Justrabo, Eve; Mousson, Christiane

    2005-05-27

    The aim of this study was to assess the feasibility of detecting anti-HLA antibodies in eluates from needle core biopsies of renal transplants with chronic allograft nephropathy. Two methods of screening, the enzyme-linked immunosorbent assay (ELISA) and flow cytometry (FlowPRA) were compared. Twenty renal transplants with CAN were removed after irreversible graft failure. To assess the feasibility of detecting anti-HLA antibodies in small samples, needle core biopsies were sampled at the same place as surgical samples and at a second cortical area. Antibodies were eluted with an acid elution kit and anti-class I and class II IgG HLA antibodies detected using ELISA and flow cytometry. Flow cytometry was found to be more sensitive than ELISA for detecting anti-HLA antibodies in eluates from renal transplants with CAN (95% vs. 75% of positive cases). Detection of anti-HLA antibodies showed good agreement between surgical samples and needle core biopsies performed at the same place for anti-class I (80% vs. 65%, r=0.724 PHLA antibodies (70% vs. 55%, r=0.827 PHLA antibodies in needle core biopsies sampled at different sites suggests that immunization to class I donor antigen could be underestimated in needle core biopsy samples. These data indicate that anti-HLA antibodies can be detected in needle core biopsies from renal transplants. Provided further evaluation is done, elution might be a complementary method to detect anti-HLA antibodies when they are bound to the transplant.

  15. Prognostic utility of preimplantation kidney biopsy from deceased older donors in first year post-transplant renal function.

    Science.gov (United States)

    Amenábar, Juan J; Camacho, Jhon A; Gómez-Larrambe, Nerea; Visus, Teresa; Pijoan, José I; González del Tánago, Jaime; Zárraga, Sofía; García-Olaverri, Jorge; Gaínza, Francisco J

    2016-01-01

    Preimplantation renal biopsy provides potentially valuable information about post-transplant renal function. To assess the prognostic value of preimplantation kidney biopsy from older donors in determining 1-year post-transplant estimated glomerular filtration rate MDRD-4 (eGFR). We evaluated a cohort of 124 renal transplant recipients from deceased donors ≥60 years old, performed at our center between March 2008 and May 2012. Biopsies were assessed by applying the score proposed by O'Valle et al. The overall score was stratified into 3 levels: 0-3, 4-5 and 6-8 points. Kidneys scoring > 8 points were discarded. A total of 77% of the donors were ≥70 years. One year post-transplant, mean eGFR (SD) was lower in transplant recipients with 6-8 points (38.5 [14.1] mL/min/1.73m(2)) than in the group scoring 4-5 points (46.3 [15.7] [p=0.03]) and the group scoring 0-3 (49.6 [12.5] [P=.04]). Seven patients (19%) had eGFR renal biopsy were associated with a worse 1-year post-transplant eGFR. Delayed graft function and acute rejection were significant risk factors for 1-year post-transplant low eGFR. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Radiation-induced grafting of diallyldimethylammonium chloride onto acrylic acid grafted polyethylene

    Science.gov (United States)

    Francis, Sanju; Dhanawade, B. R.; Mitra, D.; Varshney, Lalit; Sabharwal, Sunil

    2009-01-01

    Diallyldimethylammonium chloride (DADMAC) was grafted onto polyethylene (PE) films by a double grafting procedure. The PE film was initially modified by grafting acrylic acid (AA), through a mutual irradiation method. AA-g-PE film, thus obtained was subjected to subsequent radiation grafting reaction of DADMAC, to give a DADMAC-g-AA-g-PE film having a comb-type structure. The influence of different conditions, such as the extent of AA grafting, DADMAC concentration, absorbed dose and dose rate, on the grafting yield of DADMAC was investigated. A maximum DADMAC grafting of 30% was achieved. The equilibrium degree of swelling (EDS) of the grafted films were gravimetrically determined. TGA and FT-IR techniques were employed to characterize the grafted PE films.

  17. Radiation-induced grafting of diallyldimethylammonium chloride onto acrylic acid grafted polyethylene

    Energy Technology Data Exchange (ETDEWEB)

    Francis, Sanju [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085 (India)], E-mail: sanju@barc.gov.in; Dhanawade, B.R.; Mitra, D.; Varshney, Lalit; Sabharwal, Sunil [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085 (India)

    2009-01-15

    Diallyldimethylammonium chloride (DADMAC) was grafted onto polyethylene (PE) films by a double grafting procedure. The PE film was initially modified by grafting acrylic acid (AA), through a mutual irradiation method. AA-g-PE film, thus obtained was subjected to subsequent radiation grafting reaction of DADMAC, to give a DADMAC-g-AA-g-PE film having a comb-type structure. The influence of different conditions, such as the extent of AA grafting, DADMAC concentration, absorbed dose and dose rate, on the grafting yield of DADMAC was investigated. A maximum DADMAC grafting of 30% was achieved. The equilibrium degree of swelling (EDS) of the grafted films were gravimetrically determined. TGA and FT-IR techniques were employed to characterize the grafted PE films.

  18. Recurrent glomerular disease after kidney transplantation: an update of selected areas and the impact of protocol biopsy.

    Science.gov (United States)

    Morozumi, Kunio; Takeda, Asami; Otsuka, Yasuhiro; Horike, Keiji; Gotoh, Norihiko; Watarai, Yoshihiko

    2014-06-01

    Recurrence of native kidney disease following kidney transplantation affects between 10% and 20% of patients, and accounts for up to 8% of graft failures. In a considerable number of recipients with transplant glomerulopathy, it is impossible to distinguish between recurrent and de novo types. An accurate estimate of the incidence of recurrence is difficult due to limitations in the diagnosis of recurrent glomerulonephritis. De novo glomerular lesions may be misclassified if histological confirmation of the patient's native kidney disease is lacking. Asymptomatic histological recurrence in renal allografts may be missed if protocol biopsies are not available. Studies based on protocol biopsy are pivotal to accurately estimate the incidence of recurrence. Many factors are known to influence recurrence of kidney disease after transplantation, including the type and severity of the original disease, age at onset, interval from onset to end-stage renal disease, and clinical course of the previous transplantation. Early recognition of recurrence is possible in several glomerular diseases. Factors such as the existence of circulating permeability factors, circulating urokinase receptor and anti-phospholipase A2 receptor antibody, as well as disorders of complement regulatory proteins like factor I mutation and factor H mutation factors are expected to be useful predictors of recurrence. Peculiar clinical course of atypical haemolytic uremic syndrome after kidney transplantation is an informative sign of recurrent glomerular disease. These factors play pivotal roles in the development of recurrence of certain types of glomerulopathies. Understanding the pathogenesis of recurrent glomerulonephritis is critical to optimize prevention as well as treat individual cases of recurrent glomerulonephritis. Subclinical recurrence of IgA nephropathy after kidney transplantation is well recognized. Only protocol biopsies of clinically silent recipient can provide the accurate

  19. Increased initiation and growth of tumor cell lines, cancer stem cells and biopsy material in mice using basement membrane matrix protein (Cultrex or Matrigel) co-injection.

    Science.gov (United States)

    Fridman, Rafael; Benton, Gabriel; Aranoutova, Irina; Kleinman, Hynda K; Bonfil, R Daniel

    2012-05-17

    This protocol requires 2-4 h and presents a method for injecting tumor cells, cancer stem cells or dispersed biopsy material into subcutaneous or orthotopic locations within recipient mice. The tumor cells or biopsy are mixed with basement membrane matrix proteins (CultrexBME or Matrigel) at 4 °C and then injected into recipient animals at preferred anatomical sites. Tumor cells can also be co-injected with additional cell types, such as fibroblasts, stromal cells, endothelial cells and so on. Details are given on appropriate cell numbers, handling and concentration of the basement membrane proteins, recipient animals, injection location and techniques. This procedure enables the growth of tumors from cells or biopsy material (tumor graft) with greater efficiency of take and growth, and with retention of the primary tumor phenotype based on histology. Co-injection with additional cell types provides more physiological models of human cancers for use in drug screening and studying cancer biology.

  20. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach

    OpenAIRE

    Jimenez Rafael E; Povoski Stephen P; Wang Wenle P

    2011-01-01

    Abstract Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-...

  1. Nifty Nines and Repeating Decimals

    Science.gov (United States)

    Brown, Scott A.

    2016-01-01

    The traditional technique for converting repeating decimals to common fractions can be found in nearly every algebra textbook that has been published, as well as in many precalculus texts. However, students generally encounter repeating decimal numerals earlier than high school when they study rational numbers in prealgebra classes. Therefore, how…

  2. Nifty Nines and Repeating Decimals

    Science.gov (United States)

    Brown, Scott A.

    2016-01-01

    The traditional technique for converting repeating decimals to common fractions can be found in nearly every algebra textbook that has been published, as well as in many precalculus texts. However, students generally encounter repeating decimal numerals earlier than high school when they study rational numbers in prealgebra classes. Therefore, how…

  3. Biopsy-proven spontaneous regression of a rhabdomyomatous mesenchymal hamartoma.

    Science.gov (United States)

    Mazza, Joni M; Linnell, Erica; Votava, Henry J; Wisoff, Jeffrey H; Silverberg, Nanette B

    2015-01-01

    Rhabdomyomatous mesenchymal hamartoma (RMH) is a rare, benign, congenital tumor of the dermis and subcutaneous tissue comprised of skeletal muscle and adipose and adnexal elements. Although the majority of cases are an incidental finding in otherwise healthy patients, some have been reported in association with other anomalies. We present a full-term boy evaluated on day 2 of life for two lesions located on the midline of the lower back and right buttock that each appeared clinically as an atrophic, pink plaque. Ultrasound of the midline lesion revealed an underlying lipomyelomeningocele with a tethered cord in the spinal canal. Histopathology of the right buttock cutaneous lesion was consistent with a diagnosis of RMH. Surgical excision was performed on the midline intradural lipoma and the lesion on the buttock was monitored clinically. Repeat biopsy of this site at 1 year of age revealed complete spontaneous regression. This case highlights three interesting features: the association with an occult spinal dysraphism lipomyelomeningocele and tethered cord, the clinical presentation of an atrophic plaque as opposed to the more commonly reported raised lesions, and the phenomenon of spontaneous regression of the lesion. Most importantly, this final feature of regression in our patient suggests that, in the absence of symptoms, clinical observation of RMH lesions is warranted for spontaneous regression for 1 to 2 years provided that no functional deficit is noted and that the cutaneous or deeper lesions are not causing a medical problem.

  4. Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries

    Institute of Scientific and Technical Information of China (English)

    Xiang HU; Qiang ZHAO

    2011-01-01

    Coronary artery bypass grafting surgery is increasingly being carried out on patients with multi-vessel coronary artery disease, but the best grafting candidate for non-left antetior descending coronary arteries is unclear.This research sought to systematically compare the efficacies and safeties of coronary bypass with radial artery and other available grafts. A systematic literature retrieval was performed for all clinical trials comparing the outcomes of coronary artery bypass surgery with radial artery and other grafts in PubMed, EMBASE, and the Cochrane Library.Seven eligible clinical studies, comparing radial artery and great saphenous vein grafts, were found between 1966 and 2010: one prospective non-randomized and six prospective randomized trials. The pooling analysis obtained a relative risk of 0.507 (P<0.05) of graft occlusion in radial arteries compared with great saphenous veins. There was a significantly lower infection rate in arms (i.e., harvest sites for radial arteries) relative to legs (harvest sites for veins), with a pooled relative risk of 0.140 (P<0.05). From the reports on mortality after follow-up ranging from one year to six years,there was no significant difference in mortality between the two graft types (P=0.927). In addition, four cohort controlled trials for radial and right internal thoracic artery grafts were included. The radial graft was associated with less cardiac related events relative to the right intemal thoracic artery graft (P=0.014), but with comparable mortality and comparable rates of repeat percutaneous transluminal coronary angioplasty. Subjects with radial arteries seemed to have a lower occlusion rate and a lower graft harvest site infection rate than those with great saphenous veins. Moreover there were fewer cardiac related events with radial arteries relative to the right internal thoracic artery grafts. More studies are needed to confirm these findings concerning the favorable outcomes of coronary artery

  5. Current concepts in the biopsy of musculoskeletal tumors.

    Science.gov (United States)

    Traina, Francesco; Errani, Costantino; Toscano, Angelo; Pungetti, Camilla; Fabbri, Daniele; Mazzotti, Antonio; Donati, Davide; Faldini, Cesare

    2015-01-07

    A musculoskeletal tumor biopsy can involve fine needle aspiration, core needle biopsy, or incisional biopsy. Controversy regarding the diagnostic yield of these biopsy techniques continues. The purpose of this article is to summarize the current concepts in the biopsy of musculoskeletal tumors. We performed a literature review of clinical articles reporting on the biopsy of bone and soft-tissue primary tumors. Clinical articles were excluded on the basis on abstract content if they represented case reports, review or opinion articles, or technique descriptions. Eighteen of the thirty-nine articles that remained were excluded because the results did not indicate the diagnostic accuracy of the various biopsy techniques. Thus, twenty-one articles with diagnostic data on the biopsy of bone and soft-tissue tumors were included in this review. Core needle biopsy appeared to be more accurate than fine needle aspiration, and incisional biopsy appeared to be more accurate than both of these techniques, but the differences did not reach significance. Incisional biopsy was more expensive than the percutaneous biopsy methods. In deep musculoskeletal tumors, incorporation of ultrasonography or computed tomography for guidance is easy and safe and can be useful for increasing the accuracy of the biopsy. Advantages of a percutaneous technique compared with an incisional one are the low risk of contamination and the minimally invasive nature. Certain anatomic locations and histologic types were associated with diagnostic difficulty. Vertebral tumors had the lowest diagnostic accuracy regardless of the biopsy technique. Myxoid, infection, and round cell histologies were associated with the lowest diagnostic accuracy. The current literature has not clarified the optimal biopsy technique for the diagnosis of bone and soft-tissue tumors. However, core needle biopsy is usually preferable to incisional biopsy because of the low risk of contamination and the low cost. In addition, the

  6. Image-guided breast biopsy: state-of-the-art

    Energy Technology Data Exchange (ETDEWEB)

    O' Flynn, E.A.M., E-mail: lizoflynn@doctors.org.u [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom); Wilson, A.R.M.; Michell, M.J. [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom)

    2010-04-15

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues.

  7. All-photonic quantum repeaters

    Science.gov (United States)

    Azuma, Koji; Tamaki, Kiyoshi; Lo, Hoi-Kwong

    2015-01-01

    Quantum communication holds promise for unconditionally secure transmission of secret messages and faithful transfer of unknown quantum states. Photons appear to be the medium of choice for quantum communication. Owing to photon losses, robust quantum communication over long lossy channels requires quantum repeaters. It is widely believed that a necessary and highly demanding requirement for quantum repeaters is the existence of matter quantum memories. Here we show that such a requirement is, in fact, unnecessary by introducing the concept of all-photonic quantum repeaters based on flying qubits. In particular, we present a protocol based on photonic cluster-state machine guns and a loss-tolerant measurement equipped with local high-speed active feedforwards. We show that, with such all-photonic quantum repeaters, the communication efficiency scales polynomially with the channel distance. Our result paves a new route towards quantum repeaters with efficient single-photon sources rather than matter quantum memories. PMID:25873153

  8. The Safety of Multiple Flexible Sigmoidoscopies with Mucosal Biopsies in Healthy Clinical Trial Participants.

    Science.gov (United States)

    Chiu, Wai Kan; Brand, Rhonda M; Camp, Danielle; Edick, Stacey; Mitchell, Carol; Karas, Sherri; Zehmisch, Amanda; Ho, Ken; Brand, Randall E; Harrison, Janet; Abo, Steven; Cranston, Ross D; McGowan, Ian

    2017-08-01

    During Phase 1 pharmacokinetic/pharmacodynamics studies, participants may undergo multiple sigmoidoscopies, with a collection of 10-20 biopsies during each procedure. This article characterizes the safety of flexible sigmoidoscopies in clinical trial participants. We determined the number of flexible sigmoidoscopies and rectal biopsies that participants underwent and analyzed the frequency, duration, and severity of flexible sigmoidoscopy-related adverse events (AEs). During the study period, 278 participants underwent 1,004 flexible sigmoidoscopies with the collection of 15,930 rectal biopsies. The average number of procedures per participant was 3.6 (median 3; range 1-25), with an average time interval between procedures of 61.8 days (median 28 days; range 1-1,159). There were no serious AEs. Sixteen AEs were related to flexible sigmoidoscopy and occurred in 16 participants, leading to an overall 1.6% (16/1,004) AE rate per procedure and 0.1% (16/15,930) AE rate per biopsy. Of the 16 AEs, 8 (50%) involved abdominal pain, diarrhea, bleeding, flatulence, and bloating, with an average duration of 4.7 days (median 1 day; range 1-28). Most (14/16) AEs were categorized as Grade 1 (mild), whereas two of the AEs were Grade 2 (moderate). No participant withdrew due to procedure-related AEs. Overall, the number of AEs caused by flexible sigmoidoscopy with multiple biopsies was low and the severity was mild, suggesting that this procedure can be safely integrated into protocols requiring repeated intestinal mucosal sampling.

  9. Indications and results of renal biopsy in children: A single-center experience from Morocco

    Directory of Open Access Journals (Sweden)

    Fatima Zohra Souilmi

    2015-01-01

    Full Text Available The contribution of renal biopsy (RB is of major importance in the management of many renal diseases in children. Specific indications for performing biopsy in children include steroid-resistant nephrotic syndrome (NS and secondary nephropathies. The aim of our study was to report the common histological varieties of kidney diseases in children in Morocco. In this retrospective and descriptive study, we included all renal biopsies performed in patients under 16 years in the Department of Pediatrics of Hassan II University Hospital, Fez, Morocco from July 2009 to December 2013. Biopsy samples without glomeruli and those with less than five glomeruli or repeat biopsies on the same patient were excluded from our study. We performed 112 RBs during this period; the average age at the time of RB was 10.05 ± 4 years and the sex-ratio was 1.07. The indications for RB were NS with hematuria and/or renal failure (RF in 32.1%, active urinary sediment in 21.4%, isolated NS in 15.2%, RF in 13.4% and steroid-resistant NS in 10.7% of cases. Primary nephropathies represented 59.8% of cases, with a predominance of minimal change disease (MCD seen in 40.2% of the cases. Secondary nephropathies accounted for 27.7% of the cases, with a predominance of lupus nephritis (11.6%, followed by Henoch-Schonlein purpura nephritis (6.2% of cases and post-streptococcal glomerulonephritis (3.6%. There was one case of hepatitis B virus-associated membranous glomerulonephritis. Chronic glomerulonephritis accounted for 12.5% of the cases. Vascular and tubulo-interstitial nephritis were rare. Our study confirmed that primary glomerular nephropathy was the most common renal disease in children. The most common lesion was MCD. Secondary nephropathies were less frequent, with a predominance of lupus nephritis.

  10. Histomorphologic Features of Biopsy Sites Following Excisional and Core Needle Biopsies of the Breast.

    Science.gov (United States)

    Layfield, Lester J; Frazier, Shellaine; Schanzmeyer, Elizabeth

    2015-01-01

    Mammographic studies have documented a number of architectural changes occurring around breast biopsy sites. These changes are well described in the radiological literature, but similar studies do not appear to be present in the pathology literature. We reviewed 100 consecutive mastectomy specimens from women who had undergone prior core needle or excisional biopsies. Multiple sections of the needle tract or excisional biopsy site were reviewed and morphologic findings reported. Hemorrhage, fat necrosis, granulation tissue, necrosis of fibrous tissue, and epithelium along with fibrosis and foreign body type giant cells were common features. Less frequent were areas of synovial metaplasia, atypical spindle cells, atypical duct-like structures, single atypical cells, squamous metaplasia, proliferations of abnormal blood vessels, and hemosiderin deposition. The misinterpretation of atypical spindle cells, single atypical cells, atypical duct-like structures and squamous metaplasia could result in the false-positive diagnosis of residual malignancy. Careful attention to the reactive nature of these changes aids in their distinction from carcinoma.

  11. [Autologous fat grafting in children].

    Science.gov (United States)

    Baptista, C; Bertrand, B; Philandrianos, C; Degardin, N; Casanova, D

    2016-10-01

    Lipofilling or fat grafting transfer is defined as a technique of filling soft tissue by autologous fat grafting. The basic principle of lipofilling is based on a harvest of adipose tissue, followed by a reinjection after treatment. Lipofilling main objective is a volume defect filling, but also improving cutaneous trophicity. Lipofilling specificities among children is mainly based on these indications. Complications of autologous fat grafting among children are the same as those in adults: we distinguish short-term complications (intraoperative and perioperative) and the medium and long-term complications. The harvesting of fat tissue is the main limiting factor of the technique, due to low percentage of body fat of children. Indications of lipofilling among children may be specific or similar to those in adults. There are two types of indications: cosmetic, in which the aim of lipofilling is correcting a defect density, acquired (iatrogenic, post-traumatic scar) or malformation (otomandibular dysplasia, craniosynostosis, Parry Romberg syndrom, Poland syndrom, pectus excavatum…). The aim of functional indications is correcting a velar insufficiency or lagophthalmos. In the paediatric sector, lipofilling has become an alternative to the conventional techniques, by its reliability, safety, reproducibility, and good results.

  12. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, F.A. [Dept. of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Gow, K.; Davidoff, A. [Dept. of Surgery, St. Jude Children' s Research Hospital, Memphis, TN (United States); Flynn, P.M. [Dept. of Infectious Diseases, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2001-03-01

    Background. Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. Objective. We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. Materials and methods. We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the lungs of 24 children with suspected pulmonary aspergillosis. Twenty-two were being treated for malignancy and two for congenital immunodeficiency; 15 had received bone-marrow transplants. The accuracy of the percutaneous lung biopsy was determined by subsequent surgical resection, autopsy, or clinical course. Results. Histopathological studies showed ten biopsy specimens with septate hyphae, indicating a mold, and seven with Aspergillus flavus colonies in culture. The remaining 18 biopsies revealed no fungi. No patient had progressive aspergillosis after negative biopsy. Invasive pulmonary mold was detected by percutaneous biopsy with 100 % (10/10) sensitivity and 100 % (18/18) specificity. Percutaneous biopsy results influenced the surgical decision in 86 % (24 of 28) of the cases. Bleeding complicated the biopsy in 46 % (13/28) and hastened one death. Conclusion. Percutaneous biopsy of the lung is an accurate technique for the diagnosis of invasive pulmonary aspergillosis and correctly determines which immunosuppressed pediatric patients would benefit from therapeutic pulmonary resection. (orig.)

  13. Development of biopsy gun for aspiration and drug injection.

    Science.gov (United States)

    Kang, Hyun Guy; Cho, Sung Ho; Cho, Chang Nho; Kim, Kwang Gi

    2015-04-01

    Tumor samples are required for pathological examinations, and different instruments are generally used to obtain samples of different types of tumors. Among the many methods available for obtaining tumor tissues, gun biopsy is widely used because it is much simpler than incisional biopsy and can collect many more samples than aspiration biopsy. However, conventional biopsy guns cannot simultaneously perform biopsy aspiration, bleeding prevention, and marker injection. In this study, we developed a biopsy gun that can simultaneously perform biopsy aspiration and sample collection, in addition to injecting a styptic agent and marker to prevent bleeding and contamination in the biopsy track. We then used a prototype to evaluate the feasibility of the developed device. The collectable sample size was also assessed. Performance of the biopsy aspiration feature was also evaluated, including the maximum aspiration viscosity. Finally, we tested the maximum amount of drug that can be injected. We found that the biopsy gun developed here is an alternative tool for biopsy collection with improved procedure safety and diagnostic accuracy.

  14. High-yield biopsy technique for subepidermal blisters.

    Science.gov (United States)

    Braswell, Mark A; McCowan, Nancye K; Schulmeier, Jennifer S; Brodell, Robert T

    2015-04-01

    Dermatologists often perform 2 biopsies in patients with widespread tense blisters: one for light microscopy and another for direct immunofluorescence (DIF). Biopsy techniques recommended for blistering diseases with tense blisters are discussed, and illustrations demonstrate an alternative approach utilizing a single punch biopsy. A single punch biopsy is more cost effective and provides the same diagnostic information as the standard 2-biopsy approach for subepidermal blisters plus additional salt-split skin-like diagnostic information. A limitation for bisecting the single punch biopsy specimen is a potential complete separation of the epidermis from the dermis. The single punch biopsy technique is a simple cost-effective method for obtaining necessary diagnostic information when sampling tense blisters in patients with blistering diseases.

  15. Mapping biopsy with punch biopsies to determine surgical margin in extramammary Paget's disease.

    Science.gov (United States)

    Kato, Takeshi; Fujimoto, Noriki; Fujii, Norikazu; Tanaka, Toshihiro

    2013-12-01

    It is difficult to determine the appropriate resection margin of extramammary Paget's disease (EMPD). A high recurrence rate is reported in spite of using Mohs micrographic surgery (MMS), which is performed commonly. Preoperative mapping biopsy is easier to perform than MMS. In Japan, the following method is recommended instead of MMS: well-defined border and margins histologically confirmed by mapping biopsy should be resected with 1-cm margin and ill-defined border with 3-cm margin. This study aimed to evaluate the accuracy of the Japanese guideline and to assess our mapping biopsy method compared with MMS. Preoperative mapping biopsy specimens were obtained beyond the clinical border for at least four directions in each patient. To confirm the presence of residual Paget's cells postoperatively, narrow specimens were obtained along the surgical margin. Retrospective evaluation of 17 EMPD patients was conducted concerning histological spread of Paget's cells and recurrence ratio. There were 86 directions showing a well-defined border, and in 9.3% (8/86), Paget's cells were still observed at 1-cm resection line. On the other hand, there were 21 directions showing an ill-defined border, and unnecessary radical resection was performed in 90% (19/21) of directions with 3-cm resection line. Although postoperative histological examination showed residual Paget's cells in 47% (8/17) of patients and additional resections were not performed, recurrence rate was only 5.9% (1/17). The resection line of EMPD should be based not on clinical features, but on mapping biopsy. Mapping biopsy is equivalent to MMS concerning recurrence rate and, though conventional, is useful method to treat EMPD.

  16. Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses.

    Science.gov (United States)

    Gonzalez-Pinto, I M; Tryphonopoulos, P; Avison, D L; Nishida, S; Tekin, A; Santiago, S; Tzakis, A G

    2013-06-01

    Uterine transplantation in the sheep model has been described as a partial or whole orthotopic graft from a living donor with vascular anastomoses. As an alternative to surrogate pregnancy or adoption uterus transplantation might be indicated for cases of infertility of uterine origin. The main complications might be rejection and thrombosis. The objective of this work was to develop a model of whole uterus transplantation that was applicable to the human setting, using grafts obtained from brain-dead donors, and suitable for immunologic and viability follow-up with a reduced risk of thrombosis. Two donors and 1 recipient were operated. The first graft was used for an anatomic study; the second was used for transplantation. The donor operation consisted of an en bloc harvest of the uterus, adnexa, and proximal vagina with the distal aorta and cava. After harvest the donor sheep was humanely killed. In the recipient ewe, heterotopic implantation was performed in the lower abdomen. An End-to-side anastomoses of aorta and cava were performed below the recipient's renal vessels. A cutaneous vaginal stoma was performed in the right lower quadrant. The recipient ewe was humanely killed for an autopsy study. The anatomy of uterine veins of the ewe differs from the human. The uterine and ovarian veins join, forming the utero-ovarian vein, which drains at the confluence of the common iliac to the cava. En bloc harvesting allows for rapid graft preparation, with vascular cuffs easily anastomosed with a low risk of thrombosis. The vaginal stoma seems appropriate to facilitate follow-up and graft biopsy. This approach can be a suitable experimental model applicable to humans using grafts from brain-dead donors.

  17. Renal mass dosing and graft function in children transplanted from pediatric donors.

    Science.gov (United States)

    de Petris, L; Faraggiana, Tullio; Rizzoni, Gianfranco

    2002-06-01

    It has been suggested that "renal mass dosing" may affect graft evolution. Between 1993 and 1999, 43 children, aged 4-17 years, received 43 pediatric cadaveric grafts. The ratio between graft volume (calculated by ultrasound within the first 24 h from transplantation, by ellipsoid formula) and the recipient's body surface area (BSA) ranged between 14.1 and 110 ml/m(2). Three groups were identified: group 1, 14-29 ml/m(2) (13 patients); group 2, 30-39 ml/m(2) (16 patients); group 3, 40-110 ml/m(2) (14 patients). As a consequence of the different renal volume increments in the three groups during the first year after transplant, no differences in the absolute renal volume were observed at the end of follow-up. The average follow-up was 38 months (range 12-80). In the 37 routine graft biopsies, performed on average 13 months after transplantation and with more than five glomeruli, maximum mean glomerular diameters were mostly above normal values. There were no significant differences among the three groups. At the end of follow-up, the three groups did not differ in microalbuminuria, proteinuria, glomerular function or in incidence of hypertension. From this retrospective study, we conclude that the very wide range of renal mass dosing did not cause differences in medium-term graft evolution. A longer follow-up will be necessary to ascertain the possible influence of disproportion between pediatric donors and recipients, on a long-term graft outcome.

  18. Hybrid Graft Anterior Cruciate Ligament Reconstruction: A Predictable Graft for Knee Stabilization.

    Science.gov (United States)

    Alvarez-Pinzon, Andres M; Barksdale, Leticia; Krill, Michael K; Leo, Brian M

    2015-06-01

    Trauma to the anterior cruciate ligament (ACL) is a season-ending injury and involves months of activity modification and rehabilitation. The annual incidence of ACL tears in the United States is approximately 200,000, which allows for a broad range of individualized treatment options. Various surgical techniques, including transtibial and independent tunnel drilling, allograft and autograft tissue, and various implants, have been described in the literature. This article describes the indications and technique for a hybrid soft tissue graft for ACL reconstruction. Autologous grafts eliminate the risk of disease transmission and have recently been shown to have a lower rerupture rate, particularly in younger, active patients; however, the harvesting of autologous hamstring grafts carries a risk of donor-site morbidity, iatrogenic injury of the graft, and inadequate graft size. In contrast to a traditional autologous soft tissue graft, the hybrid graft allows for graft size customization for a desired reconstruction, especially in cases where autograft hamstrings may be iatrogenically damaged or of inadequate size when harvested. The goal of a hybrid graft ACL reconstruction is to provide a favorable-sized graft with clinical outcomes comparable with autologous soft tissue grafts. In contrast to a traditional autologous soft tissue graft, this technique provides another option in the event of unforeseen deficiencies or complications associated with harvesting and preparation of the autologous gracilis and semitendinosis soft tissue graft.

  19. Biphasic alloplastic graft used to preserve the dimension of the edentulous ridge: an experimental study in the dog.

    Science.gov (United States)

    Lindhe, J; Araújo, M G; Bufler, M; Liljenberg, B

    2013-10-01

    Loss of teeth results in marked qualitative and quantitative alterations of the alveolar process at the edentulous site. It was observed that a graft comprised of bovine bone mineral placed in the fresh extraction socket delayed tissue modeling, but preserved the dimension of the ridge at edentulous sites. To analyze the influence of a biphasic synthetic graft on tissue modeling and remodeling during healing of extraction wounds. Five beagle dogs were used. Two premolars in the maxilla and two in the mandible were included. Full thickness flaps were elevated and the distal roots were removed. An alloplastic graft (BPCAP; α-TCP core coated with nanocrystalline biomimetic hydroxyapatite) embedded in porcine collagen was placed to fill the fresh extraction socket of the premolar sites. Flaps were replaced to cover the entrance of the extraction sockets during early healing. The extraction and grafting procedures were scheduled to allow for the study of 1, 2, and 3 months socket healing. The biopsies from the maxillary sites were decalcified, embedded in paraffin, and stained to allow the study of various aspects of hard tissue formation. The biopsies from the mandibular sites were processed for ground sectioning and used to evaluate alterations of ridge dimensions after 3 months of socket healing. It was documented that the biphasic alloplastic graft did not undergo marked resorption during tissue modeling and remodeling, but allowed large amounts of bone to form within the post-extraction site. Grafting the experimental sites with this biomaterial furthermore counteracted ridge resorption that otherwise occurs following tooth extraction. © 2012 John Wiley & Sons A/S.

  20. The biopsy of the boar testes using ultrasonographic examination

    Directory of Open Access Journals (Sweden)

    Laima Liepa

    2014-03-01

    Full Text Available The biopsy of live animal testes is an important clinical manipulation to control spermatogenesis and reproductive system pathologies. The aim was to develop a method of boar testes biopsy using a biopsy gun with ultrasound guidance and to investigate the influence of this procedure on the boar testes parenchyma and quality of ejaculate. The biopsy was carried out in six 8-month-old boars. Fourteen days prior to and 21 days after biopsy, the quality of ejaculate was examined (weight of ejaculate; concentration and motility of spermatozoa with a seven-day intervals. Ultrasound images of the testes parenchyma were recorded three times: directly before and 15 minutes after the biopsy, then 21 days after the procedure. The testes biopsies of generally anesthetized boars were performed with the biopsy gun for needle biopsy with a 12cm long, disposable 16-gauge needle 1.8mm in diameter (Vitesse through 1cm skin incision in the depth of 1.2-1.6cm of parenchyma. Fifteen minutes after the biopsy, macroscopic injures of the parenchyma of all the boar testes were not detected in the ultrasound image. Twenty one days after biopsy, the hyperechogenic line 0.1-0.2cm in diameter was seen in the testes parenchyma of six boars in the depth of 1.2-1.6cm. The biopsy of boar testes did not influence the quality of boars ejaculate. The ultrasonographic examination of boar testicles before the biopsy reduced possibilities to traumatize large blood vessels of the testes. A perfect boar testicular biopsy was easy to perform using ultrasonographic examination in the pigsty conditions.

  1. Successful treatment for graft-versus-host disease after pancreas transplantation.

    Science.gov (United States)

    Chang, Jei wen; Sageshima, Junichiro; Ciancio, Gaetano; Mattiazzi, Adela; Chen, Linda; Tsai, Hsin-Lin; Ruiz, Phillip; Burke, George W

    2014-02-01

    Graft-versus-host disease (GVHD) after pancreas transplantation is a rare but serious complication: All previously reported cases were fatal. We herein report three cases of GVHD after pancreas transplantation with favorable outcomes. Patients with a history of kidney (and pancreas) transplantation subsequently received a pancreas (and kidney) transplantation (i.e., pancreas retransplantation or pancreas after kidney transplantation) and developed acute GVHD. All of them responded to increased immunosuppression (e.g., steroid bolus, antithymocyte globulin) and retained normal graft function. Because the clinical manifestations are non-specific, vigilance is necessary to make an accurate diagnosis. We underscored the importance of a biopsy of involved organs and the clinicopathologic correlation in the early diagnosis of GVHD. Augmented immunosuppression to prevent progression from a self-limited disease to life-threatening pancytopenia or sepsis may be most critical to improve outcome.

  2. New strategies for evaluating the quality of kidney grafts from elderly donors.

    Science.gov (United States)

    Wohlfahrtova, Mariana; Viklicky, Ondrej

    2015-10-01

    The increased demand for kidney transplantation and organ shortage resulted in the increased use of kidneys from suboptimal donors. Therefore, identification of kidneys that can be accepted without significantly compromising the outcome of allograft or recipient has become critical. A robust assessment of organ quality is of particular importance especially in kidneys from elderly donors in whom morphological and functional changes associated with aging and diseases are obvious. A number of predictive tools have been developed to help with evaluating the suitability of a deceased-donor kidney for transplantation. Among those, Kidney Donor Profile Index and zero hour graft biopsy in elderly donors have been already implemented in several transplant programs. This review captures the recent literature on this subject and discusses approaches for evaluating the quality of kidney grafts from elderly donors.

  3. Towards the mid-infrared optical biopsy

    DEFF Research Database (Denmark)

    Seddon, Angela B.; Benson, Trevor M.; Sujecki, Slawomir

    2016-01-01

    We are establishing a new paradigm in mid-infrared molecular sensing, mapping and imaging to open up the mid-infrared spectral region for in vivo (i.e. in person) medical diagnostics and surgery. Thus, we are working towards the mid-infrared optical biopsy ('opsy' look at, bio the biology) in situ...... of a bright mid-infrared wideband source in a portable package as a first step for medical fiber-based systems operating in the mid-infrared. Moreover, mid-infrared molecular mapping and imaging is potentially a disruptive technology to give improved monitoring of the environment, energy efficiency, security...

  4. Socket grafting with the use of autologous bone: an experimental study in the dog.

    Science.gov (United States)

    Araújo, Mauricio G; Lindhe, Jan

    2011-01-01

    studies in humans and animals have shown that following tooth removal (loss), the alveolar ridge becomes markedly reduced. Attempts made to counteract such ridge diminution by installing implants in the fresh extraction sockets were not successful, while socket grafting with anorganic bovine bone mineral prevented ridge contraction. to examine whether grafting of the alveolar socket with the use of chips of autologous bone may allow ridge preservation following tooth extraction. in five beagle dogs, the distal roots of the third and fourth mandibular premolars were removed. The sockets in the right or the left jaw quadrant were grafted with either anorganic bovine bone or with chips of autologous bone harvested from the buccal bone plate. After 3 months of healing, biopsies of the experimental sites were sampled, prepared for buccal-lingual ground sections and examined with respect to size and composition. it was observed that the majority of the autologous bone chips during healing had been resorbed and that the graft apparently did not interfere with socket healing or processes that resulted in ridge resorption. autologous bone chips placed in the fresh extraction socket will (i) neither stimulate nor retard new bone formation and (ii) not prevent ridge resorption that occurs during healing following tooth extraction.

  5. Improvement of tendon repair using muscle grafts transduced with TGF-β1 cDNA

    Directory of Open Access Journals (Sweden)

    M Majewski

    2012-02-01

    Full Text Available Tendon rupture is a common injury. Inadequate endogenous repair often leaves patients symptomatic, with tendons susceptible to re-rupture. Administration of certain growth factors improves tendon healing in animal models, but their delivery remains a challenge. Here we evaluated the delivery of TGF-β1 to tendon defects by the implantation of genetically modified muscle grafts. Rat muscle biopsies were transduced with recombinant adenovirus encoding TGF-β1 and grafted onto surgically transected Achilles tendons in recipient animals. Tissue regenerates were compared to those of controls by biomechanical testing as well as histochemical and immunohistochemical analyses. Healing was greatly accelerated when genetically modified grafts were implanted into tendon defects, with the resulting repair tissue gaining nearly normal histological appearance as early as 2 weeks postoperatively. This was associated with decreased deposition of type III collagen in favour of large fibre bundles indicative of type I collagen. These differences in tendon composition coincided with accelerated restoration of mechanical strength. Tendon thickness increased in gene-treated animals at weeks 1 and 2, but by week 8 became significantly lower than that of controls suggesting accelerated remodelling. Thus localised TGF-β1 delivery via adenovirus-modified muscle grafts improved tendon healing in this rat model and holds promise for clinical application.

  6. Postreperfusion hyperkalemia in liver trans-plantation using donation after cardiac death grafts with pathological changes

    Institute of Scientific and Technical Information of China (English)

    Wen-Jin Zhang; Wei-Liang Xia; Hui-Yun Pan; Shu-Sen Zheng

    2016-01-01

    BACKGROUND: With the increasing use of donation after cardiac death (DCD), especially of the graft liver with steatosis or other pathological changes, the frequency of postreperfu-sion hyperkalemia in liver transplantation has increased sig-niifcantly. The present study aimed to determine the factors associated with developing postreperfusion hyperkalemia in liver transplantation from DCD. METHODS: One hundred thirty-one consecutive adult pa-tients who underwent orthotopic liver transplantation from DCD were retrospectively studied. Based on serum potassium within 5 minutes after reperfusion, recipients were divided into two groups: hyperkalemia and normokalemia. According to preoperative biopsy results, the DCD graft livers were clas-siifed into ifve categories. Univariate analysis was performed using Chi-square test to identify variables that were signiif-cantly different between two groups. Multivariate logistic regression was used to conifrm the risk factors of developing hyperkalemia and postreperfusion syndrome. Correlation analysis was used to identify the relationship between the serum concentration of potassium within 5 minutes after re-perfusion and the difference in mean arterial pressure values before and within 5 minutes after reperfusion. RESULTS: Twenty-two of 131 liver recipients had hyperkale-mia episodes within 5 minutes after reperfusion. The rate of hyperkalemia was signiifcantly higher in recipients of macro-steatotic DCD graft liver (78.6%,P CONCLUSION: Macrosteatosis in the DCD graft liver was an independent risk factor of developing hyperkalemia and postreperfusion syndrome in the recipients.

  7. Paclitaxel modulates TGFbeta signaling in scleroderma skin grafts in immunodeficient mice.

    Directory of Open Access Journals (Sweden)

    2005-12-01

    Full Text Available BACKGROUND: Systemic sclerosis (SSc is characterized by excessive fibrosis and obliterative vascular lesions. Abnormal TGFbeta activation is implicated in the pathogenesis of SSc. Aberrant TGFbeta/Smad signaling can be controlled by stabilization of microtubules with paclitaxel. METHODS AND FINDINGS: SSc and healthy human skin biopsies were incubated in the presence or absence of paclitaxel followed by transplantation into severe combined immunodeficient mice. TGFbeta signaling, fibrosis, and neovessel formation were evaluated by quantitative RT-PCR and immunohistochemical staining. Paclitaxel markedly suppressed Smad2 and Smad3 phosphorylation and collagen deposition in SSc grafts. As a result, the autonomous maintenance/reconstitution of the SSc phenotype was prevented. Remarkably, SSc grafts showed a 2-fold increase in neovessel formation relative to normal grafts, regardless of paclitaxel treatment. Angiogenesis in SSc grafts was associated with a substantial increase in mouse PECAM-1 expression, indicating the mouse origin of the neovascular cells. CONCLUSION: Low-dose paclitaxel can significantly suppress TGFbeta/Smad activity and lessen fibrosis in SCID mice. Transplantation of SSc skin into SCID mice elicits a strong angiogenesis-an effect not affected by paclitaxel. Although prolonged chemotherapy with paclitaxel at higher doses is associated with pro-fibrotic and anti-angiogenic changes, the findings described here indicate that low-dose paclitaxel may have therapeutic benefits for SSc via modulating TGFbeta signaling.

  8. Interleukin-10 spot-forming cells as a novel biomarker of chronic graft-versus-host disease

    Science.gov (United States)

    Hirayama, Masahiro; Azuma, Eiichi; Nakagawa-Nakazawa, Atsuko; Kumamoto, Tadashi; Iwamoto, Shotaro; Amano, Keishiro; Tamaki, Shigehisa; Usui, Eiji; Komada, Yoshihiro

    2013-01-01

    Although there are National Institutes of Health consensus criteria for the global assessment of chronic graft-versus-host disease, no validated biomarkers have been established for this disease. Furthermore, whereas the role of T cells, B cells, and dendritic cells in chronic graft-versus-host disease has been established, the contribution of monocytes has not been clearly addressed. Using an enzyme-linked immunospot assay, we measured the spot-forming cells for interferon-γ, interleukin-4, interleukin-10, and interleukin-17 in unstimulated peripheral blood of patients following allogeneic hematopoietic stem cell transplantation. Other immunological examinations, including skin biopsy, were also done. Fifty-seven patients were enrolled. Interleukin-10 spot-forming cells were evaluable for therapeutic monitoring in 16 patients with chronic graft-versus-host disease. The number of interleukin-10 spot-forming cells in patients with active chronic graft-versus-host disease was significantly higher than the number in those with no or inactive chronic graft-versus-host disease. Interleukin-10 was predominantly produced by monocytes. CD29 expression on monocytes in patients with active chronic graft-versus-host disease was elevated. The level of plasma fibronectin, a ligand of CD29, correlated with the number of interleukin-10 spot-forming cells. Immunohistochemical analysis of the skin in active chronic graft-versus-host disease showed that infiltrating CD29+ monocytes might produce interleukin-10. A novel biomarker, interleukin-10 spot-forming cells, shows promise as both a diagnostic and prognostic indicator for chronic graft-versus-host disease, and may allow for early intervention prior to the onset of the disease. Measurement of interleukin-10 spot-forming cells would be helpful in clinical trials and in patients' management. PMID:22733028

  9. Transvitreal retino-choroidal biopsy of suspected malignant lesions of the choroid

    DEFF Research Database (Denmark)

    Jensen, O.A.; Prause, J.U.; Scherfig, E.

    1997-01-01

    ophthalmology, intraocular biopsy, transvitreal retino-choroidal biopsy, malignant melanoma of choroid, histopathology, brachytherapy......ophthalmology, intraocular biopsy, transvitreal retino-choroidal biopsy, malignant melanoma of choroid, histopathology, brachytherapy...

  10. Evaluation of early coronary graft patency after coronary artery bypass graft surgery using multislice computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Raissi Kamal

    2009-12-01

    Full Text Available Abstract Background Coronary artery bypass graft (CABG surgery is the standard of care in the treatment of advanced coronary artery disease, and its long-term results are affected by the failure of bypass grafts. The aim of the present study was to evaluate the early patency rate in coronary bypass grafts. Methods A total of 107 consecutive patients who underwent CABG were included in this study. Early graft patency was evaluated via computed tomography (CT angiography in the first week after surgery. Results There were a total of 366 grafts, comprised of 250 venous grafts and 116 arterial grafts. Multi-slice CT detected acute graft occlusions in 32 (8.7% of all the grafts, including 26 (10% of the 250 venous grafts and 6 (5% of the 116 arterial grafts. The patency rates obtained were 97.3% for the left internal mammary (IMA grafts, 50% for the radial artery grafts, and 50% for the right IMA grafts. Additionally, 107 (96.4% grafts to the left anterior descending artery (LAD were classified as patent, whereas 1 (30% of the 3 grafts in the left circumflex (LCX region and 1 (50% of the 2 grafts in the right coronary artery (RCA territory were found to be occluded. In the venous category, 8 (13.7% of the 58 grafts to LAD were found to be occluded. In the LCX region, 9 (8.5% of the 106 grafts were classified as occluded, while the remaining 97 (91.5% grafts were patent. The venous grafts to RCA were occluded in 9 (10.4% of the 86 grafts. Amongst the multiple preoperative, intraoperative, and postoperative factors, pump time was significantly longer in the patients with occluded grafts than in those with patent grafts (P = 0.04. Conclusion The IMA grafts had the highest early patency rate amongst the coronary bypass grafts. However, the other arterial grafts were associated with a high rate of acute occlusions.

  11. Proteomic study participating the enhancement of growth and salt tolerance of bottle gourd rootstock-grafted watermelon seedlings.

    Science.gov (United States)

    Yang, Yanjuan; Wang, Liping; Tian, Jing; Li, Jing; Sun, Jin; He, Lizhong; Guo, Shirong; Tezuka, Takafumi

    2012-09-01

    An insertion grafting technique to do research on salt tolerance was applied using watermelon (Citrullus lanatus [Thunb.] Mansf. cv. Xiuli) as a scion and bottle gourd (Lagenaria siceraria Standl. cv. Chaofeng Kangshengwang) as a rootstock. Rootstock-grafting significantly relieved the inhibition of growth and photosynthesis induced by salt stress in watermelon plants. Proteomic analysis revealed 40 different expressed proteins in response to rootstock-grafting and/or salt stress. These proteins were involved in Calvin cycle, amino acids biosynthesis, carbohydrate and energy metabolism, ROS defense, hormonal biosynthesis and signal transduction. Most of these proteins were up-regulated by rootstock-grafting and/or susceptible to salt stress. The enhancement of the metabolic activities of Calvin cycle, biosynthesis of amino acids, carotenoids and peroxisomes, glycolytic pathway and tricarboxylic acid cycle will probably contribute to intensify the biomass and photosynthetic capacity in rootstock-grafted seedlings under condition without salt. The accumulation of key enzymes included in these biological processes described above seems to play an important role in the enhancement of salt tolerance of rootstock-grafted seedlings. Furthermore, leucine-rich repeat transmembrane protein kinase and phospholipase may be involved in transmitting the internal and external stimuli induced by grafting and/or salt stress.

  12. Twist and its effect on ACL graft forces.

    NARCIS (Netherlands)

    Arnold, M.P.; Blankevoort, L.; Ham, A. ten; Verdonschot, N.J.J.; Kampen, A. van

    2004-01-01

    Graft tension is a controversial topic in anterior cruciate ligament (ACL) surgery. Evidence suggests a narrow range of graft tensions, which allow the graft to remodel to a stable and mature neoligament. In previous cadaver experiments, we showed that twisting the graft could modulate the graft for

  13. Twist and its effect on ACL graft forces

    NARCIS (Netherlands)

    Arnold, MP; Blankevoort, L; ten Ham, A; Verdonschot, N; van Kampen, A

    2004-01-01

    Graft tension is a controversial topic in anterior cruciate ligament (ACL) surgery. Evidence suggests a narrow range of graft tensions, which allow the graft to remodel to a stable and mature neoligament. In previous cadaver experiments, we showed that twisting the graft could modulate the graft for

  14. Grafting chitosan and polyHEMA on carbon nanotubes surfaces: "grafting to" and "grafting from" methods.

    Science.gov (United States)

    Mahmoodian, Hossein; Moradi, Omid; Shariatzadeh, Behnam

    2014-02-01

    We report a simple method for engineering chitosan (CS) functionalized multi-walled carbon nanotube (MWCNT) composites with a biomedically important polymer, poly-2-hydroxyethyl methacrylate (polyHEMA), by chemical grafting HEMA monomers via free radical polymerization. Functionalization of CS and polyHEMA occurred in three steps. First, using microwave irradiation, CS was grafted onto the surface and sidewall of the carbon nanotubes. Second, HEMA monomers were grafted onto the polymeric matrix surface. The final step involved free radical polymerization of HEMA monomers. Composite synthesis was confirmed by Fourier transform infrared (FTIR) spectroscopy. Moreover, the presence of polyHEMA on the surface of the CS functionalized carbon nanotubes was confirmed by field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM) and thermo gravimetric analysis (TGA) analyses. Furthermore, in the aqueous phase, our novel composites exhibited higher dispersibility compared with pristine MWCNTs. Considering the biomedical importance of polyHEMA and CS polymers, we expect these materials to be useful in the pharmaceutical industry as novel biomaterial composites with potential applications in drug delivery. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

    LENUS (Irish Health Repository)

    Ong, J C Y

    2012-06-01

    The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

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

    Energy Technology Data Exchange (ETDEWEB)

    Turgut, A.T. [Department of Radiology, Ankara Training and Research Hospital, Ministry of Health, TR-06590 Ankara (Turkey)]. E-mail: ahmettuncayturgut@yahoo.com; Ergun, E. [Department of Radiology, Ankara Training and Research Hospital, Ministry of Health, TR-06590 Ankara (Turkey); Kosar, U. [Department of Radiology, Ankara Training and Research Hospital, Ministry of Health, TR-06590 Ankara (Turkey); Kosar, P. [Department of Radiology, Ankara Training and Research Hospital, Ministry of Health, TR-06590 Ankara (Turkey); Ozcan, A. [Department of Anesthesiology and Reanimation, Ankara Training and Research Hospital, Ministry of Health, TR-06590 Ankara (Turkey)

    2006-01-15

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

  17. Visual loss and presumed pseudoxanthoma elasticum confirmed with genetic analysis but not with skin examination and biopsies

    Directory of Open Access Journals (Sweden)

    Aerts, Carolien

    2011-01-01

    Full Text Available Objective: Case report of a patient with angioid streaks, peau d’orange, comet tail lesions, choroidal neovascularisation and presumed pseudoxanthoma elasticum (PXE. PXE was confirmed by gene analysis but not by skin biopsies. Methods: Case report of a patient with angioid streaks identified at age 21 and follow-up till age 43 with repeated fluorescein angiography (FA and optical coherence tomography (OCT. Dermatologic examination, skin biopsies and genetical analysis performed to confirm suspected diagnosis of PXE. Results: At age 43, no specific skin lesions were identified and 3 biopsies could not confirm PXE. Genetic analysis showed a homozygous mutation in the ABCC6 gene and confirmed the diagnosis of PXE. Conclusions: This case illustrates that in patients with angioid streaks having strong ocular indicators of PXE, confirmation of PXE can be obtained not only with dermatologic examination and skin biopsies, but also with genetic analysis. PXE associated mutations can be detected occasionally in biopsy negative patients and for this reason are extremely helpful in confirming a suspected diagnosis.

  18. CHEMICAL MORPHOLOGY IN GRAFTING ACRYLAMIDE TO POLYETHYLENE

    Institute of Scientific and Technical Information of China (English)

    S. Termnak; K. Sintasanai; T. Amomsakchai; T. Nipithakul; D. Triampo

    2008-01-01

    The scanning force microscopy (SFM)/chemical force microscopy (CFM) were used to study the growth of grafted polyacrylamide (PAM) chains onto polyethylene (PE)-film with varying grafting time. Results from the CFM reveal reduced interaction between the probe and areas with grafted-PAM on the surface. The topography and the friction trace-minus-retrace (TMR) images are complementary to one another resulting from the reduced interaction of the probe that has specificity to chemical domains.

  19. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    Science.gov (United States)

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation.

  20. Serial prostate biopsy and risk of lower urinary tract symptoms: results from a large, single-institution active surveillance cohort.

    Science.gov (United States)

    Glass, Allison S; Hilton, Joan F; Cowan, Janet E; Washington, Samuel L; Carroll, Peter R

    2014-01-01

    To describe the effect of serial prostate biopsy on lower urinary tract symptoms (LUTS) in men who undergo active surveillance (AS) at a large academic institution. This is a retrospective study of men enrolled in AS for ≥6 months who underwent ≥1 biopsy and completed ≥1 International Prostate Symptom Score (IPSS) questionnaire. In additional to total IPSS, we report the mean difference between the first and last questionnaires for patients who completed ≥2 questionnaires. Multivariate models, adjusting for disease features, age, race, prostate volume and baseline, or incident benign prostatic hypertrophy (BPH), were used to assess relationships between IPSS and total biopsy exposure. Four hundred eighty-two men were eligible, and 291 completed ≥2 IPSS questionnaires. Overall, mean (standard deviation) age was 61.7 (7.8) years, and median prostate volume (interquartile range) was 42 (34-61) mL. At baseline, 11% provided history of BPH. Among men who completed multiple questionnaires, 25% experienced clinically significant worsening (IPSS increase ≥4 points). In regression model, total IPSS was not significantly associated with greater biopsy exposure (P = .25). IPSS change from initial and the latest questionnaire was not significantly associated with initial or interval biopsy exposure in an adjusted longitudinal model (P = .64 and .50, respectively), but a trend was observed with greater age decade (+4.07 points, 95% CI -0.30 to 8.4; P = .07). Repeated prostate biopsy does not appear to independently pose additional risk of LUTS in an AS population. In unadjusted analyses, greater biopsy exposure is a surrogate for increasing follow-up time, age, and BPH risk, and thus, risk of LUTS onset and progression. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Initial CT-guided needle biopsy of extremity skeletal lesions: Diagnostic performance and experience of a tertiary musculoskeletal center

    Energy Technology Data Exchange (ETDEWEB)

    Nouh, Mohamed Ragab, E-mail: mragab73@yahoo.com [Department of Radiology, Faculty of Medicine, Alexandria University (Egypt); Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait); Abu Shady, Hamdy Mohamed, E-mail: hamdi_abushadi@yahoo.com [Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait)

    2014-02-15

    Introduction: Appendicular long bones are the target for a wide spectrum of bony lesions with variable clinical presentations. Biopsy procedures are needed for subsequent proper patient's management. Most of the available literature globally assessed musculoskeletal biopsies with inclusion of repeat biopsy results. We thought to retrospectively assess the diagnostic performance of initial CT-guided percutaneous core needle biopsy (PCNB) of extremity long bone lesions in a tertiary musculoskeletal referral center. Patients and methods: We retrospectively analyzed the outcome of initial CT-guided PCNB of 49 patients who presented with extremity long bone lesions which were biopsied in our hospital during a 36 months’ time period. The diagnostic performance was assessed in terms of diagnostic yield and accuracy. Results: There were 34 males and 15 females with a mean age of 33.69 years (range from 4 to 77 years). The overall diagnostic yield of initial biopsies was 87.75% with a diagnostic accuracy of 82.85% derived from the surgically proven cases. The higher diagnostic yield was recorded with malignancy, presence of extra-osseous soft-tissue component as well as mixed and sclerotic lesions. The pathologies of the non-diagnostic biopsies included large-cell lymphoma, giant-cell tumor, langerhans cell histiocytosis, osteoid osteoma and a non-ossifying fibroma. Conclusion: Initial CT-guided PCNB in extremities’ long bones lesions showed high diagnostic performance in malignant, mixed and/or sclerotic lesions as well as lesions with extra-osseous exophytic tissue growth. Lack of extra-osseous components, benign and lytic lesions all had worse diagnostic performance.

  2. Dengue: muscle biopsy findings in 15 patients

    Directory of Open Access Journals (Sweden)

    S.M.F. Malheiros

    1993-06-01

    Full Text Available Dengue is known to produce a syndrome involving muscles, tendons and joints. The hallmark of this syndrome is severe myalgia but includes fever, cutaneous rash, and headache. The neuromuscular aspects of this infection are outlined only in isolated reports, and the muscle histopathological features during myalgia have not been described. In order to ascertain the actual neuromuscular involvement in dengue and better comprehend the histological nature of myalgia, we performed a clinical and neurological evaluation, a serum CPK level and a muscle biopsy (with histochemistry in 15 patients (4 males, median age 23 years (range 14-47 with classic dengue fever, serologically confirmed, during the bra-zilian dengue epidemics from September 1986 to March 1987. All patients had a history of fever, headache and severe myalgia. Upon examination 4 had a cutaneous rash, 3 had fever, and 3 a small hepatomegaly. The neurological examination was unremarkable in all and included a manual muscle test. CPK was mildly elevated in only 3 patients. Muscle biopsy revealed a light to moderate perivascular mononuclear infiltrate in 12 patients and lipid accumulation in 11. Mild mitochondrial proliferation was seen in 3, few central nuclei in 3, rare foci of myonecrosis in 3, and 2 patients had type grouping. Dengue in our patients, produced myalgia but no detectable muscle weakness or other neuromuscular involvement. The main histopathological correlation with myalgia seems to be a perivascular mononuclear infiltrate and lipid accumulation.

  3. [Diabetic foot microbiology through biopsy cultures].

    Science.gov (United States)

    Cabeza-De-Vaca, Francisco; Macías, Alejandro Ernesto; Alvarez, José Antonio; Cuevas, Aurora; Ramirez, América Jazmín; Ramírez, Welsy Araceli; Sifuentes-Osornio, José

    2009-01-01

    To determine the microbiology of diabetic foot wounds, through biopsy cultures. Patients with diabetic foot and clinical data of infection were recruited consecutively. Cultures were processed for aerobic organisms after mortar homogenization. For cases with multiple isolates, only the two predominant organisms were identified. The bacterial identification was carried out by biochemical procedures. The sensitivity to antibiotics was made by the disk diffusion method. A total of 91 biopsies were studied, 47 from men (52%). There were 102 isolates, 68 being Gram-negative bacilli (67%), with predominance of Escherichia coli (21%). A total of 28 Gram-positive cocci were isolated (28%) and 6 yeasts (6%). Of the 68 Gram-negative bacilli, 24 were resistant to ciprofloxacin (35%). A total of 55 Enterobacteriaceae were isolated, of which 4 (7%) produced extended-spectrum beta-lactamases. There were 8 Staphylococcus aureus isolates, 3 of which (38%) were resistant to methicillin. In comparison with reports from industrialized countries, we found a higher proportion of Gram-negative and resistant organisms.

  4. Liquid biopsies: tumor diagnosis and treatment monitoring

    Directory of Open Access Journals (Sweden)

    Binh Thanh Vu

    2016-08-01

    Full Text Available Cancer is a disease with high evolutionary, i.e., malignant, characteristics that change under selective pressure from therapy. Characterization based on molecular or primary tumor properties or clinicopathological staging does not fully reflect the state of cancer, especially when cancer cells metastasize. This is the major reason for failure of cancer treatment. Currently, there is an urgent need for new approaches that allow more effective, but less invasive, monitoring of cancer status, thereby improving the efficacy of treatments. With recent technological advances, and ldquo;liquid biopsies, and rdquo; the isolation of intact cells or analysis of components that are secreted from cells, such as nucleic acids or exosomes, could be implemented easily. This approach would facilitate real-time monitoring and accurate measurement of critical biomarkers. In this review, we summarize the recent progress in the identification of circulating tumor cells using new high-resolution approaches and discuss new circulating tumor nucleic acid- and exosome-based approaches. The information obtained through liquid biopsies could be used to gain a better understanding of cancer cell invasiveness and metastatic competence, which would then benefit translational applications such as personalized medicine. [Biomed Res Ther 2016; 3(8.000: 745-756

  5. Outcomes of AV Fistulas and AV Grafts after Interventional Stent-Graft Deployment in Haemodialysis Patients.

    Science.gov (United States)

    Schmelter, Christopher; Raab, Udo; Lazarus, Friedrich; Ruppert, Volker; Vorwerk, Dierk

    2015-08-01

    The study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients. 63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5%), followed by complications of angioplasty with vessel rupture or dissection (31.8%). A high rate of procedural success was achieved (98.5%). The most frequent location of the deployed stent-graft was the draining vein (66.7%). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5% at 6 month, 31.3% at 12 month and 19.2% at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1%), followed by stenosis at the AV access (29.5%) and the deployed stent-graft (23.5%). Re-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.

  6. Outcomes of AV Fistulas and AV Grafts after Interventional Stent-Graft Deployment in Haemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Raab, Udo, E-mail: udo.raab@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Lazarus, Friedrich, E-mail: friedrich.lazarus@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Nephrology (Germany); Ruppert, Volker, E-mail: volker.ruppert@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk, E-mail: dierk.vorwerk@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2015-08-15

    PurposeThe study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients.Materials and Methods63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5 %), followed by complications of angioplasty with vessel rupture or dissection (31.8 %).ResultsA high rate of procedural success was achieved (98.5 %). The most frequent location of the deployed stent-graft was the draining vein (66.7 %). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5 % at 6 month, 31.3 % at 12 month and 19.2 % at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1 %), followed by stenosis at the AV access (29.5 %) and the deployed stent-graft (23.5 %).ConclusionRe-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.

  7. The impact of histopathologic examination of graft-versus-host disease in the era of reduced-intensity conditioning regimen: a study from the Gruppo Italiano Trapianto di Midollo Osseo.

    Science.gov (United States)

    Massi, Daniela; Fondi, Cristina; Nozzoli, Chiara; Benemei, Silvia; Lapi, Francesco; Albarello, Luca; Avellini, Claudio; Bonoldi, Emanuela; Casini, Marco; Cesinaro, Anna Maria; Ciceri, Fabio; Colombetti, Vito; Comin, Camilla Eva; Donelli, Amedea; Fortunato, Mirella; Fratoni, Stefano; Guidi, Stefano; Messerini, Luca; Milone, Giuseppe; Rapezzi, Davide; Negri, Giovanni; Patriarca, Francesca; Peccatori, Fedro Alessandro; Ponzoni, Maurilio; Rafaniello, Paola; Raimondi, Roberto; Salomone, Edvige; Tendas, Andrea; Villari, Loredana; Santucci, Marco; Bosi, Alberto

    2011-02-01

    Reduced-intensity conditioning regimens have reshaped the clinical presentation of graft-versus-host disease after hematopoietic stem cell transplants. However, histopathologic features of graft-versus-host disease following reduced-intensity conditioning regimens have not been fully characterized. In a series of 112 biopsies (skin, n = 60; gastrointestinal [GI] tract, n = 44; liver, n = 8), we described the morphologic profile of graft-versus-host disease following reduced-intensity conditioning and investigated whether histopathologic changes of graft-versus-host disease following reduced-intensity conditioning have a diagnostic and/or prognostic value. Forty-four patients (49.5%) experienced acute graft-versus-host disease, 2 (2.2%) late-onset acute graft-versus-host disease (grade I, n = 13; grade II-IV, n = 33), 24 (27.0%) chronic graft-versus-host disease (de novo n = 12, progressive n = 12) and 19 (21.3%) overlap syndrome. In the skin, we observed: (i) phase-nonspecific changes, such as acute graft-versus-host disease features in chronic graft-versus-host disease patients (n = 4/24; 16.6%), (ii) subtle alterations such as superficial fibrosis in widened dermal papillae (n = 8), in acute graft-versus-host disease/late-onset graft-versus-host disease (n = 6/46; 13.0%) or chronic graft-versus-host disease (n = 2/24, 8.3%) patients, and (iii) features of chronic and acute graft-versus-host disease coexisting in the same specimen in overlap syndrome (n = 3/19; 15.7%). In the GI tract, we did not demonstrate peculiar features differing from those commonly observed in the myeloablative setting. By univariate analysis, a reduced overall survival was associated with graft-versus-host disease type (chronic graft-versus-host disease P = .006, acute graft-versus-host disease P = .03), older age (P = .04), and histopathologic diagnosis of "consistent with" + definite graft-versus-host disease (P = .02). Histopathologic diagnosis retained an independent prognostic value

  8. Basics of kidney biopsy: A nephrologist′s perspective

    Directory of Open Access Journals (Sweden)

    S K Agarwal

    2013-01-01

    Full Text Available The introduction of the kidney biopsy is one of the major events in the history of nephrology. Primary indications of kidney biopsy are glomerular hematuria/proteinuria with or without renal dysfunction and unexplained renal failure. Kidney biopsy is usually performed in prone position but in certain situations, supine and lateral positions may be required. Biopsy needles have changed with times from Vim-Silverman needle to Tru-cut needle to spring-loaded automatic gun. The procedure has also changed from blind bedside kidney biopsy to ultrasound marking to real-time ultrasound guidance to rarely computerized tomography guidance and laparoscopic and open biopsy. In very specific situations, transjugular kidney biopsy may be required. Most of the centers do kidney biopsy on short 1-day admission, whereas some take it as an outdoor procedure. For critical interpretation of kidney biopsy, adequate sample and clinical information are mandatory. Tissue needs to be stained with multiple stains for delineation of various components of kidney tissue. Many consider that electron microscopy (EM is a must for all kidney biopsies, but facilities for EM are limited even in big centers. Sophisticated tests such as immunohistochemistry and in-situ hybridization are useful adjuncts for definitive diagnosis in certain situations.

  9. Magnetic Resonance Imaging Guided Vacuum Assisted and Core Needle Biopsies.

    Science.gov (United States)

    Kılıç, Fahrettin; Eren, Abdulkadir; Tunç, Necmettin; Velidedeoğlu, Mehmet; Bakan, Selim; Aydoğan, Fatih; Çelik, Varol; Gazioğlu, Ertuğrul; Yılmaz, Mehmet Halit

    2016-01-01

    The purpose of this study to present the results of Magnetic resonance imaging (MRI) guided cutting needle biopsy procedures of suspicious breast lesions that can be solely detected on Magnetic resonance (MR) examination. The study included 48 patients with 48 lesions which were solely be observed in breast MRI, indistinguishable in ultrasonography and mammography, for MR guided vacuum-assisted cutting needle biopsy and 42 patients with 42 lesions for MR guided cutting needle biopsy for the lesions of the same nature. MR imaging was performed using a 1.5-Tesla MRI device. Acquired MR images were determined and biopsy protocol was performed using computer-aided diagnosis system on the workstation. Vacuum biopsies were performed using 10 G or 12 G automatic biopsy systems, cutting needle biopsy procedures were performed using fully automated 12 G biopsy needle. All biopsy procedures were finalized successfully without major complications. The lesions were 54 mass (60%), 28 were non-mass contrast enhancement (31%) and 8 were foci (9%) in the MR examination. Histopathological evaluation revealed 18 malignant (invasive, in-situ ductal carcinoma and lobular carcinoma), 66 benign (apocrine metaplasia, fibrosis, fibroadenomatoid lesion, sclerosing adenosis, fibrocystic disease and mild-to-severe epithelial proliferation) and 6 high-risk (atypical ductal hyperplasia, intraductal papilloma, radial scar) lesions. Magnetic resonance guided vacuum and cutting needle biopsy methods are successful methods fort he evaluation of solely MRI detected suspicious breast lesions. There are several advantages relative to each other in both methods.

  10. Dynamics of the alar rim graft.

    Science.gov (United States)

    Guyuron, Bahman; Bigdeli, Yaas; Sajjadian, Ali

    2015-04-01

    The purpose of this study was to review the dynamics and frequency of the use of the alar rim graft. The recorded intraoperative information for the purpose of rhinoplasty research was reviewed to investigate the frequency of the use of alar rim grafts. Intraoperative observations were also made while inserting the alar rim graft to identify the changes that occur in the structures that could be influenced by placement of this graft. The data were tabulated in an Excel file and analyzed. Of the 1427 patients who underwent nose reconstruction or rhinoplasty in this study, 565 (39.56 percent) received alar rim grafts. This included 73 primary nose reconstructions, 20 secondary nose reconstructions, two revision nose reconstructions, 304 primary rhinoplasties, 107 secondary rhinoplasties, 43 revision operations following primary rhinoplasties, and seven revision operations following secondary rhinoplasties. However, when 100 more recent consecutive cases were reviewed, 88 percent of primary rhinoplasty patients and 67 percent of secondary rhinoplasty patients received alar rim grafts. The observed dynamic changes after insertion of each graft included (1) correction of the concavity of the ala, (2) caudal advancement of the alar rim, (3) elongation of nostril, and (4) widening of the nostril. The majority of patients who undergo rhinoplasty would benefit from the alar rim graft, and this study demonstrates a steady increase in its use. Placement of an alar rim graft results in elongation of the short nostril, correction of the alar concavity, widening of the nostril, and slight caudal transposition of the alar rim.

  11. The autologus graft of epithelial tissue culture

    Directory of Open Access Journals (Sweden)

    Minaee B

    1999-08-01

    Full Text Available With the intention of research about culture and autologus graft of epithelial tissue we used 4 french Albino Rabbits with an average age of 2 months. After reproduction on the support in EMEM (Eagle's Minimum Essential Medium we used this for graft after 4 weeks. This region which grafted total replaced. After fixation of this sample and passing them through various process, histological sections were prepared. These sections were stained with H & E and masson's trichrome and studied by light microscope. We succeeded in graft. We hope in the near future by using the method of epithelium tissue culture improving to treat burned patients.

  12. Diagnostic quality of biopsy specimens: comparison between a conventional biopsy forceps and multibite forceps.

    Science.gov (United States)

    Fantin, A C; Neuweiler, J; Binek, J S; Suter, W R; Meyenberger, C

    2001-11-01

    The endoscopic biopsy is a prerequisite for histopathologic diagnosis. Various types of forceps are used to obtain tissue specimens. The aim of this study was to assess and compare the diagnostic quality of biopsy specimens obtained with a conventional forceps and a Multibite forceps. In a prospective, partially blinded, and randomized trial that included 250 patients referred for diagnostic upper and/or lower endoscopy, 510 biopsy specimens obtained with the Multibite forceps were compared with 520 specimens obtained with a conventional forceps. An experienced, blinded pathologist evaluated the specimens for diameter, depth of specimen, artifacts, anatomic orientation, vitality, general histologic quality, and diagnostic quality. Statistical analysis was performed by using the Fisher exact test. A p value of < 0.05 was regarded as significant. There were no statistically significant differences between the specimens obtained with the 2 forceps. The p values for the evaluated parameters were as follows: diameter 0.45, depth of specimen 0.56, artifacts 1.0, pathoanatomic orientation 0.40, vitality 0.45, and histologic diagnostic quality 0.53. The quality of biopsy specimens obtained with the Multibite forceps is comparable with that of specimens taken with a conventional forceps. Use of the Multibite forceps saves time in that 4 specimens can be obtained in 1 pass in situations in which a large number of specimens are needed or when the potential for transmission of infection is of concern.

  13. Renal biopsy findings among Indigenous Australians: a nationwide review.

    Science.gov (United States)

    Hoy, Wendy E; Samuel, Terence; Mott, Susan A; Kincaid-Smith, Priscilla S; Fogo, Agnes B; Dowling, John P; Hughson, Michael D; Sinniah, Rajalingam; Pugsley, David J; Kirubakaran, Meshach G; Douglas-Denton, Rebecca N; Bertram, John F

    2012-12-01

    Australia's Indigenous people have high rates of chronic kidney disease and kidney failure. To define renal disease among these people, we reviewed 643 renal biopsies on Indigenous people across Australia, and compared them with 249 biopsies of non-Indigenous patients. The intent was to reach a consensus on pathological findings and terminology, quantify glomerular size, and establish and compare regional biopsy profiles. The relative population-adjusted biopsy frequencies were 16.9, 6.6, and 1, respectively, for Aboriginal people living remotely/very remotely, for Torres Strait Islander people, and for non-remote-living Aboriginal people. Indigenous people more often had heavy proteinuria and renal failure at biopsy. No single condition defined the Indigenous biopsies and, where biopsy rates were high, all common conditions were in absolute excess. Indigenous people were more often diabetic than non-Indigenous people, but diabetic changes were still present in fewer than half their biopsies. Their biopsies also had higher rates of segmental sclerosis, post-infectious glomerulonephritis, and mixed morphologies. Among the great excess of biopsies in remote/very remote Aborigines, females predominated, with younger age at biopsy and larger mean glomerular volumes. Glomerulomegaly characterized biopsies with mesangiopathic changes only, with IgA deposition, or with diabetic change, and with focal segmental glomerulosclerosis (FSGS). This review reveals great variations in biopsy rates and findings among Indigenous Australians, and findings refute the prevailing dogma that most indigenous renal disease is due to diabetes. Glomerulomegaly in remote/very remote Aboriginal people is probably due to nephron deficiency, in part related to low birth weight, and probably contributes to the increased susceptibility to kidney disease and the predisposition to FSGS.

  14. Documenting the location of prostate biopsies with image fusion

    Science.gov (United States)

    Turkbey, Baris; Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Bernardo, Marcelino; Merino, Maria J.; Wood, Bradford J.; Choyke, Peter L.; Pinto, Peter A.

    2012-01-01

    OBJECTIVE To develop a system that documents the location of transrectal ultrasonography (TRUS)-guided prostate biopsies by fusing them to MRI scans obtained prior to biopsy, as the actual location of prostate biopsies is rarely known. PATIENTS AND METHODS Fifty patients (median age 61) with a median prostate-specific antigen (PSA) of 5.8 ng/ml underwent 3T endorectal coil MRI prior to biopsy. 3D TRUS images were obtained just prior to standard TRUS-guided 12-core sextant biopsies wherein an electromagnetic positioning device was attached to the needle guide and TRUS probe in order to track the position of each needle pass. The 3D-TRUS image documenting the location of each biopsy was fused electronically to the T2-weighted MRI. Each biopsy needle track was marked on the TRUS images and these were then transposed onto the MRI. Each biopsy site was classified pathologically as positive or negative for cancer and the Gleason score was determined. RESULTS The location of all (n = 605) needle biopsy tracks was successfully documented on the T2-weighted (T2W) MRI. Among 50 patients, 20 had 56 positive cores. At the sites of biopsy, T2W signal was considered ‘positive’ for cancer (i.e. low in signal intensity) in 34 of 56 sites. CONCLUSION It is feasible to document the location of TRUS-guided prostate biopsies on pre-procedure MRI by fusing the pre-procedure TRUS to an endorectal coil MRI using electromagnetic needle tracking. This procedure may be useful in documenting the location of prior biopsies, improving quality control and thereby avoiding under-sampling of the prostate as well as directing subsequent biopsies to regions of the prostate not previously sampled. PMID:20590543

  15. Endomyocardial biopsy in heart transplantation: schedule or event?

    Science.gov (United States)

    Chi, N-H; Chou, N-K; Tsao, C-I; Huang, S-C; Wu, I-H; Yu, H-Y; Chen, Y-S; Wang, S-S

    2012-05-01

    Endomyocardial biopsy is the gold standard to identify rejection after heart transplantation. Due to its invasiveness, discomfort, and difficult vascular access, some patients are not willing to accept routine scheduled biopsies years after heart transplantation. The purpose of this study was to identify whether there was a difference in outcomes among the scheduled versus event biopsy groups. We studied 411 patients who underwent heart transplantation from 1987 to 2011, reviewing biopsy results and pathology reports. There were 363 patients who followed the scheduled biopsy protocol, and 48 patients who were assigned to the event biopsy group. We extracted data on biopsy results, rejection episodes, rejection types, and survival time. The 2481 reviewed biopsies over 24 years, showed most rejection episodes (86.4%) to occur within 2 years after heart transplantation. The rejection incidence was low (2.1%) at 3 years after transplantation. The major reason for an event biopsy was poor vascular access, such as tiny central vein or congenital disease without a suitable central vein. Event biopsy group patients were younger than schedule biopsy patients (19.7 years old vs 47.6 years old; P biopsy group (P = .029). The 10-year rates of freedom from rejection were similar. The rejection rate was low after 3 years; episodes occurred within 2 years. Although the long-term survival in the event group was better, they had a younger man age. The rejection and freedom from rejection rates were similar. As the rejection rate was low at 3 years after transplantation, we suggest that the event principle could be applied for biopsy at 3 years after heart transplantation. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Analysis of repeated measures data

    CERN Document Server

    Islam, M Ataharul

    2017-01-01

    This book presents a broad range of statistical techniques to address emerging needs in the field of repeated measures. It also provides a comprehensive overview of extensions of generalized linear models for the bivariate exponential family of distributions, which represent a new development in analysing repeated measures data. The demand for statistical models for correlated outcomes has grown rapidly recently, mainly due to presence of two types of underlying associations: associations between outcomes, and associations between explanatory variables and outcomes. The book systematically addresses key problems arising in the modelling of repeated measures data, bearing in mind those factors that play a major role in estimating the underlying relationships between covariates and outcome variables for correlated outcome data. In addition, it presents new approaches to addressing current challenges in the field of repeated measures and models based on conditional and joint probabilities. Markov models of first...

  17. Needle core biopsy for breast lesions: An audit of 467 needle core biopsies

    Directory of Open Access Journals (Sweden)

    Selvi Radhakrishna

    2013-01-01

    Full Text Available Background: Breast cancer is the commonest cancer among women in urban India. Triple assessment includes clinical, radiological and cytological assessment of breast lesions. Guided core needle biopsy has replaced fine needle aspiration cytology in most of the western countries. In resource poor countries FNAC is still a very valuable and cost effective method to diagnose breast lesions. Pitfalls include increased rates of non diagnostic smears, and inadequate smears. Further procedures may be required and this increases the cost, anxiety and delay in diagnosis. Aims: The aim of this study is to analyze the concordance of radiological and histopathology findings in BI-RADS category 3,4,5 lesions following a core biopsy. Materials and Methods: Data was retrospectively collected from consecutive symptomatic and opportunistic screen detected patients with abnormalities who underwent ultrasound guided interventional procedures from Jan 2010 to Aug 2011. Symptomatic patients underwent clinical examination, mammogram and breast ultrasound. Women under 35 years of age had only breast ultrasound. Core biopsy was performed under ultrasound guidance or clinically by a breast surgeon/ radiologist for BI-RADS category 3,4,5 lesions. Statistical Methods: Chi square test was done to show the strength of association of imaging findings and histopathology results of core biopsy. Results: 437 patients were symptomatic and 30 patients had screen detected abnormalities. The positive predictive value for BI-RADS 5 lesions for malignancy is 93.25% and the negative predictive value of BI-RADS category 3 lesions for cancer is 98.4%. False negative diagnosis on core biopsy was 0.85%. We were able to defer surgery in 60% of the patients with a clear radiological and pathological benign diagnosis. Conclusion: The PPV and NPV for cancer is high with needle core biopsy in BI-RADS 3,4,5 lesions. Where there is no discordance between clinical, radiology and pathology findings

  18. Mortality and complications after prostate biopsy in the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial.

    Science.gov (United States)

    Pinsky, Paul F; Parnes, Howard L; Andriole, Gerald

    2014-02-01

    To examine mortality and morbidity after prostate biopsy in the intervention arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial. Abstractors from the PLCO trial recorded the types and dates of diagnostic follow-up procedures after positive screens and documented the types and dates of resultant complications. Cancers and deaths among the participants were tracked. The mortality rate in the 120-day period after prostate biopsy was compared with a control rate of deaths in the 120-day period after a negative screen in men without biopsy. Multivariate analysis was performed to control for potential confounders, including age, comorbidities and smoking. Rates of any complication, infectious and non-infectious complications were computed among men with a negative biopsy. Multivariate analysis was used to examine the risk factors for complications. Of the 37,345 men enrolled in the PLCO trial (intervention arm), 4861 had at least one biopsy after a positive screen and 28,661 had a negative screen and no biopsy. The 120-day mortality rate after biopsy was 0.95 (per 1000), compared with the control group rate of 1.8; the multivariate relative risk was 0.49 (95% CI: 0.2-1.1). Among 3706 negative biopsies, the rates (per 1000) of any complication, infectious and non-infections complications were 20.2, 7.8 and 13.0, respectively. A history of prostate enlargement or inflammation was significantly associated with higher rates of both infectious (odds ratio [OR] = 3.7) and non-infectious (OR = 2.2) complications. Black race was associated with a higher infectious complications rate (OR = 7.1) and repeat biopsy was associated with lower rates of non-infectious complications (OR = 0.3). Mortality rates were not found to be higher after prostate biopsy in the PLCO trial and complications were relatively infrequent, with several risk factors identified. Published 2013. This article has been contributed to by US Government employees and their work is in

  19. Treatment of oroantral fistula with autologous bone graft and application of a non-reabsorbable membrane

    Directory of Open Access Journals (Sweden)

    Adele Scattarella, Andrea Ballini, Felice Roberto Grassi, Andrea Carbonara, Francesco Ciccolella, Angela Dituri, Gianna Maria Nardi, Stefania Cantore, Francesco Pettini

    2010-01-01

    Full Text Available Aim: The aim of the current report is to illustrate an alternative technique for the treatment of oroantral fistula (OAF, using an autologous bone graft integrated by xenologous particulate bone graft.Background: Acute and chronic oroantral communications (OAC, OAF can occur as a result of inadequate treatment. In fact surgical procedures into the maxillary posterior area can lead to inadvertent communication with the maxillary sinus. Spontaneous healing can occur in defects smaller than 3 mm while larger communications should be treated without delay, in order to avoid sinusitis. The most used techniques for the treatment of OAF involve buccal flap, palatal rotation - advancement flap, Bichat fat pad. All these surgical procedures are connected with a significant risk of morbidity of the donor site, infections, avascular flap necrosis, impossibility to repeat the surgical technique after clinical failure, and patient discomfort.Case presentation: We report a 65-years-old female patient who came to our attention for the presence of an OAF and was treated using an autologous bone graft integrated by xenologous particulate bone graft. An expanded polytetrafluoroethylene titanium-reinforced membrane (Gore-Tex ® was used in order to obtain an optimal reconstruction of soft tissues and to assure the preservation of the bone graft from epithelial connection.Conclusions: This surgical procedure showed a good stability of the bone grafts, with a complete resolution of the OAF, optimal management of complications, including patient discomfort, and good regeneration of soft tissues.Clinical significance: The principal advantage of the use of autologous bone graft with an expanded polytetrafluoroethylene titanium-reinforced membrane (Gore-Tex ® to guide the bone regeneration is that it assures a predictable healing and allows a possible following implant-prosthetic rehabilitation.

  20. Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis

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    Bruno Moulin

    2012-01-01

    Full Text Available The clinical merit of surveillance kidney graft biopsies remains controversial. A retrospective, multicenter analysis evaluated 12-month surveillance biopsies (SB, 154 patients versus no SB (NSB, 138 patients (11 with diagnostic biopsy in patients >18 months posttransplant with estimated GFR (eGFR ≥30 mL/min. The primary objective was to describe renal function at 18 months post-transplant in patients with or without SB at month 12. Globally, most recipients in both cohorts were at low immunological risk (<10% of patients with PRA ≥30%. The immunosuppressive regimen remained unchanged following more than half of SB that exhibited chronic lesions (18/33, 54.5%. Mean (SD eGFR at month 18 (primary endpoint was 56 (19 mL/min/1.73 m² with SB and 54 (15 mL/min/1.73 m² with NSB (=0.48. In the SB group, slight nonspecific changes were observed in 51 cases, rejection (acute or chronic in 6 cases, CNI-related toxicity in 15 cases, recurrence of initial disease in two cases, and interstitial fibrosis/tubular atrophy (IF/TA in 83 cases (71.6%, of which 35 cases (30.2% were grade II/III lesions. eGFR <50 mL/min/1.73 m² at month 6 predicted IF/TA grade II or III (OR 3.85, 95% CI 1.64, 9.05, <0.002. SB at 12 months posttransplant did not prompt significant modification of immunosuppression, and no renal benefit was observed.

  1. Nanotribological study of grafted polymer

    Science.gov (United States)

    Bouhacina, T.; Aimé, J. P.; Attias, A. J.

    1998-06-01

    The frictional forces between grafted layers, organosilanes and polymer, on silica and a nanotip have been investigated as a function of the tip velocity. From the interpretation of these results and one gets a step forward for more quantitative information. Les forces de friction entre des couches greffées sur silice et une nanopointe ont été étudiées en fonction de la vitesse de la pointe. À partir de l'interprétation de ces résultats on s'avance vers plus d'infor mations quantitatives.

  2. Diffusion and Perfusion: The Keys to Fat Grafting

    Directory of Open Access Journals (Sweden)

    Roger K. Khouri, Jr, BS

    2014-09-01

    Conclusions: These models confirm that initial fat grafting survival is limited by oxygen diffusion. Preoperative expansion increases oxygen diffusion capacity allowing for additional graft retention. These models provide a scientific framework for testing the current fat grafting theories.

  3. Design and development of multilayer vascular graft

    Science.gov (United States)

    Madhavan, Krishna

    2011-07-01

    Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture

  4. Radiation resistivity of polyacenaphthylene-grafted polyethylene

    Science.gov (United States)

    Hayakawa, Kiyoshi; Kawase, Kaoru; Yamakita, Hiromi

    Thin poly (ethylene-g-acenaphthylene) films prepared by the vapor-phase grafting method were subjected to the γ-irradiation in air, and various changes in tensile and structural properties of the film were investigated by comparing with those of the untreated or crosslinked polyethylene film. Polyethylene got to lose its inherent necking property by oxidative degradation and to be brittle-fractured by the irradiation dose less than 100 Mrad in air. The polyacenaphthylene-grafted polyethylenes (extent of grafting, ˜ 54 by {100( P-P°) }/{P°}), however, kept their ductility up to 200 Mrad or more, and the rate of increase in elastic modulus as well as yield strength with the increasing irradiation dose was considerably lower than that of untreated or crosslinked polyethylene. The effect of the grafting extent, and that of the irradiation dose-rate on the fracture energy were also examined. The weight increase of polyethylene due to the oxygen consumption and the resulting formation of carbonyl group which proceeded proportionally with the irradiation dose were remarkably suppressed by the grafting, whereas the double bond formation seemed to be unaffected by it. The grafted film held the original content of gel fraction unchanged during the irradiation in air, but the average molecular weight of the sol fraction decreased gradually. Meanwhile, the gel fraction of the crosslinked polyethylene was degenerated by a small dose of irradiation. The analysis of gaseous products revealed the formation of water, methanol, acetaldehyde and so forth from the irradiated grafted film. The grafting procedure and the subsequent irradiation of the grafted film did not affect the degree of crystallinity of the backbone polyethylene. The role played by the grafted polyacenaphthylene for endowing the radiation resistivity to polyethylene and its inherent limitation in effect were discussed from the structural point of view of the grafted film.

  5. Sequential Vein Bypass Grafting is Not Associated with an Increase of Either In-hospital or Mid-term Adverse Events in Off-pump Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    Fucheng Xiao; Jian Wang; Hengchao Wu; Hansong Sun

    2015-01-01

    Background:The impact of sequential vein bypass grafting on clinical outcomes is less known in off-pump coronary artery bypass grafting (CABG).We aimed to evaluate the effects of sequential vein bypass grafting on clinical outcomes in off-pump CABG.Methods:From October 2009 to September 2013 at the Fuwai Hospital,127 patients with at least one sequential venous graft were matched with 127 patients of individual venous grafts only,using propensity score matching method to obtain risk-adjusted outcome comparison.In-hospital measurement was composite outcome of in-hospital death,myocardial infarction (MI),stroke,requirement for intra-aortic ballon pump (IABP) assistance and prolonged ventilation.Major adverse cardiac events (MACEs:Death,MI or repeat revascularization) and angina recurrence were considered as mid-term endpoints.Results:No significant difference was observed among the groups in baseline characteristics.Intraoperative mean blood flow per vein graft was 40.4 ml in individual venous grafts groups versus 59.5 ml in sequential venous grafts groups (P < 0.001).There were no differences between individual and sequential venous grafts groups with regard to composite outcome of in-hospital mortality,MI,stroke,IABP assistance and prolonged ventilation (11.0% vs.14.2%,P =0.45).Individual in-hospital measurement also did not differ significantly between the two groups.At about four years follow-up,the survival estimates free from MACEs (92.5% vs.97.3%,P =0.36) and survival rates free of angina recurrence (80.9% vs.85.5%,P =0.48) were similar among individual and sequential venous grafts groups with a mean follow-up of 22.5 months.In the Cox regression analysis,sequential vein bypass grafting was not identified as an independent predictor of both MACEs and angina recurrence.Conclusions:Compared to individual vein bypass grafting,sequential vein bypass grafting was not associated with an increase of either in-hospital or mid-term adverse events in

  6. Factors that can minimize bleeding complications after renal biopsy

    OpenAIRE

    Zhu, M. S.; J. Z. Chen; A.P. Xu

    2014-01-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding dia...

  7. Quantitative morphology and water distribution of bronchial biopsy samples.

    OpenAIRE

    Baldwin, D. R.; Wise, R.; Andrews, J. M.; HONEYBOURNE, D

    1992-01-01

    BACKGROUND: An approach to the study of the pharmacokinetics of drugs in the lung is to measure their concentrations in bronchial biopsy specimens. The main criticism of this technique is that bronchial biopsy specimens consist of more than one tissue type and that drugs are often not distributed evenly. The morphology of bronchial biopsy specimens and the distribution of water between the extracellular and the intracellular compartments is therefore important. METHODS: Fifteen subjects under...

  8. Utility of repeat cytological assessment of thyroid nodules initially classified as benign: clinical insights from multidisciplinary care in an Irish tertiary referral centre.

    Science.gov (United States)

    Glynn, Nigel; Hannon, Mark J; Lewis, Sarah; Hillery, Patrick; Al-Mousa, Mohammed; Hill, Arnold D K; Keeling, Frank; Morrin, Martina; Thompson, Christopher J; Smith, Diarmuid; Royston, Derval; Leader, Mary; Agha, Amar

    2016-08-02

    Fine needle aspiration biopsy (FNAB) is the tool of choice for evaluating thyroid nodules with the majority classified as benign following initial assessment. However, concern remains about false negative results and some guidelines have recommended routine repeat aspirates. We aimed to assess the utility of routine repeat FNAB for nodules classified as benign on initial biopsy and to examine the impact of establishing a multidisciplinary team for the care of these patients. We performed a retrospective review of 400 consecutive patients (413 nodules) who underwent FNAB of a thyroid nodule at our hospital between July 2008 and July 2011. Data recorded included demographic, clinical, histological and radiological variables. Three hundred and fifty seven patients (89 %) were female. Median follow-up was 5.5 years. Two hundred and fifty eight (63 %) nodules were diagnosed as benign. The rate of routine repeat biopsy increased significantly over the time course of the study (p for trend = 0.012). Nine Thy 2 nodules were classified differently on the basis of routine repeat biopsy; one patient was classified as malignant on repeat biopsy and was diagnosed with papillary thyroid carcinoma. Eight were classified as a follicular lesions on repeat biopsy-six diagnosed as benign following lobectomy; two declined lobectomy and were followed radiologically with no nodule size increase. The false negative rate of an initial benign cytology result, from a thyroid nodule aspirate, is low. In the setting of an experienced multidisciplinary thyroid team, routine repeat aspiration is not justified.

  9. Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

    Science.gov (United States)

    Wada, Yuki; Seko, Noriaki; Nagasawa, Naotsugu; Tamada, Masao; Kasuya, Ken-ichi; Mitomo, Hiroshi

    2007-06-01

    Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

  10. Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Yuki [Department of Biological and Chemical Engineering, Faculty of Engineering, Gunma University, 1-5-1 Tenjin-cho, Kiryu, Gunma 376-8515 (Japan)]. E-mail: wada.yuki@jaea.go.jp; Seko, Noriaki [Environment and Industrial Materials Research Division, Quantum Beam Science Directorate, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma 370-1292 (Japan); Nagasawa, Naotsugu [Environment and Industrial Materials Research Division, Quantum Beam Science Directorate, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma 370-1292 (Japan); Tamada, Masao [Environment and Industrial Materials Research Division, Quantum Beam Science Directorate, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma 370-1292 (Japan); Kasuya, Ken-ichi [Department of Biological and Chemical Engineering, Faculty of Engineering, Gunma University, 1-5-1 Tenjin-cho, Kiryu, Gunma 376-8515 (Japan); Mitomo, Hiroshi [Department of Biological and Chemical Engineering, Faculty of Engineering, Gunma University, 1-5-1 Tenjin-cho, Kiryu, Gunma 376-8515 (Japan)

    2007-06-15

    Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

  11. Targeted cryotherapy using disposable biopsy punches

    Directory of Open Access Journals (Sweden)

    Avitus John Raakesh Prasad

    2014-01-01

    Full Text Available Cryotherapy is a commonly used office procedure that causes destruction of tissue by cryonecrosis due to rapid freezing and thawing of cells. The limitation in treating plantar warts and deeper dermal lesions is that the freeze time should be longer to penetrate deeper, which results in collateral damage to normal skin surrounding the lesion. This results in unwanted side effects of prolonged pain, blistering and haemorrhage and increased healing time. The cone spray technique was used to reduce collateral damage, but deeper penetration is difficult to achieve. An innovative technique using disposable biopsy punches is described that ensures deeper freezing as compared to the plastic cone. The metal cutting edge of the punch enters deeper into the lesions as the liquid nitrogen is passed, sparing damage to surrounding skin.

  12. Targeted Cryotherapy Using Disposable Biopsy Punches

    Science.gov (United States)

    Prasad, Avitus John Raakesh

    2014-01-01

    Cryotherapy is a commonly used office procedure that causes destruction of tissue by cryonecrosis due to rapid freezing and thawing of cells. The limitation in treating plantar warts and deeper dermal lesions is that the freeze time should be longer to penetrate deeper, which results in collateral damage to normal skin surrounding the lesion. This results in unwanted side effects of prolonged pain, blistering and haemorrhage and increased healing time. The cone spray technique was used to reduce collateral damage, but deeper penetration is difficult to achieve. An innovative technique using disposable biopsy punches is described that ensures deeper freezing as compared to the plastic cone. The metal cutting edge of the punch enters deeper into the lesions as the liquid nitrogen is passed, sparing damage to surrounding skin. PMID:25136216

  13. Sentinel lymph node biopsy in oral cancer

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Grupe, Peter;

    2005-01-01

    PURPOSE: To validate lymphatic mapping combined with sentinel lymph node biopsy as a staging procedure, and to evaluate the possible clinical implications of added oblique lymphoscintigraphy and/or tomography and test the intra- and interobserver reproducibility of lymphoscintigraphy. MATERIAL...... AND METHODS: Forty patients (17 F and 23 M, aged 32-90) with 24 T1 and 16 T2 squamous cell carcinoma of the oral cavity. Planar lymphoscintigraphy, emission and transmission tomography were performed. Detection and excision of the sentinel nodes were guided by a gamma probe. The sentinel nodes were step......-sectioning and stained with hematoxylin and eosin and cytokeratin (CK 1). Histology and follow-up were used as "gold standard". Tumor location, number of sentinel lymph nodes, metastasis, and recurrences were registered. Two observers evaluated the lymphoscintigraphic images to assess the inter-rater agreement. RESULTS...

  14. Atopic dermatitis. Findings of skin biopsies.

    Science.gov (United States)

    Piloto Valdés, L; Gómez Echevarría, A H; Valdés Sánchez, A F; Ochoa Ochoa, C; Chong López, A; Mier Naranjo, G

    1990-01-01

    Twenty-eight adult patients with a clinical diagnosis of atopic dermatitis (according to the criteria of Hanifin and Lobitz) were studied at the Allergy Outpatient Service, the Dermatology Service and the Pathological Anatomy Service of the Hermanos Ameijeiras Clinical Surgical Hospital, from January to September 1986. The patients were submitted to a quantification of total serum IgE by means of the ELISA enzymatic ultramicromethod, developed at the Radioimmunoassay National Center, and skin biopsies were carried out by means of the paraffin and direct immunofluorescence methods. The most frequent histopathological findings were acanthosis, espongiosis, parakeratosis and exocitosis, as a chronic inflammatory infiltrate, mainly composed of lymphocytes, mast cells and eosinophils. In the skin direct immunofluorescence method we found depots of IgE in all the patients, having no relation in intensity to total serum IgE values.

  15. Fine needle aspiration biopsy of ophthalmic tumors☆

    Science.gov (United States)

    Singh, Arun D.; Biscotti, Charles V.

    2012-01-01

    A majority of intraocular tumors can be diagnosed based on clinical examination and ocular imaging studies, which obviate the need for diagnostic ophthalmic fine needle aspiration biopsy (FNAB). Overall, diagnostic accuracy of ophthalmic FNAB is high but limited cellularity can compromise the diagnostic potential of ophthalmic aspirate samples. The role of ophthalmic FNAB is limited in retinal tumors. Orbital FNAB should be considered in the evaluation of lacrimal gland tumors, orbital metastasis, and lymphoproliferative lesions. Negative cytologic diagnosis of malignancy should not be considered unequivocal proof that an intraocular malignancy does not exist. With improved understanding of genetic prognostic factors of uveal melanoma, ophthalmic FNAB is gaining popularity for prognostic purposes in combination with eye conserving treatment of the primary tumor. In special clinical indications, ancillary studies such as immunohistochemistry and FISH can be performed on ophthalmic FNAB samples. Assistance of an experienced cytopathologist cannot be overemphasized. PMID:23960981

  16. Confocal Microscopy in Biopsy Proven Argyrosis

    Directory of Open Access Journals (Sweden)

    Melis Palamar

    2013-01-01

    Full Text Available Purpose. To evaluate the confocal microscopy findings of a 46-year-old male with bilateral biopsy proven argyrosis. Materials and Methods. Besides routine ophthalmologic examination, anterior segment photography and confocal microscopy with cornea Rostoch module attached to HRT II (Heidelberg Engineering GmbH, Heidelberg, Germany were performed. Findings. Squamous metaplastic changes on conjunctival epithelium and intense highly reflective extracellular punctiform deposits in conjunctival substantia propria were detected. Corneal epithelium was normal. Highly reflective punctiform deposits starting from anterior to mid-stroma and increasing through Descemet’s membrane were evident. Corneal endothelium could not be evaluated due to intense stromal deposits. Conclusion. Confocal microscopy not only supports diagnosis in ocular argyrosis, but also demonstrates the intensity of the deposition in these patients.

  17. Influence of ischemia before vein grafting on early hyperplasia of the graft and the dynamic changes of the intima after grafting

    Directory of Open Access Journals (Sweden)

    Zou RongJiang

    2012-09-01

    Full Text Available Abstract Background To investigate both the influence of ischemia before grafting on early hyperplasia of the vein grafts, and the dynamic changes of the intima after grafting in a rabbit model of vein graft disease. Methods We performed paired vein graft experiments under different ischemic conditions (15 vs. 60 min; 15 vs. 90 min in the neck of the rabbits and compared the differences between the grafts. Clopidogrel, an anti-platelet agent, was administered before and after surgery. Twenty-eight days after the grafting procedure, the veins were evaluated microscopically. The dynamic changes of the intima after grafting were evaluated by scanning electron microscopy over time. Results The vein grafts subjected to 60- or 90-min ischemia exhibited no differences compared to those subjected to 15-min ischemia in terms of the mean thickness of the intimal, medial, and adventitial layers of the graft. Similarly, there was no difference in the Ki-67 labeling index (proliferation marker between the vein grafts. Vein grafts with 15-min ischemia lost endothelial cells (ECs but healed by 3 days post graft, whereas vein grafts with 90-min ischemia suffered serious EC loss, which was restored with new ECs during days 2 to 14 post graft. Conclusions Ninety-minute ischemia before vein grafting can cause serious EC loss, but does not increase early intimal hyperplasia when clopidogrel is administered. Protecting the vein from ischemia and reperfusion injury preserves ECs.

  18. Status quo and development trend of breast biopsy technology

    National Research Council Canada - National Science Library

    Zhang, Yan-Jun; Wei, Lichun; Li, Jie; Zheng, Yi-Qiong; Li, Xi-Ru

    2013-01-01

    .... With the continuous advancement of diagnostic and treatment technology for breast cancer, collection of diseased tissue has also undergone a gradual transition from traditional open surgery to biopsy...

  19. Clinicopathological Evaluation of the Kidney Biopsies: Our Center's Experience

    Directory of Open Access Journals (Sweden)

    Serhan PİŞKİNPAŞA

    2012-05-01

    Full Text Available OBJECTIVES: Kidney biopsy is a valuable tool for both diagnosis and to guide treatment of renal diseases. In this report, we aimed both clinical and pathological evaluation of the kidney biopsies in our institution. MATERIAL and METHODS: Kidney biopsies in adult patients performed between 2002-2011 at the Department of Nephrology were analyzed. Biopsies were performed with the guidance of ultrasonography, and 16 and 18 G needles for two cores were used. At least seven glomeruli and one artery was accepted as adequate for diagnosis. RESULTS: Five hundred thirty six kidney biopsy reports was evaluated. The mean age of the patients at presentation was 42.80±16.66 years (16-85 years old, and 55.4% of the patients was male. The most frequent indication of the kidney biopsies were nephrotic range proteinuria with 63.43%. The most common histopathological diagnosis in primary and secondary glomerular diseases was membranous nephropathy (n=88, 16.4% and amyloidosis (n=96, 17.9% respectively. The most frequent diagnosis of the biopsies performed due to acute kidney injury was rapidly progressing glomerulonephritis (n=20, 3.7%. The major complication rate was low (0.18%. CONCLUSION: Nephrotic range proteinuria was the most frequent indication for the kidney biopsy in our institution. Membranous nephropathy and amyloidosis were the most frequent primary and secondary glomerular diseases. Complication rate in percutaneous kidney biopsy with the guidance of ultrasonography is low.

  20. Preservative solution for skeletal muscle biopsy samples

    Science.gov (United States)

    Kurt, Yasemin Gulcan; Kurt, Bulent; Ozcan, Omer; Topal, Turgut; Kilic, Abdullah; Muftuoglu, Tuba; Acikel, Cengizhan; Sener, Kenan; Sahiner, Fatih; Yigit, Nuri; Aydin, Ibrahim; Alay, Semih; Ekinci, Safak

    2015-01-01

    Context: Muscle biopsy samples must be frozen with liquid nitrogen immediately after excision and maintained at -80°C until analysis. Because of this requirement for tissue processing, patients with neuromuscular diseases often have to travel to centers with on-site muscle pathology laboratories for muscle biopsy sample excision to ensure that samples are properly preserved. Aim: Here, we developed a preservative solution and examined its protectiveness on striated muscle tissues for a minimum of the length of time that would be required to reach a specific muscle pathology laboratory. Materials and Methods: A preservative solution called Kurt-Ozcan (KO) solution was prepared. Eight healthy Sprague-Dawley rats were sacrificed; striated muscle tissue samples were collected and divided into six different groups. Muscle tissue samples were separated into groups for morphological, enzyme histochemical, molecular, and biochemical analysis. Statistical method used: Chi-square and Kruskal Wallis tests. Results: Samples kept in the KO and University of Wisconsin (UW) solutions exhibited very good morphological scores at 3, 6, and 18 hours, but artificial changes were observed at 24 hours. Similar findings were observed for the evaluated enzyme activities. There were no differences between the control group and the samples kept in the KO or UW solution at 3, 6, and 18 hours for morphological, enzyme histochemical, and biochemical features. The messenger ribonucleic acid (mRNA) of β-actin gene was protected up to 6 hours in the KO and UW solutions. Conclusion: The KO solution protects the morphological, enzyme histochemical, and biochemical features of striated muscle tissue of healthy rats for 18 hours and preserves the mRNA for 6 hours. PMID:26019417