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Sample records for 4-mm punch biopsy

  1. Targeted Cryotherapy Using Disposable Biopsy Punches

    PubMed Central

    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

  2. Lip biopsy for the diagnosis of Sjögren's syndrome: beware of the punch.

    PubMed

    Varela-Centelles, P; Sanchez-Sanchez, M; Seoane, J

    2014-01-01

    A pilot study was performed to examine the presence of nerve fibres in minor salivary gland tissue samples obtained by two procedures: punch and linear incisional techniques. The study was undertaken on a convenience sample of five cryopreserved corpses (mean age 74 ± 3.5 years; three males and two females). Biopsies were performed on the buccal side of the lower lip, between the mid-line and the corner of the mouth. Each corpse had one side of the lower lip biopsied by punch and the contralateral side using a linear incision. All punch samples (100%) displayed severed nerve fibres, whereas no nerve fibres (0%) could be identified in the samples obtained by means of the linear incision technique. While the linear incision approach permitted retrieval of at least five glands, punch biopsies did not provide enough material for the diagnosis of Sjögren's syndrome. Within the limitations of the study, our results strongly discourage the punch technique for minor salivary gland lip biopsy and provide information on the superiority of the linear incisional biopsy in terms of neural damage. These results may also promote the undertaking of clinical trials on patients in whom Sjögren's syndrome is suspected, comparing the morbidity associated with the linear incisional technique vs. minimally invasive biopsies.

  3. Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients.

    PubMed

    Levine, Todd D; Saperstein, David S

    2015-03-01

    Fibromyalgia is a clinical syndrome that currently does not have any specific pathological finding to aid in diagnosis. Therefore, fibromyalgia is most likely a heterogeneous group of diseases with similar symptoms. Identifying and understanding the pathological basis of fibromyalgia will allow physicians to better categorize patients, increasing prospective treatment options, and improving potential therapeutic endeavors. Recent work has demonstrated that approximately 50% of patients diagnosed with fibromyalgia have damage to their small unmyelinated nerve fibers. A skin punch biopsy is a sensitive and specific diagnostic test for this damage as a reduction in nerve fiber density allows for the diagnosis of small fiber neuropathy. Small fiber neuropathy is a disease with symptoms similar to fibromyalgia, but it often has a definable etiology. Identifying small fiber neuropathy and its underlying cause in fibromyalgia patients provides them with a succinct diagnosis, increases treatment options, and facilitates more specific studies for future therapeutics.

  4. Pleuroscopic punch biopsy using insulated-tip diathermic knife-2 for the diagnosis of desmoplastic malignant mesothelioma.

    PubMed

    Masai, Kyohei; Sasada, Shinji; Izumo, Takehiro; Taniyama, Tomoko; Nakamura, Yukiko; Chavez, Christine; Sakurai, Hiroyuki; Tsuta, Koji; Tsuchida, Takaaki

    2013-10-01

    Desmoplastic malignant mesothelioma (DMM) is a rare subtype of malignant pleural mesothelioma (MPM) and is often difficult to distinguish from pleural fibrosis and reactive mesothelial hyperplasia, especially if the biopsy samples are small. We performed full-thickness pleural biopsy on a lesion suspected to be DMM using an insulated-tip diathermic knife-2 (IT knife-2) during flex-rigid pleuroscopy. IT knife-2 is a novel electrosurgical device for endoscopic submucosal dissection in the early gastrointestinal cancer. It consists of a needle knife with 3 short blades at the distal end attached to an insulated ceramic tip. A 54-year-old man presenting with chest wall mass and thickened pleura, in whom a computed tomography-guided percutaneous needle aspiration had remained negative, underwent flex-rigid pleuroscopy for definitive diagnosis. While applying electric current, we used the IT knife-2 to incise the pleura in a circular shape just above the endothoracic fascia. The incised pleura was removed by forceps and examined pathologically. The microscopic examination was compatible with DMM. We discovered that pleuroscopic punch biopsy using IT knife-2 can diagnose DMM. Use of IT knife-2 during flex-rigid pleuroscopy can obtain sufficient samples from densely thickened pleura, which is difficult to diagnose with small biopsies.

  5. mTOR Inhibition by Everolimus Does Not Impair Closure of Punch Biopsy Wounds in Renal Transplant Patients

    PubMed Central

    Dutt, Shelley B.; Gonzales, Josephine; Boyett, Megan; Costanzo, Anne; Han, Peggy P.; Steinberg, Steven; McKay, Dianne B.; Jameson, Julie M.

    2017-01-01

    Background Mammalian target of rapamycin (mTOR) inhibitors are approved to prevent allograft rejection and control malignancy. Unfortunately, they are associated with adverse effects, such as wound healing complications that detract from more extensive use. There is a lack of prospective wound healing studies to monitor patients treated with mTOR inhibitors, such as everolimus or sirolimus, especially in nondiabetics. Methods Patients receiving everolimus with standard immunosuppressant therapy or standard immunosuppressant therapy without everolimus were administered 3-mm skin biopsy punch wounds in the left scapular region. Homeostatic gene expression was examined in the skin obtained from the biopsy and wound surface area was examined on day 7. Peripheral blood mononuclear cells were examined for cytokine production. Results There are no significant changes in autophagy related 13, epidermal growth factor, insulin-like growth factor binding protein 3, IL-2, kruppel-like factor 4, and TGFB1 gene expression in the skin suggesting that there is little impact of everolimus on these genes within nonwounded skin. Peripheral blood T cells are more sensitive to cell death in everolimus-treated patients, but they retain the ability to produce proinflammatory cytokines required for efficient wound repair. Importantly, there is no delay in the closure of biopsy wounds in patients receiving everolimus as compared to those not receiving mTOR inhibition. Conclusions Everolimus treatment is not associated with impaired closure of skin biopsy wounds in kidney transplant recipients. These data highlight the importance of exploring whether larger surgical wounds would show a similar result and how other factors, such as diabetes, impact wound healing complications associated with mTOR suppression.

  6. Implementation of a non-lethal biopsy punch monitoring program for mercury in smallmouth bass, Micropterus dolomieu Lacepede, from the Eleven Point River, Missouri

    USGS Publications Warehouse

    Ackerson, R.J.; McKee, J.M.; Schmitt, C.J.; Brumbaugh, William G.

    2014-01-01

    A non-lethal biopsy method for monitoring mercury (Hg) concentrations in smallmouth bass (Micropterus dolomieu; smallmouth) from the Eleven Point River in southern Missouri USA was evaluated. A biopsy punch was used to remove a muscle tissue plug from the area immediately below the anterior dorsal fin of 31 smallmouth. An additional 35 smallmouth (controls) were held identically except that no tissue plug was removed. After sampling, all fish were held in a concrete hatchery raceway for 6 weeks. Mean survival at the end of the holding period was 97 % for both groups. Smallmouth length, weight and Fulton’s condition factor at the end of the holding period were also similar between plugged and non-plugged controls, indicating that the biopsy procedure had minimal impact on growth under these conditions. Tissue plug Hg concentrations were similar to smallmouth Hg data obtained in previous years by removing the entire fillet for analysis.

  7. Implementation of a non-lethal biopsy punch monitoring program for mercury in smallmouth bass, Micropterus dolomieu Lacepède, from the Eleven Point River, Missouri

    USGS Publications Warehouse

    Ackerson, J.R.; Schmitt, C. J.; McKee, M.J.; Brumbaugh, W.G.

    2013-01-01

    A non-lethal biopsy method for monitoring mercury (Hg) concentrations in smallmouth bass (Micropterus dolomieu; smallmouth) from the Eleven Point River in southern Missouri USA was evaluated. A biopsy punch was used to remove a muscle tissue plug from the area immediately below the anterior dorsal fin of 31 smallmouth. An additional 35 smallmouth (controls) were held identically except that no tissue plug was removed. After sampling, all fish were held in a concrete hatchery raceway for 6 weeks. Mean survival at the end of the holding period was 97 % for both groups. Smallmouth length, weight and Fulton’s condition factor at the end of the holding period were also similar between plugged and non-plugged controls, indicating that the biopsy procedure had minimal impact on growth under these conditions. Tissue plug Hg concentrations were similar to smallmouth Hg data obtained in previous years by removing the entire fillet for analysis.

  8. Biopsies

    MedlinePlus

    ... 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 ...

  9. Biopsy

    MedlinePlus

    ... Nemcek AA. Percutaneous biopsy. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, eds. Image- ... by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is ...

  10. Sun Packs Double Punch

    NASA Video Gallery

    On August 3, the sun packed a double punch, emitting a M6.0-class flare at 9:43 am EDT. This video is of the second, slightly stronger M9.3-class flare at 11:41 pm EDT. Both flares had significant ...

  11. Punch Card Programmable Microfluidics

    PubMed Central

    Korir, George; Prakash, Manu

    2015-01-01

    Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive. Combining the idea of punch card programming with arbitrary fluid control, here we describe a self-contained, hand-crank powered, multiplex and robust programmable microfluidic platform. A paper tape encodes information as a series of punched holes. A mechanical reader/actuator reads these paper tapes and correspondingly executes operations onto a microfluidic chip coupled to the platform in a plug-and-play fashion. Enabled by the complexity of codes that can be represented by a series of holes in punched paper tapes, we demonstrate independent control of 15 on-chip pumps with enhanced mixing, normally-closed valves and a novel on-demand impact-based droplet generator. We demonstrate robustness of operation by encoding a string of characters representing the word “PUNCHCARD MICROFLUIDICS” using the droplet generator. Multiplexing is demonstrated by implementing an example colorimetric water quality assays for pH, ammonia, nitrite and nitrate content in different water samples. With its portable and robust design, low cost and ease-of-use, we envision punch card programmable microfluidics will bring complex control of microfluidic chips into field-based applications in low-resource settings and in the hands of children around the world. PMID:25738834

  12. Punch card programmable microfluidics.

    PubMed

    Korir, George; Prakash, Manu

    2015-01-01

    Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive. Combining the idea of punch card programming with arbitrary fluid control, here we describe a self-contained, hand-crank powered, multiplex and robust programmable microfluidic platform. A paper tape encodes information as a series of punched holes. A mechanical reader/actuator reads these paper tapes and correspondingly executes operations onto a microfluidic chip coupled to the platform in a plug-and-play fashion. Enabled by the complexity of codes that can be represented by a series of holes in punched paper tapes, we demonstrate independent control of 15 on-chip pumps with enhanced mixing, normally-closed valves and a novel on-demand impact-based droplet generator. We demonstrate robustness of operation by encoding a string of characters representing the word "PUNCHCARD MICROFLUIDICS" using the droplet generator. Multiplexing is demonstrated by implementing an example colorimetric water quality assays for pH, ammonia, nitrite and nitrate content in different water samples. With its portable and robust design, low cost and ease-of-use, we envision punch card programmable microfluidics will bring complex control of microfluidic chips into field-based applications in low-resource settings and in the hands of children around the world.

  13. A 4MM-Wave composite mode multimode conical feedhorn

    NASA Astrophysics Data System (ADS)

    Lin, Zhisheng; Du, Zhengmi; Chen, Shener

    1996-10-01

    A 4MM-Wave composite mode multimode conical feedhorn has been developed. Its mode-ratios are calculated and its formulas of the radiation patterns are derived. The measurement results of one and two dimension radiation patterns, measured by the automatic measurement system which we had researched, and the properties of band width and sidelobe are given. Theoretical analyses and measurements show that at the centre frequency 69.1GHZ, down to -23dB, the radiation pattern is rotationally symmetric, in this range there is not any sidelobe existing, the band width is 4.5 GHZ. The multimode feedhorn is thus of certain practical using value.

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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 a... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument,...

  15. High-yield biopsy technique for subepidermal blisters.

    PubMed

    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.

  16. Portable punch and die jig

    DOEpatents

    Lewandowski, Edward F.; Anderson, Petrus A.

    1978-01-01

    A portable punch and die jig includes a U-shaped jig of predetermined width having a slot of predetermined width in the base thereof extending completely across the width of the jig adapted to fit over the walls of rectangular tubes and a punch and die assembly disposed in a hole extending through the base of the jig communicating with the slot in the base of the jig for punching a hole in the walls of the rectangular tubes at precisely determined locations.

  17. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  18. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  19. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  20. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  1. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  2. Evaluation of biopsy methods in the diagnosis of submandibular space pathology.

    PubMed

    Olubaniyi, B O; Chow, V; Mandalia, U; Haldar, S; Gok, G; Michl, P; Ramesar, K; Sellon, E; Williams, M; Howlett, D C

    2014-03-01

    The aim of this study was to evaluate the performance of fine needle aspiration cytology (FNAC), ultrasound-guided core needle biopsy (USCNB), punch biopsy, and surgical excision biopsy in neoplasms presenting within the submandibular space. A retrospective analysis of all patients with a pathological diagnosis of a submandibular space neoplasm within a 12-year period (February 1999 to June 2011) was performed. Biopsy results were compared to histopathological diagnosis obtained from surgical excision biopsy. Eighty-one specimens from 44 patients met the search criteria (15 FNAC, 24 USCNB, 7 punch biopsy, and 35 surgical excision biopsy). The final diagnosis was established by USCNB, punch biopsy, or surgical excision biopsy and not by FNAC alone. Surgical excision biopsy was performed as a primary diagnostic (n = 8), secondary diagnostic (n = 15), or as a post-diagnostic therapeutic procedure (n = 12). Non-diagnostic results were: FNAC 11/15, USCNB 2/24, and punch biopsy 1/7. Diagnostic results were: FNAC 2/15, USCNB 20/24, and punch biopsy 5/7. No complications were reported. Although punch biopsy demonstrated good yield and accuracy, its use is restricted to a small cohort of patients. USCNB is a safe and accurate technique in the submandibular space, with a low non-diagnostic rate.

  3. Bone Biopsy

    MedlinePlus

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

  4. Science in mid-Victorian Punch.

    PubMed

    Noakes, Richard

    2002-09-01

    This article examines the scientific content of the most famous comic journal of the Victorian period: Punch. Concentrating on the first three decades of the periodical (1841-1871), I show that Punch usually engaged with science that was highly topical, of consequence to the lives of its bourgeois readers, and suitable for comic interpretation. But Punch's satire of scientific topics was highly complex. It often contained allusions to non-scientific topics, and its engagement with science ranged from the utterly comic to the sharply critical. Punch prompted readers to think as well as laugh about science, and probably shaped their scientific education more than we think.

  5. Kidney biopsy

    MedlinePlus

    Renal biopsy; Biopsy - kidney ... Barisoni L, Arend LJ, Thomas DB. Introduction to renal biopsy. In: Zhou M, Mari-Galluzzi C, eds. ... Saunders; 2015:chap 7. Topham PS, Chen Y. Renal biopsy. In: Johnson RJ, Feehally J, Floege J, ...

  6. An efficient method of measuring the 4 mm helmet output factor for the Gamma Knife

    NASA Astrophysics Data System (ADS)

    Ma, Lijun; Li, X. Allen; Yu, Cedric X.

    2000-03-01

    It is essential to have accurate measurements of the 4 mm helmet output factor in the treatment of trigeminal neuralgia patients using the Gamma Knife. Because of the small collimator size and the sharp dose gradient at the beam focus, this measurement is generally tedious and difficult. We have developed an efficient method of measuring the 4 mm helmet output factor using regular radiographic films. The helmet output factor was measured by exposing a single Kodak XV film in the standard Leksell spherical phantom using the 18 mm helmet with 30-40 of its plug collimators replaced by the 4 mm plug collimators. The 4 mm helmet output factor was measured to be 0.876 ± 0.009. This is in excellent agreement with our EGS4 Monte Carlo simulated value of 0.876 ± 0.005. This helmet output factor value also agrees with more tedious TLD, diode and radiochromic film measurements that were each obtained using two separate measurements with the 18 mm helmet and the 4 mm helmet respectively. The 4 mm helmet output factor measured by the diode was 0.884 ± 0.016, and the TLD measurement was 0.890 ± 0.020. The radiochromic film measured value was 0.870 ± 0.018. Because a single-exposure measurement was performed instead of a double-exposure measurement, most of the systematic errors that appeared in the double-exposure measurements due to experimental setup variations were cancelled out. Consequently, the 4 mm helmet output factor is more precisely determined by the single-exposure approach. Therefore, routine measurement and quality assurance of the 4 mm helmet output factor of the Gamma Knife could be efficiently carried out using the proposed single-exposure technique.

  7. Choices enhance punching performance of competitive kickboxers.

    PubMed

    Halperin, Israel; Chapman, Dale W; Martin, David T; Lewthwaite, Rebecca; Wulf, Gabriele

    2016-07-27

    While self-controlled practice has been shown to enhance motor learning with various populations and novel tasks, it remains unclear if such effects would be found with athletes completing familiar tasks. Study 1 used a single case-study design with a world-champion kickboxer. We investigated whether giving the athlete a choice over the order of punches would affect punching velocity and impact force. Separated by 1 min of rest, the athlete completed 2 rounds of 12 single, maximal effort punches (lead straight, rear straight, lead hook and rear hook) delivered to a punching integrator in a counterbalanced order over six testing days. In one round the punches were delivered in a predetermined order while in the second round the order was self-selected by the athlete. In the choice condition, the world champion punched with greater velocities (6-11 %) and impact forces (5-10 %). In Study 2, the same testing procedures were repeated with 13 amateur male kickboxers over 2 testing days. Similar to Study 1, the athletes punched with significantly greater velocities (6 %, p < 0.05) and normalised impact forces (2 %, p < 0.05) in the choice condition. These findings complement research on autonomy support in motor learning by demonstrating immediate advantages in force production and velocity with experienced athletes.

  8. Biopsy - polyps

    MedlinePlus

    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 ...

  9. Liver biopsy

    MedlinePlus

    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 ...

  10. Liver Biopsy

    MedlinePlus

    ... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Liver Biopsy What is a liver biopsy? A liver biopsy is a procedure that ... remove the liver tissue sample. What is the liver and what does it do? The liver is ...

  11. Rehabilitation of the atrophic posterior mandible with short (4-mm) implants: a case report.

    PubMed

    Pistilli, Roberto; Barausse, Carlo; Checchi, Luigi; Felice, Pierto

    2014-01-01

    This case report describes a successful implant-prosthetic rehabilitation of an atrophic posterior mandible with 4-mm-long implants. The patient refused to undergo any reconstructive surgery, and because the available bone up to the inferior alveolar nerve was only 5 mm or less, the patient received four implants of 4-mm length. Four months after implant placement, a provisional prosthesis was put in place; after another 4 months, this was then in turn replaced with a definitive prosthesis. The use of such short implants allows a fixed prosthetic solution without the need for vertically augmenting the mandibular bone. This procedure considerably reduces intra- and postoperative patient discomfort compared with reconstructive surgery for the placement of longer implants. The follow-up time was 1 year after implant loading.

  12. Kidney Biopsy

    MedlinePlus

    ... the right diagnosis. What should a person do days before a kidney biopsy? Days before the procedure, ... procedure. What can a person expect on the day of the kidney biopsy? A person should arrive ...

  13. Strength of Footing with Punching Shear Preventers

    PubMed Central

    Lee, Sang-Sup; Moon, Jiho; Park, Keum-Sung; Bae, Kyu-Woong

    2014-01-01

    The punching shear failure often governs the strength of the footing-to-column connection. The punching shear failure is an undesirable failure mode, since it results in a brittle failure of the footing. In this study, a new method to increase the strength and ductility of the footing was proposed by inserting the punching shear preventers (PSPs) into the footing. The validation and effectiveness of PSP were verified through a series of experimental studies. The nonlinear finite element analysis was then performed to demonstrate the failure mechanism of the footing with PSPs in depth and to investigate the key parameters that affect the behavior of the footing with PSPs. Finally, the design recommendations for the footing with PSPs were suggested. PMID:25401141

  14. An Introduction to PunchScan

    NASA Astrophysics Data System (ADS)

    Popoveniuc, Stefan; Hosp, Ben

    PunchScan is a precinct-read optical-scan balloting system that allows voters to take their ballot with them after scanning. This does not violate the secret ballot principle because the ballots cannot be read without secret information held by the distributed authority in charge of the election. In fact, this election authority will publish the ballots for everyone to see, allowing voters whose ballots were incorrectly omitted to complain. PunchScan vote-counting is performed in private by the election authority - who uses their secret information to decode the ballots - but is verified in public by an auditor.In this paper we describe how and why PunchScan works. We have kept most of the description at an outline level so that it may be used as a straw model of a cryptographic voting system.

  15. Efficacy of Punch Reduction Prior to Cryotherapy in Patients with Viral Warts: A Case-Control Study in a Single Tertiary Center

    PubMed Central

    Choi, Ju Yeon; Oh, Seung Hwan; Lee, Jong Hee; Lee, Joo-Heung; Lee, Dong-Youn; Yang, Jun-Mo

    2017-01-01

    Background Cutaneous warts are a common complaint to visit dermatologic clinic and its course is variable, ranging from spontaneous resolution to a chronic condition refractory to treatment. Objective To evaluate the efficacy and safety of punch biopsy for cutaneous warts. Methods Thirty-nine patients who received punch biopsy for warts were reviewed through charts and photos. Among them, 15 were matched with cryotherapy-only controls in terms of size and location of the wart. We compared the number and cost of treatments between the two groups. Results Eleven of the total 39 patients were treated with cryotherapy in addition to punch biopsy and the average number of treatments was 4.1±3.3 (mean±standard deviation). In a case-control study, the ratio value of cost was 2.9±3.6 in the experimental group and was 5.9±4.1 in controls (p<0.05). Conclusion Punch biopsies can decrease the number and cost of treatment by reducing the size of warts and inducing local inflammation to accelerate resolution. Therefore, punch reduction should be considered as a viable measure to treat warts. PMID:28392648

  16. Grading of shoulder ulcerations in sows by biopsies.

    PubMed

    Jensen, Henrik E; Dahl-Pedersen, Kirstin; Barington, Kristiane; Kaiser, Marianne; Bonde, Marianne K; Herskin, Mette S; Jensen, Karin H

    2014-03-01

    Shoulder ulcerations can be graded postmortem from 0 to 4 on a pathoanatomical scale. However, veterinarians and farmers express difficulties evaluating the grade of the lesions antemortem. Accurate grading is needed in order to comply with veterinary instruction in relation to the Danish legislation, stating that sows with shoulder ulcers grade 3 or 4 must be kept loose and have access to soft bedding. Thus, the aim of the present study was to evaluate if biopsies from the center of a shoulder ulcer can be used to point out animals for which an intervention must be initiated. Postmortem, a punch biopsy was sampled from the center of the ulceration or from the tissue overlaying the tuber spina scapula. Afterward, the shoulders were cross-sectioned and evaluated grossly and histologically ("gold standard"). In total, 121 shoulders were included in the study, and the diagnostic value of a punch biopsy in grading shoulder ulcerations was evaluated. The results showed a sensitivity of 0.78, a specificity of 0.98, a positive likelihood ratio of 38.36, and a negative likelihood ratio of 0.22. The agreement between the cross-section evaluation and the punch biopsy was found to be 0.90 by calculating the Cohen kappa value. In conclusion, a single punch biopsy from the center of an ulcer is useful for determining the grade of a shoulder ulcer and can be used to facilitate the identification of sows with ulcers requiring an intervention.

  17. 3. INTERIOR VIEW LOOKING SOUTH SHOWING PUNCH AND SHEAR MACHINE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. INTERIOR VIEW LOOKING SOUTH SHOWING PUNCH AND SHEAR MACHINE (manufactured by Cleveland Punch and Shear Works Company, USA) - Cambria & Indiana Railroad, Blacksmith Shop, .25 miles northwest of Colver, Colver, Cambria County, PA

  18. Wiring harnesses documented by punched-card technique

    NASA Technical Reports Server (NTRS)

    Hicks, W. W.; Kloezeman, W. G.

    1970-01-01

    Cards representing a connector are punched, sorted, and then used to printout wiring documentation for that connector. When wiring changes are made, new cards are punched and the wiring documentation is reprinted to reflect the latest configuration.

  19. Cold knife cone biopsy

    MedlinePlus

    ... biopsy; Pap smear - cone biopsy; HPV - cone biopsy; Human papilloma virus - cone biopsy; Cervix - cone biopsy; Colposcopy - cone biopsy Images Female reproductive anatomy Cold cone biopsy Cold cone removal References American ...

  20. Liver Biopsy

    MedlinePlus

    ... for a liver biopsy by talking with a health care provider having blood tests arranging for a ride home fasting before the ... for a liver biopsy by talking with a health care provider having blood tests arranging for a ride home fasting before the ...

  1. Sagitally focusing scanning monochromator produces 0.4-mm focus (abstract)

    NASA Astrophysics Data System (ADS)

    Rosenbaum, G.; Sullivan, M.; Fischetti, R.; Rock, L.

    1992-01-01

    A sagitally focusing stage has been constructed for the double-crystal scanning monochromator on beam line X9-A at the NSLS which can be exchanged with the normally used flat crystal stage. The bending device located at 12.0 m from the source is designed to accept a beam up to 200-mm wide. The monochromator with bending stage can be scanned over Bragg angles from 10° to 71° corresponding to photon energies from 11.4 to 2.1 keV with Si-111 crystals. In conjunction with the vertically focusing mirror a point focus of 0.38 mm×0.18 mm [horizontal×vertical, full width at half maximum (FWHM) each] has been achieved at a focal length of 3.8 m (center of a four-circle diffractometer). Focused at the back of the experimental hutch (focal length=5.4 m) the focal size was 0.55 mm×0.30 mm. The measured horizontal width of the focus equals the calculated size of the demagnified source and is independent of the horizontal convergence used. The horizontal focus produced by the crystal is very clean: the full width at 1% of maximum is 1.5 mm and at 0.01% it is about 4 mm. The flux into the focus is 5×1011 photons/s at a photon energy of 7.4 keV and beam current of 200 mA. The average flux density in the center of the focus (FWHM area) is 5×1011 photons/s/mm2. The preliminary crystal presently used has been made from a thin Si plate of 0.4-mm thickness, 80-mm width, and 75-mm length (in the direction of the beam). Steel ribs of 0.6-mm thickness have been glued at 3-mm pitch to the back of the crystal in order to stiffen the plate and reduce anticlastic bending.1 Plates have been glued to this crystal plate to extend the width to size the bending stage. The crystal was cut in 111 orientation with a 4° angle between the lattice planes and the crystal surface. The asymmetric cut was used to increase the angle of incidence and thus decrease the effect of the remaining anticlastic bending. The bending stage has a bending couple at both ends of the crystal in order to produce the

  2. Gum biopsy

    MedlinePlus

    Biopsy - gingiva (gums) ... the mouth in the area of the abnormal gum tissue. You may also have an injection of numbing medicine. A small piece of gum tissue is removed and checked for problems in ...

  3. 23. NORTHEAST TO CIRCA 1875 POWER SHEAR, PUNCH, AND RIVETING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. NORTHEAST TO CIRCA 1875 POWER SHEAR, PUNCH, AND RIVETING MACHINE SET UP TO DEMONSTRATE USE IN RIVETING COMPONENTS OF WHEEL ARMS FOR ELI WINDMILLS. HISTORIC DEBRIS FROM PUNCHING WORK IS VISIBLE BENEATH THE MACHINE IN THE OPERATOR'S PIT.' ON THE LEFT IS A U-SHAPED LOVEJOY FIELD PUNCH FOR USE IN INSTALLING STEEL WINDMILL/TOWER COMPONENTS. - Kregel Windmill Company Factory, 1416 Central Avenue, Nebraska City, Otoe County, NE

  4. Athletic fashion, "Punch," and the creation of the new woman.

    PubMed

    Collins, Tracy J R

    2010-01-01

    Between 1885-1900 "Punch" satirized the personality of the New Woman. However, virtually single-handedly it also gave a body and emancipated culture to this otherwise socially abstract personality. Using illustrations from "Punch," this essay argues that using sport specific clothing and equipment in its cartoons, "Punch" completely unintentionally created a liberating picture of women while simultaneously using its captions and border texts to make the New Woman's body signify the anxieties patriarchal culture had about her social personality and politics.

  5. Deformation field heterogeneity in punch indentation

    PubMed Central

    Murthy, Tejas G.; Saldana, Christopher; Hudspeth, Matthew; M'Saoubi, Rachid

    2014-01-01

    Plastic heterogeneity in indentation is fundamental for understanding mechanics of hardness testing and impression-based deformation processing methods. The heterogeneous deformation underlying plane-strain indentation was investigated in plastic loading of copper by a flat punch. Deformation parameters were measured, in situ, by tracking the motion of asperities in high-speed optical imaging. These measurements were coupled with multi-scale analyses of strength, microstructure and crystallographic texture in the vicinity of the indentation. Self-consistency is demonstrated in description of the deformation field using the in situ mechanics-based measurements and post-mortem materials characterization. Salient features of the punch indentation process elucidated include, among others, the presence of a dead-metal zone underneath the indenter, regions of intense strain rate (e.g. slip lines) and extent of the plastic flow field. Perhaps more intriguing are the transitions between shear-type and compression-type deformation modes over the indentation region that were quantified by the high-resolution crystallographic texture measurements. The evolution of the field concomitant to the progress of indentation is discussed and primary differences between the mechanics of indentation for a rigid perfectly plastic material and a strain-hardening material are described. PMID:24910521

  6. Prostate biopsy

    MedlinePlus

    ... NSAIDs), such as aspirin and ibuprofen Herbal supplements Vitamins Continue to take any prescription medicines unless your provider tells you not to take them. Your provider may ask you to: Eat only light meals the day before the biopsy. Do an ...

  7. Growth kinetics of 1-2 mm and 3-4 mm colonies of Nostoc sphaeroides (Cyanophyta) in outdoor culture.

    PubMed

    Deng, Zhongyang; Yan, Chunlan; Lu, Fan; Hu, Qiang; Hu, Zhengyu

    2008-10-01

    Nostoc sphaeroides Kützing was cultivated in paddlewheel-driven raceway ponds and the growth kinetics of 1-2 mm and 3-4 mm colonies of N. sphaeroides was studied. The biomass productivities in 2.5 m(2) raceway ponds inoculated with 1-2 mm and 3-4 mm colonies were 5.2 and 0.25 g dry wt m(-2) d(-1), respectively. Furthermore, differently sized colonies showed different relative water content, total soluble carbohydrates, chlorophyll a content and density of filaments. This is the first report on mass culture of N. sphaeroides under outdoor conditions.

  8. Evaluation of methods for the isolation of high quality RNA from bovine and cervine hide biopsies.

    PubMed

    Brannan, Jaime L; Holman, Patricia J; Olafson, Pia U; Pruett, John H; Riggs, Penny K

    2013-02-01

    Molecular investigations of the ruminant response to ectoparasites at the parasite-host interface are critically dependent upon the quality of RNA. The complexity of ruminant skin decreases the capacity to obtain high quality RNA from biopsy samples, which directly affects the reliability of data produced by gene expression experiments. Two methods for isolating total RNA from skin were compared and the use of 4M guanidinium isothiocyanate (GITC) during frozen storage of the specimens was evaluated. In addition, the best procedure for RNA isolation from bovine skin punch biopsies was also tested on white-tailed deer skin biopsies. Skin biopsy punches were collected and frozen prior to pulverization for RNA isolation. Total RNA quantity and integrity were determined by spectrophotometry and capillary electrophoresis technology, respectively. Significantly increased total RNA yield (P < 0.05) and higher integrity (P < 0.05) were obtained with a TRI Reagent® isolation method. Freezing and subsequent storage of bovine skin punch biopsies in 4 M GITC did not affect the amount or integrity of total RNA recovered by either RNA isolation method. However, quantity and integrity of total RNA extracted with the TRI Reagent method were again significantly higher than with the alternate technique, confirming it as the superior method. The TRI Reagent isolation method also yielded high quality total RNA from white-tailed deer skin punch biopsies, suggesting the usefulness of this method for obtaining RNA of a quality suitable for gene expression studies in other ruminant species.

  9. Die and telescoping punch form convolutions in thin diaphragm

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Die and punch set forms convolutions in thin dished metal diaphragm without stretching the metal too thin at sharp curvatures. The die corresponds to the metal shape to be formed, and the punch consists of elements that progressively slide against one another under the restraint of a compressed-air cushion to mate with the die.

  10. Tester automatically checks paper tape punch and reader after maintenance

    NASA Technical Reports Server (NTRS)

    Mazer, L.; Mc Murchy, D. D.

    1967-01-01

    Device automatically bench tests paper tape punches and readers in a simulated operating environment following routine maintenance. The reader and punch operate back-to-back and the paper tape output feeds the reader. The tape leader is prepunched with an arbitrary pattern that is continuously reproduced during the check.

  11. Applying a punch with microridges in multistage deep drawing processes.

    PubMed

    Lin, Bor-Tsuen; Yang, Cheng-Yu

    2016-01-01

    The developers of high aspect ratio components aim to minimize the processing stages in deep drawing processes. This study elucidates the application of microridge punches in multistage deep drawing processes. A microridge punch improves drawing performance, thereby reducing the number of stages required in deep forming processes. As an example, the original eight-stage deep forming process for a copper cylindrical cup with a high aspect ratio was analyzed by finite element simulation. Microridge punch designs were introduced in Stages 4 and 7 to replace the original punches. In addition, Stages 3 and 6 were eliminated. Finally, these changes were verified through experiments. The results showed that the microridge punches reduced the number of deep drawing stages yielding similar thickness difference percentages. Further, the numerical and experimental results demonstrated good consistency in the thickness distribution.

  12. 4-mm-diameter three-dimensional imaging endoscope with steerable camera for minimally invasive surgery (3-D-MARVEL).

    PubMed

    Bae, Sam Y; Korniski, Ronald J; Shearn, Michael; Manohara, Harish M; Shahinian, Hrayr

    2017-01-01

    High-resolution three-dimensional (3-D) imaging (stereo imaging) by endoscopes in minimally invasive surgery, especially in space-constrained applications such as brain surgery, is one of the most desired capabilities. Such capability exists at larger than 4-mm overall diameters. We report the development of a stereo imaging endoscope of 4-mm maximum diameter, called Multiangle, Rear-Viewing Endoscopic Tool (MARVEL) that uses a single-lens system with complementary multibandpass filter (CMBF) technology to achieve 3-D imaging. In addition, the system is endowed with the capability to pan from side-to-side over an angle of [Formula: see text], which is another unique aspect of MARVEL for such a class of endoscopes. The design and construction of a single-lens, CMBF aperture camera with integrated illumination to generate 3-D images, and the actuation mechanism built into it is summarized.

  13. Punch-magnet delay eliminated by modification of circuit

    NASA Technical Reports Server (NTRS)

    Cohn, C. E.

    1969-01-01

    Reduction of retardation by diode-resistor networks of the current-decay time of a punch magnet by connection of a Zener diode in series with the damping network increases the reliability of data on paper tape.

  14. Plastic deformation of a wedge by a sliding punch

    NASA Astrophysics Data System (ADS)

    Nepershin, R. I.

    2016-11-01

    We present a self-similar solution of the problem of deformation of an ideally plastic wedge by a sliding punch with regard to contact friction; such a solution generalizes the well-known solutions of the problem of wedge penetration into a plastic half-space and of compression of an ideally plastic wedge by a plane punch. The problem is of interest for modeling the processes of plastic deformation of rough surfaces of metal pieces by a rigid tool.

  15. Measurement of relative output factors for the 8 and 4 mm collimators of Leksell Gamma Knife Perfexion by film dosimetry

    SciTech Connect

    Novotny, Josef Jr.; Bhatnagar, Jagdish P.; Quader, Mubina A.; Bednarz, Greg; Lunsford, L. Dade; Huq, M. Saiful

    2009-05-15

    Three types of films, Kodak EDR2, Gafchromic EBT, and Gafchromic MD-V2-55, were used to measure relative output factors of 4 and 8 mm collimators of the Leksell Gamma Knife Perfexion. The optical density to dose calibration curve for each of the film types was obtained by exposing the films to a range of known doses. Ten data points were acquired for each of the calibration curves in the dose ranges from 0 to 4 Gy, 0 to 8 Gy, and 0 to 80 Gy for Kodak EDR2, Gafchromic EBT, and Gafchromic MD-V2-55 films, respectively. For the measurement of relative output factors, five films of each film type were exposed to a known dose. All films were scanned using EPSON EXPRESSION 10000 XL scanner with 200 dpi resolution in 16 bit gray scale for EDR2 film and 48 bit color scale for Gafchromic films. The scanned images were imported in the red channel for both Gafchromic films. The background corrections from an unexposed film were applied to all films. The output factors obtained from film measurements were in a close agreement both with the Monte Carlo calculated values of 0.924 and 0.805 for 8 and 4 mm collimators, respectively. These values are provided by the vendor and used as default values in the vendor's treatment planning system. The largest differences were noted for the Kodak EDR 2 films (-2.1% and -4.5% for 8 and 4 mm collimators, respectively). The best agreement observed was for EBT Gafchromic film (-0.8% and +0.6% differences for 8 and 4 mm collimators, respectively). Based on the present values, no changes in the default relative output factor values were made in the treatment planning system.

  16. Skin biopsies in the assessment of the autonomic nervous system.

    PubMed

    Wang, Ningshan; Gibbons, Christopher H

    2013-01-01

    Cutaneous punch biopsies are widely used to evaluate nociceptive C fibers in patients with suspected small-fiber neuropathy. Recent advances in immunohistochemical techniques and interest in cutaneous autonomic innervation has expanded the role of skin biopsy in the evaluation of the peripheral nervous system. The dermal layers of the skin provide a unique window into the structural evaluation of the autonomic nervous system. Peripheral adrenergic and cholinergic fibers innervate a number of cutaneous structures, such as sweat glands and arrector pili muscles, and can easily be seen with punch skin biopsies. Skin biopsies allow for both regional sampling, in diseases with patchy distribution, and the opportunity for repeated sampling in progressive disorders. The structural evaluation of cutaneous autonomic innervation is still in its scientific infancy, with a number of different methodologies and techniques that will require standardization and widespread acceptance before becoming a standard of care. Future studies of autonomic innervation in acquired, hereditary, neurodegenerative, or autoimmune disorders will be necessary to determine the clinical utility of skin biopsy in these disease states.

  17. Punch injury self-harm in young people.

    PubMed

    Oxley, Cristal; Roberts, Jane E; Kraemer, Sebastian; Armstrong, Giles

    2017-04-01

    Punch injuries are a form of self-harm characterised by the intentional act of striking an object with a closed fist. We aimed to describe the characteristics and trends in young people presenting with injuries sustained via the punch mechanism. A comprehensive retrospective review of medical records was completed of all young people aged 10-18 years presenting to our Central London Emergency Department over a 12-month period. A subset of the total group was identified as the punch injury subgroup. A total of 78 punch injury presentations were identified. In this subgroup, the male:female ratio is 4.57:1; 37.18% of presentations were associated with a fracture ( n = 29) and 35.90% ( n = 28) of patients re-presented following another punch injury, as a victim of violence, or by other psychiatric presentation. In conclusion, a male preponderance was observed, with frequent re-presentations, often in high-risk circumstances. An opportunity for screening, including mental health, social and substance misuse, was identified. Further research is needed to enable targeted effective interventions in this group.

  18. Study of punching shear in arctic offshore structures

    SciTech Connect

    McLean, D.I.

    1987-01-01

    Experimental and analytical studies of punching shear in reinforced and prestressed concrete slabs and shells were performed to gain an increased understanding of the mechanism of punching shear failures in offshore structures for the Arctic. The test specimens of this project were 1/6-scale models of sections of typical perimeter walls with flat and curved configurations. Shear reinforcement was provided in the specimens with headed shear bars. The main variables investigated in the program were: the amount of shear reinforcement, curvature, prestressing, and span-continuity condition. The addition of shear reinforcement resulted in significant increases in punching shear strengths, particularly in the plate specimens. The presence of curvature in the shell specimens produced large increases in punching shear strength. An apparent upper limit on punching shear strength was reached in the shell specimens with shear reinforcement whereby the concrete rather than the reinforcement controlled the failure mechanism. Effects of prestressing in the specimens were inconclusive. The single-span plate specimen was stronger than the similar three-span plate specimen.

  19. Bone lesion biopsy

    MedlinePlus

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

  20. Muscle biopsy (image)

    MedlinePlus

    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 ...

  1. Bone biopsy (image)

    MedlinePlus

    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 ...

  2. An Ultrathin Endoscope with a 2.4-mm Working Channel Shortens the Esophagogastroduodenoscopy Time by Shortening the Suction Time

    PubMed Central

    Shinozaki, Satoshi; Miura, Yoshimasa; Ino, Yuji; Shinozaki, Kenjiro; Lefor, Alan Kawarai; Yamamoto, Hironori

    2015-01-01

    Background/Aims: Poor suction ability through a narrow working channel prolongs esophagogastroduodenoscopy (EGD). The aim of this study was to evaluate suction with a new ultrathin endoscope (EG-580NW2; Fujifilm Corp.) having a 2.4-mm working channel in clinical practice. Methods: To evaluate in vitro suction, 200 mL water was suctioned and the suction time was measured. The clinical data of 117 patients who underwent EGD were retrospectively reviewed on the basis of recorded video, and the suction time was measured by using a stopwatch. Results: In vitro, the suction time with the EG-580NW2 endoscope was significantly shorter than that with the use of an ultrathin endoscope with a 2.0-mm working channel (EG-580NW; mean ± standard deviation, 22.7±1.1 seconds vs. 34.7±2.2 seconds; p<0.001). We analyzed the total time and the suction time for routine EGD in 117 patients (50 in the EG-580NW2 group and 67 in the EG-580NW group). In the EG-580NW2 group, the total time for EGD was significantly shorter than that in the EG-580NW group (275.3±42.0 seconds vs. 300.6±46.5 seconds, p=0.003). In the EG-580NW2 group, the suction time was significantly shorter than that in the EG-580NW group (19.2±7.6 seconds vs. 38.0±15.9 seconds, p<0.001). Conclusions: An ultrathin endoscope with a 2.4-mm working channel considerably shortens the routine EGD time by shortening the suction time, in comparison with an endoscope with a 2.0-mm working channel. PMID:26668798

  3. Analysis of direct punch velocity in professional defence

    NASA Astrophysics Data System (ADS)

    Lapkova, Dora; Adamek, Milan

    2016-06-01

    This paper is focused on analysis of a direct punch. Nowadays, professional defence is basic part of effective protection of people and property. There are many striking techniques and the goal of this research was to analyze the direct punch. The analysis is aimed to measure the velocity with help of high speed camera Olympus i-Speed 2 and then find the dependences of this velocity on input parameters. For data analysis two pieces of software were used - i-Speed Control Software and MINITAB. 111 participants took part in this experiment. The results are presented in this paper - especially dependence of mean velocity on time and difference in velocity between genders.

  4. R1234yf vs. R134a Flow Boiling Heat Transfer Inside a 3.4 mm ID Microfin Tube

    NASA Astrophysics Data System (ADS)

    Diani, A.; Mancin, S.; Rossetto, L.

    2014-11-01

    The refrigerant charge minimization as well as the use of eco-friendly fluids can be considered two of the most important targets for these applications to cope with the new environmental challenges. This paper compares the R1234yf and R134a flow boiling heat transfer and pressure drop measurements inside a small microfin tube with internal diameter at the fin tip of 3.4 mm. This study is carried out in an experimental facility built at the Dipartimento di Ingegneria Industriale of the University of Padova especially designed to study both single and two phase heat transfer processes. The microfin tube is brazed inside a copper plate and electrically heated from the bottom. Several T -type thermocouples are inserted in the wall to measure the temperature distribution during the phase change process. In particular, the experimental measurements were carried out at constant saturation temperature of 30 °C, by varying the refrigerant mass velocity between 190 kg m-2 s-1 and 940 kg m-2 s-1, the vapour quality from 0.2 to 0.99, at different imposed heat fluxes. The two refrigerants are compared considering the values of the two-phase heat transfer coefficient and pressure drop.

  5. North Massif lithologies and chemical compositions viewed from 2-4 mm particles of soil sample 76503

    NASA Technical Reports Server (NTRS)

    Bishop, Kaylynn M.; Jolliff, Bradley L.; Korotev, Randy L.; Haskin, Larry A.

    1992-01-01

    We identify the lithologic and compositional components of soil 76503 based on INAA of 243 2-4-mm particles and 72 thin sections from these and associated 1-2-mm particles (76502). We present a statistical distribution of the major compositional types as the first step of a detailed comparative study of the North and South Massifs. The soil sample was collected well away from any boulder and is more representative of typical North Massif material than any single large rock or boulder sample. So far, our examination of the 76503 particles has provided a better definition of precursor igneous lithologies and their petrogenetic relationships. It has enabled us to refine the nature of mixing components for the North Massif less than 1-mm fines. It has confirmed the differences in lithologies and their proportions between materials of the North and South Massifs; e.g., the North Massif is distinguished by the absence of a 72275-type KREEP component, the abundance of a highly magnesian igneous component, and the absence of certain types of melt compositions found in the South Massif samples.

  6. Punch from a patient led to correct diagnosis.

    PubMed

    Hall, Charlotte Lara

    2016-08-24

    During a recent placement on an older people's ward, I was punched in the face by a patient. It was during visiting time, and the patient - who I will call Jim - had come out of his room and was trying to enter another patient's room.

  7. Configurational phases in elastic foams under lengthscale-free punching

    NASA Astrophysics Data System (ADS)

    Sabuwala, Tapan; Dai, Xiangyu; Gioia, Gustavo

    2016-08-01

    We carry out experiments with brick-like specimens of elastic open-cell (EOC) foams of three relative densities. Individual specimens may be "tall" (height = width = depth) or "short" (2 height = width = depth). We place each specimen on a supporting plate and use a lengthscale-free (wedge-shaped or conical) punch to apply forces downward along the specimen's height. Regardless of the type of specimen, the force-penetration curves remain linear, for the wedge-shaped punch, or quadratic, for the conical punch, up to a sizable penetration commensurate with the smallest lengthscale of the specimen. After that there is an abrupt, all-but-discontinuous change in stiffness: if the specimen is tall, the stiffness drops; if the specimen is short, the stiffness shoots up. To analyze these curious experimental results, we posit that EOC foams can be found in either of two configurational phases, here termed the low-strain phase and the high-strain phase, which share a two-dimensional interface (a surface of strain discontinuity). The analysis may be outlined as follows. In the first part of an experiment, there obtains a "similarity regime" in which the penetration of the punch and the radius of the interface are the only prevailing lengthscales (because the punch is lengthscale free). In this case, it is possible to show that the force-penetration curve must be linear, or quadratic, depending on whether the punch be wedge-shaped or conical, respectively. This prediction of the analysis is consistent with the experiments. In time, the similarity regime breaks down when the interface reaches one of the specimen's boundaries distal to the tip of the punch. If the specimen is tall, the soft, stress-free lateral boundary is reached first, and the stiffness must drop; if the specimen is short, the hard boundary in contact with the supporting plate is reached first, and the stiffness must shoot up. These predictions too are consistent with the experiments. To provide direct

  8. Neuropathological alterations in diabetic truncal neuropathy: evaluation by skin biopsy

    PubMed Central

    Lauria, G.; McArthur, J.; Hauer, P.; Griffin, J.; Cornblath, D.

    1998-01-01

    OBJECTIVES—To describe the neuropathological features in skin biopsies from patients with diabetic truncal neuropathy.
METHODS—Three patients with diabetic truncal neuropathy underwent skin biopsies from both symptomatic and asymptomatic regions of the chest and trunk. After local anaesthesia, biopsies were performed using a 3 mm diameter punch device (Acupunch). Intraepidermal nerve fibres (IENFs), the most distal processes of small myelinated and unmyelinated nerve fibres, were identified after staining with PGP 9.5 as previously described.
RESULTS—Diabetes was diagnosed at the time of the neurological presentation in two, and one was a known diabetic patient. All three had associated sensory-motor polyneuropathy. In all, skin biopsies showed a marked reduction of both epidermal and dermal nerve fibres in the symptomatic dermatomes, compared with skin from asymptomatic truncal areas. In one patient, a follow up skin biopsy when symptoms had improved showed a return of IENFs.
CONCLUSIONS—In diabetic truncal neuropathy, skin biopsies from symptomatic regions show a loss of IENFs. After clinical recovery, there is a return of the IENF population, suggesting that improvement occurs by nerve regeneration. These findings suggest that sensory nerve fibre injury in diabetic truncal neuropathy is distal to or within the sensory ganglia. Skin biopsy provides a possible tool for understanding the pathophysiology of the disease.

 PMID:9810952

  9. A 4mm spectroscopic dual-beam receiver for the Robert C. Byrd green bank radio telescope

    NASA Astrophysics Data System (ADS)

    White, Steven; Frayer, David; Stennes, Mike; Simon, Robert; Watts, Galen; Norrod, Roger; Bryerton, Eric; Srikanth, Sivasankaran; Pospieszalski, Marian

    2012-09-01

    With a 100-meter aperture, and recent improvements to its surface accuracy and servo system upgrades, the Robert C. Byrd Green Bank Telescope is the most sensitive telescope operating at 90 GHz. A dual-feed heterodyne receiver is developed for observations at the lower frequency end of the 3-4mm atmospheric window (67 to 93 GHz). The science goals are primarily molecular spectroscopic studies of star formation and astrochemistry both internal and external to the Milky Way galaxy. Studies of the structural and physical properties of star-forming, cold-cloud cores will be revolutionized with molecular spectroscopy of the deuterium and other important species within the band. Essential for spectroscopy is the ability to remove slow gain and atmospheric variations. An optical table external to the cooled components rotates into the path of either beam an ambient temperature load, an offset mirror for viewing an internal cold load, or a quarter-wave plate that produces circular polarization for VLBI observations. A composite waveguide window comprised of HDPE, Zitex, and z-cut quartz provides a high-strength, low-loss medium for transmission of the signal to the cooled corrugated feed horn. An orthomode transducer separates the polarization components which are amplified by low noise HEMT amplifiers. Warm W-band MMIC amplifiers are required to compensate a negative gain slope and to reduce noise contributions from the down conversion to the GBT IF frequencies. Initial science results and receiver performance during commissioning observations will be presented along with details of the component design.

  10. Effect of laser incidence angle on cut quality of 4 mm thick stainless steel sheet using fiber laser

    NASA Astrophysics Data System (ADS)

    Mullick, Suvradip; Agrawal, Arpit Kumar; Nath, Ashish Kumar

    2016-07-01

    Fiber laser has potential to outperform the more traditionally used CO2 lasers in sheet metal cutting applications due to its higher efficiency, better beam quality, reliability and ease of beam delivery through optical fiber. It has been however, reported that the higher focusability and shorter wavelength are advantageous for cutting thin metal sheets up to about 2 mm only. Better focasability results in narrower kerf-width, which leads to an earlier flow separation in the flow of assist gas within the kerf, resulting in uncontrolled material removal and poor cut quality. However, the advarse effect of tight focusability can be taken care by shifting the focal point position towards the bottom surface of work-piece, which results in a wider kerf size. This results in a more stable flow within the kerf for a longer depth, which improves the cut quality. It has also been reported that fiber laser has an unfavourable angle of incidence during cutting of thick sections, resulting in poor absorption at the metal surface. Therefore, the effect of laser incidence angle, along with other process parameters, viz. cutting speed and assist gas pressure on the cut quality of 4 mm thick steel sheet has been investigated. The change in laser incidence angle has been incorporated by inclining the beam towards and away from the cut front, and the quality factors are taken as the ratio of kerf width and the striation depth. Besides the absorption of laser radiation, beam inclination is also expected to influence the gas flow characteristics inside the kerf, shear force phenomena on the molten pool, laser beam coupling and laser power distribution at the inclined cut surface. Design of experiment has been used by implementing response surface methodology (RSM) to study the parametric dependence of cut quality, as well as to find out the optimum cut quality. An improvement in quality has been observed for both the inclination due to the combined effect of multiple phenomena.

  11. Optimization of prostate biopsy

    NASA Astrophysics Data System (ADS)

    Bauer, John J.; Zeng, Jianchao; Weir, James; Zhang, Wei; Sesterhenn, Isabell A.; Connelly, Roger R.; Moul, Judd W.; Mun, Seong K.

    1999-05-01

    Urologists routinely use the systematic sextant needle biopsy technique to detect prostate cancer. However, recent evidence suggests that this technique has a significant sampling error. We have developed a novel 3D computer assisted prostate biopsy simulator based upon 201 whole- mounted step-sectioned radical prostatectomy specimens to compare the diagnostic accuracy of various prostate needle biopsy protocols. Computerized prostate models have been developed to accurately depict the anatomy of the prostate and all individual tumor foci. We obtained 18-biopsies of each prostate model to determine the detection rates of various biopsy protocols. As a result, the 10- and 12- pattern biopsy protocols had a 99.0 percent detection rate, while the traditional sextant biopsy protocol rate was only 72.6 percent. The 5-region biopsy protocol had a 90.5 percent detection rate. the lateral sextant pattern revealed a detection rate of 95.5 percent, whereas the 4-pattern lateral biopsy protocol had a 93.5 percent detection rate. Our results suggest that all the biopsy protocols that use laterally placed biopsies based upon the five region anatomical model are superior to the routinely used sextant prostate biopsy pattern. Lateral biopsies in the mid and apical zones of the gland are the most important.

  12. Biomechanics of the head for Olympic boxer punches to the face

    PubMed Central

    Walilko, T; Viano, D; Bir, C

    2005-01-01

    Objective: The biomechanics of the head for punches to the jaw and the risk of head injury from translational and rotational acceleration were studied. Results: Punch force averaged 3427 (standard deviation (SD) 811) N, hand velocity 9.14 (SD 2.06) m/s, and effective punch mass 2.9 (SD 2.0) kg. Punch force was higher for the heavier weight classes, due primarily to a higher effective mass of the punch. Jaw load was 876 (SD 288) N. The peak translational acceleration was 58 (SD 13) g, rotational acceleration was 6343 (SD 1789) rad/s2, and neck shear was 994 (SD 318) N. Conclusions: Olympic boxers deliver straight punches with high impact velocity and energy transfer. The severity of the punch increases with weight class. PMID:16183766

  13. Nerve biopsy (image)

    MedlinePlus

    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 ...

  14. Sentinel node biopsy (image)

    MedlinePlus

    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, ...

  15. Gene expression changes in chronic inflammatory demyelinating polyneuropathy skin biopsies.

    PubMed

    Puttini, Stefania; Panaite, Petrica-Adrian; Mermod, Nicolas; Renaud, Susanne; Steck, Andreas J; Kuntzer, Thierry

    2014-05-15

    Chronic-inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated disease with no known biomarkers for diagnosing the disease or assessing its prognosis. We performed transcriptional profiling microarray analysis on skin punch biopsies from 20 CIDP patients and 17 healthy controls to identify disease-associated gene expression changes. We demonstrate changes in expression of genes involved in immune and chemokine regulation, growth and repair. We also found a combination of two upregulated genes that can be proposed as a novel biomarker of the disorder.

  16. Development and Validation of a Shear Punch Test Fixture

    DTIC Science & Technology

    2013-08-01

    Current DRDC Defence Research and Development Canada FSP Friction Stir Processing LVDT Linear Variable Displacement Transducer MMC Metal Matrix...properties of metallic materials. The shear punch tester uses very small, thin specimens to evaluate shear behaviour of materials, the results of which...composites (MMC) manufactured by friction stir processing (FSP) that are being developed as part of a Technology Investment Fund (TIF) project, as the

  17. Variable temperature thin film indentation with a flat punch

    NASA Astrophysics Data System (ADS)

    Cross, Graham L. W.; O; ²Connell, Barry S.; Pethica, John B.; Rowland, Harry; King, William P.

    2008-01-01

    We present modifications to conventional nanoindentation that realize variable temperature, flat punch indentation of ultrathin films. The technique provides generation of large strain, thin film extrusion of precise geometries that idealize the essential flows of nanoimprint lithography, and approximate constant area squeeze flow rheometry performed on thin, macroscopic soft matter samples. Punch radii as small as 185nm have been realized in ten-to-one confinement ratio testing of 36nm thick polymer films controllably squeezed in the melt state to a gap width of a few nanometers. Self-consistent, compressive stress versus strain measurements of a wide variety of mechanical testing conditions are provided by using a single die-sample system with temperatures ranging from 20to125°C and loading rates spanning two decades. Low roughness, well aligned flat punch dies with large contact areas provide precise detection of soft surfaces with standard nanoindenter stiffness sensitivity. Independent heating and thermometry with heaters and thermocouples attached to the die and sample allow introduction of a novel directional heat flux measurement method to ensure isothermal contact conditions. This is a crucial requirement for interpreting the mechanical response in temperature sensitive soft matter systems. Instrumented imprint is a new nanomechanics material testing platform that enables measurements of polymer and soft matter properties during large strains in confined, thin film geometries and extends materials testing capabilities of nanoindentation into low modulus, low strength glassy, and viscoelastic materials.

  18. Three years of retrospective evaluation of skin biopsy results in childhood

    PubMed Central

    Ozkanli, Seyma; Zemheri, Ebru; Zindanci, Ilkin; Kuru, Burce; Zenginkinet, Tulay; Karadag, Ayse Serap

    2015-01-01

    OBJECTIVE: In our study, we aimed to evaluate retrospectively histopathological diagnoses of children based on their skin biopsies, and determine the prevalence of the disease in question. METHODS: Among patients who applied to Medeniyet University Goztepe Training and Research Hospital between January 2011 and February 2014, we retrospectively evaluated demographic data and histopathological diagnoses of patients aged between 0-17 years whose skin punch biopsy samples were obtained. RESULTS: The study population (n=566) with skin biopsy results consisted of 287 (50.7%) male, and 279 (49.2%) female patients with a mean age of 10.04±4.84 years. Biopsy materials were obtained from the various age groups as follows: 0-2 years, n=31 (5.4%); 3-5 years, n=67 (11.8%) 6-11 years, n=165 (29.1%), and 12-17 years, n=303 (53.5%). Among all age groups, we took biopsies mostly from patients with noninfectious erythematous squamous (24%) and vascular (21.2%) diseases. The determined histopathological diagnoses were leukocytoclasis vasculitis (18.9%), psoriasis (7.4%), melanocytic nevus (5.4%), and contact dermatitis (5.1%) respectively. CONCLUSION: We determined that skin punch biopsy examinations were done most frequently during adolescence and are mostly necessary for diagnosis of erythematous squamous and vascular diseases. If clinical evidence-based prevalence studies are supported with histopathological data, more significant results can be obtained. PMID:28058339

  19. Split-thickness flap with a semicircular punched-ridge pedicled periosteal flap for implant restoration in highly atrophic patients: a technical note.

    PubMed

    Seemann, Rudolf; Perisanidis, Christos; Traxler, Hannes; Ewers, Rolf

    2014-01-01

    Attached gingiva is a crucial aspect of healthy peri-implant tissue. Severely atrophied jaws have minimal quantities of attached gingiva. Any surgical procedure bears the potential risk of further loss of attached gingiva. The split-thickness flap described here provides excellent access. Using a biopsy punch, the periosteum is easily cut in semicircular fashion on the labial surface of the bone so that it remains pedicled on the lingual or palatal ridge. The split-thickness flap permits fixation of the gingival flap to the periosteum. The periosteal flap is closed with sutures to achieve soft tissue closure over the implants even in case of simultaneous vestibuloplasty.

  20. Influence of Clearance and Punch Velocity on the Quality of Pure Thin Copper Sheets Blanked Parts

    NASA Astrophysics Data System (ADS)

    Zakariya Lubis, Didin; Mahardika, Muslim

    2016-11-01

    Research on the influence of clearance and punch velocity to determine the quality of the punched edge were conducted. This study uses pure copper sheet material with the clearance variation of 2.5, 5, 7.5 and 10%. Punch velocity is based on the ability of about Micro Punch CNC machine which is 100 and 2600 mm/min. At highest speed with a clearance of 2.5%, sheared zone is of about 395 pm or 79% of the material thickness. It can be concluded that the punch velocity gives positive influence on the sheared zone in copper. Basically the ideal outcome of the sheared edge of punching result is having rollover and small burr and contain at least 75% of the shear zone. This can be achieved with a clearance of 2.5%.

  1. Complications of prostate biopsy.

    PubMed

    Anastasiadis, Anastasios; Zapała, Lukasz; Cordeiro, Ernesto; Antoniewicz, Artur; Dimitriadis, Georgios; De Reijke, Theo

    2013-07-01

    Biopsy of the prostate is a common procedure with minor complications that are usually self-limited. However, if one considers that millions of men undergo biopsy worldwide, one realizes that although complication rate is low, the number of patients suffering from biopsy complications should not be underestimated and can be a clinically relevant problem for healthcare professionals. In this review, the authors present diagnosis and management of postbiopsy of prostate complications. Bleeding is the most common complication observed after prostate biopsy, but the use of aspirin or nonsteroidal anti-inflammatory drugs is not an absolute contraindication to prostate biopsy. Emerging resistance to ciprofloxacin is the most probable cause of the increasing risk of infectious complications after prostate biopsy. Even though extremely rare, fatal complications are possible and were described in case reports.

  2. Analysis of bone biopsies.

    PubMed

    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.

  3. Biopsies in oncology.

    PubMed

    de Bazelaire, C; Coffin, A; Cohen, S; Scemama, A; de Kerviler, E

    2014-01-01

    Imaging-guided percutaneous biopsies in patients in oncology provide an accurate diagnosis of malignant tumors. Percutaneous biopsy results are improved by correct use of sampling procedures. The risks of percutaneous biopsy are low and its complications are generally moderate. These risks can be reduced using aids such as blund tip introducers, hydrodissection and correct patient positioning. The multidisciplinary team meetings dialogue between oncologist, surgeon and radiologist correctly defines the indications in order to improve the treatment strategies.

  4. Utility of synovial biopsy

    PubMed Central

    2009-01-01

    Synovial biopsies, gained either by blind needle biopsy or minimally invasive arthroscopy, offer additional information in certain clinical situations where routine assessment has not permitted a certain diagnosis. In research settings, synovial histology and modern applications of molecular biology increase our insight into pathogenesis and enable responses to treatment with new therapeutic agents to be assessed directly at the pathophysiological level. This review focuses on the diagnostic usefulness of synovial biopsies in the light of actual developments. PMID:19951395

  5. Colposcopy - directed biopsy

    MedlinePlus

    ... squamous cells - colposcopy; Pap smear - colposcopy; HPV - colposcopy; Human papilloma virus - colposcopy; Cervix - colposcopy; Colposcopy Images Female reproductive anatomy Colposcopy-directed biopsy Uterus References American College of ...

  6. A New Sheet Metal Forming System Based on Incremental Punching

    NASA Astrophysics Data System (ADS)

    Luo, Yuanxin

    Stamping is one of the most commonly used manufacturing processes. Everyday, millions of parts are formed by this process. The conventional stamping is to form a part in one or several operations with a press machine and a set/sets of dies. It is very efficient but is not cost effective for small batch production parts and prototypes as the dies are expensive and time consuming to make. Recently, with the increasing demands for low-volume and customer-made products, a die-less forming method, Incremental Sheet Metal Forming (ISMF), has become one of the leading R&D topics in the industry. ISMF uses a small generic tool to apply a sequence of operations along the given path to deform the sheet incrementally. These small deformations accumulate to form the final shape of the part. As a result, different parts can be made by the same setup. Despite of some 30 years of research and development, however, ISMF technology is still premature for industrial applications due to the following reasons: The accuracy of the part is limited; the surface roughness is poor; and the productivity is low. This motivates the presented research. In this research, a new incremental forming system based on incremental punching is designed and built. The system consists of a 3-axes CNC platform, a high speed hydraulic cylinder with a hemispherical forming tool, and a PC-based CNC control system. The hydraulic system provides the forming force to deform the sheet metal with constant stokes, while the CNC system positions the part. When forming a part, the forming tool punches the sheet metal along the given contour of the part punch by punch; when one layer of the part is completed, the forming tool moves down to the next layer; and the process is finished till all layers are completed. The CNC control system works with standard NC code, and hence, is easy to use. In order to ensure the desirable performance of the machine, dynamic analysis of the machine is necessary. The analysis is

  7. Punch valve development testing: Low and high velocity test results

    SciTech Connect

    Replogle, W.C.; Brandon, S.L.

    1996-09-01

    This is a report on the use of quasi-static tests to predict fundamental parameters for punch valve development. This report summarizes the results from low and high velocity tests performed with 0.63 and 0.38 cm diameter plungers, 5 cm long penetrating aluminium and composite targets. The low velocity tests, 0.025 m/s, were performed to understand the effects and interactions of plunger diameter plunger tip shape, target material, and target support on penetration energy and plunger functionality. High velocity tests, 75 m/s, were compared to low velocity results.

  8. EVOLUTION AND EVALUATION OF AUTOLOGOUS MINI PUNCH GRAFTING IN VITILIGO

    PubMed Central

    Lahiri, Koushik

    2009-01-01

    Vitiligo is a result of disrupted epidermal melanization with an undecided etiology and incompletely understood pathogenesis. Various treatment options have resulted in various degrees of success. Various surgical modalities and transplantation techniques have evolved during the last few decades. Of them, miniature punch grafting (PG) has established its place as the easiest, fastest, and least expensive method. Various aspects of this particular procedure have been discussed here. The historical perspective, the instruments, evolution of mini grafting down the ages, and the methodology, advantages, and disadvantages have been discussed. A detailed discussion on the topic along with a review of relevant literature has been provided in this article. PMID:20101312

  9. 29 CFR 570.59 - Occupations involved in the operations of power-driven metal forming, punching, and shearing...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... punch presses except those provided with full automatic feed and ejection and with a fixed barrier guard... presses; and plate punches. (iii) All bending machines, such as apron brakes and press brakes. (iv)...

  10. Salivary gland biopsy

    MedlinePlus

    Biopsy - salivary gland ... You have several pairs of salivary glands that drain into your mouth: A major pair in front of the ears (parotid glands) Another major pair beneath your jaw (submandibular ...

  11. Lymph node biopsy

    MedlinePlus

    ... Performed The test is used to diagnose cancer, sarcoidosis, or an infection (such as tuberculosis): When you ... of lymph nodes and other organs and tissues ( sarcoidosis ) Risks Lymph node biopsy may result in any ...

  12. Open lung biopsy

    MedlinePlus

    ... of different conditions, such as: Rheumatoid lung disease Sarcoidosis Wegener granulomatosis Risks There is a possibility of ... biopsy Malignant mesothelioma Pulmonary tuberculosis Rheumatoid lung disease Sarcoidosis Simple pulmonary eosinophilia Solitary fibrous tumor Viral pneumonia ...

  13. Pleural needle biopsy

    MedlinePlus

    ... of the pleural membrane. Pleural biopsy can diagnose tuberculosis , cancer, and other diseases. If this type of ... lung cancer , malignant mesothelioma , and metastatic pleural tumor ), tuberculosis, other infections, or collagen vascular disease. Risks There ...

  14. Open pleural biopsy

    MedlinePlus

    ... due to a virus, fungus, or parasite Mesothelioma Tuberculosis Risks There is a slight chance of: Air ... More Metastatic pleural tumor Pleural needle biopsy Pulmonary tuberculosis Tumor Review Date 11/4/2014 Updated by: ...

  15. Mediastinoscopy with biopsy

    MedlinePlus

    ... This procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders . Normal Results Biopsies of ... of disease from one body part to another Tuberculosis Risks There is a risk of puncturing the ...

  16. John Punch, Scotist Holy War, and the Irish Catholic Revolutionary Tradition in the Seventeenth Century.

    PubMed

    Campbell, Ian W

    2016-07-01

    During the 1640s, the Irish Franciscan theologian John Punch taught his theology students in Rome that war against Protestants was made just by their religion alone. Jesuits like Luis de Molina identified the holy war tradition in which Punch stood as a Scotist one, and insisted that the Scotists had confused the natural and supernatural spheres. Among Irishmen, Punch was unusual. The main Irish Catholic revolutionary tradition employed Jesuit and Thomist theory. They argued that the Stuarts had lost the right to rule Ireland for natural reasons, not supernatural ones; because the Stuarts were tyrants, not because they were Protestants.

  17. Behavior of reinforced concrete slabs subjected to combined punching shear and biaxial tension

    SciTech Connect

    Jau, W.C.; White, R.N.; Gergely, P.

    1982-09-01

    This investigation was a continuing study of peripheral (punching) shear strength of precracked, biaxially tensioned, orthogonally reinforced concrete slabs. This research was motivated by the need to determie the strength of a reinforced concrete containment vessel wall when subjected to combined internal pressure and punching shear loads normal to the wall. The study served to determine the effect of three major variables (shear span, size of loaded area, and reinforcing steel ratio) on punching shear strength of slabs that were precracked in biaxial tension and then held at one of the two tension levels (0 or 0.8f/sub y/) during shear load application.

  18. Breast Biopsy System

    NASA Technical Reports Server (NTRS)

    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.

  19. Micro-punching process based on spallation delamination induced by laser driven-flyer

    NASA Astrophysics Data System (ADS)

    Di, Jianke; Zhou, Ming; Li, Jian; Li, Chen; Zhang, Wei; Amoako, George

    2012-01-01

    In this article, we proposed a micro-punching process for microstructure on films based on laser driven-flyer induced spallation delamination phenomenon at the interface between a film and its substrate. To validate such a micro-punching process, a series of experiments were carried out for fabrication of microstructures on Au films coated on K9 glass substrates and polyimide substrate. Results show that through such a punching process, the microstructure on Au films can be fabricated efficiently and the spatial resolution is able to reach micron level. Moreover, we found that this method was more suitable for films coated on soft substrates rather than that coated on brittle substrates due to the additional destruction of the brittle substrate. This micro-punching process has a wide range of potential application in microfluidic devices, biodevices and other MEMS devices.

  20. A Manual Retrieval System Using Computer Punch Cards for Qualitative Historical Research

    ERIC Educational Resources Information Center

    Feldman, Robert S.

    1973-01-01

    Detailed examples illustrate one of the possible applications for using the computer punch card for information retrieval in qualitative historical research, suggesting a time-saving method of organization for research data. (SM)

  1. Thyroid gland biopsy (image)

    MedlinePlus

    The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating ... sample of cells is needed from the thyroid gland a fine needle biopsy can be performed. During ...

  2. The JKR-type adhesive contact problems for power-law shaped axisymmetric punches

    NASA Astrophysics Data System (ADS)

    Borodich, Feodor M.; Galanov, Boris A.; Suarez-Alvarez, Maria M.

    2014-08-01

    The JKR (Johnson, Kendall, and Roberts) and Boussinesq-Kendall models describe adhesive frictionless contact between two isotropic elastic spheres, and between a flat-ended axisymmetric punch and an elastic half-space respectively. However, the shapes of contacting solids may be more general than spherical or flat ones. In addition, the derivation of the main formulae of these models is based on the assumption that the material points within the contact region can move along the punch surface without any friction. However, it is more natural to assume that a material point that came to contact with the punch sticks to its surface, i.e. to assume that the non-slipping boundary conditions are valid. It is shown that the frictionless JKR model may be generalized to arbitrary convex, blunt axisymmetric body, in particular to the case of the punch shape being described by monomial (power-law) punches of an arbitrary degree d≥1. The JKR and Boussinesq-Kendall models are particular cases of the problems for monomial punches, when the degree of the punch d is equal to two or it goes to infinity respectively. The generalized problems for monomial punches are studied under both frictionless and non-slipping (or no-slip) boundary conditions. It is shown that regardless of the boundary conditions, the solution to the problems is reduced to the same dimensionless relations among the actual force, displacements and contact radius. The explicit expressions are derived for the values of the pull-off force and for the corresponding critical contact radius. Connections of the results obtained for problems of nanoindentation in the case of the indenter shape near the tip has some deviation from its nominal shape and the shape function can be approximated by a monomial function of radius, are discussed.

  3. An analysis of follicular punches, mechanics, and dynamics in follicular unit extraction.

    PubMed

    Cole, John P

    2013-08-01

    Success in follicular unit extraction requires an understanding of forces, fluid dynamics, instrumentation, and individual patient variation. Sharp punches require a lower axial and tangential force to dissect follicular groups. The angle of hair emergence and the size of a punch influence the wound size and the depth of an incision. A procedure must be individualized based on surface follicular group characteristics; hair splay; and strength of attachment between the outer root sheath, inner root sheath, and adipose with regard to hair follicles.

  4. Correlation between shear punch and tensile data for neutron-irradiated aluminum alloys

    SciTech Connect

    Hamilton, M.L.; Edwards, D.J.; Toloczko, M.B.

    1995-04-01

    This work was performed to determine whether shear punch and tensile data obtained on neutron irradiated aluminum alloys exhibited the same type of relationship as had been seen in other work and to assess the validity of extrapolating the results to proton-irradiated alloys. This work was also meant to be the first of a series of similar test matrices designed to determine whether the shear punch/tensile relationship varied or was the same for different alloy classes.

  5. Punch resection alaplasty technique in dogs and cats with stenotic nares: 14 cases.

    PubMed

    Trostel, C Todd; Frankel, Daniel J

    2010-01-01

    Punch resection alaplasty is a previously unreported surgical technique for the management of stenotic nares. Nine dogs underwent the procedure in conjunction with soft palate resection and/or laryngeal sacculectomy. Three dogs and two cats were treated with the novel punch resection alaplasty technique alone. Symmetrical resection was achieved, providing excellent cosmesis. Good to excellent results were achieved in all cases, with owners feeling that their pet's overall well being was improved following surgery.

  6. Performance Assessment of Hard Rock TBM and Rock Boreability Using Punch Penetration Test

    NASA Astrophysics Data System (ADS)

    Jeong, Ho-Young; Cho, Jung-Woo; Jeon, Seokwon; Rostami, Jamal

    2016-04-01

    Rock indentation tests are often called punch penetration tests and are known to be related to penetration rates of drilling equipment and hard rock tunnel boring machines (TBMs). Various indices determined from analysis of the force-penetration plot generated from indentation tests have been used to represent the drillability, boreability, and brittleness of rocks. However, no standard for the punch penetration test procedure or method for calculating the related indices has been suggested or adopted in the rock mechanics community. This paper introduces new indices based on the punch test to predict the performance of hard rock TBMs. A series of punch tests was performed on rock specimens representing six rock formations in Korea with different dimensions, i.e., the core specimens had different lengths and diameters. Of the indices obtained from the punch tests, the peak load index and mean load index showed good correlations with the cutting forces measured in full-scale linear cutting machine tests on the same rock types. The indices also showed good linear correlations with the ratio of uniaxial strength to Brazilian tensile strength, which indicates the brittleness of rock. The scale effect of using core specimens was investigated, and a preferred dimension for the punch test specimens is proposed. This paper also discusses the results of the punch test and full-scale rock cutting tests using LCM. The results of this study confirm that the proposed indices from the punch tests can be used to provide a reliable prediction of the cutting forces that act on a disc cutter. The estimated cutting forces can then be used for optimization of cutter-head design and performance prediction of hard rock TBMs.

  7. Is effective mass in combat sports punching above its weight?

    PubMed

    Lenetsky, Seth; Nates, Roy J; Brughelli, Matt; Harris, Nigel K

    2015-04-01

    The segmental and muscular complexity of the human body can result in challenges when examining the kinetics of impacts. To better understand this complexity, combat sports literature has selected effective mass as a measure of an athlete's inertial contribution to the momentum transfer during the impact of strikes. This measure helps to clarify the analysis of striking kinetics in combat sports. This paper will review: (1) effective mass as a concept and its usage as a measure of impact intensity in combat sports, (2) the neuromuscular pattern known as "double peak muscle activation" which has been theorized to help enhance initial hand velocity upon impact and joint stiffening during impact, (3) the methods and equations used to calculate effective mass, and (4) practitioner recommendations based on the literature. We will argue in this manuscript that the act of punching presents unique challenges to the current understanding of effective mass due to additional force application during impact. This review will improve the understanding of effective mass and its roles in effective striking serving to underpin future research into performance enhancement in striking based combat sports.

  8. The effects of attentional focus instructions on punching velocity and impact forces among trained combat athletes.

    PubMed

    Halperin, Israel; Chapman, Dale W; Martin, David T; Abbiss, Chris

    2017-03-01

    Research indicates that instructing athlete's to focus on bodily movements (internal focus of attention [IFA]) may hinder performance, whereas instructing them to focus on the movement outcome (external focus of attention [EFA]) often enhances performance. Despite the importance of instructions in striking combat sports, limited research has examined the influence of IFA and EFA on performance in well-trained combat athletes. This study investigated the effects of different instructional cues on punching velocity (m · s(-1)) and normalised impact forces (N · kg(-1)) among intermediate (n = 8) and expert (n = 7) competitive boxers and kickboxers. Athletes completed three rounds of 12 maximal effort punches delivered to a punching integrator on three separate days. Day one was a familiarisation session with only control instructions provided. In the following two days athletes randomly received IFA, EFA or control instructions prior to each of the three rounds. Athletes punching with EFA were 4% faster and 5% more forceful than IFA (P < 0.05), and 2% faster and 3% more forceful than control (P < 0.05). Furthermore, experts punched 11% faster and with 13% greater force compared with intermediate athletes (P < 0.05). EFA led to a positive effect on punching performance and should be favoured over IFA and control instructions.

  9. Compaction properties of powders: the relationship between compression cycle hysteresis areas and maximally applied punch pressures.

    PubMed

    Khossravi, D

    1999-08-01

    The consolidation behaviors of various pharmaceutical solids were characterized by investigating the relationship between the calculated hysteresis areas and the maximally applied punch pressures. An Instron universal testing apparatus and an instrumented die were used to generate compression cycle profiles at various maximally applied punch pressures for the materials studied. Based on the profiles obtained, hysteresis areas were calculated for the materials studied as a function of maximally applied punch pressures. Furthermore, model profiles describing the plastic and brittle fracture processes were utilized to derive mathematical relationships between the calculated hysteresis cycle areas and the maximally applied punch pressures. The mathematical relationships derived indicate that a linear relationship between hysteresis areas and maximally applied punch pressures exists for plastic materials, whereas for brittle materials the hysteresis areas are related to the square of the maximally applied punch pressures. Experimental data obtained support the mathematical relationships derived. The goodness of fit to the models derived is used to rank order the consolidation mechanism of various drugs and pharmaceutical excipients.

  10. Ultrasound-Guided Breast Biopsy

    MedlinePlus

    ... Breast Biopsy An ultrasound-guided breast biopsy uses sound waves to help locate a lump or abnormality ... exam. The transducer sends out inaudible, high—frequency sound waves into the body and then listens for ...

  11. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Your 1- to 2-Year-Old Aspiration and Biopsy: Bone Marrow KidsHealth > For Parents > Aspiration and Biopsy: Bone Marrow A A A What's in this ... ósea What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy ...

  12. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Aspiration and Biopsy: Bone Marrow KidsHealth > For Teens > Aspiration and Biopsy: Bone Marrow A A A What's in this ... Questions What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy ...

  13. Tungsten Inert Gas and Friction Stir Welding Characteristics of 4-mm-Thick 2219-T87 Plates at Room Temperature and -196 °C

    NASA Astrophysics Data System (ADS)

    Lei, Xuefeng; Deng, Ying; Yin, Zhimin; Xu, Guofu

    2014-06-01

    2219-T87 aluminum alloy is widely used for fabricating liquid rocket propellant storage tank, due to its admirable cryogenic property. Welding is the dominant joining method in the manufacturing process of aerospace components. In this study, the tungsten inert gas welding and friction stir welding (FSW) characteristics of 4-mm-thick 2219-T87 alloy plate at room temperature (25 °C) and deep cryogenic temperature (-196 °C) were investigated by property measurements and microscopy methods. The studied 2219 base alloy exhibits a low strength plane anisotropy and excellent room temperature and cryogenic mechanical properties. The ultimate tensile strength values of TIG and FSW welding joints can reach 265 and 353 MPa at room temperature, and 342 and 438 MPa at -196 °C, respectively. The base metal consists of elongated deformed grains and many nano-scaled θ (Al2Cu) aging precipitates. Fusion zone and heat-affected zone (HAZ) of the TIG joint are characterized by coarsening dendritic grains and equiaxed recrystallized grains, respectively. The FSW-welded joint consists of the weld nugget zone, thermo-mechanically affected zone (TMAZ), and HAZ. In the weld nugget zone, a micro-scaled sub-grain structure is the main microstructure characteristic. The TMAZ and HAZ are both characterized by coarsened aging precipitates and elongated deformed grains. The excellent FSW welding properties are attributed to the preservation of the working structures and homogenous chemical compositions.

  14. Validation of the shear punch-tensile correlation technique using irradiated materials

    SciTech Connect

    Hankin, G.L.; Faulkner, R.G.; Toloczko, M.B.; Hamilton, M.L.

    1998-03-01

    It was recently demonstrated that tensile data could be successfully related to shear punch data obtained on transmission electron microscopy (TEM) discs for a variety of irradiated alloys exhibiting yield strengths that ranged from 100 to 800 MPa. This implies that the shear punch test might be a viable alternative for obtaining tensile properties using a TEM disk, which is much smaller than even the smallest miniature tensile specimens, especially when irradiated specimens are not available or when they are too radioactive to handle easily. The majority of the earlier tensile-shear punch correlation work was done using a wide variety of unirradiated materials. The current work extends this correlation effort to irradiated materials and demonstrates that the same relationships that related shear punch tests remain valid for irradiated materials. Shear punch tests were performed on two sets of specimens. In the first group, three simple alloys from the {sup 59}Ni isotopic doping series in the solution annealed and cold worked conditions were irradiated at temperatures ranging from 365 to 495 C in the Fast Flux Test Facility. The corresponding tensile data already existed for tensile specimens fabricated from the same raw materials and irradiated side-by-side with the disks. In the second group, three variants of 316 stainless steel were irradiated in FFTF at 5 temperatures between 400 and 730 C to doses ranging from 12.5 to 88 dpa. The specimens were in the form of both TEM and miniature tensile specimens and were irradiated side-by-side.

  15. Tissue-Specific and Complex Complementation Patterns in the Punch Locus of DROSOPHILA MELANOGASTER

    PubMed Central

    Mackay, William J.; Reynolds, Elaine R.; O'Donnell, Janis M.

    1985-01-01

    Mutations in the Punch locus result in loss of GTP cyclohydrolase activity, but all mutations do not affect the enzyme in the same way. There are at least three classes of Punch mutations. One class results in a dominant eye color, recessive lethal phenotype. A second class of mutations also causes a recessive lethal phenotype, but heterozygous mutants have normal eye color. They show loss of GTP cyclohydrolase function in all tissues where activity can be measured. Alleles comprising a third class are recessive eye color mutations that are homozygous viable. Individuals with this third type of mutation show loss of enzyme activity in the eye, but show normal or near-normal activity elsewhere. In order to examine the organization and function of this locus further, we have performed interallelic complementation tests on 25 Punch mutations, monitoring viability and enzyme activity in prepupae and adults. Most allele combinations are lethal. Those that complement do so in ways that are tissue-or stage-specific and unpredictable. Tests of mutants with tissue-specific phenotypes and of individuals mutant for complementing Punch lethal alleles lead us to conclude that Punch is a complex locus, both with respect to its organization and to its products. PMID:3934035

  16. The Potential Role of Sensory Testing, Skin Biopsy, and Functional Brain Imaging as Biomarkers in Chronic Pain Clinical Trials: IMMPACT Considerations.

    PubMed

    Smith, Shannon M; Dworkin, Robert H; Turk, Dennis C; Baron, Ralf; Polydefkis, Michael; Tracey, Irene; Borsook, David; Edwards, Robert R; Harris, Richard E; Wager, Tor D; Arendt-Nielsen, Lars; Burke, Laurie B; Carr, Daniel B; Chappell, Amy; Farrar, John T; Freeman, Roy; Gilron, Ian; Goli, Veeraindar; Haeussler, Juergen; Jensen, Troels; Katz, Nathaniel P; Kent, Jeffrey; Kopecky, Ernest A; Lee, David A; Maixner, William; Markman, John D; McArthur, Justin C; McDermott, Michael P; Parvathenani, Lav; Raja, Srinivasa N; Rappaport, Bob A; Rice, Andrew S C; Rowbotham, Michael C; Tobias, Jeffrey K; Wasan, Ajay D; Witter, James

    2017-02-27

    Valid and reliable biomarkers can play an important role in clinical trials as indicators of biological or pathogenic processes or as a signal of treatment response. Currently, there are no biomarkers for pain qualified by the U.S. Food and Drug Administration or the European Medicines Agency for use in clinical trials. This article summarizes an Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials meeting in which 3 potential biomarkers were discussed for use in the development of analgesic treatments: 1) sensory testing, 2) skin punch biopsy, and 3) brain imaging. The empirical evidence supporting the use of these tests is described within the context of the 4 categories of biomarkers: 1) diagnostic, 2) prognostic, 3) predictive, and 4) pharmacodynamic. Although sensory testing, skin punch biopsy, and brain imaging are promising tools for pain in clinical trials, additional evidence is needed to further support and standardize these tests for use as biomarkers in pain clinical trials.

  17. Telepathology and Optical Biopsy

    PubMed Central

    Ferrer-Roca, Olga

    2009-01-01

    The ability to obtain information about the structure of tissue without taking a sample for pathology has opened the way for new diagnostic techniques. The present paper reviews all currently available techniques capable of producing an optical biopsy, with or without morphological images. Most of these techniques are carried out by physicians who are not specialized in pathology and therefore not trained to interpret the results as a pathologist would. In these cases, the use of telepathology or distant consultation techniques is essential. PMID:20339507

  18. Microfiltration: Effect of retentate protein concentration on limiting flux and serum protein removal with 4-mm-channel ceramic microfiltration membranes.

    PubMed

    Hurt, E E; Adams, M C; Barbano, D M

    2015-04-01

    The objective of our study was to determine if the limiting flux and serum protein (SP) removal were different at 8, 9, or 10% true protein (TP) in the microfiltration (MF) retentate recirculation loop using 0.1-µm ceramic graded permeability membranes with 4-mm-channel diameters operated at 50 °C using a diluted milk protein concentrate with 85% protein on a total solids basis (MPC85) as the MF feed. The limiting flux for the MF of diluted MPC85 was determined at 3 TP concentrations in the recirculation loop (8, 9, and 10%). The experiment was replicated 3 times for a total of 9 runs. On the morning of each run, MPC85 was diluted with reverse osmosis water to an MF feed TP concentration of 5.4%. In all runs, the starting flux was 55 kg/m(2) per hour, the flux was increased in steps until the limiting flux was reached. The minimum flux increase was 10 kg/m(2) per hour. The limiting flux decreased as TP concentration in the recirculation loop increased. The limiting flux was 154 ± 0.3, 133 ± 0.7, and 117 ± 3.3 kg/m(2) per hour at recirculation loop TP concentrations of 8.2 ± 0.07, 9.2 ± 0.04, and 10.2 ± 0.09%, respectively. No effect of recirculation loop TP concentration on the SP removal factor was detected. However, the SP removal factor decreased from 0.80 ± 0.02 to 0.75 ± 0.02 as flux was increased from the starting flux of 55 kg/m(2) per hour to the limiting flux, with a similar decrease seen at all recirculation loop TP concentrations.

  19. How does prostate biopsy guidance error impact pathologic cancer risk assessment?

    NASA Astrophysics Data System (ADS)

    Martin, Peter R.; Gaed, Mena; Gómez, José A.; Moussa, Madeleine; Gibson, Eli; Cool, Derek W.; Chin, Joseph L.; Pautler, Stephen; Fenster, Aaron; Ward, Aaron D.

    2016-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the 21-47% false negative rate of clinical 2D TRUS-guided sextant biopsy, but still has a substantial false negative rate. This could be improved via biopsy needle target optimization, accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. As an initial step toward the broader goal of optimized prostate biopsy targeting, in this study we elucidated the impact of biopsy needle delivery error on the probability of obtaining a tumor sample, and on the core involvement. These are both important parameters to patient risk stratification and the decision for active surveillance vs. definitive therapy. We addressed these questions for cancer of all grades, and separately for high grade (>= Gleason 4+3) cancer. We used expert-contoured gold-standard prostatectomy histology to simulate targeted biopsies using an isotropic Gaussian needle delivery error from 1 to 6 mm, and investigated the amount of cancer obtained in each biopsy core as determined by histology. Needle delivery error resulted in variability in core involvement that could influence treatment decisions; the presence or absence of cancer in 1/3 or more of each needle core can be attributed to a needle delivery error of 4 mm. However, our data showed that by making multiple biopsy attempts at selected tumor foci, we may increase the probability of correctly characterizing the extent and grade of the cancer.

  20. Assessment of mechanical properties of the martensitic steel EUROFER97 by means of punch tests

    NASA Astrophysics Data System (ADS)

    Ruan, Y.; Spätig, P.; Victoria, M.

    2002-12-01

    The ball punch test technique was used to evaluate the conventional tensile and impact properties of the tempered martensitic steel EUROFER97 from room temperature down to liquid nitrogen temperature. The testing was carried out on unirradiated material only with small disks, 3 mm in diameter and 0.25 mm in thickness. For comparison, tensile tests were also performed over the same temperature range. Correlations between the load at the plastic bending initiation and the maximum load of the punch tests with the yield stress and the ultimate tensile stress of the tension tests could be established. The temperature dependence of the specific fracture energy of the punch test was used to define a ductile-brittle transition temperature (DBTT) and to correlate this with the DBTT measured from impact Charpy on KLST specimens. The results are compared with other available correlations done in the past on other ferritic steels.

  1. Comparison of aerogrids and punched plates for smoothing flow from short annular diffusers

    NASA Technical Reports Server (NTRS)

    Rumpf, R. L.; Shippen, W. B.

    1972-01-01

    Scale model tests were conducted to evaluate the effectiveness of aerogrids and punched plates in producing flat velocity profiles downstream of short diffusers as would be used between the compressor and combustor of advanced aircraft engines. The diffuser had an area ratio of 4.17 and a length-to-inlet-height ratio of 2.07. The aerogrids tested were plates containing 1123 contoured venturis in parallel with geometric blockages of 83, 74, and 61 percent, respectively. The punched plates contained 1123 sharp-edged orifices with blockages of 58 and 30 percent. The results show that aerogrids, with higher effective blockage for the same pressure loss, are more effective flow-smoothing devices than the punched plates. Also, the overall pressure loss decreases and the exit velocity profile becomes flatter as either type of grid is moved closer to the diffuser exit plane.

  2. Punched card programming and recording techniques employed in the automation of the WGTA1

    PubMed Central

    Polidora, V. J.; Main, Willett T.

    1963-01-01

    A system of punched card programming and recording of primate discrimination learning experiments is described to illustrate the application of these techniques to the automation of the discrete trial learning situation, allowing for punched card recording and subsequent digital computer data analyses without intermediate data reduction. The system was also designed to control several potential sources of variability inherent in the conventional WGTA testing mode, including 1) the subject's (S's) motivation to test on each trial, 2) S's attention to the stimuli, and 3) the rate of trial presentation so as to be more under S's control. Reliable techniques of punched card programming and recording are detailed. ImagesFig. 4.Fig. 5. PMID:14055959

  3. Development of a new superficial punch for Descemet's Membrane Endothelial Keratoplasty donor tissue preparation.

    PubMed

    Ruzza, Alessandro; Parekh, Mohit; Salvalaio, Gianni; Ferrari, Stefano; Ponzin, Diego

    2016-04-01

    Endothelial Keratoplasty (EK) is a corneal surgical procedure that allows a selective transplantation of the posterior layer of the cornea. Descemet's Membrane Endothelial Keratoplasty (DMEK) is one of the EK procedures in which the diseased Descemet's Membrane and the endothelium are replaced with a healthy donor tissue. To achieve this, the donor cornea is cut superficially from the endothelial side and the tissue can be separated using specific instruments like Pierse Notched, Acute or Fogla forceps. However, the pressure required to punch the superficial layer has always been a challenge and therefore a calibrated device to punch and excise the required superficial layer has been designed. This new model of punch will help to identify the peripheral edge of the DMEK lenticule which in turn helps to excise the tissue exclusively, further reducing the donor tissue wastage, as seen with the current tissue preparation methods.

  4. Heat Transfer Enhancement in Solar Air Heater Duct Fitted With Punched Hole Delta Winglets

    NASA Astrophysics Data System (ADS)

    Warrier, Hithesh. U.; Kotebavi, Vinod. M.

    2016-09-01

    This paper investigates the thermal performance of solar air heater fitted with delta winglet type vortex generators with holes punched on it by experimental and numerical analysis. Delta winglet type vortex generators having holes punched onto it are fitted in a duct of size 400*300*30mm.it is placed in duct in 3 different configurations, as an array having 5 pair in one row. Delta winglet pair has an attack angle of 30degree, with height of winglet equal to half of duct height. The study is done for Reynolds's no in the range of 9000 to 25000. Thermal performance is evaluated by analyzing both friction factor and Nussult's number using Webb's correlation for surface roughness. Numerical simulation is done using Ansys fluent. Experimental and numerical results are then compared. Results shows that heat transfer enhancement of about 20-150% can be achieved by using punched hole delta winglet.

  5. Determination of the toughness of in-service steam turbine disks using small punch testing

    NASA Astrophysics Data System (ADS)

    Foulds, J.; Viswanathan, R.

    2001-10-01

    Knowledge of the material toughness is crucial in assessing the integrity of heavy section steel components. Conventional tests to determine the toughness involve extraction of large blocks of materials and therefore are not practical on in-service components. On the other hand, conservative assumptions regarding toughness without regard to actual data can lead to expensive and premature replacement of the components. Previous EPRI studies have demonstrated the use of a relatively nondestructive technique termed the "small punch test" to estimate the fracture appearance transition temperature (FATT) and fracture toughness ( K Ic ) of high-temperature turbine rotor steels and nuclear reactor pressure vessel steels. This paper summarizes the results of research into the feasibility of extending the small punch test to characterize the toughness of the 3 to 3.5% NiCrMoV (3-3.5NiCrMoV) low alloy steel used for fossil and nuclear power plant low-pressure (LP) steam turbine disks. Results of the present study show that the small punch transition temperature, T sp , is linearly correlated with FATT, so that measurement of T sp permits estimation of the standard Charpy FATT through empirical use of the correlation. The statistical confidence prediction uncertainty bands for the correlation were found to be narrow enough to make the small punch- based FATT estimation practical for this alloy. Additionally, independent K Ic measurements made by PowerGen, UK, on some of the same test materials were in excellent agreement with measurements made here, indicating that the small punch K Ic measurement can be reproducible across laboratories. Limited testing for fracture initiation toughness showed, as has been demonstrated for other materials, that the small punch test-based initiation fracture toughness ( K Ic ) determination was within ±25% of the ASTM standard measurement of K Ic , suggesting that the test method can be used for direct determination of fracture initiation

  6. 29 CFR 570.59 - Occupations involved in the operation of power-driven metal forming, punching, and shearing...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Occupations involved in the operation of power-driven metal... in the operation of power-driven metal forming, punching, and shearing machines (Order 8). (a... following power-driven metal forming, punching, and shearing machines: (i) All rolling machines, such...

  7. 29 CFR 570.59 - Occupations involved in the operation of power-driven metal forming, punching, and shearing...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Occupations involved in the operation of power-driven metal... in the operation of power-driven metal forming, punching, and shearing machines (Order 8). (a... following power-driven metal forming, punching, and shearing machines: (i) All rolling machines, such...

  8. 29 CFR 570.59 - Occupations involved in the operation of power-driven metal forming, punching, and shearing...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Occupations involved in the operation of power-driven metal... in the operation of power-driven metal forming, punching, and shearing machines (Order 8). (a... following power-driven metal forming, punching, and shearing machines: (i) All rolling machines, such...

  9. 29 CFR 570.59 - Occupations involved in the operation of power-driven metal forming, punching, and shearing...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Occupations involved in the operation of power-driven metal... in the operation of power-driven metal forming, punching, and shearing machines (Order 8). (a... following power-driven metal forming, punching, and shearing machines: (i) All rolling machines, such...

  10. Widefield fluorescence imaging as an auxiliary tool to select the biopsy site for actinic cheilitis diagnosis

    NASA Astrophysics Data System (ADS)

    Kurachi, C.; Cosci, A.; Takahama, A.; Fontes, K. B. F. C.; Azevedo, R. S.

    2014-03-01

    Actinic cheilitis (AC) is considered a potentially malignant disorder that mainly affects the lower lip, and it is caused by prolonged sun exposure. Clinical diagnosis relies on visual inspection by a trained clinician, when suspected of dysplasia changes, a biopsy is required. The heteregenous characteristics of the AC, makes the choice of the biopsy site a difficult task. Fluorescence detection has been presented as a useful tool to to detect biochemical and morphological tissue features related to cancer diagnosis, but still its effectiveness to discriminate premalignant lesion is not completely defined. In this clinical study, 57 AC patients were investigated using widefield fluorescence imaging (WFI) to evaluate the efficacy of this technique as an auxiliary tool to biopsy site location. A handheld fluorescence system based on 400-450 nm LED illumination Distinct trained clinicians evaluate the patient either with the conventional examination or the WFI, and were blinded to the other evaluation. A biopsy site was chosen based on the clinical examination, and another site was chosen using the fluorescence visualization. A total of 114 punch biopsies were performed, and 93% of the tissue samples presented epithelial dysplasia. The majority of the sites that presented moderate or severe dysplasia were sites chosen by WFI, showing its efficiency to improve the diagnosis of AC.

  11. Cutaneous innervation of the human face as assessed by skin biopsy.

    PubMed

    Nolano, Maria; Provitera, Vincenzo; Caporaso, Giuseppe; Stancanelli, Annamaria; Leandri, Massimo; Biasiotta, Antonella; Cruccu, Giorgio; Santoro, Lucio; Truini, Andrea

    2013-02-01

    The morphology of cutaneous sensory and autonomic innervation in human trigeminal territory is still unknown. The aim of this study is to describe facial cutaneous innervation using skin biopsy. This new tool could be useful in understanding the mechanisms underlying several facial pain conditions. In 30 healthy subjects, we quantified epidermal nerve fibers (ENFs) and dermal myelinated fibers (MFs) in V1, V2 and V3, using indirect immunofluorescence and confocal microscopy applied to 2-mm punch skin biopsies from areas adjacent to the eyebrow, upper and lower lip. Using selective markers, we also evaluated the distribution of peptidergic, cholinergic and noradrenergic fibers. Facial skin appeared abundantly innervated and rich in annexes. The ENF density decreased and the MF density increased, moving from the supraorbital to the perioral skin. Noradrenergic sudomotor fibers were particularly and constantly expressed compared with other body sites. Distribution of vasoactive intestinal peptide-immunoreactive (VIP-ir) fibers appeared peculiar for their constant presence in the subepidermal neural plexus - in close contact, but without colocalization with calcitonin gene related peptide (CGRP) and substance P (Sub-P)-ir fibers. Finally, in perioral skin samples, we observed striated muscle fibers with their motor nerves and motor endplates. Our work provides the first morphological study of human facial cutaneous innervation, highlighting some unique features of this territory. Quantification of unmyelinated and myelinated fibers on 2-mm punch biopsies appeared to be feasible and reliable. Facial skin biopsy may be a new approach with which to study and to better characterize facial pain syndromes.

  12. Investigating the effect of tablet thickness and punch curvature on density distribution using finite elements method.

    PubMed

    Diarra, Harona; Mazel, Vincent; Busignies, Virginie; Tchoreloff, Pierre

    2015-09-30

    Finite elements method was used to study the influence of tablet thickness and punch curvature on the density distribution inside convex faced (CF) tablets. The modeling of the process was conducted on 2 pharmaceutical excipients (anhydrous calcium phosphate and microcrystalline cellulose) by using Drucker-Prager Cap model in Abaqus(®) software. The parameters of the model were obtained from experimental tests. Several punch shapes based on industrial standards were used. A flat-faced (FF) punch and 3 convex faced (CF) punches (8R11, 8R8 and 8R6) with a diameter of 8mm were chosen. Different tablet thicknesses were studied at a constant compression force. The simulation of the compaction of CF tablets with increasing thicknesses showed an important change on the density distribution inside the tablet. For smaller thicknesses, low density zones are located toward the center. The density is not uniform inside CF tablets and the center of the 2 faces appears with low density whereas the distribution inside FF tablets is almost independent of the tablet thickness. These results showed that FF and CF tablets, even obtained at the same compression force, do not have the same density at the center of the compact. As a consequence differences in tensile strength, as measured by diametral compression, are expected. This was confirmed by experimental tests.

  13. Frictional slip of a rigid punch on an elastic half-plane

    NASA Astrophysics Data System (ADS)

    Adams, George G.

    2016-07-01

    If a rigid punch is perfectly bonded to an elastic half-plane, the stress state possesses a well-known oscillating singularity. Because the shear and normal stresses are out of phase with each other, the application of a frictional slip model is expected to result in a slip zone at each of the corners. A solution exists in the literature if the punch is subjected to a normal load. It was shown that the extent of the slip zone is an eigenvalue which depends upon Poisson's ratio and the coefficient of friction, but is independent of the magnitude of the applied load. In this investigation, the extent of the slip zone as well as the slip displacement is determined from the perfect bond solution. The analysis is valid if the length of the slip zone is small compared with the punch width. However, the results are shown to be in excellent agreement with the solution in the literature even when the total length of the slip zones is equal to half of the punch width. A solution is then obtained for combined normal and tangential loading. This work, and its extensions, is expected to be applicable in the study of the mechanics of fretting.

  14. Randomization of Symbol Repetition of Punch Cards with Superimposed Coding in Information-Search Systems.

    ERIC Educational Resources Information Center

    Pirovich, L. Ya

    The article shows the effect of the irregularity of using separate symbols on search noise on punch cards with superimposed symbol coding in information-search system (IPS). A binomial law of random value distribution of repetition of each symbol is established and analyzed. A method of determining the maximum value of symbol repetition is…

  15. Punch geometry and formulation considerations in reducing tablet friability and their effect on in vitro dissolution.

    PubMed

    Chowhan, Z T; Amaro, A A; Ong, J T

    1992-03-01

    The tablet friability resulting from formulation variations was studied under controlled granulation moisture content and tablet crushing strength. Tablets made with lactose were more friable than tablets made with microcrystalline cellulose. Replacement of 0.5% magnesium stearate with 0.5% stearic acid in the formula reduced tablet friability, whereas the combination of 0.5% stearic acid and up to 0.25% magnesium stearate did not increase tablet friability, decrease drug dissolution rate, or increase tablet-to-tablet variability in dissolution. Tablets compressed with extra deep concave punches resulted in lower friability compared with tablets compressed with standard concave or deep concave punches. The friabilities of the standard convex and deep convex tablets were similar, indicating that a critical level of punch tip curvature was important in reducing tablet friability. The dissolution rate was not affected by the punch tip geometry, but the tablet-to-tablet dissolution variability at the 0.5% stearic acid level for the extra deep convex tablets was higher compared with the standard convex tablets.

  16. Experimental investigation into the deep penetration of soft solids by sharp and blunt punches, with application to the piercing of skin.

    PubMed

    Shergold, Oliver A; Fleck, Norman A

    2005-10-01

    An experimental study has been conducted on the penetration of silicone rubbers and human skin in vivo by sharp-tipped and flat-bottomed cylindrical punches. A penetrometer was developed to measure the penetration of human skin in vivo, while a conventional screw-driven testing machine was used to penetrate the silicone rubbers. The experiments reveal that the penetration mechanism of a soft solid depends upon the punch tip geometry: a sharp tipped punch penetrates by the formation and wedging open of a mode I planar crack, while a flat-bottomed punch penetrates by the growth of a mode II ring crack. The planar crack advances with the punch, and friction along the flanks of the punch leads to a rising load versus displacement response. In contrast, the flat-bottomed punch penetrates by jerky crack advance and the load on the punch is unsteady. The average penetration pressure on the shank cross section of a flat-bottomed punch exceeds that for a sharp-tipped punch of the same diameter In addition, the penetration pressure decreases as the diameter of the sharp-tipped punch increases. These findings are in broad agreement with the predictions of Shergold and Fleck [Proc. R. Soc. London, Ser. A (in press)] who proposed models for the penetration of a soft solid by a sharp-tipped and flat-bottomed punch.

  17. Ultrasound-guided synovial biopsy

    PubMed Central

    Sitt, Jacqueline C M; Wong, Priscilla

    2016-01-01

    Ultrasound-guided needle biopsy of synovium is an increasingly performed procedure with a high diagnostic yield. In this review, we discuss the normal synovium, as well as the indications, technique, tissue handling and clinical applications of ultrasound-guided synovial biopsy. PMID:26581578

  18. Oral biopsy in dental practice.

    PubMed

    Mota-Ramírez, Amparo; Silvestre, Francisco Javier; Simó, Juan Manuel

    2007-11-01

    The conclusions drawn from the study of an oral biopsy are considered essential for the definitive diagnosis of diseases of the oral mucosa, and for the subsequent planning of appropriate treatment. Although the obtainment of biopsies is widely used in all medical fields, the practice is not so widespread in dental practice--fundamentally because of a lack of awareness of the procedure among dental professionals. In this context, it must be taken into account that the early diagnosis of invasive oral malignancy may be critical for improving the patient prognosis. However, in some cases the results are adversely affected by incorrect manipulation of the biopsy material. The present study provides an update on the different biopsy sampling techniques and their application. Such familiarization in turn will contribute to knowledge of the material and instruments required for correct biopsy performance in dentistry, as well as of the material required for correct sample storage and transport.

  19. Development of new punch shape to replicate scale-up issues in laboratory tablet press II: a new design of punch head to emulate consolidation and dwell times in commercial tablet press.

    PubMed

    Aoki, Shigeru; Uchiyama, Jumpei; Ito, Manabu

    2014-06-01

    Differences between laboratory and commercial tablet presses are frequently observed during scale-up of tableting process. These scale-up issues result from the differences in total compression time that is the sum of consolidation and dwell times. When a lubricated blend is compressed into tablets, the tablet thickness produced by the commercial tablet press is often thicker than that by a laboratory tablet press. A new punch shape design, designated as shape adjusted for scale-up (SAS), was developed and used to demonstrate the ability to replicate scale-up issues in commercial-scale tableting processes. It was found that the consolidation time can be slightly shortened by changing the vertical curvature of the conventional punch head rim. However, this approach is not enough to replicate the consolidation time. A secondary two-stage SAS punch design and an embossed punch head was designed to replicate the consolidation and dwell times on a laboratory tablet press to match those of a commercial tablet press. The resulting tablet thickness using this second SAS punch on a laboratory tablet press was thicker than when using a conventional punch in the same laboratory tablet press. The secondary SAS punches are more useful tools for replicating and understanding potential scale-up issues. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci.

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

    MedlinePlus

    ... A biopsy also helps your doctor determine how aggressive your cancer is — the cancer's grade. The grade ... grade (grade 1) cancers are generally the least aggressive and high-grade (grade 4) cancers are generally ...

  1. [Pulmonary needle biopsy in children].

    PubMed

    Gerbeaux, J

    1975-01-01

    Pulmonary biopsy done with a needle of circular bore, can be performed on very young children. A sample of tissue, big enough to establish a precise diagnosis in 2/3 of cases, can be obtained. The main complication is pneumothorax occuring about once in five. Hemoptysia or hemorrhage has never been observed. A proposed indication of premortem biopsy accelerated the death of a child with congenital pulmonary fibrosis. The search of a diagnosis in diffuse pulmonary diseases is the major indication for pulmonary biopsy in the child.

  2. For Women Facing a Breast Biopsy

    MedlinePlus

    ... thinner than the one used for blood tests. Core needle biopsy A core biopsy uses a larger needle to sample breast ... or CT scan. Another way to do a core biopsy is known as vacuum-assisted. Surgical (open) ...

  3. Gram stain of tissue biopsy

    MedlinePlus

    ... an excellent technique for making a general, basic identification of the type of bacteria in the sample. ... A.M. Editorial team. Related MedlinePlus Health Topics Bacterial Infections Biopsy Browse the Encyclopedia A.D.A. ...

  4. Gastric tissue biopsy and culture

    MedlinePlus

    ... Mean Abnormal results may be due to: Stomach (gastric) cancer Gastritis , when the lining of the stomach becomes ... team. Related MedlinePlus Health Topics Biopsy Peptic Ulcer Stomach Cancer Stomach Disorders Browse the Encyclopedia A.D.A. ...

  5. [Optimized standards for prostate biopsy].

    PubMed

    Wullich, B; Füssel, S; Grobholz, R

    2007-06-01

    As individual risk assessment mainly depends on the correct prediction of the tumor's biological behavior, primary diagnosis plays a key role in the clinical management of prostate cancer patients. Prostate core needle biopsy, as a primary diagnostic tool, should not only confirm clinical suspicion but also supply the urologist with information which is necessary for risk-adapted therapy. The experience and competence of both the urologist and the pathologist are crucial for the quality of prostate core needle biopsy diagnosis. Optimized handling and submission of prostate core needle biopsy specimens by the urologist to the pathologist are of outstanding importance for improving the number of cancer cases detected. Increasing availability of molecular markers leads to the necessity of developing new tissue sampling procedures which allow prostate core needle biopsy specimens to be simultaneously studied histologically and by molecular approaches.

  6. Correlation Between Shear Punch and Tensile Strength for Low-Carbon Steel and Stainless Steel Sheets

    NASA Astrophysics Data System (ADS)

    Mahmudi, R.; Sadeghi, M.

    2013-02-01

    The deformation behavior of AISI 1015 low-carbon steel, and AISI 304 stainless steel sheets was investigated by uniaxial tension and the shear punch test (SPT). Both materials were cold rolled to an 80% thickness reduction and subsequently annealed in the temperature range 25-850 °C to produce a wide range of yield and ultimate strength levels. The correlations between shear punch and tensile yield and ultimate stresses were established empirically. Different linear relationships having different slopes and intercepts were found for the low-carbon and stainless steel sheets, and the possible parameters affecting the correlation were discussed. It was shown that, within limits, yield and tensile strength of thin steel sheets can be predicted from the shear data obtained by the easy-to-perform SPT.

  7. [Possibilities for injuries caused by rubber bullets from the self-defense weapon MR 35 Punch].

    PubMed

    Schyma, C; Schyma, P

    1997-01-01

    Manurhin developed a "non lethal" weapon, the MR 35 Punch, which fires 21 g weighing rubber balls of 35 mm caliber. The black powder cartridges which were used as propellant cause important variations of the projectile's velocity from 120 to 140 m/s. The resulting energies were about 150 to 200 J. The wounding potential was examined by shots on different materials and gelatin. Shots from 2 to 5 m distance caused penetrations of 3 to 8 cm in 10 percent gelatin. Covering the gelatin with skin or thick textiles did not significantly change the penetration. Skin and textiles were penetrated in all experiments. Pieces of flat bone which were embedded in gelatin were fractured by the shots, in part fracture elements were dislocated. The discussion of the wound ballistic results contradict the "non lethal" character of the MR 35 Punch.

  8. The development of a tensile-shear punch correlation for yield properties of model austenitic alloys

    SciTech Connect

    Hankin, G.L.; Faulkner, R.G.; Hamilton, M.L.; Garner, F.A.

    1997-08-01

    The effective shear yield and maximum strengths of a set of neutron-irradiated, isotopically tailored austentic alloys were evaluated using the shear punch test. The dependence on composition and neutron dose showed the same trends as were observed in the corresponding miniature tensile specimen study conducted earlier. A single tensile-shear punch correlation was developed for the three alloys in which the maximum shear stress or Tresca criterion was successfully applied to predict the slope. The correlation will predict the tensile yield strength of the three different austenitic alloys tested to within {+-}53 MPa. The accuracy of the correlation improves with increasing material strength, to within {+-} MPa for predicting tensile yield strengths in the range of 400-800 MPa.

  9. Analysis of ancient Indian silver punch-marked coins by external PIXE.

    PubMed

    Rautray, Tapash R; Nayak, Suman S; Tripathy, Bipin B; Das, Saubhagyalaxmi; Das, Manas R; Das, Satya R; Chattopadhyay, Pranab K

    2011-10-01

    Seven silver punch-marked coins were analysed using external particle induced X-ray emission technique. The main group of elements like Ag, Cu, Au, Pb and Fe were estimated along with a number of trace/minor elements such as K, Ca, Ti, V, Cr, Mn, Co, Ni and Rb in the analysed silver coins. Gold was found in all the coins and varied between 0.7% and 6.2% indicating the better economic condition of that civilisation.

  10. [Liquid Biopsy and Laboratory Medicine].

    PubMed

    Furuta, Koh

    2015-09-01

    Recent progress in cancer biology has revealed the fact that molecular profiles of primary and metastatic cancer are not necessarily the same. Furthermore, evidence of intra-tumor heterogeneity has been disclosed repeatedly. In addition to these, acquiring resistances to chemoradiation therapy is far more rapid than typical predictions. Under these circumstances, physicians are realizing that one biopsy is not enough to predict the direction of cancer progression or extension. Repeated biopsy was proposed in this context. For "re-biopsy", acquiring blood is much easier compared to regular biopsies of acquiring body tissues. Therefore, CTC or Cell-free DNA is one of the hot topics in clinical and molecular diagnostic fields. The term "liquid biopsy" is used to include these two materials. We utilized a CTC isolation device based on microfluidic principles. Procedures for the extraction of DNA from plasma (Cell-free DNA) is also available. Based on this background, we performed a feasibility study of NGS (Next Generation Sequencing) by analyzing materials from advanced gastrointestinal cancer patients. We have successfully acquired NGS results using these liquid biopsies. We have also investigated the possibility of storing CTCs by evaluating procedures after cytospin using H1975 cells with various fixation conditions under a DIC microscope examination. Because of the paucity of the number of isolated CTCs, H1975 cells were used for this purpose. After cytospin, 95% ETOH and then -80 degrees C storage provided the best results. Attempts at not only NGS but also storage in this sequence of studies have opened new fields of liquid biopsy in clinical laboratories.

  11. Using Teamcenter engineering software for a successive punching tool lifecycle management

    NASA Astrophysics Data System (ADS)

    Blaga, F.; Pele, A.-V.; Stǎnǎşel, I.; Buidoş, T.; Hule, V.

    2015-11-01

    The paper presents studies and researches results of the implementation of Teamcenter (TC) integrated management of a product lifecycle, in a virtual enterprise. The results are able to be implemented also in a real enterprise. The product was considered a successive punching and cutting tool, designed to materialize a metal sheet part. The paper defines the technical documentation flow (flow of information) in the process of constructive computer aided design of the tool. After the design phase is completed a list of parts is generated containing standard or manufactured components (BOM, Bill of Materials). The BOM may be exported to MS Excel (.xls) format and can be transferred to other departments of the company in order to supply the necessary materials and resources to achieve the final product. This paper describes the procedure to modify or change certain dimensions of sheet metal part obtained by punching. After 3D and 2D design, the digital prototype of punching tool moves to following lifecycle phase of the manufacturing process. For each operation of the technological process the corresponding phases are described in detail. Teamcenter enables to describe manufacturing company structure, underlying workstations that carry out various operations of manufacturing process. The paper revealed that the implementation of Teamcenter PDM in a company, improves efficiency of managing product information, eliminating time working with search, verification and correction of documentation, while ensuring the uniqueness and completeness of the product data.

  12. How Boxers Decide to Punch a Target: Emergent Behaviour in Nonlinear Dynamical Movement Systems

    PubMed Central

    Hristovski, Robert; Davids, Keith; Araújo, Duarte; Button, Chris

    2006-01-01

    Previous research has shown how dynamical systems theory provides a relevant framework for investigating decision-making behavior in sport. The aim of this study was to adopt concepts and tools from nonlinear dynamics in examining effects of boxer-target distance and perceived punching efficiency on emergent decision-making during a typical practice task in boxing. Results revealed the existence of critical values of scaled distances between boxers and targets for first time appearance and disappearance of a diverse range of boxing actions including jabs, hooks and uppercuts. Reasons for the diversity of actions were twofold: i) abrupt (qualitative) changes in the number of the possible punches, i.e. motor solutions to the hitting task; and ii), fine modification of the probabilities of selecting specific striking patterns. Boxers were able to exploit the emerging perception of strikeability, leading to a changing diversity of selected actions and a cascade of abrupt changes in the perceptual-motor work space of the task. Perceived efficiency of a punching action by the participants also changed as a function of the scaled distance to a target and was correlated with the probability of occurrence of specific boxing actions. Accordingly, scaled distance-dependent perceived efficiency seems an important perceptual constraint in the training task of punching a heavy bag in boxers. Key Points During the practicing with static (i.e. non moving) heavy bags novice boxers' perceptual-action system is sensitive to the scaled distance and efficiency informational constraints. These interdependent constraints shape the action behaviour of the novice boxers; During heavy bag practice novice boxers are subject to a kind of discovery learning by exploring the efficiency of their motor repertoire when changing the performer - target distances; The region close to D = 0.6 maximizes the flexibility of switching among different types of punching actions and is optimal for practicing

  13. Update on Renal Mass Biopsy.

    PubMed

    Haifler, Miki; Kutikov, Alexander

    2017-04-01

    Renal masses are diagnosed with an increasing frequency. However, a significant proportion of these masses are benign, and the majority of malignant tumors are biologically indolent. Furthermore, renal tumors are often harbored by the elderly and comorbid patients. As such, matching of renal tumor biology to appropriate treatment intensity is an urgent clinical need. Renal mass biopsy is currently a very useful clinical tool that can assist with critical clinical decision-making in patients with renal mass. Yet, renal mass biopsy is associated with limitations and, as such, may not be appropriate for all patients.

  14. Laparotomic Approach for Collecting Serial Hepatic Biopsies in Rats (Rattus norvegicus) and Mice (Mus musculus)

    PubMed Central

    Garofalo, Jennifer-Marie; Black, Sasha P; Martin, Lisa B

    2016-01-01

    Researchers often consult with laboratory animal veterinarians for suggestions on how to improve their protocols. We assisted a researcher in performing serial liver biopsies in rats (Rattus norvegicus) to assess the transport of iron on a cellular level. We developed a novel collection approach that used laparotomy through a midline abdominal incision and disposable biopsy punches to obtain liver samples at 3 different times at various intervals. We hypothesized the survival of the subjects undergoing the multiple survival procedures would be independent of the weight loss or gain sustained throughout the study. Although 2 rats died during the study, the results were statistically significant with regard to survival when comparing the Belgrade rats to the Sprague Dawley rats and Swiss Webster mice and were independent of the weight loss or gain incurred during the study. We also performed a pilot study in mice (Mus musculus), using the same method as in the rats, with equivalent results. Our study showed the survival of rodents that underwent multiple laparotomies and liver biopsies was independent of the weight gain or loss throughout the study. PMID:27177568

  15. Vacuum Enhanced Cutaneous Biopsy Instrument

    SciTech Connect

    Collins, Joseph

    1999-06-25

    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. Biopsy techniques for intraocular tumors

    PubMed Central

    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

  17. Vacuum enhanced cutaneous biopsy instrument

    DOEpatents

    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.

  18. The cutaneous nerve biopsy: technical aspects, indications, and contribution.

    PubMed

    Mellgren, Svein Ivar; Nolano, Maria; Sommer, Claudia

    2013-01-01

    Skin biopsy with a 3mm disposable circular punch is easy to perform and allows, after proper processing, the visualization of epidermal, dermal, and sweat gland nerve fibers. A technique of sampling the epidermis alone by applying a suction capsule, the "blister" technique, has also been developed. It is most common to stain immunohistochemically for the pan-axonal marker protein gene product 9.5 (PGP 9.5), an ubiquitin C-terminal hydroxylase. The sections are then observed and analyzed with bright-field microscopy or with indirect immunofluorescence with or without confocal microscopy. Most studies report quantification of intraepidermal nerve fiber density displayed in bright-field microscopy. Normative values have been established, particularly from the distal part of the leg, 10cm above the external malleolus. In diabetes mellitus early degeneration of intraepidermal nerve fibers is induced and there is slower regeneration even when there is no evidence of neuropathy. Skin biopsy is of particular value in the diagnosis of small fiber neuropathy when nerve conduction studies are normal. It may also be repeated in order to study the progressive nature of the disease and also has the potential of studying regeneration of nerve fibers and thus the effects of treatment. Inflammatory demyelinating neuropathies may also involve loss of small-diameter nerve fibers and IgM deposits in dermal myelinated nerve fibers in anti-MAG neuropathy. In some cases the presence of vasculitis in skin may indicate a nonsystemic vasculitic neuropathy and in HIV neuropathy intraepidermal nerve fiber density is reduced in a length-dependent manner. In several hereditary neuropathies intraepidermal nerve fiber density may be reduced but other abnormalities can also be demonstrated in dermal myelinated fibers. Some small swellings and varicosities may be present in the distal leg skin biopsy of healthy individuals but large axonal swellings are considered as evidence of a pathological

  19. Joint punching and frequency effects on practical magnetic characteristics of electrical steels for high-speed machines

    NASA Astrophysics Data System (ADS)

    Kedous-Lebouc, A.; Messal, O.; Youmssi, A.

    2017-03-01

    Mechanical punching of electrical steels causes a degradation of their magnetic characteristics which can extend several millimeters from the cut edge. So, in the field of industrial applications, particularly that of small electrical machines, the stator core made of rigid and thin teeth would be subject to more losses. Thus, this topic of the effect of punching has to be submitted to further deep characterization and development in order to give some insight into the different mechanisms. In this framework, this paper evaluates the combined effect of punching and frequency on the magnetization curve and iron losses in thin SiFe and CoFe soft magnetic sheets. These alloys are typically suitable for the manufacture of high-speed electrical machines used in on board applications (aircraft power generators, automotive, etc). Two SiFe alloys and a CoFe alloy have been investigated. First, different rectangular samples of variable width (15, 10, 5, 3 mm) have been industrially punched. Then, a dedicated magnetic characterization has been made, using basically a mini-Epstein frame. Measurements have been performed from 50 Hz to 1 kHz and from 0.3 T to near saturation. Both rolling and transverse directions have been considered. Finally, a first attempt to predict the degradation due to the punching is presented. A useful description of the magnetic permeability as a function of B and f is given and the degradation parameters are estimated based on the knowledge of the reference permeability.

  20. Cracking the code: a decode strategy for the international business machines punch cards of Korean war soldiers.

    PubMed

    Mitsunaga, Erin M

    2006-05-01

    During the Korean War, International Business Machines (IBM) punch cards were created for every individual involved in military combat. Each card contained all pertinent personal information about the individual and was utilized to keep track of all soldiers involved. However, at present, all of the information known about these punch cards reveals only their format and their significance; there is little to no information on how these cards were created or how to interpret the information contained without the aid of the computer system used during the war. Today, it is believed there is no one available to explain this computerized system, nor do the original computers exist. This decode strategy is the result of an attempt to decipher the information on these cards through the use of all available medical and dental records for each individual examined. By cross-referencing the relevant personal information with the known format of the cards, a basic guess-and-check method was utilized. After examining hundreds of IBM punch cards, however, it has become clear that the punch card method of recording information was not infallible. In some cases, there are gaps of information on cards where there are data recorded on personal records; in others, information is punched incorrectly onto the cards, perhaps as the result of a transcription error. Taken all together, it is clear that the information contained on each individual's card should be taken solely as another form of personal documentation.

  1. Paraprofessional Punch.

    ERIC Educational Resources Information Center

    Konkel, Mary S.

    This paper presents an outline for a plan for increasing OCLC cataloging statistics in the monograph cataloging unit of a medium-to-large academic library, along with the evaluation process used to achieve this goal. The focus of the plan was on a group of upper level paraprofessional staff. First, OCLC cooperative cataloging was redefined to…

  2. Punch List

    ERIC Educational Resources Information Center

    Biemiller, Lawrence

    2008-01-01

    This article features university architect Ron McCoy and describes his work at the Arizona State University (ASU). McCoy, now on his fifth year of overseeing construction on all four Arizona State campuses, came to ASU 14 years ago as a professor and director of the School of Architecture and Landscape Architecture. He was thinking seriously about…

  3. Punching Out.

    ERIC Educational Resources Information Center

    Hill, David

    2000-01-01

    Presents the story of the number one for-profit school in the United States, the Thomas A. Edison Charter Academy. Teachers had a heavier workload, but better pay and perks. Shortly after opening, many teachers were discontent with the long days and calendar, lack of follow through on promised benefits, and other issues. Reactions to this…

  4. Biopsies

    MedlinePlus

    ... taking, including blood thinners such as aspirin and herbal supplements, and whether you have any allergies – especially to ... doctor all medications that you are taking, including herbal supplements, and if you have any allergies, especially to ...

  5. Biopsy

    MedlinePlus

    ... Foundation for Osteopathic Dermatology What is the FOD? Governance By-Laws Committees Committee Service Conflict of Interest ... quality of the sections is not nearly as good as those of the regular ('permanent') slides. PATHOLOGIC ...

  6. Liquid biopsy in liver cancer.

    PubMed

    Labgaa, Ismail; Villanueva, Augusto

    2015-04-01

    Liver cancer has become the second cause of cancer-related death worldwide. Most patients are still diagnosed at intermediate or advanced stage, where potentially curative treatment options are not recommended. Unlike other solid tumors, there are no validated oncogenic addiction loops and the only systemic agent to improve survival in advanced disease is sorafenib. All phase 3 clinical trials testing molecular therapies after sorafenib have been negative, none of which selected patients based on predictive biomarkers of response. Theoretically, analysis of circulating cancer byproducts (e.g., circulating tumor cells, cell-free nucleic acids), namely "liquid biopsy," could provide easy access to molecular tumor information, improve patients' stratification and allow to assess tumor dynamics over time. Recent technical developments and preliminary data from other malignancies indicate that liquid biopsy might have a role in the future management of cancer patients.

  7. Testing Biopsy and Cytology Specimens for Cancer

    MedlinePlus

    ... Exams and Tests for Cancer Testing Biopsy and Cytology Specimens for Cancer Waiting to hear a possible ... best decisions about your treatment. Testing Biopsy and Cytology Specimens for Cancer How is cancer diagnosed? Types ...

  8. "One can't shake off the women": images of sport and gender in Punch, 1901-10.

    PubMed

    Constanzo, Marilyn

    2002-01-01

    Examining the manner in which the popular press portrayed middle-class Edwardian women's activity in sport provides insight into the social liberation of English women. The popular middle-class British journal Punch included thousands of images of sportswomen. Despite the misogynistic satirizing of inept women, Punch's cartoons and articles depict distinct changes in women's behavior and social expectations that are linked to their increasing involvement in sport. By engaging in sport, women unconsciously challenged and permanently altered the pervasive middle-class Victorian ideology. The contents of Punch suggests that middle-class women's participation in sport, though perhaps begun in a conservative manner, completely altered and expanded their social role and changed the traditional image of womanhood.

  9. Assessment of the constitutive law by inverse methodology: Small punch test and hardness

    NASA Astrophysics Data System (ADS)

    Isselin, J.; Iost, A.; Golek, J.; Najjar, D.; Bigerelle, M.

    2006-06-01

    The relevance of small-punch tests and indentation (hardness) tests are compared with regard to the determination of a constitutive law in the case of non active ferrite-bainite steel taken from a French power plant. Firstly, small-punch tests were performed on material samples and the load deflection curves were compared with finite element calculations using the FORGE2 Standard code. As a result the strength coefficient and the strain hardening exponent of Hollomon's constitutive law were determined by an inverse method (Simplex method). Besides, it was shown that a three-parameter constitutive law such as Ludwik Hollomon's leads to an indetermination since its parameters are correlated with each other. Secondly indentation tests were performed with a ball indenter and the parameters of the constitutive law were determined from the analysis of the load-indentation depth curves. Both methods give results in good agreement with the true stress-true strain curve obtained by classical tensile testing, thus proving their applicability to nuclear materials.

  10. Stress concentration in periodically rough Hertzian contact: Hertz to soft-flat-punch transition

    NASA Astrophysics Data System (ADS)

    Ledesma-Alonso, R.; Raphaël, E.; Léger, L.; Restagno, F.; Poulard, C.

    2016-09-01

    We report on the elastic contact between a spherical lens and a patterned substrate, composed of a hexagonal lattice of cylindrical pillars. The stress field and the size of the contact area are obtained by means of numerical methods: a superposition method of discrete pressure elements and an iterative bisection-like method. For small indentations, a transition from a Hertzian to a soft-flat-punch behaviour is observed when the surface fraction of the substrate that is covered by the pillars is increased. In particular, we present a master curve defined by two dimensionless parameters, which allows one to predict the stress at the centre of the contact region in terms of the surface fraction occupied by pillars. The transition between the limiting contact regimes, Hertzian and soft-flat-punch, is well described by a rational function. Additionally, a simple model to describe the Boussinesq-Cerruti-like contact between the lens and a single elastic pillar, which takes into account the pillar geometry and the elastic properties of the two bodies, is presented.

  11. Effects of sparring load on reaction speed and punch force during the pre-competition and competition periods in boxing.

    PubMed

    Hukkanen, Esa; Häkkinen, Keijo

    2017-03-08

    Seven male national team level boxers (age 20.3±2.7 years, height 1.80±0.06 m, mass 73.8±11.1 kg) participated in this study to investigate effects of sparring on reaction time and punch force of straight punches measured during the pre-competition and competition periods. Heart rate and blood lactate concentrations were also monitored. Sparring load was chosen in accordance with the current rules (AIBA) 3x3 minute bouts with one minute break in between. Reaction time of rear straight lengthened (p<0.01) during the sparring load of the pre-competition period after the third round (to 390 ms) in comparison to the competition period (to 310 ms). Reaction time of lead straight lengthened (p<0.05) between the 1st and 3rd round during the pre-competition with no differences during the competition period. Both rear and lead straight punch forces were greater at all measurement points during the pre-competition compared to the competition period. Punch forces increased for both rear and lead straight between the 1st and 3rd round with the highest forces after 3rd round during the pre- (rear straight 209 kg) and competition period (rear straight 176 kg). Blood lactate levels increased after every round during both periods being at its greatest after the 3rd round (17 mmol·L during the pre-competition and 13 mmol·L during the competition period). The present sparring-induced differences in reaction time and punch forces of straight punches during the pre-competition compared to the competition period may be due to different volume and intensity of training with different goals in boxing-specific and explosive strength training.

  12. Predicting punching acceleration from selected strength and power variables in elite karate athletes: a multiple regression analysis.

    PubMed

    Loturco, Irineu; Artioli, Guilherme Giannini; Kobal, Ronaldo; Gil, Saulo; Franchini, Emerson

    2014-07-01

    This study investigated the relationship between punching acceleration and selected strength and power variables in 19 professional karate athletes from the Brazilian National Team (9 men and 10 women; age, 23 ± 3 years; height, 1.71 ± 0.09 m; and body mass [BM], 67.34 ± 13.44 kg). Punching acceleration was assessed under 4 different conditions in a randomized order: (a) fixed distance aiming to attain maximum speed (FS), (b) fixed distance aiming to attain maximum impact (FI), (c) self-selected distance aiming to attain maximum speed, and (d) self-selected distance aiming to attain maximum impact. The selected strength and power variables were as follows: maximal dynamic strength in bench press and squat-machine, squat and countermovement jump height, mean propulsive power in bench throw and jump squat, and mean propulsive velocity in jump squat with 40% of BM. Upper- and lower-body power and maximal dynamic strength variables were positively correlated to punch acceleration in all conditions. Multiple regression analysis also revealed predictive variables: relative mean propulsive power in squat jump (W·kg-1), and maximal dynamic strength 1 repetition maximum in both bench press and squat-machine exercises. An impact-oriented instruction and a self-selected distance to start the movement seem to be crucial to reach the highest acceleration during punching execution. This investigation, while demonstrating strong correlations between punching acceleration and strength-power variables, also provides important information for coaches, especially for designing better training strategies to improve punching speed.

  13. Recurrence of breast carcinoma as Paget disease of the skin at a prior core needle biopsy site: Case report and review of the literature

    PubMed Central

    Calvillo, Katherina Zabicki; Guo, Lifei; Brostrom, Valerie; Schnitt, Stuart J.; Hong, Xuefei; Raza, Sughra; Lester, Susan C.

    2015-01-01

    Introduction Core needle biopsy has become the preferred method of diagnosing breast carcinomas prior to definitive surgery. The possibility of displacing tumor cells into the needle track is a concern. Presentation of case A 38 year old woman was diagnosed with right breast ductal carcinoma in situ (DCIS) with microinvasion by core needle biopsy. Bilateral skin sparing mastectomies with immediate autologous reconstruction were performed. One and a half years later the patient noted erythema and a scaling crust on the skin of the right breast that progressed over several months. Punch biopsy revealed Paget disease restricted to the epidermis. Subsequent comparison to initial clinical photographs confirmed the cancer was associated with the skin puncture site of the needle biopsy. The patient underwent complete excision with skin grafting and remains free of disease three years later. Discussion Only 13 cases of needle track recurrences have been reported. The majority presented as invasive carcinoma forming a subcutaneous mass. In the current case, detection was delayed due to not initially noting that a skin lesion was at the puncture site of the original needle biopsy. This is the only case of recurrence as tumor limited to the epidermis. Conclusion Although recurrence in a needle track occurs very infrequently, clinicians should be aware of this phenomenon and investigate any changes, particularly when occurring at a needle biopsy site. Recording the skin puncture site can aid in early detection of recurrences. Recognition of a recurrence is important for prompt treatment and optimal prognosis. PMID:26395914

  14. Methylation analyses in liquid biopsy

    PubMed Central

    Lissa, Delphine

    2016-01-01

    Lung cancer is the leading cause of cancer-related deaths worldwide. Recent implementation of low-dose computed tomography (LDCT) screening is predicted to lead to diagnosis of lung cancer at an earlier stage, with survival benefit. However, there is still a pressing need for biomarkers that will identify individuals eligible for screening, as well as improve the diagnostic accuracy of LDCT. In addition, biomarkers for prognostic stratification of patients with early stage disease, and those that can be used as surrogates to monitor tumor evolution, will greatly improve clinical management. Molecular alterations found in the DNA of tumor cells, such as mutations, translocations and methylation, are reflected in DNA that is released from the tumor into the bloodstream. Thus, in recent years, circulating tumor DNA (ctDNA) has gained increasing attention as a noninvasive alternative to tissue biopsies and potential surrogate for the entire tumor genome. Activating gene mutations found in ctDNA have been proven effective in predicting response to targeted therapy. Analysis of ctDNA is also a valuable tool for longitudinal follow-up of cancer patients that does not require serial biopsies and may anticipate the acquisition of resistance. DNA methylation has also emerged as a promising marker for early detection, prognosis and real-time follow-up of tumor dynamics that is independent of the genomic composition of the primary tumor. This review summarizes the various investigational applications of methylated ctDNA in lung cancer reported to date. It also provides a brief overview of the technologies for analysis of DNA methylation in liquid biopsies, and the challenges that befall the implementation of methylated ctDNA into routine clinical practice. PMID:27826530

  15. In-bore setup and software for 3T MRI-guided transperineal prostate biopsy

    NASA Astrophysics Data System (ADS)

    Tokuda, Junichi; Tuncali, Kemal; Iordachita, Iulian; Song, Sang-Eun; Fedorov, Andriy; Oguro, Sota; Lasso, Andras; Fennessy, Fiona M.; Tempany, Clare M.; Hata, Nobuhiko

    2012-09-01

    MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 T MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with a Z-frame that gives a physician access to the perineum of the patient at the imaging position and allows the physician to perform MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right-left (RP) and anterior-posterior (AP) axes were 1.1 ± 0.8 and 1.4 ± 1.1 mm, respectively, while the rotational errors around the RL, AP and superior-inferior axes were (0.8 ± 1.0)°, (1.7 ± 1.6)° and (0.0 ± 0.0)°, respectively. The 2D root-mean-square (RMS) needle-placement error was 3 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle-placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop setup and software, which supports manual needle placement without moving the patient out of the magnet.

  16. In-bore setup and Software for 3T MRI-guided Transperineal Prostate Biopsy

    PubMed Central

    Tokuda, Junichi; Tuncali, Kemal; Iordachita, Iulian; Song, Sang-Eun; Fedorov, Andriy; Oguro, Sota; Lasso, Andras; Fennessy, Fiona M; Tempany, Clare M; Hata, Nobuhiko

    2012-01-01

    MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 Tesla (T) MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with Z-frame that give a physician access to the perineum of the patient at the imaging position and allow performance of MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning, and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right-left (RP) and anterior-posterior (AP) axes were 1.1 ± 0.8 mm and 1.4 ± 1.1 mm respectively, while the rotational errors around the RL, AP, and superior-inferior axes were 0.8 ± 1.0 degrees, 1.7 ± 1.6 degrees, and 0.0 ± 0.0 degrees respectively. The 2D root-mean-square (RMS) needle placement error was 3.0 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop set up and software, which supports manual needle placement without moving the patient out of the magnet. PMID:22951350

  17. Basics of kidney biopsy: A nephrologist's perspective

    PubMed Central

    Agarwal, S. K.; Sethi, S.; Dinda, A. K.

    2013-01-01

    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. PMID:23960337

  18. Punch stretching process monitoring using acoustic emission signal analysis. II - Application of frequency domain deconvolution

    NASA Technical Reports Server (NTRS)

    Liang, Steven Y.; Dornfeld, David A.; Nickerson, Jackson A.

    1987-01-01

    The coloring effect on the acoustic emission signal due to the frequency response of the data acquisition/processing instrumentation may bias the interpretation of AE signal characteristics. In this paper, a frequency domain deconvolution technique, which involves the identification of the instrumentation transfer functions and multiplication of the AE signal spectrum by the inverse of these system functions, has been carried out. In this way, the change in AE signal characteristics can be better interpreted as the result of the change in only the states of the process. Punch stretching process was used as an example to demonstrate the application of the technique. Results showed that, through the deconvolution, the frequency characteristics of AE signals generated during the stretching became more distinctive and can be more effectively used as tools for process monitoring.

  19. Development of small punch testing technique and its application to evaluation of mechanical properties degradation

    SciTech Connect

    Kameda, J.

    1993-10-01

    The present paper summarizes a small punch (SP) testing technique developed and its application to mechanical properties characterization. It has been clearly shown on ferritic alloys that the SP test was evaluate the intergranular embrittling potency of segregated solute, such as P, Sn and Sb causing temper embrittlement, and the effects of neutron irradiation and post-irradiation annealing, giving rise to changes in the hardness and intergranular solute segregation, on the fracture properties in terms of the ductile-brittle transition temperature (DBTT). A linear relation of the DBTT determined by the SP test to that by Charpy V-notched tests has been theoretically and experimentally established. In Al alloy substrates coated with amorphous and overlaying ceramics, moreover, the global and local fracture properties were well characterized by the SP test together with acoustic emission techniques.

  20. Anisotropic mechanical properties of the MA956 ODS steel characterized by the small punch testing technique

    NASA Astrophysics Data System (ADS)

    Turba, K.; Hurst, R. C.; Hähner, P.

    2012-09-01

    The small punch testing technique was used to assess both creep and fracture properties of the MA956 oxide dispersion strengthened ferritic steel. The anisotropy in mechanical properties was addressed, as well as the alloy's susceptibility to thermal embrittlement. Strong anisotropy was found in the material's creep resistance at 725 °C for longer rupture times. Anisotropic behavior was also observed for the ductile-brittle transition temperature (DBTT). The origin of the anisotropy can be related to the strongly directional microstructure which enables a large amount of intergranular cracking during straining at both high and low temperatures. The DBTT of the alloy is very high, and can be further increased by at least 200 °C after 1000 h of ageing at 475 °C, due to the formation of the Cr-rich α' phase. The particularly high susceptibility of the MA956 to thermal embrittlement is mainly a consequence of its high chromium content.

  1. Methanogenic Activity and Structural Characteristics of the Microbial Biofilm On a Needle-Punched Polyester Support

    PubMed Central

    Harvey, Martin; Forsberg, Cecil W.; Beveridge, Terry J.; Pos, Jack; Ogilvie, John R.

    1984-01-01

    In a downflow stationary fixed-film anaerobic reactor receiving a swine waste influent, few bacteria were observed to be tightly adherent to the surfaces of the needle-punched polyester support material. However, there was a morphologically complex, dense population of bacteria trapped within the matrix. Frequently large microcolonies of a uniform morphological type of bacteria were observed. These were particularly evident for methanosarcina-like bacteria which grew forming large aggregates of unseparated cells. Leafy deposits of electron-dense, calcium- and phosphorus-enriched material coated the polyester matrix and some cells. As the biofilm matured there was more extensive mineral deposition which completely entrapped cells. The entrapped cells appeared to autolyze, and many were partially degraded. Further impregnation of the matrix with minerals and apparent cell death may eventually have a deleterious effect on the methanogenic activity of the biofilm. Images PMID:16346629

  2. Galenic approaches in troubleshooting of glibenclamide tablet adhesion in compression machine punches

    PubMed Central

    Boniatti, Janine; Pereira Cerqueira, Ana Lúcia; de Souza, Alexandre Carnevale; Drago Hoffmeister, Cristiane Rodrigues; da Costa, Maira Assis; Prado, Livia Deris; Tasso, Leandro; Antunes Rocha, Helvécio Vinícius

    2013-01-01

    This study aimed to examine the adhesion of glibenclamide 5 mg tablets to the tools of compression machines. This problem is not commonly reported in the literature, since it is considered as tacit knowledge. The starting point was the implementation of three technical alternatives: changing the parameters of compression, evaluating the humidity of the powder blend and the manufacturer of the lubricant magnesium stearate. The adhesion was directly related to the characteristics of magnesium stearate from different manufacturers, and the feasibility of evaluating powder flow characteristics by different techniques that are not routinely followed in various pharmaceutical companies. In vitro dissolution tests showed that the magnesium stearate manufacturer can influence on the dissolution profile of glibenclamide tablets. This study presented various aspects of tablet adhesion to compression machine punches. Troubleshooting approaches can be, most of times, conducted based on previous experience, or an experimental research needs to be implemented in order to have confident results. PMID:25473333

  3. Image-Guided Adrenal and Renal Biopsy

    PubMed Central

    Sharma, Karun V.; Venkatesan, Aradhana M.; Swerdlow, Daniel; DaSilva, Daniel; Beck, Avi; Jain, Nidhi; Wood, Bradford J.

    2010-01-01

    Image-guided biopsy is a safe and well-established technique that is familiar to most interventional radiologists (IRs). Improvements in image-guidance, biopsy tools and biopsy techniques now routinely allow for safe biopsy of renal and adrenal lesions which traditionally were considered difficult to reach or technically challenging. Image-guided biopsy is used to establish the definitive tissue diagnosis in adrenal mass lesions that can not be fully characterized with imaging or laboratory tests alone. It is also used to establish definitive diagnosis in some cases of renal parenchymal disease and has an expanding role in diagnosis and characterization of renal masses prior to treatment. Although basic principles and techniques for image-guided needle biopsy are similar regardless of organ, this paper will highlight some technical considerations, indications and complications which are unique to the adrenal gland and kidney because of their anatomic location and physiologic features. PMID:20540919

  4. Photoacoustic biopsy: a feasibility study

    NASA Astrophysics Data System (ADS)

    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.

  5. Study on the effect of punched holes on flow structure and heat transfer of the plain fin with multi-row delta winglets

    NASA Astrophysics Data System (ADS)

    Tian, Liting; Liu, Bin; Min, Chunhua; Wang, Jin; He, Yaling

    2015-11-01

    Three dimensional numerical simulations are performed to investigate the flow and heat transfer characteristics of the plain fin with multi-row delta winglets punched out from the fin. The Reynolds number based on the tube outside diameter varies from 360 to 1440. The effects of punched holes and their orientations on flow structure and heat transfer are numerically studied. Results show that a down-wash flow is formed through the hole punched at the windward side, which has little influence on the longitudinal vortices in the main flow, and a longitudinal main vortex is formed behind each delta winglet. An up-wash flow is formed through the hole punched at the leeward side, the up-wash flow impinges the longitudinal vortices generated by the delta winglet, and then a counter-rotating pair of main vortices is generated behind each delta winglet. The windward punched holes have little effect on the flow friction and heat transfer of the plain fin with delta winglets, while the leeward punched holes deteriorate the heat transfer and decrease the flow friction of the fin channel, the Nusselt number decreases by 3.5-5.0 % with a corresponding decrease of 3.9-4.8 % in the friction factor. The effect of the punched holes on the heat transfer of the fin can be well explained by the field synergy principle. The overall analysis of the thermal performance is performed for all fin configurations, including the slit fins and the wavy fins with one-row delta winglets, the plain fin with the windward punched delta winglets shows the better thermal performance than one with the leeward punched delta winglets.

  6. A longitudinal study of sensory biomarkers of progression in patients with diabetic peripheral neuropathy using skin biopsies.

    PubMed

    Narayanaswamy, H; Facer, P; Misra, V P; Timmers, M; Byttebier, G; Meert, T; Anand, P

    2012-11-01

    We aimed to identify biomarkers in skin punch biopsies that could be used to monitor progression of diabetic peripheral neuropathy (DPN), and, in future studies, to assess the efficacy of agents that may reduce progression. Patients with DPN were studied with clinical assessments, skin biopsies, quantitative sensory testing (QST), histamine-induced skin flare, nerve conduction studies and contact heat-evoked potentials (CHEPS). Skin biopsies were performed on two visits with a 6 month interval (n=29 patients) to quantify intraepidermal (IENF) and subepidermal (SENF) nerve fibres immunoreactive for: protein gene product 9.5 (PGP9.5), a pan-neuronal marker; transient receptor potential cation channel vanilloid 1 (TRPV1), the heat and capsaicin receptor; and growth associated protein-43 (GAP-43), a marker of regenerating fibres. The IENF were counted along the length of four non-consecutive sections, and results were expressed as fibres per millimetre length of section. SENF were measured by image analysis, and the area of highlighted immunoreactivity was obtained as a percentage (% area) of the field scanned. QST, skin flare and CHEPS were also performed at the two visits. We found that IENF and SENF were significantly reduced for both PGP9.5 and TRPV1 between the first and second skin biopsy over 6months. The annual rate ± standard error of the mean of IENF loss was 3.76 ± 1.46 fibres/mm for PGP9.5, and 3.13 ± 0.58 fibres/mm for TRPV1. The other tests did not show significant changes. Strongly positive GAP-43 nerve fibres were found in deep dermis in the patients with diabetes, even in those with an absence of IENF. We conclude that PGP9.5 and TRPV1 IENF and SENF in skin biopsies are useful markers of progression in DPN, whereas GAP-43 SENF could potentially help detect nerve regeneration in severe neuropathy.

  7. Evaluation and comparison of current biopsy needle localization and tracking methods using 3D ultrasound.

    PubMed

    Zhao, Yue; Shen, Yi; Bernard, Adeline; Cachard, Christian; Liebgott, Hervé

    2017-01-01

    This article compares four different biopsy needle localization algorithms in both 3D and 4D situations to evaluate their accuracy and execution time. The localization algorithms were: Principle component analysis (PCA), random Hough transform (RHT), parallel integral projection (PIP) and ROI-RK (ROI based RANSAC and Kalman filter). To enhance the contrast of the biopsy needle and background tissue, a line filtering pre-processing step was implemented. To make the PCA, RHT and PIP algorithms comparable with the ROI-RK method, a region of interest (ROI) strategy was added. Simulated and ex-vivo data were used to evaluate the performance of the different biopsy needle localization algorithms. The resolutions of the sectorial and cylindrical volumes were 0.3mm×0.4mm×0.6mmand0.1mm×0.1mm×0.2mm (axial×lateral×azimuthal) respectively. In so far as the simulation and experimental results show, the ROI-RK method successfully located and tracked the biopsy needle in both 3D and 4D situations. The tip localization error was within 1.5mm and the axis accuracy was within 1.6mm. To the best of our knowledge, considering both localization accuracy and execution time, the ROI-RK was the most stable and time-saving method. Normally, accuracy comes at the expense of time. However, the ROI-RK method was able to locate the biopsy needle with high accuracy in real time, which makes it a promising method for clinical applications.

  8. Rectourethral fistula after repeat transrectal prostate biopsy.

    PubMed

    Loran, Oleg B; Veliev, Evgeny I; Sokolov, Egor A; Dadashev, Elmar O; Guspanov, Renat I

    2013-09-01

    Transrectal prostate biopsy is considered a relatively safe procedure, with a quite small number of complications. We report a patient with a rectourethral fistula after a repeat transrectal prostate biopsy. To our knowledge, this is the first incident in the published literature.

  9. The liquid biopsy in lung cancer.

    PubMed

    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.

  10. The liquid biopsy in lung cancer

    PubMed Central

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

    2016-01-01

    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. PMID:28191282

  11. [Experimental quality control of biopsy cannulas].

    PubMed

    Schild, H H; Michel, S G

    1993-09-01

    To examine the quality and comparability of biopsy needles. 310 biopsy needles of 40 types were examined microscopically and their suitability for penetrating tissues were studied. For this purpose the pressure required to penetrate a phantom was evaluated. The results were correlated with the diameter, design and construction. 50 of the 310 needles (16%) showed faults on microscopic examination. Measurements of identical needle types within a single production run showed variations in penetration pressures up to 330% (measured as force required for penetration), the average variation was 88%. The results show that the quality of biopsy needles is not constant and leaves something to be desired. To what extent variations in quality affect the biopsy material cannot be estimated. Nevertheless, the present results indicate that stricter quality control of biopsy needles is desirable.

  12. Transplant biopsy beyond light microscopy.

    PubMed

    Adam, Benjamin; Mengel, Michael

    2015-08-07

    Despite its long-standing status as the diagnostic "gold standard", the renal transplant biopsy is limited by a fundamental dependence on descriptive, empirically-derived consensus classification. The recent shift towards personalized medicine has resulted in an increased demand for precise, mechanism-based diagnoses, which is not fully met by the contemporary transplantation pathology standard of care. The expectation is that molecular techniques will provide novel pathogenetic insights that will allow for the identification of more accurate diagnostic, prognostic, and therapeutic targets. Here we review the current state of molecular renal transplantation pathology. Despite significant research activity and progress within the field, routine adoption of clinical molecular testing has not yet been achieved. The recent development of novel molecular platforms suitable for use with formalin-fixed paraffin-embedded tissue will offer potential solution for the major barriers to implementation. The recent incorporation of molecular diagnostic criteria into the 2013 Banff classification is a reflection of progress made and future directions in the area of molecular transplantation pathology. Transcripts related to endothelial injury and NK cell activation have consistently been shown to be associated with antibody-mediated rejection. Prospective multicenter validation and implementation of molecular diagnostics for major entities remains an unmet clinical need in transplantation. It is expected that an integrated system of transplantation pathology diagnosis comprising molecular, morphological, serological, and clinical variables will ultimately provide the greatest diagnostic precision.

  13. A study on rate sensitivity of elasto-plastic fracture toughness of TRIP steel evaluated by a small punch test

    NASA Astrophysics Data System (ADS)

    Iwamoto, T.; Hashimoto, S.-ya; Shi, L.

    2012-08-01

    TRIP steel indicates an excellent characteristic in energy absorption because of its high ductility and strength by strain-induced martensitic transformation (SIMT). Recently, some shock absorption members are being used for automotive industries. For good fuel consumption of the automobile, it would realize the weight reduction without decaying performance if TRIP steel can be applied to those members. It can be considered that the fracture toughness is an important factor to evaluate the performance. To evaluate fracture toughness locally at any point of a product of those members, small punch testing method is quite effective. In the present study, first, an impact small punch testing apparatus is established. In addition, elasto-plastic fracture toughness of TRIP steel under impact loading and its rate sensitivity tested at various deflection rates are challenged to evaluate.

  14. A Study on Segmented Multiple-Step Forming of Doubly Curved Thick Plate by Reconfigurable Multi-Punch Dies

    SciTech Connect

    Ko, Young Ho; Han, Myoung Soo; Han, Jong Man

    2007-05-17

    Doubly curved thick plate forming in shipbuilding industries is currently performed by a thermal forming process, called as Line Heating by using gas flame torches. Due to the empirical manual work of it, the industries are eager for an alternative way to manufacture curved thick plates for ships. It was envisaged in this study to manufacture doubly curved thick plates by the multi-punch die forming. Experiments and finite element analyses were conducted to evaluate the feasibility of the reconfigurable discrete die forming to the thick plates. Single and segmented multiple step forming procedures were considered from both forming efficiency and accuracy. Configuration of the multi-punch dies suitable for the segmented multiple step forming was also explored. As a result, Segmented multiple step forming with matched dies had a limited formability when the objective shapes become complicate, while a unmatched die configuration provided better possibility to manufacture large curved plates for ships.

  15. Influence of punch face angle and reduction on flow mode in backward and combined radial backward extrusion process

    NASA Astrophysics Data System (ADS)

    Noh, Jeong-hoon; Hwang, Beong Bok; Lee, Ho Yong

    2015-11-01

    This paper is concerned with the analysis on the flow mode which determines lubrication limit such as stiction onto or sliding over punch face. The main goal of this study is to examine the influence of geometrical parameters such as punch face angle, reduction in area, and the gap height in radial direction in backward and combined radial-backward extrusion process on the flow mode and surface stresses such as sliding velocity, sliding distance and surface expansion. Annealed steel 17Cr3 was selected as a model material, a rigid-plastic material, for simulation, which was conducted using a commercially available FEA tool, Deform 2-D, programmed in a rigid plasticity theory. Change of flow mode during deformation was also investigated to find under which conditions of process parameter adopted the flow mode changes from stiction to transition or transition to sliding. In this paper, sliding velocities were quantitatively analyzed to determine the flow mode.

  16. Reconciling species-level vs plastic responses of evergreen leaf structure to light gradients: shade leaves punch above their weight.

    PubMed

    Lusk, Christopher H; Onoda, Yusuke; Kooyman, Robert; Gutiérrez-Girón, Alba

    2010-04-01

    *When grown in a common light environment, the leaves of shade-tolerant evergreen trees have a larger leaf mass per unit area (LMA) than their light-demanding counterparts, associated with differences in lifespan. Yet plastic responses of LMA run counter to this pattern: shade leaves have smaller LMA than sun leaves, despite often living longer. *We measured LMA and cell wall content, and conducted punch and shear tests, on sun and shade leaves of 13 rainforest evergreens of differing shade tolerance, in order to understand adaptation vs plastic responses of leaf structure and biomechanics to shade. *Species shade tolerance and leaf mechanical properties correlated better with cell wall mass per unit area than with LMA. Growth light environment had less effect on leaf mechanics than on LMA: shade leaves had, on average, 40% lower LMA than sun leaves, but differences in work-to-shear, and especially force-to-punch, were smaller. This was associated with a slightly larger cell wall fraction in shade leaves. *The persistence of shade leaves might reflect unattractiveness to herbivores because they yield smaller benefits (cell contents per area) per unit fracture force than sun leaves. In forest trees, cell wall fraction and force-to-punch are more robust correlates of species light requirements than LMA.

  17. Universality of the diffusion wake from stopped and punch-through jets in heavy-ion collisions

    NASA Astrophysics Data System (ADS)

    Betz, Barbara; Noronha, Jorge; Torrieri, Giorgio; Gyulassy, Miklos; Mishustin, Igor; Rischke, Dirk H.

    2009-03-01

    We solve (3+1)-dimensional ideal hydrodynamical equations with source terms that describe punch-through and fully stopped jets to compare their final away-side angular correlations in a static medium. For fully stopped jets, the backreaction of the medium is described by a simple Bethe-Bloch-like model that leads to an explosive burst of energy and momentum (Bragg peak) close to the end of the jet's evolution through the medium. Surprisingly enough, we find that the medium's response and the corresponding away-side angular correlations are largely insensitive to whether the jet punches through or stops inside the medium. This result is also independent of whether momentum deposition is longitudinal (as generally occurs in pQCD energy loss models) or transverse (as the Bethe-Bloch formula implies). The existence of the diffusion wake is therefore shown to be universal to all scenarios where momentum as well as energy is deposited into the medium, which can readily be understood in ideal hydrodynamics through vorticity conservation. The particle yield coming from the strong forward moving diffusion wake that is formed in the wake of both punch-through and stopped jets largely overwhelms their weak Mach cone signal after freeze-out.

  18. Interaction of a rigid punch and a circular plate with a fixed side and a stress-free face

    NASA Astrophysics Data System (ADS)

    Bazarenko, N. A.

    2013-05-01

    The axisymmetric contact problem of a rigid punch indentation into an elastic circular plate with a fixed side and a stress-free face is considered. The problem is solved by a method developed for finite bodies which is based on the properties of a biorthogonal system of vector functions. The problem is reduced to a Volterra integral equation (IE) of the first kind for the contract pressure function and to a system of two Volterra IE of the first kind for functions describing the derivative of the displacement of the plate upper surface outside the punch and the normal (or tangential) stress on the plate lower fixed surface. The last two functions are sought as the sum of a trigonometric series and a power-law function with a root singularity. The obtained ill-conditioned systems of linear algebraic equations are regularized by introducing small parameters and have a stable solution. A method for solving the Volterra IE is given. The contact pressure functions, the normal and tangential stresses on the plate fixed surface, and the dimensionless indentation force are found. Several examples of a plane punch computation are given.

  19. Shear punch strength evaluation of nanocomposite and compomer, post-conditioning in dietary solvents – An in-vitro study

    PubMed Central

    Kaur, Harsimran; Singh, Harpreet; Vinod, K.S.; Singh, Baldeep; Arora, Rachita; Chatopaddhya, Sayan

    2014-01-01

    Background Perpetual research in esthetic dentistry has stupendously contributed in improving the mechanical and esthetic properties of restorative materials. Recently introduced nanocomposite claim to possess higher optimized esthetic and mechanical properties superior to other esthetic restorative materials in clinical use. It has been highlighted in many studies that intraoral degradation of composites is a consequence of both mechanical factors and chemical degradation. Thus, this in-vitro study was conducted to determine the strength of commonly used esthetic restorative materials after conditioning them in dietary solvents, thereby, simulating the intraoral environment. Aim Evaluation of shear punch strength of nanocomposite and compomer, post-conditioning in dietary solvents. Materials and methods Two test groups mentioned above, each containing sixty preconditioned samples, divided into four subgroups of fifteen samples each and conditioned in different dietary solvents, were subjected to shear punch test in custom designed shear punch apparatus in Universal Testing Machine. Results Among the dietary solvents, citric acid caused maximum decrease in the strength while conditioning in heptane showed increase in strength of the test restorative materials. Conclusion Nanocomposite revealed to have higher strength, thereby indicating its better application universally. PMID:25737916

  20. Prevention of sepsis prior to prostate biopsy

    PubMed Central

    Toner, Liam; Bolton, Damien M

    2016-01-01

    Purpose Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy. Materials and Methods A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria. Results Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel. Conclusions The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice. PMID:26981590

  1. How small can small be: the compound eye of the parasitoid wasp Trichogramma evanescens (Westwood, 1833) (Hymenoptera, Hexapoda), an insect of 0.3- to 0.4-mm total body size.

    PubMed

    Fischer, Stefan; Müller, Carsten H G; Meyer-Rochow, V Benno

    2011-07-01

    With a body length of only 0.3-0.4 mm, the parasitoid wasp Trichogramma evanescens (Westwood) is one of the smallest insects known. Yet, despite its diminutive size, it possesses compound eyes that are of oval shapes, measuring across their long axes in dorsoventral direction 63.39 and 71.11 μm in males and females, respectively. The corresponding facet diameters are 5.90 μm for males and 6.39 μm for females. Owing to the small radii of curvature of the eyes in males (34.59 μm) and females (42.82 μm), individual ommatidia are short with respective lengths of 24.29 and 34.97 μm. The eyes are of the apposition kind, and each ommatidium possesses four cone cells of the eucone type and a centrally fused rhabdom, which throughout its length is formed by no more than eight retinula cells. A ninth cell occupies the place of the eighth retinula cell in the distal third of the rhabdom. The cone is shielded by two primary and six secondary pigment cells, all with no apparent extensions to the basement membrane, unlike the case in larger hymenopterans. The regular and dense packing of the rhabdoms reflects an effective use of space. Calculations on the optics of the eyes of Trichogramma suggest that the eyes need not be diffraction limited, provided they use mostly shorter wavelengths, that is, UV light. Publications on the visual behavior of these wasps confirm Trichogramma's sensitivity to UV radiation. On the basis of our findings, some general functional conclusions for very small compound eyes are formulated.

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

    MedlinePlus

    ... Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy ... Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration ...

  3. Brain biopsy in benign neurological disease.

    PubMed

    Gilkes, C E; Love, S; Hardie, R J; Edwards, R J; Scolding, N J; Rice, C M

    2012-05-01

    Brain biopsy is well established in clinical practice when there is suspicion of CNS malignancy. However, there is little consensus regarding the indications for brain biopsy in non-malignant neurological disease. This is due in no small part to limitations in the available literature pertaining to diagnostic brain biopsies. The published evidence largely comprises small, retrospective, single-centre analyses performed over long time periods, including non-homogeneous patient groups with considerable variation in reported outcomes. Here we present pragmatic guidance for those clinicians considering diagnostic brain biopsy in a patient with non-neoplastic neurological disease and highlight practice points with the aim of maximising the probability of gaining clinically useful information from the procedure.

  4. [Cartilage biopsy for autologous chondrocyte implantation (ACI)].

    PubMed

    Pestka, J M; Salzmann, G M; Südkamp, N P; Niemeyer, P

    2013-06-01

    Autologous chondrocyte implantation (ACI) is an established two-step procedure for the treatment of full-thickness cartilage defects of the knee. Cartilage harvest from the affected knee joint represents the first step of this procedure and is essential for further in vitro expansion of autologous chondrocytes. Nevertheless, the cartilage biopsy process itself is underrepresented in the scientific literature and currently there is only a limited amount of data available addressing this process. Biopsy location as well as the technique itself and instruments used for cartilage collection are not well defined and only little standardisation can be found. The article describes the relevant aspects of the biopsy in the context of ACI with regard to the literature available. Follow-up studies to better define and standardise the cartilage biopsy process are thus required.

  5. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... miner who died prior to March 31, 1980, an autopsy or biopsy report shall be considered even when the... concerning a miner who died prior to March 31, 1980, shall be accorded the appropriate weight in light of...

  6. Magnetic Resonance (MR)-Guided Breast Biopsy

    MedlinePlus

    ... the Breast . top of page What does the equipment look like? The traditional MRI unit is a ... is used for a surgical biopsy. Other sterile equipment involved in this procedure includes syringes, sponges, forceps, ...

  7. Giardia lamblia trophozoites in gastric biopsies.

    PubMed

    Misra, Vatsala; Misra, S P; Dwivedi, Manisha; Singh, P A

    2006-10-01

    To assess the prevalence of gastric giardiasis in gastric biopsies of patients with carcinoma stomach and in patients taking treatment for duodenal ulcer. Gastric biopsy specimens from 54 patients of carcinoma stomach and 100 antral biopsies from patients taking treatment for duodenal ulcer were included in the study. Sections were stained with haematoxylin and eosin, methylene blue and May Grunwald-Giemsa stains and examined for presence of Giardia lamblia trophozoites. Eight out of 54 (14.9%) biopsies of gastric carcinoma patients harboured trophozoites of Giardia lamblia. Associated H. pylori infection was present in all biopsies (8/8; 100%). Atrophy and intestinal metaplasia was present in 62.5% (5/8) and 25% (2/8) cases respectively. Sections from seven out of 35 patients (20%) taking treatment for duodenal ulcer showed presence of G. lamblia. H. pylori infection, gastritis and atrophy were found in 85.7% (6/7), 71.4% (5/7) and 28.6% (2/7) cases respectively. First gastric biopsy in these patients was negative for G. lamblia but 2nd and 3rd biopsies were positive. A careful search for G. lamblia trophozoites should be made while examining the gastric biopsies, especially in patients with carcinoma stomach, intestinal metaplasia, atrophic gastritis and those taking treatment for duodenal ulcer. This may help in indirect diagnosis of clinically unsuspected cases of intestinal giardiasis and may explain persistence of vague upper gastrointestinal tract (UGIT) symptoms despite clearance of H. pylori in patients on anti-ulcer therapy.

  8. From testicular biopsy to human embryo.

    PubMed

    Jezek, D; Knezević, N; Kalanj-Bognar, S; Vukelić, Z; Krhen, I

    2004-01-01

    The aim of the study was to investigate the role of a testicular biopsy in the diagnosis and therapy of infertile men with a non-obstructive azoospermia. Overall, 70 testicular biopsies from infertile men were analysed. Samples were obtained by the "open testicular biopsy" method. After dissection, several pieces of the tissue were immediately immersed into the Sperm Prep Medium (Medi-Cult) and fixative (5.5% buffered glutaraldehyde). Tissue samples transported in Sperm Prep Medium were plunged into Sperm Freezing Medium (Medi-Cult) and were stored in liquid nitrogen for potential in vitro fertilization procedures. The tissue was also processed for semithin sections and transmission electron microscopy. Semithin sections from 8 infertile patients demonstrated regular testis structure and fully preserved spermatogenesis (control biopsies). In the remaining 62 cases, spermatogenesis was impaired and a variety of pathological changes could be seen: disorganization and desquamation of spermatogenic cells, spermatid or spermatocyte "stop", spermatogonia only, "Sertoli cells only" or tubular fibrosis. However, in 65% of cases (despite the above mentioned changes of seminiferous epithelium) foci of preserved spermatogenesis could be detected. These cases were classified as "mixed atrophy" of seminiferous tubules. In 63% of infertile patients, a successful extraction of sperm from the biopsy could be performed. In azoospermic patients, histological analysis of testicular biopsy proved to be very useful in terms of diagnosis as well as therapy, i.e. for further in vitro fertilization procedures.

  9. Magnetic Resonance Imaging-Guided Osseous Biopsy in Children With Chronic Recurrent Multifocal Osteomyelitis

    SciTech Connect

    Fritz, Jan; Tzaribachev, Nikolay; Thomas, Christoph; Wehrmann, Manfred; Horger, Marius S.; Carrino, John A.; Koenig, Claudius W.; Pereira, Philippe L.

    2012-02-15

    Purpose: To report the safety and diagnostic performance of magnetic resonance (MRI)-guided core biopsy of osseous lesions in children with chronic recurrent multifocal osteomyelitis (CRMO) that were visible on MRI but were occult on radiography and computed tomography (CT). Materials and Methods: A retrospective analysis of MRI-guided osseous biopsy performed in seven children (four girls and three boys; mean age 13 years (range 11 to 14) with CRMO was performed. Indication for using MRI guidance was visibility of lesions by MRI only. MRI-guided procedures were performed with 0.2-Tesla (Magnetom Concerto; Siemens, Erlangen, Germany; n = 5) or 1.5-T (Magnetom Espree; Siemens; n = 2) open MRI systems. Core needle biopsy was obtained using an MRI-compatible 4-mm drill system. Conscious sedation or general anesthesia was used. Parameters evaluated were lesion visibility, technical success, procedure time, complications and microbiology, cytology, and histopathology findings. Results: Seven of seven (100%) targeted lesions were successfully visualized and sampled. All obtained specimens were sufficient for histopathological analysis. Length of time of the procedures was 77 min (range 64 to 107). No complications occurred. Histopathology showed no evidence of malignancy, which was confirmed at mean follow-up of 50 months (range 28 to 78). Chronic nonspecific inflammation characteristic for CRMO was present in four of seven (58%) patients, and edema with no inflammatory cells was found in three of seven (42%) patients. There was no evidence of infection in any patient. Conclusion: MRI-guided osseous biopsy is a safe and accurate technique for the diagnosis of pediatric CRMO lesions that are visible on MRI only.

  10. Small punch test evaluation of intergranular embrittlement of an alloy steel

    SciTech Connect

    Baik, J.M.; Buck, O.; Kameda, J.

    1983-12-01

    The ductile-brittle transition temperature in steel is commonly determined using Charpy V-notch impact specimens as specified by ASTM E23-81. In some specific cases, however, the use of this standardized test specimen may be impractical, if not impossible. For instance, it is well known that ferritic steels show a substantial degradation of the mechanical properties after long time exposure to an irradiation environment. Because of the increase in strength and the reduction in ductility due to neutron irradiation, the Charpy V-notch transition temperature is raised causing concern from a safety point of view. To study these radiation effects, a test specimen much smaller than the standard Charpy V-notch specimen would be extremely desirable for two reasons. First, to study neutron damage small specimens take less space within a reactor. Secondly, the damage achieved in simulation experiments, such as proton or electron accelerators, is limited to small penetration depths. Several efforts on the development of such a small test specimen, similar to that used to determine the ductility of sheet metal, as recommended by ASTM E643-78, have been described in the literature. The paper reports on correlations between small punch (SP) and Charpy V-notch (CVN) test results obtained on temper-embrittled NiCr steel. The ductile-brittle transition temperature (DBTT) with intergranular embrittlement being induced by grain boundary segregation of specific impurities was determined. The relation between test results discussed in terms of the micromechanisms of intergranular cracking. It is suggested that in radiation embrittlement investigations similar correlations may be obtained.

  11. Analyses of Transient and Tertiary Small Punch Creep Deformation of 316LN Stainless Steel

    NASA Astrophysics Data System (ADS)

    Ganesh Kumar, J.; Ganesan, V.; Laha, K.

    2016-09-01

    Creep deformation behavior of 316LN stainless steel (SS) under small punch creep (SPC) and uniaxial creep test has been assessed and compared at 923 K (650 °C). The transient and tertiary creep deformation behaviors have been analyzed according to the equation proposed for SPC deflection, δ = δ0 + δ_{{T}} \\cdot (1 - {{e}}^{ - κ \\cdot t} ) + dot{δ }_{{s}} t + δ3 {{e}}^{{[ {φ ( {t - t_{{r}} } )} ]}} on the basis of Dobes and Cadek equation for uniaxial creep strain. Trends in the variations of (i) rate of exhaustion of transient creep ( κ) with steady-state deflection rate ( dot{δ }_{{s}} ) (ii) ` κ' with time to attain steady-state deflection rate, and (iii) initial creep deflection rate with steady-state deflection rate implied that transient SPC deformation obeyed first-order reaction rate theory. The rate of exhaustion of transient creep ( r') values that were determined from uniaxial creep tests were correlated with those obtained from SPC tests. Master curves representing transient creep deformation in both SPC and uniaxial creep tests have been derived and their near coincidence brings unique equivalence between both the test techniques. The relationships between (i) rate of acceleration of tertiary creep ( φ) and steady-state deflection rate, (ii) ` φ' and time spent in tertiary stage, and (iii) final creep deflection rate and steady-state deflection rate revealed that first-order reaction rate theory governed SPC deformation throughout the tertiary region also. Interrelationship between the transient, secondary, and tertiary creep parameters indicated that the same mechanism prevailed throughout the SPC deformation.

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

    PubMed Central

    Cirakoglu, Abdullah; Ogreden, Ercan; Cetinkol, Yeliz; Calgin, Mustafa Kerem; Ayyildiz, Ali

    2016-01-01

    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. PMID:28096812

  13. A Quantitative Proteomic Workflow for Characterization of Frozen Clinical Biopsies: Laser Capture Microdissection Coupled with Label-Free Mass Spectrometry

    PubMed Central

    Shapiro, John P.; Biswas, Sabyasachi; Merchant, Anand S.; Satoskar, Anjali; Taslim, Cenny; Lin, Shili; Rovin, Brad H.; Sen, Chandan K.; Roy, Sashwati; Freitas, Michael A.

    2013-01-01

    This paper describes a simple, highly efficient and robust proteomic workflow for routine liquid-chromatography tandem mass spectrometry analysis of Laser Microdissection Pressure Catapulting (LMPC) isolates. Highly efficient protein recovery was achieved by optimization of a “one-pot” protein extraction and digestion allowing for reproducible proteomic analysis on as few as 500 LMPC isolated cells. The method was combined with label-free spectral count quantitation to characterize proteomic differences from 3,000–10,000 LMPC isolated cells. Significance analysis of spectral count data was accomplished using the edgeR tag-count R package combined with hierarchical cluster analysis. To illustrate the capability of this robust workflow, two examples are presented: 1) analysis of keratinocytes from human punch biopsies of normal skin and a chronic diabetic wound and 2) comparison of glomeruli from needle biopsies of patients with kidney disease. Differentially expressed proteins were validated by use of immunohistochemistry. These examples illustrate that tissue proteomics carried out on limited clinical material can obtain informative proteomic signatures for disease pathogenesis and demonstrate the suitability of this approach for biomarker discovery. PMID:23022584

  14. A quantitative proteomic workflow for characterization of frozen clinical biopsies: laser capture microdissection coupled with label-free mass spectrometry.

    PubMed

    Shapiro, John P; Biswas, Sabyasachi; Merchant, Anand S; Satoskar, Anjali; Taslim, Cenny; Lin, Shili; Rovin, Brad H; Sen, Chandan K; Roy, Sashwati; Freitas, Michael A

    2012-12-21

    This paper describes a simple, highly efficient and robust proteomic workflow for routine liquid-chromatography tandem mass spectrometry analysis of Laser Microdissection Pressure Catapulting (LMPC) isolates. Highly efficient protein recovery was achieved by optimization of a "one-pot" protein extraction and digestion allowing for reproducible proteomic analysis on as few as 500 LMPC isolated cells. The method was combined with label-free spectral count quantitation to characterize proteomic differences from 3000-10,000 LMPC isolated cells. Significance analysis of spectral count data was accomplished using the edgeR tag-count R package combined with hierarchical cluster analysis. To illustrate the capability of this robust workflow, two examples are presented: 1) analysis of keratinocytes from human punch biopsies of normal skin and a chronic diabetic wound and 2) comparison of glomeruli from needle biopsies of patients with kidney disease. Differentially expressed proteins were validated by use of immunohistochemistry. These examples illustrate that tissue proteomics carried out on limited clinical material can obtain informative proteomic signatures for disease pathogenesis and demonstrate the suitability of this approach for biomarker discovery.

  15. Can Contemporary Patients with Biopsy Gleason Score 3+4 Be Eligible for Active Surveillance?

    PubMed Central

    Kwon, Ohseong; Kim, Tae Jin; Lee, In Jae; Byun, Seok-Soo; Lee, Sang Eun; Hong, Sung Kyu

    2014-01-01

    Introduction We analyzed whether expansion of existing active surveillance (AS) protocols to include men with biopsy Gleason score (GS) 3+4 prostate cancer (PCa) would significantly alter pathologic and biochemical outcomes of potential candidates of AS. Methods Among patients who underwent radical prostatectomy at our center between 2006 and 2013, we identified 577 patients (group A) who preoperatively fulfilled at least one of 6 different AS criteria. Also, we identified 217 patients (group B) with biopsy GS 3+4 but fulfilled non-GS criteria from at least one of 6 AS criteria. Designating group C as expanded group incorporating all patients in group A and B, we compared risk of unfavorable disease (pathologic GS ≥4+3 and/or pathologic T stage ≥pT3a) and biochemical recurrence (BCR)-free survival between groups. Results Rates of unfavorable disease were not significantly different between patients of group A and C who met AS criteria from 5 institutions (all p>0.05), not including University of Toronto (p<0.001). Also BCR-free survivals were not significantly different between patients in group A and C meeting each of 6 AS criteria (all p>0.05). Among group B, PSAD>0.15 ng/mL/cm3 (p = 0.011) and tumor length of biopsy GS 3+4 core>4 mm (p = 0.007) were significant predictors of unfavorable disease. When these two criteria were newly applied in defining group B, rates of unfavorable disease in group A and B was 15.6% and 14.7%, respectively (p = 0.886). Conclusion Overall rate of pathologically aggressive PCa harbored by potential candidates for AS may not be increased significantly with expansion of criteria to biopsy GS 3+4 under most contemporary AS protocols. PSAD and tumor length of biopsy GS 3+4 core may be useful predictors of more aggressive disease among potential candidates for AS with biopsy GS 3+4. PMID:25268898

  16. Demonstration of the self-magnetic-pinch diode as an X-ray source for flash core-punch radiography.

    SciTech Connect

    Cordova, Steve Ray; Rovang, Dean Curtis; Portillo, Salvador; Oliver, Bryan Velten; Bruner, Nichelle Lee; Ziska, Derek Raymond

    2007-10-01

    Minimization of the radiographic spot size and maximization of the radiation dose is a continuing long-range goal for development of electron beam driven X-ray radiography sources. In collaboration with members of the Atomic Weapons Establishment(AWE), Aldermaston UK, the Advanced Radiographic Technologies Dept. 1645 is conducting research on the development of X-ray sources for flash core-punch radiography. The Hydrodynamics Dept. at AWE has defined a near term radiographic source requirement for scaled core-punch experiments to be 250 rads{at}m with a 2.75 mm source spot-size. As part of this collaborative effort, Dept. 1645 is investigating the potential of the Self-Magnetic-Pinched (SMP) diode as a source for core-punch radiography. Recent experiments conducted on the RITS-6 accelerator [1,2] demonstrated the potential of the SMP diode by meeting and exceeding the near term radiographic requirements established by AWE. During the demonstration experiments, RITS-6 was configured with a low-impedance (40 {Omega}) Magnetically Insulated Transmission Line (MITL), which provided a 75-ns, 180-kA, 7.5-MeV forward going electrical pulse to the diode. The use of a low-impedance MITL enabled greater power coupling to the SMP diode and thus allowed for increased radiation output. In addition to reconfiguring the driver (accelerator), geometric changes to the diode were also performed which allowed for an increase in dose production without sacrificing the time integrated spot characteristics. The combination of changes to both the pulsed power driver and the diode significantly increased the source x-ray intensity.

  17. Open rib biopsy guided by radionuclide technique

    SciTech Connect

    Shih, W.J.; DeLand, F.H.; Domstad, P.A.; Magoun, S.; Dillon, M.L.

    1984-07-01

    When abnormally increased radioactivity is seen in a rib or ribs by bone imaging in a patient with suspected or known malignancy, it frequently is difficult to differentiate fracture from metastatic disease. Histological examination of the lesion is crucial for diagnosis, staging, and planning of therapy. To assess the value of external localization of the site or sites of abnormal uptake in a rib as a guide for open rib biopsy, 10 patients (7 men, 3 women; age range, 34 to 68 years) with known or suspected malignancy were studied. With reference to the oscilloscope image, a cobalt 57 marker was placed on the skin overlying the focus of increased uptake, and the area of increased activity was marked on the skin as a guide to surgical resection. Of ten resected ribs, four showed metastatic disease and five had fractures. (One patient underwent two external marking procedures and two surgical procedures.) Rib biopsy was not performed in 1 patient because prior to the surgical procedure, a small subcutaneous nodule adjacent to the skin marker was excised and confirmed to be carcinoma. Appropriate courses of management (operation, irradiation, chemotherapy) were taken after the biopsies. The surgeon responsible for the biopsy should be present during the skin-marking procedure, and the area beneath the scapula and the region adjacent to the spine should be avoided. Our results indicate that the technique is a very useful aid for approaching open rib biopsies more precisely.

  18. Midazolam sedation for percutaneous liver biopsy.

    PubMed

    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.

  19. Trephine biopsy of the lung and pleura

    PubMed Central

    Steel, S. J.; Winstanley, D. P.

    1969-01-01

    During the last five years 140 biopsies of the lung or pleura have been performed with a high-speed air-drill. A specially designed trephine, 2·1 mm. in bore, proved effective in obtaining adequate specimens from patients with diffuse lung lesions. With this method 111 out of 119 (93%) consecutive lung biopsies were successful in producing specimens of lung tissue for histological examination and 101 (85%) of these biopsies were diagnostically significant. Conditions such as sarcoidosis, berylliosis, alveolar proteinosis, polyarteritis nodosa, asbestosis, and diffuse interstitial pulmonary fibrosis were conclusively diagnosed. Complications were not serious and the commonest, pneumothorax, which occurred in 26% of the lung biopsies, was usually asymptomatic. The procedure is rapid and painless and breath-holding is unnecessary. It is performed under local anaesthesia and can be repeated, if required, thus having many advantages over biopsy by open thoracotomy. However, full thoracic surgical cover should be available. Indications include diffuse and localized lesions of the lung or pleura where a definitive diagnosis is required for the purpose of treatment, prognosis, or a claim for industrial compensation. Images PMID:5348325

  20. Percutaneous Biopsy of Osteoid Osteomas Prior to Percutaneous Treatment Using Two Different Biopsy Needles

    SciTech Connect

    Laredo, Jean-Denis Hamze, Bassam; Jeribi, Riadh

    2009-09-15

    Biopsy is usually performed as the first step in percutaneous treatment of osteoid osteomas prior to laser photocoagulation. At our institution, 117 patients with a presumed diagnosis of osteoid osteoma had a trephine biopsy before a percutaneous laser photocoagulation. Biopsies were made using two different types of needles. A Bonopty biopsy needle (14-gauge cannula, 16-gauge trephine needle; Radi Medical Systems, Uppsala, Sweden) was used in 65 patients, and a Laurane biopsy needle (11-gauge cannula, 12.5-gauge trephine needle; Laurane Medical, Saint-Arnoult, France) in 43 patients. Overall biopsy results were positive for osteoid osteoma in 83 (70.9%) of the 117 cases. The Laurane needle provided a significantly higher positive rate (81.4%) than the Bonopty needle (66.1%; p < 0.05). This difference was not due to the size of the nidus, which was similar in the two groups (p < 0.05) and may be an effect of differences in needle caliber (12.5 vs. 14 gauge) as well as differences in needle design. The rate of positive biopsy results obtained in the present series with the Laurane biopsy needle is, to our knowledge, the highest rate reported in series dealing with percutaneous radiofrequency ablation and laser photocoagulation of osteoid osteomas.

  1. Criteria for initiation of delamination in quasi-static punch-shear tests of a carbon-fiber composite material.

    SciTech Connect

    Chin, Eric Brian; English, Shawn Allen; Briggs, Timothy

    2015-09-01

    V arious phenomenological delamination initiation criteria are analyzed in quasi - static punch - shear tests conducted on six different geometries. These six geometries are modeled and analyzed using elastic, large - deformation finite element analysis. Analysis output is post - processed to assess different delamination initiation criteria, and their applicability to each of the geometries. These criteria are compared to test results to assess whether or not they are appropriate based on what occurred in testing. Further, examinations of CT scans and ultrasonic images o f test specimens are conducted in the appendix to determine the sequence of failure in each test geometry.

  2. Effects of thermal fatigue on shear punch strength of tooth-colored restoratives

    PubMed Central

    Melody, Fam Mei Shi; U-Jin, Yap Adrian; Natalie, Tan Wei Min; Elizabeth, Tay Wan Ling; Chien, Jessica Yeo Siu

    2016-01-01

    Aims: This study investigated the effect of thermal fatigue on the shear strength of a range of tooth-colored restorative materials including giomers, zirconia-reinforced glass ionomer cement (GIC), nano-particle resin-modified GIC, highly viscous GICs, and composite resin. Materials and Methods: Twenty specimens of each material were fabricated in standardized washers (17 mm outer diameter, 9 mm internal diameter, 1 mm thick). The specimens were cured, stored in 100% humidity at 37.5°C for 24 h, and randomly divided into two groups of 10. Group A specimens were nonthermocycled (NT) and stored in distilled water at 37°C for 168 h. Group B specimens were thermocycled (TC) for 10,000 cycles (168 h) with baths X, Y, and Z adjusted to 35°C, 15°C, and 45°C, respectively. Each cycle had dwell times of 28 s in X, and 2s in Y/Z in the order XYXZ. Specimens then underwent shear punch testing at a crosshead speed of 0.5 mm/min with a 2 kN load cell. Statistical analysis of shear strength was done using t-test and two-way ANOVA/Scheffe's post hoc test at significance level P < 0.05. Results: The effect of thermal fatigue on shear strength was material dependent. Except for the “sculptable” giomer (Beautifil II) and a highly viscous GIC (Fuji IX GP Fast), no significant differences in shear strength were generally observed between the NT and TC groups. For both groups, the composite resin (Filtek Z250XT) had the highest shear strength while the zirconia-reinforced (zirconomer) and a highly viscous GIC (Ketac Molar Quick) had the lowest. Conclusions: The effect of thermocycling on shear strength was material dependent. Thermal fatigue, however, did not significantly influence the shear strength of most materials assessed. The “sculptable” composite and giomer were significantly stronger than the other materials evaluated. Shear strength of the “flowable” injectable hybrid giomer was intermediate between the composite and GICs. PMID:27563182

  3. Muscle biopsy findings in inflammatory myopathies.

    PubMed

    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.

  4. Complications of the percutaneous kidney biopsy.

    PubMed

    Whittier, William L

    2012-05-01

    Percutaneous kidney biopsy is an integral part of a nephrologist's practice. It has helped to define nephrology as a subspecialty. When indicated, it is a necessary procedure to help patients, as it allows for diagnostic, prognostic, and therapeutic information. Although very safe, this procedure can give rise to complications, mainly related to bleeding. Since its development in the 1950s, modifications have been made to the approach and the technique, which have improved the diagnostic yield while keeping it a safe procedure. Alterations to the standard approach may be necessary if risk factors for bleeding are present. In addition, obesity, pregnancy, and solitary kidney biopsy are all special circumstances that change the procedure itself or the risk of the procedure. Today, kidney biopsy is a vital procedure for the nephrologist: clinically relevant, safe, and effective.

  5. Surgery and sentinel lymph node biopsy.

    PubMed

    Faries, Mark B; Morton, Donald L

    2007-12-01

    In patients with melanoma, surgery is pivotal not only for the primary tumor but also for regional and often distant metastases. The minimally invasive technique of sentinel node (SN) biopsy has become standard for detection of occult regional node metastasis in patients with intermediate-thickness primary melanoma; in these patients it has a central role in determining prognosis and a significant impact on survival when biopsy results are positive. Its role in thin melanoma remains under evaluation. The regional tumor-draining SN also is a useful model for studies of melanoma-induced immunosuppression. Although completion lymphadenectomy remains the standard of care for patients with SN metastasis, results of ongoing phase III trials will indicate whether SN biopsy without further lymph node surgery is adequate therapy for certain patients with minimal regional node disease.

  6. Chest Wall Dissemination of Nocardiosis after Percutaneous Transthoracic Needle Biopsy

    SciTech Connect

    Shimamoto, Hiroshi Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kamiya, Mika; Miyazaki, Masaya; Arai, Yasuaki; Horio, Yoshitsugu

    2007-07-15

    We described a case of chest wall dissemination after percutaneous transthoracic needle biopsy. A 65-year-old man had a lung nodule which was suspected to be lung carcinoma. He underwent percutaneous transthoracic needle biopsy using an 18G semiautomated biopsy needle and pathologic diagnosis showed organizing pneumonia. Two months after the biopsy, chest wall dissemination occurred. Implantation of carcinoma along the biopsy route was suspected, but the mass was actually due to pulmonary nocardiosis.

  7. Transjugular Liver Biopsy: A Review of 77 Biopsies Using a Spring-Propelled Cutting Needle (Biopsy Gun)

    SciTech Connect

    Gorriz, Elias; Reyes, Ricardo; Lobrano, Mary Beth; Pulido-Duque, Juan M.; San Roman, Jose L.; Lonjedo, Elena; Ferral, Hector; Maynar, Manuel

    1996-11-15

    Seventy-seven transjugular liver biopsies were performed with a coaxial, spring-loaded, 18-gauge cutting needle, the Biopty gun (Bard Biopsy System, Covington, GA, USA) on consecutive patients between July 1993 and February 1995. Fifty men and 27 women were included in the study; the mean age was 45 years (range 15-69 years). The average number of punctures per patient was 5.2, with a range of 2-9, yielding an average of 4.8 samples per patient (range 1-7). The length of the samples varied from 10 to 22 mm with a constant diameter of 1 mm. The mean time required to complete the procedure was 48 min (43-52 min). Histological diagnoses were obtained in 74 of 77 patients (96%), with non-diagnostic specimens attributed to excessive fragmentation (3 cases). Complications occurred in 10 patients (puncture site hematoma, carotid artery puncture, abdominal pain, vasovagal reaction, hepatic capsule perforation, and hemobilia). The latter two complications were self-limited. In our experience this transjugular hepatic biopsy method is promising for performing biopsies in patients with chronic liver disease, due to its high success rate and low morbidity rate.

  8. Bone scan appearances following bone and bone marrow biopsy

    SciTech Connect

    McKillop, J.H.; Maharaj, D.; Boyce, B.F.; Fogelman, I.

    1984-01-01

    Bone marrow and bone biopsies are performed not infrequently in patients referred for bone scans and represent a potential cause of a ''false positive'' focal abnormality on the bone scan. The authors have therefore examined the scan appearances in a series of patients who had undergone either sternal marrow biopsy, (Salah needle, diameter 1.2 mm) trephine iliac crest marrow biopsy (Jamshidi 11 gauge needle, diameter 3.5 mm) or a transiliac bone biopsy (needle diameter 8 mm). Of 18 patients studied 1 to 45 days after sternal marrow 17 had normal scan appearances at the biopsy site and 1 had a possible abnormality. None of 9 patients studied 4 to 19 days after trephine iliac crest marrow biopsy had a hot spot at the biopsy site. A focal scan abnormality was present at the biopsy site in 9/11 patients studied 5 to 59 days after a trans iliac bone biopsy. No resultant scan abnormality was seen in 4 patients imaged within 3 days of the bone biopsy or in 3 patients imaged 79 to 138 days after the procedure. Bone marrow biopsy of the sternum or iliac crest does not usually cause bone scan abnormalities. A focal abnormality at the biopsy site is common in patients imaged 5 days to 2 months after bone biopsy. The gauge of the needle employed in the biopsy and thus the degree of bone trauma inflicted, is likely to be main factor determining the appearance of bone scan abnormalities at the biopsy site.

  9. Simulated prostate biopsy: prostate cancer distribution and clinical correlation

    NASA Astrophysics Data System (ADS)

    Bauer, John J.; Zeng, Jianchao; Zhang, Wei; Sesterhenn, Isabell A.; Dean, Robert; Moul, Judd W.; Mun, Seong K.

    2000-04-01

    Our group has recently obtained data based upon whole- mounted step-sectioned radical prostatectomy specimens using a 3D computer assisted prostate biopsy simulator that suggests an increased detection rate is possible using laterally placed biopsies. A new 10-core biopsy pattern was demonstrated to be superior to the traditional sextant biopsy. This patter includes the traditional sextant biopsy cores and four laterally placed biopsies in the right and left apex and mid portion of the prostate gland. The objective of this study is to confirm the higher prostate cancer defection rate obtained using our simulated 10-core biopsy pattern in a small clinical trial. We retrospectively reviewed 35 consecutive patients with a pathologic diagnosis of prostate cancer biopsied by a single urologist using the 10-core prostate biopsy patterns were compared with respect to prostate cancer detection rate. Of the 35 patients diagnosed with prostate cancer, 54.3 percent were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7 percent were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7 percent of patients were diagnosed solely with the laterally placed biopsies. Our results suggest that biopsy protocols that use laterally placed biopsies based upon a five region anatomical model are superior to the routinely used sextant prostate biopsy pattern.

  10. Studies on Punching Shear Resistance of Two Way Slab Specimens with Partial Replacement of Cement by GGBS with Different Edge Conditions

    NASA Astrophysics Data System (ADS)

    Nemani, Ravi Dakshina Murthy; Rao, M. V. S.; Grandhe, Veera Venkata Satya Naranyana

    2016-09-01

    The present work is an effort to quantify the punching shear load resistance effect on two way simply supported slab specimens with replacement of cement by Ground Granulated Blast Furnace Slag (GGBS) with different edge conditions at various replacement levels and evaluate its efficiency. GGBS replacement has emerged as a major alternative to conventional concrete and has rapidly drawn the concrete industry attention due to its cement savings, cost savings, environmental and socio-economic benefits. The two way slab specimens were subjected to punching shear load by in house fabricated apparatus. The slab specimens were cast using M30 grade concrete with HYSD bars. The cement was partially replaced with GGBS at different percentages i.e., 0 to 30 % at regular intervals of 10 %. The test results indicate that the two way slab specimens with partial replacement of cement by GGBS exhibit high resistance against punching shear when compared with conventional concretes slab specimens.

  11. Evaluation of the Punch-it™ NA-Sample kit for detecting microbial DNA in blood culture bottles using PCR-reverse blot hybridization assay.

    PubMed

    Kim, Jungho; Wang, Hye-Young; Kim, Seoyong; Park, Soon Deok; Yu, Kwangmin; Kim, Hyo Youl; Uh, Young; Lee, Hyeyoung

    2016-09-01

    DNA extraction efficiency affects the success of PCR-based method applications. The Punch-it™ NA-Sample kit for extracting DNA by using paper chromatography is technically easy to use and requires just two reagents and only 10min to complete. The Punch-it™ NA-Sample kit could be offered as a rapid, accurate, and convenient method for extracting bacterial and fungal DNA from blood culture bottles. We compared the efficiencies of the commercial kit (Punch-it™ NA-Sample kit) and an in-house conventional boiling method with Chelex-100 resin for DNA extraction from blood culture bottles. The efficiency of the two DNA extraction methods was assessed by PCR-reverse blot hybridization assay (PCR-REBA, REBA Sepsis-ID) for detecting Gram positive (GP) bacteria, Gram negative (GN) bacteria, and Candida species with 196 positive and 200 negative blood culture bottles. The detection limits of the two DNA extraction methods were 10(3)CFU/mL for GP bacteria, 10(3)CFU/mL for GN bacteria, and 10(4)CFU/mL for Candida. The sensitivity and specificity of the Punch-it™ NA-Sample kit by REBA Sepsis-ID were 95.4% (187/196) and 100% (200/200), respectively. The overall agreement of the two DNA extraction methods was 98.9% (392/396). Three of four samples showing discrepant results between the two extraction methods were more accurately matched up with the Punch-it™ NA-Sample kit based on conventional culture methods. The results indicated that the Punch-it™ NA-Sample kit extracted bacterial and fungal DNA in blood culture bottles and allowed extracted DNA to be used in molecular assay.

  12. Percutaneous CT-guided biopsy of the spine: results of 430 biopsies

    PubMed Central

    Rimondi, Eugenio; Errani, Costantino; Bianchi, Giuseppe; Casadei, Roberto; Alberghini, Marco; Malaguti, Maria Cristina; Rossi, Giuseppe; Durante, Stefano; Mercuri, Mario

    2008-01-01

    Biopsies of lesions in the spine are often challenging procedures with significant risk of complications. CT-guided needle biopsies could lower these risks but uncertainties still exist about the diagnostic accuracy. Aim of this retrospective study was to evaluate the diagnostic accuracy of CT-guided needle biopsies for bone lesions of the spine. We retrieved the results of 430 core needle biopsies carried out over the past fifteen years at the authors’ institute and examined the results obtained. Of the 430 biopsies performed, in 401 cases the right diagnosis was made with the first CT-guided needle biopsy (93.3% accuracy rate). Highest accuracy rates were obtained in primary and secondary malignant lesions. Most false negative results were found in cervical lesions and in benign, pseudotumoral, inflammatory, and systemic pathologies. There were only 9 complications (5 transient paresis, 4 haematomas that resolved spontaneously) that had no influence on the treatment strategy, nor on the patient’s outcome. In conclusion we can assert that this technique is reliable and safe and should be considered the gold standard in biopsies of the spine. PMID:18463900

  13. Reducing infection rates after prostate biopsy.

    PubMed

    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.

  14. Transvenous Transjugular Renal Core Biopsy with a Redesigned Biopsy Set Including a Blunt-Tipped Needle

    SciTech Connect

    Sofocleous, Constantinos T.; Bahramipour, Philip; Mele, Christopher; Hinrichs, Clay R.; Barone, Alison; Abujudeh, Hani

    2002-03-15

    A novel 19-gauge, blunt-tipped, side cutting single throw, 70-cm long transjugular needle, specifically designed for transvenous kidney biopsy, was used in seven patients with high risk for bleeding. A mean of 4 device-passes (3-6) per patient resulted in a satisfactory specimen for pathological diagnosis. Immediate post-biopsy non enhanced CT was performed to evaluate for bleeding at the biopsy site. All patients were observed for 2 hr after the procedure. No clinically significant immediate or late complication was noted.

  15. Bone scan appearances following biopsy of bone and bone marrow

    SciTech Connect

    McKillop, J.H.; Maharaj, D.; Boyce, B.F.; Fogelman, I.

    1984-10-01

    The influence of sternal marrow aspiration, iliac crest marrow aspiration, and iliac crest bone biopsy on bone scan appearances was examined. Eighteen patients were scanned a mean of 9.9 days after sternal marrow aspiration with a Salah needle. Bone scans obtained in 9 patients a mean of 10 days aftr iliac crest trephine marrow biopsy with a Jamshidi needle showed no abnormality at the biopsy site. In 18 patients with metabolic bone disease who had undergone iliac crest bone biopsy with an 8 mm needle, a scan abnormality due to the biopsy was usually present when the interval between the biopsy and the scan was 5 days to 2 months. Patients who were scanned within 3 days of iliac crest bone biopsy or more than 2 months after biopsy had normal scan appearance at the biopsy site.

  16. Lateral biopsies added to the traditional sextant prostate biopsy pattern increases the detection rate of prostate cancer.

    PubMed

    Bauer, J J; Zeng, J; Zhang, W; McLeod, D G; Sesterhenn, I A; Connelly, R R; Mun, S K; Moul, J W

    2000-07-01

    Urologists routinely use the systematic sextant needle biopsy technique to detect prostate cancer. However, recent evidence suggests that this technique has a significant sampling error and data based upon whole-mounted step-sectioned radical prostatectomy specimens using a three-dimensional computer-assisted prostate biopsy simulator suggests that an increased detection rate is possible using laterally placed biopsies. The simulated 10-core biopsy pattern (traditional sextant biopsy cores and four laterally placed biopsies in the right and left apex and mid portion of the prostate gland) was shown to be superior to the traditional sextant biopsy. The objective of this pilot study was to confirm the higher prostate cancer detection rate obtained using the 10-core biopsy pattern in patients. We reviewed data on 35 consecutive patients with a pathologic diagnosis of prostate cancer biopsied by a single urologist using the 10-core biopsy pattern. The frequency of positive biopsy was determined for each core. Additionally, the sextant and 10-core prostate biopsy patterns were compared with respect to prostate cancer detection rate. Of the 35 patients diagnosed with prostate cancer, 54.3%(19/35) were diagnosed by the sextant biopsy only. The 10-core pattern resulted in an additional 45.7%(16/35) of patients being diagnosed solely with the laterally placed biopsies. The laterally placed biopsies had the highest frequency of positive biopsies when compared to the sextant cores. In conclusion, biopsy protocols that use laterally placed biopsies based upon a five region anatomical model are superior to the routinely used sextant prostate biopsy pattern. Prostate Cancer and Prostatic Diseases (2000) 3, 43-46

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

    PubMed Central

    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

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

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

    2016-10-21

    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 [(18)F]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.

  20. Multiple Biopsies and Detection of Cervical Cancer Precursors at Colposcopy

    PubMed Central

    Wentzensen, Nicolas; Walker, Joan L.; Gold, Michael A.; Smith, Katie M.; Zuna, Rosemary E.; Mathews, Cara; Dunn, S. Terence; Zhang, Roy; Moxley, Katherine; Bishop, Erin; Tenney, Meaghan; Nugent, Elizabeth; Graubard, Barry I.; Wacholder, Sholom; Schiffman, Mark

    2015-01-01

    Purpose Women with abnormal cervical cancer screening results are referred to colposcopy and biopsy for diagnosis of cervical cancer precursors (high-grade squamous intraepithelial lesions [HSILs]). Colposcopy with a single biopsy can miss identification of HSILs. No systematic study has quantified the improved detection of HSIL by taking multiple lesion-directed biopsies. Methods The Biopsy Study was an observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results. Up to four directed biopsies were taken from distinct acetowhite lesions and ranked by colposcopic impression. A nondirected biopsy of a normal-appearing area was added if fewer than four directed biopsies were taken. HSIL identified by any biopsy was the reference standard of disease used to evaluate the incremental yield and sensitivity of multiple biopsies. Results In the overall population, sensitivities for detecting HSIL increased from 60.6% (95% CI, 54.8% to 66.6%) from a single biopsy to 85.6% (95% CI, 80.3% to 90.2%) after two biopsies and to 95.6% (95% CI, 91.3% to 99.2%) after three biopsies. A significant increase in sensitivity of multiple biopsies was observed in all subgroups. The highest increase in yield of HSIL was observed for women with a high-grade colposcopic impression, HSIL cytology, and human papillomavirus (HPV) type 16 positivity. Only 2% of all HSILs diagnosed in the participants were detected by biopsies of normal-appearing transformation zone. Conclusion Collection of additional lesion-directed biopsies during colposcopy increased detection of histologic HSIL, regardless of patient characteristics. Taking additional biopsies when multiple lesions are present should become the standard practice of colposcopic biopsy. PMID:25422481

  1. The meaning of sampling density in multiple repeat prostate biopsies

    PubMed Central

    Čapoun, Otakar; Minárik, Ivo; Kýr, Michal; Hanuš, Tomáš; Babjuk, Marek; Sobotka, Roman

    2016-01-01

    Introduction Extended transrectal ultrasound-guided prostate biopsy is a state-of-the-art tool for prostate cancer detection. Nevertheless, approximately 1/3 of cancers are missed when using this method and repeat biopsy sessions are often required. The aim of this study was to investigate how sampling density (a compound variable reflecting the number of biopsy cores and prostate volume) impacts on detection rate in multiple repeat TRUS-biopsies. Material and methods A total of 1007 consecutive patients undergoing their 1st, 2nd, 3rd and any further repeat prostate biopsies were included. The relationship between sampling density and other clinical variables (age, prostate-specific antigen level, free/total PSA ratio, digital rectal examination, number of previous biopsies) and cancer detection rate were assessed by interaction analysis. Results There were 562 primary re-biopsies, 267 second re-biopsies and 178 third and further re-biopsies included in the study. Detection rate was 25.4%, 25.8% and 25.3%, respectively. Interaction of sampling density with age was demonstrated in patients undergoing their first repeat biopsy (but not further re-biopsies). No interaction was observed with other variables investigated. Conclusions A more extensive prostate sampling leads to a higher cancer detection rate on repeat prostate biopsies, as shown previously. However, this effect seems to be particularly pronounced in men younger than 65 years undergoing their first repeat prostate biopsy. PMID:28127449

  2. Accessing Genetic Information with Liquid Biopsies.

    PubMed

    Cai, Xuyu; Janku, Filip; Zhan, Qimin; Fan, Jian-Bing

    2015-10-01

    Recent scientific advances in understanding circulating tumor cells, cell-free DNA/RNA, and exosomes in blood have laid a solid foundation for the development of routine molecular 'liquid biopsies'. This approach provides non-invasive access to genetic information--somatic mutations, epigenetic changes, and differential expression--about the physiological conditions of our body and diseases. It opens a valuable avenue for future genetic studies and human disease diagnosis, including prenatal and neurodegenerative disease diagnosis, as well as for cancer screening and monitoring. With the rapid development of highly sensitive and accurate technologies such as next-generation sequencing, molecular 'liquid biopsies' will quickly become a central piece in the future of precision medicine.

  3. Development of a Robust Static Punch Experiment for Screening Unprocessed Ultra-High Molecular Weight Polyethylene (UHMWPE) Unidirectional Cross-Ply Material

    DTIC Science & Technology

    2014-09-01

    Development of a Robust Static Punch Experiment for Screening Unprocessed Ultra-High Molecular Weight Polyethylene (UHMWPE) Unidirectional...Screening Unprocessed Ultra-High Molecular Weight Polyethylene (UHMWPE) Unidirectional Cross-Ply Material David Gray, Robert Kaste, and Paul...Unprocessed Ultra-High Molecular Weight Polyethylene (UHMWPE) Unidirectional Cross-Ply Material 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

  4. [Optimizing biopsies of the oral mucosa].

    PubMed

    Raybaud, H; Voha, C; Cardot-Leccia, N; Monteil, R A

    2012-11-01

    We had for aim to describe and illustrate the artefacts observed in biopsies of the oral mucosa, as well as the impact of sending non-representative histological material to a laboratory. This article was based on an international literature review, as well as on our experience. We analysed the problems raised, for the pathologists and the histology lab-technicians, by these artefacts as well as their impact on the pathology report patient management. We suggest simple solutions.

  5. Granulomatous cryptococcal prostatitis diagnosed by transrectal biopsy.

    PubMed

    Seo, Ill Young; Jeong, Hee Jong; Yun, Ki Jung; Rim, Joung Sik

    2006-05-01

    Cryptococcal infection primarily involves the lung and is hematogenously spread to other organs. Sometimes it might affect the genitourinary tract, and rare cases have been reported involving the prostate without systemic infection. We report a case of granulomatous prostatitis as a result of Cryptococcus neoformans yeast in an immunocompromised patient with alcoholic liver cirrhosis, which was diagnosed by transrectal ultrasound guided biopsy and treated with antifungal medication.

  6. Conjunctival biopsy in adult form galactosialidosis.

    PubMed Central

    Usui, T; Sawaguchi, S; Abe, H; Iwata, K; Oyanagi, K

    1993-01-01

    Conjunctival biopsy was performed in two siblings with adult-form galactosialidosis. Electron microscopically, several types of intracytoplasmic inclusion were observed in the fibroblasts in conjunctival stroma, lymphatic capillary endothelial cells, Schwann cells, and epithelial cells. Membrane-bound vesicles with fibrillogranular content were frequently observed, and occasional lamellar structures were noted in these inclusions. Dense granular inclusions and oil droplets were also seen. Dense granular inclusions have not been reported in this disease previously. Images PMID:8384473

  7. A Prospective Randomized Trial of Two Different Prostate Biopsy Schemes

    ClinicalTrials.gov

    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

  8. Conchotome and needle percutaneous biopsy of skeletal muscle.

    PubMed Central

    Dietrichson, P; Coakley, J; Smith, P E; Griffiths, R D; Helliwell, T R; Edwards, R H

    1987-01-01

    Percutaneous muscle biopsy is an important and acceptable technique in the study of conditions involving human skeletal muscle. A review of 436 conchotome and needle muscle biopsies obtained over 18 months in this centre is presented. Images PMID:3694206

  9. Testicular Biopsy in Evaluation of Male Infertility

    PubMed Central

    Meinhard, Elizabeth; McRae, C. U.; Chisholm, G. D.

    1973-01-01

    Testicular biopsy findings in 100 infertile men were correlated with the clinical findings. Mild or moderately severe tubular lesions were seen in 57 cases and severe changes in 43. Clinical examination and semen analysis were no guide to the severity of the testicular lesion. Though patients with normal sized testes more commonly had mild tubular lesions, many were severe. Patients with small testes more often had severe lesions but some had only mild tubular changes. Biopsy findings in both aspermic and oligospermic patients ranged from normal to a complete loss of germinal tissue. Testicular biopsy is advocated in infertile men for the complete assessment of the case and for identifying those which are potentially treatable. Patients with a severe lesion can be spared further investigations. The choice and results of treatment are discussed, particularly the surgical treatment of varicocele or obstruction. Only patients with a mild or moderate testicular tubular lesion should participate in future trials with drugs for male infertility. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9FIG. 10 PMID:4726930

  10. [Neuromuscular biopsy and diagnosis of vasculitis].

    PubMed

    Vital, Anne; Vital, Claude

    2006-09-01

    One characteristic histological lesion on biopsy specimens is mandatory to establish the diagnosis of vasculitis. Combined nerve and muscle biopsies, by the same cutaneous incision, improve significantly the percentage of positive results. Nerve fragments should be taken in every patient presenting sensory manifestations. Such vasculitic lesions are present in medium-sized arterioles and/or small vessels, and correspond mainly to 4 necrotizing vasculitis: panarteritis nodosa (PAN), microscopic polyangiitis (MPA), Churg and Strauss syndrome and Wegener granulomatosis. Microvasculitis should be added to these classical entities, because it corresponds to small vessel wall infiltration by inflammatory cells, as observed in PAN and MPA, but without any necrosis. Microvasculitis has to be differentiated from the inflammatory cell infiltrates surrounding small vessels. However, such perivascular inflammatory cell infiltrates enable the diagnosis of probable vasculitis when associated with clusters of neo-vessels, hemosiderin deposits, or a focal damage of nerve fibers. Grossly, one third of vasculitis diagnosis is confirmed on muscle fragments, a second third on nerve fragments, and the last third on both nerve and muscle fragments. Moreover, in the search for vasculitis, an unpredicted diagnosis of lymphoma or amyloidosis is occasionally established on the neuro-muscular biopsy.

  11. Survival after stereotactic biopsy of malignant gliomas

    SciTech Connect

    Coffey, R.J.; Lunsford, L.D.; Taylor, F.H.

    1988-03-01

    For many patients with malignant gliomas in inaccessible or functionally important locations, stereotactic biopsy followed by radiation therapy (RT) may be a more appropriate initial treatment than craniotomy and tumor resection. We studied the long term survival in 91 consecutive patients with malignant gliomas diagnosed by stereotactic biopsy: 64 had glioblastoma multiforme (GBM) and 27 had anaplastic astrocytoma (AA). Sixty-four per cent of the GBMs and 33% of the AAs involved deep or midline cerebral structures. The treatment prescribed after biopsy, the tumor location, the histological findings, and the patient's age at presentation (for AAs) were statistically important factors determining patient survival. If adequate RT (tumor dose of 5000 to 6000 cGy) was not prescribed, the median survival was less than or equal to 11 weeks regardless of tumor histology or location. The median survival for patients with deep or midline tumors who completed RT was similar in AA (19.4 weeks) and GBM (27 weeks) cases. Histology was an important predictor of survival only for patients with adequately treated lobar tumors. The median survival in lobar GBM patients who completed RT was 46.9 weeks, and that in lobar AA patients who completed RT was 129 weeks. Cytoreductive surgery had no statistically significant effect on survival. Among the clinical factors examined, age of less than 40 years at presentation was associated with prolonged survival only in AA patients. Constellations of clinical features, tumor location, histological diagnosis, and treatment prescribed were related to survival time.

  12. Transrectal ultrasound guided biopsy of the prostate: random sextant versus biopsies of sono-morphologically suspicious lesions.

    PubMed

    Loch, Tillmann; Eppelmann, Ursula; Lehmann, Jan; Wullich, Bernd; Loch, Annemie; Stöckle, Michael

    2004-11-01

    Transrectal ultrasound (TRUS) guided multiple systematic random biopsies are presently the method of choice for determining the presence or absence of prostate cancer. TRUS image information is only used to guide the biopsy needle into the prostate, but not to localize and target cancerous lesions. Our aim in this study was to evaluated the possible predictive value of tumor suspicious endosonographic lesions of the prostate for prostate biopsies. We prospectively compared six systematic biopsies with lesion guided biopsies in a consecutive series of 217 patients. All patients had a prostate specific antigen (PSA) level of >4 ng/ml without a history of prostate disease. In a subgroup of 145 men with sonomorphologic lesions suggestive for prostate cancer (hypoechoic areas or asymmetries predominantly in the peripheral zone), lesion-guided biopsies were taken in addition to the systematic biopsies. We evaluated the number of tumors which were diagnosed or missed by both of the biopsy strategies. Of the 217 evaluated patients, 64 (29%) had histology confirmed cancer. Four patients with negative sextant biopsies had a positive TRUS guided biopsy. Out of 145 patients with a normal TRUS, three were cancer positive by sextant biopsy. A total of 1,387 individual biopsy cores were evaluated. Of the 1,304 systematic biopsy cores, 182 (14%) were positive and 1,122 (86%) negative. Of the 329 TRUS lesion guided biopsy cores 139 (42%) were positive and 190 (58%) negative. Patients with tumor suggestive TRUS lesions have a considerably higher risk of being diagnosed with prostate cancer compared to patients without such lesions. Both systematic sextant and TRUS lesion guided biopsies missed detectable prostate cancer in a minority of patients. Taking the endosonographic morphology of the prostate gland into consideration for biopsy strategies may improve the quality of the biopsy and avoid unnecessary invasive procedures in selected cases.

  13. [Liquid Biopsy in Multimodal Treatment of Esophageal Carcinoma].

    PubMed

    Shimada, Hideaki; Yajima, Satoshi; Oshima, Yoko; Nanami, Tatsuki; Suzuki, Takashi; Otsuka, Seiko

    2015-11-01

    Predicting and monitoring the treatment response of patients with esophageal carcinoma are important. Molecular analyses of biopsy specimens are useful; however, the characteristics of the biopsy specimen are not similar to those of whole tumors, including metastatic tumors. Therefore, liquid biopsy using blood samples has been applied for the prediction of the tumor stage, sensitivity to radiotherapy, sensitivity to chemotherapy, and recurrent disease. Liquid biopsy is advantageous for monitoring the treatment response and as an objective diagnostic tool; it is cost effective.

  14. A new apparatus for standardized rat kidney biopsy.

    PubMed

    Schirutschke, Holger; Gladrow, Lars; Norkus, Christian; Parmentier, Simon Paul; Hohenstein, Bernd; Hugo, Christian P M

    2014-01-01

    Survival biopsies are frequently applied in rat kidney disease models, but several drawbacks such as surgical kidney trauma, bleeding risk and variable loss of kidney tissue are still unsolved. Therefore, we developed an easy-to-use core biopsy instrument and evaluated whether two consecutive kidney biopsies within the same kidney can be carried out in a standardized manner. On day 0, 18 Lewis rats underwent a right nephrectomy and 9 of these rats a subsequent first biopsy of the left kidney (Bx group). 9 control rats had a sham biopsy of the left kidney (Ctrl group). On day 7, a second kidney biopsy/sham biopsy was performed. On day 42, all animals were sacrificed and their kidneys were removed for histology. Biopsy cylinders contained 57±28 glomeruli per transversal section, representing an adequate sample size. PAS staining showed that the biopsy depth was limited to the renal cortex whereas surgical tissue damage was limited to the area immediately adjacent to the taken biopsy cylinder. On day 42, the reduction of functional renal mass after two biopsies was only 5.2% and no differences of body weight, blood pressure, proteinuria, serum creatinine, glomerulosclerosis, interstitial fibrosis or number of ED-1 positive macrophages were found between both groups. In summary, our apparatus offers a safe method to perform repetitive kidney biopsies with minimal trauma and sufficient sample size and quality even in experimental disease models restricted to one single kidney.

  15. 21 CFR 878.4755 - Absorbable lung biopsy plug.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Absorbable lung biopsy plug. 878.4755 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4755 Absorbable lung biopsy plug. (a) Identification. A preformed (polymerized) absorbable lung biopsy plug is intended to...

  16. The Native Kidney Biopsy: Update and Evidence for Best Practice.

    PubMed

    Hogan, Jonathan J; Mocanu, Michaela; Berns, Jeffrey S

    2016-02-05

    The kidney biopsy is the gold standard in the diagnosis and management of many diseases. Since its introduction in the 1950s, advancements have been made in biopsy technique to improve diagnostic yield while minimizing complications. Here, we review kidney biopsy indications, techniques, and complications in the modern era. We also discuss patient populations in whom special consideration must be given when considering a kidney biopsy and the important role that the kidney biopsy plays in nephrology training. These data are presented to develop best practice strategies for this essential procedure.

  17. Celiac disease. "To biopsy or not to biopsy. That is the question!".

    PubMed

    Mones, R L

    2012-12-01

    Great progress has been made in the field of celiac disease (CD). During the past 50 years we have come to understand a great deal about the pathogenesis, clinical spectrum, and treatment. Great advances have been made in the technology of diagnosing CD. Heretofore, the gold standard used for diagnosis of CD is the small intestinal biopsy. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition has recently issued guidelines that state that some patients do not require a biopsy for diagnosis. This review traces the history of CD with a particular attention to the evolution of the technology involved in the field. The question of the need for biopsy or not is discussed.

  18. [Is bone biopsy necessary for the diagnosis of metabolic bone diseases? Necessity of bone biopsy].

    PubMed

    Ito, Akemi; Yajima, Aiji

    2011-09-01

    Histological analysis of undecalcified bone biopsy specimens is a valuable clinical and research tool for studying the etiology, pathogenesis and treatment of metabolic bone diseases. In case of osteoporosis, bone biopsy is not usually required for the diagnosis ; however, bone histomorphometry may be useful in rare cases with unusual skeletal fragility. Bone histomorphometry also provides valuable information on the mechanism of action, safety and efficacy of new anti-osteoporosis drugs. Bone histomorphometry is useful for the diagnosis and the assessment of treatment response in rickets/osteomalacia and in CKD-MBD (chronic kidney disease-mineral and bone disorders) . In Japan, bone biopsy is often performed to establish the diagnosis of Paget's disease of bone, especially to differentiate it from metastatic bone disease.

  19. Ultrasound-guided serial transabdominal cardiac biopsies in cats.

    PubMed

    van Essen, Vivian J; Uilenreef, Joost J; Szatmári, Viktor; Veldhuis Kroeze, Edwin J B; Kuiper, Raoul V; Rothuizen, Jan; de Bruin, Alain

    2012-03-01

    A percutaneous/transdiaphragmatic core needle biopsy technique was developed in cats to obtain serial biopsies from different locations of the left ventricle, through which morphological and molecular changes within the same individual can be studied to unravel the mechanisms of feline cardiomyopathies. Transmural left ventricular myocardial samples were obtained from 29 anesthetized, healthy, adult cats with ultrasound guidance. An 18G automatic biopsy needle was inserted between the last left rib and the sternum through the diaphragm into the thorax. Biopsies were obtained from the left ventricular wall. In five cats, three single biopsies were taken with 4-week intervals. Autopsy was performed on six cats, of which three cats had serial biopsies. In total, 87 biopsies were obtained without long-term effects on cardiac function or structure. The biopsies caused transient single ventricular premature complexes and mild pericardial effusion without tamponade. Necropsy revealed a minimal amount of fibrous connective tissue in the diaphragm and the heart without any significant microscopic lesions in the adjacent muscle tissue. The high quality biopsy material was suitable for morphological and molecular studies. This minimally invasive, ultrasound-guided cardiac biopsy technique thus allows for the safe collection of serial biopsies to study feline cardiomyopathies in an experimental setting.

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

    PubMed

    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.

  1. Percutaneous image-guided biopsy of the musculoskeletal system.

    PubMed

    Welch, Brian T; Welch, Timothy J

    2011-09-01

    Percutaneous image-guided biopsy plays an important role in the management of multiple pathologic conditions involving the musculoskeletal system. The vast majority of these conditions require histologic diagnosis to guide decision making concerning treatment. Percutaneous image-guided biopsy has supplanted open surgical biopsy as the primary modality for tissue diagnosis in this patient cohort. The safety, efficacy, and clinical outcome of percutaneous image-guided biopsy for a multitude of musculoskeletal conditions are well documented. Improvements in needle design and image guidance have continued to further the efficacy and safety of this diagnostic technique. Complications associated with percutaneous biopsy are minimal compared with those seen in open surgical biopsy, whereas diagnostic accuracy is comparable to that of surgical biopsy.

  2. Biopsy proven and biopsy negative temporal arteritis: differences in clinical spectrum at the onset of the disease

    PubMed Central

    Duhaut, P.; Pinede, L.; Bornet, H.; Demolombe-Rague, S.; Dumontet, C.; Ninet, J.; Loire, R.; Pasquier, J.

    1999-01-01

    OBJECTIVES—To assess the clinical features of biopsy proven and negative biopsy temporal arteritis at the time of diagnosis and during a three year follow up.
METHODS—Newly diagnosed cases of giant cell arteritis were included in a prospective, multicentre study. Initial clinical and biological features, season of diagnosis, and cardiovascular events occurring during the follow up were recorded. Biopsy proven and negative biopsy cases were compared. 
RESULTS—Two hundred and seven biopsy proven, and 85 negative biopsy cases were included from 1991 to 1997. Fifty eight per cent of the biopsy proven cases, compared with 39.29% of the negative biopsy cases, were diagnosed during the autumn or winter (p = 0.003). Visual problems (31.5%, v 19.1%, p = 0.031), blindness (9.7% v 2.38%, p = 0.033), jaw claudication (40.8%, v 28.243%, p = 0.044), and temporal artery palpation abnormalities (61.3% v 29.5%, p = 7.10-7) were more frequent in the biopsy proven than in the negative biopsy group. Less specific symptoms, such as headache (82.5% v 92.9%, p = 0.021), or associated polymyalgia rheumatica (40.1% v 65.9%, p = 9 × 10-5) were more prevalent in the negative biopsy cases. Biological markers of inflammation were significantly more increased in the biopsy proven group. All cases of blindness occurring after treatment belonged to the biopsy proven group.
CONCLUSION—Biopsy proven cases seem to be more severe than biopsy negative cases at the time of diagnosis and during follow up. Seasonal difference at diagnosis may suggest a different aetiological pattern.

 PMID:10340957

  3. Cangrelor Bridge Therapy for Gastroduodenal Biopsy.

    PubMed

    Cahoon, William D; Oswalt, Allison K; Francis, Kerry E; Magee, Lauren C; Lowe, Denise K

    2017-04-01

    Dual antiplatelet therapy (DAPT) is the key for secondary prevention of acute coronary syndromes and percutaneous coronary intervention with stent placement. Premature discontinuation of DAPT can result in an increase in cardiac ischemic events and death. If early interruption of DAPT for urgent procedures or surgery is necessary, then ischemic and bleed risks must be balanced with bridging therapy. To date, no medications have a Food and Drug Administration indication for antiplatelet bridge therapy. We present a case of a woman with a history of gastrointestinal bleeding on DAPT for a drug-eluting stent who received cangrelor as bridge therapy prior to gastroduodenal biopsy.

  4. Design of a small animal biopsy robot.

    PubMed

    Bebek, Ozkan; Hwang, Myun Joong; Fei, Baowei; Cavusoglu, M

    2008-01-01

    Small animals are widely used in biomedical research studies. They have compact anatomy and small organs. Therefore it is difficult to perceive tumors or cells and perform biopsies manually. Robotics technology offers a convenient and reliable solution for accurate needle insertion. In this paper, a novel 5 degrees of freedom (DOF) robot design for inserting needles into small animal subjects is proposed. The design has a compact size, is light weight, and has high resolution. Parallel mechanisms are used in the design for stable and reliable operation. The proposed robot has two gimbal joints that carry the needle mechanism. The robot can realize dexterous alignment of the needle before insertion.

  5. Glomangiosarcoma Arising from a Prior Biopsy Site

    PubMed Central

    Maselli, Amy M.; Jambhekar, Amani V.

    2017-01-01

    Summary: Glomangiosarcoma represents a rare malignant variant of the benign glomus tumor that typically presents as a tender, slowly growing nodule with a predilection for the lower extremities. Unlike their benign counterparts, glomangiosarcomas may display aggressive characteristics such as large size, local invasion, and a tendency to recur after excision. Although wide local excision remains the treatment of choice, rare cases of systemic metastasis have been previously reported. We present a case of glomangiosarcoma arising at a prior biopsy site after excision of an unknown soft tissue lesion. PMID:28203514

  6. [Prostate biopsy: Diagnostic responsibility and recent changes].

    PubMed

    Martínez-Ballesteros, Claudio; Martínez-Salamanca, Juan Ignacio; Carballido Rodríguez, Joaquín Alberto

    2011-10-01

    In this bibliographic review we reexamine the different features in relation to indication, performance and interpretation of prostatic biopsy (PB). The main objective is to place methodological features involving PB in the current scientific scenario, establishing the correlation between the most relevant and analyzing the historic evolution this procedure has followed, particularly over the last two decades. Prostate biopsy has evolved to be a regular element in urologists` daily practice and its learning process has been simplified to the point it can be approached with adequacy during the first years of residency in Urology. This privileged position PB enjoys in daily practice and the performance obtained from it would have not been a reality without optimization of transrectal ultrasound or local anesthesia techniques, yet reviled in some forums, the real responsible of such success. The consensus reached in the various scientific associations, the clinical guidelines of which are widely consulted worldwide, is the best to support the current state of the art, being the starting point for the addition of new improvements to PB.

  7. Optical tomography of pigmented human skin biopsies

    NASA Astrophysics Data System (ADS)

    Riemann, Iris; Fischer, Peter; Kaatz, Martin; Fischer, Tobias W.; Elsner, Peter; Dimitrov, Enrico; Reif, Annette; Konig, Karsten

    2004-07-01

    The novel femtosecond NIR (near infrared) laser based high resolution imaging system DermaInspect was used for non-invasive diagnostics of pigmented skin. The system provides fluorescence and SHG images of high spatial submicron resolution (3D) and 250 ps temporal resolution (4D) based on time resolved single photon counting (TCSPC). Pigmented tissue biopsies from patients with nevi and melanoma have been investigated using the tunable 80 MHz femtosecond laser MaiTai with laser wavelengths in the range of 750 - 850 nm. The autofluorescence patterns of different intratissue cell types and structures were determined. The non-linear induced autofluorescence originates from naturally endogenous fluorophores and protein structures like NAD(P)H, flavins, elastin, collagen, phorphyrins and melanin. In addition to autofluorescence, SHG (second harmonic generation) was used to detect dermal collagen structures. Interestingly, pigmented cells showed intense luminescence signals. Further characterization of tissue components was performed via 4D measurements of the fluorescence lifetime (x, y, z, τ). The novel multiphoton technique offers the possibility of a painless high resolution non invasive diagnostic method (optical biopsy), in particular for the early detection of skin cancer.

  8. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    PubMed

    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.

  9. Combination of needle aspiration and core needle biopsy: A new technique of stereotactic biopsy

    PubMed Central

    Wani, Abrar Ahad; Wani, M. Afzal; Ramzan, Altaf U.; Nizami, Furqan A.; Malik, Nayil K.; Shafiq, S.; Ahmad, Rais; Kumar, Ashish; Lone, Iqbal; Makhdoomi, Rumana

    2016-01-01

    Aim: The study aims at describing the results of using a new technique to acquire the tissue sample in stereotactic biopsy of brain lesions. Materials and Methods: The study was performed in 19 patients over a period of 5 years in which we used the new technique, i.e., Abrar and Afzal technique (AT) of obtaining tissue biopsy. It is a combination of core tissue biopsy and needle aspiration techniques. The technique was devised to acquire greater amount of tissue for pathologic study. Results: While we could give pathologic diagnosis in 18 patients out of 19 (94.7%), in one patient, the tissue sample revealed only inflammatory cells and definitive diagnosis could not be reached. There was no significant morbidity or any mortality in the series. Conclusion: Abrar and Afzal technique is a reasonably accurate technique of acquiring larger tissue sample in stereotactic brain biopsy without any additional risks. It can be done with little modification of the conventional equipment available with the stereotactic system. PMID:27057212

  10. Magnetic Resonance Imaging Guided Vacuum Assisted and Core Needle Biopsies

    PubMed Central

    Kılıç, Fahrettin; Eren, Abdulkadir; Tunç, Necmettin; Velidedeoğlu, Mehmet; Bakan, Selim; Aydoğan, Fatih; Çelik, Varol; Gazioğlu, Ertuğrul; Yılmaz, Mehmet Halit

    2016-01-01

    Objective 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. Materials and Methods 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. Results 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. Conclusion 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.

  11. Geometric Evaluation of Systematic Transrectal Ultrasound Guided Prostate Biopsy

    PubMed Central

    Han, Misop; Chang, Doyoung; Kim, Chunwoo; Lee, Brian J.; Zuo, Yihe; Kim, Hyung-Joo; Petrisor, Doru; Trock, Bruce; Partin, Alan W.; Rodriguez, Ronald; Carter, H. Ballentine; Allaf, Mohamad; Kim, Jongwon; Stoianovici, Dan

    2013-01-01

    Purpose Transrectal ultrasound guided prostate biopsy results rely on physician ability to target the gland according to the biopsy schema. However, to our knowledge it is unknown how accurately the freehand, transrectal ultrasound guided biopsy cores are placed in the prostate and how the geometric distribution of biopsy cores may affect the prostate cancer detection rate. Materials and Methods To determine the geometric distribution of cores, we developed a biopsy simulation system with pelvic mock-ups and an optical tracking system. Mock-ups were biopsied in a freehand manner by 5 urologists and by our transrectal ultrasound robot, which can support and move the transrectal ultrasound probe. We compared 1) targeting errors, 2) the accuracy and precision of repeat biopsies, and 3) the estimated significant prostate cancer (0.5 cm3 or greater) detection rate using a probability based model. Results Urologists biopsied cores in clustered patterns and under sampled a significant portion of the prostate. The robot closely followed the predefined biopsy schema. The mean targeting error of the urologists and the robot was 9.0 and 1.0 mm, respectively. Robotic assistance significantly decreased repeat biopsy errors with improved accuracy and precision. The mean significant prostate cancer detection rate of the urologists and the robot was 36% and 43%, respectively (p <0.0001). Conclusions Systematic biopsy with freehand transrectal ultrasound guidance does not closely follow the sextant schema and may result in suboptimal sampling and cancer detection. Repeat freehand biopsy of the same target is challenging. Robotic assistance with optimized biopsy schemas can potentially improve targeting, precision and accuracy. A clinical trial is needed to confirm the additional benefits of robotic assistance. PMID:23088974

  12. A novel in vitro bovine cartilage punch model for assessing the regeneration of focal cartilage defects with biocompatible bacterial nanocellulose

    PubMed Central

    2013-01-01

    Introduction Current therapies for articular cartilage defects fail to achieve qualitatively sufficient tissue regeneration, possibly because of a mismatch between the speed of cartilage rebuilding and the resorption of degradable implant polymers. The present study focused on the self-healing capacity of resident cartilage cells in conjunction with cell-free and biocompatible (but non-resorbable) bacterial nanocellulose (BNC). This was tested in a novel in vitro bovine cartilage punch model. Methods Standardized bovine cartilage discs with a central defect filled with BNC were cultured for up to eight weeks with/without stimulation with transforming growth factor-β1 (TGF-β1. Cartilage formation and integrity were analyzed by histology, immunohistochemistry and electron microscopy. Content, release and neosynthesis of the matrix molecules proteoglycan/aggrecan, collagen II and collagen I were also quantified. Finally, gene expression of these molecules was profiled in resident chondrocytes and chondrocytes migrated onto the cartilage surface or the implant material. Results Non-stimulated and especially TGF-β1-stimulated cartilage discs displayed a preserved structural and functional integrity of the chondrocytes and surrounding matrix, remained vital in long-term culture (eight weeks) without signs of degeneration and showed substantial synthesis of cartilage-specific molecules at the protein and mRNA level. Whereas mobilization of chondrocytes from the matrix onto the surface of cartilage and implant was pivotal for successful seeding of cell-free BNC, chondrocytes did not immigrate into the central BNC area, possibly due to the relatively small diameter of its pores (2 to 5 μm). Chondrocytes on the BNC surface showed signs of successful redifferentiation over time, including increase of aggrecan/collagen type II mRNA, decrease of collagen type I mRNA and initial deposition of proteoglycan and collagen type II in long-term high-density pellet cultures

  13. Plane contact problem on indentation of a flat punch into a transversely-isotropic half-plane with functionally graded transversely-isotropic coating

    NASA Astrophysics Data System (ADS)

    Vasiliev, A. S.; Volkov, S. S.; Aizikovich, S. M.; Mitrin, B. I.

    2017-02-01

    Plane contact problem of the theory of elasticity on indentation of a non-deformable punch with a flat base into an elastic transversely-isotropic half-plane with a transversely-isotropic functionally graded coating is considered. Elastic moduli of the coating vary with depth according to arbitrary functions. An approximated analytical solution effective for a whole range of geometrical parameter (relative layer thickness) of the problem is constructed. Some properties of the contact normal pressure under the punch are obtained analytically and illustrated by the numerical examples for a transversely-isotropic homogeneous and functionally graded coatings with different types of variation of elastic moduli with depth. The distinctions in distribution of contact normal pressure for homogeneous and functionally graded materials, coated and non-coated bodies are studied analytically and numerically.

  14. Sixteen Gauge biopsy needles are better and safer than 18 Gauge in native and transplant kidney biopsies.

    PubMed

    Peters, Björn; Mölne, Johan; Hadimeri, Henrik; Hadimeri, Ursula; Stegmayr, Bernd

    2017-02-01

    Background Kidney biopsies are essential for optimal diagnosis and treatment. Purpose To examine if quality and safety aspects differ between types and sizes of biopsy needles in native and transplant kidneys. Material and Methods A total of 1299 consecutive biopsies (1039 native and 260 transplant kidneys) were included. Diagnostic quality, needle size and type, clinical data and complications were registered. Eight-three percent of the data were prospective. Results In native kidney biopsies, 16 Gauge (G) needles compared to 18 G showed more glomeruli per pass (11 vs. 8, P <  0.001) with less complications. Sub-analysis in native kidney biopsies revealed that 18 G 19-mm side-notch needles resulted in more major (11.3% vs. 3%; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.4-12.3) and overall complications (12.4% vs. 4.8%; OR, 2.8; 95% CI, 1.1-7.1) in women than in men. If the physician had performed less compared to more than four native kidney biopsies per year, minor (3.5% vs. 1.4%; OR, 2.6; 95% CI, 1.1-6.2) and overall complications (11.5% vs. 7.4%; OR, 1.6; 95% CI, 1.1-2.5) were more common. In transplant kidney biopsies, 16 G needles compared to 18 G resulted in more glomeruli per pass (12 vs. 8, P <  0.001). No differences existed in frequency of biopsy complications. The localization of performing biopsies was not a risk factor to develop complications. Conclusion Kidney biopsies taken by 16 G needles result in better histological quality and lower frequency of complications compared to 18 G. For native kidney biopsies the performer of the biopsy should do at least four biopsies per year.

  15. Unusual presentation; seeding of tumor after biopsy for hepatocellular carcinoma

    PubMed Central

    Aksoy, Asude; Karabulut, Koray; Artas, Hakan; Kilicarslan, Ahmet; Usta, Sertac; Bahcecioglu, Ibrahim Halil

    2016-01-01

    Hepatocellular cancer is one of the most common and fatal cancer tumor worldwide. However, the obtained results are questionable in terms of medical treatment of hepatocellular cancer. The muscle, soft tissue and cutaneous metastases of hepatocellular cancer, for instance, are rare and may result from interventional procedures. Seeding of tumor along the biopsy needle upon percutaneous biopsy is a very rare phenomenon. We report a very rare case of a 79 -year- old man, known to be hepatitis C virus carrier with a metastatic tumor in abdominal wall caused by seeding of tumor after three years following a percutaneous biopsy procedure. Even years later, after a biopsy procedure for diagnostic purposes and may be soft tissue metastases. This complication is a very rare condition that should not be ignored but can be observed. The biopsy requirement should be questioned closely and avoided unnecessary biopsy procedures. PMID:28083068

  16. The tabletting machine as an analytical instrument: qualification of the measurement devices for punch forces and validation of the calibration procedures.

    PubMed

    Belda, P M; Mielck, J B

    1998-11-01

    The quality of force measurement in an eccentric tabletting machine equipped with piezo-electric load washers mounted under pre-stress at the upper and lower punches, and the reliability of their calibration in situ and under working conditions were carefully investigated, since this tabletting machine is used as an 'analytical instrument' for the evaluation of the compression behaviour of pharmaceutical materials. For a quasistatic calibration procedure the repeatability under standard conditions and the robustness against variations in machine settings, installation conditions, equipment and handling were evaluated. Two differently constructed reference load cells equipped with strain gauges were used for the calibration of the upper punch sensor. The lower punch sensor was calibrated against the upper one. Except for a mechanical hysteresis, owing to uneven stress distribution over the piezo-electric sensors, the results of the quasistatic measurements are assessed to be satisfactory. In addition, dynamic calibrations were performed. One of the strain-gauged load cells was used in addition to two piezo-electric load washers installed without pre-stress. The dynamic behaviour of all the transducers used is deficient. While for the piezo-electric sensors a significant change in the slope of the calibration function with respect to the quasistatic behaviour was observed, for the strain-gauged load cell a pronounced hysteresis must be noted. Comparing the dynamic behaviour at different profiles of rates of force development generated by variations in machine speed and by maximum force setting, the variability in the sensitivity of the upper and lower punch piezo-electric load washers is comparatively small.

  17. Quantitation of dopamine, serotonin and adenosine content in a tissue punch from a brain slice using capillary electrophoresis with fast-scan cyclic voltammetry detection.

    PubMed

    Fang, Huaifang; Pajski, Megan L; Ross, Ashley E; Venton, B Jill

    2013-01-01

    Methods to determine neurochemical concentrations in small samples of tissue are needed to map interactions among neurotransmitters. In particular, correlating physiological measurements of neurotransmitter release and the tissue content in a small region would be valuable. HPLC is the standard method for tissue content analysis but it requires microliter samples and the detector often varies by the class of compound being quantified; thus detecting molecules from different classes can be difficult. In this paper, we develop capillary electrophoresis with fast-scan cyclic voltammetry detection (CE-FSCV) for analysis of dopamine, serotonin, and adenosine content in tissue punches from rat brain slices. Using field-amplified sample stacking, the limit of detection was 5 nM for dopamine, 10 nM for serotonin, and 50 nM for adenosine. Neurotransmitters could be measured from a tissue punch as small as 7 µg (7 nL) of tissue, three orders of magnitude smaller than a typical HPLC sample. Tissue content analysis of punches in successive slices through the striatum revealed higher dopamine but lower adenosine content in the anterior striatum. Stimulated dopamine release was measured in a brain slice, then a tissue punch collected from the recording region. Dopamine content and release had a correlation coefficient of 0.71, which indicates much of the variance in stimulated release is due to variance in tissue content. CE-FSCV should facilitate measurements of tissue content in nanoliter samples, leading to a better understanding of how diseases or drugs affect dopamine, serotonin, and adenosine content.

  18. Efficacy of Punch Elevation Combined with Fractional Carbon Dioxide Laser Resurfacing in Facial Atrophic Acne Scarring: A Randomized Split-face Clinical Study

    PubMed Central

    Faghihi, Gita; Nouraei, Saeid; Asilian, Ali; Keyvan, Shima; Abtahi-Naeini, Bahareh; Rakhshanpour, Mehrdad; Nilforoushzadeh, Mohammad Ali; Hosseini, Sayed Mohsen

    2015-01-01

    Background: A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO2) laser resurfacing combined with punch elevation with fractional CO2 laser resurfacing alone in the treatment of atrophic acne scars. Materials and Methods: Forty-two Iranian subjects (age range 18–55) with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO2 laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO2 laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment. Results: The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56). Their evaluation found that fractional CO2 laser treatment combined with punch elevation had greater efficacy than that with fractional CO2 laser treatment alone, assessed 4 months after treatment (P = 0.02). Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO2 laser treatment was significant on both treatment sides (P < 0.05). Conclusion: Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring. PMID:26538695

  19. Atopic dermatitis. Findings of skin biopsies.

    PubMed

    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.

  20. Automated quantitative muscle biopsy analysis system

    NASA Technical Reports Server (NTRS)

    Castleman, Kenneth R. (Inventor)

    1980-01-01

    An automated system to aid the diagnosis of neuromuscular diseases by producing fiber size histograms utilizing histochemically stained muscle biopsy tissue. Televised images of the microscopic fibers are processed electronically by a multi-microprocessor computer, which isolates, measures, and classifies the fibers and displays the fiber size distribution. The architecture of the multi-microprocessor computer, which is iterated to any required degree of complexity, features a series of individual microprocessors P.sub.n each receiving data from a shared memory M.sub.n-1 and outputing processed data to a separate shared memory M.sub.n+1 under control of a program stored in dedicated memory M.sub.n.

  1. [Surgical renal biopsies: technique, effectiveness and complications].

    PubMed

    Pinsach Elías, L; Blasco Casares, F J; Ibarz Servió, L; Valero Milián, J; Areal Calama, J; Bucar Terrades, S; Saladié Roig, J M

    1991-01-01

    Retrospective study made on 140 renal surgical biopsies (RSB) performed throughout the past 4 years in our Unit. The technique's effectiveness and morbidity are emphasized and the surgical technique and type of anaesthesia described. The sample obtained was enough to perform an essay in 100% cases, and a diagnosis was reached in 98.5%. Thirty-nine patients (27.8%) presented complications, 13 (9.2%) of which were directly related to the surgical technique. No case required blood transfusion and no deaths were reported. The type of anaesthesia used was: local plus sedation in 104 (74.2%) cases, rachianaesthesia in 10 (7.1%) and general in 26 (18.5%). The same approach was used in all patients: minimal subcostal lumbotomy, using Wilde's forceps to obtain the samples. It is believed that RSB is a highly effective, low mortality procedure, easy and quick to perform, and suitable for selected patients.

  2. Microfabricated instrument for tissue biopsy and analysis

    DOEpatents

    Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

    2001-01-01

    A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate.

  3. Patient Outcomes in Canceled MRI-Guided Breast Biopsies

    PubMed Central

    Niell, Bethany L.; Lee, Janie M.; Johansen, Christopher; Halpern, Elkan F.; Rafferty, Elizabeth A.

    2013-01-01

    OBJECTIVE. The reported frequency of aborted MRI-guided breast biopsies ranges from 8% to 17%, usually secondary to nonvisualization at attempted biopsy. Our study examines the frequency of MRI-guided breast biopsies aborted because of lesion nonvisualization and the subsequent risk of malignancy. MATERIALS AND METHODS. We identified 350 patients and 445 lesions scheduled for MRI-guided biopsy between January 1, 2007, and December 31, 2009. Medical records and imaging studies were reviewed to ascertain patient demographics, lesion and imaging characteristics, and subsequent pathology results. Chi-square statistics were calculated for patient level analyses. RESULTS. MRI-guided biopsies were aborted in 13% (56/445) of lesions and 15% (53/350; 95% CI, 11.6–19.3%) of patients because of nonvisualization of the biopsy target at the time of attempted biopsy. Of these 53 patients, 50 patients had follow-up data available. Malignancy was subsequently diagnosed in five of those 50 patients (10%; 95% CI, 3.3–21.8%) patients, three with invasive ductal carcinomas and two with ductal carcinoma in situ. The mean time to malignant diagnosis from the date of aborted biopsy was 2.6 months (range, 1.1–6.9 months). CONCLUSION. Informed consent for MRI-guided breast biopsies should include discussion of biopsy cancellation because of nonvisualization of the target lesion. The low yet significant risk of malignancy in patients subsequent to an aborted MRI-guided breast biopsy warrants short-term follow-up MRI after a canceled biopsy. PMID:24370148

  4. "Triple-punch" strategy for triple negative breast cancer therapy with minimized drug dosage and improved antitumor efficacy.

    PubMed

    Su, Shishuai; Tian, Yanhua; Li, Yiye; Ding, Yanping; Ji, Tianjiao; Wu, Meiyu; Wu, Yan; Nie, Guangjun

    2015-02-24

    Effective therapeutics against triple negative breast cancer (TNBC), which has no standard-of-care therapy, needs to be developed urgently. Here we demonstrated a strategy of integrating indocyanine green (ICG), paclitaxel (PTX), and survivin siRNA into one thermosensitive poly(2-(2-methoxyethoxy)ethyl methacrylate-co-oligo(ethylene glycol) methacrylate)-co-2-(dimethylamino)ethyl methacrylate-b-poly(D,L-lactide-co-glycolide) (P (MEO2MA-co-OEGMA-co-DMAEMA)-b-PLGA) nanoparticle (NP-IPS) for triple-punch strategy against TNBC. The NP-IPS significantly enhanced the stability of ICG. Controlled release of the PTX in tumor regions was triggered by the hyperthermia produced by laser irradiated ICG. The NP-IPS exhibited remarkable antitumor efficacy (almost complete ablation of the tumor xenografts) due to the combinational effects of chemotherapy, photothermal therapy, and gene therapy with low drug dose (ICG, 0.32 μmol/kg; PTX, 0.54 μmol/kg; siRNA, 1.5 mg/kg) and minimal side effects. Taken together, our current study demonstrates a nanoplatform for triple-therapy, which reveals a promising strategy for TNBC treatment.

  5. Operating manual for the U.S. Geological Survey minimonitor, 1988 revised edition; punched-paper-tape model

    USGS Publications Warehouse

    Ficken, James H.; Scott, Carl T.

    1988-01-01

    This manual describes the U.S. Geological Survey Minimonitor Water Quality Data Measuring and Recording System. Instructions for calibrating, servicing, maintaining, and operating the system are provided. The Survey Minimonitor is a battery-powered , multiparameter water quality monitoring instrument designed for field use. A watertight can containing signal conditioners is connected with cable and waterproof connectors to various water quality sensors. Data are recorded on a punched paper-tape recorder. An external battery is required. The operation and maintenance of various sensors and signal conditioners are discussed, for temperature, specific conductance, dissolved oxygen, and pH. Calibration instructions are provided for each parameter, along with maintenance instructions. Sections of the report explain how to connect the Minimonitor to measure direct-current voltages, such as signal outputs from other instruments. Instructions for connecting a satellite data-collection platform or a solid-state data recorder to the Minimonitor are given also. Basic information is given for servicing the Minimonitor and trouble-shooting some of its electronic components. The use of test boxes to test sensors, isolate component problems, and verify calibration values is discussed. (USGS)

  6. Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

    PubMed Central

    Cakmakci, Emin; Caliskan, Kosti Can; Tabakci, Omer Naci; Tahtabasi, Mehmet; Karpat, Zeki

    2013-01-01

    Background Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications may occur. Objectives To evaluate the efficiency, complications, safety and clinicopathological utility of ultrasonographic-guided percutaneous liver biopsy in diffuse liver disease. Patients and Methods In our retrospective study, we evaluated ultrasound-assisted needle biopsies that were performed in outpatients from October 2006 to July 2010. The liver biopsies were performed following one-night fasting using the tru-cut biopsy gun (18-20 gauge) after marking the best seen and hypovascular part of the liver, distant enough from the adjacent organs. Results A total of 1018 patients were referred to our radiology department. Most of the patients had hepatitis B (60.6%). The biopsy specimens were recorded and sent to our pathology department for histopathological examination. Conclusion According to the results of our series, percutaneous liver biopsy using the tru-cut biopsy gun guided by ultrasonography can be performed safely. We resolve that routine ultrasound of the puncture site is a quick, effective and safe procedure. The complication rate is very low. The US-assisted percutaneous liver biopsy should be used for all cases. PMID:24348609

  7. Use of core biopsy in diagnosing cervical lymphadenopathy: a viable alternative to surgical excisional biopsy of lymph nodes?

    PubMed

    Allin, D; David, S; Jacob, A; Mir, N; Giles, A; Gibbins, N

    2017-03-01

    OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy. In this study, we aimed to determine the efficacy of diagnosing neck masses. METHOD A retrospective analysis was performed of patients being investigated for a neck mass who were undergoing ultrasound-guided core biopsies of cervical lymph nodes over a 17-month period. The final histology report was scrutinised to assess whether adequate tissue was obtained to allow for full tissue diagnosis. RESULTS Over the 17-month period analysed, 70 patients with cervical lymphadenopathy underwent core biopsy. Of these, 63 (90%) were diagnostic for either lymphoma or other pathology and did not require further tissue sampling. Overall, 19 patients were diagnosed with lymphoma, of which only 1 required further biopsy due to inconclusive initial core biopsy. CONCLUSIONS Current guidelines for investigating lymphomas require that excisional biopsy be performed to obtain ample tissue to allow full nodal architecture assessment and ancillary investigation to reach an accurate histological classification. Within our head and neck multidisciplinary team, however, it is considered that results from core biopsies can be obtained in a more timely fashion and with histological accuracy equal to those of open biopsy. The results obtained demonstrate that core biopsy is an

  8. Deliveries from trophectoderm biopsied, fresh and vitrified blastocysts derived from polar body biopsied, vitrified oocytes.

    PubMed

    Grifo, Jamie; Adler, Alexis; Lee, Hsiao Ling; Morin, Scott J; Smith, Meghan; Lu, Lucy; Hodes-Wertz, Brooke; McCaffrey, Caroline; Berkeley, Alan; Munné, Santiago

    2015-08-01

    This longitudinal study reports preliminary findings of six patients who underwent first polar body biopsy followed by oocyte vitrification. All oocytes were warmed, inseminated by intracytoplasmic sperm injection and cultured to blastocyst. All suitable blastocysts underwent trophectoderm biopsy for aneuploidy screening, and supernumerary blastocysts were vitrified. Euploid blastocysts were transferred either fresh or in a subsequent programmed cycle. Of the 91 metaphase II oocytes, 30 had euploid first polar bodies. Development to blastocyst was more likely in oocytes with a euploid first polar body (66.7% versus 24.6%; P < 0.001). Nineteen euploid blastocysts were produced: 10 from oocytes with a euploid first polar body and nine from oocytes with an aneuploid first polar body. Five out of six patients (83%) had a live birth or ongoing pregnancy at the time of analysis. Eleven euploid blastocysts have been transferred and seven implanted (64%). Although the chromosomal status of the first polar body was poorly predictive of embryonic ploidy, an association was found between chromosomal status of the first polar body and development to blastocyst. Further study is required to characterize these relationships, but proof of concept is provided that twice biopsied, twice cryopreserved oocytes and embryos can lead to viable pregnancies.

  9. A case of severe necrotising pancreatitis following ampullary biopsy

    PubMed Central

    Barnes, J; French, J

    2015-01-01

    We present a case of necrotising pancreatitis following ampullary biopsy in a patient with Barrett’s oesophagus. The patient needed multiple necrosectomies and several admissions to the intensive care unit. This report is only the third and most severe case of pancreatitis following ampullary biopsy, highlighting its importance as a complication. PMID:26263955

  10. A case of severe necrotising pancreatitis following ampullary biopsy.

    PubMed

    Skelton, D; Barnes, J; French, J

    2015-05-01

    We present a case of necrotising pancreatitis following ampullary biopsy in a patient with Barrett's oesophagus. The patient needed multiple necrosectomies and several admissions to the intensive care unit. This report is only the third and most severe case of pancreatitis following ampullary biopsy, highlighting its importance as a complication.

  11. Biopsy of the right adrenal gland by the transhepatic approach

    SciTech Connect

    Price, R.B.; Bernardino, M.E.; Berkman, W.A.; Sones, P.J. Jr.; Torres, W.E.

    1983-08-01

    A transhepatic computed-tomographic-guided biopsy of a right adrenal mass is described. This method is simpler to perform than the usual posterior biopsy carried out with the patient prone and is less likely to cause a complicating pneumothorax. In seven of eight patients with right adrenal masses, adrenal tissue was obtained and an accurate diagnosis was possible. No complications resulted.

  12. Pulmonary Parenchymal Lymphoma Diagnosed by Bronchoscopic Cryoprobe Lung Biopsy.

    PubMed

    Schiavo, Dante; Batzlaff, Cassandra; Maldonado, Fabien

    2016-04-01

    A 51-year-old man presented with progressively worsening lung infiltrates and respiratory failure. Extensive investigations including bronchoscopy with bronchoalveolar lavage and conventional transbronchial forceps biopsies failed to establish the diagnosis. After transfer to our institution, he underwent repeat bronchoscopy with transbronchial cryobiopsy, which provided large, high-quality biopsy specimens establishing the diagnosis of parenchymal diffuse large B-cell lymphoma.

  13. Diffuse reflectance imaging: a tool for guided biopsy

    NASA Astrophysics Data System (ADS)

    Jayanthi, Jayaraj L.; Subhash, Narayanan; Manju, Stephen; Nisha, Unni G.; Beena, Valappil T.

    2012-01-01

    Accurate diagnosis of premalignant or malignant oral lesions depends on the quality of the biopsy, adequate clinical information and correct interpretation of the biopsy results. The major clinical challenge is to precisely locate the biopsy site in a clinically suspicious lesion. Dips due to oxygenated hemoglobin absorption have been noticed at 545 and 575 nm in the diffusely reflected white light spectra of oral mucosa and the intensity ratio R545/R575 has been found suited for early detection of oral pre-cancers. A multi-spectral diffuse reflectance (DR) imaging system has been developed consisting of an electron multiplying charge coupled device (EMCCD) camera and a liquid crystal tunable filter for guiding the clinician to an optimal biopsy site. Towards this DR images were recorded from 27 patients with potentially malignant lesions on their tongue (dorsal, lateral and ventral sides) and from 44 healthy controls at 545 and 575 nm with the DR imaging system. False colored ratio image R545/R575 of the lesion provides a visual discerning capability that helps in locating the most malignant site for biopsy. Histopathological report of guided biopsy showed that out of the 27 patients 16 were cancers, 9 pre-cancers and 2 lichen planus. In this clinical trial DR imaging has correctly guided 25 biopsy sites, yielding a sensitivity of 93% and a specificity of 98%, thereby establishing the potential of DR imaging as a tool for guided biopsy.

  14. Pre-cannulation lung biopsy shortens ECMO course.

    PubMed

    Lohmann, Pablo; Lee, Timothy C; Kearney, Debra L; Fernandes, Caraciolo J

    2016-07-01

    We describe the clinical course of an infant with respiratory failure who underwent lung biopsy prior to cannulation for undergoing extracorporeal membrane oxygenation (ECMO). Pathology revealed alveolar capillary dysplasia, and ECMO was discontinued. Rapid diagnosis allowed for closure and saved resources. We recommend considering early biopsy in infants with atypical pulmonary hypertension.

  15. Ultrasound-guided percutaneous splenic biopsy using an 18-G core biopsy needle: our experience with 52 cases

    PubMed Central

    Dawe, Gemma; Tung, Ken

    2015-01-01

    Objective: The spleen is more commonly affected in multiorgan disease, but alternative sites are selected for biopsy owing to perceived haemorrhage risk. If these sites are inaccessible or, less commonly, the spleen is the only disease site, then splenic biopsy is considered, with most studies using a 20- to 22-G needle. The primary aim of biopsy is to exclude underlying malignancy or to obtain histological analysis in known malignancy, usually lymphoma, when reclassification is required for therapy. We present, to our knowledge, the largest series of 18-G ultrasound-guided splenic core needle biopsy assessing diagnostic and complication rates. Methods: All ultrasound-guided splenic biopsy cases from May 1990 to May 2015 were identified on the radiology information system. Histological diagnosis and complications were identified from laboratory reports, case notes and discharge summaries to assess diagnostic positive and complication rates. Haemorrhages requiring transfusion, embolization or splenectomy, pneumothorax, other significant intra-abdominal injury or death are classified as major complications, whilst conservative haemorrhage management is considered a minor complication. Results: A total of 52 splenic biopsies were performed in 47 patients. A positive diagnostic yield for all biopsies was 90.4%. The major and minor complication rates were 0% and 1.9% (1/52), respectively. Conclusion: Ultrasound-guided 18-G splenic biopsy is a safe and accurate procedure with no added risk of complications when compared with smaller needles or biopsy of other abdominal organs. Advances in knowledge: This is the largest case series of ultrasound-guided splenic biopsy with an 18-G needle, and our experience confirms a high diagnostic yield and a complication rate which compares favourably with the biopsy of other abdominal organs. PMID:26337505

  16. Aspiration biopsy of testis: another method for histologic examination

    SciTech Connect

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.

    1984-08-01

    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective.

  17. CT-directed robotic biopsy testbed: motivation and concept

    NASA Astrophysics Data System (ADS)

    Cleary, Kevin R.; Stoianovici, Dan S.; Glossop, Neil D.; Gary, Kevin A.; Onda, Sumiyo; Cody, Richard; Lindisch, David; Stanimir, Alexandru; Mazilu, Dumitru; Patriciu, Alexandru; Watson, Vance; Levy, Elliot

    2001-05-01

    As a demonstration platform, we are developing a robotic biopsy testbed incorporating a mobile CT scanner, a small needle driver robot, and an optical localizer. This testbed will be used to compare robotically assisted biopsy to the current manual technique, and allow us to investigate software architectures for integrating multiple medical devices. This is a collaboration between engineers and physicians from three universities and a commercial vendor. In this paper we describe the CT-directed biopsy technique, review some other biopsy systems including passive and semi- autonomous devices, describe our testbed components, and present our software architecture. This testbed is a first step in developing the image-guided, robotically assisted, physician directed, biopsy systems of the future.

  18. Sentinel Node Biopsy in Early Breast Cancer.

    PubMed

    Basso, Stefano M M; Chiara, Giordano B; Lumachi, Franco

    2016-01-01

    The approach to the axilla is an evolving paradigm, and recognition of the complexity of breast cancer (BC) biology is changing treatment options. The sentinel lymph node biopsy (SLNB) technique is based on the excision and histological examination of the axillary lymph nodes(s), which is assumed to be the first one draining from the primary tumor. SLNB can accurately stage the axilla, and several trials have shown that there are no significant differences in local recurrence and overall survival between patients treated with or without axillary node dissection (ALND) after a negative SLNB. Surgical morbidity was significantly reduced in terms of rates of lymphedema and neuropathy, with reduced hospital stay and better quality of life after the SLNB procedure. ALND can safely be omitted in patients with ≥2 positive nodes who received conservative surgery and radiotherapy, while ALND is still recommended in clinically N1 BCs, in case of ≥3 positive nodes, and when the number of positive nodes would be crucial for the choice of chemotherapy. Micrometastatic disease can be safely managed with SLNB alone, and additional identification of micrometastases with immunohistochemistry does not affect disease-free survival or overall survival. An appropriate management of the axilla is crucial for the outcome of patients with early BC, and SLNB introduction into the clinical practice dramatically changed the surgical treatment, reducing morbidity without decreasing survival. A tailored approach should be suggested in each patient with BC, considering the biology of the tumor rather than nodal involvement.

  19. Microfabricated instrument for tissue biopsy and analysis

    DOEpatents

    Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

    1999-01-01

    A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate. For automation purposes, microvalves and micropumps may be incorporated. Also, specimens in parallel may be cut and treated with identical or varied chemicals. The instrument is disposable due to its low cost and thus could replace current expensive microtome and histology equipment.

  20. Uncompacted myelin lamellae in peripheral nerve biopsy.

    PubMed

    Vital, Claude; Vital, Anne; Bouillot, Sandrine; Favereaux, Alexandre; Lagueny, Alain; Ferrer, Xavier; Brechenmacher, Christiane; Petry, Klaus G

    2003-01-01

    Since 1979, the authors have studied 49 peripheral nerve biopsies presenting uncompacted myelin lamellae (UML). Based on the ultrastructural pattern of UML they propose a 3-category classification. The first category includes cases displaying regular UML, which was observed in 43 cases; it was more frequent in 9 cases with polyneuropathy organomegaly endocrinopathy m-protein skin changes (POEMS) syndrome as well as in 1 case of Charcot-Marie-Tooth 1B with a novel point mutation in the P0 gene. The second category consists of cases showing irregular UML, observed in 4 cases with IgM monoclonal gammopathy and anti-myelin-associated glycoprotein (MAG) activity. This group included 1 benign case and 3 B-cell malignant lymphomas. The third category is complex UML, which was present in 2 unrelated patients with an Arg 98 His missense mutation in the P0 protein gene. Irregular and complex UML are respectively related to MAG and P0, which play a crucial role in myelin lamellae compaction and adhesion.

  1. Hybrid tracers for sentinel node biopsy.

    PubMed

    Van Den Berg, N S; Buckle, T; Kleinjan, G I; Klop, W M; Horenblas, S; Van Der Poel, H G; Valdés-Olmos, R A; Van Leeuwen, F I

    2014-06-01

    Conventional sentinel node (SN) mapping is performed by injection of a radiocolloid followed by lymphoscintigraphy to identify the number and location of the primary tumor draining lymph node(s), the so-called SN(s). Over the last decade research has focused on the introduction of new imaging agents that can further aid (surgical) SN identification. Different tracers for SN mapping, with varying sizes and isotopes have been reported, most of which have proven their value in a clinical setting. A major challenge lies in transferring this diagnostic information obtained at the nuclear medicine department to the operating theatre thereby providing the surgeon with (image) guidance. Conventionally, an intraoperative injection of vital blue dye or a fluorescence dye is given to allow intraoperative optical SN identification. However, for some indications, the radiotracer-based approach remains crucial. More recently, hybrid tracers, that contain both a radioactive and fluorescent label, were introduced to allow for direct integration of pre- and intraoperative guidance technologies. Their potential is especially high when they are used in combination with new surgical imaging modalities and navigation tools. Next to a description of the known tracers for SN mapping, this review discusses the application of hybrid tracers during SN biopsy and how the introduction of these new techniques can further aid in translation of nuclear medicine information into the operating theatre.

  2. Increasing volume of vestibular soft tissues in flapless implant surgery through a modified connective punch technique: a controlled clinical trial

    PubMed Central

    BASSI, M. ANDREASI; ANDRISANI, C.; LICO, S.; SILVESTRE, F.; GARGARI, M.; ARCURI, C.

    2016-01-01

    SUMMARY Purpose The aim of this article is to make a comparative assessment between the modification of the soft-tissue profile, around the healing cap screws (HCSs), following both the traditional flapless surgery (TFS) and a new modified flapless surgery, named Modified Connective Tissue Punch (MCTP) technique. Materials and methods 8 patients (3M and 5F) (mean age 54.25±11.247 years) were enrolled in this study. Sixteen two-piece implants were placed on upper jaws, 2 for each patient, 8 with TFS and 8 with MCTP technique. In each patient the implants were placed in edentulous areas, of 2 or 3 adjacent teeth long. MCTP technique was performed on the front implant site (FIS) while the TFS was performed on the rear implant site (RIS). All implants were inserted and covered with healing cap screws (HCSs). Alginate impressions were carried out at the moment of the surgery, at 1 month and 4 months post-operative. Plaster models were poured and subsequently digitally scanned, in order to measure the distance between the gingival outline and the free margin of the HCS. The recorded values were analyzed with the ANOVA test. Results The use of MTCP technique, in comparison to TFS, showed a significative better outcome, in terms of vertical increments, of gingiva, on the VS toward the HCSs, during the entire observation period (p = 0.000 for all). Conclusion The Authors recommend the use of MCTP technique for a better vestibular soft tissue outcome in flapless implant surgery. PMID:28042442

  3. Numerical development of a new correlation between biaxial fracture strain and material fracture toughness for small punch test

    NASA Astrophysics Data System (ADS)

    Kumar, Pradeep; Dutta, B. K.; Chattopadhyay, J.

    2017-04-01

    The miniaturized specimens are used to determine mechanical properties of the materials, such as yield stress, ultimate stress, fracture toughness etc. Use of such specimens is essential whenever limited quantity of material is available for testing, such as aged/irradiated materials. The miniaturized small punch test (SPT) is a technique which is widely used to determine change in mechanical properties of the materials. Various empirical correlations are proposed in the literature to determine the value of fracture toughness (JIC) using this technique. bi-axial fracture strain is determined using SPT tests. This parameter is then used to determine JIC using available empirical correlations. The correlations between JIC and biaxial fracture strain quoted in the literature are based on experimental data acquired for large number of materials. There are number of such correlations available in the literature, which are generally not in agreement with each other. In the present work, an attempt has been made to determine the correlation between biaxial fracture strain (εqf) and crack initiation toughness (Ji) numerically. About one hundred materials are digitally generated by varying yield stress, ultimate stress, hardening coefficient and Gurson parameters. Such set of each material is then used to analyze a SPT specimen and a standard TPB specimen. Analysis of SPT specimen generated biaxial fracture strain (εqf) and analysis of TPB specimen generated value of Ji. A graph is then plotted between these two parameters for all the digitally generated materials. The best fit straight line determines the correlation. It has been also observed that it is possible to have variation in Ji for the same value of biaxial fracture strain (εqf) within a limit. Such variation in the value of Ji has been also ascertained using the graph. Experimental SPT data acquired earlier for three materials were then used to get Ji by using newly developed correlation. A reasonable

  4. Efficacy of bubaline fibrin glue on full-thickness pinch and punch skin grafting in a pig.

    PubMed

    Dejyong, Krittee; Kaewamatawong, Theerayuth; Brikshavana, Pasakorn; Durongphongtorn, Sumit

    2017-03-01

    Fibrin glue, which is formed from the action of thrombin (a serine protease) on fibrinogen, has been developed for use as an adhesive to increase the success of skin graft surgery. The objective of this study was to evaluate if bubaline fibrin glue would promote skin graft survival in pigs. The grafting was divided into two steps. First, granulation wound preparation was performed in a healthy swine by creating four full-skin depth wounds (3 × 12 cm(2)) at the dorsal part of the loin area on each side. Second, pinch and punch skin grafting, where eight skin discs (0.6 cm diameter) were regularly placed (0.6 cm distance apart) in the granulation tissue bed of each wound, was performed 5 days later. The bubaline fibrin glue was added prior to application of the 16 skin graft discs in two of the wounds, while no glue was added to the other 16 skin graft discs in the other two wounds. The number of surviving graft pieces and histological examination was evaluated after 3, 7, and 14 days post-operation and compared by pairing between the control and the bubaline fibrin glue groups. The number of grafts that remained at 3 and 7 days post-operation and the number of new microvessels at 3 days post-operation were significantly higher ( p < 0.05) in the bubaline fibrin glue group than in the control group. However, there was no significant difference in the number of fibroblasts, the intensity of scarring and the intensity of inflammation between the two groups, except for the significantly lower intensity of inflammation at 7 days post-operation in the bubaline fibrin glue group. In conclusion, bubaline fibrin glue has the advantage of decreasing the skin graft loss by approximately 31.3-37.5% compared with the control group and also promotes angiogenesis.

  5. The value of needle renal allograft biopsy. I. A retrospective study of biopsies performed during putative rejection episodes.

    PubMed Central

    Matas, A J; Sibley, R; Mauer, M; Sutherland, D E; Simmons, R L; Najarian, J S

    1983-01-01

    Following renal transplantation, immunosuppression is usually increased to treat presumed rejection episodes. However, a) many conditions mimic rejection in the post-transplant period, and b) many rejection episodes are irreversible. As increased immunosuppressive therapy is associated with an increased risk of infection, it would be ideal to limit antirejection therapy to only the rejection episodes that are reversible. The role of percutaneous allograft biopsy was studied as an aid to decide which patients to treat for rejection, to limit unnecessary immunosuppression and to predict allograft survival. One hundred thirty-five patients with suspected rejection underwent 206 allograft biopsies without complication. Two hundred four biopsies were available for study. Biopsies were coded on a 1-4 scale (minimal, mild, moderate, severe) for acute and chronic tubulointerstitial infiltrate and vascular rejection, as well as no rejection (e.g., recurrence of original disease). Treatment decisions were made on the basis of the biopsy combined with clinical data. All patients have been followed two years and outcome correlated with biopsy findings (death, nephrectomy, and return to dialysis defined as kidney loss). The results were the following: 1) biopsies represented changes within the kidney. Of 16 kidneys removed within one month of biopsy, no nephrectomy specimen showed less rejection than that seen on biopsy. 2) Eighty-one biopsies (39.7%) led to tapering or not increasing immunosuppression (either no rejection, minimal rejection, or irreversible changes). 3) Kidneys having either severe acute or chronic vascular rejection (less than 30% function at three months) had significantly (p less than 0.05) decreased survival three to 24 months postbiopsy than those with minimal or mild vascular rejection or tubulointerstitial infiltrate (83% function at three months). 4) Kidneys with moderate chronic vascular rejection and those with severe acute tubulointerstitial

  6. [The repeated biopsy in patients with lupus nephritis].

    PubMed

    Subils, Gisella; Alba, Paula; Gobbi, Carla; Astesana, Pablo; Babini, Alejandra; Albiero, Eduardo

    2014-01-01

    We retrospectively studied patients with SLE according to ACR criteria, with NL who underwent a repeat renal biopsy from 2005 to 2012. We analyzed the main indications of renal biopsies, the histopathological Class and activity and chronicity changes. RESULTS The total number of patients with NL was 120, of which 18 (15%) patients underwent repeat renal biopsy, 18 had 2 renal biopsies and 6 had 3 biopsies. 3 (16.7%) patients were smokers; 1 (5.6%) had a history of previous DBT, 2 (11.1%) had a history of hypertension; and 3 (16.7%) patients had previous obesity. The duration of SLE was 15 ± 96 months; the time between the 1st and the 2nd biopsy was 45 ± 11 months and the time between the 2nd and 3rd biopsy was 56 ± 12 months. Indications for repeat biopsy were proteinuria in 10 biopsies (41.6%); proteinuria with impaired renal function in 2 biopsies (8.3%); proteinuria with pathological urine sediment in 8 (33.3%); . and pathological proteinuria with pathological urine sediment and impaired renal function in 4 biopsies (16.6%) The most frequent histological changes found between first and repeat biopsies were class IV to class III: 2 (8.2%) ; Class IV to Class IV: 8 (33.3%), class IV to class III + V: 2 (8.2%); class IV to class IV + V 3 (12.5%); class IV to class V: 2 (8.2%). Changes in NL biopsies with proliferative activity and chronicity indices (A / C) were: A to A / C: 7 (29.1%), A / C to A / C: 7 (29.1%). The immunosuppressive therapy was increased in 79.1% and 16.6% remained without changes. 20% patients received cyclophosphamide 1 g every 30 days, 26% Cyclophosphamide 500 mg every 15 days, 23% induction therapy with mycophenolate mofetil; 23% with Rituximab; 8% Cyclosporin A. Maintenance therapy with mycophenolate mofetil was performed in 87.5%; azathioprine in 1 case. Hydroxychloroquine was used in all cases.

  7. Towards the mid-infrared optical biopsy

    NASA Astrophysics Data System (ADS)

    Seddon, Angela B.; Benson, Trevor M.; Sujecki, Slawomir; Abdel-Moneim, Nabil; Tang, Zhuoqi; Furniss, David; Sojka, Lukasz; Stone, Nick; Jayakrupakar, Nallala; Lloyd, Gavin R.; Lindsay, Ian; Ward, Jon; Farries, Mark; Moselund, Peter M.; Napier, Bruce; Lamrini, Samir; Møller, Uffe; Kubat, Irnis; Petersen, Christian R.; Bang, Ole

    2016-03-01

    We are establishing a new paradigm in mid-infrared molecular sensing, mapping and imaging to open up the midinfrared 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 in the body for real-time diagnosis. This new paradigm will be enabled through focused development of devices and systems which are robust, functionally designed, safe, compact and cost effective and are based on active and passive mid-infrared optical fibers. In particular, this will enable early diagnosis of external cancers, mid-infrared detection of cancer-margins during external surgery for precise removal of diseased tissue, in one go during the surgery, and mid-infrared endoscopy for early diagnosis of internal cancers and their precision removal. The mid-infrared spectral region has previously lacked portable, bright sources. We set a record in demonstrating extreme broad-band supercontinuum generated light 1.4 to 13.3 microns in a specially engineered, high numerical aperture mid-infrared optical fiber. The active mid-infrared fiber broadband supercontinuum for the first time offers the possibility 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, agriculture and in manufacturing and chemical processing. This work is in part supported by the European Commission: Framework Seven (FP7) Large-Scale Integrated Project MINERVA: MId-to-NEaR- infrared spectroscopy for improVed medical diAgnostics (317803; www.minerva-project.eu).

  8. High-frequency ultrasound imaging for breast cancer biopsy guidance

    PubMed Central

    Cummins, Thomas; Yoon, Changhan; Choi, Hojong; Eliahoo, Payam; Kim, Hyung Ham; Yamashita, Mary W.; Hovanessian-Larsen, Linda J.; Lang, Julie E.; Sener, Stephen F.; Vallone, John; Martin, Sue E.; Kirk Shung, K.

    2015-01-01

    Abstract. Image-guided core needle biopsy is the current gold standard for breast cancer diagnosis. Microcalcifications, an important radiographic finding on mammography suggestive of early breast cancer such as ductal carcinoma in situ, are usually biopsied under stereotactic guidance. This procedure, however, is uncomfortable for patients and requires the use of ionizing radiation. It would be preferable to biopsy microcalcifications under ultrasound guidance since it is a faster procedure, more comfortable for the patient, and requires no radiation. However, microcalcifications cannot reliably be detected with the current standard ultrasound imaging systems. This study is motivated by the clinical need for real-time high-resolution ultrasound imaging of microcalcifications, so that biopsies can be accurately performed under ultrasound guidance. We have investigated how high-frequency ultrasound imaging can enable visualization of microstructures in ex vivo breast tissue biopsy samples. We generated B-mode images of breast tissue and applied the Nakagami filtering technique to help refine image output so that microcalcifications could be better assessed during ultrasound-guided core biopsies. We describe the preliminary clinical results of high-frequency ultrasound imaging of ex vivo breast biopsy tissue with microcalcifications and without Nakagami filtering and the correlation of these images with the pathology examination by hematoxylin and eosin stain and whole slide digital scanning. PMID:26693167

  9. Strategies for prevention of ultrasound-guided prostate biopsy infections

    PubMed Central

    Lu, Diane D; Raman, Jay D

    2016-01-01

    Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to) prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. PMID:27468242

  10. Does Prebiopsy, Nonsterile Ultrasonography Gel Affect Biopsy-Site Asepsis?

    SciTech Connect

    Gurel, Kamil Karabay, Oguz; Gurel, Safiye; Hildebolt, Charles

    2008-01-15

    Purpose. The purpose of this study was to determine the extent to which the use of nonsterile gel, prior to antiseptic procedures in ultrasonography (US)-guided percutaneous biopsies, results in contamination of the biopsy site. Materials and Methods. Patients referred for US-guided percutaneous biopsies were included in this study. Transmission material used for US evaluation before biopsy-site antiseptic procedures were performed was either nonsterile gel or sterile saline. Patients were randomly assigned to two groups: nonsterile gel (n = 30) and sterile saline (n = 30). Before the transmission material was used and after antiseptic procedures were performed, microbial swabs of a 10-cm{sup 2}-diameter area were obtained at the biopsy site. Swabs were also obtained from the gel, saline, and povidine-iodine. Inoculated specimen plates were incubated at 37{sup o}C under aerobic conditions, and the numbers of colony-forming units recorded. Nominal logistic regression analysis was used to calculate the odds of postantisepsis bacterial growth (after antiseptic procedures were performed) based on group, gender, coincidental disease (diabetes, chronic renal failure, and malignancy), biopsy-site location (head and neck or breast and abdomen), and local factors (skin fold, skin tag, and hair). Results. The following odds ratios (adjusted for the other variables) and their 95% confidence intervals were calculated: (1) group (2.9 [0.8-11.1]; p = 0.10); (2) gender (1.2 [0.3-5.2]; p = 0.78); (3) coincidental disease (7.6 [0.9-166.7]; p = 0.09); (4) biopsy site location (6.2 [1.4-31.3]; p = 0.02); and (5) local factors (7.0 [1.6-36.0]; p = 0.01). No bacterial growth occurred with swabs obtained from gel, povidine-iodine, or saline. Conclusion. We conclude that nonsterile gel used prior to percutaneous biopsy does not affect biopsy-site asepsis.

  11. Ultra-High-Speed Observation of Cutting of Failure Phenomenon in Thin Metallic Lamina by Punch and Measurement of Displacements by Digital Image Correlation Method

    NASA Astrophysics Data System (ADS)

    Nishioka, Toshihisa; Iwawaki, Takashi; Fujimoto, Takehiro; Kashiwara, Yoshiyuki

    Machine components of industrial products are often produced by press cutting. However, the mechanism of cutting (ductile fracture of metals) is not perfectly understood. In order to clarify this mechanism, cutting processes were observed by an ultrahigh-speed camera. The ultrahigh-speed camera is capable of recording maximum record rate 1,000,000 frames per second (preserved images102 frames); each frame has 80,000 pixels. Therefore, this ultrahigh-speed camera is currently the world's most advanced camera in terms of spatial and time resolutions. A detailed movie of the cutting process was recorded. The details of the cutting process include the crack length versus time, crack tip opening angle, and fracture path. The crack tip opening angles were evaluated approximately 0.1 mm behind the tip of the propagating crack. The CTOA criterion was found to be almost valid during the cutting process. Furthermore, in order to use the image correlation method, random patterns were generated by spraying paint onto the metal sections. Images of a specimen section were taken after punching the sheet metal. The distributions of displacements were evaluated by the digital image correlation method. We found smoothly cut sections and rough surfaces. A smoothly cut section is very important for industrial products. In this study, the optimal speed of punching and punch-die clearances were examined. The ductile fracture criterion determined in this study is extremely useful for fabricating machine components by press cutting because it can be used for simulations without the need for a cutting system. The data of the image correlation method can be used for an intelligent hybrid method that can provide very accurate strain and stress distributions and fracture parameters such as the T* integral, which is the most promising fracture parameter for assessing the quality of metallic materials.

  12. Magnetic-resonance-guided biopsy of focal liver lesions.

    PubMed

    Smith, Ethan A; Grove, Jason J; Van Der Spek, Abraham F L; Jarboe, Marcus D

    2017-03-03

    Image-guided biopsy techniques are widely used in clinical practice. Commonly used methods employ either ultrasound (US) or computed tomography (CT) for image guidance. In certain patients, US or CT guidance may be suboptimal, or even impossible, because of artifacts, suboptimal lesion visualization, or both. We recently began performing magnetic resonance (MR)-guided biopsy of focal liver lesions in select pediatric patients with lesions that are not well visualized by US or CT. This report describes our experience performing MR-guided biopsy of focal liver lesions, with case examples to illustrate innovative techniques and novel aspects of these procedures.

  13. Third-harmonic generation imaging of breast tissue biopsies.

    PubMed

    Lee, Woowon; Kabir, Mohammad M; Emmadi, Rajyasree; Toussaint, Kimani C

    2016-11-01

    We demonstrate for the first time the imaging of unstained breast tissue biopsies using third-harmonic generation (THG) microscopy. As a label-free imaging technique, THG microscopy is compared to phase contrast and polarized light microscopy which are standard imaging methods for breast tissues. A simple feature detection algorithm is applied to detect tumour-associated lymphocyte rich regions in unstained breast biopsy tissue and compared with corresponding regions identified by a pathologist from bright-field images of hematoxylin and eosin stained breast tissue. Our results suggest that THG imaging holds potential as a complementary technique for analysing breast tissue biopsies.

  14. Automated Analysis of PIN-4 Stained Prostate Needle Biopsies

    NASA Astrophysics Data System (ADS)

    Sabata, Bikash; Babenko, Boris; Monroe, Robert; Srinivas, Chukka

    Prostate Needle biopsies are stained with the PIN-4 marker cocktail to help the pathologist distinguish between HGPIN and adenocarcinoma. The correct interpretation of multiple IHC markers can be challenging. Therefore we propose the use of computer aided diagnosis algorithms for the identification and classification of glands in a whole slide image of prostate needle biopsy. The paper presents the different issues related to the automated analysis of prostate needle biopsies and the approach taken by BioImagene in its first generation algorithms.

  15. Cancer Liquid Biopsy: Is It Ready for Clinic?

    PubMed

    Pan, Ying; Ji, John S; Jin, Jason Gang; Kuo, Winston Patrick; Kang, Hongjun

    2017-01-01

    The management of cancer relies on a combination of imaging and tissue biopsy for diagnosis, monitoring, and molecular classification-based patient stratification to ensure appropriate treatment. Conventional tissue biopsy harvests tumor samples with invasive procedures, which are often difficult for patients with advanced disease. Given the well-recognized intratumor genetic heterogeneity [1], the biopsy of small tumor fragments does not necessarily represent all the genetic aberrations in the tumor, but sampling the entire tumor in each patient is not realistic. Moreover, tumors evolve all the time from local to advanced disease and by adapting to selective pressure from treatment.

  16. Characterization of prostate cancer missed by sextant biopsy.

    PubMed

    Bak, John B; Landas, Steve K; Haas, Gabriel P

    2003-09-01

    There is a trend to increase the number of prostate biopsies taken to increase the detection rate of prostate cancer. We examined radical prostatectomy specimens and correlated the findings to those of preoperative sextant biopsy in an effort to identify the characteristics of tumors that went undetected by our biopsy regimen. Seventy-one patients diagnosed with prostate cancer based on sextant biopsy who underwent radical prostatectomy at our institution from June 1995 to November 2001 had prostatectomy specimens and biopsy slides reviewed. These specimens were step-sectioned and whole-mounted. The location, size, and grade of individual cancer foci in the prostatectomy specimens were correlated with results of the original sextant biopsies. Clinically significant tumors were defined as those with volume > 0.5 mL or Gleason score > or= 7 and extracapsular extension. In 33 patients (46%), there was concordance of biopsy and prostatectomy findings. In 38 patients (54%), additional lesions were demonstrated in the prostatectomy specimens that were not detected by our sextant biopsies. These included 13 cases (34%) with tumors > 0.5 mL and 25 cases in which the lesions were < 0.5 mL in size. However, 7 of these cases contained tumors with Gleason score > or =7. Tumors were located in the transition zone in 8 of these 38 cases (21%), and the remaining tumors were located in the peripheral zone (79%). No tumors with extracapsular extension were missed. Thus, 20 of the 71 cases (28%) had clinically significant cancers that went undetected by the traditional sextant biopsy method. Greater than 50% of patients who underwent sextant biopsy of the prostate had additional tumors that were missed when compared to the pathologic specimen. As many as 28% of these patients had clinically significant cancer based on size and grade criteria. A strategy of increased numbers of biopsies would improve the detection rate of these clinically important tumors. However, the ideal strategy

  17. Cutaneous metastatic pigmented breast carcinoma.

    PubMed

    Gaitan-Gaona, Francisco; Said, Mirra C; Valdes-Rodriguez, Rodrigo

    2016-03-16

    A 66-year-old woman presented with a 3 cm black, ulcerated nodule located on the skin of the upper abdomen, just below the breast. The lesion was painful to the touch, but the patient reported no other associated symptoms and was otherwise healthy. A 4-mm punch biopsy of the affected skin was obtained and the histological diagnosis was cutaneous metastatic pigmented breast carcinoma.

  18. Liquid Biopsy in Non-Small Cell Lung Cancer

    PubMed Central

    Molina-Vila, Miguel A.; Mayo-de-las-Casas, Clara; Giménez-Capitán, Ana; Jordana-Ariza, Núria; Garzón, Mónica; Balada, Ariadna; Villatoro, Sergi; Teixidó, Cristina; García-Peláez, Beatriz; Aguado, Cristina; Catalán, María José; Campos, Raquel; Pérez-Rosado, Ana; Bertran-Alamillo, Jordi; Martínez-Bueno, Alejandro; Gil, María-de-los-Llanos; González-Cao, María; González, Xavier; Morales-Espinosa, Daniela; Viteri, Santiago; Karachaliou, Niki; Rosell, Rafael

    2016-01-01

    Liquid biopsy analyses are already incorporated in the routine clinical practice in many hospitals and oncology departments worldwide, improving the selection of treatments and monitoring of lung cancer patients. Although they have not yet reached its full potential, liquid biopsy-based tests will soon be as widespread as “standard” biopsies and imaging techniques, offering invaluable diagnostic, prognostic, and predictive information. This review summarizes the techniques available for the isolation and analysis of circulating free DNA and RNA, exosomes, tumor-educated platelets, and circulating tumor cells from the blood of cancer patients, presents the methodological challenges associated with each of these materials, and discusses the clinical applications of liquid biopsy testing in lung cancer. PMID:28066769

  19. Liquid Biopsy in Non-Small Cell Lung Cancer.

    PubMed

    Molina-Vila, Miguel A; Mayo-de-Las-Casas, Clara; Giménez-Capitán, Ana; Jordana-Ariza, Núria; Garzón, Mónica; Balada, Ariadna; Villatoro, Sergi; Teixidó, Cristina; García-Peláez, Beatriz; Aguado, Cristina; Catalán, María José; Campos, Raquel; Pérez-Rosado, Ana; Bertran-Alamillo, Jordi; Martínez-Bueno, Alejandro; Gil, María-de-Los-Llanos; González-Cao, María; González, Xavier; Morales-Espinosa, Daniela; Viteri, Santiago; Karachaliou, Niki; Rosell, Rafael

    2016-01-01

    Liquid biopsy analyses are already incorporated in the routine clinical practice in many hospitals and oncology departments worldwide, improving the selection of treatments and monitoring of lung cancer patients. Although they have not yet reached its full potential, liquid biopsy-based tests will soon be as widespread as "standard" biopsies and imaging techniques, offering invaluable diagnostic, prognostic, and predictive information. This review summarizes the techniques available for the isolation and analysis of circulating free DNA and RNA, exosomes, tumor-educated platelets, and circulating tumor cells from the blood of cancer patients, presents the methodological challenges associated with each of these materials, and discusses the clinical applications of liquid biopsy testing in lung cancer.

  20. Pulmonary sarcoidosis: An important differential diagnosis in transbronchial lung biopsies

    PubMed Central

    Mahapatra, Qury S.; Sahai, Kavita; Rathi, K. R.; Singh, Sarvinder; Sharma, Shruti

    2014-01-01

    Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Lungs and lymphatics are the principal sites affected by this disease. The disorder is often not suspected by physicians. Materials and Methods: This was a retrospective study done on 140 transbronchial lung biopsies received for histopathological examination in the Department of Pathology for 1 year in a multispeciality tertiary care hospital, in Delhi. Results: Out of 140 transbronchial lung biopsies studied, 13 cases of sarcoidosis were diagnosed histopathologically. In these patients a clinical, pathological, and radiological corelation was done. And a final diagnosis of sarcoidosis was given after excluding other granulomatous lesions. Conclusion: Transbronchial lung biopsies have become an important tool in the diagnosis of sarcoidosis in present time. Hence sarcoidosis should be considered as a differential diagnosis when dealing with granulomatous lesions in lung biopsies. PMID:24778476

  1. CT guided percutaneous needle biopsy of the chest: initial experience

    PubMed Central

    Lazguet, Younes; Maarouf, Rachid; Karrou, Marouan; Skiker, Imane; Alloubi, Ihsan

    2016-01-01

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015. Diagnosis was achieved in 18 patients (75%), negative results were found in 3 patients (12,5%). Biopsy was repeated in these cases with two positive results. Complications were seen in 7 patients (29%), Hemoptysis in 5 patients (20%), Pneumothorax in 1 patient (4,1%) and vaso-vagal shock in 1 patient (4,1%). CT Guided Percutaneous Needle Biopsy of the Chest is a safe, minimally invasive procedure with high sensitivity, specificity and accuracy for diagnosis of lung lesions. PMID:27347300

  2. Breast Biopsy: The Effects of Hypnosis and Music.

    PubMed

    Téllez, Arnoldo; Sánchez-Jáuregui, Teresa; Juárez-García, Dehisy M; García-Solís, Manuel

    2016-01-01

    The authors evaluated the efficacies of audio-recorded hypnosis with background music and music without hypnosis in the reduction of emotional and physical disturbances in patients scheduled for breast biopsy in comparison with a control group. A total of 75 patients were randomly assigned to 3 different groups and evaluated at baseline and before and after breast biopsy using visual analog scales of stress, pain, depression, anxiety, fatigue, optimism, and general well-being. The results showed that, before breast biopsy, the music group presented less stress and anxiety, whereas the hypnosis with music group presented reduced stress, anxiety, and depression and increased optimism and general well-being. After the biopsy, the music group presented less anxiety and pain, whereas the hypnosis group showed less anxiety and increased optimism.

  3. [Biopsy of lung tissue in the diagnosis of disseminated transformations].

    PubMed

    Lewaschow, J N; Orsheschkowskij, O W

    1988-01-01

    The results of complex studies in 440 patients with disseminated processes are presented. In 135 of them the diagnosis was confirmed by clinical, roentgenologic and laboratory data and by biopsies of skin, muscles and subcutaneous lymph nodes. Transbronchial lung biopsy was performed in 218 patients. It gave positive results in 65% of the cases. Open biopsy of lung was performed in 134 cases. Hemodynamic and gas exchange studies during the operation indicated its insignificant traumatism. Complications (limited hemothorax, partial pneumothorax, subcutaneous emphysema, wound suppuration) were noted in 10 (7.5%) cases in the postoperative period. Pulmonary tests performed three weeks after the operation did not reveal significant changes in the subjects, even those with considerable initial disorders. Open biopsy permitted to verify the diagnosis in 131 (98%) patients. In 52% of these cases the diagnosis did not correspond to the presumed one and considerably influenced the subsequent treatment.

  4. The disappearing clip: an unusual complication in MRI biopsy

    PubMed Central

    Bourke, Anita Geraldine; Peter, Prasant; Jose, Chaitra Lesli

    2014-01-01

    MRI-guided biopsies are being increasingly used for otherwise occult breast lesions. Clip migration has been reported however, to the best of our knowledge, there have been no documented cases of entire disappearance of a marker clip. Absence of the postbiopsy marker clip was noted when our patient returned for preoperative hook-wire localisation even though accurate clip placement had been confirmed on the post-MRI biopsy mammogram. PMID:25139917

  5. Thoracoscopic localization of nonpalpable rib tumors for excisional biopsy.

    PubMed

    McDonald, J M; Freeman, R K

    2000-07-01

    Nonpalpable tumors of the rib can be difficult to localize accurately at the time of excisional biopsy. Furthermore, the ability of current imaging techniques to assess pleural or pulmonary involvement is not reliable. An intraoperative localization method using single port thoracoscopy is discussed which allows optimal placement of a biopsy incision and provides an accurate assessment of any tumor invasion into the adjacent pleura or lung.

  6. Barbed micro-spikes for micro-scale biopsy

    NASA Astrophysics Data System (ADS)

    Byun, Sangwon; Lim, Jung-Min; Paik, Seung-Joon; Lee, Ahra; Koo, Kyo-in; Park, Sunkil; Park, Jaehong; Choi, Byoung-Doo; Seo, Jong Mo; Kim, Kyung-ah; Chung, Hum; Song, Si Young; Jeon, Doyoung; Cho, Dongil

    2005-06-01

    Single-crystal silicon planar micro-spikes with protruding barbs are developed for micro-scale biopsy and the feasibility of using the micro-spike as a micro-scale biopsy tool is evaluated for the first time. The fabrication process utilizes a deep silicon etch to define the micro-spike outline, resulting in protruding barbs of various shapes. Shanks of the fabricated micro-spikes are 3 mm long, 100 µm thick and 250 µm wide. Barbs protruding from micro-spike shanks facilitate the biopsy procedure by tearing off and retaining samples from target tissues. Micro-spikes with barbs successfully extracted tissue samples from the small intestines of the anesthetized pig, whereas micro-spikes without barbs failed to obtain a biopsy sample. Parylene coating can be applied to improve the biocompatibility of the micro-spike without deteriorating the biopsy function of the micro-spike. In addition, to show that the biopsy with the micro-spike can be applied to tissue analysis, samples obtained by micro-spikes were examined using immunofluorescent staining. Nuclei and F-actin of cells which are extracted by the micro-spike from a transwell were clearly visualized by immunofluorescent staining.

  7. CT Fluoroscopy-Guided Lung Biopsy with Novel Steerable Biopsy Canula: Ex-Vivo Evaluation in Ventilated Porcine Lung Explants

    SciTech Connect

    Schaefer, Philipp J. Fabel, Michael; Bolte, Hendrik; Schaefer, Fritz K. W.; Jahnke, Thomas; Heller, Martin; Lammer, Johannes; Biederer, Juergen

    2010-08-15

    The purpose was to evaluate ex-vivo a prototype of a novel biopsy canula under CT fluoroscopy-guidance in ventilated porcine lung explants in respiratory motion simulations. Using an established chest phantom for porcine lung explants, n = 24 artificial lesions consisting of a fat-wax-Lipiodol mixture (approx. 70HU) were placed adjacent to sensible structures such as aorta, pericardium, diaphragm, bronchus and pulmonary artery. A piston pump connected to a reservoir beneath a flexible silicone reconstruction of a diaphragm simulated respiratory motion by rhythmic inflation and deflation of 1.5 L water. As biopsy device an 18-gauge prototype biopsy canula with a lancet-like, helically bended cutting edge was used. The artificial lesions were punctured under CT fluoroscopy-guidance (SOMATOM Sensation 64, Siemens, Erlangen, Germany; 30mAs/120 kV/5 mm slice thickness) implementing a dedicated protocol for CT fluoroscopy-guided lung biopsy. The mean-diameter of the artificial lesions was 8.3 {+-} 2.6 mm, and the mean-distance of the phantom wall to the lesions was 54.1 {+-} 13.5 mm. The mean-displacement of the lesions by respiratory motion was 14.1 {+-} 4.0 mm. The mean-duration of CT fluoroscopy was 9.6 {+-} 5.1 s. On a 4-point scale (1 = central; 2 = peripheral; 3 = marginal; 4 = off target), the mean-targeted precision was 1.9 {+-} 0.9. No misplacement of the biopsy canula affecting adjacent structures could be detected. The novel steerable biopsy canula proved to be efficient in the ex-vivo set-up. The chest phantom enabling respiratory motion and the steerable biopsy canula offer a feasible ex-vivo system for evaluating and training CT fluoroscopy-guided lung biopsy adapted to respiratory motion.

  8. Optimizing prostate needle biopsy through 3D simulation

    NASA Astrophysics Data System (ADS)

    Zeng, Jianchao; Kaplan, Charles; Xuan, Jian Hua; Sesterhenn, Isabell A.; Lynch, John H.; Freedman, Matthew T.; Mun, Seong K.

    1998-06-01

    Prostate needle biopsy is used for the detection of prostate cancer. The protocol of needle biopsy that is currently routinely used in the clinical environment is the systematic sextant technique, which defines six symmetric locations on the prostate surface for needle insertion. However, this protocol has been developed based on the long-term observation and experience of urologists. Little quantitative or scientific evidence supports the use of this biopsy technique. In this research, we aim at developing a statistically optimized new prostate needle biopsy protocol to improve the quality of diagnosis of prostate cancer. This new protocol will be developed by using a three-dimensional (3-D) computer- based probability map of prostate cancer. For this purpose, we have developed a computer-based 3-D visualization and simulation system with prostate models constructed from the digitized prostate specimens, in which the process of prostate needle biopsy can be simulated automatically by the computer. In this paper, we first develop an interactive biopsy simulation mode in the system, and evaluate the performance of the automatic biopsy simulation with the sextant biopsy protocol by comparing the results by the urologist using the interactive simulation mode with respect to 53 prostate models. This is required to confirm that the automatic simulation is accurate and reliable enough for the simulation with respect to a large number of prostate models. Then we compare the performance of the existing protocols using the automatic biopsy simulation system with respect to 107 prostate models, which will statistically identify if one protocol is better than another. Since the estimation of tumor volume is extremely important in determining the significance of a tumor and in deciding appropriate treatment methods, we further investigate correlation between the tumor volume and the positive core volume with 89 prostate models. This is done in order to develop a method to

  9. Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast.

    PubMed

    Perlet, C; Heinig, A; Prat, X; Casselman, J; Baath, L; Sittek, H; Stets, C; Lamarque, J; Anderson, I; Schneider, P; Taourel, P; Reiser, M; Heywang-Köbrunner, S H

    2002-06-01

    The purpose of this multicenter study was to determine the accuracy and clinical value of a dedicated breast biopsy system which allows for MR-guided vacuum biopsy (VB) of contrast-enhancing lesions. In five European centers, MR-guided 11-gauge VB was performed on 341 lesions. In 7 cases VB was unsuccessful. This was immediately realized on postinterventional images or direct follow-up combined with histopathology-imaging correlation; thus, a false-negative diagnosis was avoided. Histology of 334 successful biopsies yielded 84 (25%) malignancies, 17 (5%) atypical ductal hyperplasias, and 233 (70%) benign entities. Verification of malignant or borderline lesions included reexcision of the biopsy cavity. Benign histologic biopsy results were verified by retrospective correlation with the pre- and postinterventional MRI and by subsequent follow-up. Our results indicate that MR-guided VB, in combination with the dedicated biopsy coil, offers the possibility to accurately diagnose even very small lesions that can only be visualized or localized by MRI.

  10. Wall or machine suction rectal biopsy for Hirschsprung's disease: a simple modified technique can improve the adequacy of biopsy.

    PubMed

    Ali, A E; Morecroft, J A; Bowen, J C; Bruce, J; Morabito, A

    2006-08-01

    Suction rectal biopsy (SRB) may not include sufficient submucosa for histological diagnosis of Hirschsprung's disease (HD) and a repeat biopsy is required. Substitution of the conventional syringe for sustained suction from a machine or wall suction unit could provide a more consistently adequate tissue biopsy. This study was conducted to compare the adequacy of SRB specimens using a conventional method of syringe suction (SSRB) with those taken by wall or machine suction (WSRB). Hospital records of patients who had a SRB between 2002 and 2004 were studied retrospectively. The biopsy was considered inadequate if there was insufficient submucosa and a repeat specimen was requested. SSRB were taken using the conventional SSRB technique. WSRB were taken with the same Noblett forceps but with suction from wall suction or from a portable suction machine. Ninety-five infants had 103 SRB, 24 had WSRB and all (100%) were adequate for histopathological diagnosis or exclusion of HD. Seventy nine conventional SSRB were undertaken in 71 infants of which 64 (81.02%) were adequate. The difference in adequacy between WSRB and SSRB was statistically significant (P = 0.02). There were no instances of haemorrhage or bowel perforation in either subgroup. WSRB with the Noblett biopsy forceps is more likely to produce an adequate specimen and to reduce the incidence of repeat biopsies.

  11. Polymerase chain reaction detection of Leishmania DNA in skin biopsy samples in Sri Lanka where the causative agent of cutaneous leishmaniasis is Leishmania donovani.

    PubMed

    Ranasinghe, Shalindra; Wickremasinghe, Renu; Hulangamuwa, Sanjeeva; Sirimanna, Ganga; Opathella, Nandimithra; Maingon, Rhaiza D C; Chandrasekharan, Vishvanath

    2015-12-01

    Leishmania donovani is the known causative agent of both cutaneous (CL) and visceral leishmaniasis in Sri Lanka. CL is considered to be under-reported partly due to relatively poor sensitivity and specificity of microscopic diagnosis. We compared robustness of three previously described polymerase chain reaction (PCR) based methods to detect Leishmania DNA in 38 punch biopsy samples from patients presented with suspected lesions in 2010. Both, Leishmania genus-specific JW11/JW12 KDNA and LITSR/L5.8S internal transcribed spacer (ITS)1 PCR assays detected 92% (35/38) of the samples whereas a KDNA assay specific forL. donovani (LdF/LdR) detected only 71% (27/38) of samples. All positive samples showed a L. donovani banding pattern upon HaeIII ITS1 PCR-restriction fragment length polymorphism analysis. PCR assay specificity was evaluated in samples containing Mycobacterium tuberculosis, Mycobacterium leprae, and human DNA, and there was no cross-amplification in JW11/JW12 and LITSR/L5.8S PCR assays. The LdF/LdR PCR assay did not amplify M. leprae or human DNA although 500 bp and 700 bp bands were observed in M. tuberculosis samples. In conclusion, it was successfully shown in this study that it is possible to diagnose Sri Lankan CL with high accuracy, to genus and species identification, using Leishmania DNA PCR assays.

  12. Use of a hemostasis introducer sheath to guide clip delivery during stereotactic directional vacuum-assisted breast biopsy when the biopsy system malfunctions.

    PubMed

    Wang, Jane; Chang, Chun-Ju

    2010-01-01

    Stereotactic directional vacuum-assisted breast biopsy (ST DVAB) is an accurate biopsy method. Marking the biopsy site with a clip is mandatory after ST DVAB, in case excision is required. With the ST DVAB system we use, clip was delivered through the biopsy probe. We report a case with malfunctioning of the ST DVAB system during the procedure, and thus the clip could not be placed through the biopsy probe. To salvage the procedure, we placed the clip to the biopsy site via a hemostasis introducer sheath.

  13. MORPHOLOGICAL PATTERN OF ENDOMETRIAL BIOPSIES IN SOUTHWESTERN NIGERIA

    PubMed Central

    Abdullahi, YM; Ajani, MA; Iyapo, O; Aramide, KO; Okolo, CA; Akang, EEU

    2016-01-01

    Background: Endometrium remains the most sensitive indicator of ovarian function and endometrial biopsy is one of the diagnostic procedures in endometrial pathology. The current study was carried out to examine the morphological pattern of endometrial biopsies in Ibadan, South-western Nigeria and compare the results with similar studies. Method: A retrospective study was undertaken to review all cases of endometrial biopsies received in the Department of Pathology, University College Hospital, Ibadan between January 1999 and December 2008. The patients' data were retrieved from the surgical pathology daybooks and Histology Request forms. The neoplastic lesions were classified according to 2003 World Health Organization classification for endometrial neoplasms. Results: A total of 2,444 cases of endometrial biopsies were received during the 10-year study period. The functional endometrial changes were the most common histopathological diagnostic category, accounting for 53.8% (1035) of cases. Other pathological diagnoses included endometritis (7.8%), simple endometrial hyperplasia (5.8%), partial hydatidiform mole (2.3%), complete hydatidiform mole (2.1%) and malignant neoplastic lesions (3.9%). Infertility was the most common (57%) indication for endometrial biopsies followed by uterine bleeding (33%) while the least common clinical indication were the menstrual disorders (10%). Conclusion: The functional endometrial changes account for the highest morphological patterns while malignant lesions account for the least pattern of the endometrial biopsies evaluated for etiological basis of infertility, uterine bleeding and menstrual disorders in Ibadan. Infertility was the commonest indication for endometrial biopsies while the least common clinical indication was menstrual disorders. PMID:28337096

  14. Surveillance biopsies after paediatric kidney transplantation: A review.

    PubMed

    Rose, Edward M; Kennedy, Sean E; Mackie, Fiona E

    2016-09-01

    Kidney transplantation is the most effective means of treating children with end-stage kidney disease, and yet, there continues to be a limited "life span" of transplanted kidneys in paediatric recipients. Early graft monitoring, using the surveillance biopsy, has the potential to extend renal allograft survival in paediatric recipients. The surveillance biopsy provides important and timely information about acute and chronic graft pathology, particularly SCR and calcineurin inhibitor-induced nephrotoxicity, which can subsequently guide management decisions and improve long-term graft survival. The ostensible value of the surveillance biopsy is furthered by the limitations of conventional renal functional studies. However, there is still much debate surrounding the surveillance biopsy in paediatric recipients, particularly in regard to its overall utility, safety and timing. This review discusses the current literature regarding the utility, safety, and potential predictive value of surveillance biopsies for guiding post-transplant management in paediatric renal allograft recipients, as well as the viability of other potentially newer non-invasive strategies for renal allograft monitoring.

  15. Remote biopsy darting and marking of polar bears

    USGS Publications Warehouse

    Pagano, Anthony M.; Peacock, Elizabeth; McKinney, Melissa A.

    2014-01-01

    Remote biopsy darting of polar bears (Ursus maritimus) is less invasive and time intensive than physical capture and is therefore useful when capture is challenging or unsafe. We worked with two manufacturers to develop a combination biopsy and marking dart for use on polar bears. We had an 80% success rate of collecting a tissue sample with a single biopsy dart and collected tissue samples from 143 polar bears on land, in water, and on sea ice. Dye marks ensured that 96% of the bears were not resampled during the same sampling period, and we recovered 96% of the darts fired. Biopsy heads with 5 mm diameters collected an average of 0.12 g of fur, tissue, and subcutaneous adipose tissue, while biopsy heads with 7 mm diameters collected an average of 0.32 g. Tissue samples were 99.3% successful (142 of 143 samples) in providing a genetic and sex identification of individuals. We had a 64% success rate collecting adipose tissue and we successfully examined fatty acid signatures in all adipose samples. Adipose lipid content values were lower compared to values from immobilized or harvested polar bears, indicating that our method was not suitable for quantifying adipose lipid content.

  16. Repeat Prostate-Specific Antigen Tests Before Prostate Biopsy Decisions.

    PubMed

    Nordström, Tobias; Adolfsson, Jan; Grönberg, Henrik; Eklund, Martin

    2016-12-01

    Despite limited scientific support, a repeat prostate-specific antigen (PSA) test before prostate biopsy decisions is common. We analyzed biopsy outcomes in 1686 men from the STHLM3 study with PSA 3-10 ng/mL and two PSA tests taken within eight weeks and before prostate biopsy using percentages and multinomial logistic regression. We found that omitting prostate biopsy for men with PSA values decreasing to PSAs of 3 ng/mL or less would save 16.8% of biopsy procedures, while missing 5.4% of the cancers with Gleason scores (GSs) of 7 or higher. The proportion of cancers with GSs of 6 or lower was independent of the first PSA value, as well as of PSA change. Also, the risk of tumors with GSs of 7 or higher decreased with both decreasing and increasing PSA levels: It was 18.6% (95% confidence interval [CI] = 16.3% to 20.9%) for men with PSA changes of less than 20%, 12.1% (95% CI = 8.0% to 16.2%) for men with PSA levels increasing at least 20%, and 6.6% (95% CI = 3.8% to 9.3%) for men with PSA levels decreasing at least 20%.

  17. Update on Myocarditis and Inflammatory Cardiomyopathy: Reemergence of Endomyocardial Biopsy.

    PubMed

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

    2016-02-01

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

  18. Renal biopsy: Still a landmark for the nephrologist

    PubMed Central

    Visconti, Luca; Cernaro, Valeria; Ricciardi, Carlo Alberto; Lacava, Viviana; Pellicanò, Vincenzo; Lacquaniti, Antonio; Buemi, Michele; Santoro, Domenico

    2016-01-01

    Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance. Bleeding is the major primary complication that in rare cases may lead to retroperitoneal haemorrhage and need for surgical intervention and/or death. For this reason, careful evaluation of risks and benefits must be taken into account, and all procedures to minimize the risk of complications must be observed. After biopsy, an observation time of 12-24 h is necessary, whilst a prolonged observation may be needed rarely. In some cases it could be safer to use different techniques to reduce the risk of complications, such as laparoscopic or transjugular renal biopsy in patients with coagulopathy or alternative approaches in obese patients. Despite progress in medicine over the years with the introduction of more advanced molecular biology techniques, renal biopsy is still an irreplaceable tool for nephrologists. PMID:27458561

  19. Liquid Biopsy of Hepatocellular Carcinoma: Circulating Tumor-Derived Biomarkers.

    PubMed

    Yin, Chang-Qing; Yuan, Chun-Hui; Qu, Zhen; Guan, Qing; Chen, Hao; Wang, Fu-Bing

    2016-01-01

    Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide due to latent liver disease, late diagnosis, and nonresponse to systemic treatments. Till now, surgical and/or biopsy specimens are still generally used as a gold standard by the clinicians for clinical decision-making. However, apart from their invasive characteristics, tumor biopsy only mirrors a single spot of the tumor, failing to reflect current cancer dynamics and progression. Therefore, it is imperative to develop new diagnostic strategies with significant effectiveness and reliability to monitor high-risk populations and detect HCC at an early stage. In the past decade, the potent utilities of "liquid biopsy" have attracted intense concern and were developed to evaluate cancer progression in several clinical trials. "Liquid biopsies" represent a series of noninvasive tests that detect cancer byproducts easily accessible in peripheral blood, mainly including circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) that are shed into the blood from the tumor sites. In this review, we focus on the recent developments in the field of "liquid biopsy" as well as the diagnostic and prognostic significance of CTCs and cfNAs in HCC patients.

  20. [Celebrating fifty years of percutaneous renal biopsies in Spain].

    PubMed

    García Nieto, V; Luis Yanes, M I; Ruiz Pons, M

    2009-01-01

    The first renal biopsies, made as much in adults as in children, were surgical. They were made to patients who were under renal decapsulation with the intention to reduce the kidney pressure, especially in cases of nephrotic syndrome. In 1944, Nils Alwall initiated the accomplishment of percutaneous kidney biopsies by means of a needle and aspiration at the University of Lund (Sweden), although his experience was published in 1952. The first article that had by subject the practice of a percutaneous renal biopsy was written in 1950 by a Cuban doctor, Antonino Pérez Ara, and published in a local journal with little diffusion. The first work that appeared in a Spanish journal (1953) about the practice of the percutaneus renal biopsies was not signed by any Spanish group but by members of the Hospital "Calixto García" of the University of The Havana, Cuba. The first article published in Spain regarding to this subject, saw the light in 1958, now 50 years ago, in the Revista Clínica Española. The two first signers were Alfonso de la Peña Pineda and Vicente Gilsanz García, professors of the Medicine Faculty of Madrid. Later, the practice of the percutaneous renal biopsy became general in other Spanish hospitals.

  1. Liquid Biopsies for Cancer: Coming to a Patient near You

    PubMed Central

    Krishnamurthy, Nithya; Spencer, Emily; Torkamani, Ali; Nicholson, Laura

    2017-01-01

    The use of circulating tumor DNA (ctDNA) as a novel and non-invasive test for the diagnosis and surveillance of cancer is a rapidly growing area of interest, with sequencing of ctDNA acting as a potential surrogate for tissue biopsy. Circulating tumor DNA has been detected incidentally during noninvasive prenatal testing and additionally in more than 75% of known cancer patients participating in ctDNA studies evaluating its sensitivity. In the setting of mutation-based targeted tumor therapy, it shows a concordance rate >80% when compared with gold-standard tissue biopsies. Through ctDNA detection and sequencing, a simple blood test becomes a liquid biopsy for cancer, surveying a patient’s entire circulation with the goal of early detection, prognostic information, personalized therapy options, and tracking for recurrence or resistance, all with fewer or no tissue biopsies. Given the recent first-ever FDA approval of a liquid biopsy, it is important for clinicians to be aware of the rapid advancements likely to bring these tests into our practices soon. Here we review the biology, clinical implications, and recent advances in circulating tumor DNA analysis. PMID:28054963

  2. CT Guided Bone Biopsy Using a Battery Powered Intraosseous Device

    SciTech Connect

    Schnapauff, Dirk Marnitz, Tim Freyhardt, Patrick Collettini, Federico; Hartwig, Kerstin; Joehrens, Korinna; Hamm, Bernd Kroencke, Thomas Gebauer, Bernhard

    2013-10-15

    Purpose: To evaluate the feasibility of a battery powered intraosseous device to perform CT-fluoroscopy guided bone biopsy. Methods: Retrospective analysis of 12 patients in whom bone specimen were acquired from different locations under CT-fluoroscopy guidance using the OnControl bone marrow biopsy system (OBM, Vidacare, Shavano Park, TX, USA). Data of the 12 were compared to a historic cohort in whom the specimen were acquired using the classic Jamshidi Needle, as reference needle using manual force for biopsy. Results: Technical success was reached in 11 of 12 cases, indicated by central localisation of the needle within the target lesion. All specimen sampled were sufficient for histopathological workup. Compared to the historical cohort the time needed for biopsy decreased significantly from 13 {+-} 6 to 6 {+-} 4 min (P = 0.0001). Due to the shortened intervention time the radiation dose (CTDI) during CT-fluoroscopy was lowered significantly from 169 {+-} 87 to 111 {+-} 54 mGy Multiplication-Sign cm (P = 0.0001). Interventional radiologists were confident with the performance of the needle especially when using in sclerotic or osteoblastic lesions. Conclusion: The OBM is an attractive support for CT-fluoroscopy guided bone biopsy which is safe tool and compared to the classical approach using the Jamshidi needle leading to significantly reduced intervention time and radiation exposure.

  3. Small Field of View Scintimammography Gamma Camera Integrated to a Stereotactic Core Biopsy Digital X-ray System

    SciTech Connect

    Andrew Weisenberger; Fernando Barbosa; T. D. Green; R. Hoefer; Cynthia Keppel; Brian Kross; Stanislaw Majewski; Vladimir Popov; Randolph Wojcik

    2002-10-01

    A small field of view gamma camera has been developed for integration with a commercial stereotactic core biopsy system. The goal is to develop and implement a dual-modality imaging system utilizing scintimammography and digital radiography to evaluate the reliability of scintimammography in predicting the malignancy of suspected breast lesions from conventional X-ray mammography. The scintimammography gamma camera is a custom-built mini gamma camera with an active area of 5.3 cm /spl times/ 5.3 cm and is based on a 2 /spl times/ 2 array of Hamamatsu R7600-C8 position-sensitive photomultiplier tubes. The spatial resolution of the gamma camera at the collimator surface is < 4 mm full-width at half-maximum and a sensitivity of /spl sim/ 4000 Hz/mCi. The system is also capable of acquiring dynamic scintimammographic data to allow for dynamic uptake studies. Sample images of preliminary clinical results are presented to demonstrate the performance of the system.

  4. [Role of lung biopsy in diagnosis of pulmonary pathology at the prehospital level].

    PubMed

    Filippov, V P; Evgushchenko, G V; Gedymin, L E; Sidirova, N F

    2009-01-01

    The aim of the work was to assess the value of biopsy techniques for fibrobronchoscopy under local anesthesia in patients with pulmonary pathology at the prehospital level. It included 706 subjects with lobular, segmental or diffuse lesions in the lungs of specific (tuberculosis), non-specific (pneumonia, exogenous alveolitis), and other origin. All known methods of endobronchial biopsy were employed (bronchoalveolar lavage or liquid lung biopsy, tissue biopsy, transbronchial biopsy, brush biopsy, puncture and aspiration biopsy) with subsequent cytomorphological and bacteriological studies of bioptates. Diagnostic efficiency of direct biopsy was estimated at 97%, transbronchial biopsy at 5-90% depending on nosological form of lung disease, brush and puncture biopsy 20-50 and 6% respectively. Reversible complications occurred in 1.4% and were resolved by therapeutic methods. Cost effectiveness of prehospital instrumental examination of patients with pulmonary pathology is 10 times the intrahospital one.

  5. Sequential muscle biopsy changes in a case of congenital myopathy.

    SciTech Connect

    Danon, M. J.; Giometti, C. S.; Manaligod, J. R.; Swisher, C.; Center for Mechanistic Biology and Biotechnology; New York Medical Coll.; Univ. of Illinois at Chicago; Children's Memorial Hospital

    1997-05-01

    Muscle biopsies at age 7 months in a set of dizygotic male twins born floppy showed typical features of congenital fiber-type disproportion (CFTD). One of the twins died at age 1 year due to respiratory complications. The second one subsequently developed facial diplegia and external ophthalmoplegia. He never walked, remained wheelchair bound, and required continuous ventilatory support. He underwent repeat biopsies at ages 2 and 4, which showed many atrophic type 1 muscle fibers containing central nuclei and severe type 2 fiber deficiency compatible with centronuclear myopathy (CNM). Two-dimensional gel electrophoresis of muscle showed decreases of type II myosin light chains 2 and 3, suggestive of histochemical type I fiber deficiency. The progressive nature of morphological changes in one of our patients cannot be explained by maturational arrest. Repeat biopsies in cases of CFTD with rapid clinical deterioration may very well show CNM.

  6. Pericardial Tamponade: a Rare Complication of Sternal Bone Marrow Biopsy

    PubMed Central

    Santavy, Petr; Troubil, Martin; Lonsky, Vladimir

    2013-01-01

    Injury of the heart with concomitant pericardial tamponade as a result of sternal bone marrow biopsy is rare. An 80-year-old man was admitted with dehydration and non-specified abdominal pain to the regional hospital. Sternal aspiration biopsy was performed because of anemia and thrombocytopenia. Later on, because of the back pain, general weakness and blood pressure drop, an echocardiography examination was indicated. Pericardial fluid collection was found. Anticipated ascending aortic dissection was excluded on computed tomography scan, but pericardial fluid collection was confirmed. Transfer to our cardiac surgical facility ensued. Limited heart tamponade was affirmed on echocardiography and surgery was immediately indicated. Blood effusion was found in upper mediastinal fat tissue and 300 mL of blood were evacuated from opened pericardial space. Stab wound by sternal biopsy needle at the upper part of ascending aorta was repaired by pledgeted suture. Postoperative course was uneventful. PMID:24179668

  7. Liver biopsy and prognosis in acute liver failure

    PubMed Central

    Scotto, J.; Opolon, P.; Étévé, J.; Vergoz, D.; Thomas, M.; Caroli, J.

    1973-01-01

    Liver biopsy was performed in 38 patients with fulminant hepatitis and coma and repeated in 22. Stereological estimation of hepatocyte volume was correlated with levels of clotting factors. Early liver biopsy allowed prognosis in 55% of the cases. All patients with a hepatocyte volume of <35% and thromboplastin time ≤10% died; all patients but two with hepatocyte volume ≥35% and thromboplastin time >10% recovered consciousness (n = 9) or at least showed evidence of marked liver regeneration (n = 2). On serial liver biopsy a significant increase in hepatocyte volume and clotting factors was only observed in patients who recovered consciousness. The estimated liver cell mass after regeneration in patients who recovered consciousness was ≥45% and <45% in the patients who did not. ImagesFig 2Fig 3Fig 4 PMID:4785282

  8. Evaluating dermal myelinated nerve fibers in skin biopsy

    PubMed Central

    Myers, M. Iliza; Peltier, Amanda C.; Li, Jun

    2012-01-01

    Although there has been extensive research on small, unmyelinated fibers in the skin, little research has investigated dermal myelinated fibers in comparison. Glabrous, non-hairy skin contains mechanoreceptors that afford a vantage point for observation of myelinated fibers that have previously been seen only with invasively obtained nerve biopsies. This review discusses current morphometric and molecular expression data of normative and pathogenic glabrous skin obtained by various processing and analysis methods for cutaneous myelinated fibers. Recent publications have shed light on the role of glabrous skin biopsy in identifying signs of peripheral neuropathy and as a potential biomarker of distal myelin and mechanoreceptor integrity. The clinical relevance of a better understanding of the role of dermal myelinated nerve terminations in peripheral neuropathy will be addressed in light of recent publications in the growing field of skin biopsy. PMID:23192899

  9. Liquid biopsy genotyping in lung cancer: ready for clinical utility?

    PubMed

    Huang, Wei-Lun; Chen, Yi-Lin; Yang, Szu-Chun; Ho, Chung-Liang; Wei, Fang; Wong, David T; Su, Wu-Chou; Lin, Chien-Chung

    2017-01-12

    Liquid biopsy is a blood test that detects evidence of cancer cells or tumor DNA in the circulation. Despite complicated collection methods and the requirement for technique-dependent platforms, it has generated substantial interest due, in part, to its potential to detect driver oncogenes such as epidermal growth factor receptor (EGFR) mutants in lung cancer. This technology is advancing rapidly and is being incorporated into numerous EGFR tyrosine kinase inhibitor (EGFR-TKI) development programs. It appears ready for integration into clinical care. Recent studies have demonstrated that biological fluids such as saliva and urine can also be used for detecting EGFR mutant DNA through application other user-friendly techniques. This review focuses on the clinical application of liquid biopsies to lung cancer genotyping, including EGFR and other targets of genotype-directed therapy and compares multiple platforms used for liquid biopsy.

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

    NASA Astrophysics Data System (ADS)

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

    2010-02-01

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

  11. Pathologists and liquid biopsies: to be or not to be?

    PubMed

    Hofman, Paul; Popper, Helmut H

    2016-12-01

    Recently, the advent of therapies targeting genomic alterations has improved the care of patients with certain types of cancer. While molecular targets were initially detected in nucleic acid samples extracted from tumor tissue, detection of nucleic acids in circulating blood has allowed the development of what has become known as liquid biopsies, which provide a complementary and alternative sample source allowing identification of genomic alterations that might be addressed by targeted therapy. Consequently, liquid biopsies might rapidly revolutionize oncology practice in allowing administration of more effective treatments. Liquid biopsies also provide an approach towards short-term monitoring of metastatic cancer patients to evaluate efficacy of treatment and/or early detection of secondary mutations responsible for resistance to treatment. In this context, pathologists, who have already been required in recent years to take interest in the domain of molecular pathology of cancer, now face new challenges. The attitude of pathologists to and level of involvement in the practice of liquid biopsies, including mastering the methods employed in molecular analysis of blood samples, need close attention. Regardless of the level of involvement of pathologists in this new field, it is mandatory that oncologists, biologists, geneticists, and pathologists work together to coordinate the pre-analytical, analytical, and post-analytical phases of molecular assessment of tissue and liquid samples of individual cancer patients. The challenges include (1) implementation of effective and efficient procedures for reception and analysis of liquid and tissue samples for histopathological and molecular evaluation and (2) assuring short turn-around times to facilitate rapid optimization of individual patient treatment. In this paper, we will review the following: (1) recent data concerning the concept of liquid biopsies in oncology and its development for patient care, (2) advantages

  12. Do we still need renal biopsy in lupus nephritis?

    PubMed

    Haładyj, Ewa; Cervera, Ricard

    2016-01-01

    The natural course of systemic lupus erythematosus (SLE) is characterized by periods of disease activity and remissions. Prolonged disease activity results in cumulative organ damage. Lupus nephritis is one of the most common and devastating manifestations of SLE. In the era of changing therapy to less toxic regimens, some authors have stated that if mycophenolate mofetil can be used for the induction and maintenance treatment in all histological classes of lupus nephritis, renal biopsy can be omitted. This article aims to answer the question of what brings the bigger risk: renal biopsy or its abandonment.

  13. Outcomes of trophectoderm biopsy on cryopreserved blastocysts: a case series.

    PubMed

    Lathi, Ruth B; Massie, Jamie A M; Gilani, Morgan; Milki, Amin A; Westphal, Lynn M; Baker, Valerie L; Behr, Barry

    2012-11-01

    Preimplantation genetic diagnosis (PGD) is an increasingly common adjunct to IVF. The information gained from PGD may be used to reduce the incidence of chromosomally abnormal pregnancies and augment the current selection process of embryos. As such, patients may choose to utilize PGD in either fresh or cryopreserved IVF cycles. It is a common practice to cryopreserve excess embryos at the blastocyst stage. In these cases, trophectoderm biopsy is the only technique available for PGD. This articles reports this study centre's experience with trophectoderm biopsies of cryopreserved blastocysts in 12 patients who underwent 13 cycles of PGD. The implantation rate per embryo transferred was 46% and the ongoing pregnancy rate per embryo transfer was 63%. The results from this case series demonstrate that trophectoderm biopsy on cryopreserved blastocysts to perform PGD is logistically feasible. In addition, the rate of implantation and ongoing pregnancy were maintained within a reasonable range to justify the procedure. Preimplantation genetic diagnosis (PGD) is an increasingly common adjunct to IVF and is used to evaluate the genetic makeup of the embryo prior to transfer of the embryo into the uterus. The information gained from PGD may be used to identify single-gene disorders that result in genetic disease, reduce the incidence of chromosomally abnormal pregnancies and/or augment the selection process of embryos to be transferred. In order to perform PGD, a biopsy of the embryo is the performed and cells are removed for testing. PGD may be performed in either fresh or frozen (cryopreserved) IVF cycles. Patients who have cryopreserved embryos remaining in storage from a previous fresh cycle may wish to have these embryos tested with PGD. Many embryos are frozen on day 5 of development, referred to as the blastocyst stage. At this stage of development, embryo biopsy is performed via a technique known as 'trophectoderm biopsy', in which 1-3 of the cells destined to

  14. Transjugular Renal Biopsy: Our Experience and Technical Considerations

    SciTech Connect

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

    2008-09-15

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

  15. Sentinel node biopsy in the management of malignant melanoma.

    PubMed

    Russell-Jones, R; Acland, K

    2001-09-01

    The technique of sentinel lymph node (SLN) biopsy has been in use for almost a decade, but its effect on survival has not yet been established. It is however the most accurate method for staging patients with primary cutaneous melanoma who lack clinical evidence of metastatic disease. This article discusses the rationale and logistics of SLN biopsy, and the management strategies that can be employed in those patients who are SLN positive. Future therapeutic trial in patients with primary cutaneous melanoma will only be meaningful if the SLN status of the subjects is established.

  16. The pros and cons of outpatient breast biopsy.

    PubMed

    Lou, M A; Mandal, A K; Alexander, J L

    1976-06-01

    A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.

  17. MR guided breast interventions: role in biopsy targeting and lumpectomies

    PubMed Central

    Jagadeesan, Jayender; Richman, Danielle M; Kacher, Daniel F

    2015-01-01

    Synopsis Contrast enhanced breast MRI is increasingly being used to diagnose breast cancer and to perform biopsy procedures. The American Cancer Society has advised women at high risk for breast cancer to have breast MRI screening as an adjunct to screening mammography. This article places special emphasis on biopsy and operative planning involving MRI and reviews utility of breast MRI in monitoring response to neoadjuvant chemotherapy. We describe peer-reviewed data on currently accepted MR-guided therapeutic methods for addressing benign and malignant breast diseases, including intraoperative imaging. PMID:26499274

  18. Steerable real-time sonographically guided needle biopsy.

    PubMed

    Buonocore, E; Skipper, G J

    1981-02-01

    A method for dynamic real-time ultrasonic guidance for percutaneous needle biopsy has been successful in obtaining cytologic and histologic specimens from abdominal masses. The system depends on a real-time ultrasonic transducer that has been rigidly attached to a laterally placed steerable needle holder. Using simple trigonometric functions, a chart has been derived that gives the exact angulation and needle length to produce quick, reliable, guided needle placements. Examples of successful renal, hepatobiliary, and retroperitoneal biopsies are presented. Advantages of this technique include speed, accuracy, low cost, three-dimensional format, and the omission of contrast media and radiation.

  19. Endometrial biopsy interpretation. Shortcomings and problems in current gynecologic practice.

    PubMed

    Van Bogaert, L J; Maldague, P; Staquet, J P

    1978-01-01

    The analysis of 345 endometrial biopsies was carried out with special regard to the relation between pathologic findings and presenting symptoms or complaints. Only 52.4% of the biopsies showed microscopic features possibly related to the complaints. Endometrial polyps and chronic endometritis were diagnosed in 21.1 and 9.8%, respectively, of the entire study group. The currently accepted definitions of dysfunctional uterine bleeding raise the question whether endometrial polyps and atypical secretory changes may or may not be included in the syndrome.

  20. TRUS Biopsy Yield in Indian Population: A Retrospective Analysis

    PubMed Central

    Pawar, Prakash Wamanrao; Sawant, Ajit Somaji; Patil, Akshay Vijay; Narwade, Sayalee Suryabhan; Mundhe, Shankar Tanaji; Savalia, Abhishek Jaysukhbhai; Tamhankar, Ashwin Sunil

    2017-01-01

    Introduction The reported cancer detection rate of Trans-Rectal Ultrasonography (TRUS) biopsies (TRUS biopsy yield) has been around 30 percent in western countries. However it is much lower in Asian countries, including India. Hence a larger proportion of patients in India undergo unnecessary biopsies. Aims To find out the cancer detection rate of TRUS biopsy (TRUS biopsy yield) in contemporary Indian population. Also, to study the positive predictive values at different serum Prostate-Specific Antigen (PSA)/PSA Density (PSAD) cut off levels and suspicious Digital Rectal Examination (DRE) findings. Materials and Methods This retrospective study was carried out in a tertiary care institute. All symptomatic patients who underwent TRUS guided biopsy for indication of raised serum PSA level (>4 ng/ml) or suspicious DRE findings (nodule, irregularity, hard consistency, immobile rectal mucosa) from January 2012 to December 2014 were included. For serum PSA range (4-10) ng/ml, TRUS guided biopsy was done in patients with percent free/total PSA < 25. Statistical analysis used were Chi-square test, Mann-Whitney U-test, Spearman’s rank correlation analysis and Receiver-Operating Characteristic (ROC) curve. Results Out of the 235 patients included, 60 patients had malignancy (overall cancer detection rate= 25.53%). The cancer detection rate for PSA ranges of (4-10) and (10-20) ng/ml was as low as 5.95% and 13.16% respectively. Patients with malignant disease had significantly smaller prostate gland size than patients with benign disease (53.89 vs 63.06; p-value <0.05). On the other hand, cancer detection rate was 100% for PSA greater than 50ng/ml. The cancer detection rates were only upto 10% for PSA density ranges upto 0.25 ng/ml/cm3. The Area Under the Curve (AUC) for PSA and PSAD was 0.876 and 0.884 respectively. Only one patient (0.43%) had post-biopsy complication (acute bacterial prostatitis) requiring hospital admission. Conclusion The current serum PSA and PSAD cut

  1. LS-DYNA Simulation of Hemispherical-punch Stamping Process Using an Efficient Algorithm for Continuum Damage Based Elastoplastic Constitutive Equation

    NASA Astrophysics Data System (ADS)

    Salajegheh, Nima; Abedrabbo, Nader; Pourboghrat, Farhang

    2005-08-01

    An efficient integration algorithm for continuum damage based elastoplastic constitutive equations is implemented in LS-DYNA. The isotropic damage parameter is defined as the ratio of the damaged surface area over the total cross section area of the representative volume element. This parameter is incorporated into the integration algorithm as an internal variable. The developed damage model is then implemented in the FEM code LS-DYNA as user material subroutine (UMAT). Pure stretch experiments of a hemispherical punch are carried out for copper sheets and the results are compared against the predictions of the implemented damage model. Evaluation of damage parameters is carried out and the optimized values that correctly predicted the failure in the sheet are reported. Prediction of failure in the numerical analysis is performed through element deletion using the critical damage value. The set of failure parameters which accurately predict the failure behavior in copper sheets compared to experimental data is reported as well.

  2. Evaluation of irradiation effects of 16 MeV proton-irradiated 12Cr-1MoV steel by small punch (SP) tests

    SciTech Connect

    Chi, S.H.; Hong, J.H. ); Kim, I.S. . Dept. of Nuclear Engineering)

    1994-06-15

    Recently, interest in small-scale specimens for testing irradiated materials has arisen in conjunction with the need to develop materials for fusion reactor materials and to study irradiation effects using an ion irradiation facility. Several attempts have been made to evaluate material property changes due to irradiation using a small specimen technique. The SP (small punch) test is an example of small-scale specimen test techniques, originally developed by Baik et al. to estimate DBTT (ductile-to-brittle transition temperature) using broken standard CVN (Charpy 5-notch) specimens. The objective of the present study is to evaluate 16 MeV proton irradiation effects on a fusion reactor candidate material in terms of changes in energy up to failure and J[sub IC] fracture toughness (SP J[sub IC]) by using a SP test technique and a J[sub IC] - [bar [epsilon

  3. Small punch tests on martensitic/ferritic steels F82H, T91 and Optimax-A irradiated in SINQ Target-3

    NASA Astrophysics Data System (ADS)

    Jia, X.; Dai, Y.

    2003-12-01

    Small punch (SP) tests were conducted in a temperature range from -190 to 80 °C on martensitic/ferritic steels F82H, T91 and Optimax-A irradiated in SINQ Target-3 up to 9.4 dpa in a irradiation temperature range of 90-275 °C. Results demonstrate: (a) the irradiation hardening deduced from SP tests is reasonably consistent with the results obtained by tensile tests; (b) with increasing irradiation dose, the SP yield load increases at all test temperatures, while the displacement at the maximum load and the total displacement at failure decrease; (c) the ductile-to-brittle transition temperature (DBTT SP) increases with increasing irradiation dose, and does so more quickly at irradiation doses above ˜6-7 dpa; in addition, the ΔDBTT SP increases linearly with helium content.

  4. Comparison of irradiated 15Kh2MFA material mechanical properties using conventional testing methods and innovative approach of small punch testing (SPT) and automated ball indentation (ABIT)

    NASA Astrophysics Data System (ADS)

    Kopriva, R.; Petelova, P.; Eliasova, I.; Kytka, M.; Culek, M.

    2017-02-01

    Article describes two innovative testing methods – Small Punch Testing (SPT) and Automated Ball Indentation Test (ABIT) – which are based on the determination and evaluation of material properties from miniaturized testing specimens. These methods are very promising due to minimum material needed for testing and also in case of testing highly irradiated materials of components that are not included in standard surveillance programs. The test results were obtained for reactor pressure vessel (RPV) base material 15Ch2MFA in both states - initial unirradiated and irradiated. Subsequently results were compared with standard tensile tests to prove applicability of these testing methods for the evaluation of degradation of irradiated structural materials of nuclear power plants.

  5. Diagnosis: to biopsy or not to biopsy: assessing the role of surgical lung biopsy in the diagnosis of idiopathic pulmonary fibrosis.

    PubMed

    Fishbein, Michael C

    2005-11-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic disorder that is associated with a poorer prognosis than subacute idiopathic interstitial pneumonias (IIPs). IPF can be differentiated from other IIPs on the basis of its histologic pattern of usual interstitial pneumonia (UIP). Although a surgical lung biopsy specimen showing a UIP pattern is required for the definitive diagnosis of IPF, clinical criteria can be used in the absence of a lung biopsy specimen to make a likely diagnosis of IPF. The predictive value of these criteria largely depends on the expertise of the clinician and radiologist, but considerable interobserver variability exists even when evaluations are performed by experts in the field. Moreover, these criteria lead to misdiagnosis in about 25 to 35% of cases. Interobserver variability is reduced and diagnostic accuracy is improved in cases in which a diagnosis is made with a high degree of confidence. Diagnostic accuracy is also higher when the diagnosis is made by a core group of experts rather than by a referring center. The decision on whether or not to perform a surgical lung biopsy is difficult. It is clearly indicated in cases in which clinical or radiologic findings are atypical or when the diagnosis is made with a low degree of certainty.

  6. Comparison of prostate MRI-3D transrectal ultrasound fusion biopsy for first-time and repeat biopsy patients with previous atypical small acinar proliferation

    PubMed Central

    Cool, Derek W.; Romagnoli, Cesare; Izawa, Jonathan I.; Chin, Joseph; Gardi, Lori; Tessier, David; Mercado, Ashley; Mandel, Jonathan; Ward, Aaron D.; Fenster, Aaron

    2016-01-01

    Introduction: This study evaluates the clinical benefit of magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy over systematic biopsy between first-time and repeat prostate biopsy patients with prior atypical small acinar proliferation (ASAP). Materials: 100 patients were enrolled in a single-centre prospective cohort study: 50 for first biopsy, 50 for repeat biopsy with prior ASAP. Multiparameteric magnetic resonance imaging (MP-MRI) and standard 12-core ultrasound biopsy (Std-Bx) were performed on all patients. Targeted biopsy using MRI-TRUS fusion (Fn-Bx) was performed f suspicious lesions were identified on the pre-biopsy MP-MRI. Classification of clinically significant disease was assessed independently for the Std-Bx vs. Fn-Bx cores to compare the two approaches. Results: Adenocarcinoma was detected in 49/100 patients (26 first biopsy, 23 ASAP biopsy), with 25 having significant disease (17 first, 8 ASAP). Fn-Bx demonstrated significantly higher per-core cancer detection rates, cancer involvement, and Gleason scores for first-time and ASAP patients. However, Fn-Bx was significantly more likely to detect significant cancer missed on Std-Bx for ASAP patients than first-time biopsy patients. The addition of Fn-Bx to Std-Bx for ASAP patients had a 166.7% relative risk reduction for missing Gleason ≥ 3 + 4 disease (number needed to image with MP-MRI=10 patients) compared to 6.3% for first biopsy (number to image=50 patients). Negative predictive value of MP-MRI for negative biopsy was 79% for first-time and 100% for ASAP patients, with median followup of 32.1 ± 15.5 months. Conclusions: MR-TRUS Fn-Bx has a greater clinical impact for repeat biopsy patients with prior ASAP than biopsy-naïve patients by detecting more significant cancers that are missed on Std-Bx. PMID:27800057

  7. [The role of percutaneous renal biopsy in kidney transplant].

    PubMed

    Manfro, R C; Lee, J Y; Lewgoy, J; Edelweiss, M I; Gonçalves, L F; Prompt, C A

    1994-01-01

    Percutaneous renal biopsy (PRB) is an useful tool for diagnostic and therapeutic orientation in renal transplantation. PURPOSE--To evaluate the current role of PRB in post-transplant acute renal dysfunction (ARD) of renal allografts. METHODS--Sixty-five renal transplant patients were submitted to 95 valid renal biopsies with no major complications. RESULTS--There was disagreement between the clinical and the pathological diagnosis in 28 occasions (29.5%). In 36 cases (37.9%) the results of the pathological examination led to a modification in patient's management. These modifications were most commonly the avoidance or witholding of a steroid pulse (8 cases); nephrectomy of the renal allograft (8 cases); witholding or decrease of cyclosporine dosage (6 cases); giving a steroid pulse (5 cases) and giving antibiotics to treat acute pyelonephritis in 4 cases. The use of kidneys from cadaveric donors was significantly associated with an increased number of biopsies (p < 0.05). CONCLUSION--These results demonstrate that even though several less invasive procedures are currently employed, renal biopsy is still an indispensable method to the management of ARD in renal transplant patients.

  8. Role of liver biopsy in nonalcoholic fatty liver disease

    PubMed Central

    Nalbantoglu, ILKe; Brunt, Elizabeth M

    2014-01-01

    Nonalcoholic fatty liver disease (NAFLD), defined as abnormal accumulation (> 5%) of hepatic triglyceride without excess alcohol intake, is the most common form of chronic liver disease in adults and children in the United States. NAFLD encompasses a spectrum of histologic findings including uncomplicated steatosis, steatosis with inflammation and steatohepatitis [nonalcoholic steatohepatitis (NASH)]; the latter can advance to cirrhosis and hepatocellular carcinoma. NASH is currently accepted as the hepatic manifestation of the set of cardiovascular risk factors collectively known as metabolic syndrome. In 1999 a system for histologic grading and staging for NASH was proposed; this was revised by the NASH Clinical Research Network in 2005 for the entire spectrum of lesions in NAFLD, including the lesions and patterns of pediatric NAFLD, and for application in clinical research trials. Diagnosis remains distinct from grade and stage. A recent European proposal separates steatosis from activity to derive a numeric diagnosis of NASH. Even though there have been promising advancements in non-invasive testing, these tests are not yet detailed enough to replace the full range of findings provided by liver biopsy evaluation. Limitations of biopsy are acknowledged, but liver biopsy remains the “gold standard” for diagnosis and determination of amounts of necroinflammatory activity, and location of fibrosis, as well as remodeling of the parenchyma in NASH. This review focuses on the specific histologic lesions of NAFLD and NASH, grading and staging, differential diagnoses to be considered, and the continuing role of the liver biopsy in this important liver disease. PMID:25083076

  9. Liquid biopsy in gastrointestinal stromal tumors: a novel approach.

    PubMed

    Nannini, Margherita; Astolfi, Annalisa; Urbini, Milena; Biasco, Guido; Pantaleo, Maria A

    2014-08-14

    The role of molecular analysis in the management of gastrointestinal stromal tumors (GIST) remains indisputable. To date, tumor tissue extracted from specimens obtained by surgical or biopsy procedures has been the only source of the tumor DNA required for the molecular and genomic assessment of cancer. However, tumor tissue sampling has several clinical limitations: for example, the invasiveness of these procedures precludes repeated sampling. Thus, it is possible to obtain only a static molecular picture of the disease, a picture that lacks the inter- and intra-metastatic molecular heterogeneity that characterizes most GIST. In contrast, circulating tumor DNA obtained from a patient's bloodstream, known as liquid biopsy, can theoretically overcome the limitations of tissue biopsies and provide the same molecular and genomic information. GIST are recognized as a paradigm of molecular biology among solid tumors. Although few but promising data on liquid biopsy in GIST have been accumulated to date, these tumors may provide the optimal field for application of this challenging approach.

  10. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  11. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  12. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  13. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  14. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  15. [Critical haematuria after prostate biopsies with RIVAROXABAN. Case report].

    PubMed

    Olivier, J; Yakoubi, R; Gras, S; Van Agt, G; Delepaul, B

    2013-10-01

    Managing patients with new oral anticoagulants in perioperative period is not yet well protocolized. We report a clinical case of a critical haematuria after prostate biopsies to a patient treated with RIVAROXABAN. Monitoring and treatment of the haematuria have been difficult due to the lack of biological control and antidote for this treatment.

  16. Adverse perinatal outcome and later kidney biopsy in the mother.

    PubMed

    Vikse, Bjørn Egil; Irgens, Lorentz M; Bostad, Leif; Iversen, Bjarne M

    2006-03-01

    Strong associations of adverse perinatal outcomes have been identified with later cardiovascular disease in the mother. Few studies have addressed associations with kidney disease. This study investigated whether perinatal outcomes are associated with later clinical kidney disease as diagnosed by kidney biopsy. The Medical Birth Registry of Norway contains data on all childbirths in Norway since 1967. The Norwegian Kidney Biopsy Registry contains data on all kidney biopsies in Norway since 1988. All women with a first singleton delivery from 1967 to 1998 were included. Pregnancy-related predictors of later kidney biopsy were analyzed by Cox regression analyses. A total of 756,420 women were included, and after a mean period of 15.9+/-9.4 yr, 588 had a kidney biopsy. Compared with women without preeclampsia and with offspring with birth weight of >or=2.5 kg, women with no preeclampsia and with offspring with birth weight of 1.5 to 2.5 kg had a relative risk (RR) for a later kidney biopsy of 1.7, women with no preeclampsia and with offspring with birth weight of <1.5 kg had an RR of 2.9, women with preeclampsia and with offspring with a birth weight of >or=2.5 kg had an RR of 2.5, women with preeclampsia and with offspring with a birth weight of 1.5 to 2.5 kg had an RR of 4.5, and women with preeclampsia and with offspring with a birth weight of <1.5 kg had an RR of 17. Similar results were found in adjusted analyses and after exclusion of women with diabetes, kidney disease, or rheumatic disease before pregnancy. The same risk patterns applied to any of the specific categories of kidney disease as well as specific kidney diseases investigated. Women who have preeclampsia and give birth to offspring with low birth weight and short gestation have a substantially increased risk for having a later kidney biopsy.

  17. The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy.

    PubMed

    Tang, Jing-Hua; An, Xin; Lin, Xi; Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-10-20

    Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120 patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders.

  18. Single-Institution Results of Image-Guided Nonplugged Percutaneous Versus Transjugular Liver Biopsy

    SciTech Connect

    Hardman, Rulon L.; Perrich, Kiley D.; Silas, Anne M.

    2011-04-15

    Purpose: To retrospectively review patients who underwent transjugular and image-guided percutaneous biopsy and compare the relative risk of ascites, thrombocytopenia, and coagulopathy. Materials and Methods: From August 2001 through February 2006, a total of 238 liver biopsies were performed. The radiologist reviewed all patient referrals for transjugular biopsy. These patients either underwent transjugular biopsy or were reassigned to percutaneous biopsy (crossover group). Patients referred to percutaneous image-guided liver biopsy underwent this same procedure. Biopsies were considered successful if a tissue diagnosis could be made from the samples obtained. Results: A total of 36 transjugular biopsies were performed with 3 total (8.3%) and 1 major (2.8%) complications. A total of 171 percutaneous biopsies were performed with 10 (5.8%) total and 3 (1.8%) major complications. The crossover group showed a total of 4 (12.9%) complications with 1 (3.2%) major complication. Sample adequacy was 91.9% for transjugular and 99.5% for percutaneous biopsy. Conclusion: Both transjugular and percutaneous liver biopsy techniques are efficacious and safe. Contraindications such as thrombocytopenia, coagulopathy, and ascites are indicators of greater complications but are not necessarily prevented by transjugular biopsy. Percutaneous biopsy more frequently yields a diagnostic specimen than transjugular biopsy.

  19. Evaluation of distal symmetric polyneuropathy: the role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review).

    PubMed

    England, J D; Gronseth, G S; Franklin, G; Carter, G T; Kinsella, L J; Cohen, J A; Asbury, A K; Szigeti, K; Lupski, J R; Latov, N; Lewis, R A; Low, P A; Fisher, M A; Herrmann, D; Howard, J F; Lauria, G; Miller, R G; Polydefkis, M; Sumner, A J

    2009-01-01

    Distal symmetric polyneuropathy (DSP) is the most common variety of neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyneuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyneuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyneuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic neuropathy (Level B) and distal small fiber sensory polyneuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected amyloid neuropathy, mononeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyneuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyneuropathy.

  20. Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA>4ng/mL, or with PIN biopsy result

    PubMed Central

    Fiamegos, Alexandros; Varkarakis, John; Kontraros, Michael; Karagiannis, Andreas; Chrisofos, Michael; Barbalias, Dimitrios; Deliveliotis, Charalampos

    2016-01-01

    Abstract Introduction: Data from animal, clinical and prevention studies support the role of androgens in prostate cancer growth, proliferation and progression. Results of serum based epidemiologic studies in humans, however, have been inconclusive. The present study aims to define whether serum testosterone can be used as a predictor of a positive second biopsy in males considered for re-biopsy. Material and Methods: The study included 320 men who underwent a prostatic biopsy in our department from October 2011 until June 2012. Total testosterone, free testosterone, bioavailable testosterone and prostate pathology were evaluated in all cases. Patients undergoing a second biopsy were identified and biopsy results were statistically analyzed. Results: Forty men (12.5%) were assessed with a second biopsy. The diagnosis of the second biopsy was High Grade Intraepithelial Neoplasia in 14 patients (35%) and Prostate Cancer in 12 patients (30%). The comparison of prostatic volume, total testosterone, sex hormone binding globulin, free testosterone, bioavailable testosterone and albumin showed that patients with cancer of the prostate had significantly greater levels of free testosterone (p=0.043) and bioavailable T (p=0.049). Conclusion: In our study, higher free testosterone and bioavailable testosterone levels were associated with a cancer diagnosis at re-biopsy. Our results indicate a possible role for free and bioavailable testosterone in predicting the presence of prostate cancer in patients considered for re-biopsy. PMID:27532110

  1. Confocal reflectance imaging of excised malignant human bladder biopsies

    NASA Astrophysics Data System (ADS)

    Daniltchenko, Dmitri I.; Kastein, Albrecht; Koenig, Frank; Sachs, Markus; Schnorr, Dietmar; Al-Shukri, Salman; Loening, Stefan A.

    2004-08-01

    To evaluate the potential of reflectance confocal scanning laser microscopy (CM) for rapid imaging of non-processed freshly excised human bladder biopsies and cystectomy specimens. Freshly excised bladder tumors from three cystectomy specimens and random biopsies from twenty patients with a history of superficial bladder tumors were imaged with CM. Additional acetic acid washing prior to CM imaging was performed in some of the samples. Confocal images were compared to corresponding routine histologic sections. CM allows imaging of unprocessed bladder tissue at a subcellular resolution. Urothelial cell layers, collagen, vessels and muscle fibers can be rapidly visualized, in native state. In this regard, umbrella cells, basement membrane elucidated. Besides obvious limitations partly due to non-use of exogenous dyes, CM imaging offers several advantages: rapid imaging of the tissue in its native state like the basement membrane, normally seen only by using immunohistopathology. Reflectance CM opens a new avenue for imaging bladder cancer.

  2. Texture analysis for colorectal tumour biopsies using multispectral imagery.

    PubMed

    Peyret, Remy; Bouridane, Ahmed; Al-Maadeed, Somaya Ali; Kunhoth, Suchithra; Khelifi, Fouad

    2015-08-01

    Colorectal cancer is one of the most common cancers in the world. As part of its diagnosis, a histological analysis is often run on biopsy samples. Multispecral imagery taken from cancer tissues can be useful to capture more meaningful features. However, the resulting data is usually very large having a large number of varying feature types. This papers aims to investigate and compare the performances of multispectral imagery taken from colorectal biopsies using different techniques for texture feature extraction inclduing local binary patterns, Haraclick features and local intensity order patterns. Various classifiers such as Support Vector Machine and Random Forest are also investigated. The results show the superiority of multispectral imaging over the classical panchromatic approach. In the multispectral imagery's analysis, the local binary patterns combined with Support Vector Machine classifier gives very good results achieving an accuracy of 91.3%.

  3. Motion and deformation compensation for freehand prostate biopsies

    NASA Astrophysics Data System (ADS)

    Khallaghi, Siavash; Nouranian, Saman; Sojoudi, Samira; Ashab, Hussam A.; Machan, Lindsay; Chang, Silvia; Black, Peter; Gleave, Martin; Goldenberg, Larry; Abolmaesumi, Purang

    2014-03-01

    In this paper, we present a registration pipeline to compensate for prostate motion and deformation during targeted freehand prostate biopsies. We perform 2D-3D registration by reconstructing a thin-volume around the real-time 2D ultrasound imaging plane. Constrained Sum of Squared Differences (SSD) and gradient descent optimization are used to rigidly align the moving volume to the fixed thin-volume. Subsequently, B-spline de- formable registration is performed to compensate for remaining non-linear deformations. SSD and zero-bounded Limited memory Broyden Fletcher Goldfarb Shannon (LBFGS) optimizer are used to find the optimum B-spline parameters. Registration results are validated on five prostate biopsy patients. Initial experiments suggest thin- volume-to-volume registration to be more effective than slice-to-volume registration. Also, a minimum consistent 2 mm improvement of Target Registration Error (TRE) is achieved following the deformable registration.

  4. Skin Biopsy for the diagnosis of Alport Syndrome

    PubMed Central

    Lagona, E; Tsartsali, L; Kostaridou, S; Skiathitou, A; Georgaki, E; Sotsiou, F

    2008-01-01

    Alport syndrome (AS) is the most common hereditary nephritis often associated with extrarenal manifestations. It was first described by Alport on 1927. There is a primary disorder in collagen type IV which is the main component of the basement membranes. Alport syndrome is more frequently inherited as an X-linked and less commonly as an autosomal dominant or autosomal recessive trait. We describe the case of a 3-year-old boy with the X-linked variant of AS. The diagnosis was at first speculated from the child's detailed family history and was finally confirmed by a skin biopsy. Skin biopsy is an efficient and less invasive method for the X-linked variant of the AS diagnosis. PMID:18923659

  5. Microfluidic Exosome Analysis toward Liquid Biopsy for Cancer.

    PubMed

    He, Mei; Zeng, Yong

    2016-08-01

    Assessment of a tumor's molecular makeup using biofluid samples, known as liquid biopsy, is a prominent research topic in precision medicine for cancer, due to its noninvasive property allowing repeat sampling for monitoring molecular changes of tumors over time. Circulating exosomes recently have been recognized as promising tumor surrogates because they deliver enriched biomarkers, such as proteins, RNAs, and DNA. However, purification and characterization of these exosomes are technically challenging. Microfluidic lab-on-a-chip technology effectively addresses these challenges owing to its inherent advantages in integration and automation of multiple functional modules, enhancing sensing performance, and expediting analysis processes. In this article, we review the state-of-the-art development of microfluidic technologies for exosome isolation and molecular characterization with emphasis on their applications toward liquid biopsy-based analysis of cancer. Finally, we share our perspectives on current challenges and future directions of microfluidic exosome analysis.

  6. Robotically assisted small animal MRI-guided mouse biopsy

    NASA Astrophysics Data System (ADS)

    Wilson, Emmanuel; Chiodo, Chris; Wong, Kenneth H.; Fricke, Stanley; Jung, Mira; Cleary, Kevin

    2010-02-01

    Small mammals, namely mice and rats, play an important role in biomedical research. Imaging, in conjunction with accurate therapeutic agent delivery, has tremendous value in small animal research since it enables serial, non-destructive testing of animals and facilitates the study of biomarkers of disease progression. The small size of organs in mice lends some difficulty to accurate biopsies and therapeutic agent delivery. Image guidance with the use of robotic devices should enable more accurate and repeatable targeting for biopsies and delivery of therapeutic agents, as well as the ability to acquire tissue from a pre-specified location based on image anatomy. This paper presents our work in integrating a robotic needle guide device, specialized stereotaxic mouse holder, and magnetic resonance imaging, with a long-term goal of performing accurate and repeatable targeting in anesthetized mice studies.

  7. Cardiac iron overload in thalassemic patients: an endomyocardial biopsy study.

    PubMed

    Lombardo, T; Tamburino, C; Bartoloni, G; Morrone, M L; Frontini, V; Italia, F; Cordaro, S; Privitera, A; Calvi, V

    1995-09-01

    Secondary heart failure induced by organ siderosis is the main cause of death in patients affected by thalassemia major. At present it cannot be predicted whether heart siderosis is correlated with iron overload and little is known about the real cardiac histological pattern of post transfusional hemochromatosis in patients with thalassemia major and intermedia. The study aim was to evaluate cardiac iron overload by non invasive and invasive techniques. Fifteen thalassemic patients were investigated and endomyocardial biopsy performed in ten revealed different grades of endomyocardial iron overload with histochemical positivity. Non invasive techniques are not able to furnish an exact picture of the cardiac hemochromatosis. There was a significant correlation between serum ferritin and myocardial iron grade. Patients with elevated ferritin levels and poor compliance to chelating therapy are at high risk of severe heart hemochromatosis. It was seen that endomyocardial biopsy is a useful tool in studying myocardial iron.

  8. Clinical applications of liquid biopsies in gastrointestinal oncology

    PubMed Central

    Zhu, Jason

    2016-01-01

    “Liquid biopsies” are blood based assays used to detect and analyze circulating tumor products, including circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), circulating messenger RNA (mRNA), circulating microRNA (miRNA), circulating exosomes, and tumor educated platelets (TEP). For patients with gastrointestinal (GI) malignancies, blood based biopsies may offer several advantages. First, tumor tissue samples are often challenging to procure, and when obtainable, are often insufficient for genomic profiling. Second, blood based assays offer a real-time overview of the entire tumor burden, and allow anatomically unbiased genomic profiling. Third, given the convenience and relative safety of liquid biopsies, this technology may facilitate identification of genomic alterations that confer sensitivity and resistance to targeted therapeutics. This review will assess the clinical applications of circulating tumor products for patients with GI tumors. PMID:27747082

  9. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    PubMed Central

    Kayacetin, Ertugrul; Kayacetin, Serra

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base. PMID:15188520

  10. Primary cerebellopontine progressive multifocal leukoencephalopathy diagnosed premortem by cerebellar biopsy.

    PubMed

    Jones, H R; Hedley-Whyte, E T; Freidberg, S R; Kelleher, J E; Krolikowski, J

    1982-02-01

    A subacute progressive cerebellar brainstem syndrome developed in a patient with systemic lupus erythematosus in remission. Cerebellar biopsy documented the diagnosis of progressive multifocal leukoencephalopathy (PML). Data from this patient and 10 others in the literature emphasize the need to consider this diagnosis when ataxia develops in any patient with underlying malignancy, chronic infection, or other disease that involves immunological incompetence. Although the ataxic form of PML is not of nosological relevance, early diagnosis may eventually have therapeutic importance.

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

    PubMed Central

    Kopczyński, Janusz; Kowalska, Aldona

    2017-01-01

    Aim of the study 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. Material and methods 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. Results 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 131I therapy (p < 0.0001). In the multivariate analysis, only a history of 131I therapy was a statistically significant risk factor for a repeat ND-FNAB (p = 0.002). Conclusions Patients with a history of 131I 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. PMID:28239289

  12. Muscle biopsy as a tool in the study of aging.

    PubMed

    Coggan, A R

    1995-11-01

    The needle biopsy procedure provides a minimally invasive means of obtaining small samples of skeletal muscle from human volunteers. Such samples can be used to examine a variety of structural and functional characteristics of muscle, including fiber type and size, capillarization, enzymatic capacities, energy substrate or protein/mRNA concentrations, metabolic responses, and contractile properties. In conjunction with other methods, biopsy sampling can also be used to estimate total muscle mass and fiber number, and to determine rates of protein synthesis and degradation. Optimal handling and storage conditions vary widely, but in general, most of the above measurements can be made using frozen tissue, so that samples can be stored almost indefinitely. The procedure is also safe and generally well-tolerated, making it possible to perform longitudinal studies of the same person. The biopsy technique is therefore well suited for examining the underlying physiological mechanisms responsible for muscle wasting in the elderly, as well as for assessing the effects of nutritional, hormonal, and/or lifestyle (e.g., exercise) interventions intended to combat this problem. Although sample size limitations have been largely overcome by the development of microtechniques, more information is needed on how to minimize the variability introduced by studying only a small fraction of the whole muscle. Studies are also required to determine whether it is sufficient to biopsy only one muscle (and if so, which is optimal), or whether there are differential effects of aging in various muscle groups that would preclude extrapolating from one muscle to all muscles in the body.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Cardiac toxoplasmosis after heart transplantation diagnosed by endomyocardial biopsy.

    PubMed

    Petty, L A; Qamar, S; Ananthanarayanan, V; Husain, A N; Murks, C; Potter, L; Kim, G; Pursell, K; Fedson, S

    2015-10-01

    We describe a case of cardiac toxoplasmosis diagnosed by routine endomyocardial biopsy in a patient with trimethoprim-sulfamethoxazole (TMP-SMX) intolerance on atovaquone prophylaxis. Data are not available on the efficacy of atovaquone as Toxoplasma gondii prophylaxis after heart transplantation. In heart transplant patients in whom TMP-SMX is not an option, other strategies may be considered, including the addition of pyrimethamine to atovaquone.

  14. The future prospect: ductoscopy-directed brushing and biopsy.

    PubMed

    Dooley, William Chesnut

    2005-12-01

    The intraductal approach to breast cancer and premalignant lesions has now developed to yield substantial cytologic samples of exfoliated cells. Standard cytology is still inadequate in sensitivity and specificity to accurately interpret the majority of samples. As techniques evolve using ductoscopic biopsy and molecular marker panels to increase accuracy of cytologic interpretation, these tools will be able to unravel the breast carcinogenesis pathways. They will also offer considerable benefit in screening for premalignant changes and developing effective chemoprevention strategies.

  15. Prognostic Value of Allelic Imbalance in Prostate Biopsy

    DTIC Science & Technology

    2005-09-01

    cancer . J. Journal of Urology ...162: 1788-92, 1999. C.A. Fordyce, C.M. Heaphy, N.E. Joste, A.Y. Smith, W.C. Hunt and J.K. Griffith Association Between Cancer -free Survival and Telomere DNA Content in Prostate Tumors. J. Urology , 173: 610-614, 2005. ...prostate cancer . Scope: The two Aims of the project are to(i)determine whether the number of sites of AI in biopsy predicts pathological staging

  16. Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

    PubMed Central

    Gomez-Macías, GS; Garza-Guajardo, R; Segura-Luna, J

    2009-01-01

    Background: Fine needle aspiration biopsy (FNAB) is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003–2005) were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2%) were adequate and 105 (7.7%) were inadequate. Of the 237 from Group 2, 178 were adequate (75.1%) and 59 inadequate (24.8%); in Group 3 there were 321 of which 283 (88.1%) were adequate and 38 (11.8%) inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001) and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis. PMID:19621092

  17. Major Bleeding after Percutaneous Image-Guided Biopsies: Frequency, Predictors, and Periprocedural Management

    PubMed Central

    Kennedy, Sean A.; Milovanovic, Lazar; Midia, Mehran

    2015-01-01

    Major bleeding remains an uncommon yet potentially devastating complication following percutaneous image-guided biopsy. This article reviews two cases of major bleeding after percutaneous biopsy and discusses the frequency, predictors, and periprocedural management of major postprocedural bleeding. PMID:25762845

  18. Right ventricular endomyocardial biopsy in chronic Chagas' disease.

    PubMed

    Pereira Barretto, A C; Mady, C; Arteaga-Fernandez, E; Stolf, N; Lopes, E A; Higuchi, M L; Bellotti, G; Pileggi, F

    1986-02-01

    Right ventricular endomyocardial biopsy was used to study myocardial involvement in 42 patients with chronic Chagas' disease. Patients were divided into three groups: group A included 16 patients with normal ECGs, normal chest x-rays, and no symptoms; group B included 15 patients with abnormal ECGs and no cardiomegaly; and group C included 11 patients with abnormal ECGs and cardiomegaly. Biopsy fragments were analyzed for hypertrophy, degeneration of myocardial fibers, and interstitial changes such as edema, fibrosis, and inflammatory infiltrate. In group A, 5 of 16 biopsies exhibited none of the previously mentioned alterations. The frequencies pathologic alterations in groups A, B, and C, respectively, were: hypertrophy 31%, 66%, and 100%; degeneration 50%, 86%, and 81%; edema 43%, 46%, and 36%; fibrosis 12%, 33%, and 54%; and inflammatory infiltrate 37%, 66%, and 65%. These data suggest that myocardial lesions of Chagas' disease represent a continuous progression from fiber destruction to substitution by fibrosis, with compensatory hypertrophy; these data also suggest that cardiac dilatation occurs when the extent of fibrosis no longer allows for efficient compensatory hypertrophy.

  19. Core needle biopsy guidance based on EMOCT imaging (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Iftimia, Nicusor V.; Park, Jesung; Maguluri, Gopi

    2016-03-01

    We present a novel method, based on encoder mapping OCT imaging, for real-time guidance of core biopsy procedures. This method provides real-time feedback to the interventional radiologist, such that he/she can reorient the needle during the biopsy and sample the most representative area of the suspicious mass that is being investigated. This aspect is very important for tailoring therapy to the specific cancer based on biomarker analysis, which will become one of the next big advances in our search for the optimal cancer therapy. To enable individualized treatment, the genetic constitution and the DNA repair status in the affected areas is needed for each patient. Thus, representative sampling of the tumor is needed for analyzing various biomarkers, which are used as a tool to personalize cancer therapy. The encoder-based OCT enables samping of large size masses and provides full control on the imaging probe, which is passed through the bore of the biopsy guidance needle. The OCT image is built gradually, based on the feedback of an optical encoder which senses the incremental movement of the needle with a few microns resolution. Tissue mapping is independent of the needle speed, while it is advanced through the tissue. The OCT frame is analyzed in real-time and tissue cellularity is reported in a very simple manner (pie chart). Our preliminary study on a rabbit model of cancer has demonstrated the capability of this technology for accurately differentiating between viable cancer and heterogeneous or necrotic tissue.

  20. Immunocytochemical localization of peroxisomal enzymes in human liver biopsies.

    PubMed Central

    Litwin, J. A.; Völkl, A.; Müller-Höcker, J.; Hashimoto, T.; Fahimi, H. D.

    1987-01-01

    The immunocytochemical localization of catalase and three enzymes of the peroxisomal lipid beta-oxidation system--acyl-CoA oxidase, the bifunctional protein enoyl-CoA hydratase, 3-hydroxyacyl-CoA dehydrogenase, and 3-ketoacyl-CoA thiolase--in human liver biopsies was investigated by means of light and electron microscopy. The antisera raised against all four enzymes from rat liver cross-reacted with the corresponding proteins in homogenates of human liver as revealed by immunoblotting. For light-microscopic localization in glutaraldehyde-fixed Epon-embedded material, the removal of resin and controlled digestion with trypsin was necessary. At the ultrastructural level specific labeling for all four antigens was found by the protein A-gold technique in peroxisomes of liver parenchymal cells fixed with formaldehyde-low glutaraldehyde concentrations and embedded in Lowicryl K4M. In biopsies fixed with glutaraldehyde and embedded in Epon, treatment with metaperiodate or etching with sodium ethoxide improved the immunolabeling. After such treatment catalase showed the most intense labeling and acyl-CoA oxidase the weakest, the two other proteins exhibiting an intermediate immunoreaction. In material postfixed with osmium only catalase could be visualized in peroxisomes. The immunocytochemical investigation of peroxisomal proteins in human liver biopsies provides a simple and highly promising approach for further elucidation of the pathophysiology of peroxisomal disorders. Images Figures 2 and 3 Figure 4-7 Figures 9-12 Figure 1 Figure 8 Figure 13 Figure 14 Figure 15 Figure 16 PMID:2886050

  1. Three different anesthesia techniques for a comfortable prostate biopsy

    PubMed Central

    Şahin, Adnan; Ceylan, Cavit; Gazel, Eymen; Odabaş, Öner

    2015-01-01

    Aim: In this paper, we aimed to compare the efficacy of three different anesthesia techniques applied in 90 cases of which transrectal ultrasound (TRUS) -guided prostate biopsies were taken. Materials and Methods: Between February 2012 and July 2012, TRUS-guided 16 core biopsies were taken from 90 patients who comply the study criteria. Patients were randomly divided into three groups each of which consists of 30 individuals. Group 1: Was applied periprostatic block anesthesia; Group 2: Was administered intrarectal lidocaine gel; Group 3: Was applied pudendal block. Visual analog scale (VAS) of patients in groups was evaluated. Results: There was no statistically significant difference between the mean ages, prostate-specific antigen values of three groups. Although pain ratings of Groups 2 and 3 were high, no significant difference was present between each other (P > 0.05). In Groups 1 and 2, the difference between VASs was significant. In the group where periprostatic block was applied, pain ratings were significantly low compared with the other two groups (P = 0.0001). Discussion: Enabling pain and discomfort control in patients is very important during TRUS-guided prostate biopsy. In our study, we observed that the periprostatic block enables more comfortable compared with patient groups with intrarectal lidocaine gel and pudendal block and better reduction in pain scores. PMID:26229322

  2. The promise of liquid biopsy in cancer: a clinical perspective.

    PubMed

    Cortesi, Enrico; Palleschi, Michela; Magri, Valentina; Naso, Giuseppe

    2015-10-01

    The clinical utility of liquid biopsy in cancer treatment will increase as circulating tumor cells (CTCs) analysis move from the enumeration to the real-time measurement of tumor characteristics. Intratumor heterogeneity is becoming increasingly recognized as a major drawback to the shift to personalized medicine. Spatial and temporal heterogeneity might be reflected by the serial assessment of CTCs. Indeed, the developing technologies for CTCs analysis now allow digital genomic and next-generation sequencing approaches, able to differentiate molecular subtypes of the disease and to monitor genetic variation over time. The liquid biopsy of cancer might offer a real-time assessment of tumor biology, providing the opportunity to serially evaluate patients most likely to benefit from targeted drugs based on a dynamic characterization of the disease at the molecular level. Although hurdles remain before liquid biopsy is seen in routine clinical practice, the information derived from CTCs may facilitate the real-time identification of actionable mutations in cancer leading the way toward personalized medicine.

  3. Image Registration for Targeted MRI-guided Transperineal Prostate Biopsy

    PubMed Central

    Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Tokuda, Junichi; Hata, Nobuhiko; Wells, William M.; Kikinis, Ron; Tempany, Clare M.

    2012-01-01

    Purpose To develop and evaluate image registration methodology for automated re-identification of tumor-suspicious foci from pre-procedural MR exams during MR-guided transperineal prostate core biopsy. Materials and Methods A hierarchical approach for automated registration between planning and intra-procedural T2-weighted prostate MRI was developed and evaluated on the images acquired during 10 consecutive MR-guided biopsies. Registration accuracy was quantified at image-based landmarks and by evaluating spatial overlap for the manually segmented prostate and sub-structures. Registration reliability was evaluated by simulating initial mis-registration and analyzing the convergence behavior. Registration precision was characterized at the planned biopsy targets. Results The total computation time was compatible with a clinical setting, being at most 2 minutes. Deformable registration led to a significant improvement in spatial overlap of the prostate and peripheral zone contours compared to both rigid and affine registration. Average in-slice landmark registration error was 1.3±0.5 mm. Experiments simulating initial mis-registration resulted in an estimated average capture range of 6 mm and an average in-slice registration precision of ±0.3 mm. Conclusion Our registration approach requires minimum user interaction and is compatible with the time constraints of our interventional clinical workflow. The initial evaluation shows acceptable accuracy, reliability and consistency of the method. PMID:22645031

  4. Cardiac Sarcoidosis Diagnosed by Incidental Lymph Node Biopsy.

    PubMed

    Matsuda, Jun; Fujiu, Katsuhito; Roh, Solji; Tajima, Miyu; Maki, Hisataka; Kojima, Toshiya; Ushiku, Tetsuo; Nawata, Kan; Takeda, Norihiko; Watanabe, Masafumi; Akazawa, Hiroshi; Komuro, Issei

    2017-02-07

    Cardiac involvement in systemic sarcoidosis sometimes provokes life-threatening ventricular tachyarrhythmia. Steroid administration is one of the fundamental anti-arrhythmia therapies. For an indication of steroid therapy, a definitive diagnosis of sarcoidosis is required.(1)) However, cases that are clearly suspected of cardiac sarcoidosis based on their clinical courses sometimes do not meet the current diagnostic criteria and result in the loss of an appropriate opportunity to perform steroid therapy.Here we report a case that was diagnosed as sarcoidosis by incidental biopsy of an inguinal lymph node during cardiac resuscitation for cardiac tamponade.(2)) While the inguinal lymph node was not swollen on computed tomography, a specimen obtained from an incidental biopsy during the exposure of a femoral vessel for the establishment of extracorporeal cardio-pulmonary resuscitation showed a non-caseating granuloma.This findings suggest a non-swelling lymph node biopsy might be an alternative strategy for the diagnosis for sarcoidosis if other standard strategies do not result in a diagnosis of sarcoidosis.

  5. Outpatient renal needle biopsy of the transplanted kidney: safety profile.

    PubMed

    Petrone, H; Frapiccini, M G; Skare, R; Baran, M

    2011-11-01

    Since May 2005, we began performing renal graft biopsies as outpatient procedures when the patient's condition did not require hospitalization. To evaluate the safety profile of the 137 procedures performed in 111 patients, we performed a retrospective analysis of complications after all biopsies between 4 May 2005 and 6 January 6, 2011. The analysis focused on types of complications as well as needs for hospitalization with length of stay, for blood transfusion or for a further intervention. There were complications in 10.9% of procedures (n = 15) with 8% requiring hospitalization (n = 11). The complications were: gross hematuria (n = 10) including blockage of urinary flow (n = 2) with one subject requiring urologic intervention, and one patient experienced severe pain at the puncture site. Neither renal graft nor patient survival was threatened; there was no hemodynamic decompensation needing blood transfusions. The average hospital stay was 2.27 days (range = 1-8). Outpatient renal biopsies in 111 patients (137 procedures) had an 8% incidence of complications requiring admission and an average length of hospitalization of 2.27 days. Gross hematuria the most frequent problem, in no way compromised patient or graft survival showing it to be a safe outpatient procedure.

  6. Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques

    PubMed Central

    Wainstein, Alberto JA; Drummond-Lage, Ana P; Kansaon, Milhem JM; Bretas, Gustavo O; Almeida, Rodrigo F; Gloria, Ana LF; Figueiredo, Ana RP

    2015-01-01

    Background The purpose of this report is to examine the viability and safety of preoperative lymphoscintigraphy and radio guided sentinel lymph node (SLN) biopsy for conjunctival melanoma, and to identify the best technique to perform this procedure. Methods Three patients diagnosed with malignant melanoma of the conjunctiva underwent lymphoscintigraphy and SLN biopsy using a dual technique comprising isosulfan blue dye and technetium Tc 99m sulfur colloid. Each patient was anesthetized and the conjunctival melanoma was excised. SLNs were localized by a gamma probe, identified according to radioactivity and sentinel blue printing, and dissected, along with drainage of the associated lymphatic basins. The SLNs were evaluated by a pathologist using hematoxylin-eosin staining following serial sectioning and immunohistochemistry using a triple melanoma cocktail (S-100, Melan-A, and HMB-45 antigens). Results Two SLNs were stained in the jugular chain during preoperative lymphoscintigraphy in the first patient, two SLNs were identified in the preauricular and submandibular areas in the second patient, and two SLNs were identified in the submandibular and parotid areas in the third patient. All lymph nodes identified by lymphoscintigraphy were dissected and identified at surgery with 100% accuracy in all three patients. All SLNs were histologically and immunohistochemically negative. Patients had good cosmetic and functional results, and maintained their visual acuity and ocular motility. Conclusion Patients with conjunctival melanoma can undergo preoperative lymphoscintigraphy and SLN biopsy safely using radioactive technetium and isosulfan blue dye. PMID:25565762

  7. Fluorescence and Diffuse Reflectance Spectroscopy for Breast Cancer Diagnosis During Core Needle Biopsy

    DTIC Science & Technology

    2006-09-01

    for breast biopsy. A first generation probe has been designed for use in a 9-gauge vacuum assisted biopsy needle ( Suros ATEC, Suros Surgical Systems...tissue composition in vivo. 2. Methods 2.1 Probe design A fiber optic probe has been designed for use in a vacuum-assisted core biopsy needle ( Suros ...ATEC, Suros Surgical Systems, IN), which is currently employed for image guided breast biopsy at the University of Wisconsin Health and Clinics

  8. MRI/TRUS fusion software-based targeted biopsy: the new standard of care?

    PubMed

    Manfredi, M; Costa Moretti, T B; Emberton, M; Villers, A; Valerio, M

    2015-09-01

    The advent of multiparametric MRI has made it possible to change the way in which prostate biopsy is done, allowing to direct biopsies to suspicious lesions rather than randomly. The subject of this review relates to a computer-assisted strategy, the MRI/US fusion software-based targeted biopsy, and to its performance compared to the other sampling methods. Different devices with different methods to register MR images to live TRUS are currently in use to allow software-based targeted biopsy. Main clinical indications of MRI/US fusion software-based targeted biopsy are re-biopsy in men with persistent suspicious of prostate cancer after first negative standard biopsy and the follow-up of patients under active surveillance. Some studies have compared MRI/US fusion software-based targeted versus standard biopsy. In men at risk with MRI-suspicious lesion, targeted biopsy consistently detects more men with clinically significant disease as compared to standard biopsy; some studies have also shown decreased detection of insignificant disease. Only two studies directly compared MRI/US fusion software-based targeted biopsy with MRI/US fusion visual targeted biopsy, and the diagnostic ability seems to be in favor of the software approach. To date, no study comparing software-based targeted biopsy against in-bore MRI biopsy is available. The new software-based targeted approach seems to have the characteristics to be added in the standard pathway for achieving accurate risk stratification. Once reproducibility and cost-effectiveness will be verified, the actual issue will be to determine whether MRI/TRUS fusion software-based targeted biopsy represents anadd-on test or a replacement to standard TRUS biopsy.

  9. Understanding the diagnostic yield of current endoscopic biopsy for gastric neoplasm: A prospective single-center analysis based on tumor characteristics stratified by biopsy number and site.

    PubMed

    Kwack, Won G; Ho, Won J; Kim, Jae H; Lee, Jin H; Kim, Eo J; Kang, Hyoun W; Lee, Jun K

    2016-07-01

    Although there are general guidelines on endoscopic biopsy for diagnosing gastric neoplasms, they are predominantly based on outdated literature obtained with fiberscopes without analyses specific to tumor characteristics.This study aims to comprehensively characterize the contemporary endoscopic biopsy by determining the diagnostic yield across different lesion morphologies and histological stages, especially exploring how the number and site of biopsy may influence the overall yield.Biopsy samples from suspected gastric neoplasms were collected prospectively from May 2011 to August 2014 in a tertiary care medical center. A standardized methodology was used to obtain a total of 6 specimens from 2 defined sites per lesion. Rate of positive diagnosis based on the biopsy number and site was assessed for specific gastric lesion morphologies and histological stages.A total of 1080 biopsies from 180 pathologically diagnosed neoplastic lesions in 176 patients were obtained during the study. For depressed/ulcerative and polypoid lesions, the yield was already >99% by the fourth biopsy without further gain from additional biopsies. Lower overall yield was observed for infiltrative lesions (57.1% from 4 biopsies). The site of biopsy did not influence the diagnostic yield except for with infiltrative lesions in which biopsies from thickened mucosal folds were of higher yield than erosive regions.Obtaining 4 specimens may be sufficient for accurate diagnosis of a depressed/ulcerative or polypoid gastric lesion regardless of its histological stage. For infiltrative lesions, at least 5 to 6 biopsies per lesion with more representative sampling from thickened mucosal folds may be preferable.

  10. Electromyography (EMG) accuracy compared to muscle biopsy in childhood.

    PubMed

    Rabie, Malcolm; Jossiphov, Joseph; Nevo, Yoram

    2007-07-01

    Reports show wide variability of electromyography (EMG) in detecting pediatric neuromuscular disorders. The study's aim was to determine EMG/nerve conduction study accuracy compared to muscle biopsy and final clinical diagnosis, and sensitivity for myopathic motor unit potential detection in childhood. Of 550 EMG/nerve conduction studies performed by the same examiner from a pediatric neuromuscular service, 27 children (ages 6 days to 16 years [10 boys; M:F, 1:1.7]) with muscle biopsies and final clinical diagnoses were compared retrospectively. Final clinical diagnoses were congenital myopathies (5 of 27,18%), nonspecific myopathies (biopsy myopathic, final diagnosis uncertain; 6 of 27, 22%), congenital myasthenic syndrome (3 of 27, 11%), juvenile myasthenia gravis (1 of 27, 4%), arthrogryposis multiplex congenita (2 of 27, 7%), hereditary motor and sensory neuropathy (1 of 27, 4%), bilateral peroneal neuropathies (1 of 27, 4%), and normal (8 of 27, 30%). There were no muscular dystrophy or spinal muscular atrophy patients. EMG/nerve conduction studies had a 74% agreement with final clinical diagnoses and 100% agreement in neurogenic, neuromuscular junction, and normal categories. Muscle biopsies concurred with final diagnoses in 87%, and 100% in myopathic and normal categories. In congenital myasthenic syndrome, muscle biopsies showed mild variation in fiber size in 2 of 3 children and were normal in 1 of 3. EMG sensitivity for detecting myopathic motor unit potentials in myopathies was 4 of 11 (36%), greater over 2 years of age (3 of 4, 75%), compared to infants less than 2 years (1 of 7, 14%), not statistically significant (P = .0879). EMGs false-negative for myopathy in infants < 2 years of age were frequently neurogenic (3 of 6, 50%). In congenital myopathies EMG detected myopathic motor unit potentials in 40%, with false-negative results neurogenic (20%) or normal (40%). Because our study has no additional tests for active myopathies, for example Duchenne

  11. Electromagnetic-Tracked Biopsy under Ultrasound Guidance: Preliminary Results

    SciTech Connect

    Hakime, Antoine Deschamps, Frederic; Marques De Carvalho, Enio Garcia; Barah, Ali; Auperin, Anne; Baere, Thierry De

    2012-08-15

    Purpose: This study was designed to evaluate the accuracy and safety of electromagnetic needle tracking for sonographically guided percutaneous liver biopsies. Methods: We performed 23 consecutive ultrasound-guided liver biopsies for liver nodules with an electromagnetic tracking of the needle. A sensor placed at the tip of a sterile stylet (18G) inserted in a coaxial guiding trocar (16G) used for biopsy was localized in real time relative to the ultrasound imaging plane, thanks to an electromagnetic transmitter and two sensors on the ultrasound probe. This allows for electronic display of the needle tip location and the future needle path overlaid on the real-time ultrasound image. Distance between needle tip position and its electronic display, number of needle punctures, number of needle pull backs for redirection, technical success (needle positioned in the target), diagnostic success (correct histopathology result), procedure time, and complication were evaluated according to lesion sizes, depth and location, operator experience, and 'in-plane' or 'out-of-plane' needle approach. Results: Electronic display was always within 2 mm from the real position of the needle tip. The technical success rate was 100%. A single needle puncture without repuncture was used in all patients. Pull backs were necessary in six patients (26%) to obtain correct needle placement. The overall diagnostic success rate was 91%. The overall true-positive, true-negative, false-negative, and failure rates of the biopsy were 100% (19/19) 100% (2/2), 0% (0/23), and 9% (2/23). The median total procedure time from the skin puncture to the needle in the target was 30 sec (from 5-60 s). Lesion depth and localizations, operator experience, in-plane or out-of-plane approach did not affect significantly the technical, diagnostic success, or procedure time. Even when the tumor size decreased, the procedure time did not increase. Conclusions: Electromagnetic-tracked biopsy is accurate to determine

  12. [Evaluation of testicular biopsy as an aspect of Chlamydia trachomatis infection (introductory report)].

    PubMed

    Maciejewski, Z; Swierczyński, W; Dziecielski, H; Semmler, G

    1989-01-01

    The purpose of the study was demonstration of the presence of Chlamydia trachomatis in biopsy testicular specimens. The indication to testicular biopsy was azoospermia or cryptozoospermia. The studied group comprised 12 patients in whose semen C. trachomatis was found. For the identification of the organism culture in chick embryo was used. In 2 preparations C. trachomatis was demonstrated in testicular biopsy.

  13. The benefits of open lung biopsy in patients with previous non-diagnostic transbronchial lung biopsy. A guide to appropriate therapy.

    PubMed

    Toledo-Pereyra, L H; DeMeester, T R; Kinealey, A; MacMahon, H; Churg, A; Golomb, H

    1980-05-01

    In a 17-month period, 20 immunosuppressed patients underwent transbronchial biopsy of the lung for diagnostic evaluation of a pulmonary infiltrate of unknown etiology. In 19 patients, the transbronchial biopsy was nondiagnostic. Thirteen of the 19 patients were critically ill and were referred for an open lung biopsy. Eleven (85 percent) of these 13 patients left the hospital after open lung biopsy and appropriate medical treatment. Two patients who were receiving mechanical ventilation at the time of open biopsy succumbed to the combination of their underlying disease and respiratory failure. There were no deaths directly attributed to the open lung biopsy. Of the six patients whose condition appeared stable and who did not undergo open lung biopsy, two died from unrecognized progress of their underlying malignant disease. The remainder recovered. We conclude that open lung biopsy is safe in and beneficial to the diagnosis and subsequent treatment of unknown pulmonary infiltrates in immunosuppressed patients who previously had a nondiagnostic fiberoptic transbronchial biopsy of the lung.

  14. Ultrasound-Guided Percutaneous Core Needle Biopsy of Abdominal Viscera: Tips to Ensure Safe and Effective Biopsy

    PubMed Central

    Kim, Jin Woong

    2017-01-01

    Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications. PMID:28246511

  15. How to Interpret Thyroid Biopsy Results: A Three-Year Retrospective Interventional Radiology Experience

    SciTech Connect

    Oppenheimer, Jason D. Kasuganti, Deepa; Nayar, Ritu; Chrisman, Howard B.; Lewandowski, Robert J.; Nemcek, Albert A.; Ryu, Robert K.

    2010-08-15

    Results of thyroid biopsy determine whether thyroid nodule resection is appropriate and the extent of thyroid surgery. At our institution we use 20/22-gauge core biopsy (CBx) in conjunction with fine-needle aspiration (FNA) to decrease the number of passes and improve adequacy. Occasionally, both ultrasound (US)-guided FNA and CBx yield unsatisfactory specimens. To justify clinical recommendations for these unsatisfactory thyroid biopsies, we compare rates of malignancy at surgical resection for unsatisfactory biopsy results against definitive biopsy results. We retrospectively reviewed a database of 1979 patients who had a total of 2677 FNA and 663 CBx performed by experienced interventional radiologists under US guidance from 2003 to 2006 at a tertiary-care academic center. In 451 patients who had surgery following biopsy, Fisher's exact test was used to compare surgical malignancy rates between unsatisfactory and malignant biopsy cohorts as well as between unsatisfactory and benign biopsy cohorts. We defined statistical significance at P = 0.05. We reported an overall unsatisfactory thyroid biopsy rate of 3.7% (100/2677). A statistically significant higher rate of surgically proven malignancies was found in malignant biopsy patients compared to unsatisfactory biopsy patients (P = 0.0001). The incidence of surgically proven malignancy in unsatisfactory biopsy patients was not significantly different from that in benign biopsy patients (P = 0.8625). In conclusion, an extremely low incidence of malignancy was associated with both benign and unsatisfactory thyroid biopsy results. The difference in incidence between these two groups was not statistically significant. Therefore, patients with unsatisfactory biopsy specimens can be reassured and counseled accordingly.

  16. Shear punch testing of {sup 59}Ni isotopically-doped model austenitic alloys after irradiation in FFTF at different He/dpa ratios

    SciTech Connect

    Hankin, G.L.; Faulkner, R.G.; Hamilton, M.L.; Garner, F.A.

    1998-03-01

    A series of three model alloys, Fe-15Cr-25Ni, Fe-15Cr-25Ni-0.04P and Fe-15Cr45Ni were irradiated side-by-side in FFTF-MOTA in both the annealed and the cold worked condition in each of two variants, one using naturally occurring isotopic mixtures, and another doped with {sup 59}Ni to generate relatively high helium-to-dpa ratios. Previous papers in this series have addressed the influence of helium on radiation-induced evolution of microstructure, dimensional stability and mechanical properties, the latter using miniature-tensile specimens. In the final paper of this experimental series, three sets of irradiations conducted at different temperatures and displacement rates were examined by shear punch testing of standard microscopy disks. The results were used to determine the influence of helium generation rate, alloy starting condition, irradiation temperature and total neutron exposure. The results were also compared with the miniature tensile data obtained earlier. In general, all alloys approached saturation levels of strength and ductility that were relatively independent of He/dpa ratio and starting condition, but were sensitive to the irradiation temperature and total exposure. Some small influence of helium/dpa ratio on the shear strength is visible in the two series that ran at {approximately}490 C, but is not evident at 365 C.

  17. Assessment of the Effects of Cold Work on Crack Initiation in a Light Water Environment Using the Small-Punch Test

    NASA Astrophysics Data System (ADS)

    Isselin, Jerome; Kai, Akira; Sakaguchi, Kazuhiko; Shoji, Tetsuo

    2008-05-01

    Work hardening induced by manufacturing processes has important consequences for the resistance to the stress corrosion cracking (SCC) of low-carbon stainless steel in high-temperature water conditions. It is of great importance to understand the mechanisms and the factors promoting environmentally assisted cracking in such environments. In this study, the effect of work hardening on 316L austenitic stainless steel was studied using a small-punch SCC test facility applied to miniaturized specimens. Tests were performed in a boiling water reactor (BWR) environment with trapezoidal loading. After the tests, the fracture faces and the surfaces of the samples were examined with a scanning electron microscope (SEM). Focused ion beam (FIB) etching was used to prepare samples for the SEM observations. Identification of the oxide was done using a Raman spectroscope and comparison of the data to reference spectra. The results showed the unfavorable effect of cold rolling against crack initiation. The oxide composition is affected by work hardening. Hence, the ferrous oxide formation is promoted by Fe diffusion caused by the dislocation density increase associated with an active strain during the test.

  18. Cloning and Molecular Characterization of a Metabolic Gene with Developmental Functions in Drosophila. I. Analysis of the Head Function of Punch

    PubMed Central

    McLean, J. R.; Boswell, R.; O'Donnell, J.

    1990-01-01

    In an effort to understand the functions of pterins throughout development we have been studying Punch (Pu), the structural gene for the enzyme GTP cyclohydrolase in Drosophila melanogaster. This enzyme catalyzes the first step in the pterin biosynthetic pathway. The Pu gene product is required for vital functions at two distinct stages in embryogenesis, and a pigmentation function in the eye of the young adult. We have localized the Pu region to 29 kb of DNA through the analysis of lesions present in Pu mutants. Since all of the mutations that were mapped affect the eye pigmentation function of Pu, and since this function is the best defined biochemically, we have concentrated on identifying and characterizing Pu products required for eye pigmentation in our initial examination of the cloned region. Four different transcripts from this region are expressed in the adult head. We show that one of these transcripts, the 1.7-kb species, is responsible for the pigmentation function through the analysis of mutant transcripts and the use of an in vitro translation assay. A 2-kb region lying within the locus is specifically required for this eye pigmentation function. PMID:2127575

  19. Future of the Renal Biopsy: Time to Change the Conventional Modality Using Nanotechnology

    PubMed Central

    Khosroshahi, Hamid Tayebi; Sarbaz, Yashar; Shakeri Bavil, Abolhassan

    2017-01-01

    At the present time, imaging guided renal biopsy is used to provide diagnoses in most types of primary and secondary renal diseases. It has been claimed that renal biopsy can provide a link between diagnosis of renal disease and its pathological conditions. However, sometimes there is a considerable mismatch between patient renal outcome and pathological findings in renal biopsy. This is the time to address some new diagnostic methods to resolve the insufficiency of conventional percutaneous guided renal biopsy. Nanotechnology is still in its infancy in renal imaging; however, it seems that it is the next step in renal biopsy, providing solutions to the limitations of conventional modalities. PMID:28316612

  20. Accuracy Evaluation of a 3D Ultrasound-guided Biopsy System.

    PubMed

    Wooten, Walter J; Nye, Jonathan A; Schuster, David M; Nieh, Peter T; Master, Viraj A; Votaw, John R; Fei, Baowei

    2013-03-14

    Early detection of prostate cancer is critical in maximizing the probability of successful treatment. Current systematic biopsy approach takes 12 or more randomly distributed core tissue samples within the prostate and can have a high potential, especially with early disease, for a false negative diagnosis. The purpose of this study is to determine the accuracy of a 3D ultrasound-guided biopsy system. Testing was conducted on prostate phantoms created from an agar mixture which had embedded markers. The phantoms were scanned and the 3D ultrasound system was used to direct the biopsy. Each phantom was analyzed with a CT scan to obtain needle deflection measurements. The deflection experienced throughout the biopsy process was dependent on the depth of the biopsy target. The results for markers at a depth of less than 20 mm, 20-30 mm, and greater than 30 mm were 3.3 mm, 4.7 mm, and 6.2 mm, respectively. This measurement encapsulates the entire biopsy process, from the scanning of the phantom to the firing of the biopsy needle. Increased depth of the biopsy target caused a greater deflection from the intended path in most cases which was due to an angular incidence of the biopsy needle. Although some deflection was present, this system exhibits a clear advantage in the targeted biopsy of prostate cancer and has the potential to reduce the number of false negative biopsies for large lesions.

  1. Accuracy evaluation of a 3D ultrasound-guided biopsy system

    NASA Astrophysics Data System (ADS)

    Wooten, Walter J.; Nye, Jonathan A.; Schuster, David M.; Nieh, Peter T.; Master, Viraj A.; Votaw, John R.; Fei, Baowei

    2013-03-01

    Early detection of prostate cancer is critical in maximizing the probability of successful treatment. Current systematic biopsy approach takes 12 or more randomly distributed core tissue samples within the prostate and can have a high potential, especially with early disease, for a false negative diagnosis. The purpose of this study is to determine the accuracy of a 3D ultrasound-guided biopsy system. Testing was conducted on prostate phantoms created from an agar mixture which had embedded markers. The phantoms were scanned and the 3D ultrasound system was used to direct the biopsy. Each phantom was analyzed with a CT scan to obtain needle deflection measurements. The deflection experienced throughout the biopsy process was dependent on the depth of the biopsy target. The results for markers at a depth of less than 20 mm, 20-30 mm, and greater than 30 mm were 3.3 mm, 4.7 mm, and 6.2 mm, respectively. This measurement encapsulates the entire biopsy process, from the scanning of the phantom to the firing of the biopsy needle. Increased depth of the biopsy target caused a greater deflection from the intended path in most cases which was due to an angular incidence of the biopsy needle. Although some deflection was present, this system exhibits a clear advantage in the targeted biopsy of prostate cancer and has the potential to reduce the number of false negative biopsies for large lesions.

  2. Initial Experience with a Cone-beam Breast Computed Tomography-guided Biopsy System

    PubMed Central

    Seifert, Posy J; Morgan, Renee C; Conover, David L; Arieno, Andrea L

    2017-01-01

    Objective: To evaluate our initial experience with a cone-beam breast computed tomography (BCT)-guided breast biopsy system for lesion retrieval in phantom studies for use with a cone-beam BCT imaging system. Materials and Methods: Under the Institutional Review Board approval, a phantom biopsy study was performed using a dedicated BCT-guided biopsy system. Fifteen biopsies were performed on each of the small, medium, and large anthropomorphic breast phantoms with both BCT and stereotactic guidance for comparison. Each set of the 45 phantoms contained masses and calcification clusters of varying sizes. Data included mass/calcium retrieval rate and dose and length of procedure time for phantom studies. Results: Phantom mass and calcium retrieval rate were 100% for BCT and stereotactic biopsy. BCT dose for small and medium breast phantoms was found to be equivalent to or less than the corresponding stereotactic approach. Stereotactic-guided biopsy dose was 34.2 and 62.5 mGy for small and medium breast phantoms, respectively. BCT-guided biopsy dose was 15.4 and 30.0 mGy for small and medium breast phantoms, respectively. Both computed tomography biopsy and stereotactic biopsy study time ranged from 10 to 20 min. Conclusion: Initial experience with a BCT-guided biopsy system has shown to be comparable to stereotactic biopsy in phantom studies with equivalent or decreased dose. PMID:28217404

  3. Increased promoter methylation in exfoliated breast epithelial cells in women with a previous breast biopsy.

    PubMed

    Browne, Eva P; Punska, Elizabeth C; Lenington, Sarah; Otis, Christopher N; Anderton, Douglas L; Arcaro, Kathleen F

    2011-12-01

    Accurately identifying women at increased risk of developing breast cancer will provide greater opportunity for early detection and prevention. DNA promoter methylation is a promising biomarker for assessing breast cancer risk. Breast milk contains large numbers of exfoliated epithelial cells that are ideal for methylation analyses. Exfoliated epithelial cells were isolated from the milk obtained from each breast of 134 women with a history of a non-proliferative benign breast biopsy (Biopsy Group). Promoter methylation of three tumor suppressor genes, RASSF1, SFRP1 and GSTP1, was assessed by pyrosequencing of bisulfite-modified DNA. Methylation scores from the milk of the 134 women in the Biopsy Group were compared to scores from 102 women for whom a breast biopsy was not a recruitment requirement (Reference Group). Mean methylation scores for RASSF1 and GSTP1 were significantly higher in the Biopsy than in the Reference Group. For all three genes the percentage of outlier scores was greater in the Biopsy than in the Reference Group but reached statistical significance only for GSTP1. A comparison between the biopsied and non-biopsied breasts of the Biopsy Group revealed higher mean methylation and a greater number of outlier scores in the biopsied breast for both SFRP1 and RASSF1, but not for GSTP1. This is the first evidence of CpG island methylation in tumor suppressor genes of women who may be at increased risk of developing breast cancer based on having had a prior breast biopsy.

  4. A 10-year review of outpatient skin biopsy results and skin cancer subtypes.

    PubMed

    DeMarco, Sebastian S; Vos, Paul; Green, Harris; Defazio, Jennifer; Davis, Natalie; Fiz, Lindsey; Phillips, Charles

    2016-01-15

    The results of skin biopsies over a 10 year period were reviewed from the outpatient dermatology clinic at the Brody School of Medicine in Greenville, North Carolina. This research was conducted because there are very few studies that characterize this information over a long-term horizon. The biopsy rate per patient encounter, the clinical reason for the biopsy, the biopsy outcomes, the distribution of cutaneous malignancies per encounter, and the distribution of the subtypes of basal cell carcinoma, squamous cell carcinoma, and melanoma were analyzed. Biopsy logs from January 1, 2001 to December 31, 2010 were reviewed. Our investigation found that 20% of patient encounters resulted in a biopsy. Of these biopsies, 87.9% were performed to rule out malignancy and 12.1% were completed on patients suspected of having inflammatory skin conditions. The basal cell carcinomas diagnosed in Greenville, NC have more aggressive histologic subtypes compared to other studies, whereas the squamous cell carcinomas and melanomas were less aggressive.

  5. Minimalist video-assisted thoracic surgery biopsy of mediastinal tumors

    PubMed Central

    Tacconi, Federico; Rogliani, Paola; Cristino, Benedetto; Gilardi, Francesco; Palombi, Leonardo

    2016-01-01

    Background Mediastinal tumors often require surgical biopsy to achieve a precise and rapid diagnosis. However, subjects with mediastinal tumors may be unfit for general anesthesia, particularly when compression of major vessels or airways does occur. We tested the applicability in this setting of a minimalist (M) uniportal, video-assisted thoracic surgery (VATS) strategy carried out under locoregional anesthesia in awake patients (MVATS). Methods We analyzed in a comparative fashion including propensity score matching, data from a prospectively collected database of patients who were offered surgical biopsy for mediastinal tumors through either MVATS or standard VATS. Tested outcome measures included feasibility, diagnostic yield, and morbidity. Results A total of 24 procedures were performed through MVATS. Diagnostic yield was 100%. Median hospital stay and time interval to oncologic treatment were 2 days (IQR, 2–3 days) and 7 days (IQR, 5.5–11.5 days), respectively. At overall comparison (MVATS, N=24 vs. VATS, N=23), there was a significant difference in both frequency and severity of postoperative complication as measured by Clavien-Dindo classification (P<0.006). In a propensity score matched comparison (8 patients per group), grade 3 or 4 complications requiring aggressive management were found only in the general anesthesia group. Global time spent in the operating room was shorter in the MVATS group (P=0.05). Time interval to oncological treatment was the same between groups. Other differences were also found in SIRS score (P=0.05) and PaO2/FiO2 (P=0.04) thus suggesting better adaption to perioperative stress. Conclusions MVATS biopsy appears to be a reliable tool to optimize diagnostic assessment in patients with mediastinal tumors. It can offer high diagnostic accuracy due to large tissue samples, while reducing morbidity rate compared to the same operation under general anesthesia. More robust evaluation is needed to define the appropriateness of

  6. Diagnosis of breast cancer biopsies using quantitative phase imaging

    NASA Astrophysics Data System (ADS)

    Majeed, Hassaan; Kandel, Mikhail E.; Han, Kevin; Luo, Zelun; Macias, Virgilia; Tangella, Krishnarao; Balla, Andre; Popescu, Gabriel

    2015-03-01

    The standard practice in the histopathology of breast cancers is to examine a hematoxylin and eosin (H&E) stained tissue biopsy under a microscope. The pathologist looks at certain morphological features, visible under the stain, to diagnose whether a tumor is benign or malignant. This determination is made based on qualitative inspection making it subject to investigator bias. Furthermore, since this method requires a microscopic examination by the pathologist it suffers from low throughput. A quantitative, label-free and high throughput method for detection of these morphological features from images of tissue biopsies is, hence, highly desirable as it would assist the pathologist in making a quicker and more accurate diagnosis of cancers. We present here preliminary results showing the potential of using quantitative phase imaging for breast cancer screening and help with differential diagnosis. We generated optical path length maps of unstained breast tissue biopsies using Spatial Light Interference Microscopy (SLIM). As a first step towards diagnosis based on quantitative phase imaging, we carried out a qualitative evaluation of the imaging resolution and contrast of our label-free phase images. These images were shown to two pathologists who marked the tumors present in tissue as either benign or malignant. This diagnosis was then compared against the diagnosis of the two pathologists on H&E stained tissue images and the number of agreements were counted. In our experiment, the agreement between SLIM and H&E based diagnosis was measured to be 88%. Our preliminary results demonstrate the potential and promise of SLIM for a push in the future towards quantitative, label-free and high throughput diagnosis.

  7. Novel pathogenic mutations and skin biopsy analysis in Knobloch syndrome

    PubMed Central

    Suzuki, Oscar; Kague, Erika; Bagatini, Kelly; Tu, Hongmin; Heljasvaara, Ritva; Carvalhaes, Lorenza; Gava, Elisandra; de Oliveira, Gisele; Godoi, Paulo; Oliva, Glaucius; Kitten, Gregory; Pihlajaniemi, Taina; Passos-Bueno, Maria-Rita

    2009-01-01

    Purpose To facilitate future diagnosis of Knobloch syndrome (KS) and better understand its etiology, we sought to identify not yet described COL18A1 mutations in KS patients. In addition, we tested whether mutations in this gene lead to absence of the COL18A1 gene product and attempted to better characterize the functional effect of a previously reported missense mutation. Methods Direct sequencing of COL18A1 exons was performed in KS patients from four unrelated pedigrees. We used immunofluorescent histochemistry in skin biopsies to evaluate the presence of type XVIII collagen in four KS patients carrying two already described mutations: c.3277C>T, a nonsense mutation, and c.3601G>A, a missense mutation. Furthermore, we determined the binding properties of the mutated endostatin domain p.A1381T (c.3601G>A) to extracellular matrix proteins using ELISA and surface plasmon resonance assays. Results We identified four novel mutations in COL18A1, including a large deletion involving exon 41. Skin biopsies from KS patients revealed lack of type XVIII collagen in epithelial basement membranes and blood vessels. We also found a reduced affinity of p.A1381T endostatin to some extracellular matrix components. Conclusions COL18A1 mutations involved in Knobloch syndrome have a distribution bias toward the coding exons of the C-terminal end. Large deletions must also be considered when point mutations are not identified in patients with characteristic KS phenotype. We report, for the first time, lack of type XVIII collagen in KS patients by immunofluorescent histochemistry in skin biopsy samples. As a final point, we suggest the employment of this technique as a preliminary and complementary test for diagnosis of KS in cases when mutation screening either does not detect mutations or reveals mutations of uncertain effect, such as the p.A1381T change. PMID:19390655

  8. Efficacy of needle biopsy in postradiation thyroid disease

    SciTech Connect

    Rosen, I.B.; Palmer, J.A.; Bain, J.; Strawbridge, H.; Walfish, P.G.

    1983-12-01

    Retrospective review was carried out of 124 patients with nodular disease of the thyroid gland and a history of radiation exposure who had undergone needle aspiration biopsy. Latency period from time of radiation varied from 2 to 50 years; but in 92 patients it exceeded 2 decades. Our patient group included those with occupational exposure and a past history of radiation for cancer. Incidence of cancer in the entire group was 49% but, for solitary lesions, this was increased to 56%, while only a 30% incidence of cancer was found in cases of multinodular goiters. Accuracy of needle aspiration biopsy overall was 74%: for the group with cancer--90%, for the group with adenomas--65%, and for the group with ''benign'' tumors--83%. Further assessment of needle technique indicated a sensitivity of 70%, specificity of 90%, positive predictive value of 90%, and negative predictive value of 83% to 65%. The accuracy could be increased to 84% if all adenomas were considered as possible malignancies. Eighteen percent of our patients had second tumors in the head and neck or breast area. Near-total thyroidectomy was considered to be the preferred procedure without accidental nerve injury and was done in one case of hypoparathyroidism after excision of an extensive tracheal invasive cancer. No evidence of death, recurrence, or metastasis as a result of thyroid cancer has been noted. While needle biopsy is indispensable to intelligent management, the history of radiation to the head and neck area must be preeminent in the selection of patients for surgical treatment. Conservative management appears to be reasonable in those patients with ''benign'' cytology, a less than 1 cm nodule, multinodularity, a functioning thyroid scan result, but persistence in the face of a lack of response to conservative management does not appear to be warranted.

  9. Fine-needle aspiration biopsy: a historical overview.

    PubMed

    Rosa, Marilin

    2008-11-01

    Fine needle aspiration biopsy is a safe, inexpensive and accurate technique for the diagnosis of benign and malignant conditions. Its increase in popularity in the present days has made it a technique used on daily basis in the majority of medical centers in United States and around the world. However, the situation was not always like this. In its beginnings the procedure suffered from all kinds of criticism and attacks. The purpose of this manuscript is to provide an overview about the development of this technique from its birth to our days.

  10. Advanced characterization of microscopic kidney biopsies utilizing image analysis techniques.

    PubMed

    Goudas, Theodosios; Doukas, Charalampos; Chatziioannou, Aristotle; Maglogiannis, Ilias

    2012-01-01

    Correct annotation and identification of salient regions in Kidney biopsy images can provide an estimation of pathogenesis in obstructive nephropathy. This paper presents a tool for the automatic or manual segmentation of such regions along with methodology for their characterization in terms of the exhibited pathology. The proposed implementation is based on custom code written in Java and the utilization of open source tools (i.e. RapidMiner, ImageJ). The corresponding implementation details along with the initial evaluation of the proposed integrated system are also presented in the paper.

  11. Mycobacterium abscessus complex bacteremia due to prostatitis after prostate biopsy.

    PubMed

    Chen, Chung-Hua; Lin, Jesun; Lin, Jen-Shiou; Chen, Yu-Min

    2016-10-01

    We present the case of a 49-year-old man, who developed Mycobacterium abscessus complex (M. abscessus complex) bacteremia and prostatitis after prostate biopsy. The patient was successfully treated with amikacin with imipenem-cilastatin with clarithromycin. Infections caused by M. abscessus complex have been increasingly described as a complication associated with many invasive procedures. Invasive procedures might have contributed to the occurrence of the M. abscessus complex. Although M. abscessus complex infection is difficult to diagnose and treat, we should pay more attention to this kind of infection, and the correct treatment strategy will be achieved by physicians.

  12. Renal diagnosis without renal biopsy. Nephritis and sensorineural deafness.

    PubMed

    Richardson, D; Shires, M; Davison, A M

    2001-06-01

    Two examples of hereditary nephropathy within the context of clinical syndromes are described. Emphasis is put on the ability to make a renal diagnosis without renal biopsy and the benefits of screening relatives once a diagnosis is achieved. A variant of Alport's syndrome with associated macrothrombocytic thrombocytopenia, known as Epstein's syndrome, is reported. In addition siblings with Alström's syndrome characterized by pigmentary retinal degeneration (causing blindness in early childhood), progressive sensorineural hearing loss, and progressive renal failure are reported. Both cases had previously presented for non-renal pathology in advance of the onset of symptomatic renal failure and may have benefited from appropriate screening.

  13. Prognostic Value of Allelic Imbalance in Prostate Biopsy

    DTIC Science & Technology

    2006-09-01

    between outcome and telomere DNA content in prostate cancer . J. Journal of Urology , 162: 1788-92, 1999. C.A. Fordyce, C.M. Heaphy, N.E. Joste, A.Y...Smith, W.C. Hunt and J.K. Griffith Association Between Cancer -free Survival and Telomere DNA Content in Prostate Tumors. J. Urology , 173: 610-614, 2005. ...obtained at prostate biopsy can serve as a sensitive and independent marker for staging and predicting disease recurrence in prostate cancer . Scope: The

  14. Development of a 3D ultrasound-guided prostate biopsy system

    NASA Astrophysics Data System (ADS)

    Cool, Derek; Sherebrin, Shi; Izawa, Jonathan; Fenster, Aaron

    2007-03-01

    Biopsy of the prostate using ultrasound guidance is the clinical gold standard for diagnosis of prostate adenocarinoma. However, because early stage tumors are rarely visible under US, the procedure carries high false-negative rates and often patients require multiple biopsies before cancer is detected. To improve cancer detection, it is imperative that throughout the biopsy procedure, physicians know where they are within the prostate and where they have sampled during prior biopsies. The current biopsy procedure is limited to using only 2D ultrasound images to find and record target biopsy core sample sites. This information leaves ambiguity as the physician tries to interpret the 2D information and apply it to their 3D workspace. We have developed a 3D ultrasound-guided prostate biopsy system that provides 3D intra-biopsy information to physicians for needle guidance and biopsy location recording. The system is designed to conform to the workflow of the current prostate biopsy procedure, making it easier for clinical integration. In this paper, we describe the system design and validate its accuracy by performing an in vitro biopsy procedure on US/CT multi-modal patient-specific prostate phantoms. A clinical sextant biopsy was performed by a urologist on the phantoms and the 3D models of the prostates were generated with volume errors less than 4% and mean boundary errors of less than 1 mm. Using the 3D biopsy system, needles were guided to within 1.36 +/- 0.83 mm of 3D targets and the position of the biopsy sites were accurately localized to 1.06 +/- 0.89 mm for the two prostates.

  15. Diagnostic Accuracy of Robot-Guided, Software Based Transperineal MRI/TRUS Fusion Biopsy of the Prostate in a High Risk Population of Previously Biopsy Negative Men

    PubMed Central

    Schaal, Kathrin; Benndorf, Matthias; Soschynski, Martin; Lenz, Philipp; Krauss, Tobias; Drendel, Vanessa; Kurz, Philipp; Werner, Martin; Wetterauer, Ulrich; Schultze-Seemann, Wolfgang; Langer, Mathias; Jilg, Cordula A.

    2016-01-01

    Objective. In this study, we compared prostate cancer detection rates between MRI-TRUS fusion targeted and systematic biopsies using a robot-guided, software based transperineal approach. Methods and Patients. 52 patients received a MRIT/TRUS fusion followed by a systematic volume adapted biopsy using the same robot-guided transperineal approach. The primary outcome was the detection rate of clinically significant disease (Gleason grade ≥ 4). Secondary outcomes were detection rate of all cancers, sampling efficiency and utility, and serious adverse event rate. Patients received no antibiotic prophylaxis. Results. From 52 patients, 519 targeted biopsies from 135 lesions and 1561 random biopsies were generated (total n = 2080). Overall detection rate of clinically significant PCa was 44.2% (23/52) and 50.0% (26/52) for target and random biopsy, respectively. Sampling efficiency as the median number of cores needed to detect clinically significant prostate cancer was 9 for target (IQR: 6–14.0) and 32 (IQR: 24–32) for random biopsy. The utility as the number of additionally detected clinically significant PCa cases by either strategy was 0% (0/52) for target and 3.9% (2/52) for random biopsy. Conclusions. MRI/TRUS fusion based target biopsy did not show an advantage in the overall detection rate of clinically significant prostate cancer. PMID:27990424

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

    PubMed

    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.

  17. Multimodal optical biopsy probe to improve the safety and diagnostic yield of brain needle biopsies (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Desroches, Joannie; Pichette, Julien; Goyette, Andréanne; Tremblay, Marie-Andrée.; Jermyn, Michael; Petrecca, Kevin; Leblond, Frédéric

    2016-03-01

    Brain needle biopsy (BNB) is performed to collect tissue when precise neuropathological diagnosis is required to provide information about tumor type, grade, and growth patterns. The principal risks associated with this procedure are intracranial hemorrhage (due to clipping blood vessels during tissue extraction), incorrect tumor typing/grading due to non-representative or non-diagnostic samples (e.g. necrotic tissue), and missing the lesion. We present an innovative device using sub-diffuse optical tomography to detect blood vessels and Raman spectroscopy to detect molecular differences between tissue types, in order to reduce the risks of misdiagnosis, incorrect tumour grading, and non-diagnostic samples. The needle probe integrates optical fibers directly onto the external cannula of a commercial BNB needle, and can perform measurements for both optical techniques through the same fibers. This integrated optical spectroscopy system uses diffuse reflectance signals to perform a 360-degree reconstruction of the tissue adjacent to the biopsy needle, based on the optical contrast associated with hemoglobin light absorption, thereby localizing blood vessels. Raman spectra measurements are also performed interstitially for tissue characterization. A detailed sensitivity of the system is presented to demonstrate that it can detect absorbers with diameters <300 µm located up to ˜2 mm from the biopsy needle core, for bulk optical properties consistent with brain tissue. Results from animal experiments are presented to validate blood vessel detection and Raman spectrum measurement without disruption of the surgical workflow. We also present phantom measurements of Raman spectra with the needle probe and a comparison with a clinically validated Raman spectroscopy probe.

  18. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass

    PubMed Central

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

    2015-01-01

    We describe a case of 17 year-old male with a nasopharyngeal rhabdomyosarcoma who developed postobstructive pulmonary edema (POPE) after removing the endotracheal tube following biopsy. He developed muffled voice, rhinorrhea, dysphagia, odynophagia, and difficulty breathing through nose and weight loss of 20 pounds in the preceding 2 months. A nasopharyngoscopy revealed a fleshy nasopharyngeal mass compressing the soft and hard palate. Head and neck MRI revealed a large mass in the nasopharynx extending into the bilateral choana and oropharynx. Biopsy of the mass was taken under general anesthesia with endotracheal intubation. Immediately after extubation he developed oxygen desaturation, which did not improve with bag mask ventilation with 100% of oxygen, but improved after a dose of succinylcholine. He was re-intubated and pink, frothy fluid was suctioned from the endotracheal tube. Chest radiograph (CXR) was suggestive of an acute pulmonary edema. He improved with mechanical ventilation and intravenous furosemide. His pulmonary edema resolved over the next 24 h. POPE is a rare but serious complication associated with upper airway obstruction. The pathophysiology of POPE involves hemodynamic changes occurring in the lung and the heart during forceful inspiration against a closed airway due to an acute or chronic airway obstruction. This case illustrates the importance of considering the development of POPE with general anesthesia, laryngospasm and removal of endotracheal tube to make prompt diagnosis and to initiate appropriate management. PMID:26744691

  19. Biopsy proven acute interstitial nephritis after treatment with moxifloxacin

    PubMed Central

    2010-01-01

    Background Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury. At least 70% of AIN is caused by various drugs, mainly penicillines and non-steroidal anti-inflammatory drugs. Quinolones are only rarely known to cause AIN and so far cases have been mainly described with older fluoroquinolones. Case Presentation Here we describe a case of biopsy proven interstitial nephritis after moxifloxacin treatment. The patient presented with fever, rigors and dialysis dependent acute kidney injury, just a few days after treatment of a respiratory tract infection with moxifloxacin. The renal biopsy revealed dense infiltrates mainly composed of eosinophils and severe interstitial edema. A course of oral prednisolone (1 mg/kg/day) was commenced and rapidly tapered to zero within three weeks. The renal function improved, and the patient was discharged with a creatinine of 107 μmol/l. Conclusion This case illustrates that pharmacovigilance is important to early detect rare side effects, such as AIN, even in drugs with a favourable risk/benefit ratio such as moxifloxacin. PMID:20731847

  20. Predicting Low-Risk Prostate Cancer from Transperineal Saturation Biopsies

    PubMed Central

    van Leeuwen, Pim J.; Siriwardana, Amila; Roobol, Monique; Ting, Francis; Nieboer, Daan; Thompson, James; Delprado, Warick; Haynes, Anne-Marie; Brenner, Phillip; Stricker, Phillip

    2016-01-01

    Introduction. To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC). Materials and Methods. Men who underwent radical prostatectomy (RP) for clinical stage ≤T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1–5, criterion 1 stringent (Gleason score 6 + ≤5 mm total max core length PC + ≤3 mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with ≤5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score ≤6 and total tumour volume <2.5 mL, or Gleason score 7 with ≤5% grade 4 and total tumour volume <0.7 mL). Results. 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC. Conclusions. Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies. PMID:27148459

  1. Liver biopsy histopathology for diagnosis of Johne's disease in sheep.

    PubMed

    Smith, S L; Wilson, P R; Collett, M G; Heuer, C; West, D M; Stevenson, M; Chambers, J P

    2014-09-01

    Sheep with Johne's disease develop epithelioid macrophage microgranulomas, specific to Mycobacterium avium subsp. paratuberculosis (Map) infection, in the terminal ileum, mesenteric lymph nodes, and organs distant to the alimentary tract such as the liver. The objectives of this study were to determine whether liver pathology was present in ewes affected by Map and whether liver cores provide adequate tissue for this potential diagnostic marker. One hundred and twenty-six adult, low body condition ewes were euthanized, necropsied, and underwent simulated liver biopsy. Ileal lesions typical of Map were found in 60 ewes. Hepatic epithelioid microgranulomas were observed in all ewes with Type 3b (n = 40) and 82% (n = 11) with Type 3c ileal lesions. None were found in ewes unaffected by Map or with Type 1, 2, or 3a ileal lesions. Liver biopsy core samples provided adequate tissue for histopathology with a sensitivity and specificity of 96% (95% confidence interval [CI], 0.87-0.99) and 100% (95% CI, 0.95-1), respectively for detection of types 3b and 3c ileal lesions.

  2. Preimplantation diagnosis or chorionic villus biopsy? Women's attitudes and preferences.

    PubMed

    Miedzybrodzka, Z; Templeton, A; Dean, J; Haites, N; Mollison, J; Smith, N

    1993-12-01

    The objective of this work was to assess women's attitudes and preferences to two methods of prenatal diagnosis for genetic disease: embryo and chorionic villus biopsy (CVS). The design involved a structured postal questionnaire sent to women in the Grampian region with different reproductive experiences. The population sample included 46 women who had had genetic counselling because of a family history of a single gene disorder, 18 women who had had CVS for a single gene disorder, 158 women who had had CVS for other reasons, 200 women who had recently delivered a normal baby and 50 women who had experience of in-vitro fertilization (IVF). The main outcome measures were attitudes to family limitation, prenatal diagnosis, termination for fetal abnormality, embryo biopsy and CVS. Of the women surveyed, 38% preferred embryo diagnosis, whereas 42% favoured CVS and termination. Women with previous experience of CVS preferred this option whereas those with experience of IVF as infertility treatment were more likely to favour embryo diagnosis, as were women who had had genetic counselling for a single gene disorder. It was concluded that a substantial number of women find embryo diagnosis more acceptable than CVS when the pregnancy is at high risk. This is especially true amongst those with experience of IVF or who are at risk themselves. A demand for embryo diagnosis has been demonstrated.

  3. Laser-induced differential fluorescence for cancer diagnosis without biopsy

    SciTech Connect

    Vo-Dinh, T.; Panjehpour, M.; Overholt, B.F.; Buckley III, P.

    1997-01-01

    An optical diagnostic procedure based on laser-induced fluorescence was developed for direct {ital in vivo} cancer diagnosis without requiring biopsy. The methodology was applied in a clinical study involving over 100 patients in order to differentiate normal tissue from malignant tumors of the esophagus. Endogenous fluorescence of normal and malignant tissues was measured directly with the use of a fiber-optic probe inserted through an endoscope. The measurements were performed {ital in vivo} during routine endoscopy. Detection of the fluorescence signal from the tissue was performed with the use of laser excitation. This report describes the differential normalized fluorescence (DNF) procedure using the amplified spectral differences between the normalized fluorescence of malignant tissue and normal mucosa. The results of this DNF approach were compared with histopathology results of the biopsy samples and indicated excellent agreement in the classification of normal tissue and malignant tumors for the samples investigated. Data related to various grades of Barrett{close_quote}s esophagus are discussed. The DNF procedure could lead to the development of a rapid and cost-effective technique for cancer diagnosis. {copyright} {ital 1997} {ital Society for Applied Spectroscopy}

  4. Liquid Biopsy of Hepatocellular Carcinoma: Circulating Tumor-Derived Biomarkers

    PubMed Central

    Yuan, Chun-Hui; Qu, Zhen; Guan, Qing; Chen, Hao

    2016-01-01

    Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide due to latent liver disease, late diagnosis, and nonresponse to systemic treatments. Till now, surgical and/or biopsy specimens are still generally used as a gold standard by the clinicians for clinical decision-making. However, apart from their invasive characteristics, tumor biopsy only mirrors a single spot of the tumor, failing to reflect current cancer dynamics and progression. Therefore, it is imperative to develop new diagnostic strategies with significant effectiveness and reliability to monitor high-risk populations and detect HCC at an early stage. In the past decade, the potent utilities of “liquid biopsy” have attracted intense concern and were developed to evaluate cancer progression in several clinical trials. “Liquid biopsies” represent a series of noninvasive tests that detect cancer byproducts easily accessible in peripheral blood, mainly including circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) that are shed into the blood from the tumor sites. In this review, we focus on the recent developments in the field of “liquid biopsy” as well as the diagnostic and prognostic significance of CTCs and cfNAs in HCC patients. PMID:27403030

  5. Muscle Pathology Grade for Facioscapulohumeral Muscular Dystrophy Biopsies

    PubMed Central

    Statland, Jeffrey M; Shah, Bharati; Henderson, Don; van der Maarel, Silvere; Tapscott, Stephen J; Tawil, Rabi

    2015-01-01

    Background As we move towards planning for clinical trials in Facioscapulohumeral Muscular Dystrophy (FSHD), a better understanding of the clinical relationship with morphological changes in FSHD muscle biopsies will be important for stratifying patients and understanding post-therapeutic changes in muscle. Methods We performed a prospective cross-sectional study of quadriceps muscle biopsies in 74 genetically confirmed FSHD participants (64 FSHD1, 10 FSHD2). We compared a 12-point muscle pathology grade to genetic mutation, disease severity score, and quantitative myometry. Results Pathology grade had moderate correlations with genetic mutation (rho=−0.45, P<0.001), clinical severity score (rho=0.53, P<0.001), disease duration (rho=0.31, P=0.03), and quantitative myometry (rho=−0.47, P<0.001). We found no difference in the frequency of inflammation between FSHD types 1 and 2. Conclusions The pathology grade of quadriceps muscle may be a useful marker of disease activity in FSHD, and it may have a role in stratification for future clinical trials. PMID:25704033

  6. Liquid biopsy of atherosclerosis using protoporphyrin IX as a biomarker.

    PubMed

    Nascimento da Silva, Monica; Sicchieri, Letícia Bonfante; de Oliveira Silva, Flávia Rodrigues; Andrade, Maira Franco; Courrol, Lilia Coronato

    2014-03-21

    Protoporphyrin IX (PPIX), a derivative of hematoporphyrin, can accumulate in rapidly growing tissues, including tumors and atherosclerotic plaques. The objective of this study is to employ PPIX fluorescence to detect the changes in blood caused by the formation of atheromatous plaques in arteries; this measurement can function as a liquid biopsy. For this purpose twenty four rabbits were randomly divided into groups: control group (CG)--fed with a normal diet, and an experimental group (EG)--fed with a hypercholesterolemic diet (1% cholesterol). Blood samples were collected before (0 time) and after 22, 43, 64 days to measure biochemical factors. The aortas were removed after 22, 43 and 64 days to assess the atherosclerotic plaques. PPIX was extracted from the blood and fluorescence was measured in the 550-750 nm range from samples that were excited at 405 nm. Aminolevulinic acid (ALA) was administered intravenously to increase the PPIX fluorescence intensity in the arteries and consequently in the liquid biopsy of the atherosclerotic plaques. The results have shown that the PPIX fluorescence increased as the atheromatous plaques grew. The aorta fluorescence and the PPIX fluorescence increased in the animals in the experimental group that received ALA. PPIX that accumulates in atheromatous plaques transfers to the blood and can be analyzed by extracting porphyrin from total blood. Therefore, this method can aid in the early diagnosis of atherosclerosis with high sensitivity.

  7. Sentinel lymph node biopsy indications and controversies in breast cancer.

    PubMed

    Wiatrek, Rebecca; Kruper, Laura

    2011-05-01

    Sentinel lymph node biopsy (SLNB) has become the standard of care for early breast cancer. Its use in breast cancer has been evaluated in several randomized controlled trials and validated in multiple prospective studies. Additionally, it has been verified that SLNB has decreased morbidity when compared to axillary lymph node dissection (ALND). The technique used to perform sentinel lymph node mapping was also evaluated in multiple studies and the accuracy rate increases when radiocolloid and blue dye are used in combination. As SLNB became more accepted, contraindications were delineated and are still debated. Patients who have clinically positive lymph nodes or core biopsy-proven positive lymph nodes should not have SLNB, but should have an ALND as their staging procedure. The safety of SLNB in pregnant patients is not fully established. However, patients with multifocal or multicentric breast cancer and patients having neoadjuvant chemotherapy are considered candidates for SLNB. However, the details of which specific neoadjuvant patients should have SLNB are currently being evaluated in a randomized controlled trial. Patients with ductal carcinoma in situ (DCIS) benefit from SLNB when mastectomy is planned and when there is a high clinical suspicion of invasion. With the advent of SLNB, pathologic review of breast cancer lymph nodes has evolved. The significance of occult metastasis in SLNB patients is currently being debated. Additionally, the most controversial subject with regards to SLNB is determining which patients with positive SLNs benefit from further axillary dissection.

  8. Pancreatic cancer: Are "liquid biopsies" ready for prime-time?

    PubMed Central

    Lewis, Alexandra R; Valle, Juan W; McNamara, Mairead G

    2016-01-01

    Pancreatic cancer is a disease that carries a poor prognosis. Accurate tissue diagnosis is required. Tumours contain a high content of stromal tissue and therefore biopsies may be inconclusive. Circulating tumour cells (CTCs) have been investigated as a potential “liquid biopsy” in several malignancies and have proven to be of prognostic value in breast, prostate and colorectal cancers. They have been detected in patients with localised and metastatic pancreatic cancer with sensitivities ranging from 38%-100% using a variety of platforms. Circulating tumour DNA (ctDNA) has also been detected in pancreas cancer with a sensitivity ranging from 26%-100% in studies across different platforms and using different genetic markers. However, there is no clear consensus on which platform is the most effective for detection, nor which genetic markers are the most useful to use. Potential roles of liquid biopsies include diagnosis, screening, guiding therapies and prognosis. The presence of CTCs or ctDNA has been shown to be of prognostic value both at diagnosis and after treatment in patients with pancreatic cancer. However, more prospective studies are required before this promising technology is ready for adoption into routine clinical practice. PMID:27621566

  9. Bronchoscopic procedures and lung biopsies in pediatric lung transplant recipients.

    PubMed

    Wong, Jackson Y; Westall, Glen P; Snell, Gregory I

    2015-12-01

    Bronchoscopy remains a pivotal diagnostic and therapeutic intervention in pediatric patients undergoing lung transplantation (LTx). Whether performed as part of a surveillance protocol or if clinically indicated, fibre-optic bronchoscopy allows direct visualization of the transplanted allograft, and in particular, an assessment of the patency of the bronchial anastomosis (or tracheal anastomosis following heart-lung transplantation). Additionally, bronchoscopy facilitates differentiation of infective processes from rejection episodes through collection and subsequent assessment of bronchoalveolar lavage (BAL) and transbronchial biopsy (TBBx) samples. Indeed, the diagnostic criteria for the grading of acute cellular rejection is dependent upon the histopathological assessment of biopsy samples collected at the time of bronchoscopy. Typically, performed in an out-patient setting, bronchoscopy is generally a safe procedure, although complications related to hemorrhage and pneumothorax are occasionally seen. Airway complications, including stenosis, malacia, and dehiscence are diagnosed at bronchoscopy, and subsequent management including balloon dilatation, laser therapy and stent insertion can also be performed bronchoscopically. Finally, bronchoscopy has been and continues to be an important research tool allowing a better understanding of the immuno-biology of the lung allograft through the collection and analysis of collected BAL and TBBx samples. Whilst new investigational tools continue to evolve, the simple visualization and collection of samples within the lung allograft by bronchoscopy remains the gold standard in the evaluation of the lung allograft. This review describes the use and experience of bronchoscopy following lung transplantation in the pediatric setting.

  10. MRI-Safe Robot for Endorectal Prostate Biopsy

    PubMed Central

    Stoianovici, Dan; Kim, Chunwoo; Srimathveeravalli, Govindarajan; Sebrecht, Peter; Petrisor, Doru; Coleman, Jonathan; Solomon, Stephen B.; Hricak, Hedvig

    2014-01-01

    This paper reports the development of an MRI-Safe robot for direct (interventional) MRI-guided endorectal prostate biopsy. The robot is constructed of nonmagnetic and electrically nonconductive materials, and is electricity free, using pneumatic actuation and optical sensors. Targeting biopsy lesions of MRI abnormality presents substantial clinical potential for the management of prostate cancer. The paper describes MRI-Safe requirements, presents the kinematic architecture, design and construction of the robot, and a comprehensive set of preclinical tests for MRI compatibility and needle targeting accuracy. The robot has a compact and simple 3 degree-of-freedom (DoF) structure, two for orienting a needle-guide and one to preset the depth of needle insertion. The actual insertion is performed manually through the guide and up to the preset depth. To reduce the complexity and size of the robot next to the patient, the depth setting DoF is remote. Experimental results show that the robot is safe to use in any MRI environment (MRI-Safe). Comprehensive MRI tests show that the presence and motion of the robot in the MRI scanner cause virtually no image deterioration or signal to noise ratio (SNR) change. Robot’s accuracy in bench test, CT-guided in-vitro, MRI-guided in-vitro and animal tests are 0.37mm, 1.10mm, 2.09mm, and 2.58mm respectively. These values are acceptable for clinical use. PMID:25378897

  11. Percutaneous needle biopsy for indeterminate renal masses: a national survey of UK consultant urologists

    PubMed Central

    Khan, Azhar A; Shergill, Iqbal S; Quereshi, Sheila; Arya, Manit; Vandal, Mohammed T; Gujral, Sandeep S

    2007-01-01

    Background The use of percutaneous needle biopsy in the evaluation of indeterminate renal masses is controversial and its role in management remains largely unclear. We set to establish current practice on this issue in UK urology departments. Methods We conducted a national questionnaire survey of all consultant urologists in the UK, to establish current practice and attitudes towards percutaneous needle biopsy in the management of indeterminate renal masses. Results 139 (43%) consultant urologists never use biopsy, whereas 111 (34%) always employ it for the diagnosis of indeterminate renal masses. 75 (23%) urologists use biopsy only for a selected patient group. Mass in a solitary kidney, bilateral renal masses and a past history of non-renal cancer were the main indications for use of percutaneous biopsy. The risk of false negative results and biopsy not changing the eventual management of their patients were the commonest reasons not to perform biopsy. Conclusion There is a wide and varied practice amongst UK Consultant Urologists in the use of percutaneous biopsy as part of the management of indeterminate renal masses. The majority of urologists believe biopsy confers no benefit. However there is a need to clarify this issue in the wake of recent published evidence as biopsy results may provide critical information for patients with renal masses in a significant majority. It not only differentiates benign from malignant tissue but can also help in deciding the management option for patients undergoing minimally invasive treatments. PMID:17610739

  12. Surgical biopsy is still necessary for BI-RADS 4 calcifications found on digital mammography that are technically too faint for stereotactic core biopsy.

    PubMed

    Jeffries, Deborah O; Neal, Colleen H; Noroozian, Mitra; Joe, Annette I; Pinsky, Renee W; Goodsitt, Mitchell M; Helvie, Mark A

    2015-12-01

    The purpose of this study was to evaluate the outcome of faint BI-RADS 4 calcifications detected with digital mammography that were not amenable to stereotactic core biopsy due to suboptimal visualization. Following Institutional Review Board approval, a HIPAA compliant retrospective search identified 665 wire-localized surgical excisions of calcifications in 606 patients between 2007 and 2010. We included all patients that had surgical excision for initial diagnostic biopsy due to poor calcification visualization, whose current imaging was entirely digital and performed at our institution and who did not have a diagnosis of breast cancer within the prior 2 years. The final study population consisted of 20 wire-localized surgical biopsies in 19 patients performed instead of stereotactic core biopsy due to poor visibility of faint calcifications. Of the 20 biopsies, 4 (20% confidence intervals 2, 38%) were malignant, 5 (25%) showed atypia and 11 (55%) were benign. Of the malignant cases, two were invasive ductal carcinoma (2 and 1.5 mm), one was intermediate grade DCIS and one was low-grade DCIS. Malignant calcifications ranged from 3 to 12 mm. The breast density was scattered in 6/19 (32%), heterogeneously dense in 11/19 (58%) and extremely dense in 2/19 (10%). Digital mammography-detected faint calcifications that were not amenable to stereotactic biopsy due to suboptimal visualization had a risk of malignancy of 20%. While infrequent, these calcifications should continue to be considered suspicious and surgical biopsy recommended.

  13. Routine Liver Biopsy During Bariatric Surgery: an Analysis of Evidence Base.

    PubMed

    Mahawar, Kamal K; Parmar, Chetan; Graham, Yitka; Abouleid, Ayman; Carr, William R J; Jennings, Neil; Schroeder, Norbert; Small, Peter K

    2016-01-01

    Non-alcoholic fatty liver disease and non-alcoholic steato-hepatitis are common in patients undergoing bariatric surgery. Non-alcoholic steato-hepatitis can progress to cirrhosis of the liver and hepatocellular carcinoma. Non-invasive methods of diagnosing non-alcoholic steato-hepatitis are not as accurate as liver biopsy, and bariatric surgery presents a unique opportunity to carry out a simultaneous liver biopsy. Routine liver biopsy can help early and accurate diagnosis of obesity-associated liver conditions. This has led some surgeons to argue for routine liver biopsy at the time of bariatric surgery. However, most bariatric surgeons remain unconvinced and liver biopsy is currently not routine practice with bariatric surgery. This review examines published scientific literature to ascertain the usefulness of routine liver biopsy at the time of bariatric surgery.

  14. US-guided biopsy of neck masses in postoperative management of patients with thyroid cancer.

    PubMed

    Sutton, R T; Reading, C C; Charboneau, J W; James, E M; Grant, C S; Hay, I D

    1988-09-01

    High-frequency (10-MHz) sonography demonstrated a cervical mass or lymphadenopathy, or both, during postoperative follow-up of 52 patients who had undergone surgery for thyroid cancer. Percutaneous biopsy with ultrasonographic (US) guidance was performed in all 52 masses, 44 of which were nonpalpable. Malignant cells were obtained in 29 biopsies, and the results of 20 biopsies were negative, yielding benign lymphocytes only. Results in three biopsies were nondiagnostic due to hypocellular specimens. Therefore, 94% of biopsy results (49) of 52) were confidently assigned as either positive (56%) or negative (38%) for malignancy. There were no complications. High-frequency sonography can demonstrate clinically occult thyroid bed tumor recurrence and lymph node metastases. US-guided biopsy is an accurate and safe technique to confirm or exclude malignancy in patients at high risk of recurrence of thyroid cancer.

  15. [Liquid biopsy analysis using cell-free DNA (cfDNA): Opportunities and limitations].

    PubMed

    Dahl, E; Kloten, V

    2015-11-01

    Molecular biological analysis of nucleic acids in blood or other bodily fluids (i.e. liquid biopsy analyses) may supplement the pathologists' diagnostic armamentarium in a reasonable way-particularly in cancer precision medicine. Within the field of oncology, liquid biopsy can potentially be used to monitor tumor burden in the blood and to early detect emerging resistance in the course of targeted cancer therapies. An already approved application of liquid biopsy is the detection of epidermal growth factor receptor (EGFR) driver mutations in blood samples of lung cancer patients in those cases where no tissue biopsy is available. However, there is still currently considerable insecurity associated with blood-based DNA analytic methods that must be solved before liquid biopsy can be implemented for broader routine application in the diagnosis of cancer. In this article, the current state of development of liquid biopsy in molecular diagnostics from a pathology point of view is presented.

  16. Evaluation of GSTP1 and APC methylation as indicators for repeat biopsy in a high-risk cohort of men with negative initial prostate biopsies

    PubMed Central

    Trock, Bruce J.; Brotzman, Michelle J.; Mangold, Leslie A.; Bigley, Joseph W.; Epstein, Jonathan I.; McLeod, David; Klein, Eric A.; Jones, J. Stephen; Wang, Songbai; McAskill, Theresa; Mehrotra, Jyoti; Raghavan, Bhargavi; Partin, Alan W.

    2011-01-01

    OBJECTIVE To evaluate the performance of DNA methylation biomarkers in the setting of repeat biopsy in men with an initially negative prostate biopsy but a high index of suspicion for missed prostate cancer. PATIENTS AND METHODS We prospectively evaluated 86 men with an initial histologically negative prostate biopsy and high-risk features. All men underwent repeat 12-core ultrasonography-guided biopsy. DNA methylation of glutathione-S-transferase P1 (GSTP1) and adenomatous polyposis coli (APC) was determined using tissue from the initially negative biopsy and compared with histology of the repeat biopsy. The primary outcome was the relative negative predictive value (NPV) of APC compared with GSTP1, and its 95% confidence interval (CI). RESULTS On repeat biopsy, 21/86 (24%) men had prostate cancer. APC and GSTP1 methylation ratios below the threshold (predicting no cancer) produced a NPV of 0.96 and 0.80, respectively. The relative NPV was 1.2 (95% CI: 1.06–1.36), indicating APC has significantly higher NPV. Methylation ratios above the threshold yielded a sensitivity of 0.95 for APC and 0.43 for GSTP1. Combining both methylation markers produced a performance similar to that of APC alone. APC methylation patterns were consistent with a possible field effect or occurrence early in carcinogenesis. CONCLUSION APC methylation provided a very high NPV with a low percentage of false-negatives, in the first prospective study to evaluate performance of DNA methylation markers in a clinical cohort of men undergoing repeat biopsy. The potential of APC methylation to reduce unnecessary repeat biopsies warrants validation in a larger prospective cohort. PMID:22077694

  17. Can tumour response be assessed from a biopsy?

    PubMed Central

    Trott, K. R.

    1980-01-01

    During a course of radiotherapy or chemotherapy the number of clonogenic cells in a tumour decreases exponentially. After one third of the treatment period more than 99% of the remaining tumour consists of doomed cells. Therefore, it would appear to be impossible to assess the therapeutic response of tumours directly from biopsy material taken during treatment. Nevertheless, attempts to study the therapeutic response during treatment have been made in order to obtain prognostic information on individuals so as to individualize treatment. A variety of approaches have been used. In carcinoma of the cervix a close correlation has been established between the results of some of these assays and local tumour control or long term survival of patients. Even without a complete understanding of the undelying mechanisms, these methods may be useful for the selection of patients for unconventional treatments like fast neutrons or other modalities which are not available to all patients. PMID:7000119

  18. Identification of Helicobacter pylori in skin biopsy of prurigo pigmentosa.

    PubMed

    Missall, Tricia A; Pruden, Samuel; Nelson, Christine; Fohn, Laurel; Vidal, Claudia I; Hurley, M Yadira

    2012-06-01

    A 23-year-old Chinese man presented with a 3-year history of a pruritic eruption. On examination, pink urticarial papules associated with hyperpigmented reticulated patches were noted on his neck, back, and upper chest. Histopathology revealed vacuolar interface dermatitis and numerous gram-negative rods within a dilated hair follicle. The organisms were reactive with anti-Helicobacter pylori immunohistochemisty. The histologic findings and clinical presentation support the diagnosis of prurigo pigmentosa. Additional testing demonstrated a positive urease breath test and serum H. pylori IgG antibodies. The patient was referred to gastroenterology and treated with appropriate antibiotics. After treatment, esophagogastroduodenoscopy revealed chronic gastritis without evidence of H. pylori infection and his skin showed reticulated hyperpigmented patches without evidence of active inflammatory papules. Although previous reports have associated prurigo pigmentosa to H. Pylori gastritis, this is the first report of H. pylori organisms identified in a skin biopsy of prurigo pigmentosa.

  19. Prenatal Diagnosis by Amniocentesis and Chorionic Villus Biopsy

    PubMed Central

    Reynolds, J. L.

    1986-01-01

    Prenatal diagnosis forms only a small part of day-to-day family practice, but the techniques are of critical importance to couples at risk of having a child affected by genetic disorder. Second trimester amniocentesis will probably be replaced by first trimester chorionic villus biopsy and recombinant DNA technology, but the ethical and moral problems related to prenatal diagnosis are not so easily solved. Family physicians need to examine their own attitudes toward the handicapped before they offer counselling to couples at risk of bearing handicapped children. The controversy over abortion is central to the issue of prenatal diagnosis, and may only be resolved by development of prenatal treatments for certain genetic disorders. Sometimes the only thing we can offer patients is to be with them, in whatever their decisions bring. PMID:21274247

  20. Sentinel lymph node biopsy for cutaneous head and neck malignancies.

    PubMed

    Dwojak, Sunshine; Emerick, Kevin S

    2015-03-01

    Sentinel lymph node biopsy (SLNB) is a procedure that can provide critical information regarding pathologic lymph node status and accurate regional staging. This is very important for developing treatment plans and providing prognostic guidance for cutaneous malignancies. The head and neck (HN) region is unique from other body sites due to its complex lymphatic drainage pathways, multiple lymph node basins, proximity of important cranial nerves and potential for contralateral or bilateral drainage. These unique aspects of the HN previously created some uncertainty about the use of SLNB in the HN. This review will discuss the current reliable status of HN SLNB and provide a guide for its current application in cutaneous malignancy of the HN.

  1. MR-compatible biopsy needle with enhanced tip force sensing.

    PubMed

    Elayaperumal, Santhi; Bae, Jung Hwa; Christensen, David; Cutkosky, Mark R; Daniel, Bruce L; Costa, Joannes M; Black, Richard J; Faridian, Fereydoun; Moslehi, Behzad

    2013-04-01

    We describe an instrumented biopsy needle that provides physicians the capability to sense interaction forces directly at the tip of the needle's inner stylet. The sensors consist of optical fiber Bragg gratings (FBGs), and are unaffected by electromagnetic fields; hence the needle is suitable for MR-guided procedures. In comparison to previous instrumented needles that measure bending strains, the new design has additional sensors and a series of micro-machined holes at the tip. The holes increase strain sensitivity, especially to axial forces, without significantly reducing the stiffness or strength. A comparison of the dynamic forces measured with the new needle and those obtained using a force/torque sensor at the needle base shows that the enhanced tip sensitivity is particularly noticeable when there is significant friction along the needle sleeve.

  2. MR-compatible biopsy needle with enhanced tip force sensing

    PubMed Central

    Elayaperumal, Santhi; Bae, Jung Hwa; Christensen, David; Cutkosky, Mark R.; Daniel, Bruce L.; Costa, Joannes M.; Black, Richard J.; Faridian, Fereydoun; Moslehi, Behzad

    2015-01-01

    We describe an instrumented biopsy needle that provides physicians the capability to sense interaction forces directly at the tip of the needle’s inner stylet. The sensors consist of optical fiber Bragg gratings (FBGs), and are unaffected by electromagnetic fields; hence the needle is suitable for MR-guided procedures. In comparison to previous instrumented needles that measure bending strains, the new design has additional sensors and a series of micro-machined holes at the tip. The holes increase strain sensitivity, especially to axial forces, without significantly reducing the stiffness or strength. A comparison of the dynamic forces measured with the new needle and those obtained using a force/torque sensor at the needle base shows that the enhanced tip sensitivity is particularly noticeable when there is significant friction along the needle sleeve. PMID:26509189

  3. Double inlet ventricle. Lung biopsy findings and implications for management.

    PubMed Central

    Juaneda, E; Haworth, S G

    1985-01-01

    The lung was biopsied in 20 children with double inlet ventricle and pulmonary hypertension aged 2 months to 14 years. Eleven patients had two patent atrioventricular valves, three atresia of the right valve, and six hypoplasia of the left valve. Severe pulmonary arterial medial hypertrophy occurred in the nine children less than 1 year of age. The findings did not suggest a period of normality after birth when the pulmonary artery might have been banded most effectively. Of the 11 older patients, eight had medial hypertrophy and three intimal proliferation with medial atrophy. Six patients with medial hypertrophy had some reduction in pulmonary arterial pressure after banding. It is recommended that the pulmonary artery be banded as early as possible, and rebanded early if a satisfactory result is not obtained, particularly in patients destined for a Fontan-Kreutzer procedure. Early atrial septectomy should reduce the arterial and venous abnormalities seen in left atrioventricular valve hypoplasia. PMID:3994865

  4. Effects of Aspirin Therapy on Ultrasound–Guided Renal Allograft Biopsy Bleeding Complications

    PubMed Central

    Baffour, Francis I.; Hickson, LaTonya J.; Stegall, Mark D.; Dean, Patrick G.; Gunderson, Tina M.; Atwell, Thomas D.; Kurup, A. Nicholas; Schmitz, John J.; Park, Walter D.; Schmit, Grant D.

    2017-01-01

    Purpose To determine if patient aspirin exposure and timing affect bleeding risk after renal allograft biopsy. Materials and Methods Review of 6,700 renal allograft biopsies (in 2,362 unique patients) was performed. Median patient age was 53.0 years [interquartile range 43.0, 62.0]; 56.2% of patients were male. Of biopsies, 4,706 (70.2%) were performed in patients with no aspirin exposure within 10 days of biopsy; 664 (9.9%), were performed within 8–10 days of aspirin exposure; 855 (12.8%), within 4–7 days; and 475 (7.1%), within 0–3 days. Follow-up to 3 months after the procedure was completed in all patients. Biopsies were categorized as protocol or indication; 19.7% were indication biopsies. Bleeding complications were graded based on SIR criteria. Logistic regression models examined the association between aspirin use and bleeding events. Results Rate [95% confidence interval] of major bleeding complications was 0.24% [0.14, 0.39], and rate of any bleeding complication was 0.66% [0.46, 0.90]. Bleeding events were significantly associated with patients undergoing indication biopsies compared with protocol biopsies (odds ratio [OR] 2.27, P = .012). Patient factors associated with major bleeding complications in multivariate models included estimated glomerular filtration rate (OR 0.61, P = .016) and platelet count (OR 0.64, P = .033). Aspirin use was not significantly associated with increased risk of bleeding complication except for use of 325 mg of aspirin within 3 days of biopsy (any complication OR 3.87 [1.12, 13.4], P = .032; major complication OR 6.30 [1.27, 31.3], P = .024). Conclusions Renal allograft biopsy bleeding complications are very rare, particularly for protocol biopsies. Use of 325 mg of aspirin within 3 days of renal allograft biopsy was associated with increased bleeding complications. PMID:27993506

  5. A review of specialties performing temporal artery biopsies in Ontario: a retrospective cohort study

    PubMed Central

    Margolin, Edward A.

    2015-01-01

    Background Temporal artery biopsy is the gold standard for the diagnosis of giant cell arteritis, but the numbers and types of surgical specialists performing temporal artery biopsies are unknown. The goal of this study was to determine which surgical specialists performed temporal artery biopsies and how geographic location influenced this trend over a period of 10 years. Methods This retrospective cohort study included all physicians practising in Ontario from 2002 to 2013. Using comprehensive physician services data from the IntelliHEALTH Medical Services database, physicians performing temporal artery biopsies were identified by the Ontario Health Insurance Plan billing code submitted for remuneration. Physicians were categorized by specialty and geographic Local Health Integration Unit. Results A total of 9958 patients underwent a temporal artery biopsy during the study period: the biopsies were performed by 11 different subspecialties. The number of patients undergoing a temporal artery biopsy declined over the 10-year study period. Most procedures were performed by general surgeons (38.1%), followed by ophthalmologists (31.0%) and plastic surgeons (23.6%). Ophthalmologists performed more temporal artery biopsies per person compared with general surgeons, but significantly more general surgeons performed at least 1 biopsy. There was significant variation based on geographic location: plastic surgeons performed the most biopsies in regions with a population of more than 1 million people, and general surgeons performed most of the biopsies in rural areas. Interpretation Geographic location heavily influenced which specialty was most likely to perform temporal artery biopsies. General surgery, ophthalmology and plastic surgery emerged as leaders in this area, and their residency programs should include formal training in this procedure in their curricula. PMID:26442226

  6. Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

    SciTech Connect

    Cunningham, Jane D. McCusker, Mark W.; Power, Sarah; PearlyTi, Joanna; Thornton, John; Brennan, Paul; Lee, Michael J.; O’Hare, Alan; Looby, Seamus

    2015-04-15

    PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

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

    PubMed Central

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

    2014-01-01

    INTRODUCTION The needle biopsy technique for the soleus muscle is of particular interest because of its 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. METHODS Ultrasonography was used on an initial set of 12 subjects to determine the optimal biopsy zone thereby guiding the location of the incision site. Forty-five subjects were recruited and attended two 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. RESULTS Eighty-four soleus muscle biopsy procedures 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. DISCUSSION 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. PMID:24261060

  8. Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It.

    PubMed

    Plett, Sara K; Poder, Liina; Brooks, Rebecca A; Morgan, Tara A

    2016-06-01

    The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included.

  9. Electromagnetic-Optical Coherence Tomography Guidance of Transbronchial Solitary Pulmonary Nodule Biopsy

    DTIC Science & Technology

    2015-07-01

    and electromagnetic (EM) navigation for spatial guidance to targeted lung nodules, and OCT for microscopic volumetric imaging. The OCT optic fiber...imaging of, and navigation to, SPN for transbronchial biopsy, and (Aim 2) conduct a preclinical study to demonstrate the feasibility of EM-OCT biopsy...guidance of artificial SPN (aSPN) in living swine. 2. KEYWORDS Electromagnetic Navigation , Biopsy Guidance, Optical Microscopy, Optical Coherence

  10. Celiac disease: is it really possible to overcome duodenal biopsy?

    PubMed

    Grande, Elisabetta; Ferranti, Silvia; Gaggiano, Carla; Di Virgilio, Nicola; Vascotto, Marina

    2016-05-06

    We report the case of a two-year-five-month-old child who underwent screening for celiac disease due to strong familiarity. During the first observation body weight and height were at 25th and 50th centile for gender and age. Physical examination did not reveal any sign of disease. Blood tests showed increased transaminases levels and antibodies research showed: tTG IgA: 100 UI/ml, tTG IgG: 36,6 UI/ml, EMA IgA: positive. HLA study revealed homozygous allelic combination DRB1*07;DQA102:01; DQB1* 02:02 with presence of a double copy of beta chain in the composition of the  DQ2 heterodymer. Biopsy with histological examination did find neither mucosal alteration  nor lymphocytic infiltrates (Marsh 0). During follow up with free diet the patient remained asymptomatic and all antibody titers decreased up to normalization. According to ESPGHAN guidelines the finding of hypertransaminasemia as sign of celiac hepatic inflammation, a more than 10-fold increase of tTG IgA and a high-risk HLA would permit diagnosis of celiac disease but histological examination done due to mismatch between paucity of clinical sings and a "multiple risk combination" excluded it, allowing diagnosis of potential celiac disease.  We believe that this case is interesting because of its being in contrast with current literature data that suggest a linear relationship between antibodies levels and histological damage with tTG IgA at the upper reference range in case of potential celiac disease. According to guidelines we could have avoided intestinal biopsy but we would have considered as celiac a patient who is maybe just potentially affected.

  11. Optical biopsy - a new armamentarium to detect disease using light

    NASA Astrophysics Data System (ADS)

    Pu, Yang; Alfano, Robert R.

    2015-03-01

    Optical spectroscopy has been considered a promising method for cancer detection for past thirty years because of its advantages over the conventional diagnostic methods of no tissue removal, minimal invasiveness, rapid diagnoses, less time consumption and reproducibility since the first use in 1984. It offers a new armamentarium. Human tissue is mainly composed of extracellular matrix of collagen fiber, proteins, fat, water, and epithelial cells with key molecules in different structures. Tissues contain a number of key fingerprint native endogenous fluorophore molecules, such as tryptophan, collagen, elastin, reduced nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD) and porphyrins. It is well known that abnormalities in metabolic activity precede the onset of a lot of main diseases: carcinoma, diabetes mellitus, atherosclerosis, Alzheimer, and Parkinson's disease, etc. Optical spectroscopy may help in detecting various disorders. Conceivably the biochemical or morphologic changes that cause the spectra variations would appear earlier than the histological aberration. Therefore, "optical biopsy" holds a great promise as clinical tool for diagnosing early stage of carcinomas and other deceases by combining with available photonic technology (e.g. optical fibers, photon detectors, spectrographs spectroscopic ratiometer, fiber-optic endomicroscope and nasopharyngoscope) for in vivo use. This paper focuses on various methods available to detect spectroscopic changes in tissues, for example to distinguish cancerous prostate tissues and/or cells from normal prostate tissues and/or cells. The methods to be described are fluorescence, stokes shift, scattering, Raman, and time-resolved spectroscopy will be reviewed. The underlying physical and biological basis for these optical approaches will be discussed with examples. The idea is to present some of the salient works to show the usefulness and methods of Optical Biopsy for cancer detection and

  12. Mastoscopic sentinel lymph node biopsy in breast cancer

    PubMed Central

    Ding, Boni; Zhang, Hongyan; Li, Xiaorong; Qian, Liyuan; Chen, Xuedong; Wu, Wei; Wen, Yanguang; Zhao, Yujun

    2015-01-01

    Background Previous studies have demonstrated that mastoscopic sentinel lymph node biopsy (MSLNB) has good identification rate (IR) and low false negative rate (FNR). However, few studies have directly compared the surgical performance and peri- and post-operative factors of MSLNB with conventional sentinel lymph node biopsy (SLNB). Methodology Sixty patients diagnosed with breast cancer were recruited and randomly assigned to one of the three groups: MSLNB, SLNB and SLNB with lipolysis injection. Peri- and post-operative parameters were compared using general linear models. To examine the effect of age on these parameters, we performed separate analysis stratified by age (≤50 years old vs. >50 years old). Results Patients in the MSLNB group experienced longer surgery and suffered higher surgical cost than patients who underwent conventional SLNB or SLNB with lipolysis injection (p<0.0001). Despite this, they had significantly less blood loss than those who underwent conventional SLNB (22.0±7.0 ml vs.73.5±39.6 ml; p<0.0001). Analysis by age group indicates a similar pattern of difference among the three groups. MSLNB and conventional SLNB have similar IR and FNR. Conclusion As a minimally invasive technique, MSLNB can significantly reduce blood loss while providing similar IR and FNR, indicating that it can be a promising alternative to conventional SLNB. Conclusion Variations in popliteal artery terminal branching pattern occurred in 7.4% to 17.6% of patients. Pre-surgical detection of these variations with MD CTA may help to reduce the risk of iatrogenic arterial injury by enabling a better surgical treatment plan. PMID:28352718

  13. Are We Overtreating Papillomas Diagnosed on Core Needle Biopsy?

    PubMed Central

    Cyr, Amy E.; Novack, Deborah; Trinkaus, Kathryn; Margenthaler, Julie A.; Gillanders, William E.; Eberlein, Timothy J.; Ritter, Jon; Aft, Rebecca L.

    2014-01-01

    Background Breast papillomas often are diagnosed with core needle biopsy (CNB). Most studies support excision for atypical papillomas, because as many as one half will be upgraded to malignancy on final pathology. The literature is less clear on the management of papillomas without atypia on CNB. Our goal was to determine factors associated with pathology upgrade on excision. Methods Our pathology database was searched for breast papillomas diagnosed by CNB during the past 10 years. We identified 277 charts and excluded lesions associated with atypia or malignancy on CNB. Two groups were identified: papillomas that were surgically excised (group 1) and those that were not (group 2). Charts were reviewed for the subsequent diagnosis of cancer or high-risk lesions. Appropriate statistical tests were used to analyze the data. Results A total of 193 papillomas were identified. Eighty-two lesions were excised (42%). Caucasian women were more likely to undergo excision (p = 0.03). Twelve percent of excised lesions were upgraded to malignancy. Increasing age was a predictor of upgrading, but this was not significant. Clinical presentation, lesion location, biopsy technique, and breast cancer history were not associated with pathology upgrade. Two lesions in group 2 ultimately required excision due to enlargement, and both were upgraded to malignancy. Conclusions Twenty-four percent of papillomas diagnosed on CNB have upgraded pathology on excision—half to malignancy. All of the cancers diagnosed were stage 0 or I. For patients in whom excision was not performed, 2 of 111 papillomas were later excised and upgraded to malignancy. PMID:21046266

  14. [Occupational toxic neuropathies: morphology in peripheral nerve biopsies].

    PubMed

    Scelsi, Roberto; Candura, Stefano M

    2012-01-01

    Many peripheral neuropathies are caused by the (acute or chronic) toxic action of metals, solvents, pesticides, and other occupational and environmental contaminants. These agents often reproduce the anatomoclinical pictures of hereditary (e.g., Charcot-Marie-Tooth disease), autoimmune (Guillain-Barrè syndrome), or dysmetabolic (thiamine deficiency, diabetic neuropathy) forms. Toxic peripheral neuropathies can be classified on the basis of etiology, clinical features (sensitive, motor, sensitive-motor), or histopathology: neuronopathies (uncommon, mostly secondary to retrograde axonal degeneration; e.g., arsenic, thallium), axonopathies (acrylamide, esacarbons, CS2, organophosphate-induced delayed neuropathy), myelinopathies (trichloroethylene), mixed forms (axonal and demyelinating: lead). For many substances, experimental research has led to the identification of the molecular and cellular targets of neurotoxicity. Several compounds are active by biotransformation (e.g., the esacarbons n-hexane and MnBK are neurotoxic since they are metabolized to 2,5-hexanedione), Genetic, physiological and environmental factors determine the individual metabolic set-up, and they may give origin to differences in the workers' sensitivity. Cessation of exposure is often followed by (microscopically observable) regenerative phenomena and clinical improvement. The morphology of neuropathies can be studied through peripheral nerve biopsy. Samples of sural nerve (or other nervous trunks of the limbs), adequately fixed, sectioned, and stained, allow the observation of alterations in axonal fibres (e.g., giant-axonal neuropathy, dying back neuropathy), myelin (demyelination), Schwann cells, interstitium, and blood vessels; possible inflammatory infiltrates; fibre density; regenerative phenomena (growth cone, remyelination). In occupational medicine, biopsy is indicated when the anamnestic-clinical picture, laboratory tests, and instrumental exams leave doubts about the nature, type

  15. Liquid biopsy: ready to guide therapy in advanced prostate cancer?

    PubMed

    Hegemann, Miriam; Stenzl, Arnulf; Bedke, Jens; Chi, Kim N; Black, Peter C; Todenhöfer, Tilman

    2016-12-01

    The identification of molecular markers associated with response to specific therapy is a key step for the implementation of personalised treatment strategies in patients with metastatic prostate cancer. Only in a low proportion of patients biopsies of metastatic tissue are performed. Circulating tumour cells (CTC), cell-free DNA (cfDNA) and RNA offer the potential for non-invasive characterisation of disease and molecular stratification of patients. Furthermore, a 'liquid biopsy' approach permits longitudinal assessments, allowing sequential monitoring of response and progression and the potential to alter therapy based on observed molecular changes. In prostate cancer, CTC enumeration using the CellSearch© platform correlates with survival. Recent studies on the presence of androgen receptor (AR) variants in CTC have shown that such molecular characterisation of CTC provides a potential for identifying patients with resistance to agents that inhibit the androgen signalling axis, such as abiraterone and enzalutamide. New developments in CTC isolation, as well as in vitro and in vivo analysis of CTC will further promote the use of CTC as a tool for retrieving molecular information from advanced tumours in order to identify mechanisms of therapy resistance. In addition to CTC, nucleic acids such as RNA and cfDNA released by tumour cells into the peripheral blood contain important information on transcriptomic and genomic alterations in the tumours. Initial studies have shown that genomic alterations of the AR and other genes detected in CTC or cfDNA of patients with castration-resistant prostate cancer correlate with treatment outcomes to enzalutamide and abiraterone. Due to recent developments in high-throughput analysis techniques, it is likely that CTC, cfDNA and RNA will be an important component of personalised treatment strategies in the future.

  16. Near-infrared pulsed light to guide prostate biopsy

    NASA Astrophysics Data System (ADS)

    Boutet, J.; Debourdeau, M.; Laidevant, A.; Hervé, L.; Allié, C.; Vray, D.; Dinten, J.-M.

    2011-03-01

    The protocol for prostate cancer diagnosis, currently based on ultrasound guided biopsy, is limited by a lack of relevance. To improve this protocol, a new approach was proposed combining optical and ultrasound measurements to guide biopsy specifically to the tumors. Adding an optical measurement modality into an already existing ultrasound probe is challenging as the overall size of the system should not exceed a given dimension so as to fit the operative environment. Moreover, examination should not take more than 15 min to avoid any complication. A combined ultrasound and optical endorectal probe was designed to comply with the constraints of the sterilization protocols, the examination duration and required compactness. Therefore a totally innovative pulsed laser source has been designed to meet compactness requirements while providing accurate time-resolved measurements. A dedicated multi-channel photon counting system was optimized to decrease the examination duration. A fast reconstruction method based on the analysis of the intensity and time of flight of the detected photons has been associated to provide 3D localization of fluorescent dots almost immediately after acquisition. The bi-modal probe was capable of withstanding the sterilization procedures. The performance of the compact laser source has been shown at the same level as that of a standard laboratory Titane:Sapphire laser. The dedicated photon counting solution was capable of acquiring optical data in less than one minute. To evaluate the overall performance of the system in dealing with a realistic background signal, measurements and reconstructions were conducted on prostate mimicking phantom and in vivo.

  17. Cost effectiveness of routine duodenal biopsies in iron deficiency anemia

    PubMed Central

    Broide, Efrat; Matalon, Shay; Kriger-Sharabi, Ofra; Richter, Vered; Shirin, Haim; Leshno, Moshe

    2016-01-01

    AIM To investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results. METHODS We used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed. RESULTS Strategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B. CONCLUSION Our model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status. PMID:27678365

  18. Correlation between endometrial biopsy and serum progesterone level in prediction of corpus luteum function.

    PubMed

    El-hefnawi, N; Abou-gabal, A; El-etriby, A; Maged, M; Wafa, G; Ragab, I

    1987-01-01

    This study aimed to determine the correlation between endometrial biopsy and serum progesterone level in prediction of corpus luteum function in regularly menstruating women. Endometrial biopsy specimens were obtained from 40 women 20-25 years old with unproven fertility 2-3 days before the anticipated onset of menses. A simultaneous blood sample was obtained for measurement of serum progesterone levels using a radioimmunoassay technique. 27 biopsies were considered to be in-phase (IP) by histologic criteria, and the remaining 13 were out-of-phase (OOP). The mean serum progesterone level obtained from women with OOP biopsies 3-4 days before onset of menses was significantly lower than that obtained 1-2 days before the onset of menses. Menstruation occurred in women with OOP biopsies at a time when serum progesterone level was apparently rising. On the other hand, values were too small to identify any significant difference between groups of women with IP and OOP biopsies when these biopsies were performed very late in the cycle. The author states the importance of evaluating both serum progesterone and endometrial biopsy dating in the late luteal phase of the menstrual cycle. Serum progesterone was easy to perform, while endometrial biopsy showed the end result.

  19. Confirmatory biopsy for the assessment of prostate cancer in men considering active surveillance: reference centre experience

    PubMed Central

    Bosco, Cecilia; Cozzi, Gabriele; Kinsella, Janette; Bianchi, Roberto; Acher, Peter; Challacombe, Benjamin; Popert, Rick; Brown, Christian; George, Gincy; Van Hemelrijck, Mieke; Cahill, Declan

    2016-01-01

    Objectives To evaluate how accurate a 12-core transrectal biopsy derived low-risk prostate cancer diagnosis is for an active surveillance programme by comparing the histological outcome with that from confirmatory transperineal sector biopsy. Subjects and methods The cohort included 166 men diagnosed with low volume Gleason score 3+3 prostate cancer on initial transrectal biopsy who also underwent a confirmatory biopsy. Both biopsy techniques were performed according to standard protocols and samples were taken for histopathology analysis. Subgroup analysis was performed according to disease severity at baseline to determine possible disease parameters of upgrading at confirmatory biopsy. Results After confirmatory biopsy, 34% demonstrated Gleason score upgrade, out of which 25% were Gleason score 3+4 and 8.5% primary Gleason pattern 4. Results remained consistent for the subgroup analysis and a weak positive association, but not statistically significant, between prostate specific antigen (PSA), age, and percentage of positive cores, and PCa upgrading at confirmatory biopsy was found. Conclusion In our single centre study, we found that one-third of patients had higher Gleason score at confirmatory biopsy. Furthermore 8.5% of these upgraders had a primary Gleason pattern 4. Our results together with previously published evidence highlight the need for the revision of current guidelines in prostate cancer diagnosis for the selection of men for active surveillance. PMID:27170833

  20. Normal adrenal glands in small cell lung carcinoma: CT-guided biopsy

    SciTech Connect

    Pagani, J.J.

    1983-05-01

    Twenty-four small cell lung carcinoma patients with morphologically normal adrenal glands by computed tomographic (CT) criteria underwent percutaneous thin-needle biopsy of their adrenal glands. Of 43 glands biopsied, 29 had adequate cellular material for interpretation. Five (17%) of the 29 glands were positive for metastases; the rest had negative biopsies. This series indicates an approximate 17% false-negative diagnosis rate by CT when staging the adrenal glands in patients with small cell lung carcinoma. It also demonstrates the utility of percutaneous needle biopsy as an investigational tool to further evaluate normal-sized adrenal glands in the oncologic patient.

  1. The influence of multiple liver biopsies on hematologic and serum biochemical values of sheep.

    PubMed

    Harvey, R B; Lovering, S L; Bailey, E M; Norman, J O

    1984-10-01

    A rapid, simple liver biopsy technique for sheep was developed to obtain in situ liver samples for evaluation of histological tissue, enzyme assay, and ultrastructural changes that might occur during toxicological testing. The study was designed because repeated biopsies in the same individual could induce bias in hematologic, histological or serum biochemical parameters caused by the trauma of the biopsy procedure. In Experiment I, sheep were divided into a biopsied group (B), sham-operated group (SO), and a nonsurgical, untreated control group (C). Three liver biopsy samples per week were removed from each subject in Group B for five weeks. Biweekly blood samples were drawn for evaluation of hematologic and serum biochemical parameters. In Experiment II, Groups B and SO were dosed with CCl4 in order to validate the applicability of the biopsy procedure. Weekly biopsies were continued in Group B. Biweekly blood samples were evaluated for any hematologic or serum biochemical variations. Significant elevations of enzyme activities confirmed CCl4 hepatotoxicity in treated groups (B and SO) versus C group. Histological lesions in biopsy samples correlated closely with serum biochemical data in treated groups. It was concluded that the serial liver biopsy procedure causes negligible alterations in the hematologic, histological or serum biochemical parameters measured; is simple and rapid to perform, and provides a method for possible early detection of liver disease.

  2. Microtubule turnover in ooplasm biopsy reflects ageing phenomena in the parent oocyte.

    PubMed

    Goud, A P; Goud, P T; Diamond, M P; Van Oostveldt, P; Hughes, M R

    2005-07-01

    Oviductal oocytes retrieved from superovulated B6D2F1 mice at 13.5, 16 and 19 h after human chorionic gonadotrophin (HCG) (groups A, B and C respectively, n = 382) were micromanipulated to obtain 12-20 mum sized ooplasm biopsy fragments. Experiments were divided into three sets. Ooplasmic microtubule dynamics were studied in ooplasm biopsy specimens and parent oocytes (set 1) and ooplasm biopsy specimens (set 2), whilst zona pellucida dissolution time, cortical granule loss and spindle/chromatin morphology using confocal microscopy were also studied in parent oocytes (set 2). Oocytes withstood oocyte biopsy with a high survival rate (98.2%) and the biopsied oocytes underwent successful fertilization and development (set 3). An absolute one-to-one correlation was seen between the oocyte biopsy specimens and the parent oocytes in terms of ooplasmic microtubule dynamics (set 1), and increased ooplasmic microtubule dynamics in oocyte biopsy specimens paralleled ageing phenomena in the parent oocytes (set 2). Zona pellucida dissolution time was significantly lower in parent oocytes from group A versus groups B (P = 0.032), and C (P < 0.001). (Groups A, B, C include minimal, moderate, increased ooplasmic microtubule dynamics in oocyte biopsy specimens respectively.) Oocyte cortical granule loss and spindle/chromatin abnormalities were mainly seen in group C (P < 0.001). Oocyte biopsy can thus be applied to judge age-related changes in the parent oocytes.

  3. Liver biopsy for parenchymal liver disease - is routine real time image guidance unnecessary?

    PubMed

    John, Anil; Al Kaabi, Saad; Soofi, Madiha Emran; Mohannadi, Muneera; Kandath, Salva Manam; Derbala, Moataz; Yakoub, Rafie; Al-Ahdal, Esra Mohammed; Sharma, Manik; Wani, Hamid; Dweik, Nazeeh; John, Anjum; Butt, Mohammed Tariq

    2014-01-01

    Liver biopsy even today remains the standard of care for grading and staging chronic hepatitis despite advances in noninvasive markers of liver fibrosis. Literature suggests an expanding role for real-time image guided liver biopsy and declining trend for blind liver biopsies. In our center, where we perform around 400 liver biopsies per year, we performed a prospective clinical audit of our practice of blind outpatient percutaneous liver biopsies. Patients requiring histological grading and staging of chronic hepatitis routinely undergo blind outpatient percutaneous liver biopsies in our endoscopy unit unless there is a definite indication for real-time image guidance. All procedures were assessed for safety, and all specimens were evaluated by a specimen quality grading score for adequacy for grading and staging of chronic hepatitis. Of the 446 patients referred for histological grading and staging of chronic hepatitis C by liver biopsy, only 42 patients (9.5 %) required real-time ultrasound for liver biopsy. The remaining 404 patients underwent blind outpatient percutaneous liver biopsies which were found to be extremely safe with no major complications, yielding adequate liver tissue with high specimen quality score allowing optimal grading and staging of chronic hepatitis.

  4. Live births after polar body biopsy and frozen-thawed cleavage stage embryo transfer: case report

    PubMed Central

    Guimarães, Fernando; Roque, Matheus; Valle, Marcello; Kostolias, Alessandra; de Azevedo, Rodrigo A; Martinhago, Ciro D; Sampaio, Marcos; Geber, Selmo

    2016-01-01

    Pre-implantation genetic diagnosis (PGD) or screening (PGS) technology, has emerged and developed in the past few years, benefiting couples as it allows the selection and transfer of healthy embryos during IVF treatments. These techniques can be performed in oocytes (polar-body biopsy) or embryos (blastomere or trophectoderm biopsy). In this case report, we describe the first two live births to be published in Brazil after a polar-body (PB) biopsy. In case 1, a 42-year-old was submitted to PB biopsy with PGS due to advanced maternal age and poor ovarian reserve. Five MII oocytes underwent first and second polar body biopsy and four cleavage embryos were cryopreserved. The PGS analysis resulted in two euploid embryos (next generation sequence). A frozen-thawed embryo transfer (FET) was performed after endometrial priming and a healthy baby was delivered after a cesarean section (37 weeks, female, 3390g, 47.5 cm). In case 2, a 40-year old patient with balanced translocation and poor ovarian response was submitted to PB biopsy. Two MII oocytes underwent first and second polar body biopsy and two embryos were cryopreserved in cleavage stage. The analysis resulted in one euploid embryo that was transferred after endometrial priming. A preterm healthy baby (34 weeks, female, 2100g, 40 cm) was delivered via cesarean section. In conclusion, although the blastocyst biopsy is the norm when performing PGS/PGD during IVF treatments, other alternatives (as PB biopsy) should be considered in some specific situations. PMID:28050963

  5. Re-localisation of a biopsy site in endoscopic images and characterisation of its uncertainty.

    PubMed

    Allain, Baptiste; Hu, Mingxing; Lovat, Laurence B; Cook, Richard J; Vercauteren, Tom; Ourselin, Sebastien; Hawkes, David J

    2012-02-01

    Endoscopy guided probe-based optical biopsy is a new method for detecting sites for tissue biopsy and treatment. After detection, it can be useful to provide a visual aid in the endoscopic images to the endoscopist for example for guidance of forceps to the biopsy sites detected optically. A new method for re-localisation of these sites during the endoscopic examination is presented in this paper. It makes use of a sequence of endoscopic images, where the biopsy site location is known, in order to derive the same number of epipolar lines as images in the sequence projected onto a subsequent target image where the re-localised biopsy site needs to be computed. The location of the re-localised biopsy site is found by minimisation of the sum of squared distances to the epipolar lines. The method also determines analytically the uncertainty of the re-localised biopsy site. This provides the endoscopist with a confidence region around the re-localised biopsy site and a measure of the re-localisation precision. Simulations confirmed that the analytical uncertainty has the potential to be a good estimation of the experimental uncertainty. The method was tested on a physical phantom and on real data from four patients with eight sequences of images acquired during gastroscopy. The re-localisation precision and accuracy were estimated at 1 millimetre or better, which is sufficient for re-localisation of optical biopsy sites.

  6. The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy

    PubMed Central

    McLean, Carolyn; Gregor, James; Yan, Brian

    2016-01-01

    Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI) complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD), H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations. PMID:27478819

  7. Live births after polar body biopsy and frozen-thawed cleavage stage embryo transfer: case report.

    PubMed

    Guimarães, Fernando; Roque, Matheus; Valle, Marcello; Kostolias, Alessandra; Azevedo, Rodrigo A de; Martinhago, Ciro D; Sampaio, Marcos; Geber, Selmo

    2016-12-01

    Pre-implantation genetic diagnosis (PGD) or screening (PGS) technology, has emerged and developed in the past few years, benefiting couples as it allows the selection and transfer of healthy embryos during IVF treatments. These techniques can be performed in oocytes (polar-body biopsy) or embryos (blastomere or trophectoderm biopsy). In this case report, we describe the first two live births to be published in Brazil after a polar-body (PB) biopsy. In case 1, a 42-year-old was submitted to PB biopsy with PGS due to advanced maternal age and poor ovarian reserve. Five MII oocytes underwent first and second polar body biopsy and four cleavage embryos were cryopreserved. The PGS analysis resulted in two euploid embryos (next generation sequence). A frozen-thawed embryo transfer (FET) was performed after endometrial priming and a healthy baby was delivered after a cesarean section (37 weeks, female, 3390g, 47.5 cm). In case 2, a 40-year old patient with balanced translocation and poor ovarian response was submitted to PB biopsy. Two MII oocytes underwent first and second polar body biopsy and two embryos were cryopreserved in cleavage stage. The analysis resulted in one euploid embryo that was transferred after endometrial priming. A preterm healthy baby (34 weeks, female, 2100g, 40 cm) was delivered via cesarean section. In conclusion, although the blastocyst biopsy is the norm when performing PGS/PGD during IVF treatments, other alternatives (as PB biopsy) should be considered in some specific situations.

  8. Current Safety of Renal Allograft Biopsy With Indication in Adult Recipients: An Observational Study.

    PubMed

    Tsai, Shang-Feng; Chen, Cheng-Hsu; Shu, Kuo-Hsiung; Cheng, Chi-Hung; Yu, Tung-Min; Chuang, Ya-Wen; Huang, Shih-Ting; Tsai, Jun-Li; Wu, Ming-Ju

    2016-02-01

    Renal biopsy remains the golden standard diagnosis of renal function deterioration. The safety in native kidney biopsy is well defined. However, it is a different story in allograft kidney biopsy. We conduct this retrospective study to clarify the safety of allograft kidney biopsy with indication.All variables were grouped by the year of biopsy and they were compared by Mann-Whitney U test (for continuous variables) or Chi-square test (for categorical variables). We collected possible factors associated with complications, including age, gender, body weight, renal function, cause of uremia, status of coagulation, hepatitis, size of needle, and immunosuppressants.We recruited all renal transplant recipients undergoing allograft biopsy between January of 2009 and December of 2014. This is the largest database for allograft kidney biopsy with indication. Of all the 269 biopsies, there was no difference in occurrence among the total 14 complications (5.2%) over these 6 years. There were only 3 cases of hematomas (1.11%), 6 gross hematuria (2.23%), 1 hydronephrosis (0.37%), and 2 hemoglobin decline (0.74%). The outcome of this cohort is the best compared to all other studies, and it is even better than the allograft protocol kidney biopsy. Among all possible factors, patients with pathological report containing "medullary tissue only" were susceptible to complications (P < 0.001, 1.8 of relative risk).In modern era, this study demonstrates the safety of allograft kidney biopsy with indication. Identifying the renal capsule before biopsy to avoid puncture into medulla is the most important element to prevent complications.

  9. Upgrading the Gleason Score in Extended Prostate Biopsy: Implications for Treatment Choice

    SciTech Connect

    Moreira Leite, Katia Ramos Camara-Lopes, Luiz H.A.; Dall'Oglio, Marcos F.; Cury, Jose; Antunes, Alberto A.; Sanudo, Adriana; Srougi, Miguel

    2009-02-01

    Purpose: To determine the incidence of overestimation of Gleason score (GS) in extended prostate biopsy, and consequently circumventing unnecessary aggressive treatment. Methods and Materials: This is a retrospective study of 464 patients who underwent prostate biopsy and radical prostatectomy between January 2001 and November 2007. The GS from biopsy and radical prostatectomy were compared. The incidence of overestimation of GS in biopsies and tumor volume were studied. Multivariate analysis was applied to find parameters that predict upgrading the GS in prostate biopsy. Results: The exact agreement of GS between prostate biopsy and radical prostatectomy occurred in 56.9% of cases. In 29.1% cases it was underestimated, and it was overestimated in 14%. One hundred and six (22.8%) patients received a diagnosis of high GS (8, 9, or 10) in a prostate biopsy. In 29.2% of cases, the definitive Gleason Score was 7 or lower. In cases in which GS was overestimated in the biopsy, tumors were significantly smaller. In multivariate analysis, the total percentage of tumor was the only independent factor in overestimation of GS. Tumors occupying less than 33% of cores had a 5.6-fold greater chance of being overestimated. Conclusion: In the extended biopsy era and after the International Society of Urological Pathology consensus on GS, almost one third of tumors considered to have high GS at the biopsy may be intermediate-risk cancers. In that condition, tumors are smaller in biopsy. This should be remembered by professionals involved with prostate cancer to avoid overtreatment and undesirable side effects.

  10. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

    SciTech Connect

    Stattaus, Joerg Kuehl, Hilmar; Ladd, Susanne; Schroeder, Tobias; Antoch, Gerald; Baba, Hideo A.; Barkhausen, Joerg; Forsting, Michael

    2007-09-15

    Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results.

  11. Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis

    SciTech Connect

    O'Connell, J.B.; Henkin, R.E.; Robinson, J.A.; Subramanian, R.; Scanlon, P.J.; Gunnar, R.M.

    1984-07-01

    Current standards for detection of myocarditis in a clinical setting rely on endomyocardial biopsy for accurate diagnosis. With this technique a subset of patients with dilated cardiomyopathy show unsuspected myocarditis histologically. Endomyocardial biopsy, despite its specificity, may lack sensitivity due to sampling error if the inflammation is patchy or focal. Therefore, inflammation-sensitive radioisotopic imaging may be a useful adjunct in the diagnosis of myocarditis. This study was designed to evaluate the applicability of gallium-67 (67Ga) myocardial imaging as an adjunct to endomyocardial biopsy in the diagnosis of myocarditis. Sixty-eight consecutive patients referred for evaluation of dilated cardiomyopathy underwent 71 parallel studies with 67Ga imaging and biopsies that served as the basis of comparison for this study. Histologic myocarditis was identified in 8% of biopsy specimens. Clinical and hemodynamic parameters could not be used to predict the presence of myocarditis. Five of six biopsy samples (87%) with myocarditis showed dense 67Ga uptake, whereas only nine of 65 negative biopsy samples (14%) were paired with equivocally positive 67Ga scans. The single patient with myocarditis and no myocardial 67Ga uptake had dense mediastinal lymph node uptake that may have obscured cardiac uptake. The incidence of myocarditis on biopsy with a positive 67Ga scan was 36% (5/14); however, the incidence of myocarditis with a negative 67Ga scan was only 1.8% (1/57). Follow-up scans for three patients showed close correlation of 67Ga uptake with myocarditis on biopsy. In conclusion 67Ga may be a useful screening test for identifying patients with a high yield of myocarditis on biopsy, and serial scans may eliminate the need for frequent biopsies in patients with proven myocarditis.

  12. Biopsy Findings After Breast Conservation Therapy for Early-Stage Invasive Breast Cancer

    SciTech Connect

    Vapiwala, Neha Starzyk, Jill; Harris, Eleanor E.; Tchou, Julia C.; Boraas, Marcia C.; Czerniecki, Brian J.; Rosato, Ernest F.; Orel, Susan G.; Solin, Lawrence J.

    2007-10-01

    Purpose: To determine the patterns and factors predictive of positive ipsilateral breast biopsy after conservation therapy for early-stage breast cancer. Methods and Materials: We performed a retrospective review of Stage I-II breast cancer patients initially treated with lumpectomy and radiotherapy between 1977 and 1996, who later underwent post-treatment ipsilateral breast biopsies. Results: A total of 223 biopsies were performed in 193 treated breasts: 171 single and 22 multiple biopsies. Of the 223 biopsies, 56% were positive and 44% were negative for recurrence. The positive biopsy rate (PBR) was 59% for the first and 32% for subsequent biopsies. The median time to the first post-treatment biopsy was 49 months. Of the patients with negative initial biopsy findings, 11% later developed local recurrence. The PBR was 40% among patients with physical examination findings only, 65% with mammographic abnormalities only, and 79% with both findings (p = 0.001). Analysis of the procedure type revealed a PBR of 86% for core and 58% for excisional biopsies compared with 28% for aspiration cytology alone (p = 0.025). The PBR varied inversely with age at the original diagnosis: 49% if {>=}51 years, 57% if 36-50 years, and 83% if {<=}35 years (p = 0.05). The PBR correlated directly with the interval after radiotherapy: 49% if {<=}60 months, 59% if 60.1-120 months, 77% if 120.1-180 months, and 100% if >180 months after completing postlumpectomy radiotherapy (p = 0.01). The PBR was not linked with recurrence location, initial pathologic T or N stage, estrogen receptor/progesterone receptor status, or final pathologic margins (all p {>=} 0.15). Conclusion: After definitive radiotherapy for early-stage breast cancer, a greater PBR was associated with the presence of both mammographic and clinical abnormalities, excisional or core biopsies, younger age at the initial diagnosis, and longer intervals after radiotherapy completion.

  13. Screening Rectal Culture to Identify Fluoroquinolone-resistant Organisms Before Transrectal Prostate Biopsy: Do the Culture Results Between Office Visit and Biopsy Correlate?

    PubMed Central

    Liss, Michael A.; Nakamura, Kristen K.; Meuleners, Rachel; Kolla, Surendra B.; Dash, Atreya; Peterson, Ellena M.

    2014-01-01

    OBJECTIVE To investigate the performance of screening rectal cultures obtained 2 weeks before transrectal prostate biopsy to detect fluoroquinolone-resistant organisms and again at transrectal prostate biopsy. MATERIALS AND METHODS After institutional review board approval for observational study, we obtained a rectal culture on patients identified for a prostate biopsy but before antibiotic prophylaxis from September 12, 2011 to April 23, 2012. The specimen was cultured onto MacConkey agar with and without 1 µg/mL ciprofloxacin. We then obtained a second rectal culture immediately before prostate biopsy after 24 hours of ciprofloxacin prophylaxis. All cultures were blinded to the practitioner until the end of the study. RESULTS Of 108 patients enrolled, 58 patients had both rectal cultures for comparison. The median time duration between cultures was 14 (6–119) days. There were 54 of 58 concordant pairs (93%), which included 47 negative cultures and 7 positive cultures; 2 patients (3%) who were culture negative from the first screening culture became positive at biopsy. Sensitivity, specificity, negative, positive predictive values, and area under the operator curve were 95.9%, 77.8%, 95.9%, 77.8%, and 0.868, respectively. When Pseudomonas spp. are removed from the analysis, the area under the curve is increased to 0.927. CONCLUSION Screening rectal cultures 2 weeks before prostate biopsy has favorable test performance, suggesting screening cultures give an accurate estimate of fluoroquinolone-resistant colonization. PMID:23806391

  14. Appeals That Pack a Punch.

    ERIC Educational Resources Information Center

    Friesen, Patricia

    1993-01-01

    College alumni association mailings can be made more successful by targeting the audiences, delivering a strong proposition to readers, choosing a forceful format, and creating impressive copy. Efforts of the University of Minnesota, University of Iowa, and Southern Methodist University illustrate these principles. (MSE)

  15. Punch Up Algebra with POWs

    ERIC Educational Resources Information Center

    Pinkerton, Mark; Shafer, Kathryn G.

    2013-01-01

    Problem solving is a necessary component of developing a strong mathematics curriculum that will help all students achieve their life goals, regardless of their specific academic plans. What day-to-day instructional decisions do teachers need to make if they believe that problem solving is a vehicle for learning mathematical content? In this…

  16. Prevalence of Helicobacter pylori Infection in Samples of Gastric Biopsies

    PubMed Central

    Trindade, Leda Maria Delmondes Freitas; Menezes, Lania Barreto de Oliveira; de Souza Neta, Adozina Marques; Leite Rolemberg, Paulo Candido; Souza, Lais Dantas; Barreto, Ikaro Daniel de Carvalho; Meurer, Luise

    2017-01-01

    Background Helicobacter pylori (H. pylori) infection affects about 50% of the world population and its association with environmental factors and host properties is involved in gastric carcinogenesis. The study aimed to estimate the prevalence of H. pylori in samples of gastric mucosa biopsies, correlate the presence of the bacteria in the sample with the variables age, sex and origin, to identify the types of lesions found in patients with H. pylori, and to evaluate the association of the lesions with the region of the gastric mucosa. Methods A cross-sectional, retrospective study was carried out in Aracaju, Sergipe, Brazil, from January 2013 to December 2015. A total of 45,206 gastric mucosal biopsies were obtained from patients submitted to upper gastrointestinal endoscopy. Of the reports evaluated, 12,909 met the inclusion criteria since they presented the patient’s demographic data as well as the histopathological characteristics of gastric mucosal regions and positivity for H. pylori. Data were analyzed by IBM SPSS Statistic 20 and subjected to descriptive analyses (categorical variables) and inferential (Pearson’s Qui-square and linear association tests) and multiple correspondence analyses. Significance level adopted 5%. Results Of the total of 12,909 (28.6%) reports evaluated, 67% (8,647) came from urban areas and 64.5% (8,320) were female. The mean age (standard deviation (SD)) was 43 years, ranging from 8 to 100 years, prevailing between 21 and 60 years. Among the types of gastric mucosa analyzed, 95.5% (12,322) were of the antral mucosa. The absence of glandular atrophy, the mild infection intensity for H. pylori, the absence of metaplasia, the presence of foveolar hyperplasia and lymphoid follicles were statistically significant (P < 0.001) in this region. In the fundic region, the evidence of fibrinoleucocytic crust and lymphoid follicles was significant (P < 0.001). There was no evidence of associated ulcerated lesions or significant relationship

  17. Cytology Preparations of Formalin Fixative Aid Detection of Giardia in Duodenal Biopsy Samples.

    PubMed

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

    2017-04-01

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

  18. Biopsy variability of lymphocytic infiltration in breast cancer subtypes and the ImmunoSkew score

    NASA Astrophysics Data System (ADS)

    Khan, Adnan Mujahid; Yuan, Yinyin

    2016-11-01

    The number of tumour biopsies required for a good representation of tumours has been controversial. An important factor to consider is intra-tumour heterogeneity, which can vary among cancer types and subtypes. Immune cells in particular often display complex infiltrative patterns, however, there is a lack of quantitative understanding of the spatial heterogeneity of immune cells and how this fundamental biological nature of human tumours influences biopsy variability and treatment resistance. We systematically investigate biopsy variability for the lymphocytic infiltrate in 998 breast tumours using a novel virtual biopsy method. Across all breast cancers, we observe a nonlinear increase in concordance between the biopsy and whole-tumour score of lymphocytic infiltrate with increasing number of biopsies, yet little improvement is gained with more than four biopsies. Interestingly, biopsy variability of lymphocytic infiltrate differs considerably among breast cancer subtypes, with the human epidermal growth factor receptor 2-positive (HER2+) subtype having the highest variability. We subsequently identify a quantitative measure of spatial variability that predicts disease-specific survival in HER2+ subtype independent of standard clinical variables (node status, tumour size and grade). Our study demonstrates how systematic methods provide new insights that can influence future study design based on a quantitative knowledge of tumour heterogeneity.

  19. Elevated Prostate Health Index (phi) and Biopsy Reclassification During Active Surveillance of Prostate Cancer.

    PubMed

    Andreas, Darian; Tosoian, Jeffrey J; Landis, Patricia; Wolf, Sacha; Glavaris, Stephanie; Lotan, Tamara L; Schaeffer, Edward M; Sokoll, Lori J; Ross, Ashley E

    2016-07-01

    The Prostate Health Index (phi) has been FDA approved for decision-making regarding prostate biopsy. Phi has additionally been shown to positively correlate with tumor volume, extraprostatic disease and higher Gleason grade tumors. Here we describe a case in which an elevated phi encouraged biopsy of a gentleman undergoing active surveillance leading to reclassification of his disease as high risk prostate cancer.

  20. TUMOR CONTAMINATION IN THE BIOPSY PATH OF PRIMARY MALIGNANT BONE TUMORS

    PubMed Central

    Oliveira, Marcelo Parente; Lima, Pablo Moura de Andrade; de Mello, Roberto José Vieira

    2015-01-01

    Objective: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. Method: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path. Results: Among the 35 patients studied, four cases of contamination occurred (11.43%): one from osteosarcoma, two from Ewing's tumor and one from chondrosarcoma. There was no association between the type of tumor and presence of tumor contamination in the biopsy path (p = 0.65). There was also no association between the presence of tumor contamination and the biopsy technique (p = 0.06). On the other hand, there were associations between the presence of tumor contamination and local recurrence (p = 0.01) and between tumor contamination and absence of neoadjuvant chemotherapy (p = 0.02). Conclusion: Tumor contamination in the biopsy path of primary malignant bone tumors was associated with local recurrence. On the other hand, the histological type of the tumor and the type of biopsy did not have an influence on tumor contamination. Neoadjuvant chemotherapy had a protective effect against this complication. Despite these findings, tumor contamination is a complication that should always be taken into consideration, and removal of the biopsy path is recommended in tumor resection surgery. PMID:27047877