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Sample records for distribution des biopsies

  1. Biopsy

    MedlinePlus

    ... portion of the lump is removed surgically. This type of biopsy is most commonly used for tumors of the skin to distinguish benign conditions and diagnose cancers and other tumors. This can be done by 'shave', 'curette' or 'punch' methods. A " shave " slices a surface portion off with ...

  2. Biopsy

    MedlinePlus

    ... report). The biopsy test is not an exact science. In cases of difficult or unusual problems, second opinions can be helpful. Back to Index The medical information provided in this site is for educational purposes only and is the property of the American ...

  3. Sentinel-Lymphknoten-Biopsie des Melanoms mittels Indocyaningrün und "FOVIS"-System.

    PubMed

    Göppner, Daniela; Nekwasil, Stephan; Jellestad, Anne; Sachse, Alexander; Schönborn, Karl-Heinz; Gollnick, Harald

    2017-02-01

    Der Nachweis metastatischer Infiltrate im Sentinel-Lymphkoten (SLN) gilt als wesentlicher prognostischer Faktor des Melanoms. Alternativ zur Farbstoffmethode mit Patentblau zum Goldstandard der SLN-Biopsie (SLNB) mittels Radiokolloid wird die fluoreszenzoptische Darstellung mit Hilfe von Indocyaningrün (ICG) und Nahinfrarot (NIR)-Kamerasystem kommuniziert. Im Vergleich zur konventionellen Methode wurde die Wertigkeit des ICG-/NIR-Verfahrens in Abhängigkeit vom Body-Mass-Index (BMI) des Patienten und der Konzentration von ICG bezüglich der Visualisierung des Lymphabstroms und des SLNs untersucht. An zehn Patienten wurde die SLNB mittels Technetium-99m, Patentblau und ICG durchgeführt. Die Fluoreszenz-Darstellung von Lymphbahnen und SLN erfolgte in Echtzeit mittels der NIR-Kameratechnik "FOVIS". Je nach erzielter Bildqualität wurde ICG in einer Dosis von 0,25 mg bis 2,5 mg intrakutan appliziert. Neun der zehn SLN wurden fluoreszenzoptisch identifiziert (90 %), alle zehn radioaktiv (100 %), nur acht (80 %) mittels ICG-Grünfärbung bzw. Patenblau-Markierung. Transdermal wurde ein SLN dargestellt (10 %). In Korrelation zum BMI waren höhere ICG-Mengen, bis zu 2,5 mg intrakutan absolut, in der Darstellung der Lymphbahnen von Vorteil. Die SLN-Fluoreszenzmarkierung mit dem ICG/NIR-Kamera-System "FOVIS" stellt eine sichere Alternative zur Farbstoffmethode mit Patentblau ergänzend zur Radiokolloidmethode mit Technetium-99m dar. Weitere Studien zur optimalen Dosierung von ICG und transdermalen Bildgebung in Relation zum BMI sind notwendig. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. [Image fusion: use in the control of the distribution of prostatic biopsies].

    PubMed

    Mozer, Pierre; Baumann, Michaël; Chevreau, Grégoire; Troccaz, Jocelyne

    2008-02-01

    Prostate biopsies are performed under 2D TransRectal UltraSound (US) guidance by sampling the prostate according to a predefined pattern. Modern image processing tools allow better control of biopsy distribution. We evaluated the accuracy of a single operator performing a pattern of 12 ultrasound-guided biopsies by registering 3D ultrasound control images acquired after each biopsy. For each patient, prostate image alignment was performed automatically with a voxel-based registration algorithm allowing visualization of each biopsy trajectory in a single ultrasound reference volume. On average, the operator reached the target in 60% of all cases. This study shows that it is difficult to accurately reach targets in the prostate using 2D ultrasound. In the near future, real-time fusion of MRI and US images will allow selection of a target in previously acquired MR images and biopsy of this target by US guidance.

  5. Apport de la biopsie radioguidée dans le diagnostic histopathologique des tumeurs de l'enfant: expérience de l'Hôpital d'Enfant de Rabat

    PubMed Central

    El Ochi, Mohamed Réda; Bellarbi, Salma; Rouas, Lamiae; Lamalmi, Najat; Malihy, Abderrahmane; Alhamany, Zaitouna; Cherradi, Nadia

    2015-01-01

    La biopsie radioguidée constitue une alternative à la biopsie chirurgicale invasive et à la cytologie pour le diagnostic des tumeurs pédiatriques. L'intérêt de notre étude est d’évaluer la valeur diagnostique des biopsies radioguidées examinées au laboratoire d'anatomopathologie de l'hôpital d'Enfants de Rabat (HER). L’étude a porté sur 78 biopsies radioguidées recueillies dans notre laboratoire entre janvier 2008 et décembre 2011. l’âge moyen des patients était de 5 ans et 10 mois avec une prédominance masculine (65,4%). La tumeur était abdominale dans 80% des cas, thoracique dans 15% cas, thoracique et abdominale dans 2,5% et sacrée dans 1,2%. Les biopsies étaient écho-guidées dans 90% des cas et scannoguidées dans 10% des cas. Le diagnostic histopathologique était posé dans 89% des cas. L'immuno-histochimie a été indiquée dans 35% des cas. Les diagnostics les plus fréquents étaient: tumeurs neuroblastiques (42 cas), lymphomes non hodgkiniens (10 cas), rhabdomyosarcomes (6 cas), autres (sarcome d'Ewing, néphroblastomes, tumeur myofibroblastique inflammatoire, maladies de Hodgkin, leucémie aiguë, hépatoblastome et ostéosarcome). Dans notre série, la biopsie radioguidée a permis un diagnostic histopathologique certain dans 89% des cas. Elle nécessite une étroite collaboration entre clinicien, radiologue et anatomopathologiste pour discuter son indication, afin de diminuer le nombre de biopsies peu ou non représentatives. PMID:26587165

  6. Bone Biopsy

    MedlinePlus

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

  7. Rectal biopsy

    MedlinePlus

    ... biopsy; Amyloidosis - rectal biopsy; Crohn disease - rectal biopsy; Colorectal cancer - biopsy; Hirschsprung disease - rectal biopsy ... abnormal conditions of the rectum, such as: Abscesses Colorectal ... Inflammation Tumors Amyloidosis Crohn disease Hirschsprung ...

  8. Cone biopsy

    MedlinePlus

    ... grade cone biopsy; High-grade cone biopsy; Carcinoma in situ-cone biopsy; CIS - cone biopsy; ASCUS - cone biopsy; ... marked dysplasia CIN III -- severe dysplasia to carcinoma in situ Abnormal results may also be due to cervical ...

  9. Needle Biopsy

    MedlinePlus

    ... needle biopsy procedures include fine-needle aspiration and core needle biopsy. Needle biopsy may be used to ... hollow needle to draw cells from your body. Core needle biopsy. This type of needle biopsy uses ...

  10. Kidney Biopsy

    MedlinePlus

    ... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Kidney Biopsy What is a kidney biopsy? A kidney biopsy is a procedure that ... performs procedures using imaging equipment Why is a kidney biopsy performed? A health care provider will perform ...

  11. Endometrial biopsy

    MedlinePlus

    ... Names Biopsy - endometrium Images Pelvic laparoscopy Female reproductive anatomy Endometrial biopsy Uterus Endometrial biopsy References Beard JM, Osborn J. Common office procedures. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier ...

  12. Distribution of Biopsy-Proven Presumed Primary Glomerulonephropathies in 2000-2011 Among a Racially and Ethnically Diverse US Population.

    PubMed

    Sim, John J; Batech, Michael; Hever, Aviv; Harrison, Teresa N; Avelar, Taurino; Kanter, Michael H; Jacobsen, Steven J

    2016-10-01

    The incidence and distribution of primary glomerulonephropathies vary throughout the world and by race and ethnicity. We sought to evaluate the distribution of primary glomerulonephropathies among a large racially and ethnically diverse population of the United States. Case series from January 1, 2000, through December 31, 2011. Adults (aged ≥ 18 years) of an integrated health system who underwent native kidney biopsy and had kidney biopsy findings demonstrating focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MGN), minimal change disease (MCD), immunoglobulin A nephropathy (IgAN), and other. Rates and characteristics of the most common primary glomerulonephropathies overall and by race and ethnicity. 2,501 patients with primary glomerulonephropathy were identified, with a mean age 50.6 years, 45.7% women, 36.1% Hispanics, 31.2% non-Hispanic whites, 17.4% blacks, and 12.4% Asians. FSGS was the most common glomerulonephropathy (38.9%) across all race and ethnic groups, followed by MGN (12.7%), MCD (11.0%), IgAN (10.2%), and other (27.3%). The FSGS category had the greatest proportion of blacks, and patients with FSGS had the highest rate of poverty. IgAN was the second most common glomerulonephropathy among Asians (28.6%), whereas it was 1.2% among blacks. Patients with MGN presented with the highest proteinuria (protein excretion, 8.3g) whereas patients with FSGS had the highest creatinine levels (2.6mg/dL). Overall glomerulonephropathy rates increased annually in our 12-year observation period, driven by FSGS (2.7 cases/100,000) and IgAN (0.7 cases/100,000). MGN and MCD rates remained flat. Missing data for urine albumin and sediment, indication bias in performing kidney biopsies, and inexact classification of primary versus secondary disease. Among a racially and ethnically diverse cohort from a single geographical area and similar environment, FSGS was the most common glomerulonephropathy, but there was variability of other

  13. Bladder biopsy

    MedlinePlus

    ... than usual ( oliguria ). You cannot urinate despite a strong urge to do so. Alternative Names Biopsy - bladder Images Bladder catheterization, female Bladder catheterization, male Female urinary tract Male urinary tract Bladder biopsy ...

  14. Skin Biopsy

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español Skin Biopsy KidsHealth / For Teens / Skin Biopsy What's in ... en español Biopsia de piel What Is a Skin Biopsy and Who Would Need One? In a ...

  15. Testicular biopsy

    MedlinePlus

    ... Names Biopsy - testicle Images Endocrine glands Male reproductive anatomy Testicular biopsy References Garibaldi LR, Chematilly W. Disorders of pubertal development. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016: ...

  16. Breast Biopsy

    MedlinePlus

    ... time If your biopsy will be done using magnetic resonance imaging (MRI), tell your doctor if you ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

  17. Skin lesion biopsy

    MedlinePlus

    ... biopsy - skin; Skin cancer - biopsy; Melanoma - biopsy; Squamous cell cancer - biopsy; Basal cell cancer - biopsy; Mohs microsurgery ... dermatitis Infection from bacteria or fungus Melanoma Basal cell skin cancer Squamous cell skin cancer

  18. Synovial biopsy

    MedlinePlus

    ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Autoimmune Diseases Read more Biopsy Read more Fungal ...

  19. Liver Biopsy

    MedlinePlus

    ... called if any of the following occur: ● Persistent abdominal or chest pain ● Vomiting ● Pallor, weakness or dizziness ● Bleeding from the site of the biopsy ● Passage of tarry black stools For more information or to locate a pediatric gastroen- terologist in your area please visit our ...

  20. Molecular imaging of melanin distribution in vivo and quantitative differential diagnosis of human pigmented lesions using label-free harmonic generation biopsy (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Sun, Chi-Kuang; Wei, Ming-Liang; Su, Yu-Hsiang; Weng, Wei-Hung; Liao, Yi-Hua

    2017-02-01

    Harmonic generation microscopy is a noninvasive repetitive imaging technique that provides real-time 3D microscopic images of human skin with a sub-femtoliter resolution and high penetration down to the reticular dermis. In this talk, we show that with a strong resonance effect, the third-harmonic-generation (THG) modality provides enhanced contrast on melanin and allows not only differential diagnosis of various pigmented skin lesions but also quantitative imaging for longterm tracking. This unique capability makes THG microscopy the only label-free technique capable of identifying the active melanocytes in human skin and to image their different dendriticity patterns. In this talk, we will review our recent efforts to in vivo image melanin distribution and quantitatively diagnose pigmented skin lesions using label-free harmonic generation biopsy. This talk will first cover the spectroscopic study on the melanin enhanced THG effect in human cells and the calibration strategy inside human skin for quantitative imaging. We will then review our recent clinical trials including: differential diagnosis capability study on pigmented skin tumors; as well as quantitative virtual biopsy study on pre- and post- treatment evaluation on melasma and solar lentigo. Our study indicates the unmatched capability of harmonic generation microscopy to perform virtual biopsy for noninvasive histopathological diagnosis of various pigmented skin tumors, as well as its unsurpassed capability to noninvasively reveal the pathological origin of different hyperpigmentary diseases on human face as well as to monitor the efficacy of laser depigmentation treatments. This work is sponsored by National Health Research Institutes.

  1. Ureteral retrograde brush biopsy

    MedlinePlus

    Biopsy - brush - urinary tract; Retrograde ureteral brush biopsy cytology; Cytology - ureteral retrograde brush biopsy ... should not be performed in people with a: Urinary tract infection Blockage at or below the biopsy site ...

  2. Seroprevalence, distribution and risk factor for peste des petits ruminants (PPR) in Algeria.

    PubMed

    Kardjadj, Moustafa; Kouidri, Brahim; Metref, Djamil; Luka, Pam Dachung; Ben-Mahdi, Meriem Hind

    2015-11-01

    Peste des petit ruminants (PPR) is a highly contagious and infectious viral disease of small ruminants with severe socio-economic implications. The disease was first reported in the Southern part of Algeria in 2011 and by February 2012 it has reached the central part of the country. Estimating national prevalence, distribution and identification of risk factors remains a key component in understanding the epidemiology and control of the disease. The present study was carried out between January and June 2014, to include a detailed description of flock and within-flock seroprevalence and risk association between PPR seropositivity and various flock management factors in Algeria. A total of 150 flocks randomly sampled across the country were investigated and 4552 serum samples were collected from 3336 sheep and 1216 goats, respectively. C-ELISA was used to detect the presence of antibodies in small ruminant animals as an indicator of PPRV exposure. The results showed an overall true flock seroprevalence of 30.45% [95% CI 23.76-37.14] with a mean of the true within-flock prevalence as 29.87%±2.11. The mean of the true within-flock prevalence in mixed flocks (12.93%±1.85) was however found to be significantly higher than sheep flocks (5.74%±1.06). Also the mean of the true within-flock prevalence was found to be significantly higher in adult (35.36%±3.13) compared to young animals (21.83%±2.47) and in females (33.11%±2.87) compared to males (22.14%±2.31). The univariate analysis revealed that PPR overall flock seroprevalence was significantly higher (P<0.20) in large flock (50.61%) than in small flock (33.33%), in mixed flock (56.7%) than in sheep flock (35.35%) and in the flocks that had contact with other flocks (46.5%) compared to those who had not (30.6%). However the differences among studied regions and grazing system were not statistically significant. For the risk factor analysis, univariate analysis of variables followed by a multiple logistic

  3. 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 ...

  4. Open lung biopsy

    MedlinePlus

    Biopsy - open lung ... An open lung biopsy is done in the hospital using general anesthesia . This means you will be asleep and ... The open lung biopsy is done to evaluate lung problems seen on x-ray or CT scan .

  5. Oropharynx lesion biopsy

    MedlinePlus

    ... Mouth lesion biopsy; Oral cancer - biopsy Images Throat anatomy Oropharyngeal biopsy References Lee FE-H, Treanor JJ. Viral infections. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier ...

  6. Abdominal wall fat pad biopsy

    MedlinePlus

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

  7. Dark Energy Survey Year 1 Results: Calibration of redMaGiC Redshift Distributions in DES and SDSS from Cross-Correlations

    SciTech Connect

    Cawthon, R.; et al.

    We present calibrations of the redshift distributions of redMaGiC galaxies in the Dark Energy Survey Year 1 (DES Y1) and Sloan Digital Sky Survey (SDSS) DR8 data. These results determine the priors of the redshift distribution of redMaGiC galaxies, which were used for galaxy clustering measurements and as lenses for galaxy-galaxy lensing measurements in DES Y1 cosmological analyses. We empirically determine the bias in redMaGiC photometric redshift estimates using angular cross-correlations with Baryon Oscillation Spectroscopic Survey (BOSS) galaxies. For DES, we calibrate a single parameter redshift bias in three photometric redshift bins:more » $$z \\in[0.15,0.3]$$, [0.3,0.45], and [0.45,0.6]. Our best fit results in each bin give photometric redshift biases of $$|\\Delta z|<0.01$$. To further test the redMaGiC algorithm, we apply our calibration procedure to SDSS redMaGiC galaxies, where the statistical precision of the cross-correlation measurement is much higher due to a greater overlap with BOSS galaxies. For SDSS, we also find best fit results of $$|\\Delta z|<0.01$$. We compare our results to other analyses of redMaGiC photometric redshifts.« less

  8. Gram stain of tissue biopsy

    MedlinePlus

    ... biopsy To use the sharing features on this page, please enable JavaScript. Gram stain of tissue biopsy test involves using crystal violet stain to test a sample of tissue taken from a biopsy . The Gram stain method can ...

  9. Stereotactic (Mammographically Guided) Breast Biopsy

    MedlinePlus

    ... the type of biopsy being performed or the design of the biopsy machine, a biopsy of tissue ... cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. ...

  10. Ultrasound-Guided Breast Biopsy

    MedlinePlus

    ... the type of biopsy being performed or the design of the biopsy machine, a biopsy of tissue ... cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. ...

  11. Pathological examination of radical prostatectomy specimens in men with very low risk disease at biopsy reveals distinct zonal distribution of cancer in black American men.

    PubMed

    Sundi, Debasish; Kryvenko, Oleksandr N; Carter, H Ballentine; Ross, Ashley E; Epstein, Jonathan I; Schaeffer, Edward M

    2014-01-01

    Of men with very low risk prostate cancer at biopsy recent evidence shows that black American men are at greater risk for adverse oncologic outcomes after radical prostatectomy. We studied radical prostatectomy specimens from black and white men at very low risk to determine whether there are systematic pathological differences. Radical prostatectomy specimens were evaluated in men with National Comprehensive Cancer Network® (NCCN) very low risk prostate cancer. At diagnosis all men underwent extended biopsy sampling (10 or more cores) and were treated in the modern Gleason grade era. We analyzed tumor volume, grade and location in 87 black and 89 white men. For each specimen the dominant nodule was defined as the largest tumor with the highest grade. Compared to white men, black men were more likely to have significant prostate cancer (61% vs 29%), Gleason 7 or greater (37% vs 11%, each p <0.001) and a volume of greater than 0.5 cm(3) (45% vs 21%, p = 0.001). Dominant nodules in black men were larger (median 0.28 vs 0.13 cm(3), p = 0.002) and more often anterior (51% vs 29%, p = 0.003). In men who underwent pathological upgrading the dominant nodule was also more frequently anterior in black than in white men (59% vs 0%, p = 0.001). Black men with very low risk prostate cancer at diagnosis have a significantly higher prevalence of anterior cancer foci that are of higher grade and larger volume. Enhanced imaging or anterior zone sampling may detect these significant anterior tumors, improving the outcome in black men considering active surveillance. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Effet de l'anisotropie élastique cristalline sur la distribution des facteurs de Schmid à la surface des polycristaux

    NASA Astrophysics Data System (ADS)

    Sauzay, Maxime

    2006-06-01

    Experimental studies of the plasticity mechanisms of polycrystals are usually based on the Schmid factor distribution supposing crystalline elasticity isotropy. A numerical evaluation of the effect of crystalline elasticity anisotropy on the apparent Schmid factor distribution at the free surface of polycrystals is presented. Cubic elasticity is considered. Order II stresses (averaged on all grains with the same crystallographic orientation) as well as variations between averages computed on grains with the same crystallographic orientation but with different neighbour grains are computed. The Finite Element Method is used. Commonly studied metals presenting an increasing anisotropy degree are considered (aluminium, nickel, austenite, copper). Concerning order II stresses in strongly anisotropic metals, the apparent Schmid factor distribution is drifted towards small Schmid factor values (the maximum Schmid factor is equal to 0.43 instead of 0.5) and the slip activation order between characteristic orientations of the crystallographic standard triangle is modified. The computed square deviations of the stresses averaged on grains with the same crystallographic orientation but with different neighbour grains are a bit higher than the second order ones (inter-orientation scatter). Our numerical evaluations agree quantitatively with several observations and measures of the literature concerning stress and strain distribution in copper and austenite polycrystals submitted to low amplitude loadings. Hopefully, the given apparent Schmid factor distributions could help to better understand the observations of the plasticity mechanisms taking place at the free surface of polycrystals. To cite this article: M. Sauzay, C. R. Mecanique 334 (2006).

  13. Mediastinoscopy with biopsy

    MedlinePlus

    ... procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders . Normal Results Biopsies of lymph ... Hodgkin disease Lung cancer Lymphoma or other tumors Sarcoidosis The spread of disease from one body part ...

  14. Biopsy - biliary tract

    MedlinePlus

    ... be due to: Cancer of the bile ducts ( cholangiocarcinoma ) Cysts in the liver Liver cancer Pancreatic cancer ... and the A.D.A.M. Editorial team. Bile Duct Cancer Read more Bile Duct Diseases Read more Biopsy ...

  15. Breast biopsy -- stereotactic

    MedlinePlus

    ... sent to a pathologist to be examined. Normal Results A normal result means there is no sign ... follow-up mammogram or other tests. What Abnormal Results Mean If the biopsy shows benign breast tissue ...

  16. Liver biopsy under hypnosis.

    PubMed

    Adams, P C; Stenn, P G

    1992-09-01

    Two patients underwent outpatient percutaneous liver biopsy under hypnosis without complications. One patient had severe anxiety about the procedure because of a previous adverse experience with liver biopsy and the other had a history of severe allergy to local anesthesia. Both patients had undergone a session of hypnosis at least once prior to the biopsy. One received no local anesthetic and the other received 1% lidocaine as a local anesthetic. Both patients were completely cooperative during the procedure with the required respiratory maneuvers. Both patients stated that they were aware of the procedure under hypnosis but described no pain and would be most willing to have the procedure done under hypnosis in the future. Hypnosis can be a useful method of preparing carefully selected patients for percutaneous liver biopsy.

  17. Pleural needle biopsy

    MedlinePlus

    ... of the pleura Images Pleural biopsy References Klein JS, Bhave AD. Thoracic radiology: invasive diagnostic imaging and image-guided interventions. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and ...

  18. 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 ...

  19. Salivary gland biopsy

    MedlinePlus

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

  20. Dark Energy Survey Year 1 Results: Cross-Correlation Redshifts in the DES -- Calibration of the Weak Lensing Source Redshift Distributions

    SciTech Connect

    Davis, C.; et al.

    We present the calibration of the Dark Energy Survey Year 1 (DES Y1) weak lensing source galaxy redshift distributions from clustering measurements. By cross-correlating the positions of source galaxies with luminous red galaxies selected by the redMaGiC algorithm we measure the redshift distributions of the source galaxies as placed into different tomographic bins. These measurements constrain any such shifts to an accuracy ofmore » $$\\sim0.02$$ and can be computed even when the clustering measurements do not span the full redshift range. The highest-redshift source bin is not constrained by the clustering measurements because of the minimal redshift overlap with the redMaGiC galaxies. We compare our constraints with those obtained from $$\\texttt{COSMOS}$$ 30-band photometry and find that our two very different methods produce consistent constraints.« less

  1. The Kidney Donor Profile Index (KDPI) of Marginal Donors Allocated by Standardized Pre-Transplant Donor Biopsy Assessment: Distribution and Association with Graft Outcomes

    PubMed Central

    Gandolfini, I.; Buzio, C.; Zanelli, P.; Palmisano, A.; Cremaschi, E.; Vaglio, A.; Piotti, G.; Melfa, L.; La Manna, G.; Feliciangeli, G.; Cappuccilli, M.; Scolari, M.P.; Capelli, I.; Panicali, L.; Baraldi, O.; Stefoni, S.; Buscaroli, A.; Ridolfi, L.; D'Errico, A.; Cappelli, G.; Bonucchi, D.; Rubbiani, E.; Albertazzi, A.; Mehrotra, A.; Cravedi, P.; Maggiore, U.

    2015-01-01

    Pre-transplant donor biopsy (PTDB)-based marginal-donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the US. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score <4 [median KDPI:87; interquartile range(IQR):78-94] and 62 with a score =4 [median KDPI:87; IQR:76-93]; 102 dual transplants [median KDPI: 93; IQR:86-96]) and 248 single standard transplant controls [median KDPI:36; IQR:18-51]. PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year eGFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9, and -18.8ml/min, for dual transplants, single kidneys with PTDB score <4, and =4, respectively; P<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80 to 1.79; P=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded. PMID:25155294

  2. The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes.

    PubMed

    Gandolfini, I; Buzio, C; Zanelli, P; Palmisano, A; Cremaschi, E; Vaglio, A; Piotti, G; Melfa, L; La Manna, G; Feliciangeli, G; Cappuccilli, M; Scolari, M P; Capelli, I; Panicali, L; Baraldi, O; Stefoni, S; Buscaroli, A; Ridolfi, L; D'Errico, A; Cappelli, G; Bonucchi, D; Rubbiani, E; Albertazzi, A; Mehrotra, A; Cravedi, P; Maggiore, U

    2014-11-01

    Pretransplant donor biopsy (PTDB)-based marginal donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the United States. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score<4 [median KDPI: 87; interquartile range (IQR): 78-94] and 62 with a score=4 [median KDPI: 87; IQR: 76-93]; 102 dual transplants [median KDPI: 93; IQR: 86-96]) and 248 single standard transplant controls (median KDPI: 36; IQR: 18-51). PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year estimated GFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9 and -18.8 mL/min, for dual transplants, single kidneys with PTDB score<4 and =4, respectively; p<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80-1.79; p=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. 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.

  4. The Skin Punch Biopsy

    PubMed Central

    Blakeman, J. M.

    1983-01-01

    The skin punch biopsy is a simple and safe office procedure which is a valuable aid in diagnosing many skin diseases. It can be performed in a few minutes and offers in most situations a very suitable histological specimen with a minimum amount of scarring and little or no pain or discomfort to the patient. The indications for skin biopsy, selection of a proper site and the technique are described. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7 PMID:21283375

  5. Des ballons pour demain

    NASA Astrophysics Data System (ADS)

    Régipa, R.

    A partir d'une théorie sur la détermination des formes et des contraintes globales d'un ballon de révolution, ou s'en rapprochant, une nouvelle famille de ballons a été définie. Les ballons actuels, dits de ``forme naturelle'', sont calculés en général pour une tension circonférencielle nulle. Ainsi, pour une mission donnée, la tension longitudinale et la forme de l'enveloppe sont strictement imposées. Les ballons de la nouvelle génération sont globalement cylindriques et leurs pôles sont réunis par un câble axial, chargé de transmettre une partie des efforts depuis le crochet (pôle inférieur), directement au pôle supérieur. De plus, la zone latérale cylindrique est soumise à un faible champ de tensions circonférencielles. Ainsi, deux paramètres permettent de faire évoluer la distribution des tensions et la forme de l'enveloppe: - la tension du câble de liaison entre pôles (ou la longueur de ce câble) - la tension circonférencielle moyenne désirée (ou le rayon du ballon). On peut donc calculer et réaliser: - soit des ballons de forme adaptée, comme les ballons à fond plat pour le bon fonctionnement des montgolfières infrarouge (projet MIR); - soit des ballons optimisés pour une bonne répartition des contraintes et une meilleure utilisation des matériaux d'enveloppe, pour l'ensemble des programmes stratosphériques. Il s'ensuit une économie sensible des coûts de fabrication, une fiabilité accrue du fonctionnement de ces ballons et une rendement opérationnel bien supérieur, permettant entre autres, d'envisager des vols à très haute altitude en matériaux très légers.

  6. Carpal tunnel biopsy

    MedlinePlus

    ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Amyloidosis Read more Biopsy Read more Carpal Tunnel ...

  7. Bone marrow biopsy

    MedlinePlus

    ... aspiration removes a small amount of marrow in liquid form for examination. ... and a syringe is used to withdraw the liquid bone marrow. If this is done, the needle will be removed and repositioned. Or, another needle may be used for the biopsy.

  8. Upper airway biopsy

    MedlinePlus

    ... Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Biopsy Read more Cancer Read more ...

  9. 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.

  10. Distribution and transport of polychlorinated biphenyls in Little Lake Butte des Morts, Fox River, Wisconsin, April 1987-October 1988

    USGS Publications Warehouse

    House, L.B.

    1995-01-01

    The mass of PCB's transported from the lake in streamflow during 1987-88 was calculated to be 110 kilograms annually. The PCB's transport rate decreased 50 percent from 1987 to 1988, for the period April through September. Transport of PCB's was greatest during April and May of each year. The average flux rate of PCB's into the water column from the bottom sediment in the lake was estimated to be 1.2 milligrams per square meter per day. The PCB's load seems to increase at river discharges greater than 212 cubic meters per second. This increase in PCB's load might be caused by resuspension of PCB's-contaminated bottom-sediment deposits. There was little variation in PCB's load at flows less than 170 cubic meters per second. The bottom sediments are a continuing source of PCB's to Little Lake Butte des Morts and the lower Fox River.

  11. Celiac Disease Diagnosis: Endoscopic Biopsy

    MedlinePlus

    ... tissue samples are also vital to an accurate diagnosis—celiac disease can cause patchy lesions in the duodenum which ... to perform an intestinal biopsy to establish the diagnosis of celiac disease in a patient with DH; the skin biopsy ...

  12. Biopsy - Multiple Languages

    MedlinePlus

    ... Cantonese dialect) (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Nepali (नेपाली) Russian (Русский) ... हिन्दी (Hindi) Bilingual PDF Health Information Translations Japanese (日本語) Expand Section Biopsy - 日本語 (Japanese) Bilingual PDF ...

  13. Electron microprobe analysis and histochemical examination of the calcium distribution in human bone trabeculae: a methodological study using biopsy specimens from post-traumatic osteopenia

    SciTech Connect

    Obrant, K.J.; Odselius, R.

    1984-01-01

    Energy dispersive X-ray microanalysis (EDX) (or electron microprobe analysis) of the relative intensity for calcium in different bone trabeculae from the tibia epiphysis, and in different parts of one and the same trabecula, was performed on 3 patients who had earlier had a fracture of the ipsilateral tibia-diaphysis. The variation in intensity was compared with the histochemical patterns obtained with both the Goldner and the von Kossa staining techniques for detecting calcium in tissues. Previously reported calcium distribution features, found to be typical for posttraumatic osteopenia, such as striated mineralization patterns in individual trabeculae and large differences in mineralization levelmore » between different trabeculae, could be verified both by means of the two histochemical procedures and from the electron microprobe analysis. A pronounced difference was observed, however, between the two histochemical staining techniques as regards their sensitivity to detect calcium. To judge from the values obtained from the EDX measurements, the sensitivity of the Goldner technique should be more than ten times higher than that of von Kossa. The EDX measurements gave more detailed information than either of the two histochemical techniques: great variations in the intensity of the calcium peak were found in trabeculae stained as unmineralized as well as mineralized.« less

  14. The effect of different physical activity levels on muscle fiber size and type distribution of lumbar multifidus. A biopsy study on low back pain patient groups and healthy control subjects.

    PubMed

    Mazis, N; Papachristou, D J; Zouboulis, P; Tyllianakis, M; Scopa, C D; Megas, P

    2009-12-01

    Previous studies examining the multifidus fiber characteristics among low back pain (LBP) patients have not considered the variable of physical activity. The present study sought to investigate the muscle fiber size and type distribution of the lumbar multifidus muscle among LBP patient groups with different physical activity levels and healthy controls. Sixty-four patients were assigned to one of three groups named according to the physical activity level, determined for each patient by the International Physical Activity Questionnaire. These were low (LPA), medium (MPA) and high (HPA) physical activity groups. A control group comprising of 17 healthy individuals was also recruited. Muscle biopsy samples were obtained from the multifidus muscle at the level L4-L5. contrast with the control group, LBP patient groups showed a significantly higher Type II fiber distribution as well as reduced diameter in both fiber types (P<0.05). The physical activity level did not have an effect on multifidus characteristics since no significant differences were observed in fiber type and diameter (P>0.05) among LPA, MPA and HPA patient groups. Various pathological conditions were detected which were more pronounced in LBP groups compared to the control (P<0.05). Males had a larger fiber diameter compared to females for both fiber types (P<0.05). The results showed that the level of physical activity did not affect muscle fiber size and type distribution among LBP patients groups. These findings suggest that not only inactivity but also high physical activity levels can have an adverse effect on the multifidus muscle fiber characteristics.

  15. Cartographie des disques

    NASA Astrophysics Data System (ADS)

    Hameury, Jean-Marie

    2001-01-01

    Two techniques are frequently used to produce images of the accretion disc in an eclipsing binary: eclipse mapping and Doppler tomography. From the light curve, one can deduce the radial distribution of the effective temperature, assuming axial symmetry. On the other hand, from the variation of the line profile one can reconstruct an image in the velocity space, which can be converted into a real image if one knows the kinematics of the system. Deux techniques sont couramment utilisées pour obtenir des images des disques dans les systèmes binaires à éclipses. En utilisant la courbe de lumière, on peut remonter à la distribution radiale de la brillance de surface, en supposant que celle-ci a une symètrie axiale. D'autre part, les profils de raies renseignent sur la distribution de vitesse des régions émissives leur variation temporelle permet de réaliser une image dans l'espace des vitesses, que l'on peut ensuite transformer en carte dans l'espace (x,y) si on connaît la cinématique du système.

  16. 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

  17. Ponction biopsies rénales dans le Service de Néphrologie de Fès: indications et résultats: à propos de 522 cas

    PubMed Central

    Mbarki, Houda; Belghiti, Khadija Alaoui; Harmouch, Taoufiq; Najdi, Adil; Arrayhani, Mohamed; Sqalli, Tarik

    2016-01-01

    L'apport de la ponction biopsie rénale (PBR) dans le diagnostic, le choix thérapeutique et l’évaluation pronostique des néphropathies est considérable. Aucune étude marocaine n'a évalué la pratique et l'apport de la PBR. Notre objectif est d’étudier les indications de la PBR, déterminer la fréquence des maladies rénales identifiées par PBR dans notre région et de faire une confrontation entre les données clinico-biologiques et le diagnostic historique. Notre étude menée entre Janvier 2009 et Décembre 2012, est rétrospective. Nous avons inclus tous les patients du service de Néphrologie du CHU Hassan II de Fès ayant bénéficié d'une biopsie de reins natifs. 522 PBR ont été réalisées. Nous avons exclu 8 biopsies devant le manque de renseignements et avons donc retenu 514. L’âge moyen des patients au moment de la PBR est de 39 ±17 ans (3-82 ans). Le sex ratio est de 0,9. Le syndrome néphrotique est le diagnostic clinique le plus fréquent à tous les âges (58,2%). Les néphropathies glomérulaires représentent 94,2% des maladies rénales diagnostiquées, leur distribution varie selon l’âge des patients. La PBR a confirmé le premier diagnostic suspecté cliniquement dans 40,65% des cas, alors qu'elle a révélé un diagnostic inattendu chez 22,5% d'entre eux. Le diagnostic syndromique permet d'orienter vers la maladie rénale la plus probable et de guider les thérapeutiques urgentes en attendant les résultats de la PBR. Mais il ne peut en aucun remplacer la PBR qui reste le gold standard. PMID:27583085

  18. Transjugular Liver Biopsy

    PubMed Central

    Behrens, George; Ferral, Hector

    2012-01-01

    Liver biopsy is considered the gold standard for the evaluation of acute and chronic liver disorders. Transjugular liver biopsy (TJLB) was described by Dotter in 1964 and clinically performed for the first time by Hanafee in 1967. TJLB consists of obtaining liver tissue through a rigid cannula introduced into one of the hepatic veins, typically using jugular venous access. The quality of the TJLB specimens has improved so much that the samples obtained by this method are comparable with those obtained with the percutaneous technique. TJLB is indicated for patients with coagulopathy, ascites, peliosis hepatis, morbid obesity, liver transplant, or in patients undergoing a transjugular intrahepatic portosystemic shunt procedure. The technical success rate for a TJLB procedure ranges from 87 to 97%. Sample fragmentation has been reported in 14 to 25% of the TJLB samples. The complication rates are low and range between 1.3% and 6.5%. The purpose of this article is to provide a review of the fundamental aspects of the TJLB procedure, including technique, indications, contraindications, results, and complications. PMID:23729981

  19. Histological Value of Duodenal Biopsies

    PubMed Central

    Gupta, Limci; B., Hamid

    2005-01-01

    This study was performed to see the value of histopathological diagnosis in management of patients with duodenal biopsies; to look for correlation of histology and serology in suspected cases of coeliac disease; the reasons for taking duodenal biopsies and whether proper adequate histories are provided on the forms sent with request for histopathological view on duodenal biopsies. Here are the observations of the study followed by the discussion. PMID:15915293

  20. Reliability of chronic allograft nephropathy diagnosis in sequential protocol biopsies.

    PubMed

    Serón, Daniel; Moreso, Francesc; Fulladosa, Xavier; Hueso, Miguel; Carrera, Marta; Grinyó, Josep M

    2002-02-01

    Chronic allograft nephropathy (CAN) progresses rapidly during the first few months and slowly thereafter. Although the presence of CAN in protocol renal biopsies is a predictor of outcome, the reliability of this diagnosis according to Banff criteria has not been characterized. Renal lesions were evaluated according to the Banff criteria in sequential protocol biopsies performed at 4 and 14 months in 310 biopsies obtained from 155 patients. CAN progressed from 40 to 53% (P=0.001) while serum creatinine remained stable (146 +/- 44 vs. 147 +/- 48 micromol/L, P=NS). Graft survival in patients with and without CAN in the first biopsy was 74 versus 91% (P < 0.05), and in the second biopsy 75 versus 94% (P < 0.05). In 54 patients (35%) no CAN was present in both biopsies, 39 (25%) showed progression to CAN, 19 (12%) showed regression of CAN, and 43 (28%) showed CAN in both biopsies. Graft survival was: 100%, 81.6%, 82.6% and 69.4%, respectively (P < 0.01). Assuming that CAN does not regress and sampling error is normally distributed, we estimated that 25% of biopsies cannot be properly classified. The increase in the incidence of CAN between the 4th and 14th month is lower than the proportion of misclassified biopsies. Thus, monitoring the progression of CAN by means of two sequential biopsies at 4 and 14 months is inaccurate. We suggest that progression of scarring be monitored by means of a donor and a protocol biopsy performed during the first year evaluated with a quantitative approach.

  1. 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

  2. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Print What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy liquid part of the bone where blood cells are ... you might also feel the pressure of the biopsy needle pushing in. Some ... sharp cramp as the liquid bone marrow is withdrawn for the aspiration or ...

  3. Ultrasound-guided chest biopsies.

    PubMed

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

    2006-12-01

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

  4. Liquid biopsy for brain tumors

    PubMed Central

    Shankar, Ganesh M.; Balaj, Leonora; Stott, Shannon L.; Nahed, Brian; Carter, Bob S.

    2018-01-01

    Introduction Minimally invasive methods will augment the clinical approach for establishing the diagnosis or monitoring treatment response of central nervous system tumors. Liquid biopsy by blood or cerebrospinal fluid sampling holds promise in this regard. Areas covered In this literature review, the authors highlight recent studies describing the analysis of circulating tumor cells, cell free nucleic acids, and extracellular vesicles as strategies to accomplish liquid biopsy in glioblastoma and metastatic tumors. The authors then discuss the continued efforts to improve signal detection, standardize the liquid biopsy handling and preparation, develop platforms for clinical application, and establish a role for liquid biopsies in personalized medicine. Expert commentary As the technologies used to analyze these biomarkers continue to evolve, we propose that there is a future potential to precisely diagnose and monitor treatment response with liquid biopsies. PMID:28875730

  5. Liquid biopsy for brain tumors.

    PubMed

    Shankar, Ganesh M; Balaj, Leonora; Stott, Shannon L; Nahed, Brian; Carter, Bob S

    2017-10-01

    Minimally invasive methods will augment the clinical approach for establishing the diagnosis or monitoring treatment response of central nervous system tumors. Liquid biopsy by blood or cerebrospinal fluid sampling holds promise in this regard. Areas covered: In this literature review, the authors highlight recent studies describing the analysis of circulating tumor cells, cell free nucleic acids, and extracellular vesicles as strategies to accomplish liquid biopsy in glioblastoma and metastatic tumors. The authors then discuss the continued efforts to improve signal detection, standardize the liquid biopsy handling and preparation, develop platforms for clinical application, and establish a role for liquid biopsies in personalized medicine. Expert commentary: As the technologies used to analyze these biomarkers continue to evolve, we propose that there is a future potential to precisely diagnose and monitor treatment response with liquid biopsies.

  6. MRI/US fusion-guided prostate biopsy allows for equivalent cancer detection with significantly fewer needle cores in biopsy-naive men

    PubMed Central

    Yarlagadda, Vidhush K.; Lai, Win Shun; Gordetsky, Jennifer B.; Porter, Kristin K.; Nix, Jeffrey W.; Thomas, John V.; Rais-Bahrami, Soroush

    2018-01-01

    PURPOSE We aimed to investigate the efficiency and cancer detection of magnetic resonance imaging (MRI)/ultrasonography (US) fusion-guided prostate biopsy in a cohort of biopsy-naive men compared with standard-of-care systematic extended sextant transrectal ultrasonography (TRUS)-guided biopsy. METHODS From 2014 to 2016, 72 biopsy-naive men referred for initial prostate cancer evaluation who underwent MRI of the prostate were prospectively evaluated. Retrospective review was performed on 69 patients with lesions suspicious for malignancy who underwent MRI/US fusion-guided biopsy in addition to systematic extended sextant biopsy. Biometric, imaging, and pathology data from both the MRI-targeted biopsies and systematic biopsies were analyzed and compared. RESULTS There were no significant differences in overall prostate cancer detection when comparing MRI-targeted biopsies to standard systematic biopsies (P = 0.39). Furthermore, there were no significant differences in the distribution of severity of cancers based on grade groups in cases with cancer detection (P = 0.68). However, significantly fewer needle cores were taken during the MRI/US fusion-guided biopsy compared with systematic biopsy (63% less cores sampled, P < 0.001) CONCLUSION In biopsy-naive men, MRI/US fusion-guided prostate biopsy offers equal prostate cancer detection compared with systematic TRUS-guided biopsy with significantly fewer tissue cores using the targeted technique. This approach can potentially reduce morbidity in the future if used instead of systematic biopsy without sacrificing the ability to detect prostate cancer, particularly in cases with higher grade disease. PMID:29770762

  7. Magnetic Resonance (MR)-Guided Breast Biopsy

    MedlinePlus

    ... the type of biopsy being performed or the design of the biopsy machine, a biopsy of tissue ... cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. ...

  8. Diethylstilbestrol (DES) and Cancer

    MedlinePlus

    ... Genetics Services Directory Cancer Prevention Overview Research Diethylstilbestrol (DES) and Cancer On This Page What is DES? ... outlined in the table below. Fertility Problems in DES Daughters ( 7 ) Fertility Complication Hazard Ratio Percent Cumulative ...

  9. Liquid Biopsy in Oral Cancer.

    PubMed

    Lousada-Fernandez, Fatima; Rapado-Gonzalez, Oscar; Lopez-Cedrun, Jose-Luis; Lopez-Lopez, Rafael; Muinelo-Romay, Laura; Suarez-Cunqueiro, Maria Mercedes

    2018-06-08

    Oral cancer is one of the most prevalent forms of cancer worldwide. Carcinogenesis is a complex process, in which heterogeneity plays an important role in the development and progression of the disease. This review provides an overview of the current biological and clinical significance of circulating tumour cells (CTCs), circulating tumour DNA (ctDNA), and exosomes for diagnosis and prognosis of oral cancer. We highlight the importance of liquid biopsy—using blood and saliva—which represents a potential alternative to solid biopsy for diagnosis and prognosis. Moreover, liquid biomarkers allow for the real-time monitoring of tumour evolution and therapeutic responses, initiating the era of personalized medicine. However, in oral cancer, the impact of liquid biopsies in clinical settings is still limited, requiring further studies to discover the best scenario for its clinical use.

  10. Oral biopsy: oral pathologist's perspective.

    PubMed

    Kumaraswamy, K L; Vidhya, M; Rao, Prasanna Kumar; Mukunda, Archana

    2012-01-01

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

  11. 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.

  12. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    NASA Astrophysics Data System (ADS)

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

  13. CT-guided transthoracic needle biopsy: a comparison between automated biopsy gun and fine needle aspiration.

    PubMed

    Arakawa, H; Nakajima, Y; Kurihara, Y; Niimi, H; Ishikawa, T

    1996-07-01

    We retrospectively investigated the diagnostic accuracy and complication rate of transthoracic core biopsy using an automated biopsy gun and compared the findings with those of aspiration needle biopsy. Seventy-three patients underwent 74 core biopsy procedures and 50 patients underwent 52 aspiration biopsy procedures. Of these, a final diagnosis was obtained in 107 lesions with surgery or clinical course. Fifteen patients in which a final diagnosis was not obtained were excluded from the study on diagnostic accuracy. Thus, in the study of diagnostic accuracy, 63 core biopsy procedures for 62 lesions are included. Core biopsy was performed with an 18 G cutting needle using an automated biopsy gun. Aspiration biopsy was performed with a 20 G aspiration needle. Core biopsy yielded sufficient material in 57/63 procedures (90.5%). A correct diagnosis was obtained in 36 procedures (85.7%) for malignant leisons and a specific benign diagnosis was obtained in 11 procedures (52.4%). Aspiration biopsy yielded a correct diagnosis in 26 procedures (81.3%) for malignant leisons and in seven (46.7%) for benign lesions. The overall correct diagnosis were 75.8% and 71.7% with core biopsy and aspiration biopsy, respectively. Core biopsy gave a higher predictive rate than that of aspiration biopsy for both benign and malignant lessons (P < 0.02). Pneumothorax occurred in 18/74 (24.3%) patients with core biopsy and in 18/45 (40.0%) patients with aspiration biopsy. Of these, three with core biopsy and two with aspiration biopsy needed tube drainage. The other complication was haemoptysis, which occurred in six patients following core biopsy and in three after aspiration biopsy. All nine cases subsided spontaneously. There were no fatal complications. Core biopsy with a biopsy gun increase the diagnostic accuracy with a higher histologic predictive rate and no obvious additional risk of complications.

  14. Right Ventricular Pseudoaneurysm Following Endomyocardial Biopsy.

    PubMed

    Pita; Santos; Manteiga; Rodriguez; Beiras

    1996-03-01

    Ventricular perforation is an unusual complication after endomyocardial biopsy in heart transplanted patients. We report a case of asymptomatic right ventricular perforation and pseudoaneurysm formation, secondary to endomyocardial biopsy, diagnosed by angiography. The spontaneous obliteration of the pseudoaneurysm was observed.

  15. 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.

  16. 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 ...

  17. Liquid Biopsy zur Überwachung von Melanompatienten.

    PubMed

    Gaiser, Maria Rita; von Bubnoff, Nikolas; Gebhardt, Christoffer; Utikal, Jochen Sven

    2018-04-01

    In den letzten sechs Jahren wurden verschiedene innovative systemische Therapien zur Behandlung des metastasierten malignen Melanoms (MM) entwickelt. Die konventionelle Chemotherapie wurde durch neuartige Primärtherapien abgelöst, darunter systemische Immuntherapien (Anti-CTLA4- und Anti-PD1-Antikörper; Zulassung von Anti-PDL1-Antikörpern erwartet) und Therapien, die gegen bestimmte Mutationen gerichtet sind (BRAF, NRAS und c-KIT). Daher stehen die behandelnden Ärzte neuen Herausforderungen gegenüber, beispielsweise der Stratifizierung von Patienten für geeignete Behandlungen und der Überwachung von Langzeit-Respondern auf Progression. Folglich werden zuverlässige Methoden zur Überwachung von Krankheitsprogression oder Behandlungsresistenz benötigt. Lokalisierte und fortgeschrittene Krebserkrankungen können zur Bildung zirkulierender Tumorzellen und Tumor-DNA (ctDNA) führen, die sich in Proben von peripherem Blut nachweisen und quantifizieren lassen (Liquid Biopsy). Im Fall von Melanompatienten können die Ergebnisse von Liquid Biopsy als neuartige prädiktive Biomarker bei therapeutischen Entscheidungen hilfreich sein, insbesondere im Zusammenhang mit mutationsbasierten zielgerichteten Therapien. Die Herausforderungen bei der Anwendung der Liquid Biopsy beinhalten strikte Kriterien für den Phänotyp der zirkulierenden MM-Zellen oder ihrer Fragmente und die Instabilität von ctDNA im Blut. In diesem Übersichtsartikel diskutieren wir die Beschränkungen der Liquid Biopsy hinsichtlich ihrer Anwendung in der Routinediagnostik. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  18. KI-67 heterogeneity in well differentiated gastro-entero-pancreatic neuroendocrine tumors: when is biopsy reliable for grade assessment?

    PubMed

    Grillo, Federica; Valle, Luca; Ferone, Diego; Albertelli, Manuela; Brisigotti, Maria Pia; Cittadini, Giuseppe; Vanoli, Alessandro; Fiocca, Roberto; Mastracci, Luca

    2017-09-01

    Ki-67 heterogeneity can impact on gastroenteropancreatic neuroendocrine tumor grade assignment, especially when tissue is scarce. This work is aimed at devising adequacy criteria for grade assessment in biopsy specimens. To analyze the impact of biopsy size on reliability, 360 virtual biopsies of different thickness and lengths were constructed. Furthermore, to estimate the mean amount of non-neoplastic tissue component present in biopsies, 28 real biopsies were collected, the non-neoplastic components (fibrosis and inflammation) quantified and the effective area of neoplastic tissue calculated for each biopsy. Heterogeneity of Ki-67 distribution, G2 tumors and biopsy size all play an important role in reducing the reliability of biopsy samples in Ki-67-based grade assignment. In particular in G2 cases, 59.9% of virtual biopsies downgraded the tumor and the smaller the biopsy, the more frequent downgrading occurs. In real biopsies the presence of non-neoplastic tissue reduced the available total area by a mean of 20%. By coupling the results from these two different approaches we show that both biopsy size and non-neoplastic component must be taken into account for biopsy adequacy. In particular, we can speculate that if the minimum biopsy area, necessary to confidently (80% concordance) grade gastro-entero-pancreatic neuroendocrine tumors on virtual biopsies ranges between 15 and 30 mm 2 , and if real biopsies are on average composed of only 80% of neoplastic tissue, then biopsies with a surface area not <12 mm 2 should be performed; using 18G needles, this corresponds to a minimum total length of 15 mm.

  19. 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.

  20. [Real-time three-dimensional (4D) ultrasound-guided prostatic biopsies on a phantom. Comparative study versus 2D guidance].

    PubMed

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

    2007-11-01

    The objective of this study was to determine the added value of real-time three-dimensional (4D) ultrasound guidance of prostatic biopsies on a prostate phantom in terms of the precision of guidance and distribution. A prostate phantom was constructed. A real-time 3D ultrasonograph connected to a transrectal 5.9 MHz volumic transducer was used. Fourteen operators performed 336 biopsies with 2D guidance then 4D guidance according to a 12-biopsy protocol. Biopsy tracts were modelled by segmentation in a 3D ultrasound volume. Specific software allowed visualization of biopsy tracts in the reference prostate and evaluated the zone biopsied. A comparative study was performed to determine the added value of 4D guidance compared to 2D guidance by evaluating the precision of entry points and target points. The distribution was evaluated by measuring the volume investigated and by a redundancy ratio of the biopsy points. The precision of the biopsy protocol was significantly improved by 4D guidance (p = 0.037). No increase of the biopsy volume and no improvement of the distribution of biopsies were observed with 4D compared to 2D guidance. The real-time 3D ultrasound-guided prostate biopsy technique on a phantom model appears to improve the precision and reproducibility of a biopsy protocol, but the distribution of biopsies does not appear to be improved.

  1. Process utility in breast biopsy.

    PubMed

    Swan, J Shannon; Lawrence, William F; Roy, Jessica

    2006-01-01

    To determine whether the waiting trade-off (WTO) is feasible for differentiating short-term biopsy preferences in an acute situation where anxiety is the symptomatic disease state. 75 women with past experience of either breast core-needle biopsy (CNB), more invasive excisional surgical biopsy (EXB), or both, had telephone WTO assessments. Patients' baseline and test-related anxiety were valued by time trade-off (TTO) used to scale the WTO. Rating scales (RS) were obtained for convergent validity assessment with WTO and TTO. Data were obtained in 38 women who had both CNB and EXB ("paired") and 20 who had CNB only and 16 who had EXB only ("unpaired"). Patients rated only the procedure(s) they experienced. Median paired and mean unpaired WTO scores indicated patients were willing to wait significantly longer to avoid EXB (P = 0.0003, P = 0.0002, respectively). The waiting time difference between EXB and CNB was 2.1 weeks greater in unpaired data than paired data. RS scores comparing the procedures were significantly different only for paired data (P < 0.05). Median TTO preferences for baseline (1.00) and test anxiety (0.93) obtained in 74 patients were significantly different (P < 0.0001) and consistent with RS. Correlation was noted between WTO and RS (-0.307 to -0.453, P = 0.0205 to 0.0001). The median EXB quality-adjusted life years toll (1.5 quality-adjusted life days) calculated from pooled WTO data (paired and unpaired) from 54 patients is near a threshold in a published model. The WTO is feasible for discriminating preferences for short-term health states in an acute medical scenario where it might have been expected to be impracticable.

  2. 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

  3. Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies.

    PubMed

    Arsov, Christian; Rabenalt, Robert; Blondin, Dirk; Quentin, Michael; Hiester, Andreas; Godehardt, Erhard; Gabbert, Helmut E; Becker, Nikolaus; Antoch, Gerald; Albers, Peter; Schimmöller, Lars

    2015-10-01

    A significant proportion of prostate cancers (PCas) are missed by conventional transrectal ultrasound-guided biopsy (TRUS-GB). It remains unclear whether the combined approach using targeted magnetic resonance imaging (MRI)-ultrasound fusion-guided biopsy (FUS-GB) and systematic TRUS-GB is superior to targeted MRI-guided in-bore biopsy (IB-GB) for PCa detection. To compare PCa detection between IB-GB alone and FUS-GB + TRUS-GB in patients with at least one negative TRUS-GB and prostate-specific antigen ≥4 ng/ml. Patients were prospectively randomized after multiparametric prostate MRI to IB-GB (arm A) or FUS-GB + TRUS-GB (arm B) from November 2011 to July 2014. The study was powered at 80% to demonstrate an overall PCa detection rate of ≥60% in arm B compared to 40% in arm A. Secondary endpoints were the distribution of highest Gleason scores, the rate of detection of significant PCa (Gleason ≥7), the number of biopsy cores to detect one (significant) PCa, the positivity rate for biopsy cores, and tumor involvement per biopsy core. The study was halted after interim analysis because the primary endpoint was not met. The trial enrolled 267 patients, of whom 210 were analyzed (106 randomized to arm A and 104 to arm B). PCa detection was 37% in arm A and 39% in arm B (95% confidence interval for difference, -16% to 11%; p=0.7). Detection rates for significant PCa (29% vs 32%; p=0.7) and the highest percentage tumor involvement per biopsy core (48% vs 42%; p=0.4) were similar between the arms. The mean number of cores was 5.6 versus 17 (p<0.001). A limitation is the limited number of patients because of early cessation of accrual. This trial failed to identify an important improvement in detection rate for the combined biopsy approach over MRI-targeted biopsy alone. A prospective comparison between MRI-targeted biopsy alone and systematic TRUS-GB is justified. Our randomized study showed similar prostate cancer detection rates between targeted prostate biopsy

  4. Biochemical artifacts in experiments involving repeated biopsies in the same muscle

    PubMed Central

    Van Thienen, Ruud; D'Hulst, Gommaar; Deldicque, Louise; Hespel, Peter

    2014-01-01

    Abstract Needle biopsies are being extensively used in clinical trials addressing muscular adaptation to exercise and diet. Still, the potential artifacts due to biopsy sampling are often overlooked. Healthy volunteers (n = 9) underwent two biopsies through a single skin incision in a pretest. Two days later (posttest) another biopsy was taken 3 cm proximally and 3 cm distally to the pretest incision. Muscle oxygenation status (tissue oxygenation index [TOI]) was measured by near‐infrared spectroscopy. Biopsy samples were analyzed for 40 key markers (mRNA and protein contents) of myocellular O2 sensing, inflammation, cell proliferation, mitochondrial biogenesis, protein synthesis and breakdown, oxidative stress, and energy metabolism. In the pretest, all measurements were identical between proximal and distal biopsies. However, compared with the pretest, TOI in the posttest was reduced in the proximal (−10%, P < 0.05), but not in the distal area. Conversely, most inflammatory markers were upregulated at the distal (100–500%, P < 0.05), but not at the proximal site. Overall, 29 of the 40 markers measured, equally distributed over all pathways studied, were either up‐ or downregulated by 50–500% (P < 0.05). In addition, 19 markers yielded conflicting results between the proximal and distal measurements (P < 0.05). This study clearly documents that prior muscle biopsies can cause major disturbances in myocellular signaling pathways in needle biopsies specimens sampled 48 h later. In addition, different biopsy sites within identical experimental conditions yielded conflicting results. PMID:24819751

  5. Biochemical artifacts in experiments involving repeated biopsies in the same muscle.

    PubMed

    Van Thienen, Ruud; D'Hulst, Gommaar; Deldicque, Louise; Hespel, Peter

    2014-01-01

    Needle biopsies are being extensively used in clinical trials addressing muscular adaptation to exercise and diet. Still, the potential artifacts due to biopsy sampling are often overlooked. Healthy volunteers (n = 9) underwent two biopsies through a single skin incision in a pretest. Two days later (posttest) another biopsy was taken 3 cm proximally and 3 cm distally to the pretest incision. Muscle oxygenation status (tissue oxygenation index [TOI]) was measured by near-infrared spectroscopy. Biopsy samples were analyzed for 40 key markers (mRNA and protein contents) of myocellular O2 sensing, inflammation, cell proliferation, mitochondrial biogenesis, protein synthesis and breakdown, oxidative stress, and energy metabolism. In the pretest, all measurements were identical between proximal and distal biopsies. However, compared with the pretest, TOI in the posttest was reduced in the proximal (-10%, P < 0.05), but not in the distal area. Conversely, most inflammatory markers were upregulated at the distal (100-500%, P < 0.05), but not at the proximal site. Overall, 29 of the 40 markers measured, equally distributed over all pathways studied, were either up- or downregulated by 50-500% (P < 0.05). In addition, 19 markers yielded conflicting results between the proximal and distal measurements (P < 0.05). This study clearly documents that prior muscle biopsies can cause major disturbances in myocellular signaling pathways in needle biopsies specimens sampled 48 h later. In addition, different biopsy sites within identical experimental conditions yielded conflicting results.

  6. 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

  7. Temporal artery biopsy size does not matter.

    PubMed

    Kaptanis, Sarantos; Perera, Joanne K; Halkias, Constantine; Caton, Nadine; Alarcon, Lida; Vig, Stella

    2014-12-01

    This study aimed to clarify whether positive temporal artery biopsies had a greater sample length than negative biopsies in temporal arteritis. It has been suggested that biopsy length should be at least 1 cm to improve diagnostic accuracy. A retrospective review of 149 patients who had 151 temporal artery biopsies was conducted. Twenty biopsies were positive (13.3%), 124 negative (82.1%) and seven samples were insufficient (4.6%). There was no clinically significant difference in the mean biopsy size between positive (0.7 cm) and negative samples (0.65 cm) (t-test: p = .43 NS). Ninety-four patients fulfilled all three ACR criteria prior to biopsy (62.3%) and four patients (2.6%) changed ACR score from 2 to 3 after biopsy. Treatment should not be delayed in anticipation of the biopsy or withheld in the case of a negative biopsy if the patient's symptoms improve. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Distribution of IL-1β immunoreactive cells in pancreatic biopsies from living volunteers with new-onset type 1 diabetes: comparison with donors without diabetes and with longer duration of disease.

    PubMed

    Reddy, Shiva; Krogvold, Lars; Martin, Charlton; Holland, Rebecca; Choi, Jaimin; Woo, Hannah; Wu, Fiona; Dahl-Jørgensen, Knut

    2018-06-01

    Although IL-1β is considered a key mediator of beta cell destruction, its cellular expression in islets during early type 1 diabetes remains unclear. We compared its expression in rare pancreatic biopsies from new-onset living volunteers with its expression in cadaveric pancreas sections from non-diabetic autoantibody-positive and -negative individuals and those with long-standing disease. Pancreatic biopsy sections from six new-onset living volunteers (group 1) and cadaveric sections from 13 non-diabetic autoantibody-negative donors (group 2), four non-diabetic autoantibody-positive donors (group 3) and nine donors with diabetes of longer duration (0.25-12 years of disease; group 4) were triple-immunostained for IL-1β, insulin and glucagon. Intra- and peri-islet IL-1β-positive cells in insulin-positive and -negative islets and in random exocrine fields were enumerated. The mean number of IL-1β-positive cells per islet from each donor in peri- and intra-islet regions was <1.25 and <0.5, respectively. In all study groups, the percentage of islets with IL-1β cells in peri- and/or intra-islet regions was highly variable and ranged from 4.48% to 17.59% in group 1, 1.42% to 44.26% in group 2, 7.93% to 17.53% in group 3 and 3.85% to 42.86% in group 4, except in a single case where the value was 75%. In 25/32 donors, a higher percentage of islets showed IL-1β-positive cells in peri-islet than in intra-islet regions. In sections from diabetic donors (groups 1 and 4), a higher mean number of IL-1β-positive cells occurred in insulin-positive islets than in insulin-negative islets. In group 2, 70-90% of islets in 3/13 sections had weak-to-moderate IL-1β staining in alpha cells but staining was virtually absent or substantially reduced in the remaining groups. The mean number of exocrine IL-1β-positive cells in group 1 was lower than in the other groups. At onset of type 1 diabetes, the low number of islet-associated IL-1β-positive cells may be insufficient to

  9. Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors.

    PubMed

    Hayes Balmadrid, Melissa A; Shelby, Rebecca A; Wren, Anava A; Miller, Lauren S; Yoon, Sora C; Baker, Jay A; Wildermann, Liz A; Soo, Mary Scott

    2017-04-01

    This study investigated how time from breast biopsy recommendation to biopsy procedure affected pre-biopsy anxiety ( N = 140 women), and whether the relationship between wait time and anxiety was affected by psychosocial factors (chronic life stress, traumatic events, social support). Analyses showed a significant interaction between wait time and chronic life stress. Increased time from biopsy recommendation was associated with greater anxiety in women with low levels of life stress. Women with high levels of life stress experienced increased anxiety regardless of wait time. These results suggest that women may benefit from shorter wait times and receiving strategies for managing anxiety.

  10. Distribution

    Treesearch

    John R. Jones

    1985-01-01

    Quaking aspen is the most widely distributed native North American tree species (Little 1971, Sargent 1890). It grows in a great diversity of regions, environments, and communities (Harshberger 1911). Only one deciduous tree species in the world, the closely related Eurasian aspen (Populus tremula), has a wider range (Weigle and Frothingham 1911)....

  11. Number of Biopsies in Diagnosing Pulmonary Nodules

    PubMed Central

    Wehrschuetz, M.; Wehrschuetz, E.; Portugaller, H. R.

    2010-01-01

    Purpose: To determine the number of specimens to be obtained from pulmonary lesions to get the highest possible accuracy in histological work-up. Materials and methods: A retrospective evaluation (January 1999 to April 2004) covered 260 patients with thoracic lesions who underwent computer tomography (CT)-guided core-cut biopsy in coaxial technique. All biopsies were performed utilizing a 19 gauge introducer needle and a 20 gauge core-cut biopsy needle. In all, 669 usable biopsies were taken (from 1–5 biopsies in each setting). The specimens were marked sequentially and each biopsy was worked up histologicaly. The biopsy results were correlated to histology after surgery, clinical follow-up or autopsy. The number of biopsies was determined that is necessary to achieve the highest possible accuracy in diagnosing pulmonary lesions. Results: In 591 of 669 biopsies (88.3%), there were correct positive results. The overall accuracy was 87.4%. In 193 of 260 (74.2%) patients, a suspected malignancy was confirmed. In 50 of 260 (19.2%) patients, a benign lesion was correctly diagnosed. Seventeen (6.5%) patients were lost to follow-up. The first, second and third biopsies had cumulative accuracies of 63.6%, 89.2% and 91.5%, respectively (P < 0.02). More biopsies did not show any higher impact on accuracy. Conclusion: For the highest possible accuracy in diagnosing pulmonary lesions by CT-guided core-cut biopsy, at least three usable specimens are recommended to be taken. PMID:21157523

  12. Adult dementia: history, biopsy, pathology.

    PubMed

    Torack, R M

    1979-05-01

    The historical events in the evolution of Alzheimer's disease are reviewed, including the initial description by Alois Alzheimer and the subsequent controversy regarding the nosological specificity of this entity. The similarity of senile dementia and Alzheimer's disease is emphasized. The basis for the modern concept of Alzheimer's disease as premature or accelerated aging is included in the review. The pathological correlates of the major categories of adult dementia have been described. The traditional criteria of neurofibrillary tangles and senile plaques have been re-evaluated using the current insight into these changes afforded by electron microscopy and biochemistry. The significance of amyloid has been described because it occurs within the senile plaque and also as the essential component of congophilic angiopathy. The new information regarding neuronal cell counts and the loss of choline acetyltransferase has been evaluated in terms of an indication of a pathogenic mechanism of Alzheimer's disease. The current understanding of normal pressure hydrocephalus, Creutzfeldt-Jakob disease, and multi-infarct dementia has been described. Brain biopsy in dementia has been described as having diagnostic, research, pathogenic, and prognostic value. The precautions involving the performance and handling of the biopsy have been stressed, particularly because these procedures involve conditions of possible slow virus etiology. The polemic for Alzheimer's disease as aging or slow virus infection has been summarized. At this time a consideration seems justified that Alzheimer's disease is an age-related, slow virus disease due to a hitherto unknown immune defect. Aging as an etiological agent must be clarified before Alzheimer's disease, in any form, can be considered to be an inevitable consequence of longevity.

  13. Outcomes of ultrasound guided renal mass biopsies.

    PubMed

    Sutherland, Edward L; Choromanska, Agnieszka; Al-Katib, Sayf; Coffey, Mary

    2018-06-01

    The purpose of this study was to evaluate the rate of nondiagnostic ultrasound-guided renal mass biopsies (RMBs) at our institution and to determine what patient, procedural, and focal renal mass (FRM) factors were associated with nondiagnostic ultrasound-guided RMBs. Eighty-two ultrasound-guided renal mass biopsies performed between January 2014 and October 2016 were included in our study. Biopsy outcomes (diagnostic vs. nondiagnostic) and patient, procedural, and FRM characteristics were retrospectively reviewed and recorded. Univariate statistical analyses were performed to identify biopsy characteristics that were indicative of nondiagnostic biopsy. Ultrasound-guided RMBs were diagnostic in 70 out of 82 cases (85%) and non-diagnostic in 12 cases (15%). Among the diagnostic biopsies, 54 (77%) were malignant cases, 94% of which were renal cell carcinoma (RCC). Of the 12 nondiagnostic cases, the final diagnosis was RCC in 4 cases and angiomyolipoma in one case; seven of the nondiagnostic cases were lost to follow-up. A weak association (p = 0.04) was found between the number of needle passes and the biopsy outcome. None of the remaining collected RMB characteristics showed a significant correlation with a diagnostic or nondiagnostic RMB. Six patients (7%) experienced complications. Ultrasound-guided renal mass biopsy is a safe and effective method for the diagnosis of renal masses with a low rate of nondiagnostic outcomes. A nondiagnostic biopsy should not be treated as a surrogate for a diagnosis since a significant number of patients with nondiagnostic biopsies have subsequently been shown to have renal malignancies. Repeat biopsy should be considered in such cases.

  14. [Muscle biopsy in children: Usefulness in 2012].

    PubMed

    Cuisset, J-M; Maurage, C-A; Carpentier, A; Briand, G; Thévenon, A; Rouaix, N; Vallée, L

    2013-01-01

    Muscle biopsy is a mainstay diagnostic tool for investigating neuromuscular disorders in children. We report the yield of pediatric muscle biopsy in a population of 415 children by a retrospective study of 419 biopsies performed between 1/01/2000 and 31/12/2009 in a neuropediatric department, including mitochondrial respiratory chain analysis for 87 children. Two hundred and fifty-five biopsies were from boys (61%) 164 from girls (39%). Their mean age at biopsy was 6.5years; 155 (37%) biopsies were obtained before the child was 5years old. Final histopathological diagnoses were: congenital myopathy (n=193, including 15 structural congenital myopathies); progressive muscular dystrophy (n=75 [18%] including 57 dystrophinopathies); congenital muscular dystrophy (n=17, including six primary merosinopathies); dermatomyositis (n=11); spinal muscular atrophy (n=9, including six atypical spinal muscular atrophies); metabolic myopathy (n=32, including 19 mitochondrial myopathies); encephalomyopathy (n=53 [13%], including 27 with a mitochondrial respiratory chain defect). Pathological diagnosis remained undetermined in 16 cases. In 184 patients (44%), the muscle biopsy revealed specific histopathological anomalies (dystrophic process; specific ultrastructural abnormalities; perifascicular atrophy; neurogenic atrophy; metabolic anomalies) enabling a precise etiological diagnosis. For 85% of progressive muscular dystrophies, the biopsy resulted in a genetic diagnosis after identification of the protein defect. In 15% of the congenital myopathies, histopathological anomalies focused attention on one or several genes. Concerning dystrophinopathies, quantification of dystrophin deficiency on the biopsy specimen contributed to the definition of the clinical phenotype: Duchenne, or Becker. In children with a myopathy, muscle biopsy is often indispensable to establish the etiological diagnosis. Based on the results from this series, muscle biopsy can provide a precise

  15. Liquid biopsy for early stage lung cancer.

    PubMed

    Liang, Wenhua; Zhao, Yi; Huang, Weizhe; Liang, Hengrui; Zeng, Haikang; He, Jianxing

    2018-04-01

    Liquid biopsy, which analyzes biological fluids especially blood specimen to detect and quantify circulating cancer biomarkers, have been rapidly introduced and represents a promising potency in clinical practice of lung cancer diagnosis and prognosis. Unlike conventional tissue biopsy, liquid biopsy is non-invasive, safe, simple in procedure, and is not influenced by manipulators' skills. Notably, some circulating cancer biomarkers are already detectable in disease with low-burden, making liquid biopsy feasible in detecting early stage lung cancer. In this review, we described a landscape of different liquid biopsy methods by highlighting the rationale and advantages, accessing the value of various circulating biomarkers and discussing their possible future development in the detection of early lung cancer.

  16. 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.

  17. Coeliac disease: to biopsy or not?

    PubMed

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

    2018-01-01

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

  18. Clinical usefulness of temporal artery biopsy.

    PubMed Central

    Vilaseca, J; González, A; Cid, M C; Lopez-Vivancos, J; Ortega, A

    1987-01-01

    To assess the diagnostic usefulness of temporal artery biopsy in temporal arteritis (TA) and establish clinical features capable of predicting its positivity we have retrospectively studied the biopsy specimens and the clinical features of 103 patients who had undergone temporal artery biopsy. Temporal artery biopsy reached a positive predictive value of 90.2% with respect to the final diagnosis based on the criteria proposed by Ellis and Ralston and the clinical course. The simultaneous presence of recent onset headache, jaw claudication, and abnormalities of the temporal arteries on physical examination had a specificity of 94.8% with respect to the histological diagnosis and of 100% with respect to final diagnosis. The presence of any of these clinical features, though of little specificity (34.4%), had a sensitivity of 100% with respect to histological diagnosis, selecting a group of patients in whom temporal artery biopsy has more discriminative value. PMID:3592783

  19. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  20. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Gastroenterology-urology biopsy instrument. 876... Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is a...

  1. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... biopsy instrument, gastro-urology biopsy needle and needle set, and nonelectric biopsy forceps. This... regulations. (b) Classification. (1) Class II (performance standards). (2) Class I for the biopsy forceps cover and the non-electric biopsy forceps. The devices subject to this paragraph (b)(2) are exempt from...

  2. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... biopsy instrument, gastro-urology biopsy needle and needle set, and nonelectric biopsy forceps. This... regulations. (b) Classification. (1) Class II (performance standards). (2) Class I for the biopsy forceps cover and the non-electric biopsy forceps. The devices subject to this paragraph (b)(2) are exempt from...

  3. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... biopsy instrument, gastro-urology biopsy needle and needle set, and nonelectric biopsy forceps. This... regulations. (b) Classification. (1) Class II (performance standards). (2) Class I for the biopsy forceps cover and the non-electric biopsy forceps. The devices subject to this paragraph (b)(2) are exempt from...

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

    MedlinePlus

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

  5. Clinical application of Lin's biopsy grasper for intrauterine targeted biopsy and polypectomy during office hysteroscopy.

    PubMed

    Cheng, Hsin-Yi; Lin, Bao-Liang; Tseng, Jen-Yu; Ueno, Kazunori; Nakada, Sakura

    2018-06-01

    Hysteroscopy has widely been used for diagnosis of the uterine cavity; however, target biopsy has often been difficult in part to the inherent limitations of ancillary instruments. Lin's biopsy grasper was specifically designed to work in conjunction with a flexible hysteroscope to obtain intrauterine biopsy under transabdominal sonography. Herein, we share our clinical experience in the management of endometrial abnormalities with the use of Lin's biopsy grasper during office-based hysteroscopy. From February 2006 to November 2016, the use of Lin's biopsy grasper for tissue biopsy was attempted on 126 cases. We retrospectively recorded and analyzed the patients' preoperative characteristics and biopsy outcomes to demonstrate the feasibility and efficacy of Lin's biopsy grasper. Out of the one hundred and twenty-six enrolled patients, satisfactory targeted biopsies were achieved; including high diagnostic rate (92.1%, with 116 cases confirmed histologically) and adequate tissue retrieval (77.8%, with 98 cases obtaining optimal specimen volume). All patients tolerated the procedure without analgesics or anesthesia. Diagnostic flexible hysteroscopy combined with the use of Lin's biopsy grasper has proven to be an effective tool for intrauterine evaluation and obtaining tissue sample. Copyright © 2018. Published by Elsevier B.V.

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

    PubMed

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

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

  7. Association between HIV status and Positive Prostate Biopsy in a Study of U.S. Veterans

    PubMed Central

    Hsiao, Wayland; Anastasia, Katrina; Hall, John; Goodman, Michael; Rimland, David; Ritenour, Chad W. M.; Issa, Muta M.

    2009-01-01

    HIV infection is associated with increased incidence of malignancies, such as lymphomas and testicular cancers. We reviewed the relationship between HIV infection and prostate cancer in a contemporary series of prostate biopsy patients. The study is a retrospective analysis of consecutive prostate biopsies performed at a VA Medical Center. The indications for performing a prostate biopsy included an abnormal digital rectal examination and/or an elevated PSA. Patients were categorized according to their HIV status, biopsy results, and various demographic and clinical characteristics. Univariate and multivariate analyses compared distributions of HIV status, and various clinical and demographic characteristics. The adjusted measures of association between HIV status and positive biopsy were expressed as odds ratios (ORs) and corresponding 95% confidence intervals (CI). The likelihood of positive biopsy was significantly higher among 18 HIV-positive patients compared to patients with negative HIV tests (adjusted OR = 3.9; 95% CI: 1.3–11.5). In analyses restricted to prostate cancer patients, HIV-positive patients were not different from the remaining group with respect to their prostate cancer stage, PSA level, PSA velocity, PSA density, or Gleason grade. There is an association between HIV infection and prostate biopsy positive for carcinoma in a population referred for urologic workup. Further confirmation of this association by prospective studies may impact the current screening practices in HIV patients. PMID:19219374

  8. Transbronchial biopsies safely diagnose amyloid lung disease

    PubMed Central

    Govender, Praveen; Keyes, Colleen M.; Hankinson, Elizabeth A.; O’Hara, Carl J.; Sanchorawala, Vaishali; Berk, John L.

    2018-01-01

    Background Autopsy identifies lung involvement in 58–92% of patients with the most prevalent forms of systemic amyloidoses. In the absence of lung biopsies, amyloid lung disease often goes unrecognized. Report of a death following transbronchial biopsies in a patient with systemic amyloidosis cautioned against the procedure in this patient cohort. We reviewed our experience with transbronchial biopsies in patients with amyloidosis to determine the safety and utility of bronchoscopic lung biopsies. Methods We identified patients referred to the Amyloidosis Center at Boston Medical Center with lung amyloidosis diagnosed by transbronchial lung biopsies (TBBX). Amyloid typing was determined by immunohistochemistry or mass spectrometry. Standard end organ assessments, including pulmonary function test (PFT) and chest tomography (CT) imaging, and extra-thoracic biopsies established the extent of disease. Results Twenty-five (21.7%) of 115 patients with lung amyloidosis were diagnosed by TBBX. PFT classified 33.3% with restrictive physiology, 28.6% with obstructive disease, and 9.5% mixed physiology; 9.5% exhibited isolated diffusion defects while 19% had normal pulmonary testing. Two view chest or CT imaging identified focal opacities in 52% of cases and diffuse interstitial disease in 48%. Amyloid type and disease extent included 68% systemic AL disease, 16% localized (lung limited) AL disease, 12% ATTR disease, and 4% AA amyloidosis. Fluoroscopy was not used during biopsy. No procedure complications were reported. Conclusions Our case series of 25 patients supports the use of bronchoscopic transbronchial biopsies for diagnosis of parenchymal lung amyloidosis. Normal PFTs do not rule out the histologic presence of amyloid lung disease. PMID:28393574

  9. Nasal hydropulsion: a novel tumor biopsy technique.

    PubMed

    Ashbaugh, Elizabeth A; McKiernan, Brendan C; Miller, Carrie J; Powers, Barbara

    2011-01-01

    Intranasal tumors of dogs and cats pose a diagnostic and therapeutic challenge for small animal practitioners. Multiple nasal biopsy techniques have been described in the past. This report describes a simplified flushing technique to biopsy and debulk nasal tumors, which often also results in immediate clinical relief for the patient. Based on the results of this retrospective study, the authors recommend high-pressure saline hydropulsion as a minimally invasive diagnostic, and potentially therapeutic, technique for nasal tumors in dogs and cats.

  10. Determination des Parametres Atmospheriques des Etoiles Naines Blanches de Type DB

    NASA Astrophysics Data System (ADS)

    Beauchamp, Alain

    1995-01-01

    Les etoiles naines blanches dont les spectres visibles sont domines par des raies fortes d'helium neutre sont subdivisees en trois classes, DB (raies d'helium neutre seulement), DBA (raies d'helium neutre et d'hydrogene) et DBZ (raies d'helium neutre et d'elements lourds). Nous analysons trois echantillons de spectres observes de ces types de naines blanches. Les echantillons consistent, respectivement, de 48 spectres dans le domaine du visible (3700-5100 A). 24 dans l'ultraviolet (1200-3100 A) et quatre dans la partie rouge du visible (5100-6900) A). Parmi les objets de l'echantillon visible, nous identifions quatre nouvelles DBA, ainsi que deux nouvelles DBZ, auparavant classees DB. L'analyse nous permet de determiner spectroscopiquement les parametres atmospheriques, soit la temperature effective, la gravite de surface, ainsi que l'abondance relative de l'hydrogene, N(H)/N(He), dans le cas des DBA. Pour les objets plus chauds que ~15,000 K, la gravite de surface determinee est fiable, et nous obtenons les masses stellaires avec une relation masse -rayon theorique. Les exigences propres a l'analyse de ces objets ont requis d'importantes ameliorations dans la modelisation de leurs atmospheres et distributions de flux de radiation emis par ces derniers. Nous avons inclus dans les modeles d'atmospheres, pour la premiere fois a notre connaissance, les effets dus a la molecule He_sp{2 }{+}, ainsi que l'equation d'etat de Hummer et Mihalas (1988), qui tient compte des perturbations entre particules dans le calcul des populations des differents niveaux atomiques. Nous traitons la convection dans le cadre de la theorie de la longueur de melange. Trois grilles de modeles d'atmospheres a l'ETL (equilibre thermodynamique local) ont ete produites, pour un ensemble de temperatures effectives, gravites de surface et abondances d'hydrogene couvrant les proprietes des etoiles de nos echantillons; elles sont caracterisees par differentes parametrisations appelees, respectivement

  11. Testicular biopsy: clinical practice and interpretation

    PubMed Central

    Dohle, Gert R; Elzanaty, Saad; van Casteren, Niels J

    2012-01-01

    Testicular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia. Recent guidelines for male infertility have limited the indications for a diagnostic testicular biopsy to the confirmation of obstructive azoospermia in men with normal size testes and normal reproductive hormones. Nowadays, testicular biopsies are mainly performed for sperm harvesting in men with non-obstructive azoospermia, to be used for intracytoplasmic sperm injection. Testicular biopsy is also performed in men with risk factors for testicular malignancy. In a subgroup of infertile men, there is an increased risk for carcinoma in situ of the testis, especially in men with a history of cryptorchidism and testicular malignancy and in men with testicular atrophy. Ultrasonographic abnormalities, such as testicular microlithiasis, inhomogeneous parenchyma and lesions of the testes, further increase the risk of carcinoma in situ (CIS) in these men. For an accurate histological classification, proper tissue handling, fixation, preparation of the specimen and evaluation are needed. A standardized approach to testicular biopsy is recommended. In addition, approaches to the detection of CIS of the testis testicular immunohistochemistry are mandatory. In this mini-review, we describe the current indications for testicular biopsies in the diagnosis and management of male infertility. PMID:22157985

  12. Outpatient biopsy of breast cancer. Influence on survival.

    PubMed Central

    Bertario, L; Reduzzi, D; Piromalli, D; Piva, L; Di Pietro, S

    1985-01-01

    From 1948 to 1975, at the Istituto Nazionale Tumori of Milan, 209 patients underwent extended radical mastectomy (ERM) for breast cancer classified as T1 NO-1 MO. In 57 patients (27.3%), the ERM was preceded by an excisional biopsy performed in the outpatient clinic (Group A), of which 75% were performed within 30 days of admission and 25% after 30 days (average, 25 days; range 5-99). The remaining 152 patients (Group B) underwent an extemporaneous frozen biopsy. There was no difference in the distribution of the histologic types in the two groups. The axillary lymph nodes (N) and the internal mammary chain (MI) were free of neoplastic invasion (N-, MI-) in 156 patients (74.6%), 44 in Group A (77.2%) and 112 in Group B (73.7%). Actuarial 10-year survival of the patients was 79.9% in Group A and 77.7% in Group B (p = NS). It was 90% in N- MI- patients of Group A and 81.9% in those of Group B (p = NS). Instead, for N+ patients, actuarial survival at 10 years was 50% in Group A and 67% in Group B (p = NS), and for MI+ patients it was 50% and 49.8%, respectively. These present data do not support the hypothesis that a delay between biopsy and radical surgery of breast cancer is an important prognostic factor. PMID:3966829

  13. Laparoscopic ovarian biopsy pick-up method for goats.

    PubMed

    Brandão, Fabiana A S; Alves, Benner G; Alves, Kele A; Souza, Samara S; Silva, Yago P; Freitas, Vicente J F; Teixeira, Dárcio I A; Gastal, Eduardo L

    2018-02-01

    Biopsy pick-up (BPU) has been considered a safe method to harvest ovarian fragments from live animals. However, no studies have been reported on the use of BPU to collect in vivo ovarian tissue in goats. The goals of this study were: (i) to test different biopsy needle sizes to collect ovarian tissue in situ using the BPU method (Experiment 1), and (ii) to study ovarian tissue features such as preantral follicle density, morphology, class distribution, and stromal cell density in ovarian fragments obtained in vivo through a laparoscopic BPU method (Experiment 2). In Experiment 1, goat ovaries (n = 20) were collected in a slaughterhouse and subjected to in situ BPU. Three needles (16, 18, and 20G) were tested. In Experiment 2, the most efficient biopsy needle from Experiment 1 was used to perform laparoscopic BPU in goats (n = 8). In Experiment 1, the recovery rate was greater (P < 0.05; range 50-62%) with 16G and 18G needles than the 20G (17%) needle. The mean weight of ovarian fragments collected by the 16G needle was greater (P < 0.05) than the 18G and the 20G needle. In Experiment 2, 62 biopsy attempts were performed and 52 ovarian fragments were collected (90% success rate). Overall, 2054 preantral follicles were recorded in 5882 histological sections analyzed. Mean preantral follicular density was 28.4 ± 1.3 follicles per cm 2 . The follicular density differed (P < 0.05) among animals and ovarian fragments within the same animal. The mean stromal cell density in the ovarian fragments was 37.1 ± 0.5 cells per 2500 μm 2 , and differed (P < 0.05) among animals. Moreover, preantral follicle density and stromal cell density were associated (P < 0.001). The percentage of morphologically normal follicles was 70.1 ± 1.2, and differed (P < 0.05) among animals. The majority (79%) of the morphologically normal follicles was classified as primordial follicles, and differed (P < 0.05) among animals and between ovaries. In summary, a

  14. Litigation involving DES.

    PubMed

    Rheingold, P D

    1976-01-01

    Focus is on the diethylstilbestrol (DES) litigation which has resulted from the 1971 discovery that this synthetic estrogen can cause cancer in the daughters of women who used the drug during pregnancy in an effort to prevent threatened abortion. Possibly 100 suits are pending at this time in which DES daughters claim injuries. In most of these vaginal or cervical cancer has appeared -- with or without a hysterectomy having been performed. Several women died from cancer. The fact that the use of DES occurred many years ago is the legal hurdle most troublesome to lawyers. The average women coming to a lawyer's office today has a mother who used some form of DES, perhaps in 1955. Few drugstores have records today of the prescriptions which they filled 20 years ago. It has been estimated that over the 1950-1970 period more than 200 different companies manufactured or "tabletized" under their own name DES plus a variety of similar synthetic estrogens promoted for the prevention of threatened abortion. A further hurdle caused by the passage of time is that even the records of the physicians are frequently lost. A final problem created by the age of the cases is statute of limitations. If the actual manufacturer of the DES cannot be identified, this is generally the end of the lawyer's interest in the case. The chance of the plaintiff winning may be increased if the action against all the manufacturers is a class action. Most of the pending DES suits are against the manufacturer and not against the doctor. Thus far no DES case has been tried to completion. Several have been settled by the manufacturers on the eve of the trial, generally for less than the full sum that a cancer victim would expect to receive.

  15. Ventricular fibrillation complicating endomyocardial biopsy of transplanted heart.

    PubMed

    Rozmus, Grzegorz; Patel, Hamang; Rosero, Spencer; Alexis, Jeffrey D

    2013-07-01

    Life-threatening arrhythmia is an unusual complication of endomyocardial biopsy in transplanted heart. Herein we described a case of VF during endomyocardial biopsy. The possibility of VF during a biopsy necessitates immediate access to defibrillation during endomyocardial biopsy. ©2012, Wiley Periodicals, Inc.

  16. Common Data Elements for Muscle Biopsy Reporting

    PubMed Central

    Dastgir, Jahannaz; Rutkowski, Anne; Alvarez, Rachel; Cossette, Stacy A.; Yan, Ke; Hoffmann, Raymond G.; Sewry, Caroline; Hayashi, Yukiko K.; Goebel, Hans-Hilmar; Bonnemann, Carsten; Lawlor, Michael W.

    2016-01-01

    Context There is no current standard among myopathologists for reporting muscle biopsy findings. The National Institute of Neurological Disorders and Stroke has recently launched a common data element (CDE) project to standardize neuromuscular data collected in clinical reports and to facilitate their use in research. Objective To develop a more-uniform, prospective reporting tool for muscle biopsies, incorporating the elements identified by the CDE project, in an effort to improve reporting and educational resources. Design The variation in current biopsy reporting practice was evaluated through a study of 51 muscle biopsy reports from self-reported diagnoses of genetically confirmed or undiagnosed muscle disease from the Congenital Muscle Disease International Registry. Two reviewers independently extracted data from deidentified reports and entered them into the revised CDE format to identify what was missing and whether or not information provided on the revised CDE report (complete/incomplete) could be successfully interpreted by a neuropathologist. Results Analysis of the data highlighted showed (1) inconsistent reporting of key clinical features from referring physicians, and (2) considerable variability in the reporting of pertinent positive and negative histologic findings by pathologists. Conclusions We propose a format for muscle-biopsy reporting that includes the elements in the CDE checklist and a brief narrative comment that interprets the data in support of a final interpretation. Such a format standardizes cataloging of pathologic findings across the spectrum of muscle diseases and serves emerging clinical care and research needs with the expansion of genetic-testing therapeutic trials. PMID:26132600

  17. Interoperative Biopsy Site Relocalization in Endoluminal Surgery.

    PubMed

    Vemuri, Anant Suraj; Nicolau, Stephane; Sportes, Adrien; Marescaux, Jacques; Soler, Luc; Ayache, Nicholas

    2016-09-01

    Barrett's oesophagus, a premalignant condition of the oesophagus has been on a rise in the recent years. The standard diagnostic protocol for Barrett's involves obtaining biopsies at suspicious regions along the oesophagus. The localization and tracking of these biopsy sites "interoperatively" poses a significant challenge for providing targeted treatments and tracking disease progression. This paper proposes an approach to provide guided navigation and relocalization of the biopsy sites using an electromagnetic tracking system. The characteristic of our approach over existing ones is the integration of an electromagnetic sensor at the flexible endoscope tip, so that the endoscopic camera depth inside the oesophagus can be computed in real time, allowing to retrieve and display an image from a previous exploration at the same depth. We first describe our system setup and methodology for interoperative registration. We then propose three incremental experiments of our approach. First, on synthetic data with realistic noise model to analyze the error bounds of our system. The second on in vivo pig data using an optical tracking system to provide a pseudo ground truth. Accuracy results obtained were consistent with the synthetic experiments despite uncertainty introduced due to breathing motion, and remain inside acceptable error margin according to medical experts. Finally, a third experiment designed using data from pigs to simulate a real task of biopsy site relocalization, and evaluated by ten gastro-intestinal experts. It clearly demonstrated the benefit of our system toward assisted guidance by improving the biopsy site retrieval rate from 47.5% to 94%.

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

    SciTech Connect

    Laredo, Jean-Denis, E-mail: jean-denis.laredo@lrb.aphp.fr; 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. Themore » 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.« less

  19. Maladie des vibrations

    PubMed Central

    Shen, Shixin (Cindy); House, Ronald A.

    2017-01-01

    Résumé Objectif Permettre aux médecins de famille de comprendre l’épidémiologie, la pathogenèse, les symptômes, le diagnostic et la prise en charge de la maladie des vibrations, une maladie professionnelle importante et courante au Canada. Sources d’information Une recherche a été effectuée sur MEDLINE afin de relever les recherches et comptes rendus portant sur la maladie des vibrations. Une recherche a été effectuée sur Google dans le but d’obtenir la littérature grise qui convient au contexte canadien. D’autres références ont été tirées des articles relevés. Message principal La maladie des vibrations est une maladie professionnelle répandue touchant les travailleurs de diverses industries qui utilisent des outils vibrants. La maladie est cependant sous-diagnostiquée au Canada. Elle compte 3 éléments : vasculaire, sous la forme d’un phénomène de Raynaud secondaire; neurosensoriel; et musculosquelettique. Aux stades les plus avancés, la maladie des vibrations entraîne une invalidité importante et une piètre qualité de vie. Son diagnostic exige une anamnèse minutieuse, en particulier des antécédents professionnels, un examen physique, des analyses de laboratoire afin d’éliminer les autres diagnostics, et la recommandation en médecine du travail aux fins d’investigations plus poussées. La prise en charge consiste à réduire l’exposition aux vibrations, éviter les températures froides, abandonner le tabac et administrer des médicaments. Conclusion Pour assurer un diagnostic rapide de la maladie des vibrations et améliorer le pronostic et la qualité de vie, les médecins de famille devraient connaître cette maladie professionnelle courante, et pouvoir obtenir les détails pertinents durant l’anamnèse, recommander les patients aux cliniques de médecine du travail et débuter les demandes d’indemnisation de manière appropriée. PMID:28292812

  20. [Renal biopsy findings in diabetes mellitus].

    PubMed

    Kharrat, Mahmoud; Kammoun, Khawala; Charfeddine, Khaled; Yaich, Soumaya; Zaghdene, Saoussen; Chaker, Hanene; Jarraya, Faiçal; Ben Hmida, Mohamed; Jlidi, Rachid; Hachicha, Jamil

    2007-03-01

    The prevalence of diabetic patients with endstage renal disease is increased overall the word. Renal biopsy is sometimes necessary to precise the type of renal damage. To precise the type and the frequency of non diabetic nephropathy in diabetic patients. We enrolled retrospectively during 17 years, 72 diabetic patients who had a renal biopsy. A non diabetic nephropathy was found in 69.5 % of them. Its presence was correlate to the presence of hematuria and the absence of diabetic retinopathy. We can successfully treated nine patients with minimal-change nephrotic syndrome and one patient with crescentic glomerulonephritis. Renal biopsy must be done in diabetic patient with hematuria or in the absence of diabetic retinopathy.

  1. Radiofrequency Cauterization with Biopsy Introducer Needle

    PubMed Central

    Pritchard, William F.; Wray-Cahen, Diane; Karanian, John W.; Hilbert, Stephen; Wood, Bradford J.

    2014-01-01

    PURPOSE The principal risks of needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. This study compared hemorrhage after liver and kidney biopsy with and without radiofrequency (RF) ablation of the needle tract. MATERIALS AND METHODS Biopsies of liver and kidney were performed in swine through introducer needles modified to allow RF ablation with the distal 2 cm of the needle. After each biopsy, randomization determined whether the site was to undergo RF ablation during withdrawal of the introducer needle. Temperature was measured with a thermistor stylet near the needle tip, with a target temperature of 70°C–100°C with RF ablation. Blood loss was measured as grams of blood absorbed in gauze at the puncture site for 2 minutes after needle withdrawal. Selected specimens were cut for gross examination. RESULTS RF ablation reduced bleeding compared with absence of RF ablation in liver and kidney (P < .01), with mean blood loss reduced 63% and 97%, respectively. Mean amounts of blood loss (±SD) in the liver in the RF and no-RF groups were 2.03 g ± 4.03 (CI, 0.53–3.54 g) and 5.50 g ± 5.58 (CI, 3.33–7.66 g), respectively. Mean amounts of blood loss in the kidney in the RF and no-RF groups were 0.26 g ± 0.32 (CI, −0.01 to 0.53 g) and 8.79 g ± 7.72 (CI, 2.34–15.24 g), respectively. With RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed. CONCLUSION RF ablation of needle biopsy tracts reduced hemorrhage after biopsy in the liver and kidney and may reduce complications of hemorrhage as well as implantation of tumor cells in the tract. PMID:14963187

  2. Indication for peritoneal biopsy in tuberculous peritonitis.

    PubMed

    Chow, Kai Ming; Chow, Viola Chi-Ying; Szeto, Cheuk Chun

    2003-06-01

    With the introduction of effective antituberculous chemotherapy, the clinical outcome of tuberculous peritonitis depends much on the diagnostic accuracy of this disease entity. This review summarizes the current state-of-the-art thinking regarding the protean manifestation and diagnostic modalities of this major infectious disease. This review was compiled after an extensive search of the current and historical literature, comprising 1,070 cases of tuberculous peritonitis. A number of important areas were highlighted, with emphasis on the diagnostic value and clinical impact of peritoneal biopsy. We believe an aggressive diagnostic approach, particularly with peritoneal biopsy, is warranted for the diagnosis and timely treatment of tuberculous peritonitis.

  3. Technique of the sural nerve biopsy.

    PubMed

    Bevilacqua, Nicholas J; Rogers, Lee C; Malik, Rayaz A; Armstrong, David G

    2007-01-01

    A sural nerve biopsy may be useful to enable the clinician to diagnose the etiology and underlying pathology of patients presenting with symptoms of a peripheral neuropathy, when no clear underlying cause has been determined with conventional assessment such as electrophysiology or quantitative sensory testing. Given the prevalence of lower extremity neurological pathology, it is surprising that few descriptions in the peer-reviewed medical literature exist on the rationale and technique for biopsy of the sural nerve. We review the usefulness of this procedure, describe the technique, and discuss the potential complications.

  4. Etiologies des pleurésies exsudatives: à propos de 424 cas à Madagascar

    PubMed Central

    Rakotoson, Joëlson Lovaniaina; Andrianasolo, Radonirina Lazasoa; Rakotomizao, Robert Jocelyn; Vololontiana, Marie Danielle Hanta; Ravahatra, Kiady; Rajaoarifetra, Jobeline; Andrianarisoa, Christophe Félix Ange

    2011-01-01

    Introduction La pleurésie constitue un motif fréquent de consultation en pneumologie. Notre travail a pour objectif de déterminer les étiologies des pleurésies exsudatives afin d'en faciliter les démarches étiologiques. Méthodes Il s'agit d'une étude rétrospective réalisée chez des patients ayant une pleurésie exsudative et bénéficiant une biopsie pleurale à l'aveugle à l'aide de l'aiguille de Castelain, pendant une période de 5 ans (2005 à 2009). Résultats Parmi les 424 patients inclus, 259 hommes (61,08%) et 165 femmes (38,91%) étaient individualisés. Les pleurésies étaient d'origine tuberculeuse dans 298 cas (70, 28%), métastatique dans 63 cas (14,85%), inflammation non spécifique dans 51 cas (12,02%). Des fibres musculaires striées étaient biopsiées dans 12 cas (2,83%). Conclusion La biopsie pleurale occupe une place prépondérante dans la recherche étiologique des pleurésies d'exsudatives à Madagascar où la tuberculose sévit encore en mode endémique. PMID:22145067

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

    NASA Astrophysics Data System (ADS)

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

    2017-03-01

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

  6. Endometrial biopsy in Holstein-Friesian dairy cows. I. Technique, histological criteria and results.

    PubMed Central

    Bonnett, B N; Miller, R B; Etherington, W G; Martin, S W; Johnson, W H

    1991-01-01

    Endometrial biopsies were taken for histological assessment from 97 cows which calved in a commercial dairy herd between April and August 1984. Sixty-two cows were biopsied at both day 26 and 40 postpartum, 23 cows at only day 26, and 12 at day 40 only. Subjective and quantitative histological criteria were assessed. Ninety-five percent of biopsies were adequate for at least subjective assessment. The distribution of criteria within each horn-day category, as well as combined readings by day and by gravid or nongravid horn were computed and significant differences noted. There was more severe inflammation and more segmented cells at day 26 than 40 postpartum, and in the gravid compared to the nongravid horn. The distribution patterns for the criteria examined provide an overview of histological characteristics in this group of postpartum cows. PMID:1884295

  7. 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

  8. Implementing a Cervical Sentinel Lymph Node Biopsy Program: Quality Improvement in Gynaecologic Oncology.

    PubMed

    Cusimano, Maria C; Walker, Rachel; Bernardini, Marcus Q; Bouchard-Fortier, Geneviève; Laframboise, Stephane; May, Taymaa; Murphy, Joan; Rosen, Barry; Covens, Al; Clarke, Blaise; Shaw, Patricia; Rouzbahman, Marjan; Mohan, Ravi; Ferguson, Sarah E

    2017-08-01

    Sentinel lymph node (SLN) biopsy is becoming a reasonable alternative to pelvic lymphadenectomy in early-stage cervical cancer. It is therefore imperative that centres without prior experience are able to successfully implement the procedure. The objectives of the current study were to (1) describe the process of implementing an SLN biopsy program with a novel peer mentorship component and (2) assess post-program quality improvement metrics, including SLN detection rate (DR) and diagnostic parameters. An institutional SLN biopsy protocol was developed collaboratively by gynaecologic oncology, nuclear medicine, and pathology departments at University Health Network, Toronto, Ontario. All decisions were based on the best evidence available. Newly diagnosed, early-stage cervical cancer patients undergoing primary surgery were then recruited prospectively for SLN biopsy with combined technique, followed by pelvic lymphadenectomy to evaluate key quality indicators, including SLN DR, sensitivity, and negative predictive value. Surgeons with previous SLN biopsy experience mentored surgeons unfamiliar with the technique. Interim analyses and multidisciplinary rounds were regularly carried out to identify failures of technique or protocol. Thirty-nine patients (median age 42) were enrolled in the study between August 2010 and February 2014. The median number of SLNs and total pelvic lymph nodes removed per patient were 3 and 19, respectively. SLN DRs were 92% per patient (36/39), 88.5% per hemipelvis (69/78), and 85% bilaterally (33/39). SLN biopsy correctly identified seven of eight hemipelvises with nodal metastases, yielding a sensitivity of 88% (95% CI 0.47 to 1.00) and a false negative rate of 12% (95% CI 0 to 0.53). Surgeons undergoing peer mentorship (n = 3) performed as effectively (DR 100%) as surgeons (n = 2) with prior experience (DR 85%). This study provides a model upon which other centres can adopt and validate cervical SLN biopsy. High SLN DRs and accurate

  9. Volcanisme, activité anthropique et circulation des masses océaniques : leur influence respective sur la distribution des populations d'ostracodes dans la baie de Kagoshima (île de Kyushu, Japon)Impact of volcanism, human activities, and water mass circulation on the distribution of ostracod populations in Kagoshima Bay (Kyushu Island, southern Japan)

    NASA Astrophysics Data System (ADS)

    Bodergat, Anne-Marie; Oki, Kimihiko; Ishizaki, Kunihiro; Rio, Michel

    2002-11-01

    The distribution of ostracod populations in Kagoshima Bay (Japan) is analysed with reference to different environmental parameters. The bay is an area of volcanic activity of Sakurajima volcano under the influence of the Kuroshio Current. Most of the Head environment is occupied by an acidic water mass. Numbers of individual and species decrease from the Mouth of the bay towards the Basin and Head environments. In this latter, acidic water mass has a drastic effect on ostracod populations, whereas volcanic ashes and domestic inputs are not hostile. Ostracod distribution is influenced by the quality and structure of water masses. To cite this article: A.-M. Bodergat et al., C. R. Geoscience 334 (2002) 1053-1059.

  10. 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

  11. Novel pathogenic mutations and skin biopsy analysis in Knobloch syndrome.

    PubMed

    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

    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. 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. 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. 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.

  12. 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.

  13. 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

  14. Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps

    PubMed Central

    Lim, Chul-Hyun; Kim, Won Chul; Kim, Jin Soo; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong; Chung, In-Sik

    2012-01-01

    Background/Aims It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy. Methods Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue. Results Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps. Conclusions Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered. PMID:22741133

  15. Comparison of Keyes Punch Biopsy Instrument with Cervical Punch Biopsy Forceps for Diagnosing Cervical Lesions.

    PubMed

    Tyagi, Natasha; Suneja, Amita; Mishra, Kiran; Jain, Sandhya; Vaid, Neelam Bala; Guleria, Kiran

    2017-01-01

    To assess the feasibility and efficacy of Keyes punch biopsy instrument (KP) in diagnosing cervical lesions and compare it with cervical punch biopsy forceps (CP). 75 women having satisfactory colposcopy with abnormal transformation zone were included and paired colposcopic directed biopsies were taken using KP followed by CP from the same target area. It was feasible in all cases to take cervical biopsy with KP after increasing its effective length. The volume of gross specimen obtained by KP was less than CP (0.076 ± 0.097 vs. 0.101 ± 0.156 cm3, p = 0.061), however on microscopic examination, mean length and mean depth of tissue in KP was greater than CP by 0.06 mm (p = 0.810) and 0.14 mm (p = 0.634) respectively. Exact agreement was found with the final surgical specimen in 42% of cases in both the biopsy forceps. KP is almost at par with CP for diagnosing preinvasive cervical lesions and is a useful adjunct to the existing armamentarium of biopsy forceps. © 2016 S. Karger AG, Basel.

  16. Systemic Air Embolism After CT-guided Lung Biopsy

    ClinicalTrials.gov

    2017-11-27

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

  17. 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

  18. Cervical cancer biopsy reporting: a review.

    PubMed

    Reyes, Maria Carolina; Cooper, Kumarasen

    2014-01-01

    The terminology for reporting human papillomavirus-associated squamous lesions in the cervix, both in tissue samples and cytology specimens, has suffered from many changes throughout the last years creating confusion in interpreting cervical biopsy and cytology reports by clinicians. This review presents a summary and discussion of the current terminology for reporting results of cervical biopsies and cytology with emphasis in the lower anogenital squamous terminology consensus recommendations for tissue specimens and the 2001 Bethesda Workshop for reporting cytology results. Microscopic features of cervical lesions in tissue samples and cytology specimens are presented. Biomarkers, including p16 and Ki-67, are discussed and how they can help the pathologist when dealing with difficult cases.

  19. Refining the 'cucumber' technique for laryngeal biopsy.

    PubMed

    Robertson, S; Cooper, L; McPhaden, A; MacKenzie, K

    2011-06-01

    To refine the case selection process for the 'cucumber' mounting system for laryngeal biopsies. We conducted a retrospective audit of cucumber technique specimens taken between January 2002 and December 2008. We analysed the clinical indications for biopsy and the pathological diagnosis, for each specimen, in order to inform our case selection process. The cucumber technique was used for 125 laryngeal specimens. 60 specimens were taken for diagnostic sampling, 46 were taken during endoscopic laser resection, and 19 for overtly benign pathology. The cucumber technique was most useful for the interpretation of margins in endoscopic laser resection specimens. The cucumber technique is most useful for endoscopic resection cases in which tumour, dysplasia or suspicious lesions have been excised. Detailed information on resection margins is invaluable during multidisciplinary team discussions on patient management. Detailed photography of mounted specimens enables both laryngologist and pathologist to orientate and interpret specimens accurately.

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

    PubMed

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

    2017-07-01

    To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P < 0.001). For ultrasound guided-fine needle aspiration, gender, age, size, presence of vascularity, and suspicious US features were not associated with post-biopsy hematoma according to experience level. Post-biopsy hematoma occurred significantly more with ultrasound guided-core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P < 0.001) in experienced performers and ultrasound guided-core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P < 0.001). Post-biopsy hematoma occurred significantly more in ultrasound guided-core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

  1. Robotic Prostate Biopsy in Closed MRI Scanner

    DTIC Science & Technology

    2009-02-01

    radioactive seeds or diagnosis by harvesting tissue samples inside the mag- net bore, under remote control of the physician without mov- ing the patient out...and allows fast removal for reloading brachytherapy needles or col- lecting harvested biopsy tissue. The primary actuated motions of the robot...include two prismatic motions and two rotational motions for aligning the needle axis. In addition to these base motions, application-specific motions are

  2. Analysis of bronchial biopsies in chronic cough.

    PubMed

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

    2017-06-01

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

  3. Liquid biopsy for lung cancer early detection

    PubMed Central

    Liguori, Alessia; D’Aveni, Alessandro; Karachaliou, Niki; Gonzalez-Cao, Maria; Daffinà, Maria Grazia; Lazzari, Chiara; Altavilla, Giuseppe; Rosell, Rafael

    2018-01-01

    Molecularly targeted therapies and immune checkpoint inhibitors have markedly improved the therapeutic management of advanced lung cancer. However, it still remains the leading cause of cancer-related mortality worldwide, with disease stage at diagnosis representing the main prognostic factor. Detection of lung cancer at an earlier stage of disease, potentially susceptible of curative resection, can be critical to improve patients survival. Low-dose computed tomography (LDCT) screening of high-risk patients has been demonstrated to reduce mortality from lung cancer, but can be also associated with high false-positive rate, thus often resulting in unnecessary interventions for patients. Novel sensitive and specific biomarkers for identification of high-risk subjects and early detection that can be used alternatively and/or complement current routine diagnostic procedures are needed. Liquid biopsy has recently demonstrated its clinical usefulness in advanced NSCLC as a surrogate of tissue biopsy for noninvasive assessment of specific genomic alterations, thereby providing prognostic and predictive information. Different biosources from liquid biopsy, including cell free circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes and tumor-educated platelets (TEPs), have also been widely investigated for their potential role in lung cancer diagnosis. This review will provide an overview on the circulating biomarkers being evaluated for lung cancer detection, mainly focusing on results from most recent studies, the techniques developed to perform their assessment in blood and other biologic fluids and challenges in their clinical applications. PMID:29780635

  4. Liquid biopsy for lung cancer early detection.

    PubMed

    Santarpia, Mariacarmela; Liguori, Alessia; D'Aveni, Alessandro; Karachaliou, Niki; Gonzalez-Cao, Maria; Daffinà, Maria Grazia; Lazzari, Chiara; Altavilla, Giuseppe; Rosell, Rafael

    2018-04-01

    Molecularly targeted therapies and immune checkpoint inhibitors have markedly improved the therapeutic management of advanced lung cancer. However, it still remains the leading cause of cancer-related mortality worldwide, with disease stage at diagnosis representing the main prognostic factor. Detection of lung cancer at an earlier stage of disease, potentially susceptible of curative resection, can be critical to improve patients survival. Low-dose computed tomography (LDCT) screening of high-risk patients has been demonstrated to reduce mortality from lung cancer, but can be also associated with high false-positive rate, thus often resulting in unnecessary interventions for patients. Novel sensitive and specific biomarkers for identification of high-risk subjects and early detection that can be used alternatively and/or complement current routine diagnostic procedures are needed. Liquid biopsy has recently demonstrated its clinical usefulness in advanced NSCLC as a surrogate of tissue biopsy for noninvasive assessment of specific genomic alterations, thereby providing prognostic and predictive information. Different biosources from liquid biopsy, including cell free circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes and tumor-educated platelets (TEPs), have also been widely investigated for their potential role in lung cancer diagnosis. This review will provide an overview on the circulating biomarkers being evaluated for lung cancer detection, mainly focusing on results from most recent studies, the techniques developed to perform their assessment in blood and other biologic fluids and challenges in their clinical applications.

  5. [Stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain].

    PubMed

    Qin, F; Huang, Z C; Cai, M Q; Xu, X F; Lu, T T; Dong, Q; Wu, A M; Lu, Z Z; Zhao, C; Guo, Y

    2018-06-12

    Objective: To investigate the value of stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain. Methods: A total of 29 consecutive patients who underwent stereotactic biopsy of brainstem and deep brain lesions between May 2012 and January 2018 were retrospectively reviewed. The Cosman-Roberts-Wells (CRW) stereotactic frame was installed under local anesthesia. Thin-layer CT and MRI scanning were performed. Target coordinates were calculated by inputting CT-MRI data into the radionics surgical planning system. The individualized puncture path was designed according to the location of the lesions and the characteristics of the image. Target distributions were as follows: 12 cases of midbrain or pons, 2 cases of internal capsule, 3 cases of thalamus, 12 cases of basal ganglia. The biopsy samples were used for further pathological and/or genetic diagnosis. Results: Twenty-eight of the 29 cases (96.6%) were diagnosed accurately by histopathology and genomic examination following stereotactic biopsy. Pathological results were as follows: 8 cases of lymphoma, 7 cases of glioma, 4 cases of demyelination, 2 cases of germ cell tumor, 2 cases of metastatic tumor, 1 cases of cerebral sparganosis, 1 case of tuberculous granuloma, 1 case of hereditary prion disease, 1 case of glial hyperplasia, 1 case of leukemia. The accurate diagnosis of one case required a combination of histopathology and genomic examination. Undefined diagnosis was still made in 1 cases (3.45%) after biopsy. After biopsy, there were 2 cases (6.9%) with symptomatic slight hemorrhage, 1 case (3.45%) with symptomatic severe hemorrhage, and 1 cass (3.45%) with permanent neurological dysfunction. No one died because of surgery or surgical complications. Conclusions: Stereotactic biopsy is fast, safe and minimally invasive. It is an ideal strategy for accurate diagnosis of lesions in brain stem and deep brain.

  6. Comparison of Transjugular Liver Biopsy and Percutaneous Liver Biopsy With Tract Embolization in Pediatric Patients.

    PubMed

    Tulin-Silver, Sheryl; Obi, Chrystal; Kothary, Nishita; Lungren, Matthew

    2018-03-05

    The aim of the study was to compare safety and efficacy of transjugular liver biopsy (TJLB) and percutaneous liver biopsy (PLB) with tract embolization in pediatric patients with liver disease. TJLB and PLB between December 2009 and October 2015 were retrospectively reviewed. Primary endpoints were adequate sampling and complication rate. Patient age, weight, coagulation factors, ascites, blood transfusions, adequacy of biopsy sample, number of biopsy samples, and complications were compared. There were 39 TJLB (average age 10.6 years) and 120 PLB (average age 7.1 years) (P value <0.05). Average weight was 40.2 kg for TJLB and 26.8 kg for PLB (P value <0.05). Average platelets were 155 for TJLB and 252 for PLB (P value <0.05). Average INR was 1.7 for TJLB and 1.3 for PLB (P value <0.05). Mean postbiopsy hematocrit decrease was 0.8 and 0.9, for TJLB and PLB, respectively. Mean postbiopsy hemoglobin decrease was 0.3 in both groups. Number of core biopsy samples was 4.5 and 4.3, for TJLB and PLB, respectively. There was 1 biopsy yielding insufficient sample in each group. TJLB had 1 (2.6%) complication of supraventricular tachycardia. PLB had 4 (3.3%) complications, with 1 hemoperitoneum, 1 hypotension, 1 patient with decreased hemoglobin, and 1 patient with bilious drainage from the biopsy site. TJLB and PLB with gelatin sponge pledget tract embolization are both safe and effective for the diagnosis of hepatic disease in pediatric patients. To avoid radiation, PLB may be considered as first-line approach in the pediatric population, even in the setting of coagulopathy.

  7. Transcutaneous pleural biopsy with a retrograde forceps: a novel approach.

    PubMed

    Wiewiorski, Martin; Hiebinger, Andreas; Hoechel, Sebastian; Müller-Gerbl, Magdalena; Barg, Alexej; Valderrabano, Victor; Hügle, Thomas

    2016-01-01

    Pleural biopsies are commonly performed to investigate the cause of exudative pleural effusion. Biopsy needles (e.g. Abrams needle, Cope needle) are traditionally used to perform the biopsy. However, certain complications such as pneumothorax and haemothorax have been described. We present a technique utilizing a novel retrograde forceps, which could improve the simplicity and lower the complication rate of performing closed pleural biopsies. A retrograde forceps (Retroforceps, Karl Storz, Tuttlingen, Germany) was used to perform 20 transcutaneous pleural biopsies in a cadaver thorax under thoracoscopical control. Video documentation of the procedure from outside and inside the thorax was performed. The surgeon performing the biopsy was blinded to the thoracoscopical view. After the removal of the forceps, it was checked whether biopsy material was retrieved. The video material was retrospectively used to confirm whether the biopsy was taken from the pleura parietalis. Biopsy material was retrieved in 19 out of 20 biopsy attempts. Video material confirmed that the biopsy was taken from the pleura parietalis in all cases. Using a retrograde biopsy forceps is a simple and practicable procedure suitable for clinical application. This technique could potentially reduce the incidence of pneumothorax.

  8. Low-cost phantom for stereotactic breast biopsy training.

    PubMed

    Larrison, Matthew; DiBona, Alex; Hogg, David E

    2006-10-01

    This article reports on the construction of a low-cost phantom to be used for training technologists, residents, and radiologists to perform stereotactic breast biopsy. The model is adaptable to a variety of biopsy devices and realistically simulates the aspects of stereotactic breast biopsy. We believe our model provides an excellent alternative to more expensive commercial products.

  9. La microscopie ionique analytique des tissus biologiques

    NASA Astrophysics Data System (ADS)

    Galle, P.

    Proposed in 1960 by R. Castaing and G. Slodzian, secondary ion emission microanalysis is a microanalytical method which is now largely used for the study of inert material. The instrument called the analytical ion microscope can also be used for the study of biological spécimens ; images representing the distribution of a given stable or radioactive isotope in a tissue section are obtained with a resolution of 0.5 μm. Among the characteristics of this method, two are of particular interest in biological research : its capacity for isotopic analysis and its very high sensitivity which makes possible for the first time a chemical analysis of element at a very low or even at a trace concentration in a microvolume. Proposé en 1960 par R. Castaing et G. Slodzian, la microanalyse par émission ionique secondaire est une méthode qui permet, entre autre, d'obtenir des images représentant la distribution des isotopes présents à la surface d'un échantillon solide avec une résolution de 0,5 μm. D'intérêt très général, cette méthode a été d'abord largement utilisée pour l'étude des matériaux inertes. Elle offre en outre des possibilités entièrement nouvelles dans le domaine de la recherche biomédicale. L'instrument réalisé, le microscope ionique analytique présente deux caractéristiques particulièrement intéressantes pour la biologie : la possibilité d'analyse isotopique, et l'extrême sensibilité permettant de détecter et de localiser dans une coupe histologique des éléments à des concentrations très faibles voire à l'état de trace.

  10. Analysis of gingival biopsies in the Gujarati population: a retrospective study.

    PubMed

    Manjunatha, Bhari Sharanesha; Sutariya, Rakesh; Nagamahita, V; Dholia, Bhavik; Shah, Vandana

    2014-01-01

    Biopsy is an important diagnostic tool used in the diagnosis of lesions ranging from simple non-neoplastic, tumor-like lesions to malignancies, and is often the only way to diagnose oral lesions and diseases. The gingiva is the most common site for some kind of irritation or low-grade injury, resulting in localized overgrowths that are considered to be reactive and non-neoplastic lesions. This aim of this study is to analyze the frequency and distribution of gingival lesions in the Gujarati population. In this retrospective study, gingival biopsies submitted for a period of five years were included. Microscopic slides of all the cases were reviewed by two observers for confirmation of the diagnosis. Among the 106 cases of gingival biopsies, the most frequent category of lesions encountered was the non-neoplastic category, which accounted for 73.58% of the cases. Both benign and malignant neoplasms constituted 26.42% of the cases. Among the non-neoplastic lesions, Pyogenic granuloma was the most frequent lesion (38.46%), followed by fibrous hyperplasia (20.51%), inflammatory hyperplasia (19.23%), and Epulis (8.97%). Neoplasms accounted for 26.42% of the gingival biopsies (92.85% benign and 7.15% malignant). Among the benign neoplastic lesions, Fibroma (30.76%) and Fibrolipoma (26.92%) were the most frequent, followed by peripheral ossifying fibroma (23.08%) and peripheral giant cell granuloma (11%). It is difficult to compare studies carried out in various countries due to differences in people's attitudes toward oral health and the accessibility of various population groups to biopsy services. Nevertheless, this study has provided some information about the frequency and distribution of biopsied gingival lesions in the Gujarati population over a period of five years.

  11. Randomized in vitro and in vivo evaluation of different biopsy needles and devices for breast biopsy.

    PubMed

    Helbich, T H; Rudas, M; Böhm, G; Huber, S; Wagner, T; Taucher, S; Wolf, G; Mostbeck, G H

    1999-01-01

    In an experimental study (in vitro and in vivo) we evaluated the efficacy of various biopsy needles/devices for breast biopsy. In vitro, biopsies of five human cadaveric breast specimens were performed using 33 different needles/devices ranging from 14 to 20-gauge. Of these 33 needles/devices, 22 optimally performing needles were selected for the in vivo study. In the clinical part of the study, 44 breast lesions were randomly biopsied with each of the 22 needles/devices under stereotactic guidance. Tissue specimens were analysed quantitatively and qualitatively. Several automatic long-throw guns (Acecut, Asap, Biopty, Magnum) obtained greater tissue areas and had a better histopathologic score than the conventional type of a side-notch needle like Trucut, an aspiration needle like Surecut, or an end-cut needle like Autovac. The automatic long-throw guns performed better than the short-throw Monopty gun. Regardless of needle size (14-20-gauge), breast biopsies should be routinely performed with automated long-throw side-notch guns (Acecut, Asap, Biopty, Magnum).

  12. Isolation of Mycobacterium massiliense from a corneal biopsy in India.

    PubMed

    Kulandai, Lily Therese; Lakshmipathy, Dhanurekha; Ramasubban, Gayathri; Rao, Madhavan Hajib Narahari

    2014-12-01

    Rapidly growing mycobacteria (RGM) are ubiquitous and are usually considered as saprophytes, and have been recovered from the environment, particularly in dust, watery soil and water distribution systems. However, Mycobacterium massiliense is a rare causative agent of ocular infection. We report a case of M. massiliense in a 44-year-old female with signs and symptoms of a corneal ulcer. We carried out PCR-based DNA sequencing targeting the hsp 65 gene for the identification of M. massiliense . To confirm the identification, we also performed PCR-based RFLP targeting the hsp65 gene and PCR-based DNA sequencing targeting the internal transcribed spacer region, which showed 97 % nucleotide identity with M. massiliense . To the best of our knowledge, this is the first study in India to report the detection of M. massiliense from a corneal biopsy.

  13. Multi-institutional Evaluation of Upper Urinary Tract Biopsy Using Backloaded Cup Biopsy Forceps, a Nitinol Basket, and Standard Cup Biopsy Forceps.

    PubMed

    Lama, Daniel J; Safiullah, Shoaib; Patel, Roshan M; Lee, Thomas K; Balani, Jyoti P; Zhang, Lishi; Okhunov, Zhamshid; Margulis, Vitaly; Savage, Stephen J; Uchio, Edward; Landman, Jaime

    2018-04-06

    To compare the performance of 3 contemporary ureteroscopic biopsy devices for the histopathologic diagnosis of upper tract urothelial carcinoma (UTUC). We retrospectively reviewed 145 patients who underwent 182 urothelial biopsies using 2.4F backloaded cup biopsy forceps, a nitinol basket, or 3F standard cup biopsy forceps at 3 tertiary academic centers between 2011 and 2016. Experienced genitourinary pathologists provided an assessment of each specimen without knowledge of the device used for biopsy. For patients who underwent nephroureterectomy without neoadjuvant chemotherapy within 3 months of biopsy-proven UTUC diagnosis, the biopsy grade was compared with both the grade and stage of the surgical specimen. Biopsy utilization varied among the 3 institutions (P <.0001). Significant variabilities in specimen size (P = .001), the presence of intact urothelium (P = .008), and crush artifact (P = .028) were found among the biopsy devices. The quality of specimens from backloaded cup forceps was rated similarly to the nitinol basket (P >.05) and was favored over standard cup forceps specimens. Grade concordance was not affected by specimen size (P >.05), morphology (P >.1), or location (P >.5). No difference existed among the devices in the rate of acquiring a grade concordant biopsy; however, the backloaded cup forceps provided concordant biopsies that could be distinguished as low- and high-grade (P = .02). The backloaded cup forceps and nitinol basket obtained a higher quality urothelial specimen compared with standard cup forceps. Ureteroscopic biopsy device selection did not significantly impact the accuracy of the histologic diagnosis of UTUC. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. [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.

  15. Grundlagen des Tissue Engineering

    NASA Astrophysics Data System (ADS)

    Mayer, Jörg; Blum, Janaki; Wintermantel, Erich

    Die Organtransplantation stellt eine verbreitete Therapie dar, um bei krankheitsoder unfallbedingter Schädigung eines Organs die Gesamtheit seiner Funktionen wieder herzustellen, indem es durch ein Spenderorgan ersetzt wird. Organtransplantationen werden für die Leber, die Niere, die Lunge, das Herz oder bei schweren grossflächigen Verbrennungen der Haut vorgenommen. Der grosse apparative, personelle und logistische Aufwand und die Risiken der Transplantationschirurgie (Abstossungsreaktionen) sowie die mangelnde Verfügbarkeit von immunologisch kompatiblen Spenderorganen führen jedoch dazu, dass der Bedarf an Organtransplantaten nur zu einem sehr geringen Teil gedeckt werden kann. Sind Spenderorgane nicht verfügbar, können in einzelnen Fällen lebenswichtige Teilfunktionen, wie beispielsweise die Filtrationsfunktion der Niere durch die Blutreinigung mittels Dialyse ersetzt oder, bei mangelnder Funktion der Bauchspeicheldrüse (Diabetes), durch die Verabreichung von Insulin ein normaler Zustand des Gesamtorganismus auch über Jahre hinweg erhalten werden. Bei der notwendigen lebenslangen Anwendung apparativer oder medikamentöser Therapie können für den Patienten jedoch häufig schwerwiegende, möglicherweise lebensverkürzende Nebenwirkungen entstehen. Daher werden in der Forschung Alternativen gesucht, um die Funktionen des ausgefallenen Organs durch die Implantation von Zellen oder in vitro gezüchteten Geweben möglichst umfassend wieder herzustellen. Dies erfordert biologisch aktive Implantate, welche die für den Stoffwechsel des Organs wichtigen Zellen enthalten und einen organtypischen Stoffwechsel entfalten.

  16. Transthoracic needle biopsy of the lung

    PubMed Central

    DiBardino, David M.; Yarmus, Lonny B.

    2015-01-01

    Background Image guided transthoracic needle aspiration (TTNA) is a valuable tool used for the diagnosis of countless thoracic diseases. Computed tomography (CT) is the most common imaging modality used for guidance followed by ultrasound (US) for lesions abutting the pleural surface. Novel approaches using virtual CT guidance have recently been introduced. The objective of this review is to examine the current literature for TTNA biopsy of the lung focusing on diagnostic accuracy and safety. Methods MEDLINE was searched from inception to October 2015 for all case series examining image guided TTNA. Articles focusing on fluoroscopic guidance as well as influence of rapid on-site evaluation (ROSE) on yield were excluded. The diagnostic accuracy, defined as the number of true positives divided by the number of biopsies done, as well as the complication rate [pneumothorax (PTX), bleeding] was examined for CT guided TTNA, US guided TTNA as well as CT guided electromagnetic navigational-TTNA (E-TTNA). Of the 490 articles recovered 75 were included in our analysis. Results The overall pooled diagnostic accuracy for CT guided TTNA using 48 articles that met the inclusion and exclusion criteria was 92.1% (9,567/10,383). A similar yield was obtained examining ten articles using US guided TTNA of 88.7% (446/503). E-TTNA, being a new modality, only had one pilot study citing a diagnostic accuracy of 83% (19/23). Pooled PTX and hemorrhage rates were 20.5% and 2.8% respectively for CT guided TTNA. The PTX rate was lower in US guided TTNA at a pooled rate of 4.4%. E-TTNA showed a similar rate of PTX at 20% with no incidence of bleeding in a single pilot study available. Conclusions Image guided TTNA is a safe and accurate modality for the biopsy of lung pathology. This study found similar yield and safety profiles with the three imaging modalities examined. PMID:26807279

  17. Magnetic resonance elastography is as accurate as liver biopsy for liver fibrosis staging.

    PubMed

    Morisaka, Hiroyuki; Motosugi, Utaroh; Ichikawa, Shintaro; Nakazawa, Tadao; Kondo, Tetsuo; Funayama, Satoshi; Matsuda, Masanori; Ichikawa, Tomoaki; Onishi, Hiroshi

    2018-05-01

    Liver MR elastography (MRE) is available for the noninvasive assessment of liver fibrosis; however, no previous studies have compared the diagnostic ability of MRE with that of liver biopsy. To compare the diagnostic accuracy of liver fibrosis staging between MRE-based methods and liver biopsy using the resected liver specimens as the reference standard. A retrospective study at a single institution. In all, 200 patients who underwent preoperative MRE and subsequent surgical liver resection were included in this study. Data from 80 patients were used to estimate cutoff and distributions of liver stiffness values measured by MRE for each liver fibrosis stage (F0-F4, METAVIR system). In the remaining 120 patients, liver biopsy specimens were obtained from the resected liver tissues using a standard biopsy needle. 2D liver MRE with gradient-echo based sequence on a 1.5 or 3T scanner was used. Two radiologists independently measured the liver stiffness value on MRE and two types of MRE-based methods (threshold and Bayesian prediction method) were applied. Two pathologists evaluated all biopsy samples independently to stage liver fibrosis. Surgically resected whole tissue specimens were used as the reference standard. The accuracy for liver fibrosis staging was compared between liver biopsy and MRE-based methods with a modified McNemar's test. Accurate fibrosis staging was achieved in 53.3% (64/120) and 59.1% (71/120) of patients using MRE with threshold and Bayesian methods, respectively, and in 51.6% (62/120) with liver biopsy. Accuracies of MRE-based methods for diagnoses of ≥F2 (90-91% [108-9/120]), ≥F3 (79-81% [95-97/120]), and F4 (82-85% [98-102/120]) were statistically equivalent to those of liver biopsy (≥F2, 79% [95/120], P ≤ 0.01; ≥F3, 88% [105/120], P ≤ 0.006; and F4, 82% [99/120], P ≤ 0.017). MRE can be an alternative to liver biopsy for fibrosis staging. 3. Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1268-1275. © 2017

  18. Analysis of costs of transrectal prostate biopsy.

    PubMed

    Fandella, Andrea

    2011-01-01

    Literature reports mortality and morbidity data from prostatic carcinoma which permit a better use of some routine diagnostic tools such as transrectal ultrasound-guided biopsy. The aim of this work is to quantify the overall cost of transrectal ultrasound biopsy of the prostate (TRUSB) and to assess the economic impact of current procedures for diagnosing prostatic carcinoma. The total cost of TRUSB was calculated with reference to 247 procedures performed in 2008. The following cost factors were evaluated: personnel, materials, maintenance/depreciation of the equipment, energy consumption, and hospital overheads. A literature review was also carried out to check if our extrapolated costs corresponded to those of other authors worldwide, and to consider them in the wider framework of the economic effectiveness of strategies for early diagnosis of cancer of the prostate. The overall cost of TRUSB (8 samples) was EUR 249,000, obtained by adding together the costs of: personnel (EUR 160,000); materials (EUR 59,000); equipment maintenance and depreciation (EUR 12,400); energy consumption (EUR0,1); hospital overheads (EUR 17,500). With extended or saturation biopsies the cost increases for the more time needed by pathologists and can be calculated as EUR 300,000. The literature review points out TRUSB as an invasive tool for diagnosing prostatic carcinoma, clinically and economically controversial. Post-mortem data report the presence of cancer cells in the prostate of 50% of 70-year-old men, while extrapolations calculate a morbidity rate from prostatic carcinoma in 9.5% of 50-year-old men. It is therefore obvious that randomized prostatic biopsies, methods apart, have a good probability of being positive. This probability varies with the patient's age, the level of prostate specific antigen (PSA), the density of PSA/cm3 of prostate volume (PSAD), and the detection by digital exploration and/or positive transrectal ultrasound. CONCLUSIONS. Despite the severe

  19. Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines.

    PubMed

    Feakins, Roger M

    2013-12-01

    Accurate histopathological assessment of biopsies is important for the diagnosis, subclassification, and management of chronic idiopathic inflammatory bowel disease (IBD). British Society of Gastroenterology (BSG) guidelines for the initial histopathological diagnosis of IBD were published in 1997. Changes since then include: more widespread use of full colonoscopy; greater recognition of the effects of time and treatment; improved documentation of variations in anatomical distribution; better understanding of the mimics of IBD; significant progress in clinical management; and modifications of terminology. Accordingly, an update is required. These revised guidelines aim to optimise the quality and consistency of reporting of biopsies taken for the initial diagnosis of IBD by summarising the literature and making recommendations based on the available evidence. Advice from existing clinical guidelines is also taken into account. Among the subjects discussed are: distinguishing IBD from other colitides, particularly infective colitis; subclassification of IBD (as ulcerative colitis, Crohn's disease, or IBD unclassified); the discriminant value of granulomas; aspects of disease distribution, including discontinuity in ulcerative colitis; time-related changes; differences between paediatric and adult IBD; the role of ileal and upper gastrointestinal biopsies; differential diagnoses such as diverticular colitis and diversion proctocolitis; and dysplasia. The need to correlate the histological features with clinical and endoscopic findings is emphasised. An approach to the conclusion of an IBD biopsy report based on the acronym Pattern, Activity, Interpretation, Dysplasia (PAID) is suggested. The key recommendations are listed at the end of the document.

  20. Reticulation des fibres lignocellulosiques

    NASA Astrophysics Data System (ADS)

    Landrevy, Christel

    Pour faire face à la crise économique la conception de papier à valeur ajoutée est développée par les industries papetières. Le but de se projet est l'amélioration des techniques actuelles de réticulation des fibres lignocellulosiques de la pâte à papier visant à produire un papier plus résistant. En effet, lors des réactions de réticulation traditionnelles, de nombreuses liaisons intra-fibres se forment ce qui affecte négativement l'amélioration anticipée des propriétés physiques du papier ou du matériau produit. Pour éviter la formation de ces liaisons intra-fibres, un greffage sur les fibres de groupements ne pouvant pas réagir entre eux est nécessaire. La réticulation des fibres par une réaction de « click chemistry » appelée cycloaddition de Huisgen entre un azide et un alcyne vrai, catalysée par du cuivre (CuAAC) a été l'une des solutions trouvée pour remédier à ce problème. De plus, une adaptation de cette réaction en milieux aqueux pourrait favoriser son utilisation en milieu industriel. L'étude que nous désirons entreprendre lors de ce projet vise à optimiser la réaction de CuAAC et les réactions intermédiaires (propargylation, tosylation et azidation) sur la pâte kraft, en milieu aqueux. Pour cela, les réactions ont été adaptées en milieu aqueux sur la cellulose microcristalline afin de vérifier sa faisabilité, puis transférée à la pâte kraft et l'influence de différents paramètres comme le temps de réaction ou la quantité de réactifs utilisée a été étudiée. Dans un second temps, une étude des différentes propriétés conférées au papier par les réactions a été réalisée à partir d'une série de tests papetiers optiques et physiques. Mots Clés Click chemistry, Huisgen, CuAAC, propargylation, tosylation, azidation, cellulose, pâte kraft, milieu aqueux, papier.

  1. Targeted fascicular biopsy of the sciatic nerve and its major branches: rationale and operative technique.

    PubMed

    Capek, Stepan; Amrami, Kimberly K; Dyck, P James B; Spinner, Robert J

    2015-09-01

    , neurolymphomatosis, amyloidosis, prostate cancer, injury neuroma, neuromuscular choristoma, sarcoidosis, vasculitis, hemangiomatosis, arteriovenous malformation, fibrolipomatous hamartoma (lipomatosis of nerve), and cervical adenocarcinoma. The series included 11 (9.9%) temporary and 5 (4.5%) permanent complications: 3 patients (2.7%) reported permanent numbness in the peroneal division distribution, and 2 patients (1.8%) were diagnosed with neuromuscular choristoma that developed desmoid tumor at the biopsy site 3 and 8 years later. CONCLUSIONS Targeted fascicular biopsy of the sciatic nerve is a safe and efficient diagnostic procedure, and in highly selected cases can be offered as the initial procedure over distal cutaneous nerve biopsy. Diagnoses were very diverse and included entities considered very rare. Even for the more prevalent diagnoses, the biopsy technique allowed a more targeted approach with a higher diagnostic yield and justification for more aggressive treatment. In this series, new radiological patterns of some entities were identified, which could be biopsied less frequently.

  2. Sentinel lymph node biopsy in breast cancer

    PubMed Central

    Alsaif, Abdulaziz A.

    2015-01-01

    Objectives: To report our experience in sentinel lymph node biopsy (SLNB) in early breast cancer. Methods: This is a retrospective study conducted at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between January 2005 and December 2014. There were 120 patients who underwent SLNB with frozen section examination. Data collected included the characteristics of patients, index tumor, and sentinel node (SN), SLNB results, axillary recurrence rate and SLNB morbidity. Results: There were 120 patients who had 123 cancers. Sentinel node was identified in 117 patients having 120 tumors (97.6% success rate). No SN was found intraoperatively in 3 patients. Frozen section results showed that 95 patients were SN negative, those patients had no immediate axillary lymph node dissection (ALND), whereas 25 patients were SN positive and subsequently had immediate ALND. Upon further examination of the 95 negative SN’s by hematoxylin & eosin (H&E) and immunohistochemical staining for doubtful H&E cases, 10 turned out to have micrometastases (6 had delayed ALND and 4 had no further axillary surgery). Median follow up of patients was 35.5 months and the mean was 38.8 months. There was one axillary recurrence observed in the SN negative group. The morbidity of SLNB was minimal. Conclusion: The obtainable results from our local experience in SLNB in breast cancer, concur with that seen in published similar literature in particular the axillary failure rate. Sentinel lymph node biopsy resulted in minimal morbidity. PMID:26318461

  3. Role of biopsy in pediatric lymphadenopathy.

    PubMed

    Hanif, Ghazala; Ali, Shahid I; Shahid, Anum; Rehman, Fakeha; Mirza, Uzma

    2009-06-01

    To determine the role of lymph node biopsy in the diagnosis of lymphadenopathy and to find out the pattern of different diseases in relation to age, gender, and the site of lymph nodes involved. This retrospective study was carried out at the Histopathology Department of the Children's Hospital and The Institute of Child Health, Lahore, Pakistan, over a period of 9 years, from January 1999 to December 2007. Tissue samples were collected from 898 children presenting with lymphadenopathy, and the diagnosis was confirmed on histology and through various specific tests. The clinical data of the patients were collected from computerized hospital records. Among the total 898 consecutive lymph node biopsies, the most common pathology encountered was reactive hyperplasia in 356 children (39.6%), followed by tuberculosis in 262 (29.1%) and malignant lymphomas in 132 children (14.6%). The rest of the lesions include; 72 cases of granulomatous lymphadenitis (8%), 13 of histiocytosis X (1.4%), 44 (4.9%) of metastatic tumors, 16 of chronic inflammation (1.8%), and 3 cases of Kikuchi's disease (0.3%). The cause of lymphadenopathy was found to be significantly associated with age, gender, and site of the lymph nodes involved. Lymphadenopathy is a relatively common condition in the pediatric age group. Although 39.6% of children had reactive hyperplasia of unknown etiology, 60.3% children presented with a specific diagnosis.

  4. [Breast cancer: histological prognosis from biopsy material].

    PubMed

    Veith, F; Picco, C

    1977-01-01

    Two histological factors to be taken into consideration for prognosis in pretreatment schedules of breast cancer have been studied on a group of 352 cases treated by non-mutilating therapeutics at the Fondation Curie between 1960 and 1970. The tumour material the slides of which we have reexamined "blindly", i.e. ignoring the evolution of the case had been obtained mostly by drill-biopsy. Histological groups and types have been determined following an analytical classification for computer purpose. The degree of malignancy was calculated with the method of Scarff-Bloom-Richardson. The analyzed data have been memorized on computer and then confronted with the elements of the T.N.M. classification and the survival of the patients involved. It appeared that if drill-biopsie have been performed correctly the histological type may be defined in eighty percent of cases. And it is likewise possible to calculate the histological grade of malignancy for each mammary cancer. With such a material the value for prognosis by means of the Scarff-Bloom-Richardson method still remains if applied only to adenocarcinoma of the "common infiltrating type".

  5. Infections fongiques des brûlé : revue

    PubMed Central

    Arnould, JF.; Le Floch, R.

    2015-01-01

    Summary Les infections fongiques locales ou générales sont souvent d’une extrême gravité chez les brûlés. Les brûlés combinent de nombreux facteurs de risque à une immunodépression induite par la brûlure. Les infections de plaies sont le fait des genres Candida, Aspergillus et des agents de mucormycoses. Ces deux derniers cas sont à l’origine de lésions particulièrement sévères. Leur diagnostic repose sur la biopsie cutanée avec examens mycologique et anatomopathologique. Le traitement est essentiellement chirurgical, associé à une antibiothérapie adaptée. Les septicémies sont le fait de levures, essentiellement du genre Candida. Le diagnostic en est difficile dans le contexte des brûlés et repose souvent sur une forte suspicion clinique. Leur traitement repose sur les échinocandines et plus secondairement sur le fluconazole. PMID:26668558

  6. Excision versus incision biopsy in the management of malignant melanoma.

    PubMed

    Sharma, Kavita S; Lim, Philip; Brotherston, Micheal T

    2016-01-01

    The incidence of melanoma has increased over the last decade. The Breslow thickness is one of the most important histological parameters. The gold standard for histological diagnosis is an excision biopsy. Incisional, punch or shave biopsies are not recommended as they are often incomplete and can result in false negatives. To assess the validity of incision versus excision biopsies in the prediction of Breslow thickness in the histopathological analysis of malignant melanoma. A retrospective review of histopathological records was conducted for all patients undergoing incision biopsy for malignant melanoma. The Breslow thicknesses of the incisional biopsies were matched to the later corresponding excisional biopsies. The demographical data, site of melanoma and histological subtype were also examined. Sixty patients between 1st January 2005 and 31st December 2013 were identified. The most common area biopsied was the upper and lower limbs - 50%. The Breslow thickness and Clark's level were found to be significantly increased in excision versus incision biopsy specimens. Nine patients had differing mitotic rates which were all higher in the excision biopsy samples. Our data supports the UK national guidelines on the management of malignant melanoma in that incisional biopsies are not indicated in the diagnostic pathway of malignant melanoma.

  7. Safety of pediatric percutaneous liver biopsy performed by interventional radiologists.

    PubMed

    Potter, Carol; Hogan, Mark J; Henry-Kendjorsky, Katherine; Balint, Jane; Barnard, John A

    2011-08-01

    National data suggest that pediatric percutaneous liver biopsy is increasingly being performed by interventional radiologists rather than pediatric gastroenterologists. The objective of the present report is to describe the safety and effectiveness of percutaneous liver biopsy performed by interventional radiologists in a large cohort of children and to compare the results with the existing literature on biopsies performed by pediatric gastroenterologists. The medical records of 249 children undergoing ultrasound-guided percutaneous liver biopsy by interventional radiologists were reviewed for adverse events and success of obtaining tissue. Two hundred ninety-four biopsies were reviewed. There were no deaths. There were 2 instances of a 2-g or greater drop in hemoglobin following biopsy, neither of which was associated with clinical signs of hemorrhage. A small, asymptomatic pneumothorax quickly resolved without treatment. One patient developed Klebsiella sepsis 48  hours after biopsy. In all but 1 case, an adequate sample size was obtained. This low incidence of adverse events compares favorably with existing published reports of morbidity and mortality following percutaneous liver biopsy performed by pediatric gastroenterologists. Ultrasound-guided percutaneous liver biopsy performed by experienced pediatric interventional radiologists in a children's hospital setting is as safe and effective as biopsy performed by pediatric gastroenterologists.

  8. Safety and Outcomes of Percutaneous Biopsy of 61 Hepatic Adenomas.

    PubMed

    Doolittle, Derrick A; Atwell, Thomas D; Sanchez, William; Mounajjed, Taofic; Hough, David M; Schmit, Grant D; Kurup, A Nicholas

    2016-04-01

    Given the recent classification of hepatic adenoma (HA) into subtypes and recognition of imperfect specificity of MRI to differentiate HA from focal nodular hyperplasia (FNH), there is a resurgent interest in the role of biopsy to diagnose HA. The purpose of this study was to determine the safety and outcomes of biopsy of HAs. A retrospective review of the electronic medical records of all patients who underwent hepatic mass biopsy revealing HA from 2000 through 2013 was performed. The biopsy procedure parameters were evaluated. Complications were graded using the Common Terminology Criteria for Adverse Events. Pathology-specific outcomes related to the diagnosis of HA were assessed. Sixty patients (52 women and eight men) were identified with a mean age of 42 ± 13 (SD) years and a mean follow-up of 2.3 ± 3.0 years after biopsy. One patient had two HAs biopsied during the same procedure, resulting in a total of 61 biopsy-proven HAs. Of the 60 patients, one patient (2%) had a single major complication, which involved bleeding that resulted in a blood transfusion, and six patients (10%) had a minor complication. A total of six (10%) discordant biopsy results were found: Four biopsy-proven HAs (7%) revealed FNH on surgical resection or repeat biopsy, one HA (2%) showed well-differentiated hepatocellular carcinoma (HCC) at subsequent biopsy, and one HA (2%) showed findings suggestive of HCC on follow-up imaging. Complications after biopsy of HAs are uncommon. Although uncommon, discordant pathology results between biopsy and surgical resection may occur.

  9. Atypical ulcers: wound biopsy results from a university wound pathology service .

    PubMed

    Tang, Jennifer C; Vivas, Alejandra; Rey, Andrea; Kirsner, Robert S; Romanelli, Paolo

    2012-06-01

    Chronic wounds are an increasing health burden across the continuum of care and encountered by a wide variety of healthcare providers and physicians of all specialties. The majority of chronic wounds are caused by vascular insufficiency, neuropathy, or prolonged pressure. Wounds caused by other underlying health conditions or external factors such as radiation or spider bites are usually referred to as atypical. Although a wound biopsy generally is recommended in the case of refractory, nonhealing ulcers or when wounds present with atypical signs and symptoms, little is known about the distribution of atypical ulcers. A retrospective, descriptive study was conducted to describe the proportion and differential diagnosis of atypical ulcer biopsies received during a 2-year period by the wound pathology division in the division of Dermatopathology at the University of Miami Department of Dermatology and Cutaneous Surgery. Of the 350 wound biopsies received for diagnostic purposes, 104 (29.7%) were due to atypical causes. The majority of specimens were neoplasms (n = 24). Pyoderma gangrenosum was the most common atypical diagnosis encountered (n = 14). Vasculitis, predominantly leukocytoclastic vasculitis, and external causes were diagnosed in 16 and 15 biopsies, respectively. This study represents the first published case series of atypical ulcer biopsy results from a wound pathology division. Although the prevalence results cannot be generalized and are likely lower in the general population of patients with nonhealing wounds, the results confirm the usefulness of obtaining wound biopsies to provide a definitive diagnosis and to guide care.

  10. [Examination of Stereotactic Mammotome Biopsy for Microcalcification in Our Hospital].

    PubMed

    Sueoka, Noriko; Ishizuka, Mariko; Yoshikawa, Katsuhiro; Tsubota, Yu; Yamamoto, Daigo; Kon, Masanori

    2017-11-01

    We introduced stereotactic mammotome biopsy(ST-MMT)for the purpose of screening and other institutions. There are many benign cases to be diagnosed by pathological findings, so it is thought to be necessary to examine the adaptation of STMMT again. We examined the performance of ST-MMT in a case of a non-palpating calcification lesion. Between August 2013 and December 2016, ST-MMT biopsies were performed for 247 microcalcified lesions revealed by mammography(in both breasts in 9 patients; twice in the ipsilateral breast in 2 patients). The mean age of all patients was 46 years(range, 24- 89 years). We found 39 cases(15.8%)of breast cancer. A final diagnosis of breast cancer was made in 39 patients, who comprised 0% of those with Category 2, 53.8% of those with Category 3, 35.9% of those with Category 4, and 10.3% of those with Category 5. Regarding the morphology and distribution of microcalcifications, breast cancer accounted for 46.2%, 5.1%, 2.6%, 35.9%, 7.7%, and 2.6% of the cases with small round/clustered, amorphous/clustered, pleomorphic/clus- tered, pleomorphic/linear segmental, and fine linear/clustered patterns, respectively. Also, we examined each of the patients, (1) who underwent mammography for medical examinations, (2) who underwent mammography performed at other institutions, (3) who underwent follow-up for microcalcifications and postoperative follow-up mammography. The proportions of breast cancer diagnoses were (1) 11.4%, (2) 20.6%, and (3) 7.1%. Proportions of Category 3 breast cancer were (1) 10.3%, (2) 38.5%, and (3) 5.1%. Among the cases in which ST-MMT was performed in this study, Category 3 accounted for more than half. However, 10.9%(21/192 lesions)were diagnosed as malignant in Category 3. The diagnosis of breast cancer in pa- tients who underwent mammography performed at other institutions was not observed in 79.4%(104/131 lesions), and among the 104 lesions, as a result of reassessment of calcification in our hospital, Category 2 was

  11. Quand la biopsie cutanée peut étiqueter une épilepsie

    PubMed Central

    Harmouch, Taoufiq; Gallouj, Salim; Znati, Kaoutar; Sennou, Aicha Slassi; Belahcen, Faouzi; Amarti, Afaf

    2011-01-01

    La maladie de Lafora (ML) représente une forme rare et grave d’épilepsie myoclonique progressive. C'est une affection à transmission autosomique récessive, hétérogène sur le plan génétique. Nous rapportons le cas d'une adolescente de 16 ans, issue de parents consanguins de premier degré, qui présente depuis l’âge de 14 ans des crises d’épilepsie et des myoclonies. L'examen neurologique a montré un syndrome cérébelleux et une détérioration intellectuelle. La biopsie cutanée était indispensable pour orienter le diagnostic. La ML a un pronostic constamment fatal. L’étude histologique confirme le diagnostic et l’étude moléculaire peut aider à établir un conseil génétique. PMID:22187608

  12. Concordance of Gleason grading with three-dimensional ultrasound systematic biopsy and biopsy core pre-embedding.

    PubMed

    van der Aa, Anouk A M A; Mannaerts, Christophe K; van der Linden, Hans; Gayet, Maudy; Schrier, Bart Ph; Mischi, Massimo; Beerlage, Harrie P; Wijkstra, Hessel

    2018-02-01

    To determine the value of a three-dimensional (3D) greyscale transrectal ultrasound (TRUS)-guided prostate biopsy system and biopsy core pre-embedding method on concordance between Gleason scores of needle biopsies and radical prostatectomy (RP) specimens. Retrospective analysis of prostate biopsies and subsequent RP for PCa in the Jeroen Bosch Hospital, the Netherlands, from 2007 to 2016. Two cohorts were analysed: conventional 2D TRUS-guided biopsies and RP (2007-2013, n = 266) versus 3D TRUS-guided biopsies with pre-embedding (2013-2016, n = 129). The impact of 3D TRUS-guidance with pre-embedding on Gleason score (GS) concordance between biopsy and RP was evaluated using the κ-coefficient. Predictors of biopsy GS 6 upgrading were assessed using logistic regression models. Gleason concordance was comparable between the two cohorts with a κ = 0.44 for the 3D cohort, compared to κ = 0.42 for the 2D cohort. 3D TRUS-guidance with pre-embedding, did not significantly affect the risk of biopsy GS 6 upgrading in univariate and multivariate analysis. 3D TRUS-guidance with biopsy core pre-embedding did not improve Gleason concordance. Improved detection techniques are needed for recognition of low-grade disease upgrading.

  13. Canadian Consensus-based and Evidence-based Guidelines for Benign Endometrial Pathology Reporting in Biopsy Material.

    PubMed

    Parra-Herran, Carlos; Cesari, Matthew; Djordjevic, Bojana; Grondin, Katherine; Kinloch, Mary; Köbel, Martin; Pirzada, Amrah; Plotkin, Anna; Gilks, C Blake

    2018-04-19

    Standardized terminology has proven benefits in cancer reporting; in contrast, reporting of benign diagnoses in endometrial biopsy currently lacks such standardization. Unification and update on the lexicon can provide the structure and consistency needed for optimal patient care and quality assurance purposes. The Special Interest Group in Gynecologic Pathology of the Canadian Association of Pathologists-Association Canadienne des Pathologistes (CAP-ACP) embarked in an initiative to address the current need for consensus terminology in benign endometrial biopsy pathology reporting. Nine members of the Special Interest Group developed a guideline for structured diagnosis of benign endometrial pathology through critical appraisal of the available peer-reviewed literature and joint discussions. The first version of the document was circulated for feedback to a group of professionals in akin fields, the CAP-ACP Executive Committee and the CAP-ACP general membership. The final 1-page document included 17 diagnostic terms comprising the most common benign endometrial entities, as well as explanatory notes for pathologists. The proposed terminology was implemented in the practice of 5 pathologists from the group, who applied the guideline to all benign endometrial biopsies over a 2-wk period. A total of 212 benign endometrial biopsies were evaluated in this implementation step; the recommended terminology adequately covered the diagnosis in 203 cases (95.8%). A list of terminology for benign endometrial biopsy reporting, based on expert consensus and critical appraisal of the available literature, is presented. On the basis of our results of implementation at multiple centers, the proposed guideline can successfully cover the large majority of diagnostic scenarios. The document has the potential to positively impact patient care, promote quality assurance, and facilitate research initiatives aimed at improving histopathologic assessment of benign endometrium.

  14. La participation des enfants et des adolescents à la boxe

    PubMed Central

    Purcell, Laura K; LeBlanc, Claire MA

    2012-01-01

    RÉSUMÉ Des milliers de garçons et de filles de moins de 19 ans font de la boxe en Amérique du Nord. Même si la boxe comporte des avantages pour ceux qui y participent, y compris l’exercice, l’autodiscipline et la confiance en soi, le sport lui-même favorise et récompense des coups délibérés à la tête et au visage. Les personnes qui font de la boxe risquent de subir des blessures à la tête, au visage et au cou, y compris des traumatismes neurologiques chroniques et même fatals. Les commotions cérébrales sont l’une des principales blessures causées par la boxe. En raison du risque de blessures crâniennes et faciales, la Société canadienne de pédiatrie et l’American Academy of Pediatrics s’opposent vigoureusement à la boxe comme activité sportive pour les enfants et les adolescents. Ces organismes recommandent que les médecins s’élèvent contre la boxe auprès des jeunes et les encouragent à participer à d’autres activités dans lesquelles les coups intentionnels à la tête ne constituent pas un élément essentiel du sport.

  15. [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.

  16. [Prostate biopsy under magnetic resonance imaging guidance].

    PubMed

    Kuplevatskiy, V I; CherkashiN, M A; Roshchin, D A; Berezina, N A; Vorob'ev, N A

    2016-01-01

    Prostate cancer (PC) is one of the most important problems in modern oncology. According to statistical data, PC ranks second in the cancer morbidity structure in the Russian Federation and developed countries and its prevalence has been progressively increasing over the past decade. A need for early diagnosis and maximally accurate morphological verification of the diagnosis in difficult clinical cases (inconvenient tumor location for standard transrectal biopsy; gland scarring changes concurrent with prostatitis and hemorrhage; threshold values of prostate-specific antigen with unclear changes in its doubling per unit time; suspicion of biochemical recurrence or clinical tumor progression after special treatment) leads to revised diagnostic algorithms and clinically introduced new high-tech invasive diagnostic methods. This paper gives the first analysis of literature data on Russian practice using one of the new methods to verify prostate cancer (transrectal prostate cancer under magnetic resonance imaging (MRI) guidance). The have sought the 1995-2015 data in the MEDLINE and Pubmed.

  17. 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.

  18. Intrinsic Frequency and the Single Wave Biopsy

    PubMed Central

    Petrasek, Danny; Pahlevan, Niema M.; Tavallali, Peyman; Rinderknecht, Derek G.; Gharib, Morteza

    2015-01-01

    Insulin resistance is the hallmark of classical type II diabetes. In addition, insulin resistance plays a central role in metabolic syndrome, which astonishingly affects 1 out of 3 adults in North America. The insulin resistance state can precede the manifestation of diabetes and hypertension by years. Insulin resistance is correlated with a low-grade inflammatory condition, thought to be induced by obesity as well as other conditions. Currently, the methods to measure and monitor insulin resistance, such as the homeostatic model assessment and the euglycemic insulin clamp, can be impractical, expensive, and invasive. Abundant evidence exists that relates increased pulse pressure, pulse wave velocity (PWV), and vascular dysfunction with insulin resistance. We introduce a potential method of assessing insulin resistance that relies on a novel signal-processing algorithm, the intrinsic frequency method (IFM). The method requires a single pulse pressure wave, thus the term “ wave biopsy.” PMID:26183600

  19. Microarray gene expression profiling using core biopsies of renal neoplasia.

    PubMed

    Rogers, Craig G; Ditlev, Jonathon A; Tan, Min-Han; Sugimura, Jun; Qian, Chao-Nan; Cooper, Jeff; Lane, Brian; Jewett, Michael A; Kahnoski, Richard J; Kort, Eric J; Teh, Bin T

    2009-01-01

    We investigate the feasibility of using microarray gene expression profiling technology to analyze core biopsies of renal tumors for classification of tumor histology. Core biopsies were obtained ex-vivo from 7 renal tumors-comprised of four histological subtypes-following radical nephrectomy using 18-gauge biopsy needles. RNA was isolated from these samples and, in the case of biopsy samples, amplified by in vitro transcription. Microarray analysis was then used to quantify the mRNA expression patterns in these samples relative to non-diseased renal tissue mRNA. Genes with significant variation across all non-biopsy tumor samples were identified, and the relationship between tumor and biopsy samples in terms of expression levels of these genes was then quantified in terms of Euclidean distance, and visualized by complete linkage clustering. Final pathologic assessment of kidney tumors demonstrated clear cell renal cell carcinoma (4), oncocytoma (1), angiomyolipoma (1) and adrenalcortical carcinoma (1). Five of the seven biopsy samples were most similar in terms of gene expression to the resected tumors from which they were derived in terms of Euclidean distance. All seven biopsies were assigned to the correct histological class by hierarchical clustering. We demonstrate the feasibility of gene expression profiling of core biopsies of renal tumors to classify tumor histology.

  20. Microarray gene expression profiling using core biopsies of renal neoplasia

    PubMed Central

    Rogers, Craig G.; Ditlev, Jonathon A.; Tan, Min-Han; Sugimura, Jun; Qian, Chao-Nan; Cooper, Jeff; Lane, Brian; Jewett, Michael A.; Kahnoski, Richard J.; Kort, Eric J.; Teh, Bin T.

    2009-01-01

    We investigate the feasibility of using microarray gene expression profiling technology to analyze core biopsies of renal tumors for classification of tumor histology. Core biopsies were obtained ex-vivo from 7 renal tumors—comprised of four histological subtypes—following radical nephrectomy using 18-gauge biopsy needles. RNA was isolated from these samples and, in the case of biopsy samples, amplified by in vitro transcription. Microarray analysis was then used to quantify the mRNA expression patterns in these samples relative to non-diseased renal tissue mRNA. Genes with significant variation across all non-biopsy tumor samples were identified, and the relationship between tumor and biopsy samples in terms of expression levels of these genes was then quantified in terms of Euclidean distance, and visualized by complete linkage clustering. Final pathologic assessment of kidney tumors demonstrated clear cell renal cell carcinoma (4), oncocytoma (1), angiomyolipoma (1) and adrenalcortical carcinoma (1). Five of the seven biopsy samples were most similar in terms of gene expression to the resected tumors from which they were derived in terms of Euclidean distance. All seven biopsies were assigned to the correct histological class by hierarchical clustering. We demonstrate the feasibility of gene expression profiling of core biopsies of renal tumors to classify tumor histology. PMID:19966938

  1. Clinical correlation of biopsy results in patients with temporal arteritis.

    PubMed

    Yuksel, Volkan; Guclu, Orkut; Tastekin, Ebru; Halici, Umit; Huseyin, Serhat; Inal, Volkan; Canbaz, Suat

    2017-11-01

    Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. The results of our study are noteworthy, since there is limited data on pathologic diagnosis of temporal arteritis in Turkey. We studied the medical records, laboratory findings such as erythrocyte sedimentation rate and C-reactive protein levels, biopsy results, and postoperative complications of all the patients operated for temporal artery biopsy at our clinic. We used the computerized laboratory registry that keeps all records of 42 consecutive temporal artery biopsy results from January 2011 to December 2016. The mean age was 66±12.5 years. The most common manifestations on admission were temporal headache, optic neuritis and jaw claudication, respectively. Temporal artery biopsy  results confirmed tempoal arteritis in eight out of 42 (19%) patients. There was no statistically significant difference between biopsy-positive and biopsy-negative groups in terms of sex, age, erythrocyte sedimentation rate, C-reactive protein and biopsy length. We were not able to find a correlation between the analysis of biopsy results and clinical evaluation of patients with temporal arteritis. We suggest that diagnosis of temporal arteritis  depends on clinical suspicion. Laboratory examination results may not be helpful in accurate diagnosis of tempoal arteritis.

  2. [Determination of the 120-day post prostatic biopsy mortality rate].

    PubMed

    Canat, G A; Duclos, A; Couray-Targe, S; Schott, A-M; Polazzi, S; Scoazec, J-Y; Berger, F; Perrin, P

    2014-06-01

    Concerning death-rates were reported following prostate biopsy but the lack of contexts in which event occurred makes it difficult to take any position. Therefore, we aimed to determine the 120-day post-biopsy mortality rate. Between 2000 and 2011, 8804 men underwent prostate biopsy in the hospice civils de Lyon. We studied retrospectively, the mortality rate after each of the 11,816 procedures. Biopsies imputability was assessed by examining all medical records. Dates of death were extracted from our local patient management database, which is updated trimestrially with death notifications from the French National Institute for Statistics and Economic Studies. In our study 42 deaths occurred within 120days after 11,816 prostate biopsies (0.36%). Of the 42 records: 9 were lost to follow-up, 3 had no identifiable cause of death, 28 had an intercurrent event ruling out prostate biopsy as a cause of death. Only 2 deaths could be linked to biopsy. We reported at most 2 deaths possibly related to prostate biopsy over 11,816 procedures (0.02%). We confirmed the fact that prostate biopsies can be lethal but this rare outcome should not be considered as an argument against prostate screening given the circumstances in which it occurs. 5. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Prostate-specific antigen increase during dutasteride to indicate the need for prostate biopsy: influence of prostatic inflammation.

    PubMed

    Sciarra, Alessandro; Maggi, Martina; Fasulo, Andrea; Salciccia, Stefano; Gentile, Vincenzo; Cattarino, Susanna; Gentilucci, Alessandro

    2017-08-01

    The aim of this study was to analyze the significance of an increase in total prostate-specific antigen (PSA) serum levels despite dutasteride treatment as a predictor of prostate cancer (PC) at biopsy. We focused our attention on the rate of the first PSA increase and on the influence of prostatic inflammation. From 2011 to 2016, 365 men with a previous negative prostate biopsy and persistent elevated PSA levels received dutasteride treatment. The population was followed for a range of 12-48 months. One hundred twelve cases with a confirmed PSA increase >0.5 ng/ml over the nadir value during the follow-up were included in Group A and underwent a new prostate biopsy. In Group A, the PSA increase was associated with PC at the re-biopsy in 66% of cases. The percentage of PSA reduction after 6 months of treatment was not a significant indicator of the risk for PC. The distribution of inflammatory infiltrates significantly (p<00.01) varied from positive to negative prostate biopsies. The relative risk for PC at biopsy significantly increased according to PSA level during dutasteride. Treatment with dutasteride can help to analyze PSA kinetic. A persistent prostatic inflammation is a factor able to reduce the performance of PSA kinetic during dutasteride treatment.

  4. Esophageal foreign bodies and eosinophilic esophagitis--the need for esophageal mucosal biopsy: a 12-year survey across pediatric subspecialties.

    PubMed

    Williams, Paul; Jameson, Samuel; Bishop, Phyllis; Sawaya, David; Nowicki, Michael

    2013-06-01

    Esophageal foreign body impaction (EFBI) is a common problem requiring urgent endoscopy. EFBI may be the first sign of underlying esophageal pathology, yet mucosal biopsies are rarely performed. We report a retrospective analysis of 572 children requiring removal of an EFBI over a 12-year period by pediatric otolaryngologists (ENT), surgeons (PS), and gastroenterologists (PGI). The method of removal [direct laryngoscopy (DL), rigid endoscopy (RE), flexible endoscopy (FE)], type of foreign body (inanimate or food), whether mucosal biopsies were performed, and histologic findings of biopsy samples were recorded for each patient. Foreign body removal was most commonly performed by PGI (298 [52 %]); the remaining were equally distributed between ENT (136 [24 %]) and PS (138 [24 %]). The method of foreign body removal used by ENT was RE (89 %), DL (8 %), and FE (3 %). Pediatric surgery preferred FE (62 %), followed by RE (27 %) and DL (11 %). Pediatric gastroenterology used FE exclusively. Esophageal biopsies were never performed by ENT or PS; PGI performed esophageal biopsies more commonly in children with meat bolus impactions (50 %) than in children with inanimate foreign bodies (12 %). Mucosal pathology was more common in children with meat bolus impaction (100 %) than in children with inanimate foreign bodies (45 %). Esophageal mucosal biopsy should be considered for all children with EFBI not attributed to stricture, particularly those with meat bolus impaction.

  5. Probability modeling of the number of positive cores in a prostate cancer biopsy session, with applications.

    PubMed

    Serfling, Robert; Ogola, Gerald

    2016-02-10

    Among men, prostate cancer (CaP) is the most common newly diagnosed cancer and the second leading cause of death from cancer. A major issue of very large scale is avoiding both over-treatment and under-treatment of CaP cases. The central challenge is deciding clinical significance or insignificance when the CaP biopsy results are positive but only marginally so. A related concern is deciding how to increase the number of biopsy cores for larger prostates. As a foundation for improved choice of number of cores and improved interpretation of biopsy results, we develop a probability model for the number of positive cores found in a biopsy, given the total number of cores, the volumes of the tumor nodules, and - very importantly - the prostate volume. Also, three applications are carried out: guidelines for the number of cores as a function of prostate volume, decision rules for insignificant versus significant CaP using number of positive cores, and, using prior distributions on total tumor size, Bayesian posterior probabilities for insignificant CaP and posterior median CaP. The model-based results have generality of application, take prostate volume into account, and provide attractive tradeoffs of specificity versus sensitivity. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  6. A CT-guided fat transversing coaxial biopsy technique for pancreatic lesion biopsy that avoids major organs and vessels

    PubMed Central

    Lin, Chia-Ying; Ou, Ming-Ching; Liu, Yi-Sheng; Chuang, Ming-Tsung; Shan, Yan-Shen; Tsai, Hong-Ming; Wang, Chien-Kuo; Tsai, Yi-Shan

    2017-01-01

    Background/Aims: The purpose of this study is to report our results using a computed tomography (CT)-guided fat transversing coaxial biopsy technique for pancreatic lesion biopsy that avoids major organs and vessels. We retrospectively reviewed the records of patients referred to our department for pancreatic mass biopsy. Patients and Methods: The records of patients (from June 2008 to August 2014) in whom biopsy was performed under CT guidance with a coaxial needle using a fat transversing technique were reviewed. Patient demographic data and biopsy outcomes were collected. We aimed to compare differences between lesion size and biopsy outcome, the independent two-samples t-test was used. Results: A total of 122 patients who underwent 17-G coaxial needle biopsy were included. The mean pancreatic lesion size was 3.2 cm, and in 30 patients it was more than 4 cm. The majority of lesions were located in the head of the pancreas (44.3%). No transorgan biopsies were performed. In most patients, the biopsy was performed via a fat traversing detour route (93.4%), and a successful diagnosis was made based on the biopsy outcome in 96.7% patients. Complications occurred in five patients (4.1%); three of the patients developed a fever, and two developed pancreatitis. All patients recovered with symptomatic treatment. Conclusion: CT-guided coaxial core biopsy of pancreatic lesions using a fat detour route appears to be a safe and effective method for obtaining pancreatic lesion biopsies with a high success rate and low complication rate. PMID:29205187

  7. Comparison of the complications of traditional 12 cores transrectal prostate biopsy with image fusion guided transperineal prostate biopsy.

    PubMed

    Huang, Haifeng; Wang, Wei; Lin, Tingsheng; Zhang, Qing; Zhao, Xiaozhi; Lian, Huibo; Guo, Hongqian

    2016-11-17

    To compare the complications of traditional transrectal (TR) prostate biopsy and image fusion guided transperineal (TP) prostate biopsy in our center. Two hundred and fourty-two patients who underwent prostate biopsy from August 2014 to January 2015were reviewed. Among them, 144 patients underwent systematic 12-core transrectal ultrasonography (TRUS) guided prostate biopsy (TR approach) while 98 patients underwent free-hand transperineal targeted biopsy with TRUS and multi-parameter magnetic resonance imaging (mpMRI) fusion images (TP approach). The complications of the two groups were presented and a simple statistical analysis was performed to compare the two groups. The cohort of our study include242 patients, including 144 patients underwent TR biopsies while 98 patients underwentTP biopsies. There was no significant difference of major complications, including sepsis, bleeding and other complication requiring admissionbetween the two groups (P > 0.05). The incidence rate of infection and rectal bleeding in TR was much higher than TP (p < 0.05), but the incidence rate of perineal swelling in TP was much higher than TR (p < 0.05). There were no significant differences of minor complications including hematuria, lower urinary tract symptoms (LUTS), dysuria, and acuteurinary retention between the two groups (p > 0.05). The present study supports the safety of both techniques. Free-handTP targeted prostate biopsy with real-time fusion imaging of mpMRI and TR ultrasound is a good approach for prostate biopsy.

  8. Prostatic needle biopsies following primary high intensity focused ultrasound (HIFU) therapy for prostatic adenocarcinoma: histopathological features in tumour and non-tumour tissue.

    PubMed

    Ryan, Paul; Finelli, Antonio; Lawrentschuk, Nathan; Fleshner, Neil; Sweet, Joan; Cheung, Carol; van der Kwast, Theodorus; Evans, Andrew

    2012-08-01

    High intensity focused ultrasound (HIFU) is currently offered as primary treatment for patients with clinically localised prostate cancer. Data on histopathological features of post-treatment biopsies are limited. Pretreatment biopsies were identified in 45 men (age range 41-85) who received primary HIFU therapy. Post-HIFU biopsies were performed in 30 of these patients (67%) at mean 14.1 months (95% CI 11.7 to 16.5) follow-up, 22 due to rising PSA and eight as part of routine follow-up. Biopsies were examined for presence, distribution and extent of adenocarcinoma, Gleason scores, use of standard immunohistochemistry and ablative tissue changes were attributable to HIFU. In post-HIFU biopsies performed for biochemical failure, 17/22 (77%) contained adenocarcinoma; 4/22 (18%) had higher post-HIFU Gleason score; 3/22 (14%) had newly recognised bilateral involvement; and 4/22 (18%) had higher percentage tissue involvement compared with pre-HIFU biopsies. Of cases without rising post-HIFU PSA, 2/8 (25%) routine follow-up biopsies contained adenocarcinoma. Stromal fibrosis was the commonest finding in non-tumour post-HIFU biopsy tissue (17/30, 57%) with coagulative necrosis occurring in fewer cases (4/30, 13%) and over a shorter follow-up interval than cases showing fibrosis (8.5 (0.2-16.8) vs 15.3 (11.5-19.1) months). Treatment effects in tumour cells precluding the assignment of Gleason scores or use of immunohistochemistry in post-HIFU biopsies were not identified. Post-HIFU biopsies are positive in more than 75% of patients with elevated or rising PSA. Stromal fibrosis is common but the tissue effects of this modality do not appear to impair pathologists' ability to detect and grade adenocarcinoma in follow-up biopsies.

  9. Prostate atypia: does repeat biopsy detect clinically significant prostate cancer?

    PubMed

    Dorin, Ryan P; Wiener, Scott; Harris, Cory D; Wagner, Joseph R

    2015-05-01

    While the treatment pathway in response to benign or malignant prostate biopsies is well established, there is uncertainty regarding the risk of subsequently diagnosing prostate cancer when an initial diagnosis of prostate atypia is made. As such, we investigated the likelihood of a repeat biopsy diagnosing prostate cancer (PCa) in patients in which an initial biopsy diagnosed prostate atypia. We reviewed our prospectively maintained prostate biopsy database to identify patients who underwent a repeat prostate biopsy within one year of atypia (atypical small acinar proliferation; ASAP) diagnosis between November 1987 and March 2011. Patients with a history of PCa were excluded. Chart review identified patients who underwent radical prostatectomy (RP), radiotherapy (RT), or active surveillance (AS). For some analyses, patients were divided into two subgroups based on their date of service. Ten thousand seven hundred and twenty patients underwent 13,595 biopsies during November 1987-March 2011. Five hundred and sixty seven patients (5.3%) had ASAP on initial biopsy, and 287 (50.1%) of these patients underwent a repeat biopsy within one year. Of these, 122 (42.5%) were negative, 44 (15.3%) had atypia, 19 (6.6%) had prostatic intraepithelial neoplasia, and 102 (35.6%) contained PCa. Using modified Epstein's criteria, 27/53 (51%) patients with PCa on repeat biopsy were determined to have clinically significant tumors. 37 (36.3%) proceeded to RP, 25 (24.5%) underwent RT, and 40 (39.2%) received no immediate treatment. In patients who underwent surgery, Gleason grade on final pathology was upgraded in 11 (35.5%), and downgraded 1 (3.2%) patient. ASAP on initial biopsy was associated with a significant risk of PCa on repeat biopsy in patients who subsequently underwent definitive local therapy. Patients with ASAP should be counseled on the probability of harboring both clinically significant and insignificant prostate cancer. © 2015 Wiley Periodicals, Inc.

  10. Comparison of histologic diagnosis between stereotactic core needle biopsy and open surgical biopsy.

    PubMed

    Bauer, R L; Sung, J; Eckhert, K H; Koul, A; Castillo, N B; Nemoto, T

    1997-06-01

    This study correlates the histologic findings of stereotactic core needle biopsy (SCNB) with open surgical biopsy (OSB) and identifies which lesions can be treated definitively based only on the SCNB histology. Women who underwent SCNB between July 1, 1993, and January 1, 1969, were identified by retrospective chart review. Mammographic (MGM) lesions found by SCNB to be ductal or lobular hyperplasia with atypia, or carcinoma underwent OSB. When the histologic findings by SCNB were inconsistent with the MGM findings, the lesion also underwent OSB. 799 women underwent SCNB with 96 (12%) of these going on to OSB. MGM findings in the 92 who presented without a palpable mass included microcalcifications (MCS) in 39, mass in 47, MCS and mass in 7, and tissue distortion in 3. One hundred one breast lesions biopsied first by SCNB, then by OSB were correlated histologically. Sensitivity of SCNB is 89%, with a specificity of 94%. Eight-four women (88%) were able to have definitive treatment at time of OSB because of prior SCNB, and 703/799 (88%) of women were spared OSB entirely. SCNB accurately identifies benign breast histology and invasive cancers in women with MGM abnormalities, a distinct advantage over fine needle aspiration cytology. SCNB does not reliably identify women with DCIS and invasion. All women with SCNB diagnosis of ductal or lobular atypia should also undergo OSB.

  11. [Prostate cancer diagnostic by saturation randomized biopsy versus rigid targeted biopsy].

    PubMed

    Defontaines, J; Salomon, L; Champy, C; Cholley, I; Chiaradia, M; de la Taille, A

    2017-12-01

    Optimal diagram teaming up randomized biopsy (BR) to targeted biopsy (BC) is still missing for the diagnostic of prostate cancer (CP). This study compares diagram of 6, 12 or 18 BR with or without BC rigid. Between January 2014 and May 2016, 120 patients had prostate biopsy BR and BC. Each patient had 18 BR and BC. Results compared sextant (6 BR), standard (12 BR) and saturation (18 BR) protocol with or without the adding of BC for the detection of CP. Rectal examination was normal, mean PSA at 8.99ng/mL and mean volume at 54cm 3 . It was first round for 48% of patients. Forty-four cancers were found by the group 18 BR+BC (control). The detection rate was respectively, for 6, 12 and 18 BR of 61%, 82% and 91%. The add of BC increased this detection of +27% for 6 BR+BC, +13% for 12 BR+BC and +9% for 18 BR+BC. BC found 70% of all CP. Nine percent of CP were missed by BR only. Significant CP (Gleason≥7) diagnostic was the same for 12 BR+BC and 18 BR+BC. The add of BC to BR increase the detection of CP by 10%. Twelve BR+BC is the optimal diagram for the diagnostic of CP finding 95% of CP and 97% of significant CP. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Médecine des voyages

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Résumé Objectif Définir la pratique de la médecine des voyages, présenter les éléments fondamentaux d’une consultation complète préalable aux voyages à des voyageurs internationaux et aider à identifier les patients qu’il vaudrait mieux envoyer en consultation auprès de professionnels de la médecine des voyages. Sources des données Les lignes directrices et les recommandations sur la médecine des voyages et les maladies liées aux voyages publiées par les autorités sanitaires nationales et internationales ont fait l’objet d’un examen. Une recension des ouvrages connexes dans MEDLINE et EMBASE a aussi été effectuée. Message principal La médecine des voyages est une spécialité très dynamique qui se concentre sur les soins préventifs avant un voyage. Une évaluation exhaustive du risque pour chaque voyageur est essentielle pour mesurer avec exactitude les risques particuliers au voyageur, à son itinéraire et à sa destination et pour offrir des conseils sur les interventions les plus appropriées en gestion du risque afin de promouvoir la santé et prévenir les problèmes médicaux indésirables durant le voyage. Des vaccins peuvent aussi être nécessaires et doivent être personnalisés en fonction des antécédents d’immunisation du voyageur, de son itinéraire et du temps qu’il reste avant son départ. Conclusion La santé et la sécurité d’un voyageur dépendent du degré d’expertise du médecin qui offre le counseling préalable à son voyage et les vaccins, au besoin. On recommande à ceux qui donnent des conseils aux voyageurs d’être conscients de l’ampleur de cette responsabilité et de demander si possible une consultation auprès de professionnels de la médecine des voyages pour tous les voyageurs à risque élevé.

  13. Optimization of prostate biopsy: the role of magnetic resonance imaging targeted biopsy in detection, localization and risk assessment.

    PubMed

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

    2014-09-01

    Optimization of prostate biopsy requires addressing the shortcomings of standard systematic transrectal ultrasound guided biopsy, including false-negative rates, incorrect risk stratification, detection of clinically insignificant disease and the need for repeat biopsy. Magnetic resonance imaging is an evolving noninvasive imaging modality that increases the accurate localization of prostate cancer at the time of biopsy, and thereby enhances clinical risk assessment and improves the ability to appropriately counsel patients regarding therapy. In this review we 1) summarize the various sequences that comprise a prostate multiparametric magnetic resonance imaging examination along with its performance characteristics in cancer detection, localization and reporting standards; 2) evaluate potential applications of magnetic resonance imaging targeting in prostate biopsy among men with no previous biopsy, a negative previous biopsy and those with low stage cancer; and 3) describe the techniques of magnetic resonance imaging targeted biopsy and comparative study outcomes. A bibliographic search covering the period up to October 2013 was conducted using MEDLINE®/PubMed®. Articles were reviewed and categorized based on which of the 3 objectives of this review was addressed. Data were extracted, analyzed and summarized. Multiparametric magnetic resonance imaging consists of anatomical T2-weighted imaging coupled with at least 2 functional imaging techniques. It has demonstrated improved prostate cancer detection sensitivity up to 80% in the peripheral zone and 81% in the transition zone. A prostate cancer magnetic resonance imaging suspicion score has been developed, and is depicted using the Likert or PI-RADS (Prostate Imaging Reporting and Data System) scale for better standardization of magnetic resonance imaging interpretation and reporting. Among men with no previous biopsy, magnetic resonance imaging increases the frequency of significant cancer detection to 50

  14. Motorized fusion guided prostate biopsy: phantom study

    NASA Astrophysics Data System (ADS)

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

    2017-03-01

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

  15. Execution of robot-assisted biopsies within the clinical context.

    PubMed

    Rovetta, A; Sala, R

    1995-01-01

    This paper describes the first prostatic biopsy on a human patient using a robotic and telerobotic system. This system was designed at the Politecnico di Milano, and the biopsy was performed on April 7, 1995, in the Hospital Policlinico in Milan, Italy.

  16. Clinical and prognostic significance of muscle biopsy in sarcoidosis.

    PubMed

    Yanardag, Halil; Tetikkurt, Cuneyt; Bilir, Muammer

    2018-04-30

    The main objective of this study was to evaluate the influence of muscle involvement on the clinical features, prognostic outcome, extrapulmonary organ, and endobronchial involvement in sarcoidosis patients. The second aim was to assess the diagnostic yield of muscle biopsy for the histopathologic identification of sarcoidosis.  Fifty sarcoidosis patients participated in the study. The patients were classified into two groups according to the histopathologic presence of non-caseating granulomatous inflammatory pattern of the muscle biopsy samples and were evaluated retrospectively in regard to clinical features, prognosis, extrapulmonary, and endobronchial disease involvement. Pathologic examination of the muscle biopsy samples revealed non-caseating granulomas in eighteen and myositis in seven patients compatible with sarcoidosis. The diagnostic yield of muscle biopsy for demonstrating non-caseating granulomatous inflammation was fifty percent. Patients with muscle sarcoidosis showed a worse prognosis and a more severe extrapulmonary organ involvement than the patients without muscle disease. Muscle biopsy was not statistically significant to delineate diffuse endobronchial involvement while it was suggestive for endobronchial disease clinically. The results of our study reveal that muscle biopsy appears to be a useful diagnostic tool along with its safety and easy clinical applicability. It is a rewarding utility to predict the prognostic outcome and extrapulmonary involvement in sarcoidosis patients. Positive biopsy on the other hand confirms the identification of sarcoidosis in patients with single organ involvement carrying an equivocal diagnostic clinical pattern. Muscle biopsy may be considered as the initial step for the final diagnosis of sarcoidosis in such cases.

  17. 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.

  18. Timing embryo biopsy for PGD - before or after cryopreservation?

    PubMed

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

    2016-09-01

    Pre-implantation genetic diagnosis (PGD) is required in order to screen and diagnose embryos of patients at risk of having a genetically affected offspring. A biopsy to diagnose the genetic profile of the embryo may be performed either before or after cryopreservation. The aim of this study was to determine which biopsy timing yields higher embryo survival rates. Retrospective cohort study of all PGD patients in a public IVF unit between 2010 and 2013. Inclusion criteria were patients with good-quality embryos available for cryopreservation by the slow freezing method. Embryos were divided into two groups: biopsy before and biopsy after cryopreservation. The primary outcome was embryo survival rates post thawing. Sixty-five patients met inclusion criteria. 145 embryos were biopsied before cryopreservation and 228 embryos were cryopreserved and biopsied after thawing. Embryo survival was significantly greater in the latter group (77% vs. 68%, p < 0.0001). Cryopreservation preceding biopsy results in better embryo survival compared to biopsy before cryopreservation.

  19. 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 878.4755 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4755 Absorbable lung biopsy...

  20. [Closed needle-biopsy in the diagnosis of neoplasms].

    PubMed

    Sforza, M; Perelli Ercolini, M; Beani, G

    1979-04-01

    The AA. demonstrate with this communication the validity of the needle biopsie for the diagnosis of neoplasms. They had used it for the breast, thyroid, flg and some other superficial tumefactions. In the mass-screening for the feminine neoplasms the clinical examination and the needle biopsy are very good method for a careful diagnosis.

  1. Zero-Time Renal Transplant Biopsies: A Comprehensive Review.

    PubMed

    Naesens, Maarten

    2016-07-01

    Zero-time kidney biopsies, obtained at time of transplantation, are performed in many transplant centers worldwide. Decisions on kidney discard, kidney allocation, and choice of peritransplant and posttransplant treatment are sometimes based on the histological information obtained from these biopsies. This comprehensive review evaluates the practical considerations of performing zero-time biopsies, the predictive performance of zero-time histology and composite histological scores, and the clinical utility of these biopsies. The predictive performance of individual histological lesions and of composite scores for posttransplant outcome is at best moderate. No single histological lesion or composite score is sufficiently robust to be included in algorithms for kidney discard. Dual kidney transplantation has been based on histological assessment of zero-time biopsies and improves outcome in individual patients, but the waitlist effects of this strategy remain obscure. Zero-time biopsies are valuable for clinical and translational research purposes, providing insight in risk factors for posttransplant events, and as baseline for comparison with posttransplant histology. The molecular phenotype of zero-time biopsies yields novel therapeutic targets for improvement of donor selection, peritransplant management and kidney preservation. It remains however highly unclear whether the molecular expression variation in zero-time biopsies could become a better predictor for posttransplant outcome than donor/recipient baseline demographic factors.

  2. Ultrastructural examination of skin biopsies may assist in diagnosing mitochondrial cytopathy when muscle biopsies yield negative results.

    PubMed

    McAfee, John L; Warren, Christine B; Prayson, Richard A

    2017-08-01

    Ultrastructural evaluation of skin biopsies has been utilized for diagnosis of mitochondrial disease. This study investigates how frequently skin biopsies reveal mitochondrial abnormalities, correlates skin and muscle biopsy findings, and describes clinical diagnoses rendered following the evaluation. A retrospective review of surgical pathology reports from 1990 to 2015 identified skin biopsies examined by electron microscopy for suspected metabolic disease. A total of 630 biopsies were included from 615 patients. Of these patients, 178 also underwent a muscle biopsy. Of the 630 skin biopsies, 75 (12%) showed ultrastructural abnormalities and 34 (5%) specifically showed mitochondrial abnormalities including increased size (n=27), reduced or abnormal cristae (n=23), dense matrices (n=20), and increased number (n=8). Additional findings included lysosomal abnormalities (n=13), lipid accumulation (n=2) or glycogen accumulation (n=1). Of the 34 patients with mitochondrial abnormalities on skin biopsy, 20 also had muscle biopsies performed and nine showed abnormalities suggestive of a mitochondrial disorder including absent cytochrome oxidase staining (n=2), increased subsarcolemmal NADH, SDH, or cytochrome oxidase staining (n=1), or ultrastructural findings including large mitochondrial size (n=5), abnormal mitochondrial structure (n=5), and increased mitochondrial number (n=4). The most common presenting symptoms were intellectual disability (n=13), seizures (n=12), encephalopathy (n=9), and gastrointestinal disturbances (n=9). At last known follow-up, 12 patients had a definitive diagnosis of a mitochondrial disorder. One patient each had Complex I deficiency, Complex III deficiency, Charcot-Marie-Tooth disease, pyruvate dehydrogenase deficiency, and Phelan-McDermid syndrome. Our results suggest that skin biopsy sometimes yields diagnostic clues suggestive of a mitochondrial cytopathy in cases with a negative muscle biopsy. Copyright © 2017 Elsevier Inc. All rights

  3. Cancer Diagnosis Using a Liquid Biopsy: Challenges and Expectations.

    PubMed

    Castro-Giner, Francesc; Gkountela, Sofia; Donato, Cinzia; Alborelli, Ilaria; Quagliata, Luca; Ng, Charlotte K Y; Piscuoglio, Salvatore; Aceto, Nicola

    2018-05-09

    The field of cancer diagnostics has recently been impacted by new and exciting developments in the area of liquid biopsy. A liquid biopsy is a minimally invasive alternative to surgical biopsies of solid tissues, typically achieved through the withdrawal of a blood sample or other body fluids, allowing the interrogation of tumor-derived material including circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) fragments that are present at a given time point. In this short review, we discuss a few studies that summarize the state-of-the-art in the liquid biopsy field from a diagnostic perspective, and speculate on current challenges and expectations of implementing liquid biopsy testing for cancer diagnosis and monitoring in the clinical setting.

  4. An analysis of 4,514 cases of renal biopsy in Korea.

    PubMed

    Choi, I J; Jeong, H J; Han, D S; Lee, J S; Choi, K H; Kang, S W; Ha, S K; Lee, H Y; Kim, P K

    2001-04-01

    To evaluate the distribution and changing patterns of renal diseases in Korea, a total of 4,514 cases of renal biopsy collected over a 23-year period between 1973 and 1995 were reviewed. Of 4,200 cases excluding 314 unsatisfactory biopsies, adult cases comprised 59.5% and pediatric cases, 40.5%. The male to female ratio was 1.5:1 in adults and 2.2:1 in children. Glomerulonephritis (GN) comprised 80.0% of the total. The most common primary GN in adults was minimal change disease (MCD) (26.6%), followed by IgA nephropathy (IgAN) (22.1%), membranous GN (MGN) (11.8%), and membranoproliferative GN (MPGN) (5.9%). In children, the primary GN incidence rates were MCD (24.8%), IgAN (10.3%), poststreptococcal (including postinfectious) GN (PSGN) (8.6%), and focal segmental glomerulosclerosis (FSGS) (4.0%). The most common secondary GN in adults was lupus nephritis and in children Henoch-Schonlein purpura nephritis. The most common cause of nephrotic syndrome was MCD in both adults and children, followed by MGN and FSGS. The elderly, aged sixty years and older, comprised 2.7% of cases and recorded equal numbers of MCD and MGN. The proportion of the biopsies found to be seropositive for HBs antigen was 27.9%, and these showed either MGN or MPGN pattern. Repeat biopsy was performed in 168 patients, due to previous biopsy failure in 15.5%. When the primary GN cases were analyzed at 5-year intervals, the prevalence of PSGN, which was greater than 25% during the 1973-1982 period, decreased abruptly in children thereafter, whereas the prevalence of FSGS increased slowly since the 1988-1992 period in both adults and children. The decrease of PSGN and the increase of FSGS suggest a role for socioeconomic and environmental factors in Korea.

  5. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

    PubMed

    Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

    2016-09-01

    This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions.

  6. Use of Age and Medical Comorbidity to Assess Long-term Other-cause Mortality Risk in a Cohort of Men Undergoing Prostate Biopsy at an Academic Medical Center.

    PubMed

    Kominsky, Hal D; Bashline, Michael; Eun, Daniel; Pontari, Michel A; Mydlo, Jack H; Reese, Adam C

    2017-02-01

    To assess life expectancy and biopsy outcomes in men undergoing prostate biopsy at an academic medical center. We analyzed men who underwent prostate biopsy at our medical center between July 2012 and June 2014. Long-term other-cause mortality risk was determined using survival tables. Indications for biopsy and biopsy outcomes were assessed, and compared among men with varying mortality risks. A total of 417 men underwent prostate biopsy, in whom 14-year other-cause mortality risk ranged from 9% to 74%. One hundred ninety-three men (46.3%) were considered low-mortality risk (<40% risk of 14-year mortality), 131 (31.4%) intermediate risk (41%-55% 14-year mortality), and 93 (22.3%) high risk (>55% 14-year mortality). Of the 417 patients who underwent biopsy, 149 (35.7%) were found to have prostate cancer. There was no significant difference in the rate of positive biopsies (P = .72), distribution of Gleason scores (P = .60), or percentage of positive biopsy cores (P = .74) between mortality risk groups. However, by UCSF Cancer of the Prostate Risk Assessment score, there was significant trend toward higher-risk prostate cancer in men with intermediate and high-mortality risk (P = .04). In this analysis, a large number of men with limited life expectancies underwent prostate biopsy. The majority of these men had negative biopsies or low-risk cancers, suggesting that they were unlikely to benefit from biopsy. To avoid potentially unnecessary prostate biopsies, the practitioner must give serious consideration to a patient's age and medical comorbidities before making a recommendation as to whether biopsy should be performed. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Vecteurs Singuliers des Theories des Champs Conformes Minimales

    NASA Astrophysics Data System (ADS)

    Benoit, Louis

    En 1984 Belavin, Polyakov et Zamolodchikov revolutionnent la theorie des champs en explicitant une nouvelle gamme de theories, les theories quantiques des champs bidimensionnelles invariantes sous les transformations conformes. L'algebre des transformations conformes de l'espace-temps presente une caracteristique remarquable: en deux dimensions elle possede un nombre infini de generateurs. Cette propriete impose de telles conditions aux fonctions de correlations qu'il est possible de les evaluer sans aucune approximation. Les champs des theories conformes appartiennent a des representations de plus haut poids de l'algebre de Virasoro, une extension centrale de l'algebre conforme du plan. Ces representations sont etiquetees par h, le poids conforme de leur vecteur de plus haut poids, et par la charge centrale c, le facteur de l'extension centrale, commune a toutes les representations d'une meme theorie. Les theories conformes minimales sont constituees d'un nombre fini de representations. Parmi celles-ci se trouvent des theories unitaires dont les representation forment la serie discrete de l'algebre de Virasoro; leur poids h a la forme h_{p,q}(m)=[ (p(m+1) -qm)^2-1] (4m(m+1)), ou p,q et m sont des entiers positifs et p+q<= m+1. L'entier m parametrise la charge centrale: c(m)=1 -{6over m(m+1)} avec n>= 2. Ces representations possedent un sous-espace invariant engendre par deux sous-representations avec h_1=h_{p,q} + pq et h_2=h_{p,q} + (m-p)(m+1-q) dont chacun des vecteurs de plus haut poids portent le nom de vecteur singulier et sont notes respectivement |Psi _{p,q}> et |Psi_{m-p,m+1-q}>. . Les theories super-conformes sont une version super-symetrique des theories conformes. Leurs champs appartiennent a des representation de plus haut poids de l'algebre de Neveu-Schwarz, une des deux extensions super -symetriques de l'algebre de Virasoro. Les theories super -conformes minimales possedent la meme structure que les theories conformes minimales. Les representations

  8. Classification, imaging, biopsy and staging of osteosarcoma

    PubMed Central

    Kundu, Zile Singh

    2014-01-01

    Osteosarcoma is the most common primary osseous malignancy excluding malignant neoplasms of marrow origin (myeloma, lymphoma and leukemia) and accounts for approximately 20% of bone cancers. It predominantly affects patients younger than 20 years and mainly occurs in the long bones of the extremities, the most common being the metaphyseal area around the knee. These are classified as primary (central or surface) and secondary osteosarcomas arising in preexisting conditions. The conventional plain radiograph is the best for probable diagnosis as it describes features like sun burst appearance, Codman's triangle, new bone formation in soft tissues along with permeative pattern of destruction of the bone and other characteristics for specific subtypes of osteosarcomas. X-ray chest can detect metastasis in the lungs, but computerized tomography (CT) scan of the thorax is more helpful. Magnetic resonance imaging (MRI) of the lesion delineates its extent into the soft tissues, the medullary canal, the joint, skip lesions and the proximity of the tumor to the neurovascular structures. Tc99 bone scan detects the osseous metastases. Positron Emission Tomography (PET) is used for metastatic workup and/or local recurrence after resection. The role of biochemical markers like alkaline phosphatase and lactate dehydrogenase is pertinent for prognosis and treatment response. The biopsy confirms the diagnosis and reveals the grade of the tumor. Enneking system for staging malignant musculoskeletal tumors and American Joint Committee on Cancer (AJCC) staging systems are most commonly used for extremity sarcomas. PMID:24932027

  9. Computer assisted optical biopsy for colorectal polyps

    NASA Astrophysics Data System (ADS)

    Navarro-Avila, Fernando J.; Saint-Hill-Febles, Yadira; Renner, Janis; Klare, Peter; von Delius, Stefan; Navab, Nassir; Mateus, Diana

    2017-03-01

    We propose a method for computer-assisted optical biopsy for colorectal polyps, with the final goal of assisting the medical expert during the colonoscopy. In particular, we target the problem of automatic classification of polyp images in two classes: adenomatous vs non-adenoma. Our approach is based on recent advancements in convolutional neural networks (CNN) for image representation. In the paper, we describe and compare four different methodologies to address the binary classification task: a baseline with classical features and a Random Forest classifier, two methods based on features obtained from a pre-trained network, and finally, the end-to-end training of a CNN. With the pre-trained network, we show the feasibility of transferring a feature extraction mechanism trained on millions of natural images, to the task of classifying adenomatous polyps. We then demonstrate further performance improvements when training the CNN for our specific classification task. In our study, 776 polyp images were acquired and histologically analyzed after polyp resection. We report a performance increase of the CNN-based approaches with respect to both, the conventional engineered features and to a state-of-the-art method based on videos and 3D shape features.

  10. 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.

  11. Interventional radiology virtual simulator for liver biopsy.

    PubMed

    Villard, P F; Vidal, F P; ap Cenydd, L; Holbrey, R; Pisharody, S; Johnson, S; Bulpitt, A; John, N W; Bello, F; Gould, D

    2014-03-01

    Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.

  12. 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.

  13. Sonographically guided percutaneous muscle biopsy in diagnosis of neuromuscular disease: a useful alternative to open surgical biopsy.

    PubMed

    O'Sullivan, Paul J; Gorman, Grainne M; Hardiman, Orla M; Farrell, Michael J; Logan, P Mark

    2006-01-01

    The purpose of this study was to evaluate the feasibility of sonographically guided percutaneous muscle biopsy in the investigation of neuromuscular disorders. Sonographically guided percutaneous needle biopsy of skeletal muscle was performed with a 14-gauge core biopsy system in 40 patients over a 24-month period. Patients were referred from the Department of Neurology under investigation for neuromuscular disorders. Sonography was used to find suitable tissue and to avoid major vascular structures. A local anesthetic was applied below skin only. A 3- to 4-mm incision was made. Three 14-gauge samples were obtained from each patient. All samples were placed on saline-dampened gauze and sent for neuropathologic analysis. As a control, we retrospectively assessed results of the 40 most recent muscle samples acquired via open surgical biopsy. With the use of sonography, 32 (80%) of 40 patients had a histologic diagnosis made via percutaneous needle biopsy. This included 26 (93%) of 28 patients with acute muscular disease and 6 (50%) of 12 patients with chronic disease. In the surgical group (all acute disease), 38 (95%) of 40 patients had diagnostic tissue attained. Sonographically guided percutaneous 14-gauge core skeletal muscle biopsy is a useful procedure, facilitating diagnosis in acute muscular disease. It provides results comparable with those of open surgical biopsy in acute muscular disease. It may also be used in chronic muscular disease but repeated or open biopsy may be needed.

  14. Detection of blur artifacts in histopathological whole-slide images of endomyocardial biopsies.

    PubMed

    Hang Wu; Phan, John H; Bhatia, Ajay K; Cundiff, Caitlin A; Shehata, Bahig M; Wang, May D

    2015-01-01

    Histopathological whole-slide images (WSIs) have emerged as an objective and quantitative means for image-based disease diagnosis. However, WSIs may contain acquisition artifacts that affect downstream image feature extraction and quantitative disease diagnosis. We develop a method for detecting blur artifacts in WSIs using distributions of local blur metrics. As features, these distributions enable accurate classification of WSI regions as sharp or blurry. We evaluate our method using over 1000 portions of an endomyocardial biopsy (EMB) WSI. Results indicate that local blur metrics accurately detect blurry image regions.

  15. Multicentre evaluation of targeted and systematic biopsies using magnetic resonance and ultrasound image-fusion guided transperineal prostate biopsy in patients with a previous negative biopsy.

    PubMed

    Hansen, Nienke L; Kesch, Claudia; Barrett, Tristan; Koo, Brendan; Radtke, Jan P; Bonekamp, David; Schlemmer, Heinz-Peter; Warren, Anne Y; Wieczorek, Kathrin; Hohenfellner, Markus; Kastner, Christof; Hadaschik, Boris

    2017-11-01

    To evaluate the detection rates of targeted and systematic biopsies in magnetic resonance imaging (MRI) and ultrasound (US) image-fusion transperineal prostate biopsy for patients with previous benign transrectal biopsies in two high-volume centres. A two centre prospective outcome study of 487 patients with previous benign biopsies that underwent transperineal MRI/US fusion-guided targeted and systematic saturation biopsy from 2012 to 2015. Multiparametric MRI (mpMRI) was reported according to Prostate Imaging Reporting and Data System (PI-RADS) Version 1. Detection of Gleason score 7-10 prostate cancer on biopsy was the primary outcome. Positive (PPV) and negative (NPV) predictive values including 95% confidence intervals (95% CIs) were calculated. Detection rates of targeted and systematic biopsies were compared using McNemar's test. The median (interquartile range) PSA level was 9.0 (6.7-13.4) ng/mL. PI-RADS 3-5 mpMRI lesions were reported in 343 (70%) patients and Gleason score 7-10 prostate cancer was detected in 149 (31%). The PPV (95% CI) for detecting Gleason score 7-10 prostate cancer was 0.20 (±0.07) for PI-RADS 3, 0.32 (±0.09) for PI-RADS 4, and 0.70 (±0.08) for PI-RADS 5. The NPV (95% CI) of PI-RADS 1-2 was 0.92 (±0.04) for Gleason score 7-10 and 0.99 (±0.02) for Gleason score ≥4 + 3 cancer. Systematic biopsies alone found 125/138 (91%) Gleason score 7-10 cancers. In patients with suspicious lesions (PI-RADS 4-5) on mpMRI, systematic biopsies would not have detected 12/113 significant prostate cancers (11%), while targeted biopsies alone would have failed to diagnose 10/113 (9%). In equivocal lesions (PI-RADS 3), targeted biopsy alone would not have diagnosed 14/25 (56%) of Gleason score 7-10 cancers, whereas systematic biopsies alone would have missed 1/25 (4%). Combination with PSA density improved the area under the curve of PI-RADS from 0.822 to 0.846. In patients with high probability mpMRI lesions, the highest detection rates of Gleason

  16. Are concurrent systematic cores needed at the time of targeted biopsy in patients with prior negative prostate biopsies?

    PubMed

    Albisinni, S; Aoun, F; Noel, A; El Rassy, E; Lemort, M; Paesmans, M; van Velthoven, R; Roumeguère, T; Peltier, A

    2018-01-01

    MRI-guided targeted biopsies are advised in patients who have undergone an initial series of negative systematic biopsies, in whom prostate cancer (PCa) suspicion remains elevated. The aim of the study was to evaluate whether, in men with prior negative prostate biopsies, systematic cores are also warranted at the time of an MRI-targeted repeat biopsy. We enrolled patients with prior negative biopsy undergoing real time MRI/TRUS fusion guided prostate biopsy at our institute between 2014 and 2016. Patients with at least one index lesion on multiparametric MRI were included. All eligible patients underwent both systematic random biopsies (12-14 cores) and targeted biopsies (2-4 cores). The study included 74 men with a median age of 65 years, PSA level of 9.27ng/mL, and prostatic volume of 45ml. The overall PCa detection rate and the clinically significant cancer detection rate were 56.7% and 39.2%, respectively. Targeted cores demonstrated similar clinically significant PCa detection rate compared to systematic cores (33.8% vs. 28.4%, P=0.38) with significantly less tissue sampling. Indeed, a combination approach was significantly superior to a targeted-only in overall PCa detection (+16.7% overall detection rate, P=0.007). Although differences in clinically significant PCa detection were statistically non-significant (P=0.13), a combination approach did allow detecting 7 extra clinically significant PCas (+13.8%). In patients with elevated PSA and prior negative biopsies, concurrent systematic sampling may be needed at the time of targeted biopsy in order to maximize PCa detection rate. Larger studies are needed to validate our findings. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions.

    PubMed

    Cohen, Micah G; McMahon, Colm J; Kung, Justin W; Wu, Jim S

    2016-05-01

    The purpose of this study was to compare manual and battery-powered bone biopsy systems for diagnostic yield and procedural factors during core needle biopsy of sclerotic bone lesions. A total of 155 consecutive CT-guided core needle biopsies of sclerotic bone lesions were performed at one institution from January 2006 to November 2014. Before March 2012, lesions were biopsied with manual bone drill systems. After March 2012, most biopsies were performed with a battery-powered system and either noncoaxial or coaxial biopsy needles. Diagnostic yield, crush artifact, CT procedure time, procedure radiation dose, conscious sedation dose, and complications were compared between the manual and battery-powered core needle biopsy systems by Fisher exact test and t test. One-way ANOVA was used for subgroup analysis of the two battery-powered systems for procedure time and radiation dose. The diagnostic yield for all sclerotic lesions was 60.0% (93/155) and was significantly higher with the battery-powered system (73.0% [27/37]) than with the manual systems (55.9% [66/118]) (p = 0.047). There was no significant difference between the two systems in terms of crush artifact, procedure time, radiation dose, conscious sedation administered, or complications. In subgroup analysis, the coaxial battery-powered biopsies had shorter procedure times (p = 0.01) and lower radiation doses (p = 0.002) than the coaxial manual systems, but the noncoaxial battery-powered biopsies had longer average procedure times and higher radiation doses than the coaxial manual systems. In biopsy of sclerotic bone lesions, use of a battery-powered bone drill system improves diagnostic yield over use of a manual system.

  18. 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

  19. Diagnostic Yield and Safety of Cerebellar and Brainstem Parenchymal Biopsy.

    PubMed

    Tobin, W Oliver; Meyer, Fredric B; Keegan, B Mark

    2015-12-01

    We aimed to determine the diagnostic yield and safety of posterior fossa parenchymal biopsy. One-hundred-thirty-six patients who underwent 137 posterior fossa (brainstem or cerebellar) parenchymal biopsies at Mayo Clinic (Rochester, Minnesota, USA) between 1996 and 2009 were identified by chart review. Case histories; radiologic, surgical, and pathologic reports; and safety outcomes were assessed. Posterior fossa parenchymal biopsies were performed on 78 male and 58 female patients of median age 47 years (interquartile range 28-61). Preoperative clinical diagnosis in the majority of cases was of a malignant neoplasm. Glial neoplasm (51%) was the most common finding followed by lymphoma (7%) and neurosarcoidosis (7%). Normal tissue or nonspecific changes were observed in 28 cases (20%). Three deaths occurred: 2 at the time of biopsy (1%) and 1 due to underlying disease. All deaths occurred in patients who had a cerebellar biopsy. Transient neurologic deficits occurred in 15 patients (11%): worsening of presenting symptoms (4), cardiac arrhythmia (3), vertigo (2), diplopia (2), ataxia (3), seizure (1), decreased consciousness (1), and limb numbness (3). Sustained neurologic deficits occurred in 3 patients: fourth nerve palsy (1), hemiparesis (1), and facial numbness (1). The diagnostic yield of posterior fossa parenchymal biopsy in Mayo Clinic patients with diverse pathologies was 80%. The complication rate was 11% with the majority being transient, but 2 deaths were attributed to biopsy. Evaluation of the diagnostic yield and complication rate at individual neurosurgical centers is needed to determine generalizability of these results. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Renal biopsy practice: What is the gold standard?

    PubMed

    Brachemi, Soumeya; Bollée, Guillaume

    2014-11-06

    Renal biopsy (RB) is useful for diagnosis and therapy guidance of renal diseases but incurs a risk of bleeding complications of variable severity, from transitory haematuria or asymptomatic hematoma to life-threatening hemorrhage. Several risk factors for complications after RB have been identified, including high blood pressure, age, decreased renal function, obesity, anemia, low platelet count and hemostasis disorders. These should be carefully assessed and, whenever possible, corrected before the procedure. The incidence of serious complications has become low with the use of automated biopsy devices and ultrasound guidance, which is currently the "gold standard" procedure for percutaneous RB. An outpatient biopsy may be considered in a carefully selected population with no risk factor for bleeding. However, controversies persist on the duration of observation after biopsy, especially for native kidney biopsy. Transjugular RB and laparoscopic RB represent reliable alternatives to conventional percutaneous biopsy in patients at high risk of bleeding, although some factors limit their use. This aim of this review is to summarize the issues of complications after RB, assessment of hemorrhagic risk factors, optimal biopsy procedure and strategies aimed to minimize the risk of bleeding.

  1. Microincision, aspiration cutter-assisted multifocal iris biopsy for melanoma.

    PubMed

    Finger, Paul T; Milman, Tatyana

    2017-01-19

    To describe a minimally invasive method to create multifocal full-thickness surgical iridectomy biopsies. Seven patients suspected to have diffuse iris melanoma underwent multifocal surgical iridectomy biopsy through a single 1.0-mm clear corneal incision. A 25-G inked trocar was used to create one visible corneal portal, through which the anterior chamber was filled with sodium hyaluronate 1%. Then, a 25-G aspiration cutter probe was introduced through the corneal incision such that the aspiration portal was occluded by the iris biopsy sites. Then aspiration (600 mm Hg) cutting (300 cuts per minute) was used to create full- and partial-thickness surgical iridectomy biopsies at multiple locations. After each biopsy the probe was removed, and its contents aspirated into a separate 3-mL syringe (marked by clock hour location). The sodium hyaluronate 1% was removed and wound checked for leakage. Diagnostic specimens were obtained in all cases. Five were found to be diffuse iris melanomas and 2 were indeterminate iris melanocytic proliferations. No patients developed a secondary increase in intraocular pressure, hyphema, infection, cataract, or vision loss. No cases of intraocular tumor dissemination were observed. No patient complained of glare or monocular diplopia. Three of 7 corneal wounds were self-sealing. Multifocal surgical iridectomy biopsy can be minimally invasive and effective allowing for partial- and full-thickness iris biopsy. Use of a 25-G aspiration cutting probe allowed for small incision surgery, rapid rehabilitation, and no significant complications.

  2. BiopSee® - transperineal stereotactic navigated prostate biopsy.

    PubMed

    Zogal, Pawel; Sakas, Georgios; Rösch, Woerner; Baltas, Dimos

    2011-06-01

    In the recent years, prostate cancer was the most commonly diagnosed cancer in men. Currently secure diagnosis confirmation is done by a transrectal biopsy and following histopathological examination. Conventional transrectal biopsy success rates are rather low with ca. 30% detection upon the first and ca 20% after re-biopsy. The paper presents a novel system for stereotactic navigated prostate biopsy. The approach results into higher accuracy, reproducibility and unrestricted and effective access to all prostate regions. Custom designed ultrasound, new template design and integrated 2-axes stepper allows superior 2D and 3D prostate imaging quality and precise needle navigation. DICOM functionality and image fusion enable to import pre-operative datasets (e.g. multiparametric MRI, targets etc.) and overlay all available radiological information into the biopsy planning and guiding procedure. The biopsy needle insertion itself is performed under augmented reality ultrasound guidance. Each procedure step is automatically documented in order to provide quality assurance and permit data re-usage for the further treatment. First clinical results indicates success rates of ca. 70% by first biopsies by our approach.

  3. New Bacterial Infection in the Prostate after Transrectal Prostate Biopsy.

    PubMed

    Seo, Yumi; Lee, Gilho

    2018-04-23

    The prostate is prone to infections. Hypothetically, bacteria can be inoculated into the prostate during a transrectal prostate biopsy (TRPB) and progress into chronic bacterial prostatitis. Therefore, we examined new bacterial infections in biopsied prostates after TRPB and whether they affect clinical characteristics in the biopsied patients. Of men whose prostate cultures have been taken prior to TRPB, 105 men with bacteria-free benign prostate pathology underwent an additional repeated prostate culture within a year after TRPB. Twenty out of 105 men (19.05%) acquired new bacteria in their naïve prostates after TRPB. Except for one single case of Escherichia coli infection, 19 men had acquired gram-positive bacteria species. Between the culture-positive and negative groups, there were no significant differences in age, serum prostate-specific antigen (PSA) level, white blood cell (WBC) counts in expressed prostatic secretion (EPS), prostate volume, symptom severities in Korean version of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire, and patient-specific risk factors for biopsy associated infectious complications. Additionally, the TRPB procedure increased the WBC counts in post-biopsy EPS ( P = 0.031, McNemar test), but did not increase the serum PSA level and symptoms of NIH-CPSI in 20 men who acquired new bacteria after TRPB. The TRPB procedure was significantly associated with acquiring new bacterial infections in the biopsied prostate, but these localized bacteria did not affect patients' serum PSA level and symptoms after biopsy.

  4. 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).

  5. Ultrasound guidance system for prostate biopsy

    NASA Astrophysics Data System (ADS)

    Hummel, Johann; Kerschner, Reinhard; Kaar, Marcus; Birkfellner, Wolfgang; Figl, Michael

    2017-03-01

    We designed a guidance system for prostate biopsy based on PET/MR images and 3D ultrasound (US). With our proposed method common inter-modal MR-US (or CT-US in case of PET/CTs) registration can be replaced by an intra-modal 3D/3D-US/US registration and an optical tracking system (OTS). On the pre-operative site, a PET/MR calibration allows to link both hybrid modalities with an abdominal 3D-US. On the interventional site, another abdominal 3D US is taken to merge the pre-operative images with the real-time 3D-US via 3D/3D-US/US registration. Finally, the images of a tracked trans-rectal US probe can be displayed with the pre-operative images by overlay. For PET/MR image fusion we applied a point-to-point registration between PET and OTS and MR and OTS, respectively. 3D/3D-US/US registration was evaluated for images taken in supine and lateral patient position. To enable table shifts between PET/MR and US image acquisition a table calibration procedure is presented. We found fiducial registration errors of 0.9 mm and 2.8 mm, respectively, with respect to the MR and PET calibration. A target registration error between MR and 3D US amounted to 1.4 mm. The registration error for the 3D/3D-US/US registration was found to be 3.7 mm. Furthermore, we have shown that ultrasound is applicable in an MR environment.

  6. Skeletal muscle biopsy studies of cardiac patients.

    PubMed

    Fekete, G; Boros, Z; Cserhalmi, L; Apor, P

    1987-01-01

    Eleven patients diagnosed and treated for congestive cardiomyopathy (COCM) of unknown aetiology, and another 10 patients, with congestive alcoholic heart muscle disease (ACOCM) were studied. Muscle biopsy samples were obtained from the vastus lateralis (VL) and the gastrocnemius (G) muscles. In part of the sample muscle the fibre pattern was classified by means of ATPase activity staining, a technique based on the pH lability of the fibres concerned. Fibre typing and area measurements were carried out by light microscope. The other part of the sample was used as muscle homogenate of which the Ca2+-activated ATPase activity as well as citrate synthetase (CS) and aldolase activities were measured. No significant difference was found in these enzyme activities between the two groups of patients. The proportion of the slow twitch (ST) fibres in the VL, mainly in the patients with ACOCM, was lower as compared to data for healthy subjects. A similar tendency was revealed for G. In both muscles tested, the area of ST fibres was smaller in the ACOCM group. The fast twitch (FT) fibre area proved to be slightly different in the two groups of subjects tested. Occurrence of degenerative signs in the histological tests was higher in the ACOCM than in the COCM group. It was concluded that differences in the skeletal muscles of patients with ACOCM and COCM may primarily account for the alcoholism. The disease of the heart muscle has little effect on the function of skeletal muscle. Even so, a low amount or lack of physical activity may have an unfavourable influence on the skeletal muscles of patients with heart muscle disease.

  7. Renal biopsies in children: current practice and audit of outcomes.

    PubMed

    Hussain, Farida; Mallik, Meeta; Marks, Stephen D; Watson, Alan R

    2010-02-01

    There is considerable variation in the way that children are prepared for and the techniques employed in a renal biopsy. There was national agreement between UK paediatric renal centres to review current practice and audit outcomes An initial questionnaire survey was undertaken and a 12-month prospective audit performed of renal biopsies against agreed standards for the number of needle passes, adequacy of biopsy material and complication rates. Eleven of 13 centres participated. Information leaflets are sent pre-biopsy in five centres with only one using play preparation. Six of 11 routinely perform biopsies as day-case (DC) procedures and 6 use general anaesthesia (GA). Real-time ultrasound is the favoured method in eight centres. Biopsies are performed by nephrologists only in four centres, nephrologists with radiologists in five and radiology alone in two. Of 531 biopsies (352 native), 31% were performed as a DC with 49% being done under GA. The standard for the number of passes of native kidneys (95%). The major complication rate was higher than the standard of biopsy was performed as a DC or inpatient procedure (P = 0.73) or when GA or sedation was used (P = 0.8). The audit highlights significant variation in clinical practice with limited use of preparation materials and DC procedures. The results have stimulated constructive debate about preparation and indications for biopsy and training issues. The audit enables centres and individuals to monitor performance.

  8. Intraoperative loss of core biopsy clips: clinical implications.

    PubMed

    Calhoun, Kristine; Giuliano, Armando; Brenner, R James

    2008-03-01

    The purpose of this study was to report the occurrence of intraoperative loss of metallic marking clips placed during image-guided biopsy and to hypothesize the likely mechanism of this clinical problem. From January 2003 through December 2004, patients presenting for preoperative mammographic localization and operative excision of biopsy site marking clips were identified. Age, method of image-guided biopsy, number of excised specimens, and tissue diagnosis were determined. Specimen radiographs were used to identify cases of suspected intraoperative clip loss. Clips absent on specimen radiographs and postoperative mammograms were defined as lost intraoperatively. Biopsy site marking clips, surgical clips, and suction device apertures were measured. In 78 surgical procedures performed during the study period, three (3.8%) of the patients experienced clip loss. Specimen radiographs confirmed the absence of clips in all submitted tissues. A median of four (range, three to five) separate biopsy specimens were excised among these three cases. A healing biopsy site from the stereotactic biopsy preceding the clip placement procedure was confirmed in all cases. Absence of the metallic clip was confirmed on postoperative mammograms. The apertures of two types of suction device were four and two times those of the biopsy clips. Intraoperative loss of metallic clips placed at the conclusion of image-guided breast biopsy is unusual but can occur during subsequent surgical excision. Repeated inability to locate the clip on specimen radiographs after accurate preoperative localization should raise the suspicion that the target clip has been lost, not missed, during surgery, likely because of inadvertent removal of the clip with the suction device.

  9. The Importance of Biopsy in the Era of Molecular Medicine.

    PubMed

    Ziv, Etay; Durack, Jeremy C; Solomon, Stephen B

    Recent advances in the molecular characterization of cancers have triggered interest in developing a new taxonomy of disease in oncology with the goal of using the molecular profile of a patient's tumor to predict response to treatment. Image-guided needle biopsy is central to this "precision medicine" effort. In this review, we first discuss the current role of biopsy in relation to clinical examples of molecular medicine. We then outline important bottlenecks to the advancement of precision medicine and highlight the potential role of image-guided biopsy to address these challenges.

  10. 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.

  11. How to use… lymph node biopsy in paediatrics.

    PubMed

    Farndon, Sarah; Behjati, Sam; Jonas, Nico; Messahel, Boo

    2017-10-01

    Lymphadenopathy is a common finding in children. It often causes anxiety among parents and healthcare professionals because it can be a sign of cancer. There is limited high-quality evidence to guide clinicians as to which children should be referred for lymph node biopsy. The gold standard method for evaluating lymphadenopathy of unknown cause is an excision biopsy. In this Interpretation, we discuss the use of lymph node biopsy in children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Margins in Skin Excision Biopsies: Principles and Guidelines

    PubMed Central

    Ranjan, Richa; Singh, Lavleen; Arava, Sudheer K; Singh, Manoj Kumar

    2014-01-01

    Skin biopsies are usually undertaken to confirm a clinical diagnosis, to remove a lesion, and to determine the adequacy of excised tissue margin. A surgical margin is technically defined as the “edge” of the tissue removed. The term is especially pertinent when the tissue excised is suspected of being involved by a malignant process. One of the most important predictive and prognostic factors of a malignant lesion is whether the margins of the resected specimen are involved by the tumor or not. The purpose of this review is to provide an insight into grossing of a skin biopsy specimen with emphasis on techniques and reporting of excision biopsy margins. PMID:25484385

  13. Microbiological Characteristics of Acute Prostatitis After Transrectal Prostate Biopsy

    PubMed Central

    Bang, Jun-Ho; Choe, Hyun-Sop; Lee, Dong-Sup; Lee, Seung-Ju

    2013-01-01

    Purpose We aimed to identify microbiological characteristics in patients with acute prostatitis after transrectal prostate biopsy to provide guidance in the review of prevention and treatment protocols. Materials and Methods A retrospective analysis of medical records was performed in 1,814 cases who underwent prostate biopsy at Seoul St. Mary's Hospital and St. Vincent's Hospital over a 5 year period from 2006 to 2011. Cases in which acute prostatitis occurred within 7 days after the biopsy were investigated. Before starting treatment with antibiotics, sample collections were done for culture of urine and blood. Culture and drug susceptibility was identified by use of a method established by the Clinical and Laboratory Standards Institute. Results A total of 1,814 biopsy procedures were performed in 1,541 patients. For 1,246 patients, the procedure was the first biopsy, whereas for 295 patients it was a repeat biopsy. Twenty-one patients (1.36%) were identified as having acute bacterial prostatitis after the biopsy. Fifteen patients (1.2%) had acute prostatitis after the first biopsy, and 6 patients (2.03%) experienced acute prostatitis after a repeat biopsy. Even though the incidence of acute bacterial prostatitis was higher after repeat biopsy than that after the first biopsy, there was no statistically significant intergroup difference in terms of incidence (χ2=1.223, p=0.269). When the collected urine and blood samples were cultured, Escherichia coli was found in samples from 15 patients (71.4%), Klebsiella pneumoniae in 3 patients (14.3%), Enterobacter intermedius in 1 patient (4.8%), E. aerogenes in 1 patient (4.8%), and Pseudomonas aeruginosa in 1 patient (4.8%). A fluoroquinolone-resistant strain was confirmed in 5 cases (23.8%) in total. Three cases of E. coli and 1 case of Klebsiella had extended-spectrum β-lactamase activity. Conclusions Empirical treatment of acute prostatitis should be done with consideration of geographical prevalence and drug

  14. How we process trephine biopsy specimens: epoxy resin embedded bone marrow biopsies

    PubMed Central

    Krenacs, T; Bagdi, E; Stelkovics, E; Bereczki, L; Krenacs, L

    2005-01-01

    Improved cytomorphology of semithin resin sections over paraffin wax embedded sections may be important in diagnostic haematopathology. However, resin embedding can make immunohistochemical antigen detection or DNA isolation for clonal gene rearrangement assays difficult. This review describes the processing of bone marrow biopsies using buffered formaldehyde based fixation and epoxy resin embedding, with or without EDTA decalcification. Traditional semithin resin sections are completely rehydrated after etching in home made sodium methoxide solution. Resin elimination allows high resolution staining of tissue components with common histological stains. Efficient antigen retrieval and the Envision-HRP system permit the immunohistological detection of many antigens of diagnostic relevance, with retention of high quality cytomorphology. Furthermore, DNA can be extracted for clonality analysis. The technique can be completed within a similar time period to that of paraffin wax processing with only ∼30% increase in cost. This technique has been used for diagnosis in over 4000 bone marrow biopsies over the past 14 years. By meeting traditional and contemporary demands on the haematopathologist, it offers a powerful alternative to paraffin wax processing for diagnosis and research. PMID:16126867

  15. Prospective, Randomized, Pathologist-Blinded Study of Disposable Alligator-Jaw Biopsy Forceps for Gastric Mucosal Biopsy

    PubMed Central

    Abudayyeh, Suhaib; Hoffman, Jill; El-Zimaity, Hala T.; Graham, David Y.

    2010-01-01

    Background Endoscopic biopsy forceps differ in the size and shape of the biopsy cup and the presence or absence of a needle. Methods We compared 4 different “large cup” forceps (3 with needles designed for 2.8 mm biopsy channels. A gastric antral and corpus biopsy were obtained with each. Parameters examined included: weight (mg), length (mm), orientation (poor, good), intactness (1, 2, or 3 pieces), depth (superficial, above muscularis mucosae, included muscularis mucosae), crush artifact (yes, no), and overall adequacy (inadequate, suboptimal, adequate). Results 24 patients were enrolled (191 biopsies). The median length was approximately 5 mm (range 1.1 to 8.2 mm). Histologically inadequate specimens were present in 4% with the forceps without needle compared to 16% of those with needles (P = 0.061) and there were significantly fewer specimens in 3 or more pieces than did the forceps with needles 2.1% vs. 12..6% (P<0.05). Conclusions Current alligator style forceps provide a high proportion of acceptable specimens with only minor differences between brands. Forceps from one source were least preferred by endoscopy assistants and had the highest rates of inadequate biopsies and biopsies with crush artifact. Forceps without needles provide histologically acceptable samples slightly more frequently than those with needles. PMID:18799373

  16. Prospective, randomized, pathologist-blinded study of disposable alligator-jaw biopsy forceps for gastric mucosal biopsy.

    PubMed

    Abudayyeh, S; Hoffman, J; El-Zimaity, H T; Graham, D Y

    2009-05-01

    Endoscopic biopsy forceps differ in the size and shape of the biopsy cup and the presence or absence of a needle. We compared four different "large cup" forceps (three with needles) designed for 2.8mm biopsy channels. A gastric antral and corpus biopsy were obtained with each. Parameters examined included: weight (mg), length (mm), orientation (poor, good), intactness (1, 2, or 3 pieces), depth (superficial, above muscularis mucosae, included muscularis mucosae), crush artefact (yes, no), and overall adequacy (inadequate, suboptimal, adequate). Twenty-four patients were enrolled (191 biopsies). The median length was approximately 5mm (range 1.1-8.2mm). Histologically inadequate specimens were present in 4% with the forceps without needle compared to 16% of those with needles (P=0.061) and there were significantly fewer specimens in three or more pieces than did the forceps with needles 2.1% vs. 12.6% (P<0.05). Current alligator style forceps provide a high proportion of acceptable specimens with only minor differences between brands. Forceps from one source were least preferred by endoscopy assistants and had the highest rates of inadequate biopsies and biopsies with crush artefact. Forceps without needles provide histologically acceptable samples slightly more frequently than those with needles.

  17. Use of a frameless computed tomography-guided stereotactic biopsy system for nasal biopsy in five dogs.

    PubMed

    Kuhlman, Gregory M; Taylor, Amanda R; Thieman-Mankin, Kelley M; Griffin, Jay; Cook, Audrey K; Levine, Jonathan M

    2016-04-15

    5 dogs (median age, 9 years; median body weight, 31 kg [68.2 lb]) with undefined nasal masses were examined after undergoing CT of the head and nasal biopsy via a rostral rhinoscopic or unaided (blind) approach because histologic results for collected biopsy specimens (inflammatory, necrotic, or hemorrhagic disease) suggested the specimens were nonrepresentative of the underlying disease process identified via CT (aggressive or malignant disease). Clinical signs at the time dogs were evaluated included open-mouth breathing, sneezing, or unilateral epistaxis. Histologic findings pertaining to the original biopsy specimens were suggestive of benign processes such as inflammation. In an attempt to obtain better representative specimens, a frameless CT-guided stereotactic biopsy system (CTSBS) was used to collect additional biopsy specimens from masses within the nasal and sinus passages of the dogs. The second set of biopsy specimens was histologically evaluated. Histologic evaluation of biopsy specimens collected via the CTSBS revealed results suggestive of malignant neoplasia (specifically, chondrosarcoma, hemangiopericytoma, or undifferentiated sarcoma) for 3 dogs, mild mixed-cell inflammation for 1 dog, and hamartoma for 1 dog. No complications were reported. These findings resulted in a change in treatment recommendations for 3 dogs and confirmed that no additional treatment was required for 1 dog (with hamartoma). For the remaining dog, in which CT findings and clinical history were strongly suggestive of neoplasia, the final diagnosis was rhinitis. Biopsy specimens were safely collected from masses within the nasal and sinus passages of dogs by use of a frameless CTSBS, allowing a definitive diagnosis that was unachievable with other biopsy approaches.

  18. [When to ask for a skin biopsy in a patient with leg ulcer? Retrospective study of 143 consecutive biopsies].

    PubMed

    Stansal, A; Khayat, K; Duchatelle, V; Tella, E; Gautier, V; Sfeir, D; Attal, R; Lazareth, I; Priollet, P

    2018-02-01

    A vascular cause is found in around 85% of leg ulcer patients, but non-vascular causes are also observed. Their diagnosis is based on a set of clinical arguments and skin biopsy with histological analysis. The aim of this study was to analyze the results of these biopsies and to find common criteria for ulcers whose skin biopsies had led to the diagnosis of a non-vascular ulcer. A retrospective study was carried out on the analysis of 143 skin biopsies of leg ulcers. The reasons for the biopsy were mainly atypical clinical signs and/or the lack of improvement in care after 6 months, as advocated by the French health authorities. The skin biopsies led to a diagnosis of non-vascular ulcer in 4.9% of cases (7/143), including skin cancer (n=5, 3.5%), cutaneous leishmaniasis (n=1, 0.7%) and Pyoderma gangrenosum (n=1, 0.7%). The univariate statistical analysis revealed that an elevated rim and abnormal excessive granulation tissue were significantly more frequently found in these ulcers. All patients with a positive skin biopsy had associated vascular involvement. This study found a 5% rate of non-vascular causes of ulcers, mainly skin cancer. Elevated rims and abnormal excessive granulation tissue were the unusual features most commonly found in these ulcers. All patients whose skin biopsy revealed a non-vascular cause had associated vascular involvement. This information confirms the need to perform a skin biopsy, even in the presence of a vascular disease. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Des Moines metropolitan area ITS strategic plan

    DOT National Transportation Integrated Search

    1998-08-19

    The Des Moines Area Metropolitan Organization (MPO) completed an early deployment study for the Des Moines metropolitan area in late 1997. The purpose of the study was to develop a strategic plan for Intelligent Transportation Systems (ITS) deploymen...

  20. [Gene expression analyses of kidney biopsies: the European renal cDNA bank--Kröner-Fresenius biopsy bank].

    PubMed

    Cohen, C D; Kretzler, M

    2009-03-01

    Histological analysis of kidney biopsies is an essential part of our current diagnostic workup of patients with renal disease. Besides the already established diagnostic tools, new methods allow extensive analysis of the sample tissue's gene expression. Using results from a European multicenter study on gene expression analysis of renal biopsies, in this review we demonstrate that this novel approach not only expands the scope of so-called basic research but also might supplement future biopsy diagnostics. The goals are improved diagnosis and more specific therapy choice and prognosis estimates.

  1. 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.

  2. Integrated sensor biopsy device for real time tissue metabolism analysis

    NASA Astrophysics Data System (ADS)

    Delgado Alonso, Jesus; Lieberman, Robert A.; DiCarmine, Paul M.; Berry, David; Guzman, Narciso; Marpu, Sreekar B.

    2018-02-01

    Current methods for guiding cancer biopsies rely almost exclusively on images derived from X-ray, ultrasound, or magnetic resonance, which essentially characterize suspected lesions based only on tissue density. This paper presents a sensor integrated biopsy device for in situ tissue analysis that will enable biopsy teams to measure local tissue chemistry in real time during biopsy procedures, adding a valuable new set of parameters to augment and extend conventional image guidance. A first demonstrator integrating three chemical and biochemical sensors was tested in a mice strain that is a spontaneous breast cancer model. In all cases, the multisensory probe was able to discriminate between healthy tissue, the edge of the tumor, and total insertion inside the cancer tissue, recording real-time information about tissue metabolism.

  3. Respiratory analysis of coupled mitochondria in cryopreserved liver biopsies.

    PubMed

    García-Roche, Mercedes; Casal, Alberto; Carriquiry, Mariana; Radi, Rafael; Quijano, Celia; Cassina, Adriana

    2018-07-01

    The aim of this work was to develop a cryopreservation method of small liver biopsies for in situ mitochondrial function assessment. Herein we describe a detailed protocol for tissue collection, cryopreservation, high-resolution respirometry using complex I and II substrates, calculation and interpretation of respiratory parameters. Liver biopsies from cow and rat were sequentially frozen in a medium containing dimethylsulfoxide as cryoprotectant and stored for up to 3 months at -80 °C. Oxygen consumption rate studies of fresh and cryopreserved samples revealed that most respiratory parameters remained unchanged. Additionally, outer mitochondrial membrane integrity was assessed adding cytochrome c, proving that our cryopreservation method does not harm mitochondrial structure. In sum, we present a reliable way to cryopreserve small liver biopsies without affecting mitochondrial function. Our protocol will enable the transport and storage of samples, extending and facilitating mitochondrial function analysis of liver biopsies. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Percutaneous Biopsy of Retrobulbar Masses: Anatomical Considerations and MRI Guidance

    SciTech Connect

    Edalat, Faramarz, E-mail: faramarz.edalat@gmail.com; Cazzato, Roberto Luigi; Garnon, Julien

    2017-04-15

    PurposeObtaining adequate tissue from retrobulbar masses remains a challenge. To this end, a new method of retrobulbar mass biopsy using MRI guidance is presented.Materials and MethodsTwo patients (7- and 71-year-old male) with indeterminate retrobulbar masses underwent bioptic and cytological samplings using MR-compatible 18G and 20–22G needles, and multi-planar MR fluoroscopy. An inferior approach was taken to avoid injury to the optic nerve and ophthalmic arteries.ResultsThe two biopsies were completed without complication. The core biopsy resulted in a final diagnosis, whereas the cytological sampling was non-diagnostic.ConclusionPercutaneous MR-guided retrobulbar mass biopsy proved to be feasible and safe in the two cases describedmore » in this report.« less

  5. Myositis with antimitochondrial antibodies diagnosed by rectus abdominis muscle biopsy.

    PubMed

    Uenaka, Takeshi; Kowa, Hisatomo; Sekiguchi, Kenji; Nagata, Kakuya; Ohtsuka, Yoshihisa; Kanda, Fumio; Toda, Tatsushi

    2013-05-01

    Antimitochondrial antibodies are autoantibodies detected in 90% of primary biliary cirrhosis (PBC) patients. Some PBC cases are complicated by myositis, which is difficult to confirm due to minimal histological evidence of inflammation in limb muscles. Our aim was to determine the extent of inflammatory changes in a truncal muscle biopsy specimen from a PBC patient. A 48-year-old woman with a 5-year history of atrial fibrillation and chronic heart failure was evaluated for elevated serum creatine kinase level. Antimitochondrial M2 antibodies were detected, and PBC was diagnosed. A biceps brachii biopsy specimen showed mild, non-specific myogenic changes; a second biopsy was performed on the rectus abdominis muscle, which showed typical inflammatory changes. Myositis with antimitochondrial M2 antibodies was confirmed. In myositis patients with antimitochondrial M2 antibodies, muscles of the extremities are involved to a lesser extent. Radiological and histological examination focusing on truncal muscles, including a biopsy, is important. Copyright © 2012 Wiley Periodicals, Inc.

  6. 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

  7. Relationship Between Prebiopsy Multiparametric Magnetic Resonance Imaging (MRI), Biopsy Indication, and MRI-ultrasound Fusion-targeted Prostate Biopsy Outcomes.

    PubMed

    Meng, Xiaosong; Rosenkrantz, Andrew B; Mendhiratta, Neil; Fenstermaker, Michael; Huang, Richard; Wysock, James S; Bjurlin, Marc A; Marshall, Susan; Deng, Fang-Ming; Zhou, Ming; Melamed, Jonathan; Huang, William C; Lepor, Herbert; Taneja, Samir S

    2016-03-01

    Increasing evidence supports the use of magnetic resonance imaging (MRI)-ultrasound fusion-targeted prostate biopsy (MRF-TB) to improve the detection of clinically significant prostate cancer (PCa) while limiting detection of indolent disease compared to systematic 12-core biopsy (SB). To compare MRF-TB and SB results and investigate the relationship between biopsy outcomes and prebiopsy MRI. Retrospective analysis of a prospectively acquired cohort of men presenting for prostate biopsy over a 26-mo period. A total of 601 of 803 consecutively eligible men were included. All men were offered prebiopsy MRI and assigned a maximum MRI suspicion score (mSS). Men with an MRI abnormality underwent combined MRF-TB and SB. Detection rates for all PCa and high-grade PCa (Gleason score [GS] ≥7) were compared using the McNemar test. MRF-TB detected fewer GS 6 PCas (75 vs 121; p<0.001) and more GS ≥7 PCas (158 vs 117; p<0.001) than SB. Higher mSS was associated with higher detection of GS ≥7 PCa (p<0.001) but was not correlated with detection of GS 6 PCa. Prediction of GS ≥7 disease by mSS varied according to biopsy history. Compared to SB, MRF-TB identified more GS ≥7 PCas in men with no prior biopsy (88 vs 72; p=0.012), in men with a prior negative biopsy (28 vs 16; p=0.010), and in men with a prior cancer diagnosis (42 vs 29; p=0.043). MRF-TB detected fewer GS 6 PCas in men with no prior biopsy (32 vs 60; p<0.001) and men with prior cancer (30 vs 46; p=0.034). Limitations include the retrospective design and the potential for selection bias given a referral population. MRF-TB detects more high-grade PCas than SB while limiting detection of GS 6 PCa in men presenting for prostate biopsy. These findings suggest that prebiopsy multiparametric MRI and MRF-TB should be considered for all men undergoing prostate biopsy. In addition, mSS in conjunction with biopsy indications may ultimately help in identifying men at low risk of high-grade cancer for whom prostate biopsy

  8. Utilization of sentinel lymph node biopsy for uterine cancer.

    PubMed

    Wright, Jason D; Cham, Stephanie; Chen, Ling; Burke, William M; Hou, June Y; Tergas, Ana I; Desai, Vrunda; Hu, Jim C; Ananth, Cande V; Neugut, Alfred I; Hershman, Dawn L

    2017-06-01

    To limit the potential short and long-term morbidity of lymphadenectomy, sentinel lymph node biopsy has been proposed for endometrial cancer. The principle of sentinel lymph node biopsy relies on removal of a small number of lymph nodes that are the first drainage basins from a tumor and thus the most likely to harbor tumor cells. While the procedure may reduce morbidity, efficacy data are limited and little is known about how commonly the procedure is performed. We examined the patterns and predictors of use of sentinel lymph node biopsy and outcomes of the procedure in women with endometrial cancer who underwent hysterectomy. We used the Perspective database to identify women with uterine cancer who underwent hysterectomy from 2011 through 2015. Billing and charge codes were used to classify women as having undergone lymphadenectomy, sentinel lymph node biopsy, or no nodal assessment. Multivariable models were used to examine clinical, demographic, and hospital characteristics with use of sentinel lymph node biopsy. Length of stay and cost were compared among the different methods of nodal assessment. Among 28,362 patients, 9327 (32.9%) did not undergo nodal assessment, 17,669 (62.3%) underwent lymphadenectomy, and 1366 (4.8%) underwent sentinel lymph node biopsy. Sentinel lymph node biopsy was performed in 1.3% (95% confidence interval, 1.0-1.6%) of abdominal hysterectomies, 3.4% (95% confidence interval, 2.7-4.1%) of laparoscopic hysterectomies, and 7.5% (95% confidence interval, 7.0-8.0%) of robotic-assisted hysterectomies. In a multivariable model, more recent year of surgery was associated with performance of sentinel lymph node biopsy. Compared to abdominal hysterectomy, those undergoing laparoscopic (adjusted risk ratio, 2.45; 95% confidence interval, 1.89-3.18) and robotic-assisted (adjusted risk ratio, 2.69; 95% confidence interval, 2.19-3.30) hysterectomy were more likely to undergo sentinel lymph node biopsy. Among women who underwent minimally

  9. The Diagnostic Accuracy of Incisional Biopsy in the Oral Cavity.

    PubMed

    Chen, Sara; Forman, Michael; Sadow, Peter M; August, Meredith

    2016-05-01

    To determine the accuracy of incisional biopsy examination to diagnose oral lesions. This retrospective cohort study was performed to determine the concordance rate between incisional biopsy examination and definitive resection diagnosis for different oral lesions. The study sample was derived from the population of patients who presented to the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital (Boston, MA) from January 2005 through December 2012. Inclusion criteria were the diagnosis of an oral lesion from an incisional biopsy examination, subsequent diagnosis from the definitive resection of the same lesion, and complete clinical and pathologic patient records. The predictor variables were the origin and size of the lesion. The primary outcome variable was concordance between the provisional incisional biopsy diagnosis and definitive pathologic resection diagnosis. The secondary outcome variable was type of biopsy error for the discordant cases. Incisional biopsy errors were assessed and grouped into 5 categories: 1) sampling error; 2) insufficient tissue for diagnosis; 3) presence of inflammation making diagnosis difficult; 4) artifact; and 5) pathologist discordance. A total of 272 patients met the inclusion criteria. The study sample had a mean age of 47.4 years and 55.7% were women. Of these cases, 242 (88.9%) were concordant when comparing the biopsy and final resection pathology reports. At histologic evaluation, 60.0% of discordant findings were attributed to sampling error, 23.3% to pathologist discrepancy, 13.3% to insufficient tissue provided in the biopsy specimen, and 3.4% to inflammation obscuring diagnosis. Overall, concordant cases had a larger average biopsy volume (1.53 cm(3)) than discordant cases (0.42 cm(3)). The data collected indicate an 88.9% diagnostic concordance with final pathologic results for incisional oral biopsy diagnoses. Sixty percent of discordance was attributed to sampling error when sampled

  10. 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

  11. Kidney Biopsy Adequacy: A Metric-based Study.

    PubMed

    Ferrer, German; Andeen, Nicole K; Lockridge, Joseph; Norman, Douglas; Foster, Bryan R; Houghton, Donald C; Troxell, Megan L

    2018-06-05

    There are differences in renal biopsy yield related to on-site evaluation, tissue division, and operator, among others. To understand these variations, we collected adequacy-associated data (%cortex, glomeruli, arteries, length) from consecutive native and allograft kidney biopsies over a 22-month period. In total, 1332 biopsies (native: 873, allograft: 459) were included, 617 obtained by nephrologists, 663 by radiologists, and 559 with access to on-site division. Proceduralists with access to on-site evaluation had significantly lower inadequacy rates and better division of tissue for light microscopy (LM), immunofluorescence, and electron microscopy than those without access to on-site evaluation. Radiologists in our region were significantly less likely to have access to on-site evaluation than nephrologists. On multivariate analysis for native kidney biopsies, the effect of having a radiologist perform the biopsy and having access to on-site division were both significant predictors of obtaining greater calculated amount of cortex for LM. Despite the trend for radiologists to obtain more tissue in general, biopsies from nephrologists contained a greater percentage of cortex and were more likely to be considered adequate for LM (native kidney inadequacy rate for LM: 1.11% vs. 5.41%, P=0.0086). Biopsies in which inadequate or marginal cortical tissue was submitted for LM had only minor decreases in the amount of cortex submitted for immunofluorescence and electron microscopy, revealing an opportunity for improved specimen triaging when limited tissue is obtained. In conclusion, both on-site evaluation/division and proceduralist significantly affect quantitative kidney biopsy metrics, which in turn affects the pathologist's ability to render an accurate diagnosis with appropriate prognostic information for the patient and treating nephrologist.

  12. CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

    PubMed Central

    Lal, Hira; Nath, Alok; Borah, Samudra

    2012-01-01

    Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications. PMID:22438689

  13. Evolving biopsy techniques for the diagnosis of neuroblastoma in children.

    PubMed

    Campagna, Giovanni; Rosenfeld, Eric; Foster, Jennifer; Vasudevan, Sanjeev; Nuchtern, Jed; Kim, Eugene; Commander, Sarah; Naik-Mathuria, Bindi

    2018-04-14

    To compare the adequacy and safety of percutaneous core needle biopsy and surgical wedge biopsy of neuroblastoma in children. A retrospective review of patients who underwent biopsy for intermediate- or high-risk neuroblastoma at our institution between 2011 and 2015 was performed (recent cohort). Procedure details and outcomes were collected and analyzed using descriptive statistics and Wilcoxon rank tests; P < 0.05 was considered significant. Published data from 2002 to 2010 were compared (historic cohort). Since 2011, percutaneous, ultrasound-guided, core needle biopsy has been more commonly utilized (47% (16/34) recent vs. 25% (7/28) historic; P = 0.07), and the number of core needle samples increased from median 7 (historic) to 25 (recent). Complications decreased (21% (7/34) recent vs. 64% (18/28) historic; P < 0.01). Biopsy adequacy in the recent cohort was similar (94% percutaneous vs. 89% surgical; P = 1.00), which is improved from the historic cohort (71% percutaneous vs. 100% surgical; P = 0.06). Larger tumors were more likely to have a percutaneous biopsy (82 ± 37 cm percutaneous vs. 47 ± 29 cm surgical; P = 0.04). When multiple cores are obtained, percutaneous core needle biopsy is adequate for complete tissue diagnosis of neuroblastoma and can be safely performed. This can be considered as an alternative to open surgical biopsy. Treatment Study. III. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Emergency right hepatectomy after laparoscopic tru-cut liver biopsy

    PubMed Central

    Quezada, Nicolás; León, Felipe; Martínez, Jorge; Jarufe, Nicolás; Guerra, Juan Francisco

    2015-01-01

    Background Liver biopsy is a common procedure usually required for final pathologic diagnosis of different liver diseases. Morbidity following tru-cut biopsy is uncommon, with bleeding complications generally self-limited. Few cases of major hemorrhage after liver biopsies have been reported, but to our knowledge, no cases of emergency hepatectomy following a tru-cut liver biopsy have been reported previously. Presentation of case We report the case of a 38 years-old woman who presented with an intrahepatic arterial bleeding after a tru-cut liver biopsy under direct laparoscopic visualization, initially controlled by ligation of the right hepatic artery and temporary liver packing. On tenth postoperative day, she developed a pseudo-aneurysm of the anterior branch of the right hepatic artery, evolving with massive bleeding that was not amenable to control by endovascular therapy. Therefore, an emergency right hepatectomy had to be performed in order to stop the bleeding. The patient achieved hemodynamic stabilization, but developed a biliary fistula from the liver surface, refractory to non-operative treatment. In consequence, a Roux-Y hepatico-jejunostomy was performed at third month, with no further complications. Discussion Bleeding following tru-cut biopsy is a rare event. To our knowledge, this is the first report of an emergency hepatectomy due to hemorrhage following liver biopsy. Risks and complications of liver biopsy are revised. Conclusion Care must be taken when performing this kind of procedures and a high level of suspicion regarding this complication should be taken in count when clinical/hemodynamic deterioration occurs after these procedures. PMID:25618399

  15. Ability of sextant biopsies to predict radical prostatectomy stage.

    PubMed

    Wills, M L; Sauvageot, J; Partin, A W; Gurganus, R; Epstein, J I

    1998-05-01

    There are few studies evaluating multiple variables on sextant biopsies with the intent to predict stage in radical prostatectomy specimens. We studied 113 sextant biopsies with corresponding totally submitted radical prostatectomy specimens. Variables evaluated on sextant biopsies included total length and percent of cancer; maximum length and percent of cancer on one core; location (apex, mid, base); bilaterality; Gleason grade; number of cores involved; serum prostate-specific antigen (PSA) level; and serum PSA density (PSAD). Radical prostatectomy stage was classified as organ versus non-organ confined. The following variables individually correlated with radical prostatectomy stage: total cancer measured in millimeters (P <0.0001) or percent (P <0.0005); biopsy Gleason score (P <0.0001); number of involved cores (P <0.0001); maximum cancer on one core measured in millimeters (P = 0.0001); maximum percent of cancer on one core (P = 0.01); bilaterality (P = 0.01); PSA level (P = 0.03), and PSAD (P = 0.001). The most predictive sets of two variables that correlated with stage included high Gleason score (P <0.0001) combined with numbers of cores involved (P = 0.002). When biopsies had Gleason scores of 6 or less, two or fewer positive cores, and serum PSA of 0 to 4 ng/mL, 89% were organ confined. When biopsies had Gleason scores of 6 or less with two unilaterally positive cores, 87% were organ confined. In biopsies with Gleason scores of 7 or more and more than one positive core, only 10% were organ confined. The most important predictors of stage by sextant needle biopsy evaluation are numbers of cores involved with carcinoma and high Gleason score. Bilaterality and serum PSA values improved prediction in two small subgroups. In 37% of our population we were able to predict with a greater than 87% probability the organ-confined versus non-organ-confined status.

  16. Transsternal surgical biopsy of a mediastinal mass under local anesthesia.

    PubMed

    Bedini, Amedeo Vittorio; Libretti, Lidia; Pirondini, Emanuele

    2013-01-01

    We describe a minimally invasive transsternal surgical approach to obtain biopsies from retrosternal masses under local anesthesia. This original procedure was carried out in a patient with superior vena cava syndrome because she was unfit to undergo a CT-guided biopsy and at high risk for narcosis. In patients with such features this procedure could be preferable to conventional techniques. The transsternal approach is reliable, produces minimal trauma and no risk of pleural or vessel injury, and is very fast.

  17. Molecular Profiling of Liquid Biopsy Samples for Precision Medicine.

    PubMed

    Campos, Camila D M; Jackson, Joshua M; Witek, Małgorzata A; Soper, Steven A

    In the context of oncology, liquid biopsies consist of harvesting cancer biomarkers, such as circulating tumor cells, tumor-derived cell-free DNA, and extracellular vesicles, from bodily fluids. These biomarkers provide a source of clinically actionable molecular information that can enable precision medicine. Herein, we review technologies for the molecular profiling of liquid biopsy markers with special emphasis on the analysis of low abundant markers from mixed populations.

  18. La ponction biopsie hépatique à Dakar: indications, complications et apport diagnostique - à propos de 70 cas

    PubMed Central

    Touré, Papa Souleymane; Léye, Abdoulaye; Diop, Madoky Maguette; Gueye, Mame Daouda; Léye, Yakham Mohamed; Berthé, Adama; Mourtalla Ka, Mamadou

    2014-01-01

    Introduction Les objectifs de notre travail étaient de déterminer les indications, les complications et l'apport diagnostique de la ponction biopsie hépatique (PBH) transpariétale. Méthodes Il s'agissait d'une étude rétrospective descriptive allant du janvier 2006 à décembre 2010, réalisée dans le service de Médecine Interne de l'hôpital de Pikine de Dakar. Etaient inclus, tous les malades ayant subi une biopsie hépatique, en ambulatoire ou en hospitalisation. Etaient exclus, tous les patients qui ont bénéficié d'une PBH dont les résultats n'ont pas été retrouvés. Les données suivantes étaient étudié: l’âge, le sexe, les indications, la taille du fragment biopsique, Le nombre de carottes, les complications, la comparaison des diagnostics pré biopsiques avec les comptes rendus histologiques. Résultats Ont été colligées 70 patients atteints d'hépatopathie chronique ayant bénéficiés d'une PBH. Il s'agissait de 46 hommes (65.71%) et 24 femmes (34.29%). L’âge moyen des patients était de 36 ans. Les PBH étaient réalisées en ambulatoire chez 58 patients (82.86%) et chez 12 malades hospitalisés (17,14%). Les indications étaient dominées par les hépatites virales chroniques dans 62,86% (44cas), suivi des processus tumoraux du foie dans 24.29% (17 cas). Les complications survenues chez 15 patients (21.43%) étaient représentées de 14 cas de douleur (20%) et d'un cas de malaise vagal (1.43%). Les 70 PBH effectuées ont ramené une carotte dans 35,71% des cas, 2 à 6 carottes dans 32,87% des cas. La longueur moyenne des fragments biopsiques était de 22 ±8 mm. Soixante-six résultats étaient interprétables et 4 non interprétables soit une performance diagnostique de 94,29%. Conclusion La PBH est de pratique sure, avec un respect des contres indications et une bonne maitrise de la technique. Son acceptabilité a été bonne dans notre pratique et sa rentabilité diagnostique excellente. Elle devrait être beaucoup plus

  19. Déprescription des agonistes des récepteurs des benzodiazépines

    PubMed Central

    Pottie, Kevin; Thompson, Wade; Davies, Simon; Grenier, Jean; Sadowski, Cheryl A.; Welch, Vivian; Holbrook, Anne; Boyd, Cynthia; Swenson, Robert; Ma, Andy; Farrell, Barbara

    2018-01-01

    Résumé Objectif Formuler des lignes directrices fondées sur les données probantes visant à aider les cliniciens à décider du moment et de la façon sécuritaire de réduire la dose des agonistes des récepteurs des benzodiazépines (BZRA) pour mettre fin au traitement; se concentrer sur le niveau le plus élevé des données disponibles et obtenir les commentaires des professionnels de première ligne durant le processus de rédaction, de révision et d’adoption des lignes directrices. Méthodes L’équipe comptait 8 cliniciens (1 médecin de famille, 2 psychiatres, 1 psychologue clinique, 1 pharmacologue clinique, 2 pharmaciennes cliniques et 1 gériatre) et une spécialiste de la méthodologie; les membres ont divulgué tout conflit d’intérêts. Nous avons eu recours à un processus systématique, y compris l’approche GRADE (Grading of Recommendations Assessment, Development and Evaluation) pour formuler les lignes directrices. Les données ont été générées par une revue systématique d’études portant sur la déprescription des BZRA contre l’insomnie, de même que par une revue des revues sur les torts liés à la poursuite du traitement par BZRA et des synthèses narratives sur les préférences des patients et les répercussions sur les ressources. Ces données et le score GRADE de qualité des données ont servi à formuler les recommandations. L’équipe a peaufiné le texte sur le contenu et les recommandations des lignes directrices par consensus et a synthétisé les considérations cliniques afin de répondre aux questions des cliniciens de première ligne. Une version préliminaire des lignes directrices a été révisée par les cliniciens et les intervenants. Recommandations Nous recommandons d’offrir la déprescription (réduction lente de la dose) des BZRA à tous les patients âgés (≥ 65 ans) sous un BZRA, sans égard à la durée de l’usage, et suggérons d’offrir la déprescription (réduction lente de la dose)

  20. Caracterisation des revetements par projection thermique a haute vitesse obtenus a partir de differentes poudres de wc-10co-4cr pour des applications en aeronautique =

    NASA Astrophysics Data System (ADS)

    Quintero Malpica, Alfonso

    Les revetements par projection thermique HVOF (High Velocity Oxy-Fuel) sont communement utilises dans l'industrie aeronautique, notamment au sein du partenaire industriel du projet (Tecnickrome Aeronautique Inc), comme des remplacants pour les revetements produits par l'electrodeposition du chrome dur due aux problemes environnementaux. Ce projet avait pour but de trouver une poudre alternative a celle qui est actuellement utilisee pour la production des revetements de type WC-10Co-4Cr obtenus avec la technologie de projection thermique a haute vitesse HVOF et en utilisant le systeme de projection HVOF-JET KOTERTM III. Dans un premier temps, cinq poudres incluant celle de reference, ayant des distributions granulometriques differentes, ont ete projetees dans le but d'identifier quelles poudres pouvaient etre utilisees avec le systeme de projection HVOF-JET KOTERTM III en gardant des parametres similaires (debit d'hydrogene, debit d'oxygene, debit de poudre et distance de projection) que pour la poudre de reference. Les revetements obtenus a partir des poudres etudiees ont ete evalues selon les criteres d'acceptation des revetements sollicites par les principaux manufacturiers des trains d'atterrissage. Les tests ont porte sur l'epaisseur, l'adhesion, la microstructure, la microdurete, les contraintes residuelles et la rugosite. A partir des resultats obtenus, seulement deux poudres ont rencontre toutes les proprietes demandees par les specifications aeronautiques. L'influence de la variation de la distance de projection sur la qualite des revetements a ete etudiee. Cinq distances (100, 125, 150, 175 et 200 mm) ont ete choisies pour faire la projection des deux poudres selectionnees. Les revetements obtenus ont montre de proprietes des revetements similaires (epaisseur, adhesion, microstructure, microdurete, contraintes residuelles et rugosite). Il a ete trouve que la distance de projection est un parametre indirect du systeme de projection HVOF-JET KOTERTM III et

  1. Guided percutaneous fine-needle aspiration biopsy of the liver

    SciTech Connect

    Ho, C.S.; McLoughlin, M.J.; Tao, L.C.

    1981-04-01

    Forty patients with suspected malignant disease of the liver underwent percutaneous fine-needle aspiration biopsy with radioisotope scintigraphic and fluoroscopic guidance. The needle was aimed at focal defects identified on the liver scan and several passes were made. When the scan was diffusely abnormal, the liver was widely sampled with multiple passes. Thirty patients were eventually considered to have malignant disease and aspiration biopsy was positive in 28 (93%) of these patients, including 25 of 26 with liver metastases (96%). There were two false-positive results and one minor complication. In 24 patients, conventional wide-bore needle biopsy was also performed. In thismore » group, 16 patients had a final diagnosis of hepatic malignancy. Aspiration biopsies were positive in 14 of these (87%) and conventional needle biopsies were positive in four (25%). Guided percutaneous fine-needle aspiration biopsy is recommended for pathologic diagnosis of hepatic malignancy because of its simplicity, high yield, and reasonable safety.« less

  2. Effects of muscular biopsy on the mechanics of running.

    PubMed

    Morin, Jean-Benoit; Samozino, Pierre; Féasson, Léonard; Geyssant, André; Millet, Guillaume

    2009-01-01

    Muscle biopsy is a widely used technique in protocols aiming at studying physical capacities and fiber profiles of athletes, and muscular adaptations to exercise. Side effects of biopsy alone on physiological parameters have recently been pointed out, and we sought to determine whether a single biopsy had effects on the main stride mechanical parameters. Ten male runners performed 4-min runs before and after undergoing a biopsy of their left vastus lateralis muscle. Step frequency and duty factor were significantly higher after biopsy (2.86 +/- 0.14 vs. 2.82 +/- 0.15 Hz, and 0.77 +/- 0.04 vs. 0.75 +/- 0.05, respectively), whereas other factors were significantly lower: maximal vertical ground reaction force (1,601 +/- 240 vs. 1,643 +/- 230 N), loading rate (53.9 +/- 12.8 vs. 58.4 +/- 13.5 bw s(-1)), center of mass vertical displacement (0.056 +/- 0.008 vs. 0.058 +/- 0.008 m) and external mechanical work at each step (1.14 +/- 0.10 vs. 1.24 +/- 0.10 J kg(-1) step(-1)). These effects were observed on the left (biopsed) leg, but also on the right one for the external mechanical work, the duty factor and the maximal vertical ground reaction force, showing that a single biopsy had both ipsi- and contralateral effects on running mechanics.

  3. Protocol biopsies in renal transplantation: prognostic value of structural monitoring.

    PubMed

    Serón, D; Moreso, F

    2007-09-01

    The natural history of renal allograft damage has been characterized in serial protocol biopsies. The prevalence of subclinical rejection (SCR) is maximal during the first months and it is associated with the progression of interstitial fibrosis/tubular atrophy (IF/TA) and a decreased graft survival. IF/TA rapidly progress during the first months and constitutes an independent predictor of graft survival. IF/TA associated with transplant vasculopathy, SCR, or transplant glomerulopathy implies a poorer prognosis than IF/TA without additional lesions. These observations suggest that protocol biopsies could be considered a surrogate of graft survival. Preliminary data suggest that the predictive value of protocol biopsies is not inferior to acute rejection or renal function. Additionally, protocol biopsies have been employed as a secondary efficacy variable in clinical trials. This strategy has been useful to demonstrate a decrease in the progression of IF/TA in some calcineurin-free regimens. Quantification of renal damage is associated with graft survival suggesting that quantitative parameters might improve the predictive value of protocol biopsies. Validation of protocol biopsies as a surrogate of graft survival is actively pursued, as the utility of classical surrogates of graft outcome such as acute rejection has become less useful because of its decreased prevalence with actual immunosuppression.

  4. Liquid Biopsy and its Potential for Management of Hepatocellular Carcinoma.

    PubMed

    Zhou, Jian; Huang, Ao; Yang, Xin-Rong

    2016-06-01

    We summarized the recent findings of liquid biopsy in cancer field and discussed its potential utility in hepatocellular carcinoma. Literature published in MEDLINE, EMBASE, and Science Direct electronic databases was searched and reviewed. Liquid biopsy specially referred to the detection of nucleic acids (circulating cell-free DNA, cfDNA) and circulating tumor cells (CTCs) in the blood of cancer patients. Compared to conventional single-site sampling or biopsy method, liquid biopsy had the advantages such as non-invasiveness, dynamic monitoring, and the most important of all, overcoming the limit of spatial and temporal heterogeneity. The genomic information of cancer could be profiled by genotyping cfDNA/CTC and subsequently applied to make molecular classification, targeted therapy guidance, and unveil drug resistance mechanisms. The serial sampling feature of liquid biopsy made it possible to monitor treatment response in a real-time manner and predict tumor metastasis/recurrence in advance. Liquid biopsy is a non-invasive, dynamic, and informative sampling method with important clinical translational significance in cancer research and practice. Much work needs to be done before it is used in the management of HCC.

  5. Spectral biopsy for skin cancer diagnosis: initial clinical results

    NASA Astrophysics Data System (ADS)

    Moy, Austin J.; Feng, Xu; Nguyen, Hieu T. M.; Zhang, Yao; Sebastian, Katherine R.; Reichenberg, Jason S.; Tunnell, James W.

    2017-02-01

    Skin cancer is the most common form of cancer in the United States and is a recognized public health issue. Diagnosis of skin cancer involves biopsy of the suspicious lesion followed by histopathology. Biopsies, which involve excision of the lesion, are invasive, at times unnecessary, and are costly procedures ( $2.8B/year in the US). An unmet critical need exists to develop a non-invasive and inexpensive screening method that can eliminate the need for unnecessary biopsies. To address this need, our group has reported on the continued development of a noninvasive method that utilizes multimodal spectroscopy towards the goal of a "spectral biopsy" of skin. Our approach combines Raman spectroscopy, fluorescence spectroscopy, and diffuse reflectance spectroscopy to collect comprehensive optical property information from suspicious skin lesions. We previously described an updated spectral biopsy system that allows acquisition of all three forms of spectroscopy through a single fiber optic probe and is composed of off-the-shelf OEM components that are smaller, cheaper, and enable a more clinic-friendly system. We present initial patient data acquired with the spectral biopsy system, the first from an extensive clinical study (n = 250) to characterize its performance in identifying skin cancers (basal cell carcinoma, squamous cell carcinoma, and melanoma). We also present our first attempts at analyzing this initial set of clinical data using statistical-based models, and with models currently being developed to extract biophysical information from the collected spectra, all towards the goal of noninvasive skin cancer diagnosis.

  6. Ultrasound-Guided Abrams Pleural Biopsy vs CT-Guided Tru-Cut Pleural Biopsy in Malignant Pleural Disease, a 3-Year Follow-up Study.

    PubMed

    Sivakumar, Parthipan; Jayaram, Deepak; Rao, Deepak; Dhileepan, Vignesh; Ahmed, Irfan; Ahmed, Liju

    2016-12-01

    Conventional Abrams biopsy shows low sensitivity in suspected malignant pleural disease. There are limited data on the improvement in sensitivity by adding in image guidance. This retrospective study compares the diagnostic sensitivity of Abrams biopsy using ultrasound guidance with CT-guided Tru-Cut biopsy in suspected malignant pleural disease. Data were collected from 2006 to 2012 of patients who underwent image-guided biopsies for suspected non-tuberculous pleural disease. Data were collected on the result of the initial biopsy and final patient diagnosis as of June 2015. Sixty-three patients underwent image-guided Abrams biopsy and 29 underwent CT-guided Tru-Cut biopsies. The sensitivity of Abrams was 71.43 % compared to 75 % in the CT-guided Tru-Cut group. Specificity was 100 % in both groups. Image-guided Abrams biopsies demonstrate comparable diagnostic sensitivity in malignant pleural disease to CT-guided Tru-Cut biopsy.

  7. Testicular biopsy in psittacine birds (Psittaciformes): impact of endoscopy and biopsy on health, testicular morphology, and sperm parameters.

    PubMed

    Hänse, Maria; Krautwald-Junghanns, Maria-Elisabeth; Reitemeier, Susanne; Einspanier, Almuth; Schmidt, Volker

    2013-12-01

    Histologic examination of a testicular biopsy sample may be required to evaluate the reproductive status of male psittacine birds. The purpose of this study was to evaluate the viability of testicular sampling from live birds by assessing the impact on the birds' health, testicular integrity, and sperm quality. Testicular biopsy samples were obtained by endoscopy 4 times during 12 months from 9 cockatiels (Nymphicus hollandicus) and 7 rose-ringed parakeets (Psittacula krameri). Only 2 of 16 birds showed testicular cicatrization or divided testicular tissue after a single endoscopy. Further complications, such as damage to the air sacs or bleeding, predominantly occurred in subsequent endoscopies. In both species, endoscopy and testicular biopsy caused only minor or transient effects on sperm production and sperm quality. These results support that a single testicular biopsy is a viable method for evaluating the reproductive status of male psittacine birds.

  8. Reducing breast biopsies by ultrasonographic analysis and a modified self-organizing map

    NASA Astrophysics Data System (ADS)

    Zheng, Yi; Greenleaf, James F.; Gisvold, John J.

    1997-05-01

    Recent studies suggest that visual evaluation of ultrasound images could decrease negative biopsies of breast cancer diagnosis. However, visual evaluation requires highly experienced breast sonographers. The objective of this study is to develop computerized radiologist assistant to reduce breast biopsies needed for evaluating suspected breast cancer. The approach of this study utilizes a neural network and tissue features extracted from digital sonographic breast images. The features include texture parameters of breast images: characteristics of echoes within and around breast lesions, and geometrical information of breast tumors. Clusters containing only benign lesions in the feature space are then identified by a modified self- organizing map. This newly developed neural network objectively segments population distributions of lesions and accurately establishes benign and equivocal regions.t eh method was applied to high quality breast sonograms of a large number of patients collected with a controlled procedure at Mayo Clinic. The study showed that the number of biopsies in this group of women could be decreased by 40 percent to 59 percent with high confidence and that no malignancies would have been included in the nonbiopsied group. The advantages of this approach are that it is robust, simple, and effective and does not require highly experienced sonographers.

  9. A retrospective study of 51,781 adult oral and maxillofacial biopsies.

    PubMed

    Dovigi, Edwin A; Kwok, Elaine Y L; Eversole, Lewis R; Dovigi, Allan J

    2016-03-01

    Few studies have compared patient and anatomic characteristics across the broad scope of oral and maxillofacial disease seen in dental clinics. The authors conducted a study to make these comparisons by surveying a large sample of histologically diagnosed oral and maxillofacial lesions in a US adult population. A total of 51,781 specimens biopsied from 51,781 adult patients were received by an oral pathology service over 13 years (2001-2015) and analyzed. A description of patients' sex and age at diagnosis, as well as the anatomic site of biopsy was given for diagnoses of 10 oral disease types, including malignant neoplasm, benign neoplasm, infectious, reactive, potentially malignant, developmental, healthy tissue, immune dysfunction, physical trauma, and other. The authors reported reactive lesions were the most prevalent disease type found in the sample (74.9%). Malignant diagnoses comprised 1.97% of all biopsies. The 3 most prevalent diagnoses in this study included benign keratosis, chronic apical periodontitis, and radicular cyst. Different anatomic sites, patient age groups, and sexes show different distributions of disease. Certain disease types and diagnoses were found to have a higher prevalence by sex, among particular age groups, and in certain anatomic sites. This information provides clinicians with a detailed and broad scope of the variety of oral and maxillofacial lesions processed at an oral pathology service and may assist practitioners in forming clinical impressions and differential diagnoses. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  10. Magnetic Resonance and Ultrasound Image Fusion Supported Transperineal Prostate Biopsy Using the Ginsburg Protocol: Technique, Learning Points, and Biopsy Results.

    PubMed

    Hansen, Nienke; Patruno, Giulio; Wadhwa, Karan; Gaziev, Gabriele; Miano, Roberto; Barrett, Tristan; Gnanapragasam, Vincent; Doble, Andrew; Warren, Anne; Bratt, Ola; Kastner, Christof

    2016-08-01

    Prostate biopsy supported by transperineal image fusion has recently been developed as a new method to the improve accuracy of prostate cancer detection. To describe the Ginsburg protocol for transperineal prostate biopsy supported by multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound (TRUS) image fusion, provide learning points for its application, and report biopsy results. The article is supplemented by a Surgery in Motion video. This single-centre retrospective outcome study included 534 patients from March 2012 to October 2015. A total of 107 had no previous prostate biopsy, 295 had benign TRUS-guided biopsies, and 159 were on active surveillance for low-risk cancer. A Likert scale reported mpMRI for suspicion of cancer from 1 (no suspicion) to 5 (cancer highly likely). Transperineal biopsies were obtained under general anaesthesia using BiopSee fusion software (Medcom, Darmstadt, Germany). All patients had systematic biopsies, two cores from each of 12 anatomic sectors. Likert 3-5 lesions were targeted with a further two cores per lesion. Any cancer and Gleason score 7-10 cancer on biopsy were noted. Descriptive statistics and positive predictive values (PPVs) and negative predictive values (NPVs) were calculated. The detection rate of Gleason score 7-10 cancer was similar across clinical groups. Likert scale 3-5 MRI lesions were reported in 378 (71%) of the patients. Cancer was detected in 249 (66%) and Gleason score 7-10 cancer was noted in 157 (42%) of these patients. PPV for detecting 7-10 cancer was 0.15 for Likert score 3, 0.43 for score 4, and 0.63 for score 5. NPV of Likert 1-2 findings was 0.87 for Gleason score 7-10 and 0.97 for Gleason score ≥4+3=7 cancer. Limitations include lack of data on complications. Transperineal prostate biopsy supported by MRI/TRUS image fusion using the Ginsburg protocol yielded high detection rates of Gleason score 7-10 cancer. Because the NPV for excluding Gleason score 7-10 cancer was very

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

    SciTech Connect

    Schaefer, Philipp J., E-mail: jp.schaefer@rad.uni-kiel.de; Fabel, Michael; Bolte, Hendrik

    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, helicallymore » 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.« less

  12. A randomized controlled trial of electrocoagulation-enabled biopsy versus conventional biopsy in the diagnosis of endobronchial lesions.

    PubMed

    Khan, Ajmal; Aggarwal, Ashutosh N; Agarwal, Ritesh; Bal, Amanjit; Gupta, Dheeraj

    2011-01-01

    Although electrocoagulation at time of endobronchial biopsy can potentially reduce procedure-related bleeding during fiberoptic bronchoscopy (FOB), it can also impair quality of tissue specimen; credible data for either are lacking. To evaluate the impact of hot biopsy on the quality of tissue samples and to quantify the amount of procedure-related bleeding during endobronchial biopsy. In this single-center, prospective, single-blind, randomized controlled study we included adult patients referred for FOB and having endobronchial lesions. Patients were randomized to bronchial biopsy using an electrocoagulation-enabled biopsy forceps, with (EC+ group) or without (EC- group) application of electrocoagulation current (40 W for 10 s in a monopolar mode). Procedure-related bleeding was semi-quantified by observer description, as well as through a visual analogue scale. Overall quality of biopsy specimen and tissue damage were assessed and graded by a pulmonary pathologist blinded to FOB details. 160 patients were randomized to endobronchial biopsy with (n = 81) or without (n = 79) the application of electrocoagulation. There were no severe bleeding episodes in either group, and severity of bleeding in the EC+ and EC- groups was similar (median visual analogue scale scores of 14 and 16, respectively). Histopathological diagnosis was similar in the EC+ and EC- groups (77.8% and 82.3%, respectively). There was no significant difference in tissue quality between the two groups. Use of electrocoagulation-enabled endobronchial biopsy does not alter specimen quality and does not result in any significant reduction in procedure-related bleeding. Copyright © 2010 S. Karger AG, Basel.

  13. Classification of 13 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Macaulay, E.; Allam, S.; Tucker, D.; Asorey, J.; Davis, T. M.; Kremlin, A.; Lewis, G. F.; Lidman, C.; Martini, P.; Sommer, N. E.; Tucker, B. E.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Moller, A.; Muthukrishna, D. R.; Yuan, F.; Zhang, B.; Hinton, S.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.

    2018-01-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  14. Classification of 26 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Calcino, J.; Davis, T. M.; Hoormann, J. K.; Asorey, J.; Glazebrook, K.; Carnero, A.; Lidman, C.; Martini, P.; Moller, A.; Sommer, N. E.; Sharp, R.; Tucker, B. E.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Muthukrishna, D. R.; Yuan, F.; Zhang, B.; Hinton, S.; Lewis, G. F.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.

    2018-01-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  15. Classification of 25 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Calcino, J.; Davis, T. M.; Hoormann, J. K.; Asorey, J.; Glazebrook, K.; Carnero, A.; Lidman, C.; Martini, P.; Moller, A.; Sommer, N. E.; Sharp, R.; Tucker, B. E.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Muthukrishna, D. R.; Yuan, F.; Zhang, B.; Hinton, S.; Lewis, G. F.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.

    2018-01-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  16. Classification of 18 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Swann, E. S.; Lewis, G. F.; Lidman, C.; Panther, F. H.; Sharp, R.; Sommer, N. E.; Tucker, B. E.; Muthukrishna, D.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Moller, A. R.; Yuan, F.; Zhang, B.; Davis, T. M.; Hinton, S.; Asorey, J.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Maartens, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.

    2018-06-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  17. Classification of 17 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Muthukrishna, D.; Sharp, R. G.; Tucker, B. E.; Moller, A.; Sommer, N. E.; Asorey, J.; Lewis, G. F.; Lidman, C.; Mould, J.; Macaulay, E.; Maartens, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Gupta, R.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Yuan, F.; Zhang, B.; Davis, T. M.; Hinton, S.; Parkinson, D.; Uddin, S.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Childress, M.; Prajs, S.; Smith, M.; Sullivan, M.

    2017-09-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  18. A fully actuated robotic assistant for MRI-guided prostate biopsy and brachytherapy

    NASA Astrophysics Data System (ADS)

    Li, Gang; Su, Hao; Shang, Weijian; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Fischer, Gregory S.

    2013-03-01

    Intra-operative medical imaging enables incorporation of human experience and intelligence in a controlled, closed-loop fashion. Magnetic resonance imaging (MRI) is an ideal modality for surgical guidance of diagnostic and therapeutic procedures, with its ability to perform high resolution, real-time, high soft tissue contrast imaging without ionizing radiation. However, for most current image-guided approaches only static pre-operative images are accessible for guidance, which are unable to provide updated information during a surgical procedure. The high magnetic field, electrical interference, and limited access of closed-bore MRI render great challenges to developing robotic systems that can perform inside a diagnostic high-field MRI while obtaining interactively updated MR images. To overcome these limitations, we are developing a piezoelectrically actuated robotic assistant for actuated percutaneous prostate interventions under real-time MRI guidance. Utilizing a modular design, the system enables coherent and straight forward workflow for various percutaneous interventions, including prostate biopsy sampling and brachytherapy seed placement, using various needle driver configurations. The unified workflow compromises: 1) system hardware and software initialization, 2) fiducial frame registration, 3) target selection and motion planning, 4) moving to the target and performing the intervention (e.g. taking a biopsy sample) under live imaging, and 5) visualization and verification. Phantom experiments of prostate biopsy and brachytherapy were executed under MRI-guidance to evaluate the feasibility of the workflow. The robot successfully performed fully actuated biopsy sampling and delivery of simulated brachytherapy seeds under live MR imaging, as well as precise delivery of a prostate brachytherapy seed distribution with an RMS accuracy of 0.98mm.

  19. Derivation of therapeutic lung spheroid cells from minimally invasive transbronchial pulmonary biopsies.

    PubMed

    Dinh, Phuong-Uyen C; Cores, Jhon; Hensley, M Taylor; Vandergriff, Adam C; Tang, Junnan; Allen, Tyler A; Caranasos, Thomas G; Adler, Kenneth B; Lobo, Leonard J; Cheng, Ke

    2017-06-30

    Resident stem and progenitor cells have been identified in the lung over the last decade, but isolation and culture of these cells remains a challenge. Thus, although these lung stem and progenitor cells provide an ideal source for stem-cell based therapy, mesenchymal stem cells (MSCs) remain the most popular cell therapy product for the treatment of lung diseases. Surgical lung biopsies can be the tissue source but such procedures carry a high risk of mortality. In this study we demonstrate that therapeutic lung cells, termed "lung spheroid cells" (LSCs) can be generated from minimally invasive transbronchial lung biopsies using a three-dimensional culture technique. The cells were then characterized by flow cytometry and immunohistochemistry. Angiogenic potential was tested by in-vitro HUVEC tube formation assay. In-vivo bio- distribution of LSCs was examined in athymic nude mice after intravenous delivery. From one lung biopsy, we are able to derive >50 million LSC cells at Passage 2. These cells were characterized by flow cytometry and immunohistochemistry and were shown to represent a mixture of lung stem cells and supporting cells. When introduced systemically into nude mice, LSCs were retained primarily in the lungs for up to 21 days. Here, for the first time, we demonstrated that direct culture and expansion of human lung progenitor cells from pulmonary tissues, acquired through a minimally invasive biopsy, is possible and straightforward with a three-dimensional culture technique. These cells could be utilized in long-term expansion of lung progenitor cells and as part of the development of cell-based therapies for the treatment of lung diseases such as chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF).

  20. Epidemiology of biopsy-proven glomerulonephritis in Queensland adults.

    PubMed

    Jegatheesan, Dev; Nath, Karthik; Reyaldeen, Reza; Sivasuthan, Goutham; John, George T; Francis, Leo; Rajmokan, Mohana; Ranganathan, Dwarakanathan

    2016-01-01

    There is a paucity of data pertaining to the incidence of biopsy-proven glomerulonephritis (GN) in Australia. This retrospective study aims to review the data from all adult native renal biopsies performed in the state of Queensland from 2002 to 2011--comparing results with centres from across the world. Pathology reports of 3697 adult native kidney biopsies were reviewed, of which 2048 had GN diagnoses. Age, gender, clinical indication and histopathology findings were compared. The average age at biopsy was 48 ± 17 years. Male preponderance was noted overall (∼60%), with lupus nephritis being the only individual GN with female predilection. The average rate of biopsy was 12.04 per hundred thousand people per year (php/yr). Nephrotic and nephritic syndromes comprised approximately 75% of all clinical indications that lead to GN diagnoses. IgA nephropathy (1.41 php/yr) was the most common primary GN followed by focal segmental glomerulosclerosis (1.02 php/yr) and crescentic GN (0.73 php/yr). Diabetic nephropathy (0.84 php/yr), lupus nephritis (0.69 php/yr) and amyloidosis (0.19 php/yr) were the most commonly identified secondary GN. IgA nephropathy is the predominant primary GN in Queensland, and nephrotic syndrome the most common indication for a renal biopsy. While crescentic GN incidence has significantly increased with time, focal segmental glomerulosclerosis incidence has not shown any trend. Incidence of GN overall appears to increase with age. The annual rate of biopsy in this study appears lower than previously published in an Australian population. © 2015 Asian Pacific Society of Nephrology.

  1. Percutaneous ultrasound-guided renal biopsy: A Libyan experience

    PubMed Central

    Mishra, A.; Tarsin, R.; ElHabbash, B.; Zagan, N.; Markus, R.; Drebeka, S.; AbdElmola, K.; Shawish, T.; Shebani, A.; AbdElmola, T.; ElUsta, A.; Ehtuish, E. F.

    2010-01-01

    This study was done to assess the safety and efficacy of ultrasound-guided percutaneous renal biopsy (PRB), to ascertain the risk factors for complications and determine the optimal period of observation. The radiologist (A.M.) at the National Organ Transplant Centre, Central Hospital, Tripoli, Libya, performed 86 PRBs between February 1, 2006, and January 31, 2008, using an automated biopsy gun with 16-gauge needle. Coagulation profile was done in all the patients. All patients were kept on strict bed rest for six hours post-procedure. Eighty six renal biopsies were performed on 78 patients referred from rheumatology department and eight post-kidney transplant recipients; 23 were males with age range 15 – 56 years and 63 females with age range 16 – 66 years. A mean of 17.5 glomeruli were present in each specimen. A glomerular yield of less than five glomeruli was seen in four biopsies. Class I lupus nephritis (LN) was seen in 1 patient, class II lupus nephritis in 7 patients, class III LN in 13 patients and class IV LN in 29 patients. All the eight renal allografts were diagnosed as acute tubular necrosis or acute interstitial rejection. The risk of post-biopsy bleeding was higher in women, older patients and higher PTT. The overall complication rate was 5.8%. Three complications were observed within six hours of biopsy. No late complication was seen. PRB under real-time ultrasound-guidance is a safe and efficacious procedure to establish the histological diagnosis and should be done as out-patient procedure. Observation time of six hours post-biopsy is optimal. PMID:20835320

  2. In-gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score.

    PubMed

    Jyoti, Rajeev; Jina, Noel Hamesh; Haxhimolla, Hodo Z

    2017-04-01

    The recent literature has focussed predominantly on prostate cancer detection which has been revolutionized by multiparametric magnetic resonance imaging (mpMRI). Due to an overlap of features, prostatitis may mimic prostate cancer on MRI, especially in patients with chronic prostatitis. We retrospectively analysed our in-gantry MRI-guided biopsy (MRGB) results to determine incidental detection rate of prostatitis in Prostate Imaging Reporting and Data System (PIRADS) 3, 4 and 5 foci reported on diagnostic MRI of the prostate. About 137 patients underwent in-gantry MRGB for lesions with PIRADS score of 3 or above. All the biopsies were performed utilizing the dynaTRIM™ system (Invio Inc, Germany) on a three-tesla MRI scanner (Ingenia 3.0T, Philips, Netherlands) by a Radiologist and a Urologist. We biopsied 228 lesions in 137 patients. There were 55 lesions that returned positive for prostate cancer with a Gleason Score of 3 + 3 = 6 or above. There were 62 lesions that showed inflammation. The distribution of these lesions was 3 (5%) in the central zone, 32 (52%) in the transitional zone and 27 (43%) in the peripheral zone. Inflammation was found in 36 (58%) PIRADS 3 lesions, 24 (39%) PIRADS 4 lesions and 2 (3%) PIRADS 5 lesions on pre biopsy MRI evaluation. In our series, biopsies which showed inflammation had a radiological appearance on mpMRI more likely of a PIRADS 3 or 4 lesions with only 3% of PIRADS 5 biopsies showing inflammation. This would suggest that a higher PIRADS score can more reliably differentiate between prostate cancer and prostatitis. © 2016 The Royal Australian and New Zealand College of Radiologists.

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

    SciTech Connect

    Gurel, Kamil; Karabay, Oguz; Gurel, Safiye

    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 ofmore » 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.« less

  4. Influence des défauts de la structure du verre sur la résistance mécanique des fibres optiques

    NASA Astrophysics Data System (ADS)

    Chmel, A.; Baptizmanski, V. V.; Kharshak, A. A.

    1992-12-01

    For silica (pure and doped) optical fibers prepared from preforms irradiated by thermal neutrons and Ar^+ ions, the measurements of lifetime under transverse stress were carried out. It is found that the neutron bombardment leads to decrease of the lifetime and the strength of fiber while the ion implantation results in increasing of these parameters. The influence of particle irradiation on the glass strength is explained by the generation of structural defects which were observed by the infrared an Raman spectroscopy methods. The direction of the change of mechanical properties of fibers is determined by the type of defects and their distribution in the cross-section of fiber. Des préformes de fibres optiques de silice ont été exposées à un bombardement par des faisceaux de neutrons thermiques et d'ions Ar^+ à énergie de 40 keV afin d'engendrer des défauts de la structure respectivement dans le volume ou dans la couche superficielle des échantillons. Les fibres obtenues des préformes irradiées et non irradiées ont été mises en charge de flexion. On a déterminé leur temps de rupture sous diverses contraintes de traction sur la surface extérieure de la fibre en flexion. On a observé une diminution du temps de rupture des fibres après le bombardement neutronique et une augmentation après l'implantation ionique. L'analyse de la nature des défauts en faisant appel à la spectroscopie infrarouge et Raman a fait ressortir que l'irradiation aux ions entraînait essentiellement des liaisons chimiques dans une fine couche superficielle de l'échantillon alors que l'irradiation aux neutrons occasionnait une déformation des zones du réseau silicique dans toute la section de la préforme et de la fibre. L'amélioration de la résistance mécanique s'explique par une augmentation de la mobilité des éléments structuraux de la matrice de verre par suite d'une rupture partielle des liaisons chimiques et sa diminution par l'apparition de concentrateurs

  5. Medical audit of rectal biopsy diagnosis of inflammatory bowel disease.

    PubMed

    Frei, J V; Morson, B C

    1982-03-01

    The records of the rectal biopsy diagnoses of ulcerative colitis and Crohn's disease in the Department of Pathology, St Mark's Hospital, London, were reviewed. The biopsy diagnoses were compared to subsequent resection diagnoses on the same patients, and annual and seasonal variations in the frequency of these and related diagnoses were studied. The accuracy rate for the biopsy diagnosis of ulcerative colitis was about 70% and for Crohn's disease about 40% each time a biopsy was read. The low figure for the accuracy rate for Crohn's disease could be attributed to sampling error inherent in the diagnosis of a disease which is essentially patchy, showing discontinuous pathology. Also, many patients with Crohn's disease have a normal rectum which is biopsied to demonstrate the distinction from ulcerative colitis. In practical terms therefore a 40% accuracy rate in Crohn's disease is probably adequate. The rate of "false-positive" diagnoses was about 5%. There was a seasonal variation in the frequency of these two diagnoses, but no variation attributable to changes in observers, as pathology trainees in the Department change regularly. The frequency of diagnoses of non-specific inflammation and of normal colon did show such non-random variations.

  6. Labial salivary gland biopsy assessment in rheumatoid vasculitis.

    PubMed

    Flipo, R M; Janin, A; Hachulla, E; Houvenagel, E; Foulet, A; Cardon, T; Desbonnet, A; Grardel, B; Duquesnoy, B; Delcambre, B

    1994-10-01

    To assess the vascular involvement in labial salivary gland (LSG) from patients with rheumatoid vasculitis (RV). Forty seven patients with rheumatoid arthritis (RA) took part in a prospective study. Among them, 12 had proven RV. LSG biopsy was performed after local anaesthesia. Histological appearance of inflammatory vascular damage was observed in all but one patient with proven RV (92%). Inflammatory vascular involvement was also identified in LSG biopsy of seven patients with RA (20%) and only one patient in the control group (8%). A second specimen of LSG was studied after a mean treatment period of six months and failed to show any feature of inflammatory vascular involvement in three of the five cases that were analysed. The study emphasises the high incidence of immunopathological features of microvascular damage in patients with RV. LSG biopsy is minimally invasive and may be a potential useful tool for the diagnosis of RV especially when skin lesions are absent or impossible to biopsy. The assessment of the predictive value of positive LSG biopsy in RA requires a long term prospective study.

  7. Labial salivary gland biopsy assessment in rheumatoid vasculitis.

    PubMed Central

    Flipo, R M; Janin, A; Hachulla, E; Houvenagel, E; Foulet, A; Cardon, T; Desbonnet, A; Grardel, B; Duquesnoy, B; Delcambre, B

    1994-01-01

    OBJECTIVES--To assess the vascular involvement in labial salivary gland (LSG) from patients with rheumatoid vasculitis (RV). METHODS--Forty seven patients with rheumatoid arthritis (RA) took part in a prospective study. Among them, 12 had proven RV. LSG biopsy was performed after local anaesthesia. RESULTS--Histological appearance of inflammatory vascular damage was observed in all but one patient with proven RV (92%). Inflammatory vascular involvement was also identified in LSG biopsy of seven patients with RA (20%) and only one patient in the control group (8%). A second specimen of LSG was studied after a mean treatment period of six months and failed to show any feature of inflammatory vascular involvement in three of the five cases that were analysed. CONCLUSIONS--The study emphasises the high incidence of immunopathological features of microvascular damage in patients with RV. LSG biopsy is minimally invasive and may be a potential useful tool for the diagnosis of RV especially when skin lesions are absent or impossible to biopsy. The assessment of the predictive value of positive LSG biopsy in RA requires a long term prospective study. Images PMID:7979576

  8. 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. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Nose biopsy: a comparison between two sampling techniques.

    PubMed

    Segal, Nili; Osyntsov, Lidia; Olchowski, Judith; Kordeluk, Sofia; Plakht, Ygal

    2016-06-01

    Pre operative biopsy is important in obtaining preliminary information that may help in tailoring the optimal treatment. The aim of this study was to compare two sampling techniques of obtaining nasal biopsy-nasal forceps and nasal scissors in terms of pathological results. Biopsies of nasal lesions were taken from patients undergoing nasal surgery by two techniques- with nasal forceps and with nasal scissors. Each sample was examined by a senior pathologist that was blinded to the sampling method. A grading system was used to rate the crush artifact in every sample (none, mild, moderate, severe). A comparison was made between the severity of the crush artifact and the pathological results of the two techniques. One hundred and forty-four samples were taken from 46 patients. Thirty-one were males and the mean age was 49.6 years. Samples taken by forceps had significantly higher grades of crush artifacts compared to those taken by scissors. The degree of crush artifacts had a significant influence on the accuracy of the pre operative biopsy. Forceps cause significant amount of crush artifacts compared to scissors. The degree of crush artifact in the tissue sample influences the accuracy of the biopsy.

  10. Infrared needle mapping to assist biopsy procedures and training.

    PubMed

    Shar, Bruce; Leis, John; Coucher, John

    2018-04-01

    A computed tomography (CT) biopsy is a radiological procedure which involves using a needle to withdraw tissue or a fluid specimen from a lesion of interest inside a patient's body. The needle is progressively advanced into the patient's body, guided by the most recent CT scan. CT guided biopsies invariably expose patients to high dosages of radiation, due to the number of scans required whilst the needle is advanced. This study details the design of a novel method to aid biopsy procedures using infrared cameras. Two cameras are used to image the biopsy needle area, from which the proposed algorithm computes an estimate of the needle endpoint, which is projected onto the CT image space. This estimated position may be used to guide the needle between scans, and results in a reduction in the number of CT scans that need to be performed during the biopsy procedure. The authors formulate a 2D augmentation system which compensates for camera pose, and show that multiple low-cost infrared imaging devices provide a promising approach.

  11. Implementing liquid biopsies into clinical decision making for cancer immunotherapy

    PubMed Central

    Quandt, Dagmar; Zucht, Hans Dieter; Amann, Arno; Wulf-Goldenberg, Anne; Borrebaeck, Carl; Cannarile, Michael; Lambrechts, Diether; Oberacher, Herbert; Garrett, James; Nayak, Tapan; Kazinski, Michael; Massie, Charles; Schwarzenbach, Heidi; Maio, Michele; Prins, Robert; Wendik, Björn; Hockett, Richard; Enderle, Daniel; Noerholm, Mikkel; Hendriks, Hans; Zwierzina, Heinz; Seliger, Barbara

    2017-01-01

    During the last decade, novel immunotherapeutic strategies, in particular antibodies directed against immune checkpoint inhibitors, have revolutionized the treatment of different malignancies leading to an improved survival of patients. Identification of immune-related biomarkers for diagnosis, prognosis, monitoring of immune responses and selection of patients for specific cancer immunotherapies is urgently required and therefore areas of intensive research. Easily accessible samples in particular liquid biopsies (body fluids), such as blood, saliva or urine, are preferred for serial tumor biopsies. Although monitoring of immune and tumor responses prior, during and post immunotherapy has led to significant advances of patients’ outcome, valid and stable prognostic biomarkers are still missing. This might be due to the limited capacity of the technologies employed, reproducibility of results as well as assay stability and validation of results. Therefore solid approaches to assess immune regulation and modulation as well as to follow up the nature of the tumor in liquid biopsies are urgently required to discover valuable and relevant biomarkers including sample preparation, timing of the collection and the type of liquid samples. This article summarizes our knowledge of the well-known liquid material in a new context as liquid biopsy and focuses on collection and assay requirements for the analysis and the technical developments that allow the implementation of different high-throughput assays to detect alterations at the genetic and immunologic level, which could be used for monitoring treatment efficiency, acquired therapy resistance mechanisms and the prognostic value of the liquid biopsies. PMID:28501851

  12. 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.

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

    SciTech Connect

    Schnapauff, Dirk, E-mail: dirk.schnapauff@charite.de; Marnitz, Tim, E-mail: tim.marnitz@charite.de; Freyhardt, Patrick, E-mail: Patrick.freyhardt@charite.de

    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 specimenmore » 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.« less

  14. [Current situation and prospect of breast cancer liquid biopsy].

    PubMed

    Zhou, B; Xin, L; Xu, L; Ye, J M; Liu, Y H

    2018-02-01

    Liquid biopsy is a diagnostic approach by analyzing body fluid samples. Peripheral blood is the most common sample. Urine, saliva, pleural effusion and ascites are also used. Now liquid biopsy is mainly used in the area of neoplasm diagnosis and treatment. Compared with traditional tissue biopsy, liquid biopsy is minimally invasive, convenient to sample and easy to repeat. Liquid biopsy mainly includes circulating tumor cells and circulating tumor DNA (ctDNA) detection. Detection of ctDNA requires sensitive and accurate methods. The progression of next-generation sequencing (NGS) and digital PCR promote the process of studies in ctDNA. In 2016, Nature published the result of whole-genome sequencing study of breast cancer. The study found 1 628 mutations of 93 protein-coding genes which may be driver mutations of breast cancer. The result of this study provided a new platform for breast cancer ctDNA studies. In recent years, there were many studies using ctDNA detection to monitor therapeutic effect and guide treatment. NGS is a promising technique in accessing genetic information and guiding targeted therapy. It must be emphasized that ctDNA detection using NGS is still at research stage. It is important to standardize ctDNA detection technique and perform prospective clinical researches. The time is not ripe for using ctDNA detection to guide large-scale breast cancer clinical practice at present.

  15. Implementing liquid biopsies into clinical decision making for cancer immunotherapy.

    PubMed

    Quandt, Dagmar; Dieter Zucht, Hans; Amann, Arno; Wulf-Goldenberg, Anne; Borrebaeck, Carl; Cannarile, Michael; Lambrechts, Diether; Oberacher, Herbert; Garrett, James; Nayak, Tapan; Kazinski, Michael; Massie, Charles; Schwarzenbach, Heidi; Maio, Michele; Prins, Robert; Wendik, Björn; Hockett, Richard; Enderle, Daniel; Noerholm, Mikkel; Hendriks, Hans; Zwierzina, Heinz; Seliger, Barbara

    2017-07-18

    During the last decade, novel immunotherapeutic strategies, in particular antibodies directed against immune checkpoint inhibitors, have revolutionized the treatment of different malignancies leading to an improved survival of patients. Identification of immune-related biomarkers for diagnosis, prognosis, monitoring of immune responses and selection of patients for specific cancer immunotherapies is urgently required and therefore areas of intensive research. Easily accessible samples in particular liquid biopsies (body fluids), such as blood, saliva or urine, are preferred for serial tumor biopsies.Although monitoring of immune and tumor responses prior, during and post immunotherapy has led to significant advances of patients' outcome, valid and stable prognostic biomarkers are still missing. This might be due to the limited capacity of the technologies employed, reproducibility of results as well as assay stability and validation of results. Therefore solid approaches to assess immune regulation and modulation as well as to follow up the nature of the tumor in liquid biopsies are urgently required to discover valuable and relevant biomarkers including sample preparation, timing of the collection and the type of liquid samples. This article summarizes our knowledge of the well-known liquid material in a new context as liquid biopsy and focuses on collection and assay requirements for the analysis and the technical developments that allow the implementation of different high-throughput assays to detect alterations at the genetic and immunologic level, which could be used for monitoring treatment efficiency, acquired therapy resistance mechanisms and the prognostic value of the liquid biopsies.

  16. 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.

  17. Eosinophils are rare in biopsy specimens of psoriasis vulgaris.

    PubMed

    Rosa, Gabriela; Fernandez, Anthony P; Schneider, Sarah; Billings, Steven D

    2017-12-01

    Histological features of lesional biopsies can be helpful in distinguishing psoriasis subtypes from disease mimickers. However, occasionally, classic histological features are not sufficient for distinction, and additional clues would be useful. There is a common belief that the presence of eosinophils in skin biopsies argues against psoriasis, but actual literature is scant. Skin biopsies with a diagnosis of psoriasis from 2013 to 2016 were reviewed. For inclusion, both histological and clinical features were required to be consistent with psoriasis. For biopsies meeting inclusion criteria, a detailed evaluation for typical histological parameters of psoriasis, as well as presence of dermal eosinophils, was performed. Of 85 cases meeting inclusion criteria, all had either individual or grouped intracorneal neutrophils and dilated papillary blood vessels. Diminished or complete loss of the granular cell layer was seen in 83 cases (98%), and parakeratosis was seen in 84 cases (99%). Alternatively, dermal eosinophils were seen in only 15 cases (18%). Of cases with eosinophils, none had more than 3 eosinophils upon examination of the entire dermis. Active treatment did not appear to impact presence/absence or numbers of eosinophils. Eosinophils are uncommon in psoriasis biopsies, and when present, they are found in small numbers. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Antibiotic prophylaxis and complications following prostate biopsies - a systematic review.

    PubMed

    Klemann, Nina; Helgstrand, John Thomas; Brasso, Klaus; Vainer, Ben; Iversen, Peter; Røder, Martin Andreas

    2017-01-01

    Transrectal ultrasound-guided biopsies (TRUS-gb) are associated with both mild and serious complications. Prophylactic antibiotics reduce the risk of septicaemia and mortality; however, no international consensus exists on the timing and duration of antibiotics, including the optimal drug strategy. We reviewed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies. This review was drafted in accordance with the Prisma Guidelines. The PubMed, Embase and Cochrane databases were searched. A total of 19 eligible trials were identified. One trial demonstrated a significant reduction in the risk of infection after biopsy and reported that oral ciprofloxacin as either a single-dose or a three-day regimen was superior to oral chloramphenicol and norfloxacin. Of three studies investigating the timing of the first dose of antibiotic, one study found that administration 24 h before biopsy versus administration immediately before reduced the relative risk of post-biopsy infection by 55%. Seven studies compared different durations of antibiotic prophylaxis. None showed any benefit from continuing prophylaxis beyond a single dose or a one-day regimen. Evidence supporting a specific antibiotic regimen for TRUS-gb prophylaxis is scarce. Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains, posing a potentially major health issue in the future.  .

  19. NEEDLE BIOPSY OF THE LIVER—General Considerations

    PubMed Central

    Molle, William E.; Kaplan, Leo

    1952-01-01

    Needle biopsy of the liver provides concrete diagnostic information that cannot be as readily obtained in any other way. This report reviews 401 liver biopsies in 312 patients. The major indications for use of this procedure are: To determine the cause of an obscure liver enlargement; to establish the cause of jaundice; to distinguish between malignant disease and cirrhosis of the liver; to determine when hepatitis has subsided; and to evaluate the results of treatment. At times, systemic disease that has not been recognized by other means may be diagnosed by this technique. There is risk in performing this test, and the 0.25 per cent mortality in this series compares favorably with that reported from other clinics. Where the diagnosis by biopsy could be compared with observations at operation or autopsy, the correct diagnosis was made by biopsy in 85 per cent of cases. Greater accuracy was obtained by two or more biopsic examinations in one case then by single biopsy. In several cases in which surgical operation was considered, biopsic information made it unnecessary, and vice versa. PMID:14886754

  20. Visual Biopsy by Hydrogen Peroxide-Induced Signal Amplification.

    PubMed

    Zhao, Wenjie; Yang, Sheng; Yang, Jinfeng; Li, Jishan; Zheng, Jing; Qing, Zhihe; Yang, Ronghua

    2016-11-01

    Visual biopsy has attracted special interest by surgeons due to its simplicity and practicality; however, the limited sensitivity of the technology makes it difficult to achieve an early diagnosis. To circumvent this problem, herein, we report a visual signal amplification strategy for establishing a marker-recognizable biopsy that enables early cancer diagnosis. In our proposed approach, hydrogen peroxide (H 2 O 2 ) was selected as a potential underlying marker for its compact relationship in cancer progression. For selective recognition of H 2 O 2 in the process of visual biopsy, a benzylbenzeneboronic acid pinacol ester-decorated copolymer, namely, PMPC-Bpe, was synthesized, affording the final formation of the H 2 O 2 -responsive micelles in which amylose was trapped. The presence of H 2 O 2 activates the boronate ester recognition site and induces it releasing abundant indicator amylose, leading to signal amplification. The indicator came across the solution of KI/I 2 added to the sample, and the formative amylose-KI/I 2 complex has a distinct blue color at 574 nm for visual amplification detection. The feasibility of the proposed method is demonstrated by visualizing the H 2 O 2 content of cancer at different stages and three kinds of actual cancerous samples. As far as we know, this is the first paradigm to rationally design a signaling amplification-based molecular recognizable biopsy for visual and sensitive disease identification, which will extend new possibilities for marker-recognition and signal amplification-based biopsy in disease progressing.

  1. Penthrox inhaler analgesia in transrectal ultrasound-guided prostate biopsy.

    PubMed

    Lee, Chanyang; Woo, Henry H

    2015-06-01

    Periprostatic injection of local anaesthetic (PILA) has been shown to significantly reduce pain in patients undergoing transrectal ultrasound-guided prostate biopsy (TRUSPB). However, this method does not address pain that is associated with ultrasound probe insertion, and the injection of local anaesthetic itself causes pain. The aim of this study was to explore the efficacy of methoxyflurane delivered by a Penthrox inhaler as a novel method of pain relief during TRUSPB. From July 2012 to July 2013, 64 patients were scheduled at a single centre to undergo TRUSPB while receiving analgesia via Penthrox inhaler. Fifteen minutes after the biopsy procedure, these patients were asked to complete a pain score survey using a 10-cm visual analogue scale (VAS) to separately report the degree of pain experienced during digital rectal examination (DRE), ultrasound probe insertion and core biopsy. The median pain scores on a 10-cm VAS were 2.0, 2.4 and 3.0 during DRE, probe insertion and needle biopsy, respectively, while using the Penthrox inhaler. Of the 64 patients, 11 had undergone TRUSPB previously receiving PILA. In these patients, PILA was significantly better than the Penthrox inhaler for pain relief during needle biopsy (median pain score 2.0 versus 4.0; P = 0.012). The Penthrox inhaler appears to be a safe and effective method of analgesia for TRUSPB. Patients who had experienced both PILA and Penthrox reported pain scores that significantly favoured PILA over the Penthrox inhaler. © 2014 Royal Australasian College of Surgeons.

  2. L'astronomie des Anciens

    NASA Astrophysics Data System (ADS)

    Nazé, Yaël

    2009-04-01

    Quelle que soit la civilisation à laquelle il appartient, l'être humain cherche dans le ciel des réponses aux questions qu'il se pose sur son origine, son avenir et sa finalité. Le premier mérite de ce livre est de nous rappeler que l'astronomie a commencé ainsi à travers les mythes célestes imaginés par les Anciens pour expliquer l'ordre du monde et la place qu'ils y occupaient. Mais les savoirs astronomiques passés étaient loin d'être négligeables et certainement pas limités aux seuls travaux des Grecs : c'est ce que l'auteur montre à travers une passionnante enquête, de Stonehenge à Gizeh en passant par Pékin et Mexico, fondée sur l'étude des monuments anciens et des sources écrites encore accessibles. Les tablettes mésopotamiennes, les annales chinoises, les chroniques médiévales, etc. sont en outre d'une singulière utilité pour les astronomes modernes : comment sinon remonter aux variations de la durée du jour au cours des siècles, ou percer la nature de l'explosion qui a frappé tant d'observateurs en 1054 ? Ce livre offre un voyage magnifiquement illustré à travers les âges, entre astronomie et archéologie.

  3. Importance of the site of endoscopic gastric biopsy in ulcerating lesions of the stomach.

    PubMed Central

    Hatfield, A R; Slavin, G; Segal, A W; Levi, A J

    1975-01-01

    Twenty freshly resected stomach specimens, each containing an ulcerated carcinoma, were studied in an attempt to determine the best site for gastric biopsy. Using endoscopic biopsy forceps multiple biopsies were obtained from various sites around the ulcer. Carcinoma was detected with similar frequency in biopsies from the slough and from the rim of the ulcer. The positive biopsy rate was increased to 95% when the results from the rim and the slough were combined. It is suggested that the diagnostic accuracy of endoscopic gastric biopsy can be improved by taking biopsies from both the rim and the slough of an ulcer. Images Fig. 2 PMID:1193417

  4. A preliminary exploration of the feasibility of offering men information about potential prostate cancer treatment options before they know their biopsy results.

    PubMed

    Zeliadt, Steven B; Hannon, Peggy A; Trivedi, Ranak B; Bonner, Laura M; Vu, Thuy T; Simons, Carol; Kimmie, Crystal A; Hu, Elaine Y; Zipperer, Chris; Lin, Daniel W

    2013-02-06

    A small pre-test study was conducted to ascertain potential harm and anxiety associated with distributing information about possible cancer treatment options at the time of biopsy, prior to knowledge about a definitive cancer diagnosis. Priming men about the availability of multiple options before they have a confirmed diagnosis may be an opportunity to engage patients in more informed decision-making. Men with an elevated PSA test or suspicious Digital Rectal Examination (DRE) who were referred to a urology clinic for a biopsy were randomized to receive either the clinic's usual care (UC) biopsy instruction sheet (n = 11) or a pre-biopsy educational (ED) packet containing the biopsy instruction sheet along with a booklet about the biopsy procedure and a prostate cancer treatment decision aid originally written for newly diagnosed men that described in detail possible treatment options (n = 18). A total of 62% of men who were approached agreed to be randomized, and 83% of the ED group confirmed they used the materials. Anxiety scores were similar for both groups while awaiting the biopsy procedure, with anxiety scores trending lower in the ED group: 41.2 on a prostate-specific anxiety instrument compared to 51.7 in the UC group (p = 0.13). ED participants reported better overall quality of life while awaiting biopsy compared to the UC group (76.4 vs. 48.5, p = 0.01). The small number of men in the ED group who went on to be diagnosed with cancer reported being better informed about the risks and side effects of each option compared to men diagnosed with cancer in the UC group (p = 0.07). In qualitative discussions, men generally reported they found the pre-biopsy materials to be helpful and indicated having information about possible treatment options reduced their anxiety. However, 2 of 18 men reported they did not want to think about treatment options until after they knew their biopsy results. In this small sample offering pre-biopsy education about potential

  5. Upgrading and Downgrading of Prostate Cancer from Biopsy to Radical Prostatectomy: Incidence and Predictive Factors Using the Modified Gleason Grading System and Factoring in Tertiary Grades

    PubMed Central

    Epstein, Jonathan I.; Feng, Zhaoyong; Trock, Bruce J.; Pierorazio, Phillip M.

    2015-01-01

    Background Prior studies assessing the correlation of Gleason score (GS) at needle biopsy and corresponding radical prostatectomy (RP) predated the use of the modified Gleason scoring system and did not factor in tertiary grade patterns. Objective To assess the relation of biopsy and RP grade in the largest study to date. Design, setting, and participants A total of 7643 totally embedded RP and corresponding needle biopsies (2004–2010) were analyzed according to the updated Gleason system. Interventions All patients underwent prostate biopsy prior to RP. Measurements The relation of upgrading or downgrading to patient and cancer characteristics was compared using the chi-square test, Student t test, and multivariable logistic regression. Results and limitations A total of 36.3% of cases were upgraded from a needle biopsy GS 5–6 to a higher grade at RP (11.2% with GS 6 plus tertiary). Half of the cases had matching GS 3 + 4 = 7 at biopsy and RP with an approximately equal number of cases downgraded and upgraded at RP. With biopsy GS 4 + 3 = 7, RP GS was almost equally 3 + 4 = 7 and 4 + 3 = 7. Biopsy GS 8 led to an almost equal distribution between RP GS 4 + 3 = 7, 8, and 9–10. A total of 58% of the cases had matching GS 9–10 at biopsy and RP. In multivariable analysis, increasing age (p < 0.0001), increasing serum prostate-specific antigen level (p < 0.0001), decreasing RP weight (p < 0.0001), and increasing maximum percentage cancer/core (p < 0.0001) predicted the upgrade from biopsy GS 5–6 to higher at RP. Despite factoring in multiple variables including the number of positive cores and the maximum percentage of cancer per core, the concordance indexes were not sufficiently high to justify the use of nomograms for predicting upgrading and downgrading for the individual patient. Conclusions Almost 20% of RP cases have tertiary patterns. A needle biopsy can sample a tertiary higher Gleason pattern in the RP, which is then not recorded in the standard GS

  6. Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades.

    PubMed

    Epstein, Jonathan I; Feng, Zhaoyong; Trock, Bruce J; Pierorazio, Phillip M

    2012-05-01

    Prior studies assessing the correlation of Gleason score (GS) at needle biopsy and corresponding radical prostatectomy (RP) predated the use of the modified Gleason scoring system and did not factor in tertiary grade patterns. To assess the relation of biopsy and RP grade in the largest study to date. A total of 7643 totally embedded RP and corresponding needle biopsies (2004-2010) were analyzed according to the updated Gleason system. All patients underwent prostate biopsy prior to RP. The relation of upgrading or downgrading to patient and cancer characteristics was compared using the chi-square test, Student t test, and multivariable logistic regression. A total of 36.3% of cases were upgraded from a needle biopsy GS 5-6 to a higher grade at RP (11.2% with GS 6 plus tertiary). Half of the cases had matching GS 3+4=7 at biopsy and RP with an approximately equal number of cases downgraded and upgraded at RP. With biopsy GS 4+3=7, RP GS was almost equally 3+4=7 and 4+3=7. Biopsy GS 8 led to an almost equal distribution between RP GS 4+3=7, 8, and 9-10. A total of 58% of the cases had matching GS 9-10 at biopsy and RP. In multivariable analysis, increasing age (p<0.0001), increasing serum prostate-specific antigen level (p<0.0001), decreasing RP weight (p<0.0001), and increasing maximum percentage cancer/core (p<0.0001) predicted the upgrade from biopsy GS 5-6 to higher at RP. Despite factoring in multiple variables including the number of positive cores and the maximum percentage of cancer per core, the concordance indexes were not sufficiently high to justify the use of nomograms for predicting upgrading and downgrading for the individual patient. Almost 20% of RP cases have tertiary patterns. A needle biopsy can sample a tertiary higher Gleason pattern in the RP, which is then not recorded in the standard GS reporting, resulting in an apparent overgrading on the needle biopsy. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All

  7. Yield and complications in percutaneous renal biopsy. A comparison between ultrasound-guided gun-biopsy and manual techniques in native and transplant kidneys.

    PubMed

    Nyman, R S; Cappelen-Smith, J; al Suhaibani, H; Alfurayh, O; Shakweer, W; Akhtar, M

    1997-05-01

    To compare the yield and complications of ultrasound-guided gun-biopsy and manual Tru-Cut techniques in percutaneous renal biopsy. A total of 448 biopsies were reviewed. They comprised 124 manual and 131 gun-biopsies in native kidneys, and 111 manual and 82 gun-biopsies in transplant kidneys. The gun-biopsies were performed under real-time ultrasound (US) guidance. The manual technique used US mainly for marking the position of the kidney. There was a significantly higher diagnostic yield and fewer complications in the gun-biopsy group. A total of 8 major complications were found, all in the manual group. Provided that the operator is experienced in US scanning, a switch from the manual technique to real-time US-guided gun-biopsy will result in the improvement of diagnostic accuracy together with a reduced risk of complications.

  8. Diagnostic accuracy of three biopsy techniques in 117 dogs with intra-nasal neoplasia.

    PubMed

    Harris, B J; Lourenço, B N; Dobson, J M; Herrtage, M E

    2014-04-01

    To determine if nasal biopsies taken at rhinoscopy are more accurate for diagnosing neoplasia than biopsies taken blindly or using advanced imaging for guidance. A retrospective study of 117 dogs with nasal mass lesions that were divided into three groups according to the method of nasal biopsy collection; advanced imaging-guided, rhinoscopy-guided and blind biopsy. Signalment, imaging and rhinoscopic findings, and histopathological diagnosis were compared between groups. The proportion of first attempt biopsies confirming neoplasia were determined for each group. There were no statistically significant differences in the proportion of biopsies that confirmed neoplasia obtained via advanced imaging-guided, rhinoscopy-guided or blind biopsy techniques. In dogs with a high index of suspicion of nasal neoplasia, blind biopsy may be as diagnostic as rhinoscopy-guided biopsy. Repeated biopsies are frequently required for definitive diagnosis. © 2014 British Small Animal Veterinary Association.

  9. Elaboration de revetements nanocomposites avec des proprietes superhydrophobes, semi-conductrices et photocatalytiques

    NASA Astrophysics Data System (ADS)

    Madidi, Fatima Zahra

    Les lignes aeriennes de transport et de distribution de l'energie electrique sont souvent exposees a diverses contraintes. Parmi celles-ci, la pollution des isolateurs constitue l'un des facteurs de premiere importance dans la fiabilite du transport d'energie. En effet, la presence de pollution sur les isolateurs lorsqu'elle est humidifiee entraine la diminution de leur performance electrique en favorisant l'apparition d'arcs de contournement. De telles pannes peuvent parfois causer des impacts socioeconomiques importants. Par ailleurs, le developpement de nouveaux revetements pour ces isolateurs peut s'averer un moyen efficace pour les proteger contre l'apparition de l'arc de contournement. Les revetements superhydrophobes ont fait l'objet de nombreuses etudes au cours de ces dernieres annees. Ces surfaces sont preparees en combinant une rugosite nano-microstructuree avec une faible energie de surface. En outre, de telles surfaces ont de nombreuses applications si elles sont durables et n'ont pas d'effets nocifs sur l'environnement. L'objectif principal de la presente etude vise d'abord l'elaboration de revetements superhydrophobes, puis l'etude de leur duree de vie, leurs proprietes dielectriques et photocatalytiques. Une grande variete de materiaux a faible energie de surface peuvent etre utilises pour le developpement de ces revetements. Dans cette recherche, le caoutchouc de silicone (CS) est employe car il presente de nombreuses proprietes, notamment une forte hydrophobie, une resistance aux rayonnements ultraviolets, et une bonne tenue au feu sans degagement de produits toxiques. Toutefois, le point faible de ces materiaux est la degradation de leurs proprietes hydrophobes. Afin d'ameliorer certaines proprietes du caoutchouc de silicone, des nanoparticules seront additionnees au polymere de base. La technique d'elaboration des revetements consiste a ajouter des nanoparticules de dioxyde de titane (TiO2) au polymere de base, par des methodes ayant un

  10. [Application of Liquid Biopsy for Lung Cancer Treatment.

    PubMed

    Mori, Shunsuke; Yatabe, Yasushi

    2016-05-01

    Liquid biopsy is defined as a non-invasive blood test that detects features of tumor cells, which are shed into the blood stream from the primary tumor and/or metastatic sites. This method is developing based on research on circulating tumor cells (CTCs) and the circulating free/fragments of tumor DNA (cfDNA). CfDNA can be detected in the absence of detectable CTCs, and has been shown to increase with the disease condition. The detection of cfDNA can be used for tumor genotyping, monitoring of the tumor burden, and monitoring minimal residual diseases, and recent results showed that cfDNA is a highly specific biomarker with intermediate sensitivity. Liquid biopsy with cfDNA is promising, and is becoming an alternative to re- biopsy. However, there are some caveats: it has not been elucidated which patients and tumor types can be accessed with cfDNA. Further research is warranted.

  11. 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

    2017-03-14

    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.

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

    PubMed Central

    Ho, Chung-Liang; Wei, Fang; Wong, David T.; Su, Wu-Chou; Lin, Chien-Chung

    2017-01-01

    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. PMID:28099915

  13. Variability of transrectal ultrasound-guided prostate biopsy prophylactic measures.

    PubMed

    Hillelsohn, Joel H; Duty, Brian; Blute, Michael L; Okhunov, Zhamshid; Kashan, Mahyar; Moldwin, Robert; Ashley, Richard N

    2012-12-01

    To assess the variability of pre-prostate biopsy prophylaxis among American urologists. A survey was electronically mailed to 3355 urologists around the country. Urologists were surveyed on their antibiotic prophylaxis choice, the route and duration of antimicrobial prophylaxis. Additionally they were questioned about their knowledge of local antimicrobial resistance and if rectal enemas were routinely used. There were 679 (21%) responses to the survey. The survey revealed differences in pre-prostate biopsy prophylaxis among urologists. Ten different classes of antibiotics were used orally, 4 classes intramuscular, 5 classes intravenous, and there was also 14 different duration regimens. Despite the initiation of the 2008 American Urological Association Guidelines on this topic, there still is a lack of uniformity in prostate biopsy prophylaxis.

  14. Kidney biopsy in AA amyloidosis: impact of histopathology on prognosis.

    PubMed

    Kendi Celebi, Zeynep; Kiremitci, Saba; Ozturk, Bengi; Akturk, Serkan; Erdogmus, Siyar; Duman, Neval; Ates, Kenan; Erturk, Sehsuvar; Nergizoglu, Gokhan; Kutlay, Sim; Sengul, Sule; Ensari, Arzu; Keven, Kenan

    2017-09-01

    In AA amyloidosis, while kidney biopsy is widely considered for diagnosis by clinicians, there is no evidence that the detailed investigation of renal histopathology can be utilized for the prognosis and clinical outcomes. In this study, we aimed to obtain whether histopathologic findings in kidney biopsy of AA amyloidosis might have prognostic and clinical value. This is a retrospective cohort study that included 38 patients who were diagnosed with AA amyloidosis by kidney biopsy between 2005 and 2013.The kidney biopsy specimens of patients were evaluated and graded for several characteristics of histopathological lesions and their relationship with renal outcomes. Segmental amyloid deposition in the kidney biopsy was seen in 29%, global amyloid deposition in 71, diffuse involvement of glomeruli in 84.2%, focal involvement in 7%, glomerular enlargement in 53%, tubular atrophy in 75% and interstitial fibrosis in 78% of patients. Histopathologically, glomerular enlargement, interstitial fibrosis, tubular atrophy, interstitial inflammation and global amyloid deposition were significantly associated with lower estimated glomerular filtration rate (eGFR) (p = .02, p < .001, p = .001, p = .009, p = .002, respectively) in univariate analysis. In multivariate analysis, tubular atrophy was the only predictor of eGFR (p = .019 B = -20.573). In the follow-up at an average of 27 months, 18 patients developed end-stage renal disease (ESRD). Among them, global amyloid deposition was the only risk factor for the development of ESRD (p = .01, OR = 18.750, %95 CI= 2.021-173.942). This is the first study showing that the histopathological findings in kidney biopsy of AA amyloidosis might have a prognostic and clinical value for renal outcomes.

  15. 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

  16. Small incision iris tumour biopsy using a cavernous sampling forceps.

    PubMed

    Chronopoulos, Argyrios; Kilic, Ergin; Joussen, Antonia M; Lipski, Andreas

    2014-11-01

    The aim of this retrospective report is to describe our experience with the Essen-23G biopsy forceps (Akgül forceps) for biopsies of pigmented iris tumours. In this retrospective study of cases between October 2012 and September 2013, patients with iris tumours and clinical signs for malignancy underwent biopsy to secure the diagnosis. The Essen-23G-forceps was used to grasp and extract tissue through a clear corneal incision. Eventual entry and bimanual manipulation with a 23G mini-scissors was achieved through a second incision. Tissue samples were fixed in a sterile tube for further histopathological and immunohistochemical evaluation. Seven eyes of seven patients underwent biopsy using the forceps. The average thickness of the iris tumours was 1.07±0.79 mm. A second corneal incision for scissoring in a bimanual technique was necessary in 5 cases (71%). In 6 cases (85%), a precise histological and immunohistochemical diagnosis was achieved. Complications were limited to minute bleeding at the biopsy site and one case of relative pupil enlargement (anisocoria) without further refractive issues. Iris tumour biopsies can be successfully approached using a cavernous 23G intraocular forceps with a low risk for procedure-related complications. The conical interior design allows for removal of whole tissue pieces with minimal manipulative artefacts. An optional bimanual access through a second corneal incision and use of a 23G scissors provides better efficacy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Nonalbumin proteinuria predominates in biopsy-proven tenofovir nephrotoxicity.

    PubMed

    Sise, Meghan E; Hirsch, Jamie S; Canetta, Pietro A; Herlitz, Leal; Mohan, Sumit

    2015-05-15

    Tenofovir disoproxil fumarate (TDF) nephrotoxicity is characterized by proximal renal tubular injury and dysmorphic mitochondria resulting in proteinuria, orthoglycemic glycosuria, and other markers of proximal tubular dysfunction. The objective of this study was to determine the pattern of proteinuria in patients with biopsy-proven TDF nephrotoxicity. Retrospective chart review. Patients with biopsy-proven TDF nephrotoxicity were identified and their medical charts and biopsy reports were reviewed. Comparison was made with HIV-infected patients not on TDF who underwent kidney biopsy. We identified 43 biopsy-proven cases of TDF nephrotoxicity; mean age 54.7 ± 0.4 years, 53% men, 42% whites. Thirty-seven cases reported proteinuria by dipstick of which only 60% had at least 2+ proteinuria. Twenty-seven patients had urine protein quantified by either 24-h collection or spot urine protein-to-creatinine ratio; median proteinuria was 1742 mg/day [interquartile range (IQR) 1200-2000 mg] and 1667 mg/g creatinine (IQR 851-1967 mg/g), respectively. Ten patients had concurrent urinary albumin measured, with a median 236 mg/g creatinine (IQR 137-343 mg/g). The mean urine albumin-to-urine protein ratio (uAPR) was 0.17 (IQR 0.14-0.19), confirming that TDF nephrotoxicity is primarily associated with nonalbumin proteinuria. Control cases had a uAPR of 0.65 (IQR 0.55-0.79) P < 0.001. Histopathology showed the predominance of proximal tubular injury with characteristic mitochondrial abnormalities. In the largest published cohort of patients with biopsy-proven TDF nephrotoxicity, we show that low uAPR is a reliable feature of this disease. Because of the predominance of nonalbumin proteinuria, dipstick urinalysis may be unreliable in TDF nephrotoxicity.

  18. 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.

  19. Combinaison de méthodes géophysiques pour estimer la distribution spatiale des sols affectés par l'excès d'eau

    NASA Astrophysics Data System (ADS)

    Chaplot, Vincent; Walter, Christian; Curmi, Pierre; Hollier-Larousse, Alain; Robain, Henri

    2004-04-01

    Geophysical methods have already shown their interest for the continuous characterisation of soils over landscapes, rapidly and, non-intrusively. But in bottomland areas, difficulties are encountered in relating geophysical properties to soil spatial distribution due to large variations in the depth, texture and/or water content of soils. Indeed, respective variations of these parameters can result in ambiguous geophysical responses. For example, a decrease in soil water content, which causes an increase in electrical resistivity, may be offset by an increase in soil clay content, inducing a decrease in resistivity. The objective of this study was to improve the continuous characterisation of soils affected by an excess of water by using a combination of geophysical techniques. Three techniques, the radio-magnetotelluric (RMT), the ground penetrating radar (GPR) and the electrostatic quadrupole (ESQP) were implemented along eight representative transects where soils were extensively described. The soil cover shows a succession from downslope to upslope consisting in fibric Fluvisols, gleyic Fluvisols, and Albefluvisols. None of the geophysical methods allows us to distinguish all soil limits and to estimate the geometry of soil horizons. The ESQP discriminates Fluvisols from Albefluvisols, whereas the RMT above all reveals differences in soil material thickness, which do not permit to discriminate between these soils. In complement, the GPR allows the estimation of the geometry of organic horizons and anthropic structures, such as ditches. Finally, the combination of these three techniques allows us to assess the main features of soil spatial distribution in bottomlands. To cite this article: V. Chaplot et al., C. R. Geoscience 336 (2004).

  20. [The lesions of flat epithelial atypia diagnosed on breast biopsy].

    PubMed

    Peres, A; Becette, V; Guinebretiere, J-M; Cherel, P; Barranger, E

    2011-10-01

    Among pre-invasive breast diseases, the lesion of flat epithelial atypia has a level of risk that remains unclear. The clinical significance of these lesions and how to behave during their diagnostic biopsy (monitoring vs. surgery) are still uncertain, because few studies (including monitoring) are available and because of the polymorphic spectrum of lesions and their many denominations across the studies in the literature. This article aims to update our knowledge and provide elements for the management of these lesions diagnosed on breast biopsy. Copyright © 2011. Published by Elsevier SAS.

  1. 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

  2. Sentinel Node Biopsy in Melanoma: A Short Update

    PubMed Central

    Ferrara, Gerardo; Partenzi, Antonietta; Filosa, Alessandra

    2018-01-01

    Several controversies are still ongoing about sentinel node biopsy in melanoma. It is basically a staging procedure for melanoma > 0.75 mm in thickness or for thinner melanoma in the presence of ulceration, high mitotic rate, and/or lymphovascular invasion. Complete lymph node dissection after a positive sentinel node can also allow a better locoregional disease control but seems not to prevent the development of distant metastases. The use of sentinel node biopsy in atypical Spitz tumors should be discouraged because of their peculiar biological properties. PMID:29719827

  3. 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.

  4. Transjugular Renal Biopsy: Our Experience and Technical Considerations

    SciTech Connect

    See, Teik Choon, E-mail: teikchoon.see@addenbrookes.nhs.u; Thompson, Barbara C.; Howie, Alexander J.

    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 failedmore » 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

  5. Pure neuritic leprosy: Resolving diagnostic issues in acid fast bacilli (AFB)-negative nerve biopsies: A single centre experience from South India.

    PubMed

    Hui, Monalisa; Uppin, Megha S; Challa, Sundaram; Meena, A K; Kaul, Subhash

    2015-01-01

    Demonstration of lepra bacilli is essential for definite or unequivocal diagnosis of pure neuritic leprosy (PNL) on nerve biopsy. However, nerves always do not show bacilli owing to the changes of previous therapy or due to low bacillary load in tuberculoid forms. In absence of granuloma or lepra bacilli, other morphologic changes in endoneurium and perineurium can be of help in making a probable diagnosis of PNL and treating the patient with multidrug therapy. Forty-six biopsies of PNL were retrospectively reviewed and histologic findings were compared with 25 biopsies of non leprosy neuropathies (NLN) including vasculitic neuropathy and chronic inflammatory demyelinating polyneuropathy (CIDP). The distribution of endoneurial infiltrate and fibrosis, perineurial thickening, and myelin abnormalities were compared between PNL and NLN biopsies and analyzed by Chi-square test. Out of 46 PNL casses, 24 (52.17 %) biopsies were negative for acid fast bacilli (AFB). In these cases, the features which favor a diagnosis of AFB-negative PNL were endoneurial infiltrate (51.1%), endoneurial fibrosis (54.2%), perineurial thickening (70.8%), and reduced number of myelinated nerve fibers (75%). Nerve biopsy is an efficient tool to diagnose PNL and differentiate it from other causes of NLN. In absence of AFB, the diagnosis of PNL is challenging. In this article, we have satisfactorily evaluated the various hisopthological features and found that endoneurial inflammation, dense fibrosis, and reduction in the number of myelinated nerve fibers are strong supportive indicators of PNL regardless of AFB positivity.

  6. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    SciTech Connect

    Martin, Peter R., E-mail: pmarti46@uwo.ca; Cool, Derek W.; Romagnoli, Cesare

    2014-07-15

    Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiologymore » resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm{sup 3} or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for

  7. Evidence-based interpretation of liver biopsies.

    PubMed

    Crawford, James M

    2006-04-01

    'Evidence based medicine' is a paradigm introduced in the 1990s in which collection of clinical data in a reproducible and unbiased way is intended to guide clinical decision-making. This paradigm has been promulgated across the spectrum of medicine, but with more limited critical analysis in the realm of pathology. The 'evidence base' in support of our practices in Anatomic Pathology is a critical issue, given the key role that such diagnoses play in patient management decisions. The question is, 'On what basis are diagnostic opinions rendered in Anatomic Pathology?' The operative question becomes, 'What is the published literature that supports our anatomic pathology interpretations?' This second question was applied to the published literature in Hepatopathology, by identifying the 'citation classics' of this discipline. Specifically, the top 150 most-cited liver pathology articles were analyzed for: authorship; journal of publication; type of publication; and year of publication. Results are as follows. First, it is indeed true that the preeminent hepatopathologists of the age are the most cited authors in the 'top 150'. Second, the most cited articles in hepatopathology are not published in the pathology literature, but are instead published in much higher impact clinical journals. Third, the pathology of viral hepatitis is demonstrated to be extraordinarily well-grounded in 'evidence based medicine'. Much of the remainder of the hepatopathology literature falls into a 'narrative based' paradigm, which is the rigorous reporting of case experience without statistical clinical outcomes validation. Finally, the years of publication reflect, on the one hand, a vigorous recent literature in the pharmaceutical treatment of viral hepatitis, and on the other, a broadly distributed set of 'narrative' articles from the 1960s, 1970s, 1980s, and 1990s. In conclusion, the discipline of hepatopathology appears to be well-grounded in 'evidence based medicine' in the realm of

  8. The Epidemiological, Clinical, and Histopathological Characteristics of Lacrimal Gland Biopsies in a Tertiary Care Center in Israel.

    PubMed

    Priel, Ayelet; Vishnevskia-Dai, Vicktoria; Hochma, Liran; Gildener-Leapman, Juliana; Ben Simon, Guy J; Rosner, Mordechai; Antman, Gal; Zloto, Ofira

    2018-02-01

    The distribution of pathology and clinical characteristics of lacrimal gland diseases are different in different areas of the world. To evaluate the incidence rate, patient characteristics, and indications for surgical intervention of lacrimal gland lesions in a tertiary care center in Israel. All biopsied or surgically removed lacrimal gland lesions at the Goldschleger Eye Institute from 2009 to 2015 were identified. The following data were collected: age, gender, indications for surgical intervention, diagnosis, treatment, and prognosis. We evaluated 28 lacrimal gland biopsies from 26 patients (11 men, 15 women). Mean age at biopsy was 47.5 years old. The most common presenting symptoms were: eyelid swollenness (57.14%), ptosis (32.14%), and proptosis (10.71%). All patients underwent computed tomography and magnetic resonance imaging. In 28 cases, infiltrations of the lacrimal gland were found. In nine cases infiltration of muscles or orbital extension were found. The most common pathologies were non-specified inflammation (44.82%), lymphoma (20.68%), and immunoglobulin G4-related disease (10.34%). The treatment was diverse according to the patient diagnosis. Prognosis of lacrimal gland disease was good; however, in five patients the systemic disease progressed. Lesions of the lacrimal gland comprise a wide variety of pathological findings that require different treatment strategies. Lacrimal gland biopsies enable physicians to precisely recognize the pathology; therefore, it is important to consider this surgical method in any patient with lesions in the lacrimal gland.

  9. Quantitative Large-Scale Three-Dimensional Imaging of Human Kidney Biopsies: A Bridge to Precision Medicine in Kidney Disease.

    PubMed

    Winfree, Seth; Dagher, Pierre C; Dunn, Kenneth W; Eadon, Michael T; Ferkowicz, Michael; Barwinska, Daria; Kelly, Katherine J; Sutton, Timothy A; El-Achkar, Tarek M

    2018-06-05

    Kidney biopsy remains the gold standard for uncovering the pathogenesis of acute and chronic kidney diseases. However, the ability to perform high resolution, quantitative, molecular and cellular interrogation of this precious tissue is still at a developing stage compared to other fields such as oncology. Here, we discuss recent advances in performing large-scale, three-dimensional (3D), multi-fluorescence imaging of kidney biopsies and quantitative analysis referred to as 3D tissue cytometry. This approach allows the accurate measurement of specific cell types and their spatial distribution in a thick section spanning the entire length of the biopsy. By uncovering specific disease signatures, including rare occurrences, and linking them to the biology in situ, this approach will enhance our understanding of disease pathogenesis. Furthermore, by providing accurate quantitation of cellular events, 3D cytometry may improve the accuracy of prognosticating the clinical course and response to therapy. Therefore, large-scale 3D imaging and cytometry of kidney biopsy is poised to become a bridge towards personalized medicine for patients with kidney disease. © 2018 S. Karger AG, Basel.

  10. An analysis of oral biopsies extracted from 1995 to 2009, in an oral medicine and surgery unit in Galicia (Spain).

    PubMed

    Sixto-Requeijo, Raquel; Diniz-Freitas, Marco; Torreira-Lorenzo, Juan-Carlos; García-García, Abel; Gándara-Rey, José M

    2012-01-01

    To conduct an analysis of the frequency of oral lesions in biopsies over a 14-year period in the Oral Medicine, Oral Surgery and Implantology Unit. We conducted a retrospective study of biopsies removed from 1995-2009, recording data regarding age, sex, location of the lesions, biopsy types, anatomical and pathological diagnosis and definitive diagnosis. Of the 562 patients studied, the average age was 51.8 years, with a standard deviation of 18.5 (range 5-96). The distribution by sex was 318 (56.6%) women and 244 (43.4%) men. The most common diagnostic category was mucosal pathologies in 37.9% of cases, followed by odontogenic cysts in 27.8%. Malignant tumors accounted for 3.9% of cases, oral squamous cell carcinomas were the most frequent malignancy, appearing in 22 cases. Bisphosphonate-related osteonecrosis of the jaws was the most common injury within the bone lesions group. Following the performance of 647 biopsies on 562 patients, we can say that the most common injury was radicular cysts (appearing in 108 cases), having found statistical differences in relation to the patients' sex and age.

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

    PubMed Central

    Hari, Smriti; Kumari, Swati; Srivastava, Anurag; Thulkar, Sanjay; Mathur, Sandeep; Veedu, Prasad Thotton

    2016-01-01

    Background & objectives: Biopsy of palpable breast masses can be performed manually by palpation guidance or under imaging guidance. Based on retrospective studies, image guided biopsy is considered more accurate than palpation guided breast biopsy; however, these techniques have not been compared prospectively. We conducted this prospective study to verify the superiority and determine the size of beneficial effect of image guided biopsy over palpation guided biopsy. Methods: Over a period of 18 months, 36 patients each with palpable breast masses were randomized into palpation guided and image guided breast biopsy arms. Ultrasound was used for image guidance in 33 patients and mammographic (stereotactic) guidance in three patients. All biopsies were performed using 14 gauge automated core biopsy needles. Inconclusive, suspicious or imaging-histologic discordant biopsies were repeated. Results: Malignancy was found in 30 of 36 women in palpation guided biopsy arm and 27 of 36 women in image guided biopsy arm. Palpation guided biopsy had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 46.7, 100, 100, 27.3 per cent, respectively, for diagnosing breast cancer. Nineteen of 36 women (52.8%) required repeat biopsy because of inadequate samples (7 of 19), suspicious findings (2 of 19) or imaging-histologic discordance (10 of 19). On repeat biopsy, malignancy was found in all cases of imaging-histologic discordance. Image guided biopsy had 96.3 per cent sensitivity and 100 per cent specificity. There was no case of inadequate sample or imaging-histologic discordance with image guided biopsy. Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates. PMID:27488003

  12. Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria.

    PubMed

    Oluyemi, Aderemi; Awolola, Nicholas; Oyedeji, Olufemi

    2016-01-01

    Colorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria. This is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 -July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria. A total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%). The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis. The study supports the present wisdom that polyps are clearly less

  13. Analysis of "dry" mesothelioma with ultrasound guided biopsies.

    PubMed

    Stigt, Jos A; Boers, James E; Groen, Harry J M

    2012-12-01

    Image-guided sampling of the thickened pleura is a sensitive approach in patients with malignant pleural mesothelioma with pleural effusion. Malignant pleural mesothelioma presenting without effusion however is more of a diagnostic challenge. In this study we report the diagnostic yield and complications of ultrasound-guided cutting needle biopsies in this particular category of patients. A retrospective database analysis from September 2007 until January 2012 was performed in 56 patients with malignant pleural mesothelioma. Clinical characteristics and results of diagnostic evaluations were analysed. Of the 56 patients with malignant pleural mesothelioma, 20 patients presented without pleural effusion of with locular effusion. Ultrasound-guided cutting needle biopsy was performed in 14/20 patients with a diagnostic accuracy of 80%. Only 1 patient had mild haemoptysis immediately following biopsies. Diagnosing patients with pleural thickenings suspect for malignant mesothelioma without pleural effusion or with loculated pleural effusion is effective and safe with ultrasound-guided cutting needle biopsies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Liquid biopsies in gastrointestinal malignancies: when is the big day?

    PubMed

    Lopez, Anthony; Harada, Kazuto; Mizrak Kaya, Dilsa; Dong, Xiaochuan; Song, Shumei; Ajani, Jaffer A

    2018-01-01

    Tumor tissue sample is currently the gold standard for diagnosing gastrointestinal cancers, but also for genomic/immune component analyses that can help in the selection of therapy. However, this approach of studying a 'representative' sample of the tumor does not address inherent heterogeneity. Liquid biopsies, mainly represented by circulating tumor cells, circulating tumor DNA, tumor exosomes, and microRNAs, have the potential to assess various biomarkers for early detection of cancer, carrying out genomic/immune profiling for not only selection of appropriate therapy but also to monitor effect of therapy. Areas covered: This review summarizes the current evidence in the literature on liquid biopsies in gastrointestinal cancers concerning diagnosis, prognosis, and response to therapy. The following terms were used in PubMed: 'esophageal', 'gastric', 'colorectal', 'cancer', 'circulating tumor cells', 'circulating tumor DNA', microRNA', 'diagnosis', 'prognosis', 'response', 'resistance'. Expert commentary: Data increasingly supports the potential of liquid biopsies for early detection, selection of therapy, and monitoring response to therapy. One major question is whether assaying various components of the blood would accommodate considerable context-dependent heterogeneity of gastrointestinal tumors. There are many potential strategies to exploit liquid biopsy use. To put them in to perspective, well-designed and meticulous prospective studies will be needed to prove their usefulness.

  15. [Cerebral stereotactic biopsy and surgery: Report of 100 cases].

    PubMed

    Khouja, N; Khaldi, M; Boubaker, A; Yedeas, M; Bahri, K; Ben Hammouda, K; Aouidj, L; Jemel, H

    1999-12-01

    To report the results of the use of the stereotactic techniques in the management of intra cranial lesions. Between july 1994 and march 1998, we carried out 117 stereotactic procedures of whom only 100 cases were analyzed. All the procedures were achieved after a CT scan. Patients were separated in two groups: (A) stereotactic biopsy (91 patients), (B) surgery with laser guidance (9 patients). The mean age in group A was 38 years (2-75 years) versus 27 years (11-66 years) in group B. The sex-ratio was 1.3. In the group A, the correct pathological diagnosis was obtained in 91.2% of cases. Glial tumors was the frequent histopathological variety of tumor (67.47%). Only one patient was operated after biopsy for a bilateral meningioma of the anterior 1/3 of the falx. There was only one death (1.09%) and 3.29% of transitory complications. In the group B, all patients were operated with laser guidance. Thirty seven per cent of patients underwent radiotherapy after the stereotactic biopsy or surgery. Stereotactic biopsy is a reliable method for the histopathological diagnosis of deep-seated brain lesions. Surgery with laser guidance is a useful alternative for the management of small deep-seated lesions or lesions located in functional areas.

  16. [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.

  17. Integrating liquid biopsies into the management of cancer.

    PubMed

    Siravegna, Giulia; Marsoni, Silvia; Siena, Salvatore; Bardelli, Alberto

    2017-09-01

    During cancer progression and treatment, multiple subclonal populations of tumour cells compete with one another, with selective pressures leading to the emergence of predominant subclones that replicate and spread most proficiently, and are least susceptible to treatment. At present, the molecular landscapes of solid tumours are established using surgical or biopsy tissue samples. Tissue-based tumour profiles are, however, subject to sampling bias, provide only a snapshot of tumour heterogeneity, and cannot be obtained repeatedly. Genomic profiles of circulating cell-free tumour DNA (ctDNA) have been shown to closely match those of the corresponding tumours, with important implications for both molecular pathology and clinical oncology. Analyses of circulating nucleic acids, commonly referred to as 'liquid biopsies', can be used to monitor response to treatment, assess the emergence of drug resistance, and quantify minimal residual disease. In addition to blood, several other body fluids, such as urine, saliva, pleural effusions, and cerebrospinal fluid, can contain tumour-derived genetic information. The molecular profiles gathered from ctDNA can be further complemented with those obtained through analysis of circulating tumour cells (CTCs), as well as RNA, proteins, and lipids contained within vesicles, such as exosomes. In this Review, we examine how different forms of liquid biopsies can be exploited to guide patient care and should ultimately be integrated into clinical practice, focusing on liquid biopsy of ctDNA - arguably the most clinically advanced approach.

  18. Usefulness of sural nerve biopsy in the genomic era.

    PubMed

    Kanda, Takashi

    2009-08-01

    The value of peripheral nerve biopsy is now sometimes questioned due to the high complication rate and the recent development of noninvasive molecular techniques for diagnosis of hereditary neuropathy. However, the disorders that can be diagnosed by genetic analysis are limited and sural nerve biopsy is still a powerful tool for making a correct diagnosis of peripheral neuropathy. Histological evaluation of the sural nerve has long focused on changes of the two major components of peripheral nerves, axons and myelin, as well as on the detection of diagnostic changes such as amyloid deposits, sarcoid tubercles, and vasculitis. In addition to these components, the sural nerve biopsy specimen contains various important cells, including perineurial cells, mast cells, endothelial cells, pericytes, and lymphocytes. Among these cells, the endothelial cells and pericytes form the blood-nerve barrier (BNB) and investigation of these cells can reveal important information, especially in inflammatory neuropathies. To better understand the biological basis of BNB, we established rat and human immortal cell lines from the endothelial cells and pericytes of endoneurial microvessels. Characterization of these cell lines is now underway at our laboratory. These BNB cell lines should provide useful information concerning the pathophysiology of peripheral neuropathy, and we should obtain a new perspective for the investigation of nerve biopsy specimens after understanding the molecular background of the BNB.

  19. Optical spectroscopy for stereotactic biopsy of brain tumors

    NASA Astrophysics Data System (ADS)

    Markwardt, Niklas; von Berg, Anna; Fiedler, Sebastian; Goetz, Marcus; Haj-Hosseini, Neda; Polzer, Christoph; Stepp, Herbert; Zelenkov, Petr; Rühm, Adrian

    2015-07-01

    Stereotactic biopsy procedure is performed to obtain a tissue sample for diagnosis purposes. Currently, a fiber-based mechano-optical device for stereotactic biopsies of brain tumors is developed. Two different fluorophores are employed to improve the safety and reliability of this procedure: The fluorescence of intravenously applied indocyanine green (ICG) facilitates the recognition of blood vessels and thus helps minimize the risk of cerebral hemorrhages. 5- aminolevulinic-acid-induced protoporphyrin IX (PpIX) fluorescence is used to localize vital tumor tissue. ICG fluorescence detection using a 2-fiber probe turned out to be an applicable method to recognize blood vessels about 1.5 mm ahead of the fiber tip during a brain tumor biopsy. Moreover, the suitability of two different PpIX excitation wavelengths regarding practical aspects was investigated: While PpIX excitation in the violet region (at 405 nm) allows for higher sensitivity, red excitation (at 633 nm) is noticeably superior with regard to blood layers obscuring the fluorescence signal. Contact measurements on brain simulating agar phantoms demonstrated that a typical blood coverage of the tumor reduces the PpIX signal to about 75% and nearly 0% for 633 nm and 405 nm excitation, respectively. As a result, 633 nm seems to be the wavelength of choice for PpIX-assisted detection of high-grade gliomas in stereotactic biopsy.

  20. Segmentation of prostate biopsy needles in transrectal ultrasound images

    NASA Astrophysics Data System (ADS)

    Krefting, Dagmar; Haupt, Barbara; Tolxdorff, Thomas; Kempkensteffen, Carsten; Miller, Kurt

    2007-03-01

    Prostate cancer is the most common cancer in men. Tissue extraction at different locations (biopsy) is the gold-standard for diagnosis of prostate cancer. These biopsies are commonly guided by transrectal ultrasound imaging (TRUS). Exact location of the extracted tissue within the gland is desired for more specific diagnosis and provides better therapy planning. While the orientation and the position of the needle within clinical TRUS image are limited, the appearing length and visibility of the needle varies strongly. Marker lines are present and tissue inhomogeneities and deflection artefacts may appear. Simple intensity, gradient oder edge-detecting based segmentation methods fail. Therefore a multivariate statistical classificator is implemented. The independent feature model is built by supervised learning using a set of manually segmented needles. The feature space is spanned by common binary object features as size and eccentricity as well as imaging-system dependent features like distance and orientation relative to the marker line. The object extraction is done by multi-step binarization of the region of interest. The ROI is automatically determined at the beginning of the segmentation and marker lines are removed from the images. The segmentation itself is realized by scale-invariant classification using maximum likelihood estimation and Mahalanobis distance as discriminator. The technique presented here could be successfully applied in 94% of 1835 TRUS images from 30 tissue extractions. It provides a robust method for biopsy needle localization in clinical prostate biopsy TRUS images.

  1. Stereotactic biopsy complicated by pneumocephalus and acute pulmonary edema.

    PubMed

    Roth, Jonathan; Avneri, Itzik; Nimrod, Adi; Kanner, Andrew A

    2007-11-01

    The aim of this study was to describe pneumocephalus as a rare complication of stereotactic biopsy and as a possible cause of acute neurogenic pulmonary edema. A case of frameless stereotactic biopsy complicated by pneumocephalus presenting with acute lung injury 48 hours after the procedure. A frameless stereotactic procedure was performed in the standard fashion. Immediate postoperative CT showed no intracranial air except for a gas inclusion at the biopsy site within the lesion. The skin staple placed at the end of surgery on the skin incision was removed 36 hours later. A CT scan performed 48 hours postoperatively showed new pneumocephalus. The patient exhibited acute respiratory distress but no new neurologic symptoms. There was no detectable systemic cause for the pulmonary edema. The patient received supportive respiratory treatment and fully recovered. Pneumocephalus is apparently a rare complication of stereotactic brain biopsy and one that may result from early removal of the skin staple or suture. The occurrence of acute neurogenic pulmonary edema may be attributed to the pneumocephalus.

  2. Thin-needle aspiration biopsy of the prostate.

    PubMed

    Koss, L G; Woyke, S; Schreiber, K; Kohlberg, W; Freed, S Z

    1984-05-01

    The authors summarize the current status of thin-needle aspiration biopsy of the prostate and evaluate the accomplishments and limitations of this method of diagnosis. Historical developments, indications, technique, contraindications, complications, cytology of aspirates, diagnostic efficacy of aspirates, and grading of prostatic carcinomas are discussed.

  3. [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. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  4. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis.

    PubMed

    Kasivisvanathan, Veeru; Rannikko, Antti S; Borghi, Marcelo; Panebianco, Valeria; Mynderse, Lance A; Vaarala, Markku H; Briganti, Alberto; Budäus, Lars; Hellawell, Giles; Hindley, Richard G; Roobol, Monique J; Eggener, Scott; Ghei, Maneesh; Villers, Arnauld; Bladou, Franck; Villeirs, Geert M; Virdi, Jaspal; Boxler, Silvan; Robert, Grégoire; Singh, Paras B; Venderink, Wulphert; Hadaschik, Boris A; Ruffion, Alain; Hu, Jim C; Margolis, Daniel; Crouzet, Sébastien; Klotz, Laurence; Taneja, Samir S; Pinto, Peter; Gill, Inderbir; Allen, Clare; Giganti, Francesco; Freeman, Alex; Morris, Stephen; Punwani, Shonit; Williams, Norman R; Brew-Graves, Chris; Deeks, Jonathan; Takwoingi, Yemisi; Emberton, Mark; Moore, Caroline M

    2018-05-10

    Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited. In a multicenter, randomized, noninferiority trial, we assigned men with a clinical suspicion of prostate cancer who had not undergone biopsy previously to undergo MRI, with or without targeted biopsy, or standard transrectal ultrasonography-guided biopsy. Men in the MRI-targeted biopsy group underwent a targeted biopsy (without standard biopsy cores) if the MRI was suggestive of prostate cancer; men whose MRI results were not suggestive of prostate cancer were not offered biopsy. Standard biopsy was a 10-to-12-core, transrectal ultrasonography-guided biopsy. The primary outcome was the proportion of men who received a diagnosis of clinically significant cancer. Secondary outcomes included the proportion of men who received a diagnosis of clinically insignificant cancer. A total of 500 men underwent randomization. In the MRI-targeted biopsy group, 71 of 252 men (28%) had MRI results that were not suggestive of prostate cancer, so they did not undergo biopsy. Clinically significant cancer was detected in 95 men (38%) in the MRI-targeted biopsy group, as compared with 64 of 248 (26%) in the standard-biopsy group (adjusted difference, 12 percentage points; 95% confidence interval [CI], 4 to 20; P=0.005). MRI, with or without targeted biopsy, was noninferior to standard biopsy, and the 95% confidence interval indicated the superiority of this strategy over standard biopsy. Fewer men in the MRI-targeted biopsy group than in the standard-biopsy group received a diagnosis of clinically insignificant cancer (adjusted difference, -13 percentage points; 95% CI, -19 to -7; P<0.001). The use of risk assessment with MRI before biopsy and MRI-targeted biopsy was superior to

  5. Cutting performance orthogonal test of single plane puncture biopsy needle based on puncture force

    NASA Astrophysics Data System (ADS)

    Xu, Yingqiang; Zhang, Qinhe; Liu, Guowei

    2017-04-01

    Needle biopsy is a method to extract the cells from the patient's body with a needle for tissue pathological examination. Many factors affect the cutting process of soft tissue, including the geometry of the biopsy needle, the mechanical properties of the soft tissue, the parameters of the puncture process and the interaction between them. This paper conducted orthogonal experiment of main cutting parameters based on single plane puncture biopsy needle, and obtained the cutting force curve of single plane puncture biopsy needle by studying the influence of the inclination angle, diameter and velocity of the single plane puncture biopsy needle on the puncture force of the biopsy needle. Stage analysis of the cutting process of biopsy needle puncture was made to determine the main influencing factors of puncture force during the cutting process, which provides a certain theoretical support for the design of new type of puncture biopsy needle and the operation of puncture biopsy.

  6. Clinicopathological predictors for progression of chronic kidney disease in nephrosclerosis: a biopsy-based cohort study.

    PubMed

    Yamanouchi, Masayuki; Hoshino, Junichi; Ubara, Yoshifumi; Takaichi, Kenmei; Kinowaki, Keiichi; Fujii, Takeshi; Ohashi, Kenichi; Mise, Koki; Toyama, Tadashi; Hara, Akinori; Shimizu, Miho; Furuichi, Kengo; Wada, Takashi

    2018-05-19

    Biopsy-based studies on nephrosclerosis are lacking and the clinicopathological predictors for progression of chronic kidney disease (CKD) are not well established. We retrospectively assessed 401 patients with biopsy-proven nephrosclerosis in Japan. Progression of CKD was defined as new-onset end-stage renal disease, decrease of estimated glomerular filtration rate (eGFR) by  ≥50% or doubling of serum creatinine, and the sub-distribution hazard ratio (SHR) with 95% confidence interval (CI) for CKD progression was determined for various clinical and histological characteristics in competing risks analysis. The incremental value of pathological information for predicting CKD progression was assessed by calculating Harrell's C-statistics, the Akaike information criterion (AIC), net reclassification improvement and integrated discrimination improvement. During a median follow-up period of 5.3 years, 117 patients showed progression of CKD and 10 patients died before the defined kidney event. Multivariable sub-distribution hazards model identified serum albumin (SHR 0.48; 95% CI 0.35-0.67), hemoglobin A1c (SHR 0.71; 95% CI 0.54-0.94), eGFR (SHR 0.98; 95% CI 0.97-0.99), urinary albumin/creatinine ratio (UACR) (SHR 1.18; 95% CI 1.08-1.29), percentage of segmental/global glomerulosclerosis (%GS) (SHR 1.01; 95% CI 1.00-1.02) and interstitial fibrosis and tubular atrophy (IFTA) (SHR 1.52; 95% CI 1.20-1.92) as risk factors for CKD progression. The C-statistic of a model with only clinical variables was improved by adding %GS (0.790 versus 0.796, P < 0.01) and IFTA (0.790 versus 0.811, P < 0.01). The reclassification statistic was also improved after adding the biopsy data to the clinical data. The model including IFTA was superior, with the lowest AIC. The study implies that in addition to the traditional markers of eGFR and UACR, we may explore the markers of serum albumin and hemoglobin A1c, which are widely available but not routinely measured in patients

  7. The value of endomyocardial biopsy in diagnosis and guiding therapy.

    PubMed

    Khan, Tayyaba; Selvakumar, Dinesh; Trivedi, Siddharth; Rao, Karan; Harapoz, Mehmet; Thiagalingam, Aravinda; Denniss, A Robert; Varikatt, Winny

    2017-12-01

    Endomyocardial biopsy (EMB) is a highly-specialised procedure that is associated with some controversy as to its diagnostic role due to its inconsistency in diagnosing a wide variety of cardiac diseases. Given the advances and sophistication in echocardiography and cardiac magnetic resonance imaging (MRI), the vast majority of cardiac diseases can be diagnosed by these non-invasive procedures. Under-sampling and the fact that biopsy site is limited to the right side of the interventricular septum further limits its value. In spite of all these limitations, there still remains a group of pathological conditions that require biopsy for a conclusive diagnosis such as myocarditis, amyloidosis, sarcoidosis and giant cell myocarditis. Correct patient selection and the quantity of tissue samples impart a significant influence on the accuracy of the diagnosis, and thus the value of EMB is variable for each patient. The purpose of this study was to evaluate the role of EMB in patient care, through its ability to either change clinical diagnosis or alter patient management. Our study was based in a single teaching centre. An audit of cardiac biopsies performed over a 10 year period identified 250 patients. We assessed indications, histology, electron microscopic findings, final clinical diagnosis and how they influenced patient management. A definite diagnosis on histology was given in 44 of 250 patients (17.6%). Non-specific findings were observed in the remaining 206 patients (82.4%). Histology influenced patient management in 73 (29.2%) patients. Histological examination in the remaining 177 biopsies (70.8%) did not provide a definite diagnosis or influence patient management. It was additionally found that the number of tissue fragments sampled has significant impact on diagnostic accuracy. A more accurate diagnosis of 45% was obtained when ≥5 fragments were sampled, as compared to 1-3 fragments where accuracy dropped to 20%. Our study indicated that sampling for

  8. 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.

  9. 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 Central

    Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-01-01

    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, 120patients 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. PMID:26416245

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

    SciTech Connect

    Hardman, Rulon L., E-mail: hardmanr@uthscsa.edu; 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 totalmore » (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.« less

  11. Canadian Forces Education and Training for Interagency Operational Contexts (Education et Instruction des Forces Canadiennes Pour les Contextes Operationnels Interorganisationnels)

    DTIC Science & Technology

    2009-11-01

    organismes gouvernementaux dans le processus de planification opérationnelle (PPO) des FC. Le rapport se termine par des recommandations de travaux...B.D., THOMSON, M.H., BROWN, A.L., SARTORI, J.A., TAYLOR, T.E., WALDHERR, S.U. 2008. Organizational trust in the Canadian Forces. DRDC T No. CR2008...enablers for distributed team collaboration. DRDC T No. CR2007-137. Toronto, ON: Defence Research and Development Canada. FUGLESTAD, P.T., SNYDER

  12. Electrical property sensing biopsy needle for prostate cancer detection.

    PubMed

    Mishra, V; Schned, A R; Hartov, A; Heaney, J A; Seigne, J; Halter, R J

    2013-11-01

    Significant electrical property differences have been demonstrated to exist between malignant and benign prostate tissues. We evaluated how well a custom designed clinically deployable electrical property sensing biopsy needle is able to discriminate between these tissue types in an ex vivo prostate model. An electrical impedance spectroscopy (EIS) sensing biopsy (Bx) needle was developed to record resistive (ρR) and reactive (ρX) components of electrical impedance from 100 Hz to 1 MHz. Standard twelve-core biopsy protocols were followed, in which the EIS-Bx device was used to gauge electrical properties prior to extracting tissue cores through biopsy needle firing from 36 ex vivo human prostates. Histopathological assessment of the cores was statistically compared to the impedance spectrum gauged from each core. The magnitudes of the mean resistive and reactive components were significantly higher in cancer tissues (P < 0.05). ROC curves showed that ρR at 63.09 kHz was optimal for discriminating cancer from benign tissues; this parameter had 75.4% specificity, 76.1% sensitivity, and ROC AUC of 0.779. Similarly, 251.1 kHz was optimal when using ρX to discriminate cancer from benign tissues; this parameter had a 77.9% specificity, 71.4% sensitivity, and ROC AUC of 0.79. Significant electrical property differences noted between benign and malignant prostate tissues suggest the potential efficacy an EIS-Bx device would provide for cancer detection in a clinical setting. By sensing a greater fraction of the prostate's volume in real-time, the EIS-Bx device has the potential to improve the accuracy of cancer grading and volume estimation made with current biopsy procedures. © 2013 Wiley Periodicals, Inc.

  13. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication

    PubMed Central

    Sezgin, Orhan; Ates, Fehmi; Altintas, Engin; Saritas, Bunyamin

    2017-01-01

    Aim: Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB. Materials and methods: The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject’s anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy. Results: Groups were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1-10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group. Conclusion: Premedication with Meperidine or Midazolam in PLB would improve patients’ tolerance, comfort, and attitude against a possible repeat PLB. How to cite this article: Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepato-Gastroenterol 2017;7(2):146-149. PMID:29201797

  14. Breast Cancer Risk Prediction and Mammography Biopsy Decisions

    PubMed Central

    Armstrong, Katrina; Handorf, Elizabeth A.; Chen, Jinbo; Demeter, Mirar N. Bristol

    2012-01-01

    Background Controversy continues about screening mammography, in part because of the risk of false-negative and false-positive mammograms. Pre-test breast cancer risk factors may improve the positive and negative predictive value of screening. Purpose To create a model that estimates the potential impact of pre-test risk prediction using clinical and genomic information on the reclassification of women with abnormal mammograms (BI-RADS3 and BI-RADS4 [Breast Imaging-Reporting and Data System]) above and below the threshold for breast biopsy. Methods The current study modeled 1-year breast cancer risk in women with abnormal screening mammograms using existing data on breast cancer risk factors, 12 validated breast cancer single nucleotide polymorphisms (SNPs), and probability of cancer given the BI-RADS category. Examination was made of reclassification of women above and below biopsy thresholds of 1%, 2%, and 3% risk. The Breast Cancer Surveillance Consortium data were collected from 1996 to 2002. Data analysis was conducted in 2010 and 2011. Results Using a biopsy risk threshold of 2% and the standard risk factor model, 5% of women with a BI-RADS3 mammogram had a risk above the threshold, and 3% of women with BIRADS4A mammograms had a risk below the threshold. The addition of 12 SNPs in the model resulted in 8% of women with a BI-RADS3 mammogram above the threshold for biopsy and 7% of women with BI-RADS4A mammograms below the threshold. Conclusions The incorporation of pre-test breast cancer risk factors could change biopsy decisions for a small proportion of women with abnormal mammograms. The greatest impact comes from standard breast cancer risk factors. PMID:23253645

  15. Psoriasis skin biopsy image segmentation using Deep Convolutional Neural Network.

    PubMed

    Pal, Anabik; Garain, Utpal; Chandra, Aditi; Chatterjee, Raghunath; Senapati, Swapan

    2018-06-01

    Development of machine assisted tools for automatic analysis of psoriasis skin biopsy image plays an important role in clinical assistance. Development of automatic approach for accurate segmentation of psoriasis skin biopsy image is the initial prerequisite for developing such system. However, the complex cellular structure, presence of imaging artifacts, uneven staining variation make the task challenging. This paper presents a pioneering attempt for automatic segmentation of psoriasis skin biopsy images. Several deep neural architectures are tried for segmenting psoriasis skin biopsy images. Deep models are used for classifying the super-pixels generated by Simple Linear Iterative Clustering (SLIC) and the segmentation performance of these architectures is compared with the traditional hand-crafted feature based classifiers built on popularly used classifiers like K-Nearest Neighbor (KNN), Support Vector Machine (SVM) and Random Forest (RF). A U-shaped Fully Convolutional Neural Network (FCN) is also used in an end to end learning fashion where input is the original color image and the output is the segmentation class map for the skin layers. An annotated real psoriasis skin biopsy image data set of ninety (90) images is developed and used for this research. The segmentation performance is evaluated with two metrics namely, Jaccard's Coefficient (JC) and the Ratio of Correct Pixel Classification (RCPC) accuracy. The experimental results show that the CNN based approaches outperform the traditional hand-crafted feature based classification approaches. The present research shows that practical system can be developed for machine assisted analysis of psoriasis disease. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Risk of hospitalization and death following prostate biopsy in Scotland.

    PubMed

    Brewster, D H; Fischbacher, C M; Nolan, J; Nowell, S; Redpath, D; Nabi, G

    2017-01-01

    To investigate the risk of hospitalization and death following prostate biopsy. Retrospective cohort study. Our study population comprised 10,285 patients with a record of first ever prostate biopsy between 2009 and 2013 on computerized acute hospital discharge or outpatient records covering Scotland. Using the general population as a comparison group, expected numbers of admissions/deaths were derived by applying age-, sex-, deprivation category-, and calendar year-specific rates of hospital admissions/deaths to the study population. Indirectly standardized hospital admission ratios (SHRs) and mortality ratios (SMRs) were calculated by dividing the observed numbers of admissions/deaths by expected numbers. Compared with background rates, patients were more likely to be admitted to hospital within 30 days (SHR 2.7; 95% confidence interval 2.4, 2.9) and 120 days (SHR 4.0; 3.8, 4.1) of biopsy. Patients with prior co-morbidity had higher SHRs. The risk of death within 30 days of biopsy was not increased significantly (SMR 1.6; 0.9, 2.7), but within 120 days, the risk of death was significantly higher than expected (SMR 1.9; 1.5, 2.4). The risk of death increased with age and tended to be higher among patients with prior co-morbidity. Overall risks of hospitalization and of death up to 120 days were increased both in men diagnosed and those not diagnosed with prostate cancer. Higher rates of adverse events in older patients and patients with prior co-morbidity emphasizes the need for careful patient selection for prostate biopsy and justifies ongoing efforts to minimize the risk of complications. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Magnetic Resonance Imaging Targeted Biopsy Improves Selection of Patients Considered for Active Surveillance for Clinically Low Risk Prostate Cancer Based on Systematic Biopsies.

    PubMed

    Ouzzane, Adil; Renard-Penna, Raphaele; Marliere, François; Mozer, Pierre; Olivier, Jonathan; Barkatz, Johann; Puech, Philippe; Villers, Arnauld

    2015-08-01

    Current selection criteria for active surveillance based on systematic biopsy underestimate prostate cancer volume and grade. We investigated the role of additional magnetic resonance imaging targeted biopsy in reclassifying patients eligible for active surveillance based on systematic biopsy. We performed a study at 2 institutions in a total of 281 men with increased prostate specific antigen. All men met certain criteria, including 1) prebiopsy magnetic resonance imaging, 12-core transrectal systematic biopsy and 2 additional magnetic resonance imaging targeted biopsies of lesions suspicious for cancer during the same sequence as systematic biopsy, and 2) eligibility for active surveillance based on systematic biopsy results. Criteria for active surveillance were prostate specific antigen less than 10 ng/ml, no Gleason grade 4/5, 5 mm or less involvement of any biopsy core and 2 or fewer positive systematic biopsy cores. Patient characteristics were compared between reclassified and nonreclassified groups based on magnetic resonance imaging targeted biopsy results. On magnetic resonance imaging 58% of the 281 patients had suspicious lesions. Magnetic resonance imaging targeted biopsy was positive for cancer in 81 of 163 patients (50%). Of 281 patients 28 (10%) were reclassified by magnetic resonance imaging targeted biopsy as ineligible for active surveillance based on Gleason score in 8, cancer length in 20 and Gleason score plus cancer length in 9. Suspicious areas on magnetic resonance imaging were in the anterior part of the prostate in 15 of the 28 men (54%). Reclassified patients had a smaller prostate volume (37 vs 52 cc) and were older (66.5 vs 63 years) than those who were not reclassified (p < 0.05). Magnetic resonance imaging targeted biopsy reclassified 10% of patients who were eligible for active surveillance based on systematic biopsy. Its incorporation into the active surveillance eligibility criteria may decrease the risk of reclassification to

  18. Comparison of efficacy, safety, and cost-effectiveness of in-office cup forcep biopsies versus operating room biopsies for laryngopharyngeal tumors.

    PubMed

    Naidu, Harini; Noordzij, J Pieter; Samim, Arang; Jalisi, Scharukh; Grillone, Gregory A

    2012-09-01

    To compare the diagnostic yield, safety, and cost of biopsies of laryngopharyngeal tumor performed in an office setting with those performed in the operating room (OR) under general anesthesia. This was a retrospective review of patients' records at Boston Medical Center from 2006 to 2008. In-office biopsies were performed using flexible digital videolaryngoscopy with cup forcep biopsies taken via the working channel in patients in whom cancer was strongly suspected. Patients whose in-office biopsies were nondiagnostic or suspected to be falsely negative were taken to the OR for biopsy under general anesthesia and served as the control group. Twelve patients fit the selection criteria and had in-office biopsies attempted. One patient could not tolerate the in-office biopsy. Seven of the 11 in-office biopsies performed were diagnostic for squamous cell carcinoma. The average cost (facility and professional otolaryngology charges) for an in-office biopsy was $2053.91. Five of these patients required further biopsy in the OR at an average cost (charges for surgeon, OR, anesthesia, and recovery room) of $9024.47. There were no significant complications reported for any of the procedures. In patients with strongly suspected laryngopharyngeal cancer, in-office cup forcep biopsies were 64% diagnostic. When compared with the OR, in-office cup biopsies of laryngopharyngeal tumor are safe and considerably more cost-effective. Although 36% of patients required operative biopsies, the cost would have been considerably higher in this cohort if all patients had gone to the OR for biopsies. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  19. Liver biopsy in type 2 diabetes mellitus: Steatohepatitis represents the sole feature of liver damage.

    PubMed

    Masarone, Mario; Rosato, Valerio; Aglitti, Andrea; Bucci, Tommaso; Caruso, Rosa; Salvatore, Teresa; Sasso, Ferdinando Carlo; Tripodi, Marie Francoise; Persico, Marcello

    2017-01-01

    Recent studies report a prevalence of non-alcoholic fatty liver disease (NAFLD) of between 70% and 80% in patients with metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM). Nevertheless, it is not possible to differentiate between simple steatosis and non-alcoholic steatohepatitis (NASH) with non-invasive tests. The aim of this study was to differentiate between simple steatosis and NASH by liver biopsy in patients with hypertransaminasemia and MS or T2DM. Two hundred and fifteen patients with increased ALT levels and MS, and 136 patients at their first diagnosis of T2DM regardless of ALT values were consecutively admitted to a tertiary hepatology center between January 2004 and November 2014. Exclusion criteria were other causes of liver disease/ALT increase. Each patient underwent a clinical, laboratory and ultrasound evaluation, and a liver biopsy. Gender distribution, age, and body mass index were similar in the two groups of patients, whereas cholesterol levels, glycemia and blood pressure were significantly different between the two groups. The prevalence of NAFLD was 94.82% in MS patients and 100% in T2DM patients. NASH was present in 58.52% of MS patients and 96.82% of T2DM. Consequently, this study reveals that, by using liver biopsy, almost all patients with T2DM or MS have NAFLD, which in patients with T2DM means NASH. Importantly, it suggests that NASH may be one of the early complications of T2DM due to its pathophysiological correlation with insulin resistance.

  20. Using XML to encode TMA DES metadata.

    PubMed

    Lyttleton, Oliver; Wright, Alexander; Treanor, Darren; Lewis, Paul

    2011-01-01

    The Tissue Microarray Data Exchange Specification (TMA DES) is an XML specification for encoding TMA experiment data. While TMA DES data is encoded in XML, the files that describe its syntax, structure, and semantics are not. The DTD format is used to describe the syntax and structure of TMA DES, and the ISO 11179 format is used to define the semantics of TMA DES. However, XML Schema can be used in place of DTDs, and another XML encoded format, RDF, can be used in place of ISO 11179. Encoding all TMA DES data and metadata in XML would simplify the development and usage of programs which validate and parse TMA DES data. XML Schema has advantages over DTDs such as support for data types, and a more powerful means of specifying constraints on data values. An advantage of RDF encoded in XML over ISO 11179 is that XML defines rules for encoding data, whereas ISO 11179 does not. We created an XML Schema version of the TMA DES DTD. We wrote a program that converted ISO 11179 definitions to RDF encoded in XML, and used it to convert the TMA DES ISO 11179 definitions to RDF. We validated a sample TMA DES XML file that was supplied with the publication that originally specified TMA DES using our XML Schema. We successfully validated the RDF produced by our ISO 11179 converter with the W3C RDF validation service. All TMA DES data could be encoded using XML, which simplifies its processing. XML Schema allows datatypes and valid value ranges to be specified for CDEs, which enables a wider range of error checking to be performed using XML Schemas than could be performed using DTDs.

  1. Using XML to encode TMA DES metadata

    PubMed Central

    Lyttleton, Oliver; Wright, Alexander; Treanor, Darren; Lewis, Paul

    2011-01-01

    Background: The Tissue Microarray Data Exchange Specification (TMA DES) is an XML specification for encoding TMA experiment data. While TMA DES data is encoded in XML, the files that describe its syntax, structure, and semantics are not. The DTD format is used to describe the syntax and structure of TMA DES, and the ISO 11179 format is used to define the semantics of TMA DES. However, XML Schema can be used in place of DTDs, and another XML encoded format, RDF, can be used in place of ISO 11179. Encoding all TMA DES data and metadata in XML would simplify the development and usage of programs which validate and parse TMA DES data. XML Schema has advantages over DTDs such as support for data types, and a more powerful means of specifying constraints on data values. An advantage of RDF encoded in XML over ISO 11179 is that XML defines rules for encoding data, whereas ISO 11179 does not. Materials and Methods: We created an XML Schema version of the TMA DES DTD. We wrote a program that converted ISO 11179 definitions to RDF encoded in XML, and used it to convert the TMA DES ISO 11179 definitions to RDF. Results: We validated a sample TMA DES XML file that was supplied with the publication that originally specified TMA DES using our XML Schema. We successfully validated the RDF produced by our ISO 11179 converter with the W3C RDF validation service. Conclusions: All TMA DES data could be encoded using XML, which simplifies its processing. XML Schema allows datatypes and valid value ranges to be specified for CDEs, which enables a wider range of error checking to be performed using XML Schemas than could be performed using DTDs. PMID:21969921

  2. [Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied].

    PubMed

    Tamarelle, B; Perrin, P; Devonec, M; Paparel, P; Ruffion, A

    To identify hospitalizations directly related to a complication occurring within 30 days following a transrectal prostate biopsy (PBP). Overall hospitalization rates, mortality rates, potential predisposing factors for complications. Single-center study including all patients who underwent PBP between January 2005 and January 2012. Any hospitalization occurring within 30 days of the PBP for urgent motive was considered potentially attributable to biopsy. We identified the reason for hospitalization with direct complications (urinary infection or fever, rectal bleeding, bladder caillotage, retention) and indirect (underlying comorbidities decompensation) of the biopsy. The contributing factors were anticoagulant or antiplatelet treatment well as waning immunity factors (corticosteroid therapy, HIV, chemotherapy or immunodulateur). Among 2715 men who underwent PBP, there were 120 (4.4%) hospitalizations including 28 (1.03%) caused by the biopsy. Twenty-five (0.92%) were related to a direct complication of biopsy: 14 (56%) for urinary tract infection or fever including 1 hospitalization in intensive care, 5 (20%) for rectal bleeding which required several transfusions 1, 10 (40%) urinary retention and 3 (0.11%) for an indirect complication (2 coronary syndromes and 1 respiratory failure). Several direct complications were associated in 3 cases. Only two hospitalizations associated with rectal bleeding were taking an antiplatelet or anticoagulant. There was no association between hospitalization for urinary tract infections and a decreased immune status. The first death observed in our study occurred at D31 of pulmonary embolism (advanced metastatic patient with bladder cancer). Twenty (60.6%) patients urgently hospitalized did not have prostate cancer. Within this large sample of patients the overall rate of hospitalization due to the realization of a PBP was 1%. It has not been found predictive of complications leading to hospitalization. 4. Copyright © 2016

  3. Developpement d'un modele analytique pour l'analyse en elasticite lineaire de champs de deformation et contrainte au sein d'un polycristal. comparaison avec la methode des elements finis =

    NASA Astrophysics Data System (ADS)

    Bretin, Remy

    L'endommagement par fatigue des materiaux est un probleme courant dans de nombreux domaines, dont celui de l'aeronautique. Afin de prevenir la rupture par fatigue des materiaux il est necessaire de determiner leur duree de vie en fatigue. Malheureusement, dues aux nombreuses heterogeneites presentes, la duree de vie en fatigue peut fortement varier entre deux pieces identiques faites dans le meme materiau ayant subi les memes traitements. Il est donc necessaire de considerer ces heterogeneites dans nos modeles afin d'avoir une meilleure estimation de la duree de vie des materiaux. Comme premiere etape vers une meilleure consideration des heterogeneites dans nos modeles, une etude en elasticite lineaire de l'influence des orientations cristallographiques sur les champs de deformations et de contraintes dans un polycristal a ete realisee a l'aide de la methode des elements finis. Des correlations ont pu etre etablies a partir des resultats obtenus, et un modele analytique en elasticite lineaire prenant en compte les distributions d'orientations cristallographiques et les effets de voisinage a pu etre developpe. Ce modele repose sur les bases des modeles d'homogeneisation classique, comme le schema auto-coherent, et reprend aussi les principes de voisinage des automates cellulaires. En prenant pour reference les resultats des analyses elements finis, le modele analytique ici developpe a montre avoir une precision deux fois plus grande que le modele auto-coherent, quel que soit le materiau etudie.

  4. Nasal biopsies of children exposed to air pollutants.

    PubMed

    Calderón-Garcidueñas, L; Rodriguez-Alcaraz, A; Valencia-Salazar, G; Mora-Tascareño, A; García, R; Osnaya, N; Villarreal-Calderón, A; Devlin, R B; Van Dyke, T

    2001-01-01

    Southwest Metropolitan Mexico City (SWMMC) atmosphere is a complex mixture of air pollutants, including ozone, particulate matter, and aldehydes. Children in SWMMC are exposed chronically and sequentially to numerous toxicants, and they exhibit significant nasal damage. The objective of this study was to assess p53 accumulation by immunohistochemistry in nasal biopsies of SWMMC children. We evaluated 111 biopsies from 107 children (83 exposed SWMMC children and 24 control children residents in a pollutant-compliant Caribbean island). Complete clinical histories and physical examinations, including an ear-nose-throat (ENT) exam were done. There was a significant statistical difference in the upper and lower respiratory symptomatology and ENT findings between control and exposed children (p < 0.001). Control children gave no respiratory symptomatology in the 3 months prior to the study; their biopsies exhibited normal ciliated respiratory epithelium and were p53-negative. SWMMC children complained of epistaxis, nasal obstruction. and crusting. Irregular areas of whitish-gray recessed mucosa over the inferior and middle turbinates were seen in 25% of SWMMC children, and their nasal biopsies displayed basal cell hyperplasia, decreased numbers of ciliated and goblet cells, neutrophilic epithelial infiltrates, squamous metaplasia. and mild dysplasia. Four of 21 SWMMC children with grossly abnormal mucosal changes exhibited strong transmural nuclear p53 staining in their nasal biopsies (p 0.005, odds ratio 26). In the context of lifetime exposures to toxic and potentially carcinogenic air pollutants, p53 nasal induction in children could potentially represent. a) a checkpoint response to toxic exposures, setting up a selective condition for p53 mutation, or b) a p53 mutation has already occurred as a result of such selection. Because the biological significance of p53 nuclear accumulation in the nasal biopsies of these children is not clear at this point, we strongly

  5. Current Status and Problems of T790M Detection, a Molecular Biomarker of Acquired Resistance to EGFR Tyrosine Kinase Inhibitors, with Liquid Biopsy and Re-biopsy.

    PubMed

    Komiya, Kazutoshi; Nakashima, Chiho; Nakamura, Tomomi; Hirakawa, Haruki; Abe, Tomonori; Ogusu, Shinsuke; Takahashi, Koichiro; Takeda, Yuji; Egashira, Yoshiaki; Kimura, Shinya; Sueoka-Aragane, Naoko

    2018-06-01

    The purpose of this study was to consider appropriate application of liquid and re-biopsy through analysis of current status in practice. We performed a retrospective analysis of 22 patients with epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer who exhibited 1st/2nd generation EGFR-tyrosine kinase inhibitors resistance. The cobas® method was used to detect T790M with re-biopsy and the mutation-biased PCR and quenched probe method was used with liquid biopsy. T790M detection rate was 52% with re-biopsy and 58% with liquid biopsy. The concordance between tissue and plasma was 58%. One patient who was T790M-positive with liquid biopsy showed heterogeneity among metastatic lesions in terms of osimertinib efficacy, as revealed by T790M detection with re-biopsy. Liquid biopsy reflects the whole body, whereas re-biopsy is useful for spatial diagnosis. Considering these characteristics, a combination of liquid and re-biopsy contribute to enhanced treatment. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  6. Can we improve the biopsy quality of upper urinary tract urothelial tumors? Single-center preliminary results of a new biopsy forceps.

    PubMed

    Al-Qahtani, Saeed M; Legraverend, Dorian; Gil-Diez de Medina, Sixtina; Sibony, Mathilde; Traxer, Olivier

    2014-01-01

    Our aim was to evaluate the biopsy quality of upper urinary tract urothelial transitional cell carcinoma with a new biopsy forceps (BIGopsy®, Cook Medical) compared to a classic biopsy forceps (Piranha®, Boston Scientific). From December 2009 to December 2011, 20 patients with upper urinary tract urothelial transitional cell carcinoma underwent conservative treatment endoscopically. All lesions were evaluated and biopsied with 3 Fr cup forceps using both types of forceps (BIGopsy and Piranha). A single pathologist blindly analyzed the specimens in order to determine the optimal biopsy for each patient. Specimen histopathology results were graded; however, they were staged if the lamina propria was not invaded (T1) or if the tumor was detected at the lamina propria (T1+). Of the 20 upper urinary tract lesions, 12 (60%) were in the renal pelvis, 3 (15%) in the upper calyx, 1 (5%) in the middle calyx, 1 (5%) in the lower calyx, 1 (5%) in the upper third of the ureter and 2 (10%) in the middle third of the ureter. We did not detect T1 in all biopsies. One patient had no valid biopsies by both forceps. A diagnosis of urothelial carcinoma was made in 17 BIGopsy biopsies compared to 7 Piranha biopsies. Despite the limited number of cases, our study demonstrated the advantage of the new forceps (BIGopsy) in obtaining a valid biopsy of upper urinary tract urothelial tumors. Therefore, we recommend it in evaluating this pathology for optimal treatment. © 2014 S. Karger AG, Basel.

  7. The eternal enigma in prostatic biopsy access route.

    PubMed

    Fabiani, Andrea; Principi, Emanuele; Filosa, Alessandra; Servi, Lucilla

    2017-10-03

    Dear Editors,We read with interest the article by Di Franco and co-workers (1). The introduction of prostatic magnetic resonance and the relative fusion-biopsy have not yet allowed the expected improvements in prostate biopsy. To our knowledge, there are no works that demonstrate the superiority of fusion techniques on the remaining ultrasound guided prostate biopsies that are still the widely used in the diagnosis of prostate cancer. Furthemore, these technologies are expensive exams and they are not yet available in all centers, especially in those minors. We work at a "minor" center and we always keep in mind that the goal of  prostatic biopsy is the diagnosis and the staging of prostatic neoplasms.. However, it remains uncertain which of the two techniques, transperineal (TP) or transrectal (TR), is superior in terms of detection rate during first biopsy setting. Several studies have compared the prostate cancer detection rate but TR and TP access route in prostatic gland sampling seems to be equivalent in terms of efficiency and complications, as reported by Shen PF et al. (2), despite several methodological limitations recognized in their work. The results reported by Di Franco CA et al. represent the real life experience of most urologists that perform the PB based on their own training experience and available technical devices. From an historical viewpoint, the TP route has been the first one to be used to reach the prostate, both for diagnostic and therapeutic purposes. To date, because it seems to be more invasive and difficult, the TP route is less used worldwide than the TR one (2). Theoretically, the TP approach should detect more prostate cancer than the TR way  because the cores of the TP approach are directed longitudinally to the peripheral zone and the anterior part of the prostate (4). The results reported by Di Franco et al. seems to confirm these considerations. However, our real life experience differ from the conclusions reached in their

  8. 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

  9. In-Bore MR-Guided Biopsy Systems and Utility of PI-RADS.

    PubMed

    Fütterer, Jurgen J; Moche, Michael; Busse, Harald; Yakar, Derya

    2016-06-01

    A diagnostic dilemma exists in cases wherein a patient with clinical suspicion for prostate cancer has a negative transrectal ultrasound-guided biopsy session. Although transrectal ultrasound-guided biopsy is the standard of care, a paradigm shift is being observed. In biopsy-naive patients and patients with at least 1 negative biopsy session, multiparametric magnetic resonance imaging (MRI) is being utilized for tumor detection and subsequent targeting. Several commercial devices are now available for targeted prostate biopsy ranging from transrectal ultrasound-MR fusion biopsy to in bore MR-guided biopsy. In this review, we will give an update on the current status of in-bore MRI-guided biopsy systems and discuss value of prostate imaging-reporting and data system (PIRADS).

  10. Identification of Type VI Collagen Synthesizing Cells in Human Diabetic Glomerulosclerosis Using Renal Biopsy Sections

    PubMed Central

    Razzaque, Mohammed Shawkat; Koji, Takehiko; Harada, Takashi; Taguchi, Takashi

    1997-01-01

    Although the role of extracellular matrices in the development of glomerulosclerosis has been discussed widely, the cellular origin of type VI collagen in diabetic nephropathy (DN) has remained relatively unexplored. This study reports the distribution and cellular origin of type VI collagen in DN. Type VI collagen‐specific oligonucleotide probes and monoclonal antibody were used to assess the relative expression of mRNA for \\alpha1 (VI) chain and its translated protein in paraffin‐embedded renal biopsy sections of DN. By immunohistochemistry, compared to the control, increased deposition of type VI collagen was noted in the diffuse and nodular lesions of diabetic glomeruli. For cellular localization of type VI collagen mRNA, paraffin‐embedded renal sections of the control and DN were hybridized in situ with digoxigenin (Dig)‐labeled antisense oligo‐DNA probe complementary to a part of \\alpha1 (VI) mRNA. In comparison to the control kidney sections, increased numbers of intraglomerular cells (both mesangial and epithelial cells) were positive for α1 (VI) mRNA in renal biopsy sections of DN. From the results, we conclude that overexpression of type VI collagen by intraglomerular cells with its increased deposition might significantly contribute to the glomerulosclerosis found in DN. PMID:9497854

  11. [Value of aspiration biopsy of subcutaneous fat in amyloidosis].

    PubMed

    Ponce, P; Carvalho, F; Coelho, A

    1986-01-01

    Fine-needle aspiration of subcutaneous fat (FNAF) was performed in 24 patients, 12 with previously diagnosed amyloidosis presenting with proteinuria or nephrotic syndrome, and 12 presenting a nephrotic syndrome without amyloidosis on renal biopsy. FNAF was positive in 10 of 12 patients with amyloidosis (sensitivity: 83%) and negative in 12 of 12 patients with non-amyloid nephrotic syndrome (specificity: 100%). Considering a 2.5 to 10% prevalence of amyloidosis in adult patients with proteinuria or nephrotic syndrome, a positive FNAF is diagnostic of amyloidosis, and a negative FNAF rules out the diagnosis with a probability of 98 to 99%. FNAF is a simple and safe method which can be useful in patients who cannot undergo a renal biopsy.

  12. 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. © 2016 Society for Laboratory Automation and Screening.

  13. 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.

  14. Lung Biopsies with the Curved Radial Reload™ Stapler.

    PubMed

    ElSaegh, Mohamed Moneer; Petsa, Afroditi; Dunning, Joel

    2016-04-01

    We describe our experience at the James Cook University Hospital (UK) in using the curved Radial Reload™ (RR) stapler (Medtronic, Dublin, Ireland) for lung wedge resections, which is an endoscopic stapler used mainly in endoscopic general surgery. A single center experience (James Cook University Hospital) for patients who had superficial or deep video-assisted thoracoscopic surgery (VATS) lung wedge resection, using the curved RR stapler. Seven patients had superficial or deep VATS lung biopsies-their ages ranged from 38 to 75 years, with a median length of hospital stay of two days (one to six days), and a mean length of hospital stay of 2.5 days. No complications were encountered. The curved RR stapler is effective in several situations and allows fewer firing of staplers. Our experience would suggest that they are as haemostatic and pneumostatic as the straight staplers and can be used effectively in both superficial and deep lung biopsies.

  15. E. coli Multiresistant Meningitis after Transrectal Prostate Biopsy

    PubMed Central

    Alecsandru, Diana; Gestoso, Israel; Romero, Ana; Martinez, Alfonso; García, Ana; Lobo, Julio; Yagüe, M. Ruiz

    2006-01-01

    Escherichia coli meningitis is a frequent pathology in children younger than 3 years old, but is an uncommon disease in adults. E. coli infection is the main cause of intrahospital bacteremia as a consequence of the employment of different medical procedures. Our patient, male, 69 years old, presented with fever, progressive difficulty in breathing, and shivers 24 h after transrectal prostate biopsy, with an absence of any other symptoms. He received prophylactic treatment with ciprofloxacin and later empirical treatment with ampicillin and tobramicin. After that, the patient presented with fever, headache, behavioral changes, somnolence, disorientation, a fluctuating level of conscience, cutaneous widespread pallor, and acute urinary retention. On physical exploration, we observed generalized hypoventilation, Glasgow 10, stiffness of the neck, inconclusive Kernig; the remaining neurological exploration was normal. Systematic of blood: leukocytes = 8,510/mm3 (94.5% polymorphonuclear), platelet = 87,000/mm3, pH = 7.51, pCO2 = 28.8 mmHg, pO2 = 61 mmHg, O2 saturation = 93.8%, and remaining values were normal. Chest X- ray, cranial CT scan, urine cultures were normal. Blood culture: E. coli. CSF: glucose <0.4 g/l, total proteins = 3.05 g/l, PMN = 7 cells. Microscopic examination of the CSF: Gram-negative bacilli; CSF's culture: abundant E. coli. The case of acute meningitis by multiresistant E. coli after transrectal prostate biopsy presented demonstrates that antibiotic prevention with ciprofloxacin is not absolutely risk free. Besides the use of antibiotic prevention for multiresistant microorganisms, the urologist and other physicians involved in the procedure must not forget that the rate of major complications of transrectal prostate biopsy is 1%, especially when it is performed in patients who will not benefit from that biopsy. PMID:17619698

  16. Ex vivo evaluation of canine lung biopsy techniques.

    PubMed

    Marvel, Sarah; Monnet, Eric

    2013-05-01

    An ex vivo comparison of thoracoscopic lung biopsy techniques in dogs. Experimental. Cadaveric canine lung lobes. Lungs were inflated to 10 cmH2 O. After collecting biopsies 3 cm from the edge of lung lobes, leak pressures were recorded as inflation pressure was increased to 40 cmH2 O. Pre-tied loop ligature, square knot (SQ), modified 4S Roeder knot (M4SR) with glycomer 631 and polyglactin 910 size 0 and 2-0 were used in addition to EndoGIA 45-2.5 mm (Covidien, Norwalk, CT) and a vessel sealant device (VSDS single and VSDD double seal). Six biopsies were performed with each of these modalities. Median airway pressure at which leakage occurred was 28 (20-34)cmH2 O for EndoGIA 45; 33 (14-40) for VSDD; and 33 (10-40) for VSDS while other groups reached a median pressure of 40 cmH2 O (P < .0001). Leakage occurred at 20 cmH2 O in 1 sample with the EndoGIA and the VSDS, and in 2 with the VSDD while leakage did not occur in any other group (P = .36). Leakage occurred at 30 cmH2 O in 1 specimen each of the 0-polyglactin SQ, 2-0 glycomer 631 M4SR, 2-0 polyglactin M4SR, and 2-0 Surgitie (Covidien, Norwalk, CT); 2 with the VSDS; and 3 with the EndoGIA and the VSDD while leakage did not occur in any other group (P = .26). All tested techniques seemed safe except the vessel sealant device since it did not consistently seal every biopsy and leaked at pressures <20 cmH2 O. © Copyright 2013 by The American College of Veterinary Surgeons.

  17. Screening for Helicobacter pylori in Idiopathic Pulmonary Fibrosis Lung Biopsies.

    PubMed

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

    2016-01-01

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

  18. Diagnostic yield of pleural biopsy in exudative pleural effusion.

    PubMed

    Devkota, K C; Chokhani, R; Gautam, S

    2014-09-01

    To know the diagnostic role of pleural biopsy in determining underlying etiological causes of exudative pleural effusion. A total of 47 patients, aged 16-104 years with mean age of 47.36 years, of either sex, with exudative pleural effusion underwent closed pleural biopsy with Abram's needle in standard way. Average 4-6 biopsy specimens were obtained from each patient, which were sent for histopathological examination. In this study, 47 cases of exudative pleural effusion were included, among them 26 (55.31%) cases were male and 21 (44.69%) were female with mean age 47.36 years. Cough was reported by 42 (89.36%) cases, expectoration 28 (59.57%), hemoptysis 3 (6.38%), breathlessness 27 (57.44%), wheezing 3 (6.38%), chest pain 38 (80.85%) and fever by 30 (63.82%) cases. Out of 47 cases, 28 (59.57%) cases had a positive yield, whereas in 19 (40.43%) cases the result was nonspecific inflammation. Out of 28 (59.57%) cases with positive yield 21 (44.68%) were found to have granulomatous inflammation and 10 (21.28%) cases were malignant. Among malignant pleural effusion, 4 cases were squamous cell carcinoma; 3 small cell carcinoma; 1 case adenocarcinoma and 1 case found to have mesothelioma. Tuberculosis and malignancy are the two most common causes of exudative pleural effusion in our set up. Pleural biopsy is a safe, simple and well validated diagnostic tool that helps us to differentiate between malignancy and tuberculosis.

  19. Circulating tumor DNA as a liquid biopsy for cancer.

    PubMed

    Heitzer, Ellen; Ulz, Peter; Geigl, Jochen B

    2015-01-01

    Targeted therapies have markedly changed the treatment of cancer over the past 10 years. However, almost all tumors acquire resistance to systemic treatment as a result of tumor heterogeneity, clonal evolution, and selection. Although genotyping is the most currently used method for categorizing tumors for clinical decisions, tumor tissues provide only a snapshot, or are often difficult to obtain. To overcome these issues, methods are needed for a rapid, cost-effective, and noninvasive identification of biomarkers at various time points during the course of disease. Because cell-free circulating tumor DNA (ctDNA) is a potential surrogate for the entire tumor genome, the use of ctDNA as a liquid biopsy may help to obtain the genetic follow-up data that are urgently needed. This review includes recent studies exploring the diagnostic, prognostic, and predictive potential of ctDNA as a liquid biopsy in cancer. In addition, it covers biological and technical aspects, including recent advances in the analytical sensitivity and accuracy of DNA analysis as well as hurdles that have to be overcome before implementation into clinical routine. Although the analysis of ctDNA is a promising area, and despite all efforts to develop suitable tools for a comprehensive analysis of tumor genomes from plasma DNA, the liquid biopsy is not yet routinely used as a clinical application. Harmonization of preanalytical and analytical procedures is needed to provide clinical standards to validate the liquid biopsy as a clinical biomarker in well-designed and sufficiently powered multicenter studies. © 2014 American Association for Clinical Chemistry.

  20. Tissue proteomics: a new investigative tool for renal biopsy analysis.

    PubMed

    Sedor, John R

    2009-05-01

    Renal biopsy is viewed as the gold standard for diagnosis and management of many kidney diseases, especially glomerulopathies. However, the histopathological descriptions currently used in clinical practice often are neither diagnostic nor prognostic. The paper by Sethi et al. highlights the availability of a newer investigative tool that can be used to better define pathogenesis and, perhaps more important, to discover robust biomarkers of kidney disease cause and outcome.

  1. Biopsy guided by dermoscopy in cutaneous pigmented lesion - Case report*

    PubMed Central

    Bomm, Lislaine; Benez, Marcela Duarte Villela; Maceira, Juan Manuel Piñeiro; Succi, Isabel Cristina Brasil; Scotelaro, Maria de Fatima Guimarães

    2013-01-01

    It may be clinically difficult to differentiate early-stage melanoma from benign tumors, specially pigmented seborrheic keratosis. Dermoscopy can help; however, the findings are not always conclusive. Therefore, histopathology may be necessary for a correct diagnosis. We describe a melanocytic lesion with dubious clinic and dermoscopic findings. An incisional biopsy of a suspicious area, guided by dermoscopy, was performed to clarify the findings. PMID:23539018

  2. Hypnosis decreases presurgical distress in excisional breast biopsy patients.

    PubMed

    Schnur, Julie B; Bovbjerg, Dana H; David, Daniel; Tatrow, Kristin; Goldfarb, Alisan B; Silverstein, Jeffrey H; Weltz, Christina R; Montgomery, Guy H

    2008-02-01

    Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures. Groups did not differ in terms of the following: demographics (age, education, ethnicity, marital status, all P's > 0.28); medical variables (presurgery diagnosis, previous excisional biopsy, previous breast cancer, all P's > 0.11); or preintervention distress (SV-POMS P > 0.74) assessed on the day of surgery. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

  3. The muscle biopsy technique. Historical and methodological considerations.

    PubMed

    Ekblom, B

    2017-05-01

    The muscle biopsy method is an important tool for clinical and scientific work. In this study, the two most used instruments, the Bergström needle and the Well-Blakesley conchotome, are described. The technique of using those instruments, risks, and other considerations are discussed. Finally, a few consequences and the error of the method for determining muscle fiber type, fiber area, substrates, and metabolites are presented. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. 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. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Prostate cancer detection in patients with prior negative biopsy undergoing cognitive-, robotic- or in-bore MRI target biopsy.

    PubMed

    Kaufmann, Sascha; Russo, Giorgio I; Bamberg, Fabian; Löwe, Lorenz; Morgia, Giuseppe; Nikolaou, Konstantin; Stenzl, Arnulf; Kruck, Stephan; Bedke, Jens

    2018-05-01

    To evaluate the detection rate among three different targeted biopsy approaches of robot-assisted MRI/TRUS fusion (RA-TB), mpMRI in-bore (MRGB), cognitive fusion guidance biopsy (COG-TB) for the detection of prostate cancer (PC) and clinically significant PC (csPC). Between 2014 and 2016, 156 patients with a lesion on mpMRI, performed in accordance with ESUR guidelines, due to cancer suspicion or on-going cancer suspicion after prior negative prostate biopsy, underwent targeted biopsy with RA-TB, MRGB or COG-TB. All lesions were rated according to PI-RADS v2. We compared detection rates between techniques. Models were constructed to predict the detection of overall PC and csPC and using a 1000 boot-strap sample. In the all cohort, 73, 45 and 38 patients underwent RA-TB, MRGB or COG-TB, respectively. Overall PC was found in 39 (52.42%), 23 (51.11%) and 11 (28.95%) (p = 0.04) patients of RA-TB, MRGB and COG-TB arm, respectively. As concerning the detection of csPC, it was found in 26 (35.62%),18 (40.0%) and 9 (23.68%) patients of RA-TB, MRGB and COG-TB arm (p = 0.27). Model 1 showed that RA-TB [OR: 10.08 (95% CI 1.95-51.97); p < 0.01] and MRGB [OR: 12.88 (95% CI 2.36-70.25); p < 0.01] were associated with overall PC detection in TB, while only MRGB was associated with csPC at TB (model 2) [OR: 5.72; (95% CI 1.40-23.35); p < 0.01]. The c-index for model 1 and model 2 was 0.86 and 0.85, respectively. We did not report significant complications between groups. In-bore biopsy and MRI/TRUS fusion-guided biopsy showed greater accuracy in detecting PC compared to cognitive fusion as modeled in a newly established normogram.

  6. Survey of Kidney Biopsy Clinical Practice and Training in the United States.

    PubMed

    Yuan, Christina M; Nee, Robert; Little, Dustin J; Narayan, Rajeev; Childs, John M; Prince, Lisa K; Raghavan, Rajeev; Oliver, James D

    2018-05-07

    Practicing clinical nephrologists are performing fewer diagnostic kidney biopsies. Requiring biopsy procedural competence for graduating nephrology fellows is controversial. An anonymous, on-line survey of all Walter Reed training program graduates ( n =82; 1985-2017) and all United States nephrology program directors ( n =149; August to October of 2017), regarding kidney biopsy practice and training, was undertaken. Walter Reed graduates' response and completion rates were 71% and 98%, respectively. The majority felt adequately trained in native kidney biopsy (83%), transplant biopsy (82%), and tissue interpretation (78%), with no difference for ≤10 versus >10 practice years. Thirty-five percent continued to perform biopsies (13% did ≥10 native biopsies/year); 93% referred at least some biopsies. The most common barriers to performing biopsy were logistics (81%) and time (74%). Program director response and completion rates were 60% and 77%. Seventy-two percent cited ≥1 barrier to fellow competence. The most common barriers were logistics (45%), time (45%), and likelihood that biopsy would not be performed postgraduation (41%). Fifty-one percent indicated that fellows should not be required to demonstrate minimal procedural competence in biopsy, although 97% agreed that fellows should demonstrate competence in knowing/managing indications, contraindications, and complications. Program directors citing ≥1 barrier or whose fellows did <50 native biopsies/year in total were more likely to think that procedural competence should not be required versus those citing no barriers ( P =0.02), or whose fellows performed ≥50 biopsies ( P <0.01). Almost two-thirds of graduate respondents from a single military training program no longer perform biopsy, and 51% of responding nephrology program directors indicated that biopsy procedural competence should not be required. These findings should inform discussion of kidney biopsy curriculum requirements. Copyright

  7. Atypia on breast core needle biopsies: reproducibility and significance.

    PubMed

    Darvishian, Farbod; Singh, Baljit; Simsir, Aylin; Ye, Weimin; Cangiarella, Joan F

    2009-01-01

    This study analyzes the interobserver variability in interpreting atypia on breast core needle biopsies and in each category of atypia calculates the upgrade risk of carcinoma in the subsequent surgical excision. We identified 51 cases of atypia on breast core needle biopsies performed at our institution from January 2003 to August 2006. The atypia was classified into 4 categories: atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and atypia of undetermined significance (AUS). After a tutorial session, these cases were independently reviewed by four pathologists, whose overall multi-rater kappa value for agreement on different categories of atypia was 0.79 (95% CI, 0.69-0.89), which is within the substantial agreement range. The upgrade risk in each category of atypia was as follows: ADH 20% (p = 0.04); ALH 10% (p = 0.6); FEA 16.6% (p = 0.23), and AUS 100% (p = 0.96). Based on our findings, we conclude that follow-up excision should be performed after a diagnosis of ADH. The upgrade risk did not reach statistical significance in ALH or FEA. Although follow-up excision cannot be strongly recommended in ALH and FEA, it should be considered since the upgrade risk is not negligible. Strict adherence to the diagnostic criteria and tutorial sessions can help pathologists to achieve substantial agreement in interpreting atypia on breast core needle biopsies.

  8. Rapid motion compensation for prostate biopsy using GPU.

    PubMed

    Shen, Feimo; Narayanan, Ramkrishnan; Suri, Jasjit S

    2008-01-01

    Image-guided procedures have become routine in medicine. Due to the nature of three-dimensional (3-D) structure of the target organs, two-dimensional (2-D) image acquisition is gradually being replaced by 3-D imaging. Specifically in the diagnosis of prostate cancer, biopsy can be performed using 3-D transrectal ultrasound (TRUS) image guidance. Because prostatic cancers are multifocal, it is crucial to accurately guide biopsy needles towards planned targets. Further the gland tends to move due to external physical disturbances, discomfort introduced by the procedure or intrinsic peristalsis. As a result the exact position of the gland must be rapidly updated so as to correspond with the originally acquired 3-D TRUS volume prior to biopsy planning. A graphics processing unit (GPU) is used in this study to compute rapid updates performing 3-D motion compensation via registration of the live 2-D image and the acquired 3-D TRUS volume. The parallel computational framework on the GPU is exploited resulting in mean compute times of 0.46 seconds for updating the position of a live 2-D buffer image containing 91,000 pixels. A 2x sub-sampling resulted in a further improvement to 0.19 seconds. With the increase in GPU multiprocessors and sub-sampling, we observe that real time motion compensation can be achieved.

  9. [Analysis of 115 kidney biopsies performed in Dakar (Senegal)].

    PubMed

    Diouf, B; Ka, E F; Niang, A; Mbengue, M; Ka, M M; Diouf, M L; Pouye, A; Moreira-Diop, T

    2001-01-01

    Few data are now avalable concerning renal pathology in black African. That is why we under took this study as a contribution to the better knowlege of pathological aspects of kidney disease in Dakar by analysing our 6 years's experience. It was a retrospective study concerning all the patients who underwent renal biopsyfrom January 1993 to December 1998. The samples were studied on light microscopy and immunoflorescence at the nephrology unit of Necker Hospital in Paris. We performed 115 renal biopsies during this period conceming 64 males and 51 females from 5 to 60 years old (mean age 28 years). Nephrotic syndrome represented 67% of the indications, followed by lupus nephritis (13%). We found primary glomerulonephritis in 75% of all cases. Anatomicaly, 54 cases of focal and segmental hyalinosis were found (47% of all biopsies). The other lesions were extra-membranous glomerulonephritis (8,6%), minimal change glomerulonephritis 6%, endo and extra-capillary glomerulonephritis 2,6%, Mesangial glomerulonephrits, extra-capillary glomerunephrotis, IgA nephropaty represented each 1,7%. In 5% of cases the lesions did not permit a precise classification. Focal and segmental hyalinosis is the main primary lesion and lupus nephritis the main secondary one in kidney deseases biopsied in Dakar.

  10. Effects of laser polar-body biopsy on embryo quality.

    PubMed

    Levin, Ishai; Almog, Benny; Shwartz, Tamar; Gold, Veronica; Ben-Yosef, Dalit; Shaubi, Michal; Amit, Ami; Malcov, Mira

    2012-05-01

    To evaluate the effect of laser polar-body biopsy (PBB) for preimplantation genetic diagnosis on embryo quality. Retrospective case-control analysis. The quality of 145 embryos after PBB was compared to 276 embryos of the same group of women without biopsy. University-based tertiary-care medical center. Women with inherited genetics disease. Laser PBB of IVF embryos for genetic diagnosis. The study and control embryos were compared for fertilization rate, pronuclear grading, and cleavage-stage parameters on days 1, 2, and 3 after oocyte retrieval. The study embryos demonstrated higher rates of cleavage arrest (3.6% vs. 0.7%), higher rate of significant fragmentation on day 2 (9.5% vs. 3.0%), and lower rate of good cleavage embryos on day 2 (69.1% vs. 78.4%) compared with control embryos. On day 3, the study embryos had lower cleavage rates (six or more blastomeres; 56.5% vs. 74.5%), higher fragmentation (11.7% vs. 3.9%), higher rate of embryos presenting inferior cleavage pattern (57.2% vs. 38.5%), and lower mean blastomere number (5.8 ± 2.1 vs. 6.6 ± 1.9) compared with control embryos. Polar-body biopsy may have a negative effect on embryo quality. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. 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.

  12. The Utility of Sentinel Node Biopsy for Sinonasal Melanoma.

    PubMed

    Oldenburg, Michael S; Price, Daniel L

    2017-10-01

    Objective  Report two positive sentinel node biopsies for sinonasal melanoma. Design  Retrospective review. Setting  Academic tertiary care center. Participants  Patients who underwent sentinel node biopsy for sinonasal melanoma between November 1, 2014 and November 1, 2015. Main Outcome Measures  Clinical course. Results  Two patients were identified. Patient 1 (83M) presented with a sinonasal melanoma anterior to the left inferior turbinate and was clinically N0 neck. Lymphoscintigraphy revealed two sentinel nodes in the ipsilateral and three in the contralateral cervical basins. The left level I sentinel node was positive for melanoma and lymphadenectomy showed no additional metastases. Patient 2 (71F) presented after incomplete resection of a sinonasal melanoma of the left posterior maxillary sinus wall and was clinically N0 neck. Lymphoscintigraphy with single-photon emission computed tomography (SPECT/CT) localization revealed one sentinel node in the parapharyngeal space and another in the ipsilateral cervical basin. Metastatic melanoma was found in both nodes and completion lymphadenectomy was negative for additional disease. Both patients developed distant metastasis in less than 1 year after surgical resection but responded well to adjuvant immunomodulatory chemotherapeutic agents. Conclusion  Sentinel node biopsy for sinonasal melanoma can provide crucial clinical evidence of regional metastasis prior to overt clinical signs and symptoms. This intraoperative tool has the potential to improve detection of regional metastasis and improve long-term outcomes of this aggressive malignancy.

  13. CT fluoroscopy-guided robotically-assisted lung biopsy

    NASA Astrophysics Data System (ADS)

    Xu, Sheng; Fichtinger, Gabor; Taylor, Russell H.; Banovac, Filip; Cleary, Kevin

    2006-03-01

    Lung biopsy is a common interventional radiology procedure. One of the difficulties in performing the lung biopsy is that lesions move with respiration. This paper presents a new robotically assisted lung biopsy system for CT fluoroscopy that can automatically compensate for the respiratory motion during the intervention. The system consists of a needle placement robot to hold the needle on the CT scan plane, a radiolucent Z-frame for registration of the CT and robot coordinate systems, and a frame grabber to obtain the CT fluoroscopy image in real-time. The CT fluoroscopy images are used to noninvasively track the motion of a pulmonary lesion in real-time. The position of the lesion in the images is automatically determined by the image processing software and the motion of the robot is controlled to compensate for the lesion motion. The system was validated under CT fluoroscopy using a respiratory motion simulator. A swine study was also done to show the feasibility of the technique in a respiring animal.

  14. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

    PubMed

    Vaidya, S; Lakhey, M; Vaidya, S; Sharma, P K; Hirachand, S; Lama, S; KC, S

    2013-03-01

    Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

  15. Recurrent gastrointestinal bleeding and hepatic infarction after liver biopsy.

    PubMed

    Bishehsari, Faraz; Ting, Peng-Sheng; Green, Richard M

    2014-02-21

    Hepatic artery pseudoaneurysms (HAP) are rare events, particularly after liver biopsy, but can be associated with serious complications. Therefore a high suspicion is necessary for timely diagnosis and appropriate treatment. We report on a case of HAP that potentially formed after a liver biopsy in a patient with sarcoidosis. The HAP in our case was virtually undetectable initially by angiography but resulted in several complications including recurrent gastrointestinal bleeding, hemorrhagic cholecystitis and finally hepatic infarction with abscess formation until it became detectable at a size of 5-mm. The patient remains asymptomatic over a year after endovascular embolization of the HAP. In this report, we demonstrate that a small HAP can avoid detection by angiography at an early stage while being symptomatic for a prolonged course. A high clinical suspicion with a close clinical/radiological follow-up is needed in symptomatic patients with history of liver biopsy despite initial negative work up. Once diagnosed, HAP can be safely and effectively treated by endovascular embolization.

  16. Prospective evaluation of magnetic resonance imaging guided in-bore prostate biopsy versus systematic transrectal ultrasound guided prostate biopsy in biopsy naïve men with elevated prostate specific antigen.

    PubMed

    Quentin, Michael; Blondin, Dirk; Arsov, Christian; Schimmöller, Lars; Hiester, Andreas; Godehardt, Erhard; Albers, Peter; Antoch, Gerald; Rabenalt, Robert

    2014-11-01

    Magnetic resonance imaging guided biopsy is increasingly performed to diagnose prostate cancer. However, there is a lack of well controlled, prospective trials to support this treatment method. We prospectively compared magnetic resonance imaging guided in-bore biopsy with standard systematic transrectal ultrasound guided biopsy in biopsy naïve men with increased prostate specific antigen. We performed a prospective study in 132 biopsy naïve men with increased prostate specific antigen (greater than 4 ng/ml). After 3 Tesla functional multiparametric magnetic resonance imaging patients were referred for magnetic resonance imaging guided in-bore biopsy of prostate lesions (maximum 3) followed by standard systematic transrectal ultrasound guided biopsy (12 cores). We analyzed the detection rates of prostate cancer and significant prostate cancer (greater than 5 mm total cancer length or any Gleason pattern greater than 3). A total of 128 patients with a mean ± SD age of 66.1 ± 8.1 years met all study requirements. Median prostate specific antigen was 6.7 ng/ml (IQR 5.1-9.0). Transrectal ultrasound and magnetic resonance imaging guided biopsies provided the same 53.1% detection rate, including 79.4% and 85.3%, respectively, for significant prostate cancer. Magnetic resonance imaging and transrectal ultrasound guided biopsies missed 7.8% and 9.4% of clinically significant prostate cancers, respectively. Magnetic resonance imaging biopsy required significantly fewer cores and revealed a higher percent of cancer involvement per biopsy core (each p <0.01). Combining the 2 methods provided a 60.9% detection rate with an 82.1% rate for significant prostate cancer. Magnetic resonance imaging guided in-bore and systematic transrectal ultrasound guided biopsies achieved equally high detection rates in biopsy naïve patients with increased prostate specific antigen. Magnetic resonance imaging guided in-bore biopsies required significantly fewer cores and revealed a

  17. Attitudes towards drug-eluting stent use and the distribution of motivation type among interventional cardiologists.

    PubMed

    Qian, Feng; Phelps, Charles E; Ling, Frederick S; Hannan, Edward L; Veazie, Peter J

    2012-06-01

    The safety of drug-eluting stent (DES) use was called into question in 2006. However, the attitudes towards DES use after DES safety concerns were expressed and the distribution of chronic motivation type among interventional cardiologists are unknown. This study aims to examine the current attitudes towards DES use among interventional cardiologists and to investigate the distribution of chronic motivation type among these doctors. A questionnaire survey of interventional cardiologists was conducted in New York State from October 2008 to April 2009. The questionnaire included face valid items to measure the attitudes towards DES use, valid Regulatory Focus Questionnaire to measure the chronic motivation type, and items collecting demographic information. A total of 119 valid responses were received (response rate: 47%). There were no statistically significant differences regarding the demographic factors between the respondents and the non-respondents. The vast majority of interventional cardiologists (92%) agreed that 'DES is a revolutionary technology' and that 'DES use will increase in the future' (70%). The chronic motivation type of the respondents was predominantly sensitive to positive outcomes (89%). Interventional cardiologists had a very positive attitude regarding DES technology and predicted future growth of DES use. The vast majority of interventional cardiologists were found to be concerned about achieving positive outcomes and wanted to prevent errors of omission. To the best of our knowledge, this is the first study to report the distribution of chronic motivation type among doctors. © 2011 Blackwell Publishing Ltd.

  18. Membrane fluidization by alcohols inhibits DesK-DesR signalling in Bacillus subtilis.

    PubMed

    Vaňousová, Kateřina; Beranová, Jana; Fišer, Radovan; Jemioła-Rzemińska, Malgorzata; Matyska Lišková, Petra; Cybulski, Larisa; Strzałka, Kazimierz; Konopásek, Ivo

    2018-03-01

    After cold shock, the Bacillus subtilis desaturase Des introduces double bonds into the fatty acids of existing membrane phospholipids. The synthesis of Des is regulated exclusively by the two-component system DesK/DesR; DesK serves as a sensor of the state of the membrane and triggers Des synthesis after a decrease in membrane fluidity. The aim of our work is to investigate the biophysical changes in the membrane that are able to affect the DesK signalling state. Using linear alcohols (ethanol, propanol, butanol, hexanol, octanol) and benzyl alcohol, we were able to suppress Des synthesis after a temperature downshift. The changes in the biophysical properties of the membrane caused by alcohol addition were followed using membrane fluorescent probes and differential scanning calorimetry. We found that the membrane fluidization induced by alcohols was reflected in an increased hydration at the lipid-water interface. This is associated with a decrease in DesK activity. The addition of alcohol mimics a temperature increase, which can be measured isothermically by fluorescence anisotropy. The effect of alcohols on the membrane periphery is in line with the concept of the mechanism by which two hydrophilic motifs located at opposite ends of the transmembrane region of DesK, which work as a molecular caliper, sense temperature-dependent variations in membrane properties. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Diagnostic Yield and Safety of Brain Biopsy for Suspected Primary Central Nervous System Angiitis.

    PubMed

    Torres, Jose; Loomis, Caitlin; Cucchiara, Brett; Smith, Michelle; Messé, Steven

    2016-08-01

    The utility and safety of brain biopsy for suspected primary angiitis of the central nervous system (PACNS) are uncertain. Factors predictive of a positive biopsy have not been well described. Our aim was to evaluate the diagnostic yield and safety of brain biopsy in suspected PACNS and determine whether any prebiopsy variables are associated with a positive biopsy. This is a retrospective study of consecutive patients who underwent diagnostic brain biopsy for PACNS at a single institution. The relationship between biopsy yield and patient demographics, surgical technique, laboratory testing, neuroimaging, biopsy characteristics, and prebiopsy immunosuppressive therapy were examined. PACNS was confirmed in 9 of 79 patients (11%). Biopsy identified alternative diagnoses in 24 patients (30%), with cerebral amyloid angiopathy (8 patients), encephalitis (5 patients), demyelination (3 patients), and CNS lymphoma (3 patients) most commonly found. There was no correlation between a positive biopsy and cerebrospinal fluid results, neuroimaging, surgical technique, biopsy characteristics, or preoperative immunosuppressive therapy. Smaller biopsies (P=0.02) and closed procedures (P=0.013) were less likely to yield a diagnosis. Postoperative complications occurred in 13 patients (16%), 3 (4%) of which were serious. Brain biopsy leads to pathological confirmation of vasculitis in a minority of suspected PACNS cases but alternative diagnoses are often identified. Importantly, rare but meaningful complications may occur. © 2016 American Heart Association, Inc.

  20. Mantle biopsy: a technique for nondestructive tissue-sampling of freshwater mussels

    Treesearch

    David J. Berg; Wendell R. Haag; Sheldon I. Guttman; James B. Sickel

    1995-01-01

    Mantle biopsy is a means of obtaining tissue samples for genetic, physiological, and contaminant studies of bivalves; but the effects of this biopsy on survival have not been determined. We describe a simple technique for obtaining such samples from unionacean bivalves and how we compared survival among biopsied and control organisms in field experiments. Survival was...

  1. Electromagnetic-Tracked Biopsy under Ultrasound Guidance: Preliminary Results

    SciTech Connect

    Hakime, Antoine, E-mail: thakime@yahoo.com; Deschamps, Frederic; Marques De Carvalho, Enio Garcia

    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 onmore » 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

  2. Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging and Fusion Guided Targeted Biopsy Evaluated by Transperineal Template Saturation Prostate Biopsy for the Detection and Characterization of Prostate Cancer.

    PubMed

    Mortezavi, Ashkan; Märzendorfer, Olivia; Donati, Olivio F; Rizzi, Gianluca; Rupp, Niels J; Wettstein, Marian S; Gross, Oliver; Sulser, Tullio; Hermanns, Thomas; Eberli, Daniel

    2018-02-21

    We evaluated the diagnostic accuracy of multiparametric magnetic resonance imaging and multiparametric magnetic resonance imaging/transrectal ultrasound fusion guided targeted biopsy against that of transperineal template saturation prostate biopsy to detect prostate cancer. We retrospectively analyzed the records of 415 men who consecutively presented for prostate biopsy between November 2014 and September 2016 at our tertiary care center. Multiparametric magnetic resonance imaging was performed using a 3 Tesla device without an endorectal coil, followed by transperineal template saturation prostate biopsy with the BiopSee® fusion system. Additional fusion guided targeted biopsy was done in men with a suspicious lesion on multiparametric magnetic resonance imaging, defined as Likert score 3 to 5. Any Gleason pattern 4 or greater was defined as clinically significant prostate cancer. The detection rates of multiparametric magnetic resonance imaging and fusion guided targeted biopsy were compared with the detection rate of transperineal template saturation prostate biopsy using the McNemar test. We obtained a median of 40 (range 30 to 55) and 3 (range 2 to 4) transperineal template saturation prostate biopsy and fusion guided targeted biopsy cores, respectively. Of the 124 patients (29.9%) without a suspicious lesion on multiparametric magnetic resonance imaging 32 (25.8%) were found to have clinically significant prostate cancer on transperineal template saturation prostate biopsy. Of the 291 patients (70.1%) with a Likert score of 3 to 5 clinically significant prostate cancer was detected in 129 (44.3%) by multiparametric magnetic resonance imaging fusion guided targeted biopsy, in 176 (60.5%) by transperineal template saturation prostate biopsy and in 187 (64.3%) by the combined approach. Overall 58 cases (19.9%) of clinically significant prostate cancer would have been missed if fusion guided targeted biopsy had been performed exclusively. The sensitivity of

  3. A low cost solution for post-biopsy complications using available RFA generator and coaxial core biopsy needle.

    PubMed

    Azlan, C A; Mohd Nasir, N F; Saifizul, A A; Faizul, M S; Ng, K H; Abdullah, B J J

    2007-12-01

    Percutaneous image-guided needle biopsy is typically performed in highly vascular organs or in tumours with rich macroscopic and microscopic blood supply. The main risks related to this procedure are haemorrhage and implantation of tumour cells in the needle tract after the biopsy needle is withdrawn. From numerous conducted studies, it was found that heating the needle tract using alternating current in radiofrequency (RF) range has a potential to minimize these effects. However, this solution requires the use of specially designed needles, which would make the procedure relatively expensive and complicated. Thus, we propose a simple solution by using readily available coaxial core biopsy needles connected to a radiofrequency ablation (RFA) generator. In order to do so, we have designed and developed an adapter to interface between these two devices. For evaluation purpose, we used a bovine liver as a sample tissue. The experimental procedure was done to study the effect of different parameter settings on the size of coagulation necrosis caused by the RF current heating on the subject. The delivery of the RF energy was varied by changing the values for delivered power, power delivery duration, and insertion depth. The results showed that the size of the coagulation necrosis is affected by all of the parameters tested. In general, the size of the region is enlarged with higher delivery of RF power, longer duration of power delivery, and shallower needle insertion and become relatively constant after a certain value. We also found that the solution proposed provides a low cost and practical way to minimizes unwanted post-biopsy effects.

  4. The cost effectiveness of vacuum-assisted versus core-needle versus surgical biopsy of breast lesions.

    PubMed

    Fernández-García, P; Marco-Doménech, S F; Lizán-Tudela, L; Ibáñez-Gual, M V; Navarro-Ballester, A; Casanovas-Feliu, E

    To determine the cost effectiveness of breast biopsy by 9G vacuum-assisted guided by vertical stereotaxy or ultrasonography in comparison with breast biopsy by 14G core-needle biopsy and surgical biopsy. We analyzed a total of 997 biopsies (181 vacuum-assisted, 626 core, and 190 surgical biopsies). We calculated the total costs (indirect and direct) of the three types of biopsy. We did not calculate intangible costs. We measured the percentage of correct diagnoses obtained with each technique. To identify the most cost-effective option, we calculated the mean ratios for the three types of biopsies. Total costs were €225.09 for core biopsy, €638.90 for vacuum-assisted biopsy, and €1780.01 for surgical biopsy. The overall percentage of correct diagnoses was 91.81% for core biopsy, 94.03% for vacuum-assisted biopsy, and 100% for surgical biopsy; however, these differences did not reach statistical significance (p=0.3485). For microcalcifications, the percentage of correct diagnoses was 50% for core biopsy and 96.77% for vacuum-assisted biopsy (p<0.0001). For nodules, there were no significant differences among techniques. The mean cost-effectiveness ratio considering all lesions was 2.45 for core biopsy, 6.79 for vacuum-assisted biopsy, and 17.80 for surgical biopsy. Core biopsy was the dominant option for the diagnosis of suspicious breast lesions in general. However, in cases with microcalcifications, the low percentage of correct diagnoses achieved by core biopsy (50%) advises against its use in this context, where vacuum-assisted biopsy would be the technique of choice because it is more cost-effective than surgical biopsy, the other technique indicated for biopsying microcalcifications. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results.

    PubMed

    Perlman, Katherine L; Shelby, Rebecca A; Wren, Anava A; Kelleher, Sarah A; Dorfman, Caroline S; O'Connor, Erin; Kim, Connie; Johnson, Karen S; Soo, Mary Scott

    2017-12-01

    Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This longitudinal study examines psychosocial and biopsy- and spirituality-related factors associated with mood in patients day of CNB and one week after receiving results. Ninety women undergoing CNB completed questionnaires on psychosocial factors (chronic stress, social support), biopsy experiences (pain, radiologist communication), and spirituality (peace, meaning, faith) day of CNB. Measures of positive and negative mood were completed day of CNB and one week after receiving results (benign n = 50; abnormal n = 25). Multiple linear regression analyses were conducted. Greater positive mood correlated with greater peace (β = .25, p = .02) day of CNB. Lower negative mood correlated with greater peace (β = -.29, p = .004) and there was a trend for a relationship with less pain during CNB (β = .19, p = .07). For patients with benign results, day of CNB positive mood predicted positive mood post-results (β = .31, p = .03) and only chronic stress predicted negative mood (β = .33, p = .03). For women with abnormal results, greater meaning day of CNB predicted lower negative mood post-results (β = -.45, p = .03). Meaning and peace may be important for women undergoing CNB and receiving abnormal results.

  6. Cost Analysis of Channeled, Distal Chip Laryngoscope for In-office Laryngopharyngeal Biopsies.

    PubMed

    Marcus, Sonya; Timen, Micah; Dion, Gregory R; Fritz, Mark A; Branski, Ryan C; Amin, Milan R

    2018-02-19

    Given that financial considerations play an increasingly prominent role in clinical decision-making, we sought (1) to determine the cost-effectiveness of in-office biopsy for the patient, the provider, and the health-care system, and (2) to determine the diagnostic accuracy of in-office biopsy. Retrospective, financial analyses were performed. Patients who underwent in-office (Current Procedural Terminology Code 31576) or operative biopsy (CPT Code 31535) for laryngopharyngeal lesions were included. Two financial analyses were performed: (1) the average cost of operating room (OR) versus in-office biopsy was calculated, and (2) a break-even analysis was calculated to determine the cost-effectiveness of in-office biopsy for the provider. In addition, the diagnostic accuracy of in-office biopsies and need for additional biopsies or procedures was recorded. Of the 48 patients included in the current study, 28 underwent in-office biopsy. A pathologic sample was obtained in 26 of 28 (92.9%) biopsies performed in the office. Of these patients, 16 avoided subsequent OR procedures. The average per patient cost was $7000 and $11,000 for in-office and OR biopsy, respectively. Break-even analysis demonstrated that the provider could achieve a profit 2 years after purchase of the necessary equipment. In-office laryngopharyngeal biopsies are accurate and, overall, more cost-effective than OR biopsies. Purchase of the channeled, distal chip laryngoscope and biopsy forceps to perform in-office biopsies can be profitable for a provider with a videolaryngoscopy tower. In-office biopsy should be considered the initial diagnostic tool for suspected laryngopharyngeal malignancies noted on videolaryngoscopy. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. How to Interpret Thyroid Biopsy Results: A Three-Year Retrospective Interventional Radiology Experience

    SciTech Connect

    Oppenheimer, Jason D., E-mail: j-oppenheimer@md.northwestern.edu; Kasuganti, Deepa; Nayar, Ritu

    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 undermore » 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.« less

  8. [Comparison of hot versus cold biopsy forceps in the diagnosis of endobronchial lesions].

    PubMed

    Firoozbakhsh, Shahram; Seifirad, Soroush; Safavi, Enayat; Dinparast, Reza; Taslimi, Shervin; Derakhshandeilami, Gholamreza

    2011-11-01

    Traditionally cold biopsy forceps were used for endobronchial biopsy, and recently electrocautery (hot) bronchoscopy biopsy forceps are introduced. It is hypothesized that hot biopsy forceps may decrease procedure related bleeding and also may decrease the quality of obtained samples. Patients with different indications for endobronchial biopsy during fiberoptic bronchoscopy underwent three hot and three cold biopsies with a random fashion. All biopsies were obtained with a single biopsy forceps with and without the application of an electrocoagulation current, set on soft coagulation mode (40W). A four point scale was used for quantification of bleeding. A single pathologist blinded to the patients' history was requested to review all samples. A three point scale was used to assess electrocoagulation damage. A total of 240 biopsies were obtained from 40 patients. Frequency of positive concordance between the two methods was 85%. The degree of electrocoagulation damage of the samples was as follows: grade 1=52.5%, grade 2=32.5%, and grade 3=15%. The average bleeding score following hot biopsy was significantly lower compared to the cold biopsy (P=.006). The concordance between diagnostic yield of hot and cold biopsies was 85%. There was no significant difference between the diagnostic yields of two biopsy methods (P=.687). Hot biopsy forceps significantly decreased the procedure related bleeding. The quality of samples was not impaired significantly. Regarding low prevalence of bleeding following endobronchial biopsy, routine use of hot bronchoscopy forceps is not reasonable. However, familiarity of bronchoscopists with this method may improve bronchoscopy safety. Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.

  9. Comparative Effectiveness of Frame-based, Frameless and Intraoperative MRI Guided Brain Biopsy Techniques

    PubMed Central

    Lu, Yi; Yeung, Cecil; Radmanesh, Alireza; Wiemann, Robert; Black, Peter M.; Golby, Alexandra J.

    2015-01-01

    Objective Intraoperative MRI (IoMRI) guided brain biopsy provides a real time visual feedback of the lesion that is sampled during surgery. The objective of the study is to compare the diagnostic yield and safety profiles of ioMRI needle brain biopsy with two traditional brain biopsy methods: frame-based and frameless stereotactic brain biopsies. Methods A retrospective analysis from 288 consecutive needle brain biopsies in 277 patients undergoing stereotactic brain biopsy with any of the three biopsy methods at Brigham and Women's Hospital from 2000 to 2008 was performed. Variables such as age, sex, history of radiation and previous surgery, pathology results, complications and postoperative stays were analyzed. Results Over the course of eight years, 288 brain biopsies were performed. 253 (87.8%) biopsies yielded positive diagnostic tissue. Young age (<40 years), history of brain radiation or surgery were significant negative predictors for a positive biopsy diagnostic yield. Excluding patients with prior radiation or surgeries, no significant difference in diagnostic yield was detected among the three groups, with frame-based, frameless and ioMRI guided needle biopsies yield 96.9%, 91.8% and 89.9% positive diagnostic yield, respectively. 19 biopsies (6.6%) were complicated by serious adverse events. The ioMRI-guided brain biopsy was associated with less serious adverse events and the shortest postoperative hospital stay. Conclusions Frame-based, frameless stereotactic and ioMRI guided brain needle biopsy have comparable diagnostic yield for patients with no prior treatments (either radiation or surgery). IoMRI guided brain biopsy is associated with fewer serious adverse events and shorter hospital stay. PMID:25088233

  10. Effect of Advanced Imaging Technology on How Biopsies Are Done and Who Does Them1

    PubMed Central

    Bhargavan, Mythreyi; Kerlan, Robert K.; Sunshine, Jonathan H.

    2010-01-01

    Purpose: To assess national levels and trends in utilization of biopsy procedures during the past decade and investigate the relative roles of biopsy approaches (open, endoscopic, and percutaneous) and physician specialties. Materials and Methods: Institutional review board approval was not necessary because only public domain data were used. Aggregated Medicare claims data were used to determine utilization of biopsies performed in 10 anatomic regions from 1997 to 2008. Utilization levels according to biopsy approach and anatomic region were calculated. Trends in the relative utilization of percutaneous needle biopsy (PNB) and imaging-guided percutaneous biopsy (IGPB) were assessed. The relative roles of radiologists and nonradiologists in the performance of all biopsies, PNBs, and IGPBs were evaluated. Results: Biopsy procedures with all approaches increased from 1380 to 1945 biopsies per 100 000 Medicare enrollees between 1997 and 2008, which represents a compound annual growth rate (CAGR) of 3%. Utilization of non-PNBs fell, while the absolute level and relative share of PNBs increased. In 2008, 67% of all biopsies were performed by using a percutaneous route. IGPB as a percentage of all PNBs increased over time in the regions for which data were available. Radiology was the leading specialty providing biopsy services. The total number of biopsies performed by radiologists increased at a CAGR of 8%, and radiologists’ share of all biopsies increased from 35% to 56%. Conclusion: During the past decade, there was continuing substitution away from invasive approaches and non–imaging-guided percutaneous approaches in favor of PNBs and IGPBs, likely related to increasing use of advanced imaging modalities for biopsy guidance. Consequently, radiologists are performing an increasing share of biopsies across all anatomic regions. © RSNA, 2010 Supplemental material:http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10092130/-/DC1 PMID:20587643

  11. Ultrasound-guided synovial Tru-cut biopsy: indications, technique, and outcome in 111 cases.

    PubMed

    Sitt, Jacqueline C M; Griffith, James F; Lai, Fernand M; Hui, Mamie; Chiu, K H; Lee, Ryan K L; Ng, Alex W H; Leung, Jason

    2017-05-01

    To investigate the diagnostic performance of ultrasound-guided synovial biopsy. Clinical notes, pathology and microbiology reports, ultrasound and other imaging studies of 100 patients who underwent 111 ultrasound-guided synovial biopsies were reviewed. Biopsies were compared with the final clinical diagnosis established after synovectomy (n = 43) or clinical/imaging follow-up (n = 57) (mean 30 months). Other than a single vasovagal episode, no complication of synovial biopsy was encountered. One hundred and seven (96 %) of the 111 biopsies yielded synovium histologically. Pathology ± microbiology findings for these 107 conclusive biopsies comprised synovial tumour (n = 30, 28 %), synovial infection (n = 18, 17 %), synovial inflammation (n = 45, 42 %), including gouty arthritis (n = 3), and no abnormality (n = 14, 13 %). The accuracy, sensitivity, and specificity of synovial biopsy was 99 %, 97 %, and 100 % for synovial tumour; 100 %, 100 %, and 100 % for native joint infection; and 78 %, 45 %, and 100 % for prosthetic joint infection. False-negative synovial biopsy did not seem to be related to antibiotic therapy. Ultrasound-guided Tru-cut synovial biopsy is a safe and reliable technique with a high diagnostic yield for diagnosing synovial tumour and also, most likely, for joint infection. Regarding joint infection, synovial biopsy of native joints seems to have a higher diagnostic yield than that for infected prosthetic joints. • Ultrasound-guided Tru-cut synovial biopsy has high accuracy (99 %) for diagnosing synovial tumour. • It has good accuracy, sensitivity, and high specificity for diagnosis of joint infection. • Synovial biopsy of native joints works better than biopsy of prosthetic joints. • A negative synovial biopsy culture from a native joint largely excludes septic arthritis. • Ultrasound-guided Tru-cut synovial biopsy is a safe and well-tolerated procedure.

  12. Scramjet Thermal Management (Tenue thermique des superstatoreacteurs)

    DTIC Science & Technology

    2010-09-01

    RTO-EN-AVT-185 13 - 1 Scramjet Thermal Management (Tenue thermique des superstatoréacteurs) Marc BOUCHEZ MBDA France Rond-point Marcel...SPEED PROPULSION: ENGINE DESIGN – INTEGRATION AND THERMAL MANAGEMENT” fut donné à l’Institut Von Karman en septembre 2010 et à l’Université Wright de ...Dayton (Ohio, USA) en décembre 2010. Le présent cours aborde la tenue thermique. Il est basé sur des informations publiées, et des détails

  13. Localization of acyl ghrelin- and des-acyl ghrelin-immunoreactive cells in the rat stomach and their responses to intragastric pH.

    PubMed

    Mizutani, Makoto; Atsuchi, Kaori; Asakawa, Akihiro; Matsuda, Norifumi; Fujimura, Masaki; Inui, Akio; Kato, Ikuo; Fujimiya, Mineko

    2009-11-01

    Acyl ghrelin has a 28-amino acid sequence with O-n-octanoyl acid modification at the serine 3 position, whereas des-acyl ghrelin has no octanoyl acid modification. Although these peptides exert different physiological functions, no previous studies have shown the different localization of acyl ghrelin and des-acyl ghrelin in the stomach. Here we have developed an antibody specific for des-acyl ghrelin that does not crossreact with acyl ghrelin. Both acyl ghrelin- and des-acyl ghrelin-immunoreactive cells were distributed in the oxyntic and antral mucosa of the rat stomach, with higher density in the antral mucosa than oxyntic mucosa. Immunofluorescence double staining showed that acyl ghrelin- and des-acyl ghrelin-positive reactions overlapped in closed-type round cells, whereas des-acyl ghrelin-positive reaction was found in open-type cells in which acyl ghrelin was negative. Acyl ghrelin-/des-acyl ghrelin-positive closed-type cells contain obestatin; on the other hand, des-acyl ghrelin-positive open-type cells contain somatostatin. We measured the release of acyl ghrelin and des-acyl ghrelin in vascularly perfused rat stomach by ELISA, and the effects of different intragastric pH levels on the release of each peptide were examined. The release of des-acyl ghrelin from the perfused stomach was greater at pH 2 than at pH 4; however, the release of acyl ghrelin was not affected by intragastric pH. The present study demonstrated the differential localization of acyl ghrelin and des-acyl ghrelin in the rat stomach and their different responses to the intragastric pH.

  14. Conventional forceps or hot biopsy: comparative study of two methods in diagnosis of endobronchial lesions.

    PubMed

    Jabbari, Hamidreza; Fakhri, Mohammad; Lotfaliani, Mojtaba; Kiani, Arda

    2013-01-01

    It is suggested that hot electrocoagulation-enabled forceps (hot biopsy) may reduce hemorrhage risk after the biopsy in endobronchial tumors. The main concern in this method is possible reduction of the specimen's quality. To compare the procedure related hemorrhage with hot biopsy and conventional forceps biopsy and the diagnostic quality of the obtained specimens with either technique. In this prospective study, assessment of the biopsy samples and quantity of hemorrhage were done in a blind fashion. At first, for each patient a definite clinical diagnosis was made based on pathologic examination of all available samples, clinical data, and imaging findings. Then, second pathologist reviewed all samples to evaluate the quality of the samples. A total of 36 patients with endobronchial lesions were included in this study. Definite diagnosis was made in 83% of the patients. Diagnostic yield of the two methods were not statistically different, while the mean hemorrhage grades of all hot biopsy protocols were significantly lower as compared to that of conventional biopsy (p=0.003, p<0.001 and p<0.001 for 10,20and40 voltages respectively). No significant difference was detected between the qualities of specimens obtained by hot biopsy methods in comparison with conventional biopsy (p>0.05 for all three voltages). Hot biopsy can be a valuable alternative to forceps biopsy in evaluating endobronchial lesions.

  15. Economic Costs Avoided by Diagnosing Melanoma Six Months Earlier Justify >100 Benign Biopsies.

    PubMed

    Aires, Daniel J; Wick, Jo; Shaath, Tarek S; Rajpara, Anand N; Patel, Vikas; Badawi, Ahmed H; Li, Cicy; Fraga, Garth R; Doolittle, Gary; Liu, Deede Y

    2016-05-01

    New melanoma drugs bring enormous benefits but do so at significant costs. Because melanoma grows deeper and deadlier over time, deeper lesions are costlier due to increased sentinel lymph node biopsy, chemotherapy, and disease-associated income loss. Prior studies have justified pigmented lesion biopsies on a "value per life" basis; by contrast we sought to assess how many biopsies are justified per melanoma found on a purely economic basis. We modeled how melanomas in the United States would behave if diagnosis were delayed by 6 months, eg, not biopsied, only observed until the next surveillance visit. Economic loss from delayed biopsy is the obverse of economic benefit of performing biopsy earlier. Growth rates were based on Liu et al. The results of this study can be applied to all patients presenting to dermatologists with pigmented skin lesions suspicious for melanoma. In-situ melanomas were excluded because no studies to date have modeled growth rates analogous to those for invasive melanoma. We assume conservatively that all melanomas not biopsied initially will be biopsied and treated 6 months later. Major modeled costs are (1) increased sentinel lymph node biopsy, (2) increased chemotherapy for metastatic lesions using increased 5-yr death as metastasis marker, and (3) income loss per melanoma death at $413,370 as previously published. Costs avoided by diagnosing melanoma earlier justify 170 biopsies per melanoma found. Efforts to penalize "unnecessary" biopsies may be economically counterproductive.

    J Drugs Dermatol. 2016;15(5):527-532.

  16. Value of percutaneous needle biopsy of small renal tumors in patients referred for cryoablation.

    PubMed

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Sakurai, Jun; Matsui, Yusuke; Araki, Motoo; Nasu, Yasutomo; Kanazawa, Susumu

    2017-04-01

    To retrospectively evaluate the safety and diagnostic yield of needle biopsy of small renal tumors, and the clinical consequences of performing needle biopsy in patients referred for percutaneous cryoablation before their treatment. Biopsy was performed for 120 tumors (mean diameter, 2.2 cm) in 119 patients. All procedures were divided into diagnostic and non-diagnostic biopsies. Various variables were compared between the two groups. All cryoablation procedures were divided into two groups: procedures with or without simultaneous biopsy. The rates of benign or non-diagnostic tumors in each group were compared. After performing 120 initial and eight repeat biopsies, Grade 1 bleedings occurred in 44 cases. Six tumors were non-diagnostic and 114 were pathologically diagnosed. There were no significant variables between the diagnostic and non-diagnostic biopsies. Unnecessary cryoablation was avoided in nine benign lesions by performing biopsy in advance. Cryoablation performed simultaneously with biopsy included significantly more benign or non-diagnostic tumors than cryoablation performed after biopsy (15.2% vs. 1.4%; p = .01). Percutaneous biopsy of small renal tumors referred for cryoablation was a safe procedure with high diagnostic yield. The confirmation of pathological diagnosis prior to cryoablation is necessary because patients with benign tumors can avoid unnecessary treatment.

  17. Holonic Approach for Control and Coordination of Distributed Sensors

    DTIC Science & Technology

    2008-08-01

    Kuokka, D. R., Weber, J. C., Tenenbaum, J. M., Gruber, T . R., and Olsen, G . R. (1993), SHADE: Technology for Knowledge-Based Collaborative 70 DRDC...H o l o n i c a p p ro a ch fo r c o n t ro l a n d coordination of distributed sensors A. Benaskeur H. Irandoust DRDC Valcartier Defence R&D...contrôle de la gestion des capteurs, et en par- ticulier les processus de planification des tâches et l’allocation des capteurs, sont discutés en

  18. Etat des lieux des soins de premier recours des malades mentaux à Antananarivo : étude rétrospective

    PubMed Central

    Bakohariliva, Hasina Andrianarivony; Rafehivola, Imisanavalona Hanitrinihaja; Raobelle, Evah Norotiana; Raharivelo, Adeline; Rajaonarison, Bertille Hortense

    2018-01-01

    Résumé Religion et guérisseurs traditionnels occupent encore une place prépondérante dans la prise en charge des maladies mentales à Madagascar. Ainsi, nous nous sommes fixés comme objectif d'établir un état des lieux sur les soins de premier recours des malades mentaux. Nous avons mené une étude rétrospective descriptive s'étalant sur une période de 16 mois allant de janvier 2014 en avril 2015 au sein du service de psychiatrie du CHU de Befelatanana à Antananarivo. La prévalence des psychoses était de 25%. Le genre féminin (53%), l'ethnie merina (77%), les étudiants (45%), le niveau d'étude secondaire (40%), les célibataires (72%), la religion protestante (45%), ainsi que le niveau socio-économique moyen (57,5%) étaient prédominants. Dans les paramètres cliniques, le mode de début brutal (52%), le premier recours à la religion (40%), la présence d'antécédents des cas similaire (90%), étaient majoritaires. La schizophrénie était la pathologie la plus rencontrée dans la moitié des cas. Le délai d'amélioration en cas de traitement religieux et traditionnels était dans la moitié des cas de plus de 10 jours d'hospitalisation. Les patients ayant reçu une prise en charge psychiatrique en premier recours, étaient améliorés dans 75 % cas en moins de 10jours. Le retard du recours aux soins psychiatriques est une réalité à Madagascar qui aggrave le pronostic des psychoses. PMID:29632623

  19. Clinical, biopsy, and mass spectrometry findings of renal gelsolin amyloidosis.

    PubMed

    Sethi, Sanjeev; Dasari, Surendra; Amin, Md Shahrier; Vrana, Julie A; Theis, Jason D; Alexander, Mariam P; Kurtin, Paul J

    2017-04-01

    Gelsolin amyloidosis is a rare type of amyloidosis typically involving the cranial and peripheral nerves, but rarely the kidney. Here we report the clinical, kidney biopsy, and mass spectrometry findings in 12 cases of renal gelsolin amyloidosis. Of the 12 patients, five were men and seven were women with mean age at diagnosis of 63.8 years. Gelsolin amyloidosis was most common in Caucasians (six patients) and Asians (four patients), and included one each African-American and Hispanic patients. Nephrotic syndrome was the most common cause of biopsy, although most patients also had progressive loss of kidney function. Hematological and serological evaluation was negative in 11 patients, while one patient had a monoclonal gammopathy. The renal biopsy showed large amounts of pale eosinophilic Congo red-positive amyloid deposits typically restricted to the glomeruli. Immunofluorescence studies were negative for immunoglobulins in nine cases with three cases of smudgy glomerular staining for IgG. Electron microscopy showed mostly random arrangement of amyloid fibrils with focally parallel bundles/sheets of amyloid fibrils present. Laser microdissection of the amyloid deposits followed by mass spectrometry showed large spectra numbers for gelsolin, serum amyloid P component, and apolipoproteins E and AIV. Furthermore, the p. Asn211Lys gelsolin mutation on mass spectrometry studies was detected in three patients by mass spectrometry, which appears to represent a renal-limited form of gelsolin amyloidosis. Thus, renal gelsolin amyloidosis is seen in older patients, presents with nephrotic syndrome and progressive chronic kidney disease, and histologically exhibits glomerular involvement. The diagnosis can be confirmed by mass spectrometry studies. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  20. Role of sentinel lymph node biopsy in oral cancer.

    PubMed

    Calabrese, L; Bruschini, R; Ansarin, M; Giugliano, G; De Cicco, C; Ionna, F; Paganelli, G; Maffini, F; Werner, J A; Soutar, D

    2006-12-01

    Squamous cell carcinoma of the oral cavity represents about 2% of all malignant neoplasms and 47% of those developing in the head and neck area. The tongue is the most common site involved, and this incidence is increasing mainly in young people, possibly related to human papilloma virus infections. Prognosis depends on the stage: the 5-year survival rate of tongue squamous cell carcinoma, whatever the T stage, is 73% in pN0 cases, 40% in patients with positive nodes without extracapsular spread (pNl ECS-), and 29% when nodes are metastatic with extracapsular spread (pNl ECS+: p > or = 0.0001). Nodal micrometastases (cN0 pN1) are found in up to 50% of cN0 tongue squamous cell carcinoma patients operated on the neck. At present, no clinical, imaging staging modalities or biological markers are available to diagnose nodal micrometastases. The sentinel node biopsy has been tested since 1996 in order to find a solution to this problem. The sentinel node is the first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, and should be predictive of the nodal stage. According to the literature, sentinel node biopsy is a reliable technique in selected cN0 cases, but the procedure is still experimental and should not be performed outside validation trials. Successful application of sentinel node biopsy in the head and neck region requires surgical experience and specific technical devices, including pre-operative lymphoscintigraphy and intra-operative gamma-probe. Moreover, dynamic lymphoscintigraphy seems to be able to show the lymphatic stream from the primary tumour and could allow a selective neck dissection to be tailored thus reducing the related morbidity.

  1. Exosomes as a liquid biopsy for lung cancer.

    PubMed

    Cui, Shaohua; Cheng, Zhuoan; Qin, Wenxin; Jiang, Liyan

    2018-02-01

    In lung cancer and other malignancies, the so-called "liquid biopsy" is quickly moving into clinical practice. Its full potential has not yet been fully identified, but the "liquid biopsy" is no longer a promise but has become a reality that allows for better treatment selection and monitoring of lung cancer. This emerging field has significant potential to make up for the limitations of the traditional tissue-derived biomaterials. Exosomes are spherical nano-sized vesicles with a diameter of 40-100 nm and a density of 1.13-1.19 g/ml. In both physiological and pathological conditions, exosomes can be released by different cell types, including immune cells, stem cells and tumor cells. These small molecules may serve as promising biomarkers in lung cancer "liquid biopsy" as they can be easily obtained from most body fluids. In addition, the lipid bilayer of exosomes allows for stable cargoes which are relatively hard to degrade. Furthermore, the composition of exosomes reflects that of their parental cells, suggesting that exosomes are potential surrogates of the original cells and, therefore, are useful for understanding cell biology. Previous studies have demonstrated that exosomes play important roles in cell-to-cell communication. Moreover, tumor-derived exosomes are evolved in tumor-specific biological process, including tumor proliferation and progression. Recently, a growing number of studies has focused on exosomal cargo and their use in lung cancer genesis and progression. In addition, their utility as lung cancer diagnostic, prognostic and predictive biomarkers have also been studied. The current review primarily summaries lung cancer-related exosomal biomarkers that have recently been identified and discusses their potential in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. 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.

  3. Can Breast Cancer Biopsy Influence Sentinel Lymph Node Status?

    PubMed

    Giuliani, Michela; Patrolecco, Federica; Rella, Rossella; Di Giovanni, Silvia Eleonora; Infante, Amato; Rinaldi, Pierluigi; Romani, Maurizio; Mulè, Antonino; Arciuolo, Damiano; Belli, Paolo; Bonomo, Lorenzo

    2016-12-01

    We evaluated whether the needle size could influence metastasis occurrence in the axillary sentinel lymph node (SLN) in ultrasound-guided core needle biopsy (US-CNB) of breast cancer (BC). The data from all patients with breast lesions who had undergone US-CNB at our institution from January 2011 to January 2015 were retrospectively reviewed. A total of 377 BC cases were included using the following criteria: (1) percutaneous biopsy-proven invasive BC; and (2) SLN dissection with histopathologic examination. The patients were divided into 2 groups according to the needle size used: 14 gauge versus 16 or 18 gauge. SLN metastasis classification followed the 7th American Joint Committee on Cancer (2010) TNM pathologic staging factors: macrometastases, micrometastases, isolated tumor cells, or negative. Only macrometastases and micrometastases were considered positive, and the positive and negative rates were calculated for the overall population and for both needle size groups. Of the 377 BC cases, 268 US-CNB procedures were performed using a 14-gauge needle and 109 with a 16- or 18-gauge needle, respectively. The negative rate was significantly related statistically with the needle size, with a greater prevalence in the 14-gauge group on both extemporaneous analysis (P = .019) and definitive analysis (P = .002). The macrometastasis rate was 17% (63 of 377) for the 14-gauge and 3% (12 of 377) for the 16- and 18-gauge needles, respectively. Our preliminary results have suggested that use of a large needle size in CNB does not influence SLN status; thus, preoperative breast biopsy can be considered a safe procedure in the diagnosis of malignant breast lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Prophylactic antibiotics reduce sepsis after biopsy of the prostate.

    PubMed

    Hayatzaki, Khalilullah; Menne, Sveinar; Nielsen, Karsten

    2014-11-01

    Prostate cancer is the most common form of cancer in Danish men, and the incidence is rising. The diag-nosis is made by transrectal prostate biopsy guided by ultrasound. This procedure has several complications, the most severe being sepsis. In our department, this is sought prevented by administering the prophylactic antibiotics metronidazol and ciprofloxacin. This study examined the rate of sepsis in patients who had the procedure performed at our department. The electronic patient records of all patients who had transrectal ultrasound of the prostate with biopsies performed at the Department of Urology at Naestved Hospital in the period from 1 May 2009 to 31 May 2011 were examined, and all admissions to our department (or any department in the same region) due to sepsis within two weeks of the procedure were registered. A total of 438 patients had the procedure performed, some multiple times, which resulted in a total of 511 procedures. In all, four patients were later admitted due to sepsis, corresponding to 0.91%. Three of the patients had positive blood and urine cultures in which Escherichia coli resistant to ciprofloxacin were found, the last had been prescribed antibiotics by a general practitioner the previous day, and no bacteria could be cultured. The frequency of sepsis after transrectal needle biopsies from the prostate at our department was found to be below 1% in this study, which is comparable to international findings. Most of the cases of sepsis were related to ciprofloxacin-resistant bacteria. Further randomised studies are needed to investigate the ideal prophylactic regime. not relevant. not relevant.

  5. Is intestinal biopsy always needed for diagnosis of celiac disease?

    PubMed

    Scoglio, Riccardo; Di Pasquale, Giuseppe; Pagano, Giuseppe; Lucanto, Maria Cristina; Magazzù, Giuseppe; Sferlazzas, Concetta

    2003-06-01

    Intestinal biopsy is required for a diagnosis of celiac disease (CD). The aim of this study was to assess diagnostic accuracy of transglutaminase antibodies (TGA) in comparison and in association with that of antiemdomysial antibodies (AEA), calculating the post-test odds of having the disease, to verify whether some patients might avoid undergoing intestinal biopsy for a diagnosis of CD. A total of 181 consecutive patients (131 < 18 yr), referred to our celiac clinic by primary care physicians for suspect CD. Overall diagnostic accuracy, negative predictive value, and likelihood ratio (LR) were calculated both for each serological test and for serial testing (TGA and after AEA, assuming the post-test probability of TGA as pretest probability of AEA). Both serological determination and histological evaluation were blindly performed. Histology of duodenal mucosa was considered the gold standard. The overall accuracy of TGA and of AEA were 92.8% (89.1-96.6) and 93.4% (89.7-97.0), respectively. The negative predictive value of TGA and AEA were 97.2% (91.9-102.6) and 87.2% (77.7-96.8), respectively. Positive likelihood ratios for TGA and AEA were 3.89 (3.40-4.38) and 7.48 (6.73-8.23), respectively. Serial testing, in groups of patients with prevalence of CD estimated higher than 75%, such as those with classic symptoms of CD, would provide a post-test probability of more than 99%. Our results suggest that serial testing with TGA and AEA might allow, in some cases, the avoidance of intestinal biopsy to confirm the diagnosis of CD.

  6. Current Strategies for Quantitating Fibrosis in Liver Biopsy

    PubMed Central

    Wang, Yan; Hou, Jin-Lin

    2015-01-01

    Objective: The present mini-review updated the progress in methodologies based on using liver biopsy. Data Sources: Articles for study of liver fibrosis, liver biopsy or fibrosis assessment published on high impact peer review journals from 1980 to 2014. Study Selection: Key articles were selected mainly according to their levels of relevance to this topic and citations. Results: With the recently mounting progress in chronic liver disease therapeutics, comes by a pressing need for precise, accurate, and dynamic assessment of hepatic fibrosis and cirrhosis in individual patients. Histopathological information is recognized as the most valuable data for fibrosis assessment. Conventional histology categorical systems describe the changes of fibrosis patterns in liver tissue; but the simplified ordinal digits assigned by these systems cannot reflect the fibrosis dynamics with sufficient precision and reproducibility. Morphometric assessment by computer assist digital image analysis, such as collagen proportionate area (CPA), detects change of fibrosis amount in tissue section in a continuous variable, and has shown its independent diagnostic value for assessment of advanced or late-stage of fibrosis. Due to its evident sensitivity to sampling variances, morphometric measurement is feasible to be taken as a reliable statistical parameter for the study of a large cohort. Combining state-of-art imaging technology and fundamental principle in Tissue Engineering, structure-based quantitation was recently initiated with a novel proof-of-concept tool, qFibrosis. qFibrosis showed not only the superior performance to CPA in accurately and reproducibly differentiating adjacent stages of fibrosis, but also the possibility for facilitating analysis of fibrotic regression and cirrhosis sub-staging. Conclusions: With input from multidisciplinary innovation, liver biopsy assessment as a new “gold standard” is anticipated to substantially support the accelerated progress of

  7. Minimalist video-assisted thoracic surgery biopsy of mediastinal tumors.

    PubMed

    Tacconi, Federico; Rogliani, Paola; Cristino, Benedetto; Gilardi, Francesco; Palombi, Leonardo; Pompeo, Eugenio

    2016-12-01

    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). 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. 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 PaO 2 /FiO 2 (P=0.04) thus suggesting better adaption to perioperative stress. 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 MVATS in this specific clinical setting.

  8. Added value of second biopsy target in screen-detected widespread suspicious breast calcifications.

    PubMed

    Falkner, Nathalie M; Hince, Dana; Porter, Gareth; Dessauvagie, Ben; Jeganathan, Sanjay; Bulsara, Max; Lo, Glen

    2018-06-01

    There is controversy on the optimal work-up of screen-detected widespread breast calcifications: whether to biopsy a single target or multiple targets. This study evaluates agreement between multiple biopsy targets within the same screen-detected widespread (≥25 mm) breast calcification to determine if the second biopsy adds value. Retrospective observational study of women screened in a statewide general population risk breast cancer mammographic screening program from 2009 to 2016. Screening episodes recalled for widespread calcifications where further views indicated biopsy, and two or more separate target areas were sampled within the same lesion were included. Percentage agreement and Cohen's Kappa were calculated. A total of 293317 women were screened during 761124 separate episodes with recalls for widespread calcifications in 2355 episodes. In 171 women, a second target was biopsied within the same lesion. In 149 (86%) cases, the second target biopsy result agreed with the first biopsy (κ = 0.6768). Agreement increased with increasing mammography score (85%, 86% and 92% for score 3, 4 and 5 lesions). Same day multiple biopsied lesions were three times more likely to yield concordant results compared to post-hoc second target biopsy cases. While a single target biopsy is sufficient to discriminate a benign vs. malignant diagnosis in most cases, in 14% there is added value in performing a second target biopsy. Biopsies performed prospectively are more likely to yield concordant results compared to post-hoc second target biopsy cases, suggesting a single prospective biopsy may be sufficient when results are radiological-pathological concordant; discordance still requires repeat sampling. © 2018 The Royal Australian and New Zealand College of Radiologists.

  9. Accuracy and safety of ultrasound-guided percutaneous needle core biopsy of renal masses

    PubMed Central

    Wang, Xianding; Lv, Yuanhang; Xu, Zilin; Aniu, Muguo; Qiu, Yang; Wei, Bing; Li, Xiaohong; Wei, Qiang; Dong, Qiang; Lin, Tao

    2018-01-01

    Abstract Our aim is to determine the sufficiency, accuracy, and safety of ultrasound-guided percutaneous needle core biopsy of renal masses in Chinese patients. Patients who had undergone ultrasound-guided needle core renal mass biopsy from June 2012 to June 2016 at West China Hospital, China were retrospectively reviewed. The information obtained included demographics, mass-related parameters, biopsy indications, technique, complications, pathologic results, and follow-up. Concordance of surgical resection pathology and follow-up data were assessed. Renal mass biopsies were performed in 106 patients. Thirty-nine (36.8%) were asymptomatic. The male/female ratio was 60/46, with a median age of 49.5 years. Median mass size was 8.1 cm (range 1.8–20). Biopsy was performed through a 16-gauge needle, with median cores of 2 taken (range 1–5). Only one significant biopsy-related complication (hemorrhage requiring transfusion) was encountered. An adequate tissue sample was obtained in 97.2% (103/106) of biopsies. Eighty-seven biopsies (82.1%) showed malignant neoplasms, 16 (15.1%) yielded benignity, and 3 (2.8%) were nondiagnostic. After biopsy, 46 patients (43.4%) underwent surgery. Compared with the subsequent mass resection pathology, the biopsy diagnoses were identical in 43 cases. The accuracy rate of biopsy distinguishing malignant from benign lesions was 99.1%, and the rate for determining tumor histological type (excluding the nondiagnostic biopsies) was 95.1%. The sensitivity and specificity in detecting malignancy were 98.9% and 100%, respectively. In several situations, there is still a role for biopsy before intervention. Percutaneous needle core biopsy under ultrasonography guidance is highly accurate and safe, and can determine the proper management of undefinable masses. PMID:29595650

  10. 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.

  11. Magnetic resonance imaging-ultrasound fusion biopsy for prediction of final prostate pathology.

    PubMed

    Le, Jesse D; Stephenson, Samuel; Brugger, Michelle; Lu, David Y; Lieu, Patricia; Sonn, Geoffrey A; Natarajan, Shyam; Dorey, Frederick J; Huang, Jiaoti; Margolis, Daniel J A; Reiter, Robert E; Marks, Leonard S

    2014-11-01

    We explored the impact of magnetic resonance imaging-ultrasound fusion prostate biopsy on the prediction of final surgical pathology. A total of 54 consecutive men undergoing radical prostatectomy at UCLA after fusion biopsy were included in this prospective, institutional review board approved pilot study. Using magnetic resonance imaging-ultrasound fusion, tissue was obtained from a 12-point systematic grid (mapping biopsy) and from regions of interest detected by multiparametric magnetic resonance imaging (targeted biopsy). A single radiologist read all magnetic resonance imaging, and a single pathologist independently rereviewed all biopsy and whole mount pathology, blinded to prior interpretation and matched specimen. Gleason score concordance between biopsy and prostatectomy was the primary end point. Mean patient age was 62 years and median prostate specific antigen was 6.2 ng/ml. Final Gleason score at prostatectomy was 6 (13%), 7 (70%) and 8-9 (17%). A tertiary pattern was detected in 17 (31%) men. Of 45 high suspicion (image grade 4-5) magnetic resonance imaging targets 32 (71%) contained prostate cancer. The per core cancer detection rate was 20% by systematic mapping biopsy and 42% by targeted biopsy. The highest Gleason pattern at prostatectomy was detected by systematic mapping biopsy in 54%, targeted biopsy in 54% and a combination in 81% of cases. Overall 17% of cases were upgraded from fusion biopsy to final pathology and 1 (2%) was downgraded. The combination of targeted biopsy and systematic mapping biopsy was needed to obtain the best predictive accuracy. In this pilot study magnetic resonance imaging-ultrasound fusion biopsy allowed for the prediction of final prostate pathology with greater accuracy than that reported previously using conventional methods (81% vs 40% to 65%). If confirmed, these results will have important clinical implications. Copyright © 2014 American Urological Association Education and Research, Inc. Published by

  12. Multi-Quadrant Biopsy Technique Improves Diagnostic Ability in Large Heterogeneous Renal Masses.

    PubMed

    Abel, E Jason; Heckman, Jennifer E; Hinshaw, Louis; Best, Sara; Lubner, Meghan; Jarrard, David F; Downs, Tracy M; Nakada, Stephen Y; Lee, Fred T; Huang, Wei; Ziemlewicz, Timothy

    2015-10-01

    Percutaneous biopsy obtained from a single location is prone to sampling error in large heterogeneous renal masses, leading to nondiagnostic results or failure to detect poor prognostic features. We evaluated the accuracy of percutaneous biopsy for large renal masses using a modified multi-quadrant technique vs a standard biopsy technique. Clinical and pathological data for all patients with cT2 or greater renal masses who underwent percutaneous biopsy from 2009 to 2014 were reviewed. The multi-quadrant technique was defined as multiple core biopsies from at least 4 separate solid enhancing areas in the tumor. The incidence of nondiagnostic findings, sarcomatoid features and procedural complications was recorded, and concordance between biopsy specimens and nephrectomy pathology was compared. A total of 122 biopsies were performed for 117 tumors in 116 patients (46 using the standard biopsy technique and 76 using the multi-quadrant technique). Median tumor size was 10 cm (IQR 8-12). Biopsy was nondiagnostic in 5 of 46 (10.9%) standard and 0 of 76 (0%) multi-quadrant biopsies (p=0.007). Renal cell carcinoma was identified in 96 of 115 (82.0%) tumors and nonrenal cell carcinoma tumors were identified in 21 (18.0%). One complication occurred using the standard biopsy technique and no complications were reported using the multi-quadrant technique. Sarcomatoid features were present in 23 of 96 (23.9%) large renal cell carcinomas studied. Sensitivity for identifying sarcomatoid features was higher using the multi-quadrant technique compared to the standard biopsy technique at 13 of 15 (86.7%) vs 2 of 8 (25.0%) (p=0.0062). The multi-quadrant percutaneous biopsy technique increases the ability to identify aggressive pathological features in large renal tumors and decreases nondiagnostic biopsy rates. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. Profil bactériologique du pied diabétique et son impact sur le choix des antibiotiques

    PubMed Central

    Zemmouri, Adil; Tarchouli, Mohamed; Benbouha, Abdellatif; Lamkinsi, Tarik; Bensghir, Mustapha; Elouennass, Mostafa; Haimeur, Cherqui

    2015-01-01

    Introduction Analyse du profil bactériologique des pieds diabétiques pris en charge à l'hôpital militaire de Rabat et son influence sur l'antibiothérapie de première intention. Méthodes Etude prospective non randomisée étalée sur 18 mois, ayant concerné 105 patients. Après recueil des données et en attente des résultats bactériologiques nos patients ont été divisés en deux groupes: un groupe a été mis sous Amoxicilline + Acide clavulanique + Gentamycine (59 patients) et un groupe sous Ertapénème±Gentamycine (46 patients). Résultats L’étude a regroupé 85 hommes et 20 femmes (sexe ratio = 4.26). L’âge moyen est de 64.4 ans. La gangrène a été observée chez 79% des malades; elle était humide-donc surinfectée en principe- dans 43% des cas. Par ailleurs, 67% des malades ont un chiffre de globules blancs 12000 définissant une infection sévère. L'ostéolyse a été mise en évidence chez 27% de nos patients. Parmi les différentes techniques de prélèvements: 81% ont été profonds dont 21% de biopsie osseuse per opératoire et 14% de prélèvements combinés. 42% de ces prélèvements sont poly microbiens et 21% sont stériles. Les résultats bactériologiques viennent confirmer la prédominance des bactéries aérobies à Gram positif. Le taux de remplacement de l'Ertapénème est de 22% contre un taux de 50% pour l'Amoxiclav. Conclusion L'antibiothérapie ne doit être instaurée qu'en cas d'infection du pied diabétique diagnostiquée sur les critères cliniques établis par les consensus internationaux récents. Le respect des mesures de lutte contre la diffusion de la résistance bactérienne s'avère primordiale. PMID:27386024

  14. 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. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Liver biopsy: Analysis of results of two specialist teams.

    PubMed

    Anania, Giulia; Gigante, Elia; Piciucchi, Matteo; Pilozzi, Emanuela; Pucci, Eugenio; Pellicelli, Adriano Maria; Capotondi, Carlo; Rossi, Michele; Baccini, Flavia; Antonelli, Giulio; Begini, Paola; Delle Fave, Gianfranco; Marignani, Massimo

    2014-05-15

    To analyze the safety and the adequacy of a sample of liver biopsies (LB) obtained by gastroenterologist (G) and interventional radiologist (IR) teams. Medical records of consecutive patients evaluated at our GI unit from 01/01/2004 to 31/12/2010 for whom LB was considered necessary to diagnose and/or stage liver disease, both in the setting of day hospital and regular admission (RA) care, were retrieved and the data entered in a database. Patients were divided into two groups: one undergoing an ultrasonography (US)-assisted procedure by the G team and one undergoing US-guided biopsy by the IR team. For the first group, an intercostal approach (US-assisted) and a Menghini modified type needle 16 G (length 90 mm) were used. The IR team used a subcostal approach (US-guided) and a semiautomatic modified Menghini type needle 18 G (length 150 mm). All the biopsies were evaluated for appropriateness according to the current guidelines. The number of portal tracts present in each biopsy was assessed by a revision performed by a single pathologist unaware of the previous pathology report. Clinical, laboratory and demographic patient characteristics, the adverse events rate and the diagnostic adequacy of LB were analyzed. During the study period, 226 patients, 126 males (56%) and 100 females (44%), underwent LB: 167 (74%) were carried out by the G team, whereas 59 (26%) by the IR team. LB was mostly performed in a day hospital setting by the G team, while IR completed more procedures on inpatients (P < 0.0001). The groups did not differ in median age, body mass index (BMI), presence of comorbidities and coagulation parameters. Complications occurred in 26 patients (16 G team vs 10 IR team, P = 0.15). Most gross samples obtained were considered suitable for basal histological evaluation, with no difference among the two teams (96.4% G team vs 91.5% IR, P = 0.16). However, the samples obtained by the G team had a higher mean number of portal tracts (G team 9.5 ± 4.8; range 1

  16. Greening America's Capitals - Des Moines, IA

    EPA Pesticide Factsheets

    Report from Greening America's Capitals project in Des Moines, IA, to help the city enhance the 6th Avenue Corridor with pedestrian and bike improvements and green infrastructure to manage stormwater.

  17. Aircraft Disinsection: A Guide for Military and Civilian Air Carriers (Desinsectisation des aeronefs: Un guide a l’intention des responsables des transports aeriens civils et militaires)

    DTIC Science & Technology

    1996-04-01

    regulations. - Ceratitis capitata (Mediterranean fruit fly). Quarantine regulations generally reduce - Rhagoletis pomonella (Apple maggot). the chances of a...d’insectes nuisibles dans un pays, en 6vitant des risques pour la sant6 des 6quipages, pour la s~curit6 de 1’a~ronef et pour l’industrie. Ce rapport examine 1...diffrrents officiels responsables de la r~glementation des insectes nuisibles introduits, de l’inscription des pesticides et de leur utilisation en

  18. Caracterisation des proprietes acoustiques des materiaux poreux a cellules ouvertes et a matrice rigide ou souple

    NASA Astrophysics Data System (ADS)

    Salissou, Yacoubou

    L'objectif global vise par les travaux de cette these est d'ameliorer la caracterisation des proprietes macroscopiques des materiaux poreux a structure rigide ou souple par des approches inverses et indirectes basees sur des mesures acoustiques faites en tube d'impedance. La precision des approches inverses et indirectes utilisees aujourd'hui est principalement limitee par la qualite des mesures acoustiques obtenues en tube d'impedance. En consequence, cette these se penche sur quatre problemes qui aideront a l'atteinte de l'objectif global precite. Le premier probleme porte sur une caracterisation precise de la porosite ouverte des materiaux poreux. Cette propriete en est une de passage permettant de lier la mesure des proprietes dynamiques acoustiques d'un materiau poreux aux proprietes effectives de sa phase fluide decrite par les modeles semi-phenomenologiques. Le deuxieme probleme traite de l'hypothese de symetrie des materiaux poreux selon leur epaisseur ou un index et un critere sont proposes pour quantifier l'asymetrie d'un materiau. Cette hypothese est souvent source d'imprecision des methodes de caracterisation inverses et indirectes en tube d'impedance. Le critere d'asymetrie propose permet ainsi de s'assurer de l'applicabilite et de la precision de ces methodes pour un materiau donne. Le troisieme probleme vise a mieux comprendre le probleme de transmission sonore en tube d'impedance en presentant pour la premiere fois un developpement exact du probleme par decomposition d'ondes. Ce developpement permet d'etablir clairement les limites des nombreuses methodes existantes basees sur des tubes de transmission a 2, 3 ou 4 microphones. La meilleure comprehension de ce probleme de transmission est importante puisque c'est par ce type de mesures que des methodes permettent d'extraire successivement la matrice de transfert d'un materiau poreux et ses proprietes dynamiques intrinseques comme son impedance caracteristique et son nombre d'onde complexe. Enfin, le

  19. Asian Lineage of Peste des Petits Ruminants Virus, Africa

    PubMed Central

    Kwiatek, Olivier; Ali, Yahia Hassan; Saeed, Intisar Kamil; Khalafalla, Abdelmelik Ibrahim; Mohamed, Osama Ishag; Abu Obeida, Ali; Abdelrahman, Magdi Badawi; Osman, Halima Mohamed; Taha, Khalid Mohamed; Abbas, Zakia; El Harrak, Mehdi; Lhor, Youssef; Diallo, Adama; Lancelot, Renaud; Albina, Emmanuel

    2011-01-01

    Interest in peste des petits ruminants virus (PPRV) has been stimulated by recent changes in its host and geographic distribution. For this study, biological specimens were collected from camels, sheep, and goats clinically suspected of having PPRV infection in Sudan during 2000–2009 and from sheep soon after the first reported outbreaks in Morocco in 2008. Reverse transcription PCR analysis confirmed the wide distribution of PPRV throughout Sudan and spread of the virus in Morocco. Molecular typing of 32 samples positive for PPRV provided strong evidence of the introduction and broad spread of Asian lineage IV. This lineage was defined further by 2 subclusters; one consisted of camel and goat isolates and some of the sheep isolates, while the other contained only sheep isolates, a finding with suggests a genetic bias according to the host. This study provides evidence of the recent spread of PPRV lineage IV in Africa. PMID:21762576

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

    PubMed

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

    2010-06-01

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

  1. 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. Copyright © 2012 American Association for the Study of Liver Diseases.

  2. Saliva Liquid Biopsy for Point-of-Care Applications

    PubMed Central

    Aro, Katri; Wei, Fang; Wong, David T.; Tu, Michael

    2017-01-01

    Saliva is a non-invasive biofluid, which is easy to collect, transport, and store. Because of its accessibility and connection to systemic diseases, saliva is one of the best candidates for the advancement of point-of-care medicine, where individuals are able to easily monitor their health status by using portable convenient tools such as smartphones. There are a variety of scenarios with which saliva can be used: studies have been conducted on using saliva to measure stress hormones, enzyme levels, developmental disease biomarkers, and even cancer mutations. If validated biomarkers were combined with high-quality detection tools, saliva would open up a new frontier in high-quality healthcare, allowing physicians and patients to work together for real-time health monitoring and high-impact personalized preventative medicine. One of the most exciting emerging frontiers of saliva is liquid biopsy, which is a non-invasive means to assess the presence and characteristics of cancer in a patient. This article will review current basic knowledge of biomarkers, review their relation to different diseases and conditions, and explore liquid biopsy for point-of-care applications. PMID:28443278

  3. Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

    PubMed

    Walfish, P G; Strawbridge, H T; Rosen, I B

    1985-12-01

    To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered.

  4. Neurological symptoms in patients with biopsy proven celiac disease.

    PubMed

    Bürk, Katrin; Farecki, Marie-Louise; Lamprecht, Georg; Roth, Guenter; Decker, Patrice; Weller, Michael; Rammensee, Hans-Georg; Oertel, Wolfang

    2009-12-15

    In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet. (c) 2009 Movement Disorder Society.

  5. Optical biopsy for the diagnosis of dysplasia in Barrett's oesophagus

    NASA Astrophysics Data System (ADS)

    Pickard, David C. O.; Bigio, Irving J.; Bown, Stephen G.; Lovat, Laurence B.; Ripley, Paul M.; Novelli, Marco

    2002-05-01

    Several research groups have been developing optical-spectroscopy methods, often mediated by fibre-optic probes, to noninvasively identify dysplasia and cancer in situ and in real time: often called 'optical biopsy'. Researchers at Los Alamos National Laboratory (Los Alamos, New Mexico) have developed the method of elastic-scattering spectroscopy (ESS). ESS is a point measurement that is sensitive to the morphological changes at the cellular and sub-cellular level, including changes in the size and/or density of the nuclei, mitochondria or other organelles. It is therefore sensitive to morphology features that a pathologist looks for during histological examination. We report on the first stages of a clinical study currently under way at the Middlesex Hospital an University College London, designed to test the ESS method for identification of dysplasia in Barrett's oesophagus. Preliminary results using elastic-scattering spectroscopy during endoscopic examination show that this technique has potential as a real-time test for in vivo detection of dysplasia or early cancer within Barrett's mucosa, or at least as a guide to assist in locating optimum sites for biopsy. Initial data sets are encouraging and the randomly chosen testing and training sets give specificities and sensitivities comparable to the accuracy of histology. It is evident that the ESS technique is proving to be convenient for the physicians given its speed and compatibility with endoscopic equipment. It is intended to begin prospective trials in the next few months to assess the systems suitability for general clinical practice.

  6. High Frequency Ultrasound Array Designed for Ultrasound Guided Breast Biopsy

    PubMed Central

    Cummins, Thomas; Eliahoo, Payam; Shung, K. Kirk

    2016-01-01

    This paper describes the development of a miniaturized high frequency linear array that can be integrated within a core biopsy needle to improve tissue sampling accuracy during breast cancer biopsy procedures. The 64 element linear array has an element width of 14 μm, kerf width of 6 μm, element length of 1 mm and element thickness of 24 μm. The 2–2 array composite was fabricated using deep reactive ion etching of PMN-PT single crystal material. The array composite fabrication process as well as a novel high density electrical interconnect solution are presented and discussed. Array performance measurements show that the array had a center frequency and fractional bandwidth (−6 dB) of 59.1 MHz and 29.4%, respectively. Insertion loss and adjacent element cross talk at the center frequency were −41.0 dB and −23.7 dB, respectively. A B-mode image of a tungsten wire target phantom was captured using a synthetic aperture imaging system and the imaging test results demonstrate axial and lateral resolutions of 33.2 μm and 115.6 um, respectively. PMID:27046895

  7. Stormram 4: An MR Safe Robotic System for Breast Biopsy.

    PubMed

    Groenhuis, Vincent; Siepel, Françoise J; Veltman, Jeroen; van Zandwijk, Jordy K; Stramigioli, Stefano

    2018-05-21

    Suspicious lesions in the breast that are only visible on magnetic resonance imaging (MRI) need to be biopsied under MR guidance with high accuracy and efficiency for accurate diagnosis. The aim of this study is to present a novel robotic system, the Stormram 4, and to perform preclinical tests in an MRI environment. Excluding racks and needle, its dimensions are 72 × 51 × 40 mm. The Stormram 4 is driven by two linear and two curved pneumatic stepper motors. The linear motor is capable of exerting 63 N of force at a pressure of 0.65 MPa. In an MRI environment the maximum observed stepping frequency is 30 Hz (unloaded), or 8 Hz when full force is needed. The Stormram 4's mean positioning error is 0.73 ± 0.47 mm in free air, and 1.29 ± 0.59 mm when targeting breast phantoms in MRI. Excluding the off-the-shelf needle, the robot is inherently MR safe. The robot is able to accurately target lesions under MRI guidance, reducing tissue damage and risk of false negatives. These results are promising for clinical experiments, improving the quality of healthcare in the field of MRI-guided breast biopsies.

  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. Liquid biopsy for early detection of lung cancer.

    PubMed

    Hofman, Paul

    2017-01-01

    The possibility of complete recovery for a lung cancer patient depends on very early diagnosis, as it allows total surgical resection. Screening for this cancer in a high-risk population can be performed using a radiological approach, but this holds a certain number of limitations. Liquid biopsy could become an alternative and complementary screening approach to chest imaging for early diagnosis of lung cancer. Several circulating biomarkers indicative of lung cancer can be investigated in blood, such as circulating tumor cells, circulating free nucleic acids (RNA and DNA) and proteins. However, none of these biomarkers have yet been adopted in routine clinical practice and studies are ongoing to confirm or not the usefulness and practical interest in routine early diagnosis and screening for lung cancers. Several potential circulating biomarkers for the early detection of lung cancer exist. When coupled to thoracic imaging, these biomarkers must give diagnosis of a totally resectable lung cancer and potentially provide new recommendations for surveillance by imagery of high-risk populations without a detectable nodule. Optimization of the specificity and sensitivity of the detection methods as well as standardization of the techniques is essential before considering for daily practice a liquid biopsy as an early diagnostic tool, or possibly as a predictive test, of lung cancer.

  10. Refer prior to biopsy of suspected appendicular soft tissue sarcoma.

    PubMed

    Elliott, Robert S J; Flint, Michael; French, Gary

    2012-11-23

    Appendicular soft tissue tumours are rare and inappropriate investigation can result in unnecessary loss of limb or life. We reviewed the investigation and referrals of patients to our institution. This is a review of prospectively collected data stored in a tumour registry database. We included all patients (126) referred to the service for investigation and management with a primary soft tissue tumour in 2006 and 2007. There was a highly significant association (RR=6.2) between pre referral procedures (PRPs) and suffering a complication (P<0.0001) in comparison to non-biopsied referrals (NBRs). Those referred by general surgeons were more likely (RR=2.6) to have undergone PRP (p<0.0017). The median interval between referral and senior author review was 8 days for the PRP group and 10 days for the NBR group (P=0.2574). Biopsy of suspected appendicular soft tissue sarcoma should be performed by a tumour specialist or in prior consultation with, to minimise adverse outcomes. There was minimal delay till review by an orthopaedic tumour specialist at Middlemore Hospital and achieving a tissue diagnosis does not expedite this.

  11. Malignant melanoma (non-metastatic): sentinel lymph node biopsy

    PubMed Central

    2016-01-01

    Introduction The incidence of malignant melanoma has increased over the past 25 years in the UK, but death rates have remained fairly constant. The 5-year survival rate ranges from 20% to 95%, depending on disease stage. Risks are greater in white populations and in people with higher numbers of skin naevi. Methods and outcomes We conducted a systematic overview, aiming to answer the following clinical question: What is the evidence for performing a sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2014 (BMJ Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). Results At this update, searching of electronic databases retrieved 221 studies. After deduplication and removal of conference abstracts, 99 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 58 studies and the further review of 41 full publications. Of the 41 full articles evaluated, one systematic review and three RCTs were added at this update. We performed a GRADE evaluation for two PICO combinations. Conclusions In this systematic overview, we evaluated the evidence for performing sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes. PMID:26788739

  12. Malignant melanoma (non-metastatic): sentinel lymph node biopsy.

    PubMed

    Pay, Andy

    2016-01-19

    The incidence of malignant melanoma has increased over the past 25 years in the UK, but death rates have remained fairly constant. The 5-year survival rate ranges from 20% to 95%, depending on disease stage. Risks are greater in white populations and in people with higher numbers of skin naevi. We conducted a systematic overview, aiming to answer the following clinical question: What is the evidence for performing a sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). At this update, searching of electronic databases retrieved 221 studies. After deduplication and removal of conference abstracts, 99 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 58 studies and the further review of 41 full publications. Of the 41 full articles evaluated, one systematic review and three RCTs were added at this update. We performed a GRADE evaluation for two PICO combinations. In this systematic overview, we evaluated the evidence for performing sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes.

  13. The Prognostic Value of Histopathologic Lesions in Native Kidney Biopsy Specimens: Results from the Boston Kidney Biopsy Cohort Study.

    PubMed

    Srivastava, Anand; Palsson, Ragnar; Kaze, Arnaud D; Chen, Margaret E; Palacios, Polly; Sabbisetti, Venkata; Betensky, Rebecca A; Steinman, Theodore I; Thadhani, Ravi I; McMahon, Gearoid M; Stillman, Isaac E; Rennke, Helmut G; Waikar, Sushrut S

    2018-06-04

    Background Few studies have evaluated whether histopathologic lesions on kidney biopsy provide prognostic information beyond clinical and laboratory data. Methods We enrolled 676 individuals undergoing native kidney biopsy at three tertiary care hospitals into a prospective, observational cohort study. Biopsy specimens were adjudicated for semiquantitative scores in 13 categories of histopathology by two experienced renal pathologists. Proportional hazards models tested the association between histopathologic lesions and risk of kidney disease progression (≥40% eGFR decline or RRT). Results Mean baseline eGFR was 57.5±36.0 ml/min per 1.73 m 2 During follow-up (median, 34.3 months), 199 individuals suffered kidney disease progression. After adjustment for demographics, clinicopathologic diagnosis, and laboratory values, the following lesions (hazard ratio; 95% confidence interval) were independently associated with progression: inflammation in nonfibrosed interstitium (0.52; 0.32 to 0.83), moderate and severe versus minimal interstitial fibrosis/tubular atrophy (2.14; 1.24 to 3.69 and 3.42; 1.99 to 5.87, respectively), moderate and severe versus minimal global glomerulosclerosis (2.17; 1.36 to 3.45 and 3.31; 2.04 to 5.38, respectively), moderate and severe versus minimal arterial sclerosis (1.78; 1.15 to 2.74 and 1.64; 1.04 to 2.60, respectively), and moderate and severe versus minimal arteriolar sclerosis (1.63; 1.08 to 2.46 and 2.33; 1.42 to 3.83, respectively). An 11-point chronicity score derived from semiquantitative assessments of chronic lesions independently associated with higher risk of kidney disease progression (hazard ratio per one-point increase, 1.19; 95% confidence interval, 1.12 to 1.27). Conclusions Across a diverse group of kidney diseases, histopathologic lesions on kidney biopsy provide prognostic information, even after adjustment for proteinuria and eGFR. Copyright © 2018 by the American Society of Nephrology.

  14. Strategies facilitant les tests en pre-certification pour la robustesse a l'egard des radiations =

    NASA Astrophysics Data System (ADS)

    Souari, Anis

    . permettant d’evaluer d’une facon realiste la sensibilite des circuits integres face. aux effets des radiations afin d’eviter d’envoyer des circuits non robustes a la phase tres. couteuse de la certification. Les circuits cibles par nos travaux sont les circuits integres. programmables par l’usager (FPGA) a base de memoire SRAM et le type de pannes ciblees, causees par les radiations, est les SEU (single event upset) consistant a un basculement de. l’etat logique d’un element de memoire a son complementaire. En effet, les FPGA a base de. memoire SRAM sont de plus en plus demandes par la communaute de l’aerospatial grace a. leurs caracteristiques de prototypage rapide et de reconfiguration sur site mais ils sont. vulnerables face aux radiations ou les SEU sont les pannes les plus frequentes dans les. elements de memoire de type SRAM. Nous proposons une nouvelle approche d’injection de. pannes par emulation permettant de mimer les effets des radiations sur la memoire de. configuration des FPGA et de generer des resultats les plus fideles possibles des resultats des. tests de certification. Cette approche est basee sur la consideration de la difference de. sensibilite des elements de memoire de configuration lorsqu’ils sont a l’etat '1' et a l’etat '0', observee sous des tests acceleres sous faisceaux de protons au renomme laboratoire. TRIUMF, dans la procedure de generation des sequences de test dans le but de mimer la. distribution des pannes dans la memoire de configuration. Les resultats des experimentations. de validation montrent que la strategie proposee est efficace et genere des resultats realistes. Ces resultats revelent que ne pas considerer la difference de sensibilite peut mener a une. sous-estimation de la sensibilite des circuits face aux radiations. Dans la meme optique d’optimisation de la procedure d’injection des pannes par emulation, a. savoir le test de pre-certification, nous proposons

  15. Whole exome sequencing for determination of tumor mutation load in liquid biopsy from advanced cancer patients.

    PubMed

    Koeppel, Florence; Blanchard, Steven; Jovelet, Cécile; Genin, Bérengère; Marcaillou, Charles; Martin, Emmanuel; Rouleau, Etienne; Solary, Eric; Soria, Jean-Charles; André, Fabrice; Lacroix, Ludovic

    2017-01-01

    Tumor mutation load (TML) has been proposed as a biomarker of patient response to immunotherapy in several studies. TML is usually determined by tumor biopsy DNA (tDNA) whole exome sequencing (WES), therefore TML evaluation is limited by informative biopsy availability. Circulating cell free DNA (cfDNA) provided by liquid biopsy is a surrogate specimen to biopsy for molecular profiling. Nevertheless performing WES on DNA from plasma is technically challenging and the ability to determine tumor mutation load from liquid biopsies remains to be demonstrated. In the current study, WES was performed on cfDNA from 32 metastatic patients of various cancer types included into MOSCATO 01 (NCT01566019) and/or MATCHR (NCT02517892) molecular triage trials. Results from targeted gene sequencing (TGS) and WES performed on cfDNA were compared to results from tumor tissue biopsy. In cfDNA samples, WES mutation detection sensitivity was 92% compared to targeted sequencing (TGS). When comparing cfDNA-WES to tDNA-WES, mutation detection sensitivity was 53%, consistent with previously published prospective study comparing cfDNA-TGS to tDNA-TGS. For samples in which presence of tumor DNA was confirmed in cfDNA, tumor mutation load from liquid biopsy was correlated with tumor biopsy. Taken together, this study demonstrated that liquid biopsy may be applied to determine tumor mutation load. Qualification of liquid biopsy for interpretation is a crucial point to use cfDNA for mutational load estimation.

  16. Whole exome sequencing for determination of tumor mutation load in liquid biopsy from advanced cancer patients

    PubMed Central

    Blanchard, Steven; Jovelet, Cécile; Genin, Bérengère; Marcaillou, Charles; Martin, Emmanuel; Rouleau, Etienne; Solary, Eric; Soria, Jean-Charles; André, Fabrice; Lacroix, Ludovic

    2017-01-01

    Tumor mutation load (TML) has been proposed as a biomarker of patient response to immunotherapy in several studies. TML is usually determined by tumor biopsy DNA (tDNA) whole exome sequencing (WES), therefore TML evaluation is limited by informative biopsy availability. Circulating cell free DNA (cfDNA) provided by liquid biopsy is a surrogate specimen to biopsy for molecular profiling. Nevertheless performing WES on DNA from plasma is technically challenging and the ability to determine tumor mutation load from liquid biopsies remains to be demonstrated. In the current study, WES was performed on cfDNA from 32 metastatic patients of various cancer types included into MOSCATO 01 (NCT01566019) and/or MATCHR (NCT02517892) molecular triage trials. Results from targeted gene sequencing (TGS) and WES performed on cfDNA were compared to results from tumor tissue biopsy. In cfDNA samples, WES mutation detection sensitivity was 92% compared to targeted sequencing (TGS). When comparing cfDNA-WES to tDNA-WES, mutation detection sensitivity was 53%, consistent with previously published prospective study comparing cfDNA-TGS to tDNA-TGS. For samples in which presence of tumor DNA was confirmed in cfDNA, tumor mutation load from liquid biopsy was correlated with tumor biopsy. Taken together, this study demonstrated that liquid biopsy may be applied to determine tumor mutation load. Qualification of liquid biopsy for interpretation is a crucial point to use cfDNA for mutational load estimation. PMID:29161279

  17. Utility of pre-procurement bedside liver biopsy in the deceased extended-criteria liver donor.

    PubMed

    Mangus, Richard S; Borup, Tim C; Popa, Sam; Saxena, Romil; Cummings, Oscar; Tector, A Joseph

    2014-12-01

    The Indiana Organ Procurement Organization (IOPO) utilizes preoperative bedside liver biopsies in certain extended-criteria donors (ECDs), obtained by the on-site coordinator, to determine the utility of pursuing donation. This study reports the clinical and financial outcomes for this management strategy. All bedside liver biopsies obtained in ECDs over a five-yr period were reviewed. Study variables included the following: indication for biopsy, biopsy results, taking the case to the operating room, transplantation of the donor liver, and graft survival. All biopsies were processed at a single university center. There were 110 donors biopsied. Primary indications included the following: old age (29%), extensive/current alcohol abuse (26%), hepatitis C-positive serology (21%), obesity (25%), and severely elevated liver function enzymes (18%). Biopsy results demonstrated a potentially transplantable liver in 73 cases (66%), all of whom were taken to the OR (while 37 ruled out for donation based upon liver biopsy [34%]). Of all biopsied livers, 49 ultimately were transplanted (45%). Intra-operative decisions included the following: transplant 51/73 (70%), surgeon decision to exclude 20/73 (27%), nonuse due to finding of malignancy two (3%). Bedside liver biopsy may be a valuable tool to determine the utility in pursuing donation in ECDs, particularly with liver-only donors. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome

    SciTech Connect

    Vance, Waseet; Tucker, Susan L.; Crevoisier, Renaud de

    2007-03-01

    Purpose: To determine the value of a 2-year post-radiotherapy (RT) prostate biopsy for predicting eventual biochemical failure in patients who were treated for localized prostate cancer. Methods and Materials: This study comprised 164 patients who underwent a planned 2-year post-RT prostate biopsy. The independent prognostic value of the biopsy results for forecasting eventual biochemical outcome and overall survival was tested with other factors (the Gleason score, 1992 American Joint Committee on Cancer tumor stage, pretreatment prostate-specific antigen level, risk group, and RT dose) in a multivariate analysis. The current nadir + 2 (CN + 2) definition of biochemical failure wasmore » used. Patients with rising prostate-specific antigen (PSA) or suspicious digital rectal examination before the biopsy were excluded. Results: The biopsy results were normal in 78 patients, scant atypical and malignant cells in 30, carcinoma with treatment effect in 43, and carcinoma without treatment effect in 13. Using the CN + 2 definition, we found a significant association between biopsy results and eventual biochemical failure. We also found that the biopsy status provides predictive information independent of the PSA status at the time of biopsy. Conclusion: A 2-year post-RT prostate biopsy may be useful for forecasting CN + 2 biochemical failure. Posttreatment prostate biopsy may be useful for identifying patients for aggressive salvage therapy.« less

  19. Comparison of routinely used intestinal biopsy forceps in dogs: an ex vivo histopathological approach.

    PubMed

    Dahan, J; Semin, M O; Monton, C; Amiriantz, S; Concordet, D; Raymond-Letron, I; Dossin, O

    2017-03-01

    To compare the quality of duodenal and ileal samples obtained with different biopsy forceps. Fifteen dogs were included in a prospective ex vivo study. After euthanasia, the duodenum and the ileum were sampled with four different forceps and evaluated according to a standardised scoring system. The biopsy forceps evaluated had alligator jaws or cups with smooth edge with or without a needle. The global quality of the biopsies was better in the ileum that in the duodenum regardless of the biopsy forceps. Biopsy forceps with smooth edge including a needle resulted in fewer artefacts than biopsy forceps with smooth edge but no needle in both sites and those with alligator jaws without a needle provided deeper biopsies than those with smooth edge without a needle only in the duodenum. There was no effect of the biopsy forceps type on the size of the biopsies. Our findings may aid in choosing the appropriate type of forceps for intestinal biopsy. © 2017 British Small Animal Veterinary Association.

  20. Evolution of prostate biopsy techniques. Looking back on a meaningful journey.

    PubMed

    Sivaraman, A; Sanchez-Salas, R; Castro-Marin, M; Barret, E; Guillot-Tantay, C; Prapotnich, D; Cathelineau, X

    2016-10-01

    The technique of prostate biopsy has evolved a long way since its inception to being a safe diagnostic procedure. The principles of the biopsy technique continue to improvise with the knowledge about prostate cancer and availability of newer treatment options like active surveillance and focal therapy. Currently, we depend on accurate cancer information from the biopsy more than ever for deciding the ideal treatment option. The aim of this review is to present the major milestones in prostate biopsy technique evolutions and its impact on the prostate cancer management. We performed a detailed non-systematic literature review to present the historical facts on the transformations in prostate biopsy techniques and also the direction of present research to improve accurate cancer detection. There is a clear change in trend in biopsy technique before and after the introduction of transrectal ultrasound and prostate specific antigen. In the earlier era, the biopsies were aimed at palpable nodules and obtaining adequate prostatic tissue for diagnosis while the later era has moved towards detection of non-palpable and early prostate cancer. Recently, there is an increasing trend towards image guided targeted biopsies to extract maximum cancer information from minimum biopsy cores. Prostate biopsy techniques have seen major changes since its inception and have a major impact on prostate cancer management. There is a great potential for research which can further support the newer treatment options like focal therapy. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Diagnostic accuracy of pre-treatment biopsy for grading cutaneous mast cell tumours in dogs.

    PubMed

    Shaw, T; Kudnig, S T; Firestone, S M

    2018-06-01

    Mast cell tumours (MCTs) are common tumours of the canine skin, and are estimated to represent up to 20% of all skin tumours in dogs. Tumour grade has a major impact on the incidence of local recurrence and metastatic potential. In addition to helping the clinician with surgical planning, knowledge of the tumour grade also assists in proper prognostication and client education. For pre-treatment biopsies to be useful, there must exist a high level of correlation between the histopathological grade obtained from the pre-treatment biopsy and the actual histopathological grade from the excisional biopsy. The aim of this study was to determine concordance of tumour grade between various biopsy techniques (wedge, punch, needle core) and the "gold standard" excisional biopsy method. We found an overall concordance rate of 96% based on the Patnaik grading system, and an overall concordance rate of 92% based on the Kiupel grading system. The accuracy of the various biopsy techniques (wedge, punch and needle core) when compared with excisional biopsy was 92%, 100% and 100%, respectively, based on the Patnaik grading system, and 90%, 95% and 100%, respectively, based on the Kiupel grading system. Of the cases with discordant results, the pre-treatment biopsies tended to underestimate the grade of the tumour. Based on these results, we conclude that pre-treatment biopsies are sufficiently accurate for differentiating low-grade from high-grade MCTs, regardless of biopsy technique or tumour location. © 2017 John Wiley & Sons Ltd.

  2. Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration.

    PubMed

    Jain, Ashali; Khalid, Maria; Qureshi, Muhammad M; Georgian-Smith, Dianne; Kaplan, Jonah A; Buch, Karen; Grinstaff, Mark W; Hirsch, Ariel E; Hines, Neely L; Anderson, Stephan W; Gallagher, Katherine M; Bates, David D B; Bloch, B Nicolas

    2017-11-01

    To evaluate breast biopsy marker migration in stereotactic core needle biopsy procedures and identify contributing factors. This retrospective study analyzed 268 stereotactic biopsy markers placed in 263 consecutive patients undergoing stereotactic biopsies using 9G vacuum-assisted devices from August 2010-July 2013. Mammograms were reviewed and factors contributing to marker migration were evaluated. Basic descriptive statistics were calculated and comparisons were performed based on radiographically-confirmed marker migration. Of the 268 placed stereotactic biopsy markers, 35 (13.1%) migrated ≥1 cm from their biopsy cavity. Range: 1-6 cm; mean (± SD): 2.35 ± 1.22 cm. Of the 35 migrated biopsy markers, 9 (25.7%) migrated ≥3.5 cm. Patient age, biopsy pathology, number of cores, and left versus right breast were not associated with migration status (P> 0.10). Global fatty breast density (P= 0.025) and biopsy in the inner region of breast (P = 0.031) were associated with marker migration. Superior biopsy approach (P= 0.025), locally heterogeneous breast density, and t-shaped biopsy markers (P= 0.035) were significant for no marker migration. Multiple factors were found to influence marker migration. An overall migration rate of 13% supports endeavors of research groups actively developing new biopsy marker designs for improved resistance to migration. • Breast biopsy marker migration is documented in 13% of 268 procedures. • Marker migration is affected by physical, biological, and pathological factors. • Breast density, marker shape, needle approach etc. affect migration. • Study demonstrates marker migration prevalence; marker design improvements are needed.

  3. Fast MRI-guided vacuum-assisted breast biopsy: initial experience.

    PubMed

    Liberman, Laura; Morris, Elizabeth A; Dershaw, D David; Thornton, Cynthia M; Van Zee, Kimberly J; Tan, Lee K

    2003-11-01

    The purpose of this study was to evaluate a new method for performing MRI-guided vacuum-assisted breast biopsy in a study of lesions that had subsequent surgical excision. SUBJECTS AND METHODS. Twenty women scheduled for MRI-guided needle localization and surgical biopsy were prospectively entered in the study. MRI-guided biopsy was performed with a vacuum-assisted probe, followed by placement of a localizing clip, and then needle localization for surgical excision. Vacuum-assisted biopsy and surgical histology were correlated. Vacuum-assisted biopsy was successfully performed in 19 (95%) of the 20 women. The median size of 27 MRI-detected lesions that had biopsy was 1.0 cm (range, 0.4-6.4 cm). Cancer was present in eight (30%) of 27 lesions and in six (32%) of 19 women; among these eight cancers, five were infiltrating and three were ductal carcinoma in situ (DCIS). Among these 27 lesions, histology was benign at vacuum-assisted biopsy and at surgery in 19 (70%), cancer at vacuum-assisted biopsy in six (22%), atypical ductal hyperplasia at vacuum-assisted biopsy and DCIS at surgery in one (4%), and benign at vacuum-assisted biopsy with surgery showing microscopic DCIS that was occult at MRI in one (4%). The median time to perform vacuum-assisted biopsy of a single lesion was 35 min (mean, 35 min; range, 24-48 min). Placement of a localizing clip, attempted in 26 lesions, was successful in 25 (96%) of 26, and the clip was retrieved on specimen radiography in 22 (96%) of 23. One complication occurred: a hematoma that resolved with compression. MRI-guided vacuum-assisted biopsy is a fast, safe, and accurate alternative to surgical biopsy for breast lesions detected on MRI.

  4. Improved Survival in Male Melanoma Patients in the Era of Sentinel Node Biopsy.

    PubMed

    Koskivuo, I; Vihinen, P; Mäki, M; Talve, L; Vahlberg, T; Suominen, E

    2017-03-01

    Sentinel node biopsy is a standard method for nodal staging in patients with clinically localized cutaneous melanoma, but the survival advantage of sentinel node biopsy remains unsolved. The aim of this case-control study was to investigate the survival benefit of sentinel node biopsy. A total of 305 prospective melanoma patients undergoing sentinel node biopsy were compared with 616 retrospective control patients with clinically localized melanoma whom have not undergone sentinel node biopsy. Survival differences were calculated with the median follow-up time of 71 months in sentinel node biopsy patients and 74 months in control patients. Analyses were calculated overall and separately in males and females. Overall, there were no differences in relapse-free survival or cancer-specific survival between sentinel node biopsy patients and control patients. Male sentinel node biopsy patients had significantly higher relapse-free survival ( P = 0.021) and cancer-specific survival ( P = 0.024) than control patients. In females, no differences were found. Cancer-specific survival rates at 5 years were 87.8% in sentinel node biopsy patients and 85.2% in controls overall with 88.3% in male sentinel node biopsy patients and 80.6% in male controls and 87.3% in female sentinel node biopsy patients and 89.8% in female controls. Sentinel node biopsy did not improve survival in melanoma patients overall. While females had no differences in survival, males had significantly improved relapse-free survival and cancer-specific survival following sentinel node biopsy.

  5. Complications and adequacy of transplant kidney biopsies: A comparison of techniques.

    PubMed

    Plattner, Brett W; Chen, Pauline; Cross, Richard; Leavitt, Matthew A; Killen, Paul D; Heung, Michael

    2018-05-01

    Kidney biopsies are an essential tool in the diagnosis and management of kidney diseases, particularly in kidney transplant recipients. Biopsies carry a risk for serious complications and not all biopsies achieve adequate tissue. We examined the impact of kidney biopsy technique on complications and biopsy adequacy. The cohort consisted of consecutive kidney transplant patients undergoing biopsy by one of three techniques: ultrasound localization, real-time ultrasound guidance, and ultrasound-guided trocar placement. Variables of interest included patient characteristics and procedural characteristics. The primary outcome was serious complication attributable to kidney biopsy, and the secondary outcome was biopsy adequacy as defined by Banff criteria. Among 263 patients undergoing biopsy, 27 (10.3%) had a complication (14 with gross hematuria, 10 requiring blood transfusion, 3 requiring an unplanned interventional radiology procedure, 1 kidney loss; no deaths). Complications were more common among patients biopsied using ultrasound-guided trocar compared to real-time ultrasound and ultrasound localization (21.4% vs 7.9% vs 7.1%, respectively, p = 0.008). After adjusting for patient and procedure characteristics, technique was no longer significantly associated with complication. Biopsy adequacy was significantly higher when using ultrasound localization and real-time ultrasound compared to ultrasound-guided trocar (84.6% vs 86.8% vs 69.6%, p = 0.029), and this finding persisted in adjusted analysis. Kidney biopsy complications appear to be similar when using any of the three techniques examined in our study. However, ultrasound-guided trocar technique may yield lower biopsy adequacy when compared to non-trocar techniques.

  6. Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion.

    PubMed

    Rajawat, Govind Singh; Batra, Supreet; Takhar, Rajendra Prasad; Rathi, Lalit; Bhandari, Chand; Gupta, Manohar Lal

    2017-01-01

    Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. The objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy. This was a cross-sectional study. This study was conducted at Institute of Respiratory Diseases, SMS Medical College, Jaipur, a tertiary care center of West India. A total of 250 cases of pleural effusion were evaluated with complete pleural fluid biochemical, microbiological, and cytological examination. Out of these 250 patients, 59 were excluded from the study as the diagnosis could be established on initial pleural fluid examination. The remaining (191) patients were considered for closed pleural biopsy with Abrams pleural biopsy needle. The main outcome measure was diagnostic yield in the form of confirming diagnosis. Out of the 191 patients with exudative lymphocytic pleural effusion, 123 (64.40%) were diagnosed on the first pleural biopsy. Among the remaining 68 patients, 22 patients had repeat pleural biopsy with a diagnostic yield of 59.9%. The overall pleural biopsy could establish the diagnosis in 136 (71.20%) patients with pleural effusion. The most common diagnosis on pleural biopsy was malignancy followed by tuberculosis. Closed pleural biopsy provides diagnostic yield nearly comparative to thoracoscopy in properly selected patients of pleural effusions. In view of good yield, low cost, easy availability, and very low complication rate, it should be used routinely in all cases of undiagnosed exudative lymphocytic pleural effusion. There was no comparison with a similar group undergoing thoracoscopic pleural biopsy.

  7. Pure neuritic leprosy: Resolving diagnostic issues in acid fast bacilli (AFB)-negative nerve biopsies: A single centre experience from South India

    PubMed Central

    Hui, Monalisa; Uppin, Megha S.; Challa, Sundaram; Meena, A. K.; Kaul, Subhash

    2015-01-01

    Background and Purpose: Demonstration of lepra bacilli is essential for definite or unequivocal diagnosis of pure neuritic leprosy (PNL) on nerve biopsy. However, nerves always do not show bacilli owing to the changes of previous therapy or due to low bacillary load in tuberculoid forms. In absence of granuloma or lepra bacilli, other morphologic changes in endoneurium and perineurium can be of help in making a probable diagnosis of PNL and treating the patient with multidrug therapy. Materials and Methods: Forty-six biopsies of PNL were retrospectively reviewed and histologic findings were compared with 25 biopsies of non leprosy neuropathies (NLN) including vasculitic neuropathy and chronic inflammatory demyelinating polyneuropathy (CIDP). The distribution of endoneurial infiltrate and fibrosis, perineurial thickening, and myelin abnormalities were compared between PNL and NLN biopsies and analyzed by Chi-square test. Results: Out of 46 PNL casses, 24 (52.17 %) biopsies were negative for acid fast bacilli (AFB). In these cases, the features which favor a diagnosis of AFB-negative PNL were endoneurial infiltrate (51.1%), endoneurial fibrosis (54.2%), perineurial thickening (70.8%), and reduced number of myelinated nerve fibers (75%). Interpretation and Conclusion: Nerve biopsy is an efficient tool to diagnose PNL and differentiate it from other causes of NLN. In absence of AFB, the diagnosis of PNL is challenging. In this article, we have satisfactorily evaluated the various hisopthological features and found that endoneurial inflammation, dense fibrosis, and reduction in the number of myelinated nerve fibers are strong supportive indicators of PNL regardless of AFB positivity. PMID:26425006

  8. Use or Reduction of Propagation and Noise Effects in Distributed Military Systems: Electromagnetic Wave Propagation Panel Symposium Held in Rethymno, Crete, Greece on 15-18 October 1990 (Utilisation ou Reduction des Effets de la Propagation et du Bruit dans les Systemes Militaires Distribues)

    DTIC Science & Technology

    1991-06-01

    resolution are essential. The resulting frequency Paul A K., Anharmonic Frequency Analysis, pattern would be nonuniform and would change Mati. Comp...veloppement laire donnte par Ia relation empiri- de la trainte ainsi que Ie mouvemnent des par que 1231 ticules neutres dans Ia haute atmosph~re. log D...1515, 1973b. Bahar, E., Depolarization in nonuniform multi- layered structures--Full wave solutions, J. Math. Phys,, 15(2), 202-208, 1974, Ba , and M

  9. Effets perturbateurs endocriniens des pesticides organochlores.

    PubMed

    Charlier, C; Plomteux, G

    2002-01-01

    Xenoestrogens such organochlorine pesticides are known to induce changes in reproductive development, function or behaviour in wildlife. Because these compounds are able to modify the estrogens metabolism, or to compete with estradiol for binding to the estrogen receptor, it may be possible that these products affect the risk of developing impaired fertility, precocious puberty or some kinds of cancer in man. Le plus ancien récit de lutte contre la pollution remonte à une légende indienne racontant que la divinité Sing-bonga était incommodée par les émanations des fours dans lesquels les Asuras fondaient leurs métaux (1). Evidemment depuis, la problématique n-a cessé de s-accroître et la contamination de la Terre par de nombreux polluants est devenue aujourd-hui un problème majeur de notre Société. La protection de notre environnement est une question capitale qui doit être respectée malgré la pression économique actuelle et qui ne cessera de croître au cours des prochaines années même si l-identification objective et indiscutable de ce qui est essentiel - donc devant être prioritairement garanti sur la planète - est difficile à cerner (2). « Un oiseau en mauvais état ne pond pas de bons oeufs » disait un proverbe grec. Mais ce n-est qu-à partir de la seconde moitié du XXème siècle que les toxicologues ont commencé à identifier les effets qu-avaient entraînés à l-échelle mondiale les pollutions émises aux XIXème siècle sur la faune sauvage et sur le cheptel (3). L-histoire contemporaine des pesticides industriels commence vers 1874 (synthèse des organochlorés) et se poursuit tout au long de ces 2 siècles en passant par la synthèse des organophosphorés (1950), des carbamates (1970) et des pyréthroïdes (1975) (4). Le dichlorodiphényltrichloroéthane (DDT) a été synthétisé pour la première fois par un étudiant en cours de préparation de sa thèse de doctorat : Othmer Zeidler. La production, reprise par les

  10. Single use versus reuse of endoscopy biopsy forceps: A survey of patient preference.

    PubMed

    Davavala, Sandeep; Abraham, Philip; Desai, Devendra; Joshi, Anand; Gupta, Tarun; Samant, Hrishikesh

    2016-01-01

    Although there are no confirmatory data on this, we suspect that most endoscopy centres in India reuse single-use ('disposable') endoscopic biopsy forceps due to the cost of these forceps and the perceived low risk of infection transmission on reuse. Low-cost single-use biopsy forceps are now available in India, bringing into question the justification for such a practice. We aimed to determine the type of forceps (single-use or reused) patients would prefer during endoscopy for themselves, whether this is dependent on cost, and what cost would be acceptable to them. Among patients (conveniently selected from indoor or outdoor) reporting for endoscopy at the division of gastroenterology at a private tertiary-level hospital, we distributed an information sheet about the survey 30-45 minutes before the procedure. After they completed reading the sheet, an endoscopy nurse and/or doctor explained the study. The patient then completed a questionnaire of multiple choices with tick boxes. Of 151 patients approached, 4 declined to participate. Of 147 patients surveyed (age range 16-83 years; 82 men), 127 (86.4%) preferred single-use forceps, 16 (10.9%) preferred reused forceps, and 4 (2.7%) could not decide and left the decision to the physician. When informed that single-use forceps may be available for about ₹1000 (approximately US$ 15), 131 patients (89.1%) preferred these forceps, 11 (7.4%) preferred reused forceps, and 5 (3.4%) could not decide. Forty-four patients (33.1%) stated that an acceptable cost for a forceps for them would be ₹500 (approximately US$ 8), for 65 patients (48.9%) patients it was ₹1000, and for 24 (18.1%) it was ₹1500. About 90% of patients in this survey preferred single-use forceps; a cost of ₹1000 for single-use forceps was acceptable to over two-thirds of them.

  11. Effective osimertinib treatment in a patient with discordant T790 M mutation detection between liquid biopsy and tissue biopsy.

    PubMed

    Mambetsariev, Isa; Vora, Lalit; Yu, Kim Wai; Salgia, Ravi

    2018-03-21

    We report the successful treatment of the patient with osimertinib 80 mg/day following disease progression and a discordance in the detection of a mechanism of resistance epithelial growth factor receptor (EGFR) T790 M between liquid biopsy and tissue biopsy methods. A 57-year-old Hispanic male patient initially diagnosed with an EGFR 19 deletion positive lung adenocarcinoma and clinically responded to initial erlotinib treatment. The patient subsequently progressed on erlotinib 150 mg/day and repeat biopsies both tissue and liquid were sent for next-generation sequencing (NGS). A T790 M EGFR mutation was detected in the blood sample using a liquid biopsy technique, but the tissue biopsy failed to show a T790 M mutation in a newly biopsied tissue sample. He was then successfully treated with osimertinib 80 mg/day, has clinically and radiologically responded, and remains on osimertinib treatment after 10 months. Second-line osimertinib treatment, when administered at 80 mg/day, is both well tolerated and efficacious in a patient with previously erlotinib treated lung adenocarcinoma and a T790 M mutation detected by liquid biopsy.

  12. Novel biopsy forceps for diagnosis of biliary tract diseases during endoscopic retrograde cholangiopancreatography: a prospective comparative study with 90° adjustable and conventional biopsy forceps.

    PubMed

    Ishii, Kentaro; Itoi, Takao; Sofuni, Atsushi; Itokawa, Fumihide; Tsuchiya, Takayoshi; Kurihara, Toshio; Tsuji, Shujiro; Ikeuchi, Nobuhito; Umeda, Junko; Moriyasu, Fuminori

    2012-01-01

    Recently, controllable biopsy forceps (MTW, D°sseldorf, Germany) have been developed. This biopsy forceps were 90° adjustable. In the present study, the feasibility and efficacy of the controllable biopsy forceps were compared with those of conventional biopsy forceps in patients with biliary tract disease. A total of 27 patients with biliary tract lesions were enrolled. We evaluated the procedure time, the sample tissue size and the diagnostic accuracy. In addition, the physicians performing the procedure rated their impressions about operability into 3 classes: excellent, fair and poor. The sensitivity in distinguishing benign from malignant lesions was 71.4% (15/21) for the 90° adjustable type and 66.7% (14/21) for the conventional type. The accuracy rate was 77.8% (21/27) for the 90° adjustable type and 74.0% (20/27) for the conventional type. In terms of operability as rated by each physician, the 'excellent' rate was given more frequently to the 90° adjustable type 25.9% than for the conventional type 11.1% (p=0.047). This preliminary study showed that controllable biopsy forceps compared to conventional type biopsy forceps, despite a larger diameter, enables biopsy in a similar procedure time and its ease of use was rated better.

  13. A study to evaluate the efficacy of image-guided core biopsy in the diagnosis and management of lymphoma--results in 103 biopsies.

    PubMed

    Vandervelde, C; Kamani, T; Varghese, A; Ramesar, K; Grace, R; Howlett, D C

    2008-04-01

    The reason for this study was to evaluate the ability of image-guided core biopsy to replace surgical excision by providing sufficient diagnostic and treatment information. All consecutive image-guided core biopsies in patients with a final diagnosis of lymphoma over a 6-year period at our institution were collected retrospectively. Case notes and pathology reports were reviewed and the diagnostic techniques used were recorded. Pathology reports were graded according to their diagnostic completeness and their ability to provide treatment information. Out of a total of 328 instances of lymphoma, 103 image-guided core biopsies were performed in 96 patients. In 78% of these, the diagnostic information obtained from the biopsy provided a fully graded and subtyped diagnosis of lymphoma with sufficient information to initiate therapy. In the head and neck 67% of core biopsies were fully diagnostic for treatment purposes compared to 91% in the thorax, abdomen and pelvis. Image-guided core biopsy has a number of cost and safety advantages over surgical excision biopsy and in suitable cases it can obviate the need for surgery in cases of suspected lymphoma. This is especially relevant for elderly patients and those with poor performance status.

  14. CARCINOMA IN SITU OF THE UTERINE CERVIX—DIAGNOSIS BY BIOPSY

    PubMed Central

    Fluhmann, C. Frederic; Lyons, Harold M.

    1960-01-01

    In 50 cases of carcinoma in situ of the cervix uteri, the lesion was present in the cervical canal in 36 instances, but the squamous epithelium of the portio was involved in only 14 cases. Since single biopsy from the portio or external os may show no malignant change even in cases in which vaginal smears are positive for cancer, single biopsy is indicated only in the presence of gross suspicious lesions. When positive smears have been obtained, cold-knife cone biopsy is indicated (a) whenever gross lesions are not visible on the ectocervix, (b) if carcinoma in situ is found in a biopsy of the external os, in order to determine the presence or absence of invasion, and (c) when there are repeated positive smears and biopsy of the portio has not shown the presence of malignancy. The technique of cone biopsy is given in detail. PMID:13823610

  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